Chemistry final exam

Tumor marker: Carcinoembryonic antigen

Colorectal cancer

Tumor marker: Alpha-fetoprotein (AFP)

Liver, testicular and ovarian cancer. Best for hepatic cancer

Tumor marker: prostate specific antigen (PSA)

Prostate cancer

Tumor marker: CA-125

Ovarian cancer

Tumor marker: CA 19-9

Pancreatic cancer

Tumor marker: CA 15-3, CA 549, CA 27.29

Advance stages of breast cancer

Tumor marker: Human chorionic gonadotropin (hCG)

Trophoblastic disease: Hydatoform mole

Tumor marker: Enzymes/proteins

ALP- Bone

LD - Liver

ACP - Prostate

Immunoglobulins - Multiple myeloma

Tumor marker: Other hormones

High calcitonin - Thyroid cancer

ACTH - normally in pituitary but cancerous form in lungs, pancreas, breast, colon

Tumor marker: HVA / VMA

Pheochromacytoma Neuroblastoma

Tumor marker: BRCA 1 and BRCA 2

Breast on ovarina

A prehepatic condition will result from:

Hemolysis, but normal liver function

What will the test results be for a prehepatic condition?

Total Bilirubin - Increased

Direct Bilirubin - Normal

Urine Urobilinogen - Increased

Urine bilirubin - Negative

Fecal urobilinogen - Increased

A hepatic condition will result from:

Impaired uptake or abnormal secretion of bilirubin

What will the test results be for a hepatic condition?

Total Bilirubin - Increased

Direct Bilirubin - Increased

Urine Urobilinogen - Normal or increased

Urine bilirubin - Increased / positive

Fecal urobilinogen - Normal or decreased

A post hepatic condition will result from?

Obstruction of biles (stones)

What will the test results be for a post-hepatic condition?

Total Bilirubin - Increased

Direct Bilirubin - Increased

Urine Urobilinogen - Decreased

Urine bilirubin - Increased

Fecal urobilinogen - Decreased, clay colored

Transmission of Hepatitis A and Heptatis E

Fecal-oral route

How is the incubation for Hepatitis A?

Short incubation (28 days)

How is the incubation for Hepatitis B?

Long incubation (120 days)

Which of the Hepatitis in a single RNA virus?

Hepatitis A

Which of the Hepatitis is a DNA virus?

Hepatitis B

Which of the Hepatitis is/are RNA viruses?

Hepatitis C, Hepatitis D, and Hepatitis E

What Hepatitis can be transmitted through parenternal, perinatal, sexual, contaminated body fluids?

Hepatitis B

What Hepatitis can be transmitted through Parenternal, sexual and fecal-oral?

Hepatitis C

What Hepatitis needs a coinfection in order to infect a person?

Hepatitis D, needs coninfection with Hepatitis B

What Hepatitis does not have a vaccine?

Hepatitis C and Hepatitis E

What Hepatitis can go Chronic?

Hepatitis B, Hepatitis C, and Hepatitis D

What is the core window in a Hepatitis infection?

It is the only indication of an acute HBV infection. Hepatitis B core antibody rises, while Hepatitis B surface antigen disappears and before Hepatitis B surface antibody appears.

What is the formula for CrCl?

CrCl=

Urine creatinine x urine volume / plasma creatinine x time (mins)

What is the function of the pancreas?

Digestion, hormone production, and production of enzymes

What are tests to evaluate the pancreas?

Glucose, lipase and amylase

What two important hormones are secreted by the pancreas?

Insulin and glucagon

What is the function of the GI tract?

Gastric secretion and role in digestion

What lab tests can be done to evaluate the GI tract?

Gastrin, pH - gastroccult, lactose tolerance test, D-xylose test

What is the function of the cardiac region?

Cannot live without it. pumps blood to all the tissues

What lab tests are used to evaluate the cardiac?

CK-MB, LD, Myoglobin, troponin, BNP, HsCRP, homocysteine

What is the difference between Colorimeter and spectrophotometer?

Colorimeter - uses filter as a monochromator. Measures the % of colored substances in a solution

Spectophotometer - uses monochromator ro measure light

What is stated by Beer’s law?

