tRENDGoes in a directiongradually

Shift is circled; notice the dots are all on one side of the mean very suddenly

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Part 1Ch4,5,7,8,9Know shifts and trends Shift a sudden change in data and the meanTrend gradual change in the data an mean

Know the rules for acceptable and unacceptable deviations

Be able to calculate standard deviation

SD=√∑ (x i−x )2

n−1

Be able to calculate CV

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CV (%)= 100 sx (mean)

Supercooling the process of lowering the temperature of a liquid or a gas below its freezing point without it becoming a solid.

test Q#4 I may have copied down wrong :analytical error indicates what when it goes in which direction

systemic error influences observations constantly in one direction (higher or lower) , by measuring slope and y intercept you can estimate systemic error

RANDOM ANALYTICAL ERRRandom error: Error varies from sample to sample.Causes include instrument instability, temperature variations, reagent variation, handling techniques, and operator variables.. Random error is present in all measurements and can be either positive or negative.Random error is calculated as the SD of the points about the regression line (Sy/x). Sy/x

essentially refers to average distance of the data from the regression line (Fig. 4-7). The higher the Sy/x, the wider is the scatter and

Define Specificity proportion without disease who test negative/ruling out disease. Ability of

analytic method to quantitate one analyte in the presence of others in a mixture like sruem

sPecificity the P means start with the negatives

specificity%= T NTN+FP

∨¿of nondiseased peoplewhotest negativenumber of nondiseased people tested

sensitivity proportion of patients with disease who test positive for a test of the disorderseNsitivity the N means start with Positives

sensitivity%= T PTP+FN

∨¿ of ppl with+ test result∧disease¿of totaldiseased peopletested

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Efficiency how good a test is at detection and predicting the presence of disease or physiologic condition

Accuracy closest to actual valuePredictability the predictive value of a test can be expressed as a function of sensitivity, specificity and

disease prevalence

PPV all the positives PPV= TPTP+FP

NPV all negatives NPV= TNTN+FN

Nonparametric methods of normal range determinationParametric tests Gaussian data

Nonparametric analysis is used to analyze data that is abnormal distribution, like a skewed population data for interval studies. Analyze wih percentagesNormal distribution contains

ᶲ ≈68% within ± 1 SDᶲ ≈95% within ± 2 SDᶲ ≈99% within ± 3 SD

pregnancy tests and specificity , improving sensitivityhigh sensitivity= screeninghigh specificity is confirmation by changing cutoff/medical decision limit you determine percet of positive and negative tests

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Notice test cutoff value for + test result is at 5units.

Sensitivity= TPTP+FN

= 88+2

=80 %

Specificity= TNTN+FP

= 77+3

=70 %

New test cutoff is 8units

sensitivity= TPTP+FN

= 44+6

=40 %

specificity= TNTN+FP

= 88+2

=80 %

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be able to calculate sensitivity and specificity see above, be able to calculate each given Tp TN FP FN of a pregnancy test know the pieces of spectrometer eg monochromator

• Components of a Spectrophotometer– Light source (most commonly used is UV)– Monochromators (isolate individual wavelengths of light)– Sample cell (usually square to decrease error)– Photodetectors (converts transmitted energy to electrical energy, most common is a

photomultiplier tube)– A/D (analog to digital converter, converts voltage to digital signals and processed to

produce absorbance readings on a display)formula for calculating the abosorbancy of a solution

ᶲ A = 2 – log %Tᶲ A = a X b X c

o a is absorptivity o b is light patho c is conentration

define different instruments and how they are used in the lab , refer to ppt

4

New test cutoff is 2units , less false negatives= better cut off value

sensitivity= TPTP+FN

= 99+1

=90 %

specificity= TNTN+FP

= 44+6

=40 %

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define immunoassays like FPIA MEIA and RIDRID radial immunodeficiency , immune precipitation method to quantitate protein (Ag)

(immunodiffusion, ouchterloney circles )MEIA solid phase microparticles, with glass fiber matrix support Ag sandwhiched between Ab

and enzyme labeled Ab fluorescence detection and quantitation by interaction of enzyme and substrate.

