REVIEW QUESTIONS FOR CC2 PRELIMS

I. IDENTIFICATION: ( 1 pt. Each)

1. The major intracellular cation.
2. The major extracellular cation..
3. In automation, this is the method of removing interfering substances.
4. This automated aspect corresponds to sample delivery in the manual method.
5. The normal pH of blood.
6. The most common method for electrolyte determination.
7. The major intracellular anion.
8. The major extracellular anion.
9. The heart of the centrifugal analyzer in automation..
10. The layer in dry slide technology that removes interfering substances.

Indicate ≤ if decreased, and ≥ if increased, and N if normal .

Substance or
Condition Na Cl K Ca Mg I.P.

Fever 11 12 13 14 15 16
Diarrhea 17 18 19 20 21 22
Osteoarthritis 23 24 25 26 27 28
ketoacidosis 29 30 31 32 33 34
heart failure 35 36 37 38 39 40

NORMAL VALUES OF THE FOLLOWING SUBSTANCES

II. GIVE THE NORMAL VALUES OF THE FOLLOWING SUBSTANCES:

Most Normal Values are method dependent. Here are normal values adapted for common methods:

1. BILIRUBIN - TB - up to 2 mg/dL
2. GLUCOSE - 60 -110 mg/dL
3. BLOOD URIC ACID - M: 3-7 mg/dL, F: 2-6 mg/dL
4. BLOOD UREA NITROGEN - 9-18 mg/dL
5. TRIGLYCERIDE - less than 2 mmol/L or less than 150 mg/dL
6. CHOLESTEROL - less than 250 mg/dL
7. ALBUMIN - 3.2-5.5 g/L
8. GLOBULIN - less than 2 g/L
9. TOTAL PROTEIN - 5.5 - 8.5 g/L
10. A/G RATIO - 1.5-3:1
11. CREATININE - 0.5 - 1.5 mg/dL
12. FIBRINOGEN - 200-400 mg/dL

As mentioned above, normal values for other tests would vary.

Answers to Identification

1. The first semi-automated apparatus in clinical chemistry. - autotechnicon
2. The supernatant fluid when clotted blood has been centrifuged.-serum
3. The supernatant fluid when unclotted blood has been centrifuged.-plasma
4. A process wherein a needle is introduced into a vein to obtain blood.-phlebotomy
5. The simplest form of lipid.- fatty acids
6. Major function of the kidneys.- excretion
7. It is the confidence limits in QC.- +- 2 SD
8. The conversion factor for glucose.- 0.0555
9. The normal pH of serum.- 7.35-7.45
10. The good cholesterol.- HDL (High Density Lipoprotein)

REVIEW QUESTIONS FOR CC1 FINAL EXAMS

I. IDENTIFICATION: ( 1 PT. EACH)

1. The first semi-automated apparatus in clinical chemistry.
2. The supernatant fluid when clotted blood has been centrifuged.
3. The supernatant fluid when unclotted blood has been centrifuged.
4. A process wherein a needle is introduced into a vein to obtain blood.
5. The simplest form of lipid.
6. Major function of the kidneys.
7. It is the confidence limits in QC.
8. The conversion factor for glucose.
9. The normal pH of serum.
10. The good cholesterol.


II. GIVE THE NORMAL VALUES OF THE FOLLOWING SUBSTANCES:

1. BILIRUBIN
2. GLUCOSE
3. BLOOD URIC ACID
4. BLOOD UREA NITROGEN
5. TRIGLYCERIDE
6. CHOLESTEROL
7. ALBUMIN
8. GLOBULIN
9. TOTAL PROTEIN
10. A/G RATIO
11. CREATININE
12. FIBRINOGEN


III. PROBLEM SOLVING :

1. WRITE DOWN THE FORMULA .
2. SHOW COMPUTATIONS.
3. ENCLOSE ANSWERS IN BOXES.

1. What is the Normality of a 10 % NaCl solution? ( 5 pts.)
2. What is the Molarity of a 2 N H2SO4 solution? ( 5 pts.)
3. What is the dilution if you add o.50 ml of serum to 6.5 ml of diluent?(6pts.)
4. How would you prepare 1:10 serum dilution? ( 5 pts.)
5. How would you prepare a 0.85 % NaCl solution? (5 pts.)