States that the concentration of a substances is directed related to the absorbance. The more concetrated, the more light it absorbes, the less light goes through.

Darker colors = more light is absorbed = increased absorbance

Darker colors = less light passes through the substance = decreased transmittance

What is the purpose of a standard in the use of a spectophotometer?

It is a known amount of a substance and is used to calibrate the instrument or calculate an unknown concentration from a known one

Define electrical Impedence.

A change in electrical resistance as cells in a conductive liquid pass through an orifice

Define light scattering.

The ability of individual cells to scatter light (flow cytometry)

Define Nephelometry.

Antigen - antibody complexes to scatter light

Define Turbidimetry

Antigen - antibody complexes to transmit light

Define osmometry

The measure of the osmalality of a solution. This is determined by measuring the colligative properties of a solution

Define colligative properties

relates to the number of solutes in a solution rather than their size, mass or charge. The colligative properties will increase as the number of solutes increases

Explain Coulter principle.

A change in electrical resistance as cells in a conductive liquid pass through an orifice automated cell counting - hematolgy

Explain flow cytometry

Particles are counted using a light scattering technique (laser beam). It is based on particles will scatter light. The addition of fluorescent dyes and stains add to the ability of this system to differentiate cell type. Distinguish or type lymphocyte and tumor cells

What is the difference between nephelometry and turbidimetry?

Nephelometry refers to the detection of light scattered

Turbidimetry refer to measurement of light transmitted

What is the difference between rate and endpoint measurement?

Rate measurement is taken when the point of highest change in intesity of scatttered light occuts wirh respect to time.

Endpoint reading is taken when the change in intesity of scattered light with respect ot time is small, basically at the equivalence point, and can take from 10 minutes to an hour

Describe a histogram?

Display of cell analysis, such as volume. Measured values are on the X-axis and concentration on the y-axis

What is coincidence correlation?

Electronic circuitry that corrects for the possibility that two cells will pass through an aperture at one time.

Define the pinciple of osmometry.

measures the colligative properties of solutions (boiling points, freezing points, osmotic pressure, etc) that in turn relates to the number of particles in a solution

Describe sort logic as it relates to cell counting.

Fluid streams carreis cells passed an orifice. Cells are identified by electronic garing (size) - tells the instrument to initiate a pulse. Different cells have different pulses and then can be categorized or sorted.

What is Coulometry?

Measures the amount of current needed to convert a substance is measured and used to determine the concentration

What is the purpose of the reference electrode?

Produces a constant flow of electrons. DIfferences in potential can be detected by coparing the indicator to the reference electrode

What are the two key components of electrochemistry?

Current and potential

What are the different types of support media and what they are used for?

Agarose gel - protein

Cellulose acetate - protein

Polyacrylamide gel - alkaline phosphatase isoenzyme

Name the bands in protein electrophoresis and the order on celullose acetate.

Anode (+) -- Albumin, alpha 1, alpha 2, beta, gamma -- Cathode (-)

What are some other tests that can be run using electrophoresis?

Separation of antibodies, diffentiate hemoglobins, lipoproteins, iaoenzymes, immunoelectrophoresis

What are some sources of errors that can occur in electrophoresis?

Sample application waas too much, buffers too old or contaminated, wrong pH for testing, support media is contaminated, stains are too old

What is “wick flow”?

The upward movement of buffer through both immersed ends of a membrane to replace lost moisture. Wick flow can reduce separation and lead to compression of the final band patterns

What are 3 basic components of chromatography?

Sample

Mobile phase (eluate)

stationary phase

What is the difference between an eluant, eluate and elution?

Eluant - mobile phase

Eluate - the oslution coming out of the column dissolved in the mobile phase

Elution - the whole process of removing the solute from the stationary phase

What is the difference between mobile and stationary phase?

Mobile phase - solvent that serves as the carrier of the compound through a column

stationary phase - the separating material that remains in a fixed position

What is the difference between polar and nonpolar solvents?

Polar - pertains to molecules that are hydrophilic. Polar substances dissolve in polar solvents

Nonpolar - pertains to molecules that have a hydrophobic affinity. Nonpolar substances tend to dissolve in nonpolar solvents

What is the major advantage of HPLC over immunoassay techniques?

Ability to measure multiple drugs at one time

What the use of atomic absorption in the laboratory?

