Chemistry Internship Study Questions Section 1

Fill in the chart, For “highest” levels, list the most common conditions:
A
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Protein
Fill in the chart, For “highest” levels, list the most common conditions:
B
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Muscle
Fill in the chart, For “highest” levels, list the most common conditions:
C
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Purine
Fill in the chart, For “highest” levels, list the most common conditions:
D
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Renal Disease, Heart Failure, Shock
Fill in the chart, For “highest” levels, list the most common conditions:
E
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Renal Disease, Muscle Disease
Fill in the chart, For “highest” levels, list the most common conditions:
F
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Gout, Leukemia, Chemotherapy
Fill in the chart, For “highest” levels, list the most common conditions:
G
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6-20 mg/dL
Fill in the chart, For “highest” levels, list the most common conditions:
H
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0.5-1.1 mg/dL
Fill in the chart, For “highest” levels, list the most common conditions:
I
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3.0-8.5 mg/dL
Is conjugated Bilirubin Direct or Indirect?
Direct
Is unconjugated Bilirubin Direct or Indirect?
Indirect
Is conjugated Bilirubin water soluble?
Yes
Is unconjugated Bilirubin water soluble?
No
Is conjugated Bilirubin Detectable in Urine?
Yes
Is unconjugated Bilirubin Detectable in Urine?
No
Is conjugated Bilirubin Albumin-Bound?
No
Is unconjugated Bilirubin Albumin-Bound?
Yes
Fill in the chart, indicate if levels will be typically normal, increased, or decreased:
A
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Hemolytic Disorders, Hemolytic Disease of the Newborn, Transfusion Reactions
Fill in the chart, indicate if levels will be typically normal, increased, or decreased:
B
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Increased
Fill in the chart, indicate if levels will be typically normal, increased, or decreased:
C
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Normal
Fill in the chart, indicate if levels will be typically normal, increased, or decreased:
D
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Negative
Fill in the chart, indicate if levels will be typically normal, increased, or decreased:
E
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Increased
Fill in the chart, indicate if levels will be typically normal, increased, or decreased:
F
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Liver Disease, Hepatitis, Cirrhosis
Fill in the chart, indicate if levels will be typically normal, increased, or decreased:
G
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Increased
Fill in the chart, indicate if levels will be typically normal, increased, or decreased:
H
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Increased
Fill in the chart, indicate if levels will be typically normal, increased, or decreased:
I
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Positive
Fill in the chart, indicate if levels will be typically normal, increased, or decreased:
J
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Increased OR Normal
Fill in the chart, indicate if levels will be typically normal, increased, or decreased:
K
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Bile duct obstruction from gall stones, Tumors
Fill in the chart, indicate if levels will be typically normal, increased, or decreased:
L
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Normal
Fill in the chart, indicate if levels will be typically normal, increased, or decreased:
M
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Increased
Fill in the chart, indicate if levels will be typically normal, increased, or decreased:
N
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Increased
Fill in the chart, indicate if levels will be typically normal, increased, or decreased:
O
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Decreased
List the reference ranges (including reporting units) for:
Total Cholesterol
<200 mg/dL
List the reference ranges (including reporting units) for:
Triglyceride
<150 mg/dL
List the reference ranges (including reporting units) for:
HDL
>60 mg/dL
List the reference ranges (including reporting units) for:
LDL
<110 mg/dL
Why would it be acceptable to run total cholesterol on a random sample versus a fasting sample?
Most cholesterol is produced by the liver.
Only 10-15% comes from dietary intake.
Describe the appearance of a serum sample collected after a meal and allowed to sit refrigerated overnight.
Clear with milky top layer
What lipoprotein is consistent with a serum sample that appears clear with a milky top later after a meal and has been allowed to sit refrigerated overnight?
Chylomicrons
Match the lipid with its carrier protein (lipoprotein):
VLDL
ENDOgenous Triglyceride
Match the lipid with its carrier protein (lipoprotein):
LDL
Transports Cholesterol TO Tissues
Match the lipid with its carrier protein (lipoprotein):
HDL
Transports Cholesterol AWAY FROM Tissues
Match the lipid with its carrier protein (lipoprotein):
Chylomicrons
EXOgenous Triglyceride
Match the lipid with its carrier protein (lipoprotein):
Endogenous Triglyceride
VLDL
Match the lipid with its carrier protein (lipoprotein):
Transports Cholesterol TO Tissues
LDL
Match the lipid with its carrier protein (lipoprotein):
Transports Cholesterol AWAY FROM Tissues
HDL
Match the lipid with its carrier protein (lipoprotein):
EXOgenous Triglyceride
Chylomicrons
What genetically controlled lipoprotein is responsible for coronary heard disease at an early age when detected in high amounts?