6. Construct a Levey-Jennings chart based on the following data:
(use a graphing paper) ( 5 pts.)

Control values standard values unknown values

Day 1 3.2 mmol/L 5.4 mmol/L 6.7 mmol/L
Day 2 4.5 mmol/L 2.6 mmol/L 4.2 mmol/L
Day 3 4.0 mmol/L 5.0 mmol/L 3.8 mmol/L
Day 4 3.0 mmol/L 3.5 mmol/L 5.0 mmol/L
Day 5 4.2 mmol/L 2.5 mmol/L 6.7 mmol/L
Day 6 3.5 mmol/L 5.5 mmol/L 5.5 mmol/L
Day 7 4.5 mmol/L 6.0 mmol/L 5.2 mmol/L
Day 8 4.1 mmol/L 5.5 mmol/L 6.7 mmol/L
Day 9 4.3 mmol/L 3.6 mmol/L 5.4 mmol/L
Day 10 3.0 mmol/L 5.2 mmol/L 4.6 mmol/L
Day 11 4.1mmol/L 4.4 mmol/L 2.7 mmol/L
Day 12 6.5 mmol/L 2.6 mmol/L 5.2 mmol/L
Day 13 4.0 mmol/L 5.0 mmol/L 4.8 mmol/L
Day 14 2.8 mmol/L 5.5 mmol/L 5.0 mmol/L
Day 15 4.2 mmol/L 2.5 mmol/L 7.7 mmol/L
Day 16 5.5 mmol/L 5.5 mmol/L 2.5 mmol/L
Day 17 7.5 mmol/L 7.0 mmol/L 3.2 mmol/L
Day 18 3.1 mmol/L 5.5 mmol/L 2.7 mmol/L
Day 19 4.3 mmol/L 4.6 mmol/L 5.4 mmol/L
Day 20 5.2 mmol/L 5.2 mmol/L 3.6 mmol/L


Based on the constructed CHART: ( 5 pts.)

1. Determine if the control values are “in control” or “out of control”
2. Are there any Westgard Rules violated? If there are, encircle with red ink the violations.
3. If there are violations, Identify whether “trend” or “shift”.
4.What appropriate measures could be adapted to correct the error?

Questions on Clinical Toxicology

I. IDENTIFICATION/FILL IN THE BLANKS: ( 1 PT. EACH)

1.__________________________________________ The major excretory organ responsible for drug excretion.

2.__________________________________________The major metabolic organ which converts drugs to their metabolites.

3.__________________________________________ Give one substance that could cause an irreversible damage to the liver.

4.__________________________________________Major carrier protein of almost all drugs in the body.

5.__________________________________________The normal pH of blood.

6.__________________________________________The less toxic metabolite of ethanol, which is produced by the liver.

7.__________________________________________ Give one specific example of a natural poison.

8.__________________________________________ Give the species of poppy that is toxic to man.

9.__________________________________________ It is the term used to describe the reaction and metabolism of the drug inside the body..

10._________________________________________It is the time required for the concentration of a drug to go down to half of its original concentration.

TRANSCRIPTION

TRANSCRIBE THE FOLLOWING:

1. SGOT
2. DTL
3. SGPT
4. ACS
5. NPO
6. FBS
7. wl
8. nm
9. A
10. mg/dL
11. mEq/L
12. stat
13. % T
14. Cu
15. Cs
16. As
17. Au
18. TAG
19. OGTT
20. IGTT

Answers will be posted next week.

Diagnostic Exams- Identification with Answers

I. IDENTIFICATION: ( 1 PT. EACH)

1. He was responsible for the manufacture of the first autoanalyzer.
Dr. Leonard Skeggs

2. Term for the person who performs phlebotomy.
Phlebotomist, venipuncturist

3. Traditional expression of concentration of substances.
milligrams per deciliter

4. A process wherein a needle is introduced into a vein to obtain blood.
phlebotomy, venipuncture

5. The simplest form of carbohydrate.
monosaccharide

6. Formation of stones in the kidneys.
nephrolithiasis

7. It is the percentile expression of the standard deviation over the mean.
Coeffecient of Variation

8. The reference method for glucose.
Hexokinase

9. The normal pH of blood.
7.35 70 7.45

10. The stabilizing protein in serum.
Albumin

Transcription answers

Transcribe the Following:

1. GH - Growth Hormone
2. LH - Luteinizing hormone
3. TSH - Thyroid Stimulating Hormone
4, TRH - Thyroid Releasing Hormone
5. FSH - Follicle Stimulating Hormone
6. PRL - Prolcatin
7. HCG - Human Chorionic Gonadotropic Hormone
8. HSTT - Human Sommatomammotropin
9. GnRH - Gonadal Releasing Hormone
10. CRF = Cortisol Releasing Factor
11. GHIH - Growth Hormone Inhibitory Hormone
12. T3 - Triiodothyronine
13. T4 - Thyroxine, Tetraiodothyronine
14. ADH - Anit-diuretic Hormone
15. TBG - Thyroxine Binding Globulin
16. TBPA - Thyroxine Binding Pre-Albumin
17. RIA - Radioimmunoassay
18. ELISA - Enzyme-linked Immunoassay
19. EMIT - Enzyme Multiplied Immunoassay Technique
20. CBG - Cortisol Binging Globulin

CC 3 DIAGNOSTIC EXAMS

Clinical Chemistry 3 - Diagnostic Tests

MULTIPLE CHOICE

1. The pH of normal arterial blood.

a.	7.25-7.45	c.	7.45-7.55
b.	7.35-7.45	d.	7.15-5.25

ANS: B PTS: 1

2. What is the stabilizing protein?

a.	globulin	c.	fibrinogen
b.	albumin	d.	all of the listed

ANS: B PTS: 1

3. The reference method for glucose is:

a.	hexokinase	c.	neocuproine
b.	nelson somogyi	d.	orthotoluidine

ANS: A PTS: 1

4. What is the law empoyed in spectrophotometry?

a.	Beer-Lambert’s Law	c.	Avogrado’s Principles
b.	Boyle’s Law	d.	Einstein’s Law

ANS: A PTS: 1

5. What is the normal ratio of carbonic acid to bicarbonate?

a.	1:10	c.	20:1
b.	10:1	d.	1:20

ANS: C PTS: 1

6. The type of bilirubin found in urine.

a.	direct	c.	total
b.	indirect	d.	all in the list

ANS: A PTS: 1

7. Conversion factor of bilirubin.

a.	83.5	c.	17.1
b.	2.34	d.	0.0555

ANS: C PTS: 1

8. The reference method for bilirubin determination.

a.	Evelyn and Malloy	c.	Jendrassik and Grof
b.	Diazotization	d.	Jaffe

ANS: C PTS: 1

9. All of the following are methods for acid phosphatase determination , EXCEPT:

a.	Bodansky	c.	King Armstrong
b.	Bessey Lowrey Brock	d.	Reitman and Frankel

ANS: D PTS: 1

10. The following should be observed in BGA determination, EXCEPT:

a.	collection should be anaerobic	c.	allow sample to stand at RT for 15’
b.	if not tested stat, preserve in ice	d.	Use dry heparin as AC

ANS: C PTS: 1

11. The following are observed in venipuncture, EXCEPT:

a.	ideal angle is 15-30 degrees	c.	puncture deliberately but smoothly
b.	circular sterilization should be done	d.	remove the needle before the tourniquet

ANS: D PTS: 1

12. The following are observed in triglyceride determination, EXCEPT:

a.	avoid cigarette	c.	avoid strenuous exercise
b.	8 hr - fasting	d.	avoid alcohol

ANS: B PTS: 1

13. The following are considered as pacreatic enzymes:

a.	AMS and LPS	c.	ALT and AST
b.	ACP and ALP	d.	LDH and CPK

ANS: A PTS: 1

14. The following are considered as liver enzymes:

a.	ALP	c.	CPK
b.	GGT	d.	ALT

ANS: C PTS: 1

15. The normal value for glucose:

a.	50-110 mg/dL	c.	60- 130 mg/dL
b.	80-130 mg/dL	d.	50-100 mg/dL

ANS: A PTS: 1

MATCHING

Match the reagent with the substance tested

a.	alkaline picrate	e.	double iodide of potassium and mercury
b.	orthotoluidine	f.	thymolphthalein monophosphate
c.	diazotized sulfanilic acid	g.	uranyl acetate
d.	phosphotungstic acid	h.	peroxidase

1. triglyceride

2. creatinine

3. sodium

4. uric acid

5. glucose

6. urea nitrogen

7. bilirubin

8. acid phosphatase

Review Questions for Endocrinology and Toxicology

DISCUSS BRIEFLY BUT CONCISELY THE FOLLOWING TOPICS:

1. HORMONES
2. FUNCTIONS OF HORMONES
3. ENDOCRINE GLANDS
4. HORMONES SECRETED BY THESE GLANDS
5. CLINICAL SIGNIFICANCE
6. DIVISIONS OF TOXICOLOGY
7. THERAPEUTIC DRUG MONITORING
8. HALF-LIFE
9. STEADY STATE
10. TOXICODYNAMICS/TOXICOKINETICS

ANSWERS TO THE PREVIOUS QUESTIONS on CLINICAL TOXICOLOGY

1._____ KIDNEYS____________________________ The major excretory organ responsible for drug excretion.

