AAB MT CHEMISTRY STUDY GUIDE (VERIFIED 2023/2024)

AAB MT CHEMISTRY STUDY GUIDE (VERIFIED 2023/2024) Which of the four elements in proteins differentiates this class of substances from carbohydrates and lipids? - CORRECT ANSWER-Nitrogen Which of the proteins is soluble in water? - CORRECT ANSWER-Albumin How are amino acids joined together to form a chainlike structure? - CORRECT ANSWER-Peptide bonding Amino acid sequence of a protein represent which level of protein structure? - CORRECT ANSWER-Primary structure The alpha helix and beta pleated sheet represent which level of protein structure? - CORRECT ANSWER-Secondary structure The 3D structure of a protein represent which level of protein structure? - CORRECT ANSWER-Tertiary structure 2 or more polypeptide chains represent which level of protein structure? - CORRECT ANSWER-Quaternary structure Protein classification that contains peptide chains only - CORRECT ANSWER-Simple proteins Protein classification that contains a protein and a prosthetic group (Lipoproteins, Glycoproteins, Mucoproteins, Nucleoproteins) - CORRECT ANSWER-Conjugated proteins Protein classification for proteins that come off of an electrophoreisis - CORRECT ANSWER-Plasma proteins Proteins may become denatured when subjected to mechanical agitation, heat, or chemical treatment. What does denaturation of proteins refer to? - CORRECT ANSWER-Alteration in tertiary structure How many immunoglobulin classes are currently recognized? What are the immunoglobulins? - CORRECT ANSWER-5 - IgG - IgA - IgM - IgE - IgD Glycoproteins and Mucoproteins are usually bound to which substance? - CORRECT ANSWER-Carbohydrates Which reagent is employed in the serum protein determination? This is the most common method used for measurement of total proteins - CORRECT ANSWER-Biuret What are the different ways measure total proteins - CORRECT ANSWER-- Kjeldahl - Refractometry - Biuret - Dye binding The measurement of nitrogen content in total proteins - CORRECT ANSWER-Kjeldahl The measurement of refractive index for total proteins - CORRECT ANSWERRefractometry Different dyes used in the dye binding method for measurement of total proteins - CORRECT ANSWER-- Bromphenol blue - Ponceau S - Amido black - Coomassie brilliant blue Largest fraction of proteins and first peak that comes off of the electrophoresis. - CORRECT ANSWER-Albumin Why should hemolyzed serum not be used for total protein analysis? - CORRECT ANSWER-Hemoglobin is absorbed at the same wavelength as protein in the reagent What is NOT true of the biuret reactions? A.) Follows beer's law for a reasonable range of protein B.) Depends on the presence of at least 2 peptide linkages C.) Is insensitive to the low protein levels of urine D.) Is relatively free from interference by lipids and hemoglobin - CORRECT ANSWERD Why is bromcresol purple the preferred indicator for albumin dye binding techniques? - CORRECT ANSWER-There is less interference from pigment(s) What protein has this function: Maintenance of osmotic pressure of the intravascular fluid also binds and transports a large number of compounds - CORRECT ANSWERAlbumin Calculation of total globulins - CORRECT ANSWER-- Total protein - Albumin = total globulins - A/G ratio Direct measurement of total globulins - CORRECT ANSWER-Colorimetry The total protein is 7.1 g/dL. The serum protein results are: Albumin 53.0% 3.8 g/dL Alpha1 3.6% 0.3 g/dL Alpha2 11.0% 0.8 g/dL Beta 17.6% 1.2 g/dL Gamma 14.8% 1.1 g/dL What is the A/G ratio? - CORRECT ANSWER-A/G ratio = Albumin%/ Total globulin% 53%/47% = 1.1 What is the most anodic protein on electrophoresis at pH 8.6? - CORRECT ANSWERAlbumin Serum protein electrophoresis At pH 8.6, all proteins carry a net __ charge. The anions migrate toward the __. Dyes included to stain the proteins and a __ is used for quantification. __ migrates fastest to the anode. - CORRECT ANSWER-- Negative - Anode - Scanning densitometer - Albumin A serum protein electrophoresis pattern displaying a High alpha 2 is seen in which disease state? - CORRECT ANSWER-Acute inflammation A serum protein electrophoresis pattern displaying a High Alpha 2/Gamma Ratio & low albumin is seen in which disease state? - CORRECT ANSWER-Nephrotic syndrome A serum protein electrophoresis pattern displaying a High alpha 1 & 2 and Low albumin is seen in which disease state? - CORRECT ANSWER-Malignant tumor A serum protein electrophoresis pattern displaying a High gamma and Low albumin is seen in which disease state? - CORRECT ANSWER-Viral hepatitis A serum protein electrophoresis pattern displaying high gamma is seen in which disease state? - CORRECT ANSWER-Monoclonal gammopathy (Multiple myeloma/waldenstroms) A serum protein electrophoresis pattern displaying a beta gamma bridge or broad gamma is seen in which disease state? - CORRECT ANSWER-Active cirrhosis (liver) If an electrophoretic pattern shows 30% albumin, 4%-10% alpha-globulin, 4%-10% beta-globulin, and 45% gamma globulin, then what condition may exist in the patient? - CORRECT ANSWER-Monoclonal gammopathy (Multiple myeloma/waldenstroms) What are the plasma proteins? - CORRECT ANSWER-- Albumin - Alpha 1-globulin - Alpha 2-globulin - Beta-globulin - Gamma-globulin What are the Alpha 2 globulins - CORRECT ANSWER-- Haptoglobin - Ceruloplasmin - Alpha-2 Macroglobulin What are the Alpha 1 globulins - CORRECT ANSWER-- Alpha 1-Antitrypsin - Alpha 1-Glycoprotein - Alpha-Fetoprotein - Alpha-Lipoprotein What are the Beta-globulins? - CORRECT ANSWER-- Beta 2-Microglobulin - Plasminogen/Fibrinogen - Angiotstatin - Properdin - Transferrin - Hemopexin - Beta lipoprotein - Complement - C-reactive protein Decreased haptoglobin clinical significance - CORRECT ANSWER-- Hemolytic anemias - Hemolytic transfusion reactions - Hemolytic disease of the newborn Decreased Albumin clinical signifigance - CORRECT ANSWER-- Malnutrition - Liver disease - Nephrotic syndrome (kidney diseases) Increased Albumin clinical signifigance - CORRECT ANSWER-Dehydration Decreased ceruloplasmin clinical signifigance - CORRECT ANSWER-- Wilsons disease - Menkes syndrome - Severe liver disease Copper containing protein that has peroxidase activity/breaks down H2O2; product of O2 respiration - CORRECT ANSWER-Ceruloplasmin Protein that inhibits trypsin, pepsin, and plasmin - CORRECT ANSWER-Alpha 2- Macroglobulin Clinical significance of increased Alpha 2-Macroglobulin - CORRECT ANSWER-- Nephrotic syndrome (kidney diseases) - Pregnancy Which beta globulin is a marker of inflammation; indicator of oncoming CHD? - CORRECT ANSWER-C-reactive protien Which beta globulin is a tumor marker for blood cell cancers? - CORRECT ANSWERBeta 2-Microglobulin Which beta globulin transports cholesterol in the blood? - CORRECT ANSWER-Betalipoprotein Which beta globulin transports iron and prevents loss of iron through the kidneys? - CORRECT ANSWER-Transferrin The most abundant immunoglobin - CORRECT ANSWER-IgG This immunoglobulin crosses blood vessels and placenta. It is responsible for humoral immunity and acts mainly by complement mediated destruction - CORRECT ANSWERIgG Which immunoglobulins fix complement? - CORRECT ANSWER-IgG and IgM This immunoglobulin is found in mothers milk. It prevents antigens or foreign substances from entering the body. - CORRECT ANSWER-IgA Which immunoglobulin cannot cross the blood stream or the placenta? - CORRECT ANSWER-IgM The largest immunoglobulin and the first antibody to be produced. It