FPIA fluid phase antigen antibody complexes ,homogeneous immunoassay uzes polarized light to excite the fluorescent label. quantitation Ag-Ab complexes by using tubidimetry(light transmitted) and nephelometry(light scattered) to measure the way it interacts with light

antigen and antibody EPITOPE the antigenic determinant on the Ag, the antigenic site to which an F(ab) can bind

antigen antibody comples and increased affinity stronger the affinity and avidity the greater possibility of cross-reactivity

competitive inhibition enzyme reaction is what?

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Define EIA enzyme immunoassay uses enzyme bound antibody to detect angtigen, substrate produces colorogenic reaction

Why is chemiluminescence better The detection limits are very small , up to 1 zmol and its specificity is the alkaline phosphatase is the most sensitive chemiluminescent assay

Why are EMIT assays different? Think preparation, don’t have to separate first, skip a whole step.Its unique feature is the ability to detect this binding without resorting to a cumbersome separation of the bound component.  This is accomplished by including in the mixture of antibodies and sample an enzyme that is attached to the drug. Antibodies that do not become bound to drug in the sample bind instead to this enzyme-drug "conjugate". The conjugate is designed in such a way that when antibodies bind to its drug portion, the enzyme is deactivated. The more drug there is in the sample, the more of the antibody is bound to it and less is available to deactivate the conjugate. If an enzyme substrate is present that is converted to a colored or fluorescent product, the presence of drug will inhibit the formation of the detectible product to a degree related to the concentration of the drug.

Define southern blot western and northernSouthern DNA extracted from sample, enzymatically digested, separation by

electrophoresis, denatured, transferred to a membrane, and finally probed to produce a band.

Northern same as southern but RNA instead of DNAWestern protein separationELISA direct and indirect tesing for antigen or antibody. Specificity confirmed with Western blot protein separation technique to isolate specific protein you are looking for

Western blot technique used to detect antibodies to specific epitopes of electrophoretically separated substrates of antigens. A technique where electrophoresis of antigenic material yields separation of the antigenic components by molecular weight. Blotting the separated antigen to nitrocellulose retains the electrophoretic position and will have a reaction with specific antibodies, if present, in the different antigenic bands. EIA reactions then detects the antibodies that have been bound to the antigens on the nitrocellulose membrane, the EIA reaction characterizes the antibody specificity. This is done to confirm specificity of antibodies detected by ELISA

EMIT capture method . detects very small concentrations of antigen with multiple epitopes, no separation step

Common polymorphisms seen in genes SNP single nucleiotide polymorphisms

PCR steps

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Competitive immunoassay. The labeled Ag(*) aka ‘tracer’ competes with the same unlabeled Ag to bind to a limited number of binding sites. This is done with known and constant amt of Ab binding sites and Ag* to determine unknown amount of Ag that isn’t labeled. More flouresence = more Ag* to Ag ratio. Low fluorescence= more Ag to Ag* ratio

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denaturing anneling and extentionFISH fluorescent in suitu hybridization technique solution hybridizations performed on cells, tissue or

chromosomes fixed on a slide, allows morphologic viewing of target DNA and specific probePro cons of clinical POC tests

Higher turnaround timeAble to do at bedsideHigher Cost of equipment due to individually run tests and disposable 1 use equipment

POCT LABTurn around time fast turn around time slowerInfrequent calibration Frequent calibrationHigh consumables Low consumablesCost high Cost low

Why is POCT difficult to immpliment in hopspitals primary difficulties in the implementation of POCT in a health care facility is instilling the importance of quality control in nonlaboratorians performing POCT!

Ionized calcium tests for POCT different why?My notes say “are for a different government agency”

What regulations does POCT have to comply with (check?)CLIA regulation , need ClIA licence to level of complexicity

Proficiency testing of POCt is why? Think errors in kitsMonitor quality control, competency of personnel, correct patient identification(barcoded), instrument maintenance.So many users and meters, software used to “control” quality control, use “lock out” method.