2._____ LIVER______________________________The major metabolic organ which converts drugs to their metabolites.
3._____ ALCOHOL___________________________ Give one substance that could cause an irreversible damage to the liver.
4.______ALBUMIN___________________________Major carrier protein of almost all drugs in the body.
5.______7.35-7.45____________________________The normal pH of blood.
6.______ACETALDEHYDE______________________The less toxic metabolite of ethanol, which is produced by the liver.
7.______SNAKE VENOM_______________________ Give one specific example of a natural poison.
8.______PAPAVER____________________________ Give the species of poppy that is toxic to man.
9.______TOXICODYNAMICS____________________ It is the term used to describe the reaction and metabolism of the drug inside the body..
10._____HALF-LIFE___________________________It is the time required for the concentration of a drug to go down to half of its original concentration.

Clinical Toxicology Questions

I. IDENTIFICATION/FILL IN THE BLANKS: ( 1 PT. EACH)

1.__________________________________________ The major excretory organ responsible for drug excretion.

2.__________________________________________The major metabolic organ which converts drugs to their metabolites.
3.__________________________________________ Give one substance that could cause an irreversible damage to the liver.
4.__________________________________________Major carrier protein of almost all drugs in the body.
5.__________________________________________The normal pH of blood.
6.__________________________________________The less toxic metabolite of ethanol, which is produced by the liver.
7.__________________________________________ Give one specific example of a natural poison.
8.__________________________________________ Give the species of poppy that is toxic to man.
9.__________________________________________ It is the term used to describe the reaction and metabolism of the drug inside the body..
10._________________________________________It is the time required for the concentration of a drug to go down to half of its original concentration.

Clinical Toxicology (Toxicodynamics and Toxicokinetics) Quiz

I. IDENTIFICATION:

1. & 2 ____________________________Identify the two roles of the target molecule.
2. _______________________________
3. _______________________________It is called tissue involution or internal elimination of dead cells.
4. ______________________________ This particular drug of abuse increases release and diminish uptake of norepinephrine, serotonin and dopamine.
5. ______________________________ Transcribe DDT.
6. ______________________________ The term used to denote the cell or tissue that the drug has to act on.
7. ______________________________ Transcribe GABA.
8. ______________________________ This decreases hydrolysis of acetylcholine.
9. & 10______________________________ These type of drugs produce inhibitory
effect on the muscarinic receptors (M2 and M3). __________________________
11. ______________________________ They act on voltage-gated Na+ channels.
12. _______________________________Transcribe NMDA.
13. _______________________________Transcribe ATP
14. _______________________________ Transcribe ADP
15. _______________________________ Transcribe ECT.

CHOICES FOR 16- 25

A. DYSREGULATION OF GENE EXPRESSION
B. DYSREGULATION OF ONGOING CELLULAR FUNCTION
C. CELLULAR MAINTENANCE DYSFUNCTION
D. EXTERNAL MAINTENANCE DYSFUNCTION

16. Inappropriate cell function
17. Impaired ATP synthesis
18. Impaired Calcium regulation
19. Inappropriate protein synthesis
20. Impaired function of integrated systems
21. Impaired microtubular function
22. Inappropriate muscular activity
23. Inappropriate neuromuscular activity
24. Cell injury and death
25. Impaired membrane function

TRUE OR FALSE: IN THE FIRST BLANK, WRITE WHETHER TRUE OR FALSE, IF FALSE UNDERLINETHE WORD/S THAT MAKE/S IT FALSE AND WRITE THE CORRECT WORD IN THE SECOND BLANK.

1. _______ ________ Toxicodynamics involve toxicities interfering with cells specialized to provide support to other cells, tissues or whole organism.
2. _______ ________Repair involves only the internal cellular structure.
3. _______ ________ Alcohol converted to toxic metabolite produces direct injury .
4. _______ ________Alcohol stimulates GABA receptor and inhibits NMDA receptor
5. _______ ________Chronic intake of ethanol causes necrosis, cirrhosis, cancer of the lungs.
6. _______ ________Arsenic and mercury cause disrepair of the cells.

ESSAY: DISCUSS CONCISELY THE FOLLOWING.

1. DISCUSS THE POTENTIAL STAGES IN THE DEVELOPMENT OF TOXICITY.( 10 PTS.)

2. WHAT IS THE SIGNIFICANCE OF TOXICODYNAMICS? ( 10 PTS.)