is also the most effective immunoglobulin. This immunoglobulin is involved in the primary response, it is a pentamer, and it is efficient in agglutination in reactions - CORRECT ANSWER-IgM Which immunoglobulins are a monomer? - CORRECT ANSWER-- IgG - IgE - IgD This immunoglobulin is a cold-reacting antibody that is increased in waldenstrom's macroglobulinemia (type of non-hodgkins lymphoma) - CORRECT ANSWER-IgM This immunoglobulin attaches to basophil and mast cells and causes the release of histamine/heparin. It is the least abundant immunoglobulin and is elevated in parasitic infections. It also mediates immediate hypersensitivity (allergies, asthma, hay fever) - CORRECT ANSWER-IgE This immunoglobulin has no significant role in the body but it is on the surface of the B cells and may function as a B cell receptor - CORRECT ANSWER-IgD This immunoglobulin is a monomer in serum and a dimer in secretions, it has a J piece and a secretory component and is found primarily in body secretions. - CORRECT ANSWER-IgA Decreased alpha fetoprotein values are associated with which condition? - CORRECT ANSWER-Down syndrome This marker stores oxygen in muscle cells and is found in striated skeletal muscle and cardiac muscle. Increased values are indicative of acute myocardial infarctions, muscular dystrophy, and crush injuries - CORRECT ANSWER-Myoglobin Earliest marker post MI - CORRECT ANSWER-Myoglobin A complex of 3 proteins found in striated and cardiac muscles that regulates muscle contraction. This marker is the most sensitive indicator for acute myocardial infarction - CORRECT ANSWER-Troponin What are the tumor markers? - CORRECT ANSWER-- Carcinoembryonic antigen - Alpha fetoprotein - Human chorionic gonadotropin - Prostate specific antigen - CA 125 - CA 27-29 - CA 15-3 - CA 19-9 Oncofetal antigen found in fetal colon. This tumor marker is found in colorectal carcinoma and is non specific for colon cancer. (Most widely used tumor marker to monitor disease progression and reoccurrence) - CORRECT ANSWERCarcinoembryonic antigen (CEA) An oncofetal antigen secreted by fetal liver that is elevated in patients with hepatocellular carcinoma, ovarian cancer, and testicular cancer - CORRECT ANSWERAlpha-fetoprotein Hormone produced by the placenta to sustain pregnancy by stimulating the ovaries to produce estrogen and progesterone This marker is used for detection of trophoblastic diseases (hydatidiform mole, trophoblastic neoplasia, choriocarcinoma) It is a prognostic indicator for ovarian cancer and as diagnostic marker for testicular cancer - CORRECT ANSWER-Human chorionic gonadotropic (HCG) Test used to determine if their will be multiple births - CORRECT ANSWER-Human chorionic gonadotropic (HCG) This enzyme is secreted by prostate epithelial cells and is normally found in small amounts in healthy males. This has replaces prostatic acid phosphatase as the tumor marker for prostate cancer - CORRECT ANSWER-Prostate specific antigen (PSA) Carbohydrate epitope that is produced by ovarian epithelial cells and are elevated in ovarian cancer. It is a prognostic indicator for ovarian cancer and is used to monitor disease status (non-specific for ovarian cancer) - CORRECT ANSWER-CA 125 Carbohydrate epitopes that are markers for metastatic breast carcinoma - CORRECT ANSWER-- CA 27-29 - CA 15-3 Carbohydrate epitope that is a marker used to monitor pancreatic cancer, gastrointestinal cancer, and adenocarcinoma - CORRECT ANSWER-CA 19-9 Disease states associated with hypoproteinemia - CORRECT ANSWER-- Nephrotic syndrome - Malnutrition - Liver disease - Burns Disease states associated with hyperproteinemia - CORRECT ANSWER-- Dehydration - Multiple myeloma - Waldenstrom's Macroglobulinemia