What is included in the written procedures for the test systems? Eg critical patient values, procedure, reagents , equipment, interferances

What are waived test in lab and what do they includehematocrit

Where can POCT be used At bedside, physician offices, at home fingerstick, lab

Part2Ch 10,11,12Electrophoresis patterns and commonalities

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normal

Monoclonal increase in gamma regionSharp increase in immunoglobulins

Alpha 1 antitrypsin deficiencyDecrease alpha 1

Nephrotic syndrome , crown, princess nephriti,decrease relative albumin, increase alpha 2 and beta

InflammationIncreased alpha 1 2 and beta

Cirrhosis BETA GAMMA BRIDGE OF CIRROSIS

α1

albumin α2 β

α2βα1

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What are the different fractions see aboveImmunoglobulinsigM Synthesized by

neonate, pentamereigA In secrections, DimerigG Crosses the placenta,

most in bloodigE Allergies increaseigD No one cares

Nephrotic syndrome and what happens at alpha and beta fractionsAlpha 2 and beta increase

Congestive heart failure causes prerenal hyperazotemia , a high level of nitrogen waste in blood, a common form of renal failure caused by decreased blood flow to kidneys

Troponin doesn’t increase with skeletal muscle damage but is specific marker for what?Specifc marker for myocardial damage, gold standard for acure myocardial syndrome

Nitrogen is excreted as what?urea

Enzymes decrease what in in a reaction Activation energy

pancreatic enzymespancreatic amalase and pancreatic lipase

Causes of hemoproteniemia Edema

Nonprotein nitrogen compoundsammonia

What is onciotic pressure and what does it doMaintains colloid osmotic pressure in intravascular fluid and fluid balance in tissue, albumin

Hepatic encephalophathy measured by what concentrationsAmmonia pp277

Amminoacidopathies and charachteristic smellsSweaty feet and isovaleric acidemia

Liver is major organ to produx what enzyme activity in serum acid phosphotase activity liver enzymes are ALT AST ALP GGT

Positive and negative nitrogen balabnce in the body Positive =eating food produces nitrogenNegative nitrogen blance= hypoprotenemia , malnutrition, malabsobrion, or excessive plasma protein loss

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Osmotic force— plasma proteins function in the distribution of water throughout the compartments of the body. Their colloid osmotic force, due to their size, does not allow protein to cross the capillary membranes. As a result, water is absorbed from the tissue into the venous portion of the capillary. When the concentration of plasma proteins is significantly decreased, the concomitant decrease in the plasma colloidal osmotic (oncotic) pressure results in increased levels of interstitial fluid and edema. This is often seen in renal disease when proteinuria results in a decreased plasma protein concentration and swelling of the hands and feet.

Normal

Normal

 

[ ] Fall2012

Define apopenzymeprotein portion of enzyme

Serum lactate dehydrogenase can be elvated in serum during Pernicious anemia, and megaloblastic anemia due to hemolysisi and release of LD in cells

Multiple sclerosis gives what diagnostic bands?oligoclonal bands

Seum BUN increased in what conditionGlomerularnephritis

Lactate dehydrogenase in normal limits during what condition eg acute appendicitis no intravascular hemolysisi

PKU is caused by what amino acid deficiency phenylalanine hydroxylase

Most abundant immunoglobulin in blood igG

Hyperuricemia associated with what conditions gout

Branched chain amino aidsLeucine, isoleucine, valine

Creatinine mainly in skeletal muscle heart and brain, grossly elevated condition is ______

muscular dystropy& fisrt early to rise as a marker for acute myeocardial infarction

ckmm Cardiac marker used to diagnose congestive heart failure

BNPImmunofixation electrophresisi in book→

Top chart is IgA lambda monoclonal bandBottom chart is IgM kappa monoclonal band

Maple syrup urine disease is due to overflow of what aminoacid?

