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CSMLS chemistry Exam Study Guide.

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CSMLS chemistry Exam Study Guide. Chilled Samples - answerACTH, lactic acid, ammonia, blood gases, acetone, gastrin, glucagon, pyruvate, renin Protect samples from light - answerbili, carotene, erythrocyte protoporphyrin, vitamin A, vitamin B12 Warm Samples - answerCold agglutinins, cryoglobuli...

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  • November 11, 2024
  • 34
  • 2024/2025
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Thebright
©THEBRIGHT EXAM SOLUTIONS

11/8/2024 12:08 PM


CSMLS chemistry Exam Study Guide.


Chilled Samples - answer✔ACTH, lactic acid, ammonia, blood gases, acetone, gastrin, glucagon,
pyruvate, renin

Protect samples from light - answer✔bili, carotene, erythrocyte protoporphyrin, vitamin A, vitamin B12

Warm Samples - answer✔Cold agglutinins, cryoglobulins

Fasting samples - answer✔Fasting blood sugar, triglycerides, lipid panel, gastrin, insulin

Formalin pigment - answer✔Aka acid formalin hematin. Brown, granrular, doubly refractile deposit



Remove with picric acid after 100% alcohol in rehydration step. Tissue will be yellow. Remove yellow
discolouration with RTW (30min), acid alcohol + wash in RTW, prolonged alcohol wash and lithium
carbonate in 70% alcohol

Mercury Pigment - answer✔Dark brown to black crystals.



Remove during dehydration: 20mL of strong alcoholic iodine



From sections: bring to water, place in 0.5% alcoholic iodine or gram's iodine, rinse with water, place
into sodium thiosulphate until brown discolouration gone.

Hematoxylin - answer✔Not a true dye. Must be oxidized to hematein (ripened by exposure to
atmospheric oxygen, sodium iodate, mercuric oxide, potassium permanganate)

Hematein - answer✔Weak, anionic dye. Oxidation product of hematoxylin, active coloring agent



Little affinity for tissue, but becomes strong dye when combined with metallic mordant (alum salts, iron
salts)

Hematoxylin Differentiation - answer✔Uses 1% HCL in 70% ethanol (acid alcohol). H+ ions compete with
mordant for tissue groups. Alumnium-hematein is red and soluble pH <5. Blue insoluble lake in pH>5

, ©THEBRIGHT EXAM SOLUTIONS

11/8/2024 12:08 PM


Cytoplasm and connective tissue will be colorless.



Nuclei will be RED with sharp nuclear detail.



- MUST use BLUEING Agent (alkali reagent) to reverse discolouration (Scott's TW)

Decolorization - answer✔Removal of excess stain macroscopically

Differentiation - answer✔Controlled removal of excess stain microscopically

Eosin - answer✔Cytoplasmic stain.

- pH 7 = negatively charged

- pH <6 can stain proteins

- pH< 4= decreased negative charges because molecule converts to free acid, muddy tissues



RBC = dark pink, Muscles = pink, collagen = light pink

Casts - answer✔fibrous or protein materials found in the urine with renal disease or another
abnormality



- Formed in the lumen of the distal convoluted tubule and collecting duct

- Major constituent = uromodulin ( tamm horsfall protein)

- Factors that influence cast formation: decreased pH, decreased output, Increased solute concentration
(SG), increased protein

Renal tubular cell casts - answer✔Most significant, round, eccentric nucleus, larger than WBC.



- Tubular necrosis, renal tubules

transitional epithelial cast - answer✔Round/pear shape, central nucleus



- Renal carcinoma, renal pelvis, bladder, upper urethra

, ©THEBRIGHT EXAM SOLUTIONS

11/8/2024 12:08 PM

Creatinine clearance formula - answer✔= U (concentration of urine creatinine - mg/dL) * V ( volume of
urine in mL/time in minutes) / P (concentration of plasma creatinine mg/dL)

Hemolysis - answer✔K+ Inc

LD Inc

Aldolase (ALD) inc

Acid phosphatase (ACP) increased

Mg++ Increased

PO4 increased

Hgb increased = may show extra band

Iron increased



Klamp the leak

Serum red top - answer✔For most chemistry tests

Plasma - answer✔Heparin better than oxalate, EDTA, citrate

Potassium oxalate - answer✔An anticoagulant commonly used with the antiglycolytic agent sodium
fluoride.



For glucose test (slows glycolysis)

EDTA tube - answer✔Used for cell counts and differential and Hb1Ac



NOT FOR Na+/K+ or Ca++ (chelated calcium - false negative)

CSF glucose - answer✔2/3 (60-65%) of plasma glucose levels



2.2-3.9 mmol/L

Plasma Glucose (fasting) RI - answer✔4.1-5.6 mmol/L



<5.6 mmol/L = normal

, ©THEBRIGHT EXAM SOLUTIONS

11/8/2024 12:08 PM

>7.0 mmol/L = diabetic

Sodium Serum (na+) RI - answer✔136-145 mmol/L

Triglycerides - answer✔<1.70 mmol/L



Primary form of lipid storage. Transported by chlyomicrons (exogenous) and VLDL (endogenous)



Enzymatic methods measurement. Involve liberation of glycerol by lipase. Glycerol contamination from
stoppers of evacuation tubes or ingestion of glycerol-coasted medication can cause falsely elevated
results

BUN (urea) RI - answer✔2.1-7.1 mmol/L

Troponin I RI - answer✔< 27 ng/L

Potassium serum (K+) RI - answer✔3.5-5.1 mmol/L

Magnesium Serum (Mg) RI - answer✔0.66-1.07 mmol/L

Total Calcium (Ca2+) RI - answer✔2.15-2.55 mmol/L

Free calcium (ca2+) RI - answer✔1.15-1.33 mmol/L

Total bilirubin serum RI - answer✔5-21 umol/L



conjugated = 0-4 umol/L

unconjugated = <17 umol/L

Insulin - answer✔Hormone produced from beta cells of islets of langerhans of pancreas.



Decreased serum glucose. Stimulates glucose uptake by cells

Glucagon - answer✔Hormone produced from alpha cells of islets of pancreas.



Stimulates glycogenolysis (breakdown of glycogen -> glucose)

GAG CHET - answer✔All cause increase in serum glucose

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