Final Exam
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What does SPEP stand for? What are the 5 major peaks? Oncotic pressure is maintained by what?
Serum protein electrophoresis albumin, alpha-1, alpha-2, beta, gamma albumin
What is the largest contributor to alpha-1? What does this contributor do? What is the largest contributor to alpha-2? What does this contributor do?
Antitrypsin Acute phase reactant Haptoglobin Binds free Hgb
How does liver damage lead to ascites?
• Liver damage decreases albumin production (liver synthesizes alb) • Decrease in oncotic pressure • Fluid leaks from vessels
What does ESRD stand for? What is the Cockcroft-Gault equation? What does it measure?
End stage renal disease (140-age)(mass) 72 - Creatserum Glomerular filtration rate
What if creatinine clearance is low but serum creatinine is high?
• Suspect error in collection of urine. • If seum creatinine is normal, we would expect normal clearance
What is the BUN:Creatinine reference range?
10:1 - 20:1 (reference range)
What does a higher (>20:1) BUN:Creatinine ratio indicate?
Higher – BUN is elevated, Creatinine is normal Problem is NOT renal or post-renal –> it is being cleared Problem is pre-renal
What does a Low BUN:Crea (<10:1) indicate?
BUN low, creatinine low Problem is RENAL.
What tests are used to assess renal function? What is the value of testing this particular analyte?
BUN, Creatinine. Produced and exceted.
How is [BUN] converted to [urea]? What can influence BUN values?
2.14 Diet
What do increased creatinine levels indicate? What is the creatinine clearance test?
Impaired kidney fx or disease. 24 hour measurement of serum/plasma and urine secretion of urea
• Uric acid is the product of _____. • Catabolic metabolites are converted to uric acid in _____. • Uric acid is _____ in plasma. • What happens when there is high quantities of uric acid in plasma?
• Purine catabolism (from nucleic acids, from tissue destruction) • Liver • Insoluble • Dx for gout, hereditary metabolic issues, kidney disease
What happens when uric acid levels build up due to purine catabolism?
• Uric acid precipitates out and forms crystals • Crystals accumulate in joints (and can cause urinary calculi).
Gout is a result of _____ which may be present in _____. High _____ is not diagnostic of gout but ID of _____ is.
A buildup up monosodium ureate crystals, urine Uric acid, monosodium ureate crystals
Hyperuricemia may indicate: • _____ • Tx with cytotoxic drugs • _____ and _____ process • _____ • _____
Hyperuricemia may indicate: • Gout • Tx withcytoxic drugs • Hemolytic and proliferative process • Renal disease • Purine-rich diet
Hypouricemia may indicate • _____ disease • Overtreatment of _____
Hypouricemia may indicate • Liver disease • Over treatment of allopurinol (Drug used to treat gout and kidney stones caused by uric acid)
What is the Caraway method used for? What enzyme is used for this test? Why would an MT not want to use the Caraway method?
Uric acid testing (oxidation of uric acid) Uricase Lacks specificity.
_____ is used to asses liver function. This is found in _____ concentrations in the liver.
Ammonia (Deamination and conversion converts ammonia to urea) Low
_____ can lead to increased ammonia levels. What can lead us to rule out liver involvement?
Enzyme deficiencies Other liver markers are normal.
Liver problems can be the result of ____ or ____. This syndrome primarily affects children under _____. The cause is unknown, but seems to occur following _____ or ingestion of toxins such as _____.
• Enzyme deficiencies • Reye’s syndrome • 18 • Acute viral infections • Salicylate