The BCAA leucine, isoleucine, and valine.Lack of branched-chain alpha-ketoacid decarboxylase,

Transferrin deficiency causes heavy metals inAtransferrinemia , absence of transferrin, hemosiderosis / iron deposits in the heart and the liver pp244

LD measurement is interference when? hemolysis

Viral hep has what elelvated enzymes AST ALT

Excreacelular enzyme that is clinicaly measured amylase

Guthrie testBacillus subtilis

HaptoglobinBinds hemoglobin

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Toxic condition high serum urea, cratinein and renal failue uremia

Alkaptinuria black urine

Liver damage due to ethanol determined by measuring what liver enzymeGGT

Breakdown of amino acids producesurea

Highest occurin acute phase reactant protein inhibits proteolysis alpha 1 anti trypsin

Define reactant order kineticsFirst order kinetics where the reaction rate is directly proportional to the substrate concentration. Substrate binds readily to free enzyme at a low substrate concentration. If the amount of enzyme exceeds the amount of substrate, the reaction rate steadily increases as more substrate is added. Maximum reaction velocity is reached when the substrate concentration is high enough to saturate all available enzyme.Zero order kinetics where the reaction rate depends on the enzyme concentration. Where after product is formed the resulting free enzyme immidiatly combines with excess free substrate

Increase alpha 1 fetoprotein in amniotic fluid spina bifida

predicts short term premature birth riskGlycoprotein fibronectin

Dehydration is seen with increased serum Albumin. hyperprotenemia

Cirrosisi electropatternBeta gamma bridge

Metabolism of purine leads to final product of uric acid

Serum urea levels is more affected by diet and metabolism than serum creatine

Glomerular filtration rate estimate what? Creatinine clearance

nonprotien nitrogen compound not synthesized by the liverammonia

Hepatitis is seen whit a normal level of CK

Primary The primary structure refers to amino acid linear sequence of the polypeptide chain. The primary structure is held together by covalent or peptide bonds

Secondary Two main types of secondary structure, the alpha helix and the beta strand or beta sheets, These secondary structures are defined by patterns of hydrogen bonds between the main-chain peptide groups.

Tertiary structure Tertiary structure refers to three-dimensional structure of a single protein molecule. The alpha-helices and beta-sheets are folded into a compact globule. non-specific hydrophobic interactions lock into place specific tertiary interactions, such as salt bridges, hydrogen bonds, and the tight packing of side chains and disulfide bonds.

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Quaternary structure Quaternary structure is the three-dimensional structure of a multi-subunit protein and how the subunits fit together

Tryrosinemia and enzyme decificencieDisorder of tyrosine catabolism, excretion of tyrosine in urine or its metabloites

Protein fractions not produced in the liver gamma globulins

High sensitivity CRP A marker for risk of cardiovascular disease

Isoenzymes clinically significant LD CK alkaline phosphtaseLD and alkaline phosphatase are both elevated in hemolysis due to high concentrations in RBC.

Adenylate kinas pp 293 is an enzyme released from erythrocytes during hemolysisi that can be confused for CK.Hepatic failure will have what abnormal levels of ammonia?

increased ammonia Isoenzyme indicates brain damage

ckbbKidney stones aminoacidopahthy

cystinuriaChemotherapy patients would be seen with what increased levels

Uric acid due to chemotherapys increased cell turnover rate Decreased Serum albumin levels

Can reflect malabsorbtion or malnutrition levels of the patient AA, nonessential & most abundant?

