Term
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Definition
An enzyme that hydrolyzes and breaks proteins
(for example, an enzyme that breaks thyroglobin protein into Tyrosine, T2, T3, and T4 fragments) |
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Term
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Definition
An enzyme that reduces and oxidizes electron acceptors
(for example, reactions from NADH to NAD+ (and back to NADH), such as LD converting pyruvate and NADH to NAD+ and lactate--(causing acidosis of intense exercise) |
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Term
|
Definition
An enzyme that converts between amino-acids and keto-acids
For example, AST catalyzes [Asp and alpha-ketoglutarate] to and from [Glu and oxaloacetate] |
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Term
|
Definition
An enzyme that hydrolyzes a phosphate ion off of a compound (i.e. it dephosphorylates them) |
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Term
|
Definition
an enzyme that breaks chemical bonds using a water molecule
for example, lipases and phosphatases |
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Term
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Definition
An enzyme that takes phosophate from ATP, and gives it to (or 'phosphorylates') a substrate
For example, give the phosphate to Glucose --> it becomes Glucose-6-P |
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Term
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Definition
an enzyme that reduces oxygen
for example O2 --> H202 |
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Term
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Definition
emits frequencies above 725 nm, in other words "low-energy emissions" |
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Term
|
Definition
emits frequencies 600-725 nm
(note: often a red-appearing substance is that which absorbs frequencies around ~400-500) |
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Term
|
Definition
emission frequencies around 580-600 nm
yellow-appearing substance often absorbs around ~410
for example, yellow bilirubin absorbance is measured at 450
And, a very light yellow vanillin substance (which is a product of VMA, which is a product of epinephrine and norepinephrine) absorbance is measured at 360 |
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Term
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Definition
Emission frequencies around 500-580 nm
note: green solutions are absorbing around 400 and also 800 |
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Term
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Definition
Emits 440-500 nm
absorbance ~600(commonly)
for example, Methylene blue = has maximal absorbance at 668 and 609 |
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Term
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Definition
emits 380-440 nm
(absorbance commonly measured around 500-525) |
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Term
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Definition
emission frequencies below 380 nm; in other words, 'high energy emissions' |
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Term
useful substance absorbance wavelengths |
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Definition
Red quinoneimine dye: 500
Bilirubin's natural yellow color absorption: 450
commonly used NADH absorption wavelength: 340
colorless NAD+ absorption: 280
hemoglobin Hb interference absorbance: <600
bilirubin interference and absorbance: <530
approximate turbidity light-scattering reading of CSF and urine protein: 415 |
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Term
useful instrument wavelengths |
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Definition
wavelength range for hydrogen UV lamp: below 300 w/ known characteristic sharp emission line at 656
wavelength range for quartz-halogen (aka halogen, aka tungsten halide) lamp: 300 to infrared
wavelength range for xenon lamp's continuous emissions: 300-2000
stray light common cut-off filters wavelengths: approx. <380 and >680 |
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Term
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Definition
ruthenium-label oxidation emission in chemiluminescence: 620
Didymum glass maximal absorbance sharp peak: 585
mercury lamp's high output line useful for fluorescence: 365
holmium oxide glass maximal absorbance, sharp peak: 361 |
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Term
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Definition
cancer drug with many different protocols
temperature and light sensitive
sometimes very large dilutions are needed when on aggressive therapy |
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Term
Cyclosporin and Tacrolimus methods |
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Definition
50% of drug is bound to RBC's--therefore use EDTA-whole blood collection |
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Term
commonly used drug-level methods |
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Definition
EMIT (uses enzyme-labelled drug, antibodies, and substrates like glucose-6-P and NADPH)
can use ELISA (drug, sandwiched between IgG's, enzyme on one side, wash, and substrates such as nitroblue-T to measure ALP activity)
reaction rate is proportional to drug-level |
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Term
|
Definition
common to use chromatography methods
for urine samples, add organic alkali reagent to extract metabolites |
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Term
Ultrapure aromatic molecules methods |
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Definition
common to use liquid scintillation--a flash of light that occurs when compound is hit by beta particle (e-) emission (e.g. emission from a Tritrium probe) |
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Term
Unsaturated cyclic molecules methods |
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Definition
often detected using fluorometry--wherein a wavelength of excitation (higher energy wavelength that excites compound) and a wavelength of emission (lower energy emission from the previously-excited compound) are characteristic of the compound |
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Term
Phenilic groups (such as catecholamines--epinephrine and norepinephrine) methods |
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Definition
common to use HPLC-ECD--wherein HPLC separation is done first; and, then electrode is oxidized or reduced with a current proportional to concentration |
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Term
|
Definition
common to use immunoassay as screens; but, then confirm by using GC-MS-- first, GC uses a mobile phase in the form of gas and separates compounds, and then MS to separate characteristic mass-charge fragments of compound |
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Term
|
Definition
common to use MS (mass spec), and using inductively charged plasma ionization to form the cations |
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Term
Amino and organic acids methods |
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Definition
Tandem mass spec using electrospray ionization for introduction and Argon-bombardment in the second chamber to form characteristic daughter ions |
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Term
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Definition
Atomic absorption using graphite furnace for more sensitivity and Triton X-100 reagent to modify the matrix
Anode-stripping voltometry has been used--wherein you plate the cathode using electrons and then oxidize it to produce a current proportional to concentration |
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Term
I-A elements (Na, K, Li, Rb, Cs, Fr) methods |
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Definition
Flame photometry--as elements return to ground-state, they release characteristic photons proportional to concentration --sources of error include high temps and flow rates--so, use a dilution reagent internal standard, such as lithium sulfate or cesium nitrate |
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Term
Metals (not including I-A) methods |
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Definition
Atomic absorption photometry --elements in ground-state absorb their corresponding photons (such as Ca absorbing Ca+-to-Ca emissions from a diluted, cooled, modulated cathode ray tube) proportional to concentration |
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Term
