Clinical Chemistry 1 - CSMLS
Amylase - correct answer-AMS, a hydrolase
major sources: pancreas and salivary glands
Are first order kinetics dependent on substrate or enzyme concentration? - correct
answer-substrate - enzyme excess.
Are results for indirect ISE measurements higher or lower than direct? - correct
answer-Lower. Should be about 7% lower but in practice indirect methods are about 2%
lower than direct.
At what rate does blood glucose change if a specimen was left uncentrifuged at room
temperature? - correct answer-glucose decreases by ~7%/hour
At what rate is CO2 concentration altered if exposed to air before testing? - correct
answer-Decrease of 4-6 mmol/L per hour.
Causes of low sodium include: - correct answer-loss exceeds intake (renal disease,
addison's, vomiting, burns
secondary to excessive water retention (dilutional)
Clinical significance of 5'NTP? - correct answer-elevated in primary hepatobiliary disorders
Clinical significance of ACP? - correct answer-Differential diagnosis of prostatic disease
(now usually done with prostate specific antigen)
Bone tissue malignancy
Clinical significance of ALP - correct answer-Increased in hepatobiliary obstruction
Bone disease (10-25x)
Clinical significance of ALT: - correct answer-Liver: marked increase in viral or toxic hepatitis
moderate increase in cirrhosis, obstructive jaundice
*more specific liver enzyme than AST
Clinical significance of amylase - correct answer-Increased in acute pancreatitis
other pancreatic disorders
mumps
Clinical significance of AST - correct answer-MI: rise w/in 6-8 hours, peak at 18-24 and
return to normal 4-5 days.
Liver disease: marked increase in viral hepatitis and acute liver disorders
Clinical significance of BNP? - correct answer-BNP is increased in CHF
used as an indicator of severity of heart condition
, Clinical significance of CK: - correct answer-MI: rises 4-5 hours, peaks 18-24, returns to
normal 3-4 days
Muscle disease/trauma
PE
hypothyroid (inverse relationship with thyroid activity)
Clinical significance of GGT? - correct answer-Best indicator of biliary obstruction (5-30x
increase)
hepatitis (but not as good as AST/ALT)
Alcoholism
Clinical significance of LD? - correct answer-5 isoenzymes: frequency:
LD2>LD3>LD1>LD4>LD5
MI: rises 8-12 hours after, peaks 48-60 hours after, returns to normal 7-10 days
increased in anemia, mono, liver disease (high LD5)
Clinical significance of lipase? - correct answer-elevated in acute pancreatitis
decreased in CF and late chronic pancreatitis
creatine is converted to creatinine daily at a spontaneous rate of? - correct answer-2%
CSF has approximately what percent of plasma glucose concentration? - correct
answer-60-70%
Electrodes measure what parameter? - correct answer-activity
How are some of the interferences eliminated in the Jaffe reaction for creatinine - correct
answer-using a kinetic assay with a time range specific for creatinine reaction (some
interfering substances tend to react either very quickly or very slowly, creatinine is best
measured at 20-80 seconds)
How do competitive inhibitors affect a reaction rate? - correct answer-the Km is increased -
takes more substrate to reach Vmax (Vmax stays the same)
How do non-competitive inhibitors affect reaction rates? - correct answer-Doesn't alter Km,
but will decrease the Vmax
How is chloride measured? - correct answer-ISE: solid-state; AgCl crystal
How is CO2 measured? - correct answer-pH electrode
How is creatinine measured? - correct answer-Jaffe reaction - uses picric acid and NaOH,
coloured product. *not specific for creatinine
How is GFR usually measured? - correct answer-creatinine clearance
How is potassium measured? - correct answer-ISE: liquid ion exchange membrane,
valinomycin
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