Chapter 5 - Factors Affecting Chemistry Analyte Values

d.) B & C

These increase with age

The following analytes decrease with age, EXCEPT:
a.) Proteins and enzymes
b.) Immunoglobulins
c.) Blood cholesterol and other lipids
d.) B & C
e.) NOTA

Alkaline phosphatase (ALP)
Albumin
Bilirubin
Blood urea nitrogen (BUN)
Calcium
Cholesterol
Creatinine
Creatinine Kinase (CK)
Iron
Magnesium
Phosphate
Testosterone
Urea
Uric acid

What analytes are higher in men?

alpha-lipoproteins
cholesterol
estrogen
gamma

What analytes are higher in women?

Alkaline phosphatase (ALP)

This analyte is higher in girls and boys before puberty than adults, with girls having a more elevated level. It has a significant role in bone formation.

Aldosterone/renin
Fasting blood sugar
Gastrin
Inorganic phosphate
Insulin
Lipid profile
Oral Glucose Tolerance Test (OGTT)
Triglyceride

Most tests in clinical chemistry require that the patient has fasted, particularly with which analytes that are to be tested for?

f.) C & D

This, alongside phosphorous, potassium, and ALP

The following would increase after recent food ingestion, EXCEPT: a.) Glucose b.) Triglycerides c.) Chloride d.) Amylase e.) A & B f.) C & D

intake of purine-rich foods

What would increase uric acid level?

ALP

An increase in _________ will occur 2-4 hours after a meal

ammonium ions, urates, urea

What analytes would a high-protein diet increase?

5-hydroxyindoleacetic acid

Ingestion of banana, tomato, avocado, and pineapple would affect levels of ______________________.

serotonin

A powerful smooth muscle stimulant and vasoconstrictor.

from tryptophan by Argentaffin cells of intestines

How is serotonin produced?

c.) Both

Which of the following statements are TRUE?
a.) An excess amount of serotonin is produced when a carcinoid tumor involving the Argentaffin cells develops.
b.) Increased serotonin results in increased 5-HIAA.
c.) Both
d.) Neither

Tryptophan-rich foods

If a patient will be tested for 5-HIAA, what foods he/she cannot eat?

catecholamine

Causes vasoconstriction, vasodilation, cardiac stimulation, breakdown of glycogen, and lipid transport. Also used as a tumor marker for chromaffin cells of adrenal medulla.

caffeine-rich foods/drinks

What foods/drinks can increase catecholamines?

lipemia

Refers to the amount of emulsified fat in the blood, causing undue turbidity of plasma.

chylous/chyle

Milky, alkaline fluid consisting of lymph and emulsified fat.

chylomicrons

Transporters of exogenous triglyceride

BCG
O-cresophthalein
Acid ammonium molybdate
Reduction in amylase, lipase, uricase, urease activity
Decreased total protein and total bilirubin

What determinations are affected by milky serum?

ultracentrifugation blanking technique

What remedies are made for milky serum?

icteresia

Degree of yellowishness of serum, usually due to increased bilirubin.

carotene-rich foods

What foods can make the serum icteric?

O-Toluidine
Icterus index
Hydroxy Azobenzene Benzoic Acid (HABA)
Biuret

Determinations affected by icteric sample

O-Toluidine

A method for glucose

Icterus index

A liver function test

Hydroxy Azobenzene Benzoic Acid (HABA)

A method for albumin

Biuret

A method for total protein

c.) Both

Oral contraceptives alter which of the following?
a.) Coagulation parameters
b.) Thyroid function
c.) Both
d.) Neither

erythromycin

This affects liver function test b inducing hepatic microsomal enzymes.

liver and pancreatic enzymes

Opiates such as morphine and meperidine cause an increase in __________________.

potassium and hyponatremia

Diuretics cause decreased _________________ and __________________.

thiazide-type medications

These can cause hyperglycemia and pre-renal azotemia secondary to the decrease in blood volume.

creatine kinase and lactate dehydrogenase

Intramuscular injections can cause an increase of _____________________ and _______________________.

FALSE; muscular activity can have an effect on analytes

TRUE OR FALSE? A patient does not need to have minimal physical exertion.

CK

What is increased in ambulatory patients?

1 & 2

Cholesterol and triglycerides are decreased with exercise

The following are increased with exercise, EXCEPT: 1.) Cholesterol 2.) Triglycerides 3.) Lactic acid 4.) Creatine 5.) Protein

d.) A & B

Calcium and glucose are slightly decreased.

Which of the following would increase in pregnancy?
a.) Uric acid
b.) Cortisol
c.) Calcium
d.) A & B
e.) AOTA

a.) Triglycerides

Which of the following would be increased by both alcohol consumption and tobacco smoking?
a.) Triglycerides
b.) Urea
c.) Gamma-glutamyl transferase
d.) Cholesterol

c.) Both

Which of the following are TRUE?
a.) Increased body weight increases uric acid, cortisol production, and creatinine excretion
b.) Obesity is a major cause of Type 2 Diabetes Mellitus.
c.) Both
d.) Neither

Adrenocorticotropic hormone (ACTH)
Aldosterone
Cortisol
Iron

Which diurnal variations would be increased in the morning?

ACP
growth hormone
parathyroid hormone
thyroid-stimulating hormone

Which diurnal variations would increase in the evening?

Yes. Analytes such as albumin, cholesterol, aldosterone, and calcium can increase when a patient is standing up, which is why they should be in a relaxed state when blood is being collected.

Does position/posture have an effect on analytes? Why or why not?

TRUE

TRUE OR FALSE? Stress prior to venipuncture can also cause an increase in analytes.

race
immediate cooling
hemolysis

Other factors affecting chemistry analyte values