Chemistry Rotation Test 2

Flame Photometry internal standards (if you are analyzing for Na or Lithium)

-Why do we need internal standards?

-Standards are made at the following concentrations: 5, 10, 25, 50, 75, and 100 mg/mL.

-The instrument is calibrated with a series of standard solutions that cover the range of concentrations expected of the samples. Standard calibrations are commonly used in instrumental analysis. They are useful when sample concentrations may vary by several orders of magnitude and when the value of the analyte must be known with a high degree of accuracy.

What is lithium therapy used for?

It is a psychiatric medication that is used as a mood-stabilizer. Primarily used to treat bipolar disorder - effective in preventing mania and treating depression.

What can be diagnosed from blood gas testing?

Blood gases is a measurement of how much oxygen and carbon dioxide is in your blood. It also determines the acidity (pH) of your blood.

Diagnoses: Respiratory acidosis/alkalosis & Metabolic acidosis/alkalosis, Diabetic ketoacidosis, Lactic acidosis,

What causes different types of acidosis and alkalosis?

-Respiratory acidosis is characterized by a lower pH and an increased PCO2 and is due to respiratory depression - not enough oxygen in and carbon dioxide out. This can be caused by many things, including pneumonia, chronic obstructive pulmonary disease (COPD), and over-sedation from narcotics.

-Respiratory alkalosis, characterized by a raised pH and a decreased PCO2, is due to over ventilation caused by hyperventilating, pain, emotional distress, or certain lung diseases that interfere with oxygen exchange.

-Metabolic acidosis is characterized by a lower pH and decreased HCO3-; the blood is too acidic on a metabolic/kidney level. Causes include diabetes, shock, and renal failure.

-Metabolic alkalosis is characterized by an elevated pH and increased HCO3- and is seen in hypokalemia, chronic vomiting (losing acid from the stomach), and sodium bicarbonate overdose.

What are the normals ranges for blood gases?

Partial pressure of oxygen (PaO2) - 75 - 100 mmHg

Partial pressure of carbon dioxide (PaCO2) - 38 - 42 mmHg

Arterial blood pH of 7.38 - 7.42

Oxygen saturation (SaO2) - 94 - 100%

Bicarbonate - (HCO3) - 22 - 28 mEq/L

*At altitudes of 3,000 feet and above, the oxygen values are lower.

What is directly measured from the blood gas analyzer?

It measures the pressure of oxygen and carbon dioxide in the blood, as well as the concentration of hydrogen ions in your arteries.

What are the requirements for a blood gas specimen?

It is collected in a 5mL Heparinized Plastic Syringe (ideal sample = 5mL, absolute minimum is 1mL). Arterial or Venous puncture. Transport on ice. After draw, pressure must be applied for 5 minutes to site of puncture.

What are the normal ranges for electrolytes? Case studies? Anion gap?

A Normal blood sodium level is 135 - 145 milliEquivalents/liter (mEq/L)

The normal blood potassium level is 3.5 - 5.0 milliEquivalents/liter (mEq/L)

The normal serum range for chloride is 98 - 108 mmol/L

The normal serum range for bicarbonate is 22-30 mmol/L

*Find out normal blood oxygen range

*Anion gap measures the difference between anions and cations in blood. It is used to diagnose acid-base imbalances in the body including lactic acidosis, and certain diabetes-related conditions. The normal value for the serum anion gap is 8-16 mEq/L.

Cardiac diagnosis, liver disease diagnosis, prostate diagnosis, and pancreatitis diagnosis....

Look up high and low values for AST, ALT, etc.

LD methodology:

-What does it look like in time?

-What does it look like in absorbance?

-What is being measured?

Lactate dehydrogenase measurements are used in the diagnosis and treatment of liver diseases, cardiac diseases and tumors of the lung or kidney.

The system monitors the rate of change in absorbance at 340 nm over a fixed-time interval. The rate of change in absorbance is directly proportional to the activity of LD in the sample.

What case studies show enzyme results?

?

Know the buffering systems in the body and how they work.

There are three primary systems that regulate the H+ concentration in the body fluids to prevent acidosis or alkalosis: (1) the chemical acid-base buffer systems of the body fluids, which immediately combine with acid or base to prevent excessive changes in H+ concentration; (2) the respiratory center, which regulates the removal of CO2 (and, therefore, H2CO3) from the

extracellular fluid; and (3) the kidneys, which can excrete either acid or alkaline urine, thereby readjusting the extracellular fluid H+ concentration toward normal during acidosis or alkalosis.

What is the equation for calculating the bicarb:carbonic acid ratio?

Use the Henderson-Hasselbalch equation:

pH = pKa + Log ( [HCO3-]/[H2CO3] )

What is the normal ratio at 7.4 pH?

20:1

What causes ISE to be selective?

it converts the activity of a specific ion dissolved in a solution into an electrical potential, which can be measured by a voltmeter or pH meter

Why is carbon monoxide so lethal?

Its so deadly because it is not oxygen. It takes the place of oxygen in your body and you wont even notice it. Because it is odorless and colorless, it is deadly to those who don't have carbon monoxide detectors.

Carbon monoxide combines with the respiratory pigment haemoglobin to form methaemoglobin which has very low affinity for oxygen. Lack of oxygen leads to coma and finally ends in death. People who die of Carbon Monoxide poisoning have a characteristic cherry-red colour.

What ISEs need to analyze for potassium?

valinomycin

What will the blood gas results be for a patient with emphysema?

low oxygen

Know the major intra and extra cellular cations and anions.

cations = sodium & potassium

anions = chloride and bicarbonate

What is the protein portion of an enzyme?

apoenzyme

Know exactly what test results are diagnostic for specific disease (ex: diabetes mellitis, acute liver disease, etc.)

...

Know milliequivalent formulas.

mEq = (mg x valence)/atomic, molecular or formula weight

mg = (mEq x atomic, molecular or formula weight)/valence

***Equiv Weight (g) = (atomic, molecular or formula weight)/valence

Normal blood oxygen levels

95-100 percent. If the level is below 90 percent, it is considered low resulting in hypoxemia.[1] Blood oxygen levels below 80 percent may compromise organ function, such as the brain and heart, and should be promptly addressed. Continued low oxygen levels may lead to respiratory or cardiac arrest. Oxygen therapy may be used to assist in raising blood oxygen levels.