Lp (a)
Give the manual calculation for VLDL
Triglycerides / 5
Give the manual calculation for LDL
Total – HDL – (Triglycerides/5)
Under what situation are the VLDL & LDL calculations invalid?
When triglycerides are >400
The enzymatic method for triglyceride quantitation involves measuring liberated glycerol. What is the enzyme used in this method?
Lipase
List the reference range for total bilirubin in a normal adult
0.1-1.2 mg/dL
List the reference range for direct bilirubin in a normal adult
0-0.5 mg/dL
How is an indirect bilirubin calculated?
Total – Direct
Describe any specimen handling requirements for bilirubin if testing is delayed
Avoid light exposure (may cause false negative)
What is the name of the reagent used in the classic bilirubin reaction?
Diazo
How will hemolysis in the sample affect bilirubin results?
Decrease Value
How will lipemia in the sample affect bilirubin results?
Increase Value
What is the purpose of adding an accelerant to a bilirubin reaction?
Converts Indirect to Direct so that all bilirubin (total) is measured
What is the accelerant used in the Malloy-Evelyn method for total bilirubin?
Methanol
What is the accelerant used in the Jendrassik-Grof method for total bilirubin?
Caffeine-benzoate
When can determination of bilirubin by direct spectrophotometry be used?
Newborns only (x<1 month).
Read absorbance @ 450 nm
After birth, at what age will a newborn’s bilirubin level equal normal adult levels?
1 Month
What is the formula to find the corrected CrCl?
Observed Creatinine Clearance * (1.73 / Body Surface Area)
What is the formula to find the observed CrCl?
(Urine Creatinine *Urine volume) / (Serum Creatinine * Time (min))
Why must sodium fluoride tubes be avoided when measuring BUN & Creatinine?
Causes Falsely Decreased BUN
What body function is being assessed by the creatinine clearance?
Glomerular Filtration Rate
What is the normal average Creatinine Clearance for an adult?
120 mLs/min (on average)
Calculate the Observed CrCl results for the given set of data:
Urine Creatinine = 100 mg/dL
Serum Creatinine = 1.1 mg/dL
Collection Time = 12 hours
Urine Volume = 655 mLs
Body Surface Area = 2.34 m2
83 mLs/Minute
Calculate the Observed CrCl results for the given set of data:
Urine Creatinine = 56 mg/dL
Serum Creatinine = 1.2 mg/dL
Collection Time = 24 Hours
Urine Volume = 1 Liter
Body Surface Area = 1.6 m2
32 mLs/Minute
Calculate the Corrected CrCl results for the given set of data:
Urine Creatinine = 100 mg/dL
Serum Creatinine = 1.1 mg/dL
Collection Time = 12 hours
Urine Volume = 655 mLs
Body Surface Area = 2.34 m2
61 mLs/Minute
Calculate the Corrected CrCl results for the given set of data:
Urine Creatinine = 56 mg/dL
Serum Creatinine = 1.2 mg/dL
Collection Time = 24 Hours
Urine Volume = 1 Liter
Body Surface Area = 1.6 m2
35 mLs/Minute
What is the name of the classic reaction for creatinine?
Jaffe
What is the primary reagents used for the Jaffe method (classic reaction for creatinine)?
Alkaline Picrate
What is an eGFR?
Estimated Glomerular Filtration Rate
What is the benefit of performing an eGFR over a traditional CrCl?
No need for urine decreased levels associated with chronic kidney disease. Calculated from serum creatinine, body weight, height, sex, and race.
Why may the Cystatin C test be preferred over a creatinine clearance for assessment of renal function?
Formed at a constant rate.
No urine needed.
A decreased GFR will cause a Increase in the Serum.
What is a normal BUN:Cr ratio?
10:1 – 20:1
What is the purpose/use of calculating a BUN:Cr ratio?
May help differentiate pre-renal from renal causes of an Increased BUN
High ammonia levels are consistent with what organ failure?
Liver
What disease is associated with high ammonia and encephalopathy in children who have taken aspirin to treat flu symptoms?
Reye’s Syndrome
What type of tube and special handling is required when collecting samples for ammonia?
Lithium heparin tubes are preferred.
EDTA tubes are OKAY.
Place on Ice!
Separate ASAP & Freeze up to 24 Hours