|
Definition
ion-selective electrodes (ISE)--where an ionic potential is generated across a membrane that is proportional to concentration, as compared to a reference electrode with a fixed potential and a salt bridge for electron flow such as Calomel (Hg/HgCl2 paste) |
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Term
|
Definition
a solid-state ISE with AgCl crystals in the membrane
Butcher-Cotlove coulometric titration--wherein a constant current is applied until complete oxidation--sources of error include other halogen radicals and premature termination of current due to dirty electrode
a colorimetric detection of iron thianocyanate red
schales and schales titration with a diphenylcarbozone indicator |
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Term
|
Definition
severinghaus electrode where carbonic acid is formed and pH change is proportional to concentration
Malic dehydrogenase method that starts with bicarb and ends with NAD product |
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Term
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Definition
ISE with salicate glass membrane and HCl buffer |
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Term
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Definition
ISE with glass membrane and NaCl buffer--one source of error is high-lipid samples that displace the ions and lower the values, especially with higher dilutions |
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Term
|
Definition
ISE with valinomycin-coated membrane and KCl buffer--note: this ion is 0.1 higher in serum than plasma
***note: during acidosis, H+ is high, pushed into cells, in exchange for K+--overall result of acidosis on K+ levels ==== increased K+ readings in plasma |
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Term
|
Definition
ISE with monactin and nonactin coated membrane and NH4Cl buffer |
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Term
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Definition
ISE with proprietary ionophore and LiCl buffer |
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Term
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Definition
Atomic absorption is the reference method--just remember to use lantham-oxide to chelate and remove phosphate from interfering
dye-binding methods--just make sure to buffer at proteins' pI to release it from proteins
ISE method with polymer-membrane that allows exchange with a dioctylphenyl cation
note: EDTA and K-oxalate/Na-fluoride tubes bind and chelate this ion---falsely lowering the result |
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Term
|
Definition
Fiske-subbarow method that makes NH4-molybdophosphate blue |
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Term
|
Definition
clark electrode--using Ag/AgCl anode and a current for reduction; minimum decomposition potential depends on concentration |
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Term
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Definition
saturate aliquot w/ excess iron, wash w/ magnesium carbonate, and run serum iron assay |
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Term
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Definition
atomic absorption is reference method
dye-binding methods use HCl to remove it from transferrin, reactions with "-anthroline" ligands, ascorbic acid, and sodium metabisulfite
anode-stripping voltometry has been used
ranges are low (ug/dL range), so methods are subject to contamination |
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Term
|
Definition
freezing-point methods hyperfreeze sample, wait for temperature to plataeu and no current to flow (through wheatstone bridge); resistance being proportional to concentration
dew-point methods preferable for volatile compounds; high concentration causes less moisture in chamber and less VP depression |
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Term
|
Definition
bromcresol green dye is most common reagent (purple at pH 5.2)
commassie blue starts as red concentrate and turns blue when bound to proteins; it is used for microalbuminuria because it is sensitive at low levels (3mg/dL) |
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Term
Serum total protein methods |
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Definition
biuret reagent, including copper sulfate, K-tartrate; interacts with tripeptides and larger (levels above 1 g/dL) |
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Term
Protein separation methods |
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Definition
Electrophoresis after centrifugation and concentration
permeated gel chromotrography separates proteins from other small particles that get stuck in the small pores |
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Term
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Definition
on agarose gel electrophoresis, it has it's own distinct band |
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Term
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Definition
on polycacrylamide gel electrophoresis, shows high resolution |
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Term
Urine and CSF protein methods |
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Definition
turbidimetric light-scattering absorbance-like methods use very caustic trichloroacetic acid 13.5% or SSA 10% for precipitation; detect levels around 10-150 mg/dL |
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Term
|
Definition
in HPLC w/ ion exchange, it has a weak charge (less attracted to negative stationary phase), so it elutes faster than S, D, E, C, but not quite as fast as F; S interferes and causes false increase |
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Term
|
Definition
blood cells in specimen can lower glucose and increase lactic acid--whole blood is 10% lower glucose; high hematocrit associated with lower glucose values
copper reduction in stool indicates many reducing substances and intolerance during digestion |
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Term
|
Definition
Glucose oxidase methods -inhibited by ascorbic acid -first step is specific to glucose -glucose oxidase makes H202 -trinder reaction uses H202 and makes red quinoneimine dye -or, there is a glucose oxidase polarographic O2 electrode that can measure consumption of O2 as glucose is oxidized
hexokinase method -most specific, even in first step -reference method -requires Mg2+ (make sure there is enough Mg2+ and no anticoagulant-chelation of Mg2+) -after kinase reaction, it uses glucose-6-phosphate dehydrogenase to produce NADH -hemolyzed specimen can effect biochemical pathways and final NADH production and levels
point-of-care whole blood monitors use amperiometric methods that utilize glucose oxidase or glucose dehydrogenase |
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Term
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Definition
O-Toluidine method -old caustic method that requires heat; uses sugar to make schiff base; method still around because it can utilize these random sugars |
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Term
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Definition
-centrifuged and refrigerated serum can give initial observations -alcoholism, smoking, progesterone, and patient that did not fast for 12 hours, can cause high TG values -heparin can activate lipoprotein lipase in specimens and cause low TG values |
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Term
|
Definition
Abell-Kendall is a reference method; uses saponification and oxidation to produce a color product
Liebermann-Buchard is a reference method that uses high heat and strong sulfuric acid to produce green product
Cholesterol-oxidase Trinder reaction is not reference due to enzymatic variability --it requires Cholesterol-Ester-Hydrolase to remove ester from cholesterol --then, use cholesterol oxidase to make H202 and a reduction reaction to produce red product |
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Term
|
Definition
reference method uses KBr and ultra-centrifugation for separation before applying Abell-Kendall reference method--i.e. saponification and oxidation to form color product
a cholesterol-oxidase method adds specific IgG antibodies (with cyclodextrin) to block LDL, VLDL, and chylomicron activity and separate HDL, as well as a hydrolase step to remove ester groups
common to use a precipitation step with heparin, chlorides, and/or salts, along with centrifugation step
one source of error is ApoB(LDL) not being removed--use dextran sulfate to remove ApoB protein