Normal range of cerebrospinal fluid protein - CORRECT ANSWER-15-45 mg/dl CSF protein is increased in: - CORRECT ANSWER-Spinal Meningitis and Multiple sclerosis What is used to measure cerebrospinal fluid protein - CORRECT ANSWER-Biuret This is the first substance to be elevated in renal insufficiency and it is proportional to the individuals muscle mass. - CORRECT ANSWER-Creatinine In acute renal failure, which non protein nitrogen rises the fastest? - CORRECT ANSWER-Blood urea nitrogen (BUN) The creatinine clearance test is based on which assumption? A.) Creatinine passes into the ultrafiltrate B.) Creatinine is retained in the blood C.) Creatinine is converted to creatine D.) Creatinine is passively reabsorbed by the kidney tubule - CORRECT ANSWER-A What measures the glomerular filtration rate? - CORRECT ANSWER-Creatinine clearance Creatinine clearance formula - CORRECT ANSWER-Urine creatinine x urine volume (ml/min) ---------------------------------------- Serum creatinine Then divide by 1440 (minutes in 24 hours) (eGFR only requires serum creatinine) What is the classical method for creatinine reaction? - CORRECT ANSWER-Jaffe Why can untreated urine be used for the determination of urea by the diacetyl monoxomine method? A.) Dialysis in an auto analyzer removed interfering substances B.) The method is not measuring ammonia C.) The increased temperature destroys the ammonia D.) Zinc does not interfere - CORRECT ANSWER-B An elevated creatinine value is most likely to be accompanied by which of these values? - CORRECT ANSWER-- Elevated blood urea nitrogen - 10X creatinine value The measurement of creatinine is based on the formation of a yellow-red color and which reagent? - CORRECT ANSWER-Alkaline picrate What is the reference method for non protein nitrogen's - CORRECT ANSWER-Isotope dilution mass spectrometry What is the most common clearance test used to measure the glomerular filtration rate? - CORRECT ANSWER-Creatinine This constitutes half of the non protein nitrogen substances in the blood. It is synthesized in the liver during protein catabolism and is the major excretory product of protein metabolism - CORRECT ANSWER-Blood urea nitrogen (BUN) What is the term for Increased nitrogen containing compounds - CORRECT ANSWERAzotemia Normal BUN/Creatinine ratio - CORRECT ANSWER-10:1 to 20:1 In the urease method of blood urea nitrogen, urea is enzymatically converted to which end product? - CORRECT ANSWER-Ammonia The final breakdown product of purine metablosm in humans - CORRECT ANSWERUric acid The final breakdown product of purine metabolism in other mammals - CORRECT ANSWER-Allantoin The breakdown products of nucleic acid catabolism - CORRECT ANSWER-Purines Most uric acid in plasma is present as monosodium urate which precipitates in acidic urine as __ - CORRECT ANSWER-Uric acid crystals (urinalyses) Which reagent is employed in the alkaline oxidation of uric acid? - CORRECT ANSWER-Phosphotungstic acid What does the uricase method for uric acid depend on? - CORRECT ANSWERUltraviolet absorption at 290 nm before/after treatment with uricase Which disease state is associated with an elevation of serum uric acid? - CORRECT ANSWER-Gout What non protein nitrogen is used as a prognostic indicator for liver failure? This breakdown product is used by liver cells in the production of urea. In severe liver disease this is not removed from circulation. - CORRECT ANSWER-Ammonia __ is neurotoxic and is associated with encephalopathy it is not dependent on renal function, but liver function - CORRECT ANSWER-Ammonia Which non protein nitrogen is increased in patients with Reye's syndrome - CORRECT ANSWER-Ammonia Clinical significance of increased ammonia - CORRECