Chemistry Tests

Instrumentation

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What are the 4 analytical parts of the Cobas 8000?

• ISE unit: sodium, chloride, potassium

• c702 unit

• c701 unit

• c 602 unit

What are the 4 analytical parts of the Cobas 6000?

• ISE

• c501

• C601

• ECL

What types of methods are utilized on the Cobas 8000?

• Photometric

• Electro Chemiluminiscent

• Ion-selective electrode

Serum and urine QC are in the same bottles

False

If routine QC is out of range, describe the next steps…

• Repeat the test using a new QC aliquot as some errors are possibly resolved by repeating the test

• If the QC is still out of range recheck for contamination, the procedure, calibration, or the expiration date of the reagent

• After correcting the possible error that has occurred repeat the test

The primary sample for general chemistry is?

Green top lithium heparin with gel

Reagents are kept at what temperature?

Depends on the assay

Calibration verifications are required by CAP when?

An assay has less than 3 calibrators

When is manual pipetting necessary?

When dealing with very small volumes of reagent and a small number of tubes for pipetting, manual pipetting provides more flexibility and accuracy

How are dilutions handled for most analytes?

The dilution factor and dilution concentrations are calculated. Then the dilution in prepared with the proper solvent and solute by measuring the volume needed. Serial dilution can also be used.

Why would there be an aspiration error?

• bubbles on serum

• QNS plasma

• fibrin clot

General Chemistry

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The major carrier protein of drugs in circulation is?

Albumin

The major side affect of acetaminophen overdose is?

Hepatotoxicity

What is the treatment for methanol toxicity?

Ethanol

If you are treating a patient with N-acetylcysteine, what did they overdose on?

Tylenol

The primary structure of a protein is amino acids…

linked by peptide bonds

All of the following are functions of proteins except?

Helps digest food particles

Which of the following affect enzyme performance?

• Heat

• Decreased temperature

• Exposure to urea

Which of the following may be associated with bilirubin metabolism?

A, B, C

The normal BUN to creatine ratio is

10:1

All of the following are functions of the kidney except?

Synthesize urea

Lipids are transported by the body by?

Lipoproteins

What are the major functions of apolipoproteins?

All of the above

The major carrier of exogenous (dietary) triglycerides is?

Chylomicrons

Which of the following are considered primary tissue sources of alkaline phosphatase?

Liver, bone, and kidney

Which of the following enzymes aid in the diagnosis of acute pancreatitis?

Lipase and Amylase

Which electrolyte plays a major role in regulation of water balance in the body?

Sodium

Which of the following is an important activator in the coagulation system?

Calcium

Which of the following serves as a major form of storage for iron?

Ferritin

The term gluconeogenesis refers to the?

Synthesis of glucose from non carbohydrate sources

Glycolysis is

Conversion of glucose to lactate or pyruvate

One of the major buffer sites employed by the body to maintain the blood pH level is?

Plasma/bicarbonate

At pH 7.4, the normal ratio of bicarbonate in arterial blood is?

20:1

If a blood gas specimen is left exposed to air, which of the following changes will occur?

pO2 and pH increase, pCO2 decreases

In the circulation system, bicarbonate leaves the red blood cells and enter the plasma through an exchange with?

Chloride

Carboxyhemoglobin

• Is carbon monoxide + hemoglobin

• Produces hypoxia

• Samples have a cherry red apperan

Arterial Blood Gas

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The pH of blood is regulated by buffers and by

Lungs and kidneys

The plasma bicarbonate concentration is mostly controlled by the

Kidneys

The rate of excretion of CO2 is controlled by the

Lungs

All testing of ABG specimens must be tested within ___ minutes…

10

Specimen rejections include…

• Contamination of air due to dead space

• Unlabeled syringes

• Clotted specimens

Reference Ranges of…

1. pH

2. pCO2

3. HCO3

1. 7.35-7.45

2. 35-45

3. 22-26

pH: 7.25

pCO2: 69

HCO3: 28

Respiratory acidosis

pH: 7.30

pCO2: 36

HCO3: 18

metabolic acidosis

pH: 7.47

pCO2: 28

HCO3: 25

Respiratory alkalosis

Diabetic ketoacidosis is an example of

Metabolic acidosis