Glutamine pp227 Ammonia testing

Special procedure for ammonia, whole blood ammonia increased after collection so must place on ice immidiatly following collection in heparin or edta tube. Spin down within 20 minutes of collection at 0-4degrees and assay ASAP if not freeze the sample

Decreased ceruloplasmin in serum indicates less able to transport copper will lead up to copper buildup in tissues also known as _______ and may have _________

wilsons and kayser-fleisher ringsFibrinogen is where

not in serum in plasmaPart3 13.14.15

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Familial hypercholesterolemia is A disease where heterozygous have ½ LDL receptors on cells so LDL isn’t able to enter the cell and leads to buildup of LDL in abnormally high levels in the plasma elevated LDL pp335

A patient with a 2hr post prandial glucose of 220 and serum insulin 15Would be diagnosed as NIDDM non insulin depedenent diabeites mellitis

Hyperkalemia is seen in whatpaient condiions?is not seen in vomiting and diarrhea, seen in acute renal failure, intravascular hemolysis, and oral potassium replacement therapy

Higher risk of coronary hear t disease is seen wih wha liporoein levels? decreased hdl and increased total cholesterol (because of increased LDL)

What is the main contributor to serum osmolalitySodium contributes most to total serum osmolality

The Glucose of a normal person will be at what comparable levels for the 2hour post prandial test and the fasting glucose test ?

equal levels during a 2hr post prandial and a fasting glucose test due to a normal pesons blood sugar should be at fasting levels 2hours afte eating

True or False? an Indicaor of the severity of CO2 deprivation is excess lactate FalseIs Increased lactate is acidic??

Which reducing sugar is associated with accumulation in the plasma due to a genetic deficiency in carbohydrate metabolism?

Redux sugar galactose accumulated of due to genetic deficiency in carb metabolism , galactosemia pp321 , increased levels in the plasma, and glactose accumulation in the blood. most common deficiencygalactose-1-phosphate uridyl transferase. And can be ID by measureing erythrocyte galactose-1-phosphate uridyltransferase activity

Respiratory acidosis is compensated with? plasma bicarbonate , think bicarbonate is synthesized by the Kidneys in compensation to acidosis

If total cholesterol is 400 triglycerides is 300 HDL 100 calculate LDL

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LDL=TotalCholesterol−HDL−Triglycerides5

LDL=400−300−Triglycerides not given5

Look at the patients Total Cholesterol, it is very out of range. Answer is LDL increases Calculate anion gap without potassiumSodium 150PoassiumIrrelevant

5

Chloride 110Bicarbonate 30

Aniongap withK=¿Aniongap without K=¿Aniongap without K=[ 150 ]−( [110 ]+ [30 ])=10What hormone inhibits glycolysis and glucose uptake by the muscle cells and raises blood glucose concentration?

Growth hormone a pituitary hmone that promotes increased plasma glucose by decreasing the entry of glucose ino cells (inhibits glucose uptake by cells) and increases glycolsis

True or False? Alkalosisi is caused by hyperkalemia?Hyperkalemia NOT caused by alkalosisiHyperKalemia can be caused by hypoaldosterone, hemolysis,or acute renal failure

What is the main extracellular cation

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sodiumIn the Reverse cholesterol transport pathway the primary apoproein is what ? what is it doing?

HDL removes cholesterolWhat fatty acid is not associated with increased LDL-cholesterol

Monosaturated-cis-fatty acidsHypernatremia commonly seen with

Excess sweating and no water replacementWater leaves the cell and sodium follows

What is the most important buffer in plasma?Bircarbonic and carbonic acid

HDL gathers excess cholesterol and transports back to where?

LiverA A1c panel on he red blood cells can be falsely reported due to a decreased patient ________

Rbc lilfe span A1C is assumed to be an assessment of normal RBC and glucose over a 3mo period due to 120 assumed in circulation

Review definitions

Which lipoprotein is transports 60-75% of the plasma cholesterol?LDL is the major lipoprotein responsisble for the delivery of exogenous cholesterol to peripeal cells b/c efficien LL recepors on cell membrane pp335

Premature sign of arteriosclerosis can be indicated by increased values of what?Elevated LDL is associated with premature arteriosclerosis due to its promotion of plaque formaion

Preferred screening for diabetic and nonpregnant person is? a fasting plasma glucose

If a Potassium level of 6.8 is seen in the patientserum, what would you do before reporting out ? (Normal K serum is 3.5-5.1mmol/L pp4.28

check first for hemolysisTrue or false? A Patient with lactic acidosis with have increased anionic gap→

trueGiven A Total cholesterol 400, HDL 100 and Triglycerides of300 calculate the LDL

LDL=400−100−3005

=240 LDL

Calcium concentration regulated by? Parathyroid hormone in serum could be calciums affect on parathyroid hormone

PTH regulated Ca levels pp374 , PTH promotes abosorbtion of Calcium at the kidney and stimulates ca relaes into seuma t the BM. Decreased serum levels of ionized free calcium

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stimulates PTH production which works to increase Calcium levels by breaking down bone or retaining more Calcium at the renal system

A Patient is seen with a Fasting glucose 130 1hr 225, and 2hrpost prandial 205 What is the idagnosisi? diabeties

What is a Major intacellular cation(think hemolysis)Potassium

Chief electrolyte to maintain osmotic pressure sodium

what is the preferred glucose reference method?Hexokinase reaction due to less interference pp323

Unseparated glucose and levels of glucose decreasedVitamin D deficiency would do what to phosphate?

inorganic phosphate levels declineto determine a diabetic patients glucose control over 2 months what test would you run? glucoslysated hemoglobin a1cChylomychrons true statements

largest, least dense , float up and form creamy layer, produced by intestine. Deliver dietary lipids to hepatic and peripheral cells APO B48

Type1 diabetes is associated with what conditions?Ketoacidosis beta cells and inappropriate hyper glycemia

Type2Hyperglycemia as a result of insulin resistance with an insulin secretory defect

A Hyperglucemic patient is seen with what type of specific gravity in urine and urine osmolality and levels of serum and urine glucose?

Elevated SG osmolality and serum and urine glucose

True False Hypokaliemia caused by acidosisFalse hyperkalemia is caused by acidosis

Define osmolalityConcentration of solutes of a solution mmol/Kg

SIADH syndrome of inappropriate antidiuretic hormone low plasma osmolality and low serum NA. SIADH is seen with hyponatreima decreased sodium

For glucose determinations which tube would you use? sodium fluoride

Chloride is maJor what

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Extracellular anionLipemic specimen is being tested for total cholesterol what would you do ?

dilute and report using friend equation if total cholesterol is too muchChylomychrons make the sample

milkySerum tryglyceride estimate

Vldlcystic fibrosis is done with a

sweat testTrue or false? A decreased serum potassium will be observed in a blood sample allwed to sit and clot

False Hemolyzed sample and ion levels of the sample compared to non hemolyzed

Increased KAn OGTT on a nonpregnant plasma glucose

Fasting& 2hour Normal <140, prediabeties 140-200, diabties >200

Serum irion calcium is measured withIon selective electrode

The majority of CO2 present in blood is in the form of bicarbonate

Anion gap QC for lab Na K Cl CO2 total

Hemolyzed sample electrode that is increasedpotassium

Disease from familial absence of high lipoproteinTangier disease is hypoalphalipoproeinemia pp344

Glucose oxidase reaction is most specific for beta d glucose

Insulin Makes glucose enter the cell and depletes extracellular blood sugar

A significant increase of Lp(a) in plasma marks for what?CHD

Define type 2 diabeties Insulin resistant ,polydipsia polyphagia

Which lipoprotein has the most protein %HDL most with protein

VLDL transports endogenos triglycerides

Buffering capacity of the blood is severly limited by the reverse exchange process between bicarbonate and hyper glycemic factor produced by the pancrease

Hyperparathyroidism is seen with increased calcium and increased ph

dehydration will have Plasma concentration and distribution to the tissue withincreased osmolal of 400

Decreased risk of coronary artery disease is apo A1

Carries ccholesterol to peripheral tissue is LDL

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Part4 16.17Which of the following elements can be measured usoing spectrophotometry methods?

IronMajority of iron in whole blood is bound to ?

HemoglobinPatient with iron overload has what levels?

Serum iron Transferrin TIBC %sat FerritinIron deficient ↓ ↑ ↑ ↓ ↓Iron overload ↑ ↓ ↓ ↑ ↑

Hendersson haselbach equation Respiratory acidosisi Basophilic stippling, anorexia, and low hemoglobin indicate what

IeadWhy combine liqud chromatography and ICP-MS

to separate different arsenic Blood PH and calculationsHyperventilation gets rid of acid to compensate for metabolic acidosis or extreme bicarb lossHypoventilation compensates for metabolic alkalosis . hypoventilation casues holing in of CO2 increases acididty , a respiratory mechanismCalculate serum pHpH=pK+ logcHCO3− ¿

.0307 XPCO2¿

Low serum copper and increased urine copper indicates what?

Wilsons diseaseWhat are trace elements mostly measured with?

ICPMSEssential and nonessential trace elements ??

cadmium non essentialessential trace iron copper zincnonessential trace: selenium, chromium, manganese

Compensation kidneys compensate for the lungs and vice versa

NL values in uncompensated metabolic acidosis would be? CO2

In which condition would hypochloremia be expected hypercholremia may occur when increase in HCO3-, hyperchloremia occurs at excessive losss of Cl- Pp367 Chloride shift leads to metabolic alkalosisi

An acidic ph is seen with low O2 percent and saturation, and a high PCO2 and normal HCO3-Emphysema seen with low oxygen and high co2

Bicarbonate to carbonic acid ratio is for Henderson hasselbach equation20:1

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Transferrin transports and iron and is decreased iniron deficienc

Early morning blood test for serum irson and TIBC due to diphasic urine cyclic

A low pH, increased glucose and presence of ketones Diabetic keto acidosis, patient should be metabolic acidosis

2x in smokerscadmium

3 techniques for analysis fo stuffAAS ICP-MS AES

Define cofactoris a non-protein chemical compound that is bound to a protein and is required for the protein's biological activity

Manganese chronic toxicity resemblesparkinsons

Menkes copper deficiency

Lead is measured in Whole venous blood

hyperventilationbreathing too fast, getting rid of CO2 acid or compensating for high acidity due to less bicarb sectretion by kindeys, or over loss of bicarbonate in kidneys due to improper filtrationReference range for arterial blod pH

Arterial circulation VeinPO2 90mmHg 40mmhgPCO2 40mmHg 46mmhgpH 7.40 7.35

True False?Hypoventilation causes Partially compensated respiratory alkalosis

FalseSolubility coefficient of carbon dioxide in plasma

.0307Metabolic acidosis can be caused by

severe diaharreaAnxiety crazy breathing can cause

respiratory alkaloisHyperkeratosisi and stomatis are symtoms of what trace elemtn poisoning?

Arsenic ppt slide 8Trace element deficiency causes acrodermatitias and enteropathica

zinc ppt slide44is increased in iron overload and and binds and stores iron

FerritinWhat would the PCO2 value be represented as in MAXIMALLY compensated metabolic acidosis? Choices: 60, 45, 35,15

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PCO2 would be seen in maximally compensated metabolic acidosis as 15mmhg!!! Due to extreme loss of bicarbonate by kidneys, body tries to reduce acid as much as it can to match the lowered base Bicarbonate deficiency = metabolic acidosisi

Dermatititis sklin disorder and eczema Chromium

Toxcicity can dcrease IQ and development lead

Buffer causes changes of fluctuations in ph and co2Bicarbonate buffer

Which iron is measured with an immunoassay Ferritin is the option no the test, can also be transferrin. Ppt slide35 book pp417

Oxygen contamination of a sampleOxygen contaminates a blood gas sample, the O would falsely increase Co2 would decrease

Wilsons disease treatmentWith zinc due to competitive uptake ,and Wilson is overload of copper

True or False:Base excess can be something about positive and negative blood proteinstrue

Chronic renal falureAcidosis

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