collection can be non-fasting (unlike TG or LDL) |
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Term
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Definition
Freidewald formula -total and HDL are done in the same procedure must be done in same procedure Total = HDL+LDL+TG/5 (or TG/2 if using mmol/L)
one method of separation uses antibodies for VLDL, HDL, and chylomicrons and centrifugation with a mesh to block out antibody-bound particles
detergent-based methods can work as long as TG is lower than 700 --react HDL, VLDL, and chylomicrons in a non-color producing oxidase step; remove LDL cholesterol and react in a color-producing step |
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Term
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Definition
Fluorescence polarization (FPOL)
TLC L/S ratio (Sphengomyelin, S, is internal standard; ratio increases as fetal lung matures) |
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Term
Lp(a) (ApoB100 and protein(a)) methods |
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Definition
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Term
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Definition
bilirubinometers -bilirubin itself is a yellow compound
transcutaneous methods -use multi-wavelength reflectance photometry to correct for skin pigments
pH sensitive--use different pH for total vs. direct (pH 4)
specimens are light-sensitive--e.g. photo-oxidation can cause falsely low values
neonatal samples can get up to 12-30 mg/dL, and need a dilution to bring into linear range
hemolysis affects the total more than direct result
Hb interferes with product absorbance readings (below 600 nm), after the reaction, and causes false elevations; (but it can also inhibit the diazo reaction, during the method, and cause falsely low values)
bilirubin oxidase methods -convert bilirubin back into biliverdin in decreasing absorbance reaction
diazo reactions with bilirubin produce a diazo-pigment-isomer
Evelyn-Malloy method -based on solubility -direct is soluble in water -total soluble in ethanol -use diazo reagent to produce purplish-red azobilirubin -Hb can interfere with readings (<600 nm)
Jendrassic-grof method -most common, based on pH -direct, use HCl -total, use caffiene to prepare -use diazo reagent -use Fehling's reagent to minimize Hb effects--shift from purplish-red to blue azobilirubin
Use bichromatic methods of detection to minimize Hb affects |
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Term
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Definition
Glutamic dehydrogenase reaction -produce glutamate and NAD(P)+
Nessler reaction -produce NH4-dimercuric iodate--orange
Berthelot reaction -produce indophenol
Keep on ice, prevent hemolysis (since RBCs contain deaminase enzymes that form ammonia), and don't use NH4-heparin tubes |
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Term
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Definition
Diacteyl method -produce diazine
Urease enzyme methods -produce NH4+
Nessler method -produce NH4-dimercuric iodate--orange
Glutamic dehydrogenase method -produce glutamate and NAD(P)+ |
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Term
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Definition
urine--measured for every quantitative urine sample
blood--separate from cells and freeze, avoid pH extremes
Jaffe method -old classic method -rapidly produce red color -not entirely, but 98% specific -uses the explosive molecule ''trinitrophenol'' (aka TNP, aka Picric acid) and an alkaline solution (such as NaOH)
Creatinine hydrolase methods -more expensive, less explosive -produces lactic acid
creatinase methods -produce NH4+ and measure w/ ISE |
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Term
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Definition
Henry-Caraway method -use phosphotungstate reduction to produce tungsten blue
Uricase, aka urate oxidase, method -most common -produce H2O2 and then quinoneimine dye
urine specimen must be above pH 8; otherwise, will form microcrystals |
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Term
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Definition
produce glutamyl-glycyl-glycine and p-nitroalanine--yellow |
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Term
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Definition
-converts between pyruvate/NADH and lactate/NAD-- detection can be done by decreasing absorbance methods -this enzyme is part of glycolysis (EM) pathway, so serum is specimen of choice, but don't freeze |
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Term
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Definition
has sulfhydryl groups at active site that can be oxidized; or, can be inhibited by anticoagulants-hemolysis; therefore, serum is specimen of choice, frozen and protected from light |
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Term
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Definition
malate dehydrogenase method converts oxaloacetate to acetate and NAD in a decreasing absorbance reaction |
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Term
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Definition
LDH method converts pyruvate to lactate and NAD in a decreasing absorbance reaction |
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Term
ALP (alkaline phosphatase) methods |
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Definition
Bessie-lowry-brock method converts p-npp to 4-npp--yellow
hemolysis and age of sample can cause false elevations (RBCs have some ALP) |
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Term
ACP (acid phosphatase) methods |
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Definition
Bessie-lowry-brock method buffered at pH 5
very heat-sensitive, pH-sensitive, and completely inhibition by tartrate salts |
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Term
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Definition
convert starch (dye-labelled) to blue dye-labelled glucose products |
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Term
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Definition
best methods are similar to trinder method (uses H202 to produce quinoneimine dye)
inhibted by anticoagulants and products of hemolysis |
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Term
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Definition
separated by isoelectric electrophoresis |
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Term
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Definition
related to hemoglobin, found in muscle cells
methods are being replaced by troponin-I assays |
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Term
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Definition
TN-I and TN-T are unique to cardiac muscle
more sensitive assays allow for earlier MI detection |
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Term
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Definition
a molecule released by ventricles to lower blood pressure--may be elevated in CHF or renal failure--Biosite diagnostic test uses a fluroescent tag to measure this molecule and rule out CHF |
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Term
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Definition
recommended screening test, especially hyper-thyroid screening |
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Term
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Definition
more sensitive than FT4; can be used as a follow-up test if FT4 is normal
T3 uptake test indicates current relationship between T and TBG -measures radioactivity, proportional to saturation %; normal saturation is 25-37% -not entirely reliable test to determine T levels, since TBG level is not always consistent--i.e. drugs that bind TBG--can cause false high saturation; pregnancy hormones that increase TBG synthesis--can cause falsely low saturation |
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Term
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Definition
recommended for screening thyroid conditions
3rd generation method is a highly sensitive chemoluminescence assay, MEIA |
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Term
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Definition
leaks into blood from thryoid in different conditions, such as Grave's, Hashimotos, etc...
very useful disease marker, after diagnosis has been made |
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Term
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Definition
c-terminal and mid-molecule fragments have longer half-life (2-4 hours), which makes them more sensitive indicators |
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Term
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Definition
colorimetric methods -5 HIAA (urinary excretory form) react with nitrosonapthol--purple
HPLC
before testing, avoid foods like bananas, avacados, and cheese which can give false elevations |
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Term
catecholamines (epi- and norepinephrine) methods |
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Definition
useful during pheochromocytoma (adrenal medulla tumor)
colorimetric methods -use sodium metabisulfite to break everything down to VMA -VMA (urine excretory form) react with NaIO4--vanillin product
HPLC -advantage: don't have to worry about food-products causing false elevations |
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Term
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Definition
urine excretory product of dopamine (e.g. nerve tumors)
HPLC--best method |
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Term
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Definition
glucoronic acid conjugates of this molecule are found in urine (such as 17-hydroxy and 17-keto forms)
porter-silber colorimetric methods -react 17-OH form with phenylhydrazine--yellow
Zimmerman colorimetric methods -react 17-keto form with m-dinitrobenzene--purple
HPLC
NOTE--durinal variations are significant--highest values seen in the morning |
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Term
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Definition
this molecule works to cause sodium-retention, increase blood volume
levels can depend significantly on posture--upright standing posture for 2 hours can increase results up to 3 times |
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Term
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Definition
it is made from pro-insulin; has a longer half-life (20 min); doesn't react with antibodies during immunoassays; it is not found in external injections--in other words, it is more sensitive detector than insulin for insulin tumors |
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Term
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Definition
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Term
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Definition
40-100 mg/dL (maternal-insulin is present in newborn) |
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Term
glucose--impaired fasting glucose |
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Definition
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Term
glucose--diabetes concern |
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Definition
Fasting glucose > 126 mg/dL |
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Term
glucose--hypoglycemia concern |
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Definition
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Term
glucose--impaired glucose tolerance |
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Definition
2-hour post glucose load 140-200 mg/dL |
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Term
glucose--diabetes confirmatory |
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Definition
fasting glucose >126 mg/dL (twice to confirm)
2-hour post glucose load >200 mg/dL
fasting-3-hour 100g test--2 values above >105,190,165,145
HbA1c >6.5% |
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Term
|
Definition
40-70 mg/dL and 2/3 of plasma level |
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Term
HbA1c(glycated Hb)--normal |
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Definition
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Term
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Definition
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|
Term
lactic acid--level that indicates only 1% trauma patient survival |
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Definition
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Term
xylose--intestinal malabsorption indicator |
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Definition
5 hour urine level compared to oral intake <25% |
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Term
total cholesterol--optimal level |
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Definition
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Term
LDL cholesterol--optimal level |
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Definition
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Term
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Definition
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|
Term
triglycerides--optimal level |
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Definition
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Term
L/S ratio--mature fetal lungs |
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Definition
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Term
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Definition
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Term
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Definition
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|
Term
total bilirubin--universal critical level |
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Definition
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|
Term
total bilirubin--normal newborn jaundice level between days 2 and 7 |
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Definition
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Term
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Definition
7-27 umol/L (notice: micromoles/liter) |
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Term
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Definition
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Term
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Definition
7-18 mg/dL
the nitrogen part of Urea; a bit less than half of urea by weight |
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Term
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Definition
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|
Term
creatinine--normal 24-hour urine |
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Definition
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|
Term
creatinine clearance--normal |
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Definition
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|
Term
BUN/creatinine ratio--pre-renal (lack of perfusion) azotemia |
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Definition
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|
Term
BUN/creatinine ratio--intrarenal (internal damage to nephrons) azotemia |
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Definition
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Term
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Definition
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Term
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Definition
6-8.2 g/dL (notice units: grams/deciliter) |
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Term
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Definition
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|
Term
Albumin,a1-globulin,a2-globulin,B-globulin,gamma-globulin--approximate fractions of total protein |
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Definition
57%,3.5%,11.5%,12.5%,15.5% |
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Term
albumin/globulin ratio--in common disease states |
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Definition
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Term
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Definition
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|
Term
protein in CSF--viral meningitis |
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Definition
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|
Term
protein in CSF--in bacterial meningitis |
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Definition
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|
Term
protein in urine--normal 24-hr urine level |
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Definition
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|
Term
albumin in urine--24 hour urine--in microalbuminuria |
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Definition
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Term
C-reactive protein (a highly sensitive beta globulin)--normal range |
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Definition
<0.5 mg/dL, however, if value is trending up--indicates disease state |
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Term
CK-MB/total CK ratio--in AMI |
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Definition
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|
Term
AST and ALT--specific indicator of liver disease (as opposed to vague indicator of other types of disease) |
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Definition
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|
Term
AST and ALT--hepatic 'necrosis' indicator (as opposed to just hepatic 'stress') |
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Definition
ALT>AST (ALT comes from mitochondria--more damage than just cytoplasmic leakage) |
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Term
PSA(prostate specific antigen)--normal |
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Definition
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Term
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Definition
|
|
Term
troponin TN-I--very specific diagnostic indicator of AMI |
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Definition
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|
Term
BNP--can't rule out CHF (congestive heart failure) level |
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Definition
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|
Term
T3--normal % free (--not bound to TBG, albumin, and pre-albumin) |
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Definition
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|
Term
T4--normal % free (--not bound to TBG, albumin, and pre-albumin) |
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Definition
0.04 (more abundant form) |
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Term
TBG saturation--somewhat indicative of normal thyroid function |
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Definition
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Term
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Definition
|
|
Term
ions higher serum than inside cells--approximated values |
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Definition
Na+ (142--10), Ca2+ (5--0), Cl- (103--2), and HCO3- (27--8) |
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Term
ions higher inside cells than serum--approximated values |
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Definition
K+ (4--160), Mg2+ (3--35), phosphate (2--140), and proteins (16--55) |
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Term
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Definition
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Term
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Definition
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Term
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Definition
about half of total, which is 8.4-10.2 mg/dL |
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Term
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Definition
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Term
|
Definition
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|
Term
Cl- in sweat--diagnostic of cystic fibrosis |
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Definition
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Term
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Definition
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Term
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Definition
|
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Term
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Definition
~5-30 umol/L or 25-55% saturation |
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Term
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Definition
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|
Term
pO2 arterial--normal range |
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Definition
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Term
|
Definition
22-29 mmol/L--mostly just reflect bicarb level |
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Term
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Definition
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|
Term
bicarb/carbonic acid ratio--normal |
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Definition
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|
Term
|
Definition
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|
Term
Lithium--therapeutic range just below dangerous toxicity |
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Definition
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Term
|
Definition
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Term
|
Definition
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|
Term
osmolality--urine/plasma ratio indicative of pyelonephritis |
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Definition
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|
Term
osmolality--urine/plasma ratio indicative of dehydration |
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Definition
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Term
|
Definition
7-16 mEq/L i.e. normal amount of anions, not named bicarb or chloride (value = sodium minus (bicarb + chloride)) |
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Term
|
Definition
0-20 mmol/L i.e. normal amount of contributors to concentration, not named Na, glucose, or BUN (value = measured osm value minus (2Na + Glucose/20 + BUN/3)) |
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Term
K+--grossly hemolyzed level |
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Definition
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Term
K+--contamination or wrong-tube level (K-3-EDTA or K-2-Oxalate tube) |
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Definition
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Term
K+--how much does it change during acidosis |
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Definition
.6 mmol/L increase for each .1 pH decrease |
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Term
Cl- --normal change per unit of bicarb change |
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Definition
1 to 1 ratio; if bicarb goes down, Cl- goes up (shifts out of cell) by same amount |
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Term
Anion gap--name 5 causes of insufficient Cl- shift (large gap) |
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Definition
Lactic Acid (Lactate) Diabetes (Ketonate) Methanol (Formate) Antifreeze (Oxalate) Aspirin overdose (salicylate) |
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Term
Hyperkalemia--general symptoms |
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Definition
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Term
hypokalemia--general symptoms |
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Definition
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Term
hyponatremia--general causes |
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Definition
edema, burns, adrenal insufficiency |
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Term
hypernatremia--general causes |
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Definition
sodium retention
Conn's disease, Cushing's syndrome, renal failure |
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Term
Nernst equation--how much does potential change if concentration is changed by a factor of 10 (for example, pH decreases by 1 unit)? |
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Definition
~60 mV for a one-electron reaction ~30 mV for a two-electron reaction |
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Term
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Definition
low pH caused by low bicarb (e.g. vomiting)
CO2 may be low--but this is only compensatory (pay attention to both pH and CO2--low pH indicates it is an acidosis--NOT a respiratory alkalosis due to low CO2) |
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Term
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Definition
high pH
root cause is high bicarb (e.g. overdose on tums) |
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Term
Ca2+ --symptoms of high calcium |
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Definition
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Term
Ca2+ -- symptoms of low calcium |
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Definition
