Final Exam

Which two conditions can “physiologically” elevate serum alkaline phosphatase?
Growth, third trimester of pregnancy
In the liver, bilirubin is converted to
Bilirubin diglucuronide
Calculate the creatinine clearance
CrCl= [Ucrea]/[SerumCrea] x volume/ (hours x 60)

corrected for BSA: CrCl x 1.73/bsa =

AST and ALT are both elevated in which of the following disesae
viral hepatitis
Calcium concentration in the serum is regulated by
PTH
Blood PCO2 may be measured by
calculation of blood pH and total CO2 concentration
A stimulant that causes localized sweating for a sweat test is
pilocarpine nitrate
In the sweat test, the sweating stimulant is introduced to the skin by application of
an electric current
Most of the carbon dioxide present in the blood is in the form of
bicarbonate ion
The degree to which the kidney concentrated the glomerular filtrate can be determined by
urine to serum osmalality ratio
A physician suspects his patient has pancreatitis, which tests would be most indicative of this disease?
amylase
Lab results consistent with Respiratory acidosis
decreased pH, increased PCO2
Lab results consistent with Respiratory alkalosis
increased pH, increased pCO2
Lab results consistent with Metabolic acidosis
decreased pH, normal PCO2
Lab results consistent with Metabolic alkalosis
increased pH, normal PCO2
Assay of transketolase activity in blood is used to detect deficiency in
thiamine
The most sensitive enzymatic indicator for liver damage from ethanol intake is
gamma-glutamyl transferase
Slight increase in Alkaline phosphate and GGT, marked increase in aminotransferase and AST
acute hepatitis
Slight increase in Aminotransferase and AST, marked increase in GGT and ALP
obstructive jaundice
slight increase in ALK, aminotransferase, GGT, and ASP
chronic hepatitis
kernicterus is an abnormal accumulation of bilirubin in
brain tissue
serum anion gap is increased in patients with
lactic acidosis
The buffering capacity of blood is maintained by a reversible exchange process between bicarbonate and
chloride
Which of the following electrolytes is the cheif plasma cation whose main function is maintaining osmotic pressure
sodium
a reciprocal relationship exists between
calcium and phosphorus
at pH 7.40 what is the ratio between bicarbonate and carbonic acid
20:1

pKa = 6.1 (known)
pKa = pH – log (acid/base)
6.1 = 7.4 – log x
1.3 = log x
10^1.3 = 20/1 = 20:1

acidosis and alkalosis are best defined as fluctuations in blood pH and CO2 content due to
bicarbonate buffer
a common cause of respiratory alkalosis is
hyperventilation
Metabolic acidosis is described as an
decrease in CO2 and PCO2 and decrease in pH
respiratory acidosis is described as an
increase in CO2 and decrease in pH
unless blood gas measurement are made immediately after sampling, in vitro glycolysis of the blood causes
fall in pH and rise in PCO2
a hospitalized patient is experiencing increased tetany. which of the following tests should be ordered
calcium
in the jaffe reaction, creatinine reacts with
alkaline picrate solution to yeild an orange-red complex
bile acid concentrations are useful to assess
hepatobiliary disease
the greatest activities of serum AST and ALT are seen in
acute hepatitis
BeriBeri is associated with a deficiency in
thiamine
Night blindness is associated with deficiency of which of the following vitamins
A
Scurvy is associated with a deficiency in Vitamin
C
Pellagra is associated with a deficiency in vitamin
niacin
Rickets is associated with deficiency in
vitamin D
in which of the following disease states is conjugated bilirubin a major serum component
biliary obstruction
The creatinine clearance (mL/min) is equal to:
[urinary creatinine x volume]/ plasma creatinine
Henderson-Hasselbalch equation
pH = pKa + log (salt/acid)
a K level of 6.8 mEg/L, what is the first step?
check for hemolysis
specimens for blood gas determination should be drawn into a syringe containing
heparin
a patient suspected of having metabolic alkalosis would have which of the following laboratory findings
Co2 and pH increased
which of the following is most likely to be ordered in addition to serum calcium to determine the cause of tetany
magnesium
arterial blood is exposed to room air, which changes occur
elevated PO2, decreased PCO2 and elevated pH
a patient with glomerulonephritis would present with the following serum results
increased BUN
most automated blood gas analyzers directly measure
pH, PCO2, and PO2
a pH of 7.0 represents a H+ concentration of
100 nmol/L
a patient is admitted to the ER in a state of metabolic alkalosis, which of the following would be consistent with this diagnosis?
high TCO2 and increased HCO3
what substance gives feces its normal color?
urobilin
in monitoring Glomerular function, which of the following test has the highest sensitivity?
creatinine clearance
urobilinogen is formed in the
intestine
Method for bilrubin measurement
Jendrassik Grof method
the most specific enzyme for acute pancreatitis is
lipase
in respiratory acidosis, a compensortory mechanism is the increase in
plasma bicarbonate concentration
best assay to diagnose coma due to hepatic failure
ammonia
serum concentration of B12 are elevated in patients with
chronic granulocytic leukemia
characteristics of malabsorption syndrome due to pancreatic insufficiency include
fecal fat greater than 10 g/day
in acute pancreatitis, the relative increase in urinary amylase activity is greater than that of serum amylase activity because
there is an increased renal clearance of amylase
in which of the following conditions does decreased activity of glucuronyl transferase result in increased unconjugated bilirubin and kernicterus in neonates
Crigler-Najjar syndrome
a blood creatinine value of 5 mg/dL is most likely to be found with which of the following blood values?
urea nitrogen 80 mg/dL
an emphysema patient suffering from fluids accumuation in the alveolar spaces is likely to be in what metabolic state?
respiratory acidosis
of which of the following disease, which one is associated with the greatest elevation of lactate dehydrogenase isoenzyme I
b12 deficiency
the expected blood gas results from a patient in renal failure would match the pattern of
metabolic acidosis
the most important buffer pair in plasma is
bicarb/carbonic acid
severe diarrhea causes
metabolic acidosis
the test that evaluates renal tubular function
osmolarity
x

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