Measure trace metals (copper, lead, zinc, etc)

How does the principle of fluorescence work?

Based upon the concept that some materials can absorb light at one wavelength and then emit light at a different (usually longer) wave length.

How is fluorescence used in the clinical laboratory?

FPIA - monitoring therapeutic drugs, drugs of abuse, catecholamines immunotechniques in immunology

What is chemiluminescence?

When an organic substance oxidizes, it will produce light, when attained an excited enery state - releases energy in the form of light

What disease states will cause hypoprooteinemia?

Nephrotic syndrome, loss of blood, internal bleeding, extensive burns, liver disease

What disease states will cause hyperproteinemia?

Dehydration, waldenstrom macroglobulinemia, chronic inflammatory states, collagen vascular disorders, multiple myeloma

What is the principle of Protein electrophoresis and what does it measures?

Protein separated based on electric charge, size and shape. It measures albumin, alpha 1, alpha 2, beta and gamma

What is the principle of Kjeldahl method and what does it measures?

Measures nitrogen content. Formed ammonium borate is titrated by HCL. It measures Total protein

What is the principle of refractometry and what does it mesures?

Measures refractive index due to solutes. Measures total protein

What is the principle of Biuret method and what does it measures?

Formation of violet-colored chelate between cupric ions and peptide bonds. It measures total protein

What is the principle of Dye-binding method and what does it measures?

Based on the ability of proteins to bind dye. It measures albumin

What is the principle of tubidimetric/nephelometric method and what does it measures?

Precipitation of protein with TCA or SSA. It measures urine and CSF total protein and may be used for albumin

What is the principle of urine dipstick and what does it measure?

Protein-error of indicators pH and measures albumin

What fraction of protein electrophoresis will be affected by Multiple myeloma?

Increased gamma protein

What fraction of protein electrophoresis will be affected by Alpha 1 antitrypsin deficiency?

Decreased Alpha 1 protein

What fraction of protein electrophoresis will be affected by Nephrotic syndrome?

Increased alpha 2 protein, beta increased, decreased in albumin

What fraction of protein electrophoresis will be affected by Inflammation?

Increase in all proteins

What fraction of protein electrophoresis will be affected by Cirrhosis?

Beta-gamma bridge

What is the difference between immunofixation and immnoelectrophoresis?

Immunoelectrophoresis - antiserum to protein are placed in a trough parallel to the migration path of the separation proteins and diffuse into agar

Immunofixation - proteins are electrophoresis then fixative is added to stabilize the proteins

What is the most common method for identidying protein in the urine?

24 hrs urines - turbidemetric as well as other methods

Routine UA - dipstick

Most common method for identifying protein in CSF?

Turbidemetric as well as other methods

What is A/G ratio?

Total protein - albumin = globulin

Albumin/Globulin

What disease states will cause an increase in CSF protein?

Meningitis - fungal, viral, bacterial

MS

what disease states will cause an increase in urine protein?

Kidney disease, strenous exercise, diabetes

What are the hormones that regulate glucose?

Insulin - decreases glucose

Glucagon - increases glucose

Describe Glycolysis.

Glucose → pyruvate or lactate + ATP. Generate energy for cells

Describe Glycogenesis

conversion of glucose to glycogen for storage in the liver or muscle until more glucose is needed

Describe glycogenolysis.

Breakdown of glycogen to glucose. Reclain glucose to increase blood sugar or obtain energy

What is glycated hemoglobin?

Hemoglobin molecule attached to glucose. HgbA1C - whole blood EDTA

Describe gluconeogenesis

Formation of glucose from noncarbohydrate soruces (proteins and lipids)

Glycerol, lactate, amino acids → glucose

increased blood sugar in the absence of glucose and glycogen

What disease states are seen with hypoglycemia?

Liver disease, insulin excess, glycogen storage disease, ethanol ingestion

What disease states are seen with hyperglycemia?

Diabetes mellitus, Cushing’s syndrome, Pancreatitits

Define carbohydrates

Consists of carbon, hydrogen, and oxygen and may contain an aldehyde or a ketone.

Its the primary energy source for the Brain, RBC, and retinal cells

Regulation is controlled by endocrine and metabolic processes