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Term
muscle weakness--associated with which 3 ions |
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Definition
high K+, high Ca2+, high Mg2+ |
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Term
rickets--which ion is low? |
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Definition
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Term
hyperparathyroid--high PTH |
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Definition
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Term
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Definition
history of thyroidectomy
low Ca
high phosphates |
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Term
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Definition
can be caused by ACTH from pituitary tumor
high cortisol
Na+ retention |
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Term
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Definition
adrenal cortex fail
low cortisol
low aldosterone
(high ACTH may be compensatory)
Na+ excretion
K+ retention
abnormally low anion gap due to low Na+ |
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Term
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Definition
high aldosterone
high Na+
low K+
can be caused by high renin in fibromuscular hyperplasia |
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Term
high sodium levels--general effects |
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Definition
Hypertension
high osmolality of blood |
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Term
late renal failure--notable ion levels |
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Definition
low sodium, high K
however, there is a large anion gap caused by low Cl-, low bicarb |
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Term
anion gap--in ketoacidosis of diabetes type I |
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Definition
low Na, high K
however, very large anion gap is indicative of many ketones (anions) in blood --reflects on metabolic panel as low Cl- and low bicarb |
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Term
anion gap--in ketoacidosis of diabetes type II |
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Definition
similar pattern as type I, but not quite as pronounced |
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Term
CSF Cl- levels--trend in bacterial meningitis |
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Definition
Cl- levels decrease as lactate anions increase |
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Term
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Definition
thick mucous (pneumonia, bronchitis), malabsorption, sweat chloride 60-200 |
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Term
Iron--common causes of high levels |
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Definition
hemolytic anemia megaloblastic anemia (heme synthesis blockage) severe hepatitis iron intoxication (kids) |
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Term
Iron--common causes of low levels |
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Definition
chronic blood loss (most common) pregnancy malabsorption |
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Term
TIBC (transferrin)--common causes of high levels |
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Definition
pregnancy iron deficiency chronic bleeding |
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Term
TIBC (transferrin)--common causes of low levels |
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Definition
infections/inflammation (less production) renal conditions (loss) |
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Term
Iron vs. TIBC--in Iron Deficiency Anemia |
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Definition
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Term
Iron vs. TIBC--in (chronic) iron poisoning (hemochromatosis; chronic hemolysis, etc...) |
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Definition
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Term
Iron vs. TIBC--in acute hemolytic conditions (acute hemolysis) |
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Definition
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Term
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Definition
liver cannot make Ceruloplasmin
copper gets deposited in the tissues
Copper “halo” in Iris of eyes |
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Term
hyponatremia--general effects |
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Definition
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Term
osmolal gap--trend in ketoacidosis |
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Definition
gap increase
in other words, osm detection is much higher than the estimated osm calculation-- because the osm calculation only takes into account Na, Glucose, and BUN (2Na + G/20 + BUN/3) |
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Term
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Definition
-low pH (acidic) blood
-high CO2 levels (lack of ventilation; insufficient breathing) |
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Term
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Definition
pH is increased, caused by low CO2 levels (hyper-ventilation of CO2 out of the body) |
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Term
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Definition
adrenal medulla tumor
sporadically elevated catecholamines (epi, norepi)
detect VMA in urine |
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Term
neuro- or ganglioblastoma |
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Definition
nerve cell tumors high dopa, dopamine detect HVA in urine |
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Term
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Definition
high androgen levels in female male characteristics (infertility) caused by issue in adrenal cortex (hyperplasia) or gonads (polycystic ovaries) |
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Term
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Definition
bHCG peaks in first trimester
HPL elevates until delivery
Estriol elevates
progesterone elevates |
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Term
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Definition
Starts with high FSH, no FSH after it is over
low estradiol
no LH peak |
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Term
trophoblastic choriocarcinoma of the fetus |
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Definition
not common, but very serious high bHCG low HPL |
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Term
hyperthyroid--generalized symptoms |
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Definition
anxiety weight loss mild hyperglycemia |
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Term
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Definition
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Term
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Definition
high free T4 high TSH
additional testing, such as T3 suppression, need to distinguish it from tertiary |
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Term
hypothyroid--general symptoms |
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Definition
mild hypoglycemia feels cold sleepy fatigue |
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Term
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Definition
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Term
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Definition
low free T4 low TSH
additional testing needed, like TRH stimulation test, to distinguish it from tertiary |
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Term
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Definition
neonatal primary hypothyroid cat-like cry treated with T4 |
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Term
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Definition
common adult condition primary hypothyroid treated with T4 |
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Term
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Definition
auto-immune destruction of thyroid primary hypothyroid |
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Term
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Definition
iodine deficiency primary hypothyroid |
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Term
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Definition
auto-immune activation of TSH receptors primary hyperthyroid exopthalmus eyes |
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Term
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Definition
benign tumors nodular, un-symmetric growth primary hyperthyroid |
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Term
normal urine--most abundant protein |
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Definition
tamm-horsfall protein
(albumin not supposed to be in normal urine) |
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Term
high protein content in urine |
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Definition
hypertension--albumin acute glomerulonephritis--albumin, globulins, RBCs nephrotic syndrome--albumin, globulins, fat droplets multiple myeloma--bence-jones light-chain gamma globulin |
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Term
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Definition
buffer evaporates: reduced separation too much sample: tailing old stain: unsatisfactory staining bent applicator wires: bow-tie pattern over-application: globulin too high; (albumin low) dry, uneven blotting: distorted protein zones no power or wicks: no band movement wrong side of plate: no bands |
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Term
electrophoresis--multiple myeloma (early) |
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Definition
high beta low gamma (immunocompromised) |
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Term
electrophoresis--multiple myeloma (late) |
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Definition
large spike in gamma region--bence jones light chains |
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Term
electrophoresis--acute inflammation |
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Definition
high alpha-1 (a-1-antitrypsin) high alpha-2 (haptoglobin) |
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Term
electrophoresis--alpha-1-antitrypsin deficiency |
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Definition
low alpha-1
associated with high risk of lung and liver disease |
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Term
electrophoresis--hypogammaglobinemia |
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Definition
low gamma
associated with recurrent infections |
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Term
electrophoresis--nephrotic syndrome |
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Definition
low albumin low gamma high alpha-2 (macroglobulin) |
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Term
electrophoresis--chronic liver disease |
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Definition
high beta-gamma bridge (no drop-off between beta and gamma region) |
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Term
electrophoresis--multiple sclerosis |
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Definition
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Term
spina-bifida of fetus--protein biomarker |
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Definition
high AFP after 5 weeks
(it is normally present in first 5 weeks of pregnancy) |
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Term
C-reactive protein is in range, but trending up |
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Definition
indicates worsening conditions
normal range is below 5 mg/dL, but changes in level are a highly-sensitive indicator of disease trends |
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Term
protein that can sometimes be used as a general wellness, nutrition, or recovery from disease indicator |
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Definition
pre-albumin
transports thyroid hormone
low during malnutrition |
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Term
electrophoresis--high L1 and LD2 |
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Definition
associated with blood cells and heart conditions |
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Term
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Definition
LD1>LD2
LD1 elevation is more specific to heart disease |
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Term
electrophoresis--high LD 3 |
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Definition
lung disease (e.g. embolism or infarct) |
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Term
electrophoresis--high LD4 and LD5 |
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Definition
liver issues, and/or skeletal muscle issues |
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Term
ALP, besides placenta, can indicate what types of disease? |
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Definition
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Term
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Definition
marker for prostate gland cancer--as opposed to benign PSA elevations
also, useful in rape investigations |
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Term
insecticides common effect |
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Definition
can inhibit cholinesterase (SChE) enzyme that is needed to break down muscle relaxant succinyl choline |
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Term
early acute myocardial infarction |
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Definition
CK-MB is very sensitive (if not specific)
Troponin-I (TN-I) is very sensitive and specific |
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Term
AMI progression--5 types of enzyme elevations |
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Definition
TN-I elevation --rules it in
CK peak: Day 1 (starts at 2 hours, ends at 2 days)
AST peak: Day 2 (starts at 5 hours, ends at 5 days)
LD peak: Day 3 (starts at 12 hours, ends at 12 days)
a-HBD: same as LD pattern |
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Term
quick estimate of perfect renal function (100% clearance) |
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Definition
130 mL/min (130/1 = urine/plasma) |
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Term
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Definition
-causes a metabolic alkalosis -toxic to nerves -can occur in hepatic disease (since liver is only organ able to detoxify ammonia) |
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Term
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Definition
-Elevated blood levels of nitrogen waste products (BUN, Creatinine, Uric Acid) -low creatinine clearance = creatinine level rises in blood and lowers in urine |
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Term
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Definition
-kidneys not perfused with blood; may be caused by shock, trauma, or CHF -BUN rises faster than creatinine in the blood (BUN/Creatinine ratio > 24) |
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Term
Renal (intra-renal) Azotemia |
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Definition
-Intrinsic kidney damage, e.g. nephritis conditions -Creatinine rises in blood faster than does BUN (BUN/creatinine ratio <15) |
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Term
Post-Renal Azotemia--causes, results |
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Definition
-urethral obstructions; kidney stones -if not removed, may shutdown kidney (<12 creatinine clearance) |
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Term
Uric Acid—potential causes, results, and treatment |
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Definition
-can be caused by cell-proliferation conditions (product of purine (found in DNA) metabolism) -can cause gout, kidney stones (it isn’t very soluble) -can be treated with allopurinol (which inhibits xanthine oxidase’s breakdown of purines) |
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Term
Normal jaundice in newborns |
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Definition
-starts around day 2 or 3 (up to ~7 mg/dL) -peaks around day 5 (up to ~12 mg/dL) -goes away after about day 30 (when liver is mature)(up to ~1 mg/dL) |
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Term
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Definition
-a.k.a. Hemolytic Jaundice -high unconjugated (indirect) bilirubin -direct/total ratio is less than 0.2--- direct bilirubin isn't really affected that much -Urine Bilirubin = Negative -Urine Urobilinogen = Positive |
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Term
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Definition
-occurs after albumin gets saturated with insoluble bilirubin -free (insoluble, unconjugated, or indirect) bilirubin can cross the blood brain barrier and cause neurological problems |
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Term
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Definition
-e.g. hepatitis jaundice -indirect bilirubin (high) -direct bilirubin (high) -Urine Bilirubin = Positive |
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Term
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Definition
-i.e. obstructive or hepatobiliary jaundice -ratio of direct/indirect is greater than 1 to 1-- direct bilirubin is high -urine bilirubin = positive |
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Term
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Definition
-normal neonatal jaundice doesn’t go away -due to presence of a maternal UDP-gluc-transferase inhibitor in newborn |
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Term
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Definition
-decreased bilirubin uptake leading to decreased bilirubin diglucoronide (conjugated bilirubin) formation -a pre-hepatic jaundice |
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Term
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Definition
-UDP-glucuronyl transferase deficiency -a pre-hepatic jaundice |
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Term
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Definition
-bilirubin not secreted in bile ducts -a post-hepatic jaundice |
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Term
Atherosclerosis--potential cause, risk factors, and decreased risk factor |
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Definition
-Injury to Endothelial Cells (possibly caused by hypertension) leading to calcified plaques, leading to clots, thromboses, and infarcts (blockages of blood vessels) -Increased risk in males, diabetes, smokers, obesity, hypertension, and Lp(a) protein (a complex of apo-B100 (LDL) and protein (a)) -Decreased risk associated with apo A-1 proteins (HDL) |
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Term
Hyperlipoproteinemia--type I |
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Definition
-lipoprotein lipase deficiency -dietary TG high (dark chylomicron band; at top; furthest from albumin) -creamy layer at top of refrigerated serum |
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Term
Hyperlipoproteinemia--type IIa |
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Definition
-most common type -cholesterol (LDL; beta) increase -dark LDL (apoB100) band (usually the largest band anyway) -can be caused by apoB-100 receptor defect -“familial hypercholesterolemia” -refrigerated serum is clear |
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Term
Hyperlipoproteinemia--type IIb |
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Definition
-like type IIa but includes somewhat increased TG (VLDL; pre-beta band) -refrigerated serum is faintly turbid |
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Term
Hyperlipoproteinemia--type III |
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Definition
-everything increased -includes an IDL increase -- floating band between beta (LDL) and pre-beta (VLDL) -“familial beta dyslipoproteinemia” -refrigerated serum is faintly turbid and faint creamy layer at top |
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Term
Hyperlipoproteinemia--type IV |
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Definition
-significant triglyceride increase (VLDL) -very dark pre-beta band -refrigerated serum is turbid (VLDL, i.e. endogenous triglycerides) |
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Term
Hyperlipoproteinemia--type V |
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Definition
-combination of type I and type IV -chylomicron band and pre-beta band -refrigerated serum is both dark creamy layer at top (chylomicrons, i.e. dietary triglycerides) and turbid (VLDL, i.e. endogenous triglycerides) |
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Term
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Definition
-apo-B genetic defect -very low LDL levels -reduced risk of coronary artery disease; however, increased risk of CNS damage hemolytic anemia - “abetalipoprotenemia” |
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Term
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Definition
-a Apo A-I deficiency -mutation in ATP-binding cassette gene -characteristic low HDL levels |
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Term
defective lipid degradation ---name 4 lysosomal disorders |
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Definition
-niemman-pick disease (sphingomyelinase deficiency) -tay-sachs (N-acetyl-beta-hexosaminadase A deficiency in leukocytes---causes increased levels of GM2-ganglioside—leads to seizures, inability to sit up) -fabry (sex-linked) -gaucher disease (b-glucocerebrosidase A def) |
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Term
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Definition
-lactase deficiency (a.k.a beta-galactosidase def) in small intestine -lactose fermented by bacteria in colon |
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Term
lactate dehydrogenase deficiency |
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Definition
-a glycogen storage disease -can't recycle byproducts of carbohydrates -causes elevation in pyruvate,lactate -painful exercise symptoms |
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Term
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Definition
-G-6-P phosphate deficiency; G-6-P can't be removed from the liver -glycogenolysis is inhibited -causes hypoglycemia -increase in fats and lactic acidosis -epinephrine test is diagnostic--in normal patient, epinpehrine should stimulate glycogenolysis |
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Term
signs of bacterial meningitis (as opposed to viral) in CSF |
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Definition
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Term
indicator inversely related to trauma or burn patient survival |
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Definition
-lactate levels (a product of anaerobic glycolysis) -an example of a metabolic acidosis |
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Term
ketone body formation--in presence of glucose |
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Definition
-i.e. increased levels of things like acetoacetic acid and beta-OH-butyric acid -an example of metabolic acidosis |
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Term
ketone body formation--in starvation when glucose is absent |
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Definition
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Term
diabetes--two different physiological causes; same result |
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Definition
-mellitus --insulin pathway defect causes high glucose levels, which causes dehydration
-insipidus --ADH pathway defect causes lack of water retention by kidneys, which causes dehydration |
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Term
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Definition
-autoimmune destruction of insulin-producing beta cells -develops earlier in life, less common but more serious -very clear, not borderline, glucose results -symptoms range from no insulin (hyperglycemic ketoacidosis) to insulin shock (hypoglycemic coma) |
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Term
diabetes mellitus type II |
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Definition
-insulin process not working properly (e.g. stretched-receptor theory) -less serious, more common; starts later in life, after 40 usually, with more borderline glucose results; may need insulin therapy, but may be managed by diet and exercise |
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Term
hyperglycemia--name 5 associated conditions besides diabetes |
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Definition
-pregnancy -cushing's (elevated cortisol increases gluconeogensis) -grave's (TSH receptor activation; elevated T) -pheochromocytoma (epi- and norepi-nephrine sporadic elavations; adrenal medulla; increases glycogenolysis) -acromegaly (growth hormone; adult form of gigantism; flat bones enlarged; increased gluconeogensis) |
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Term
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Definition
-pancreatic tumor -intermittent hypoglycemia |
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