Biochemistry and Clinical Correlations: Protein, Electrolytes, and Metabolic Disorders

Aldosterone acts on the distal tubule to:

Increase sodium reabsorption and potassium excretion

Which of the following disaccharides must be withdrawn from the diet of patients with galactosemia?

Lactose

Discrepancies in calculated and measured osmolalities in a diabetic serum is most likely due to:

Ketone bodies

What happens to calcium when phosphorus is increased?

It decreases

If albumin (pI = 4.6) is placed a solution of B-2 barbital buffer it will have a:

Negative charge

What clinical condition does low total protein cause in a patient?

Edema

What happens to total protein and albumin levels in the nephrotic syndrome?

They decrease

In the body, what charge do most proteins carry?

Negative

What is the main physiological function of albumin?

Maintenance of osmotic pressure in the vessels

Creatinine clearance assesses the rate of

Glomerular filtration

Which protein accounts for over half of the serum protein?

Albumin

What causes a decreased gamma globulin fraction?

Hypogammaglobulinemia

Which personnel should run daily controls?

Personnel who routinely perform patient testing

Define Westgard rule: 1/3s

One control exceeds the mean by more than 3 SD

Which class of immunoglobulin has four subclasses?

IgG

Calculate)and)interpret)the)anionic)gap)of)the)following)set)of)electrolytes:)Sodium:)146mEq/L;)Chloride:) 110)mEq/L;)CO2:)25)mEq/L

11)mmol/L,)normal

A)known)Type)II)diabetic)has)500mg/24hr)albumin)in)her)urine.)This)indicates:

Possibility)of)renal)nephropathy

Hyperkalemia)is)commonly)associated)with

Addisonian)crisis

Which)of)the)following)values)represent)normal)SWEAT)electrolyte)concentrations?

Sodium)=)15)mmol/L,)chloride)=)16)mmol/L

Calculate)the)anion)gap)for)the)following:)Na:)132mM;)K:)3.5mM;)Cl)93mM)and)HCO3)25

14mM

What)is)beta^gamma)bridging?

An)increase)in)IgA)causing)a)bridging)effect

Urea)is)synthesized)by)the)____________)in)response)to)the)catabolism)of

Liver/amino)acids)and)proteins

This)in^born)error)of)metabolism)is)usually)notice)by)the)mother)due)to)the)particular)sweet)odor)of)the) child's)urine.

Maple)Syrup)Urine)Disease

If)a)patient)has)a)BUN/creatinine)ratio)of)30,)what)could)be)a)possible)diagnosis?

Pre^renal)azotemia

What)is)the)main)physiological)function)of)albumin?

Maintenance)of)osmotic)pressure)in)the)vessels

What)is)the)clinical)significance)of)pre^albumin?

Indicator)of)nutritional)status

If)you)electrophoresed)plasma)instead)of)serum,)what)difference)would)you)see)in)the)electrophoretic) pattern?

6th)peak)between)beta)and)gamma)band

A)24^hour)urine)has)a)volume)of)1000)mL)and)a)total)protein)of)100)mg/dL.)The)24^hour)urinary)protein) excretion)is)therefore:

1.0)g/day

In)the)body,)what)charge)do)most)proteins)carry?

Negative

The main organ for which the measurement of enzymes in serum/plasma/tissue is done is to assess disease is which of the following?

Liver

Fatty acids are utilized by the human body for energy when glucose is not available. The breakdown products of beta-oxidation of fatty acids are called:

Ketones

Some diseases, such as Multiple Myeloma and systemic lupus, are characterized by cryoglobulins, what are they?

Gamma Globulins

What is the most common method for measuring serum albumin?

Bromcresol green

The enzyme deficiency for this disease is HGA oxidase, leading to increased homogentisic acid, degenerative arthritis and hyperppigmentation. The urine darkens after standing in fluorescent light.

Alkaptonuria

Serum total protein is 12 g/dL. SPE (serum protein electrophoresis) shows a monoclonal spike in the immunoglobulin region. IFE shows an IgG with a klight chain. What is your most probable diagnosis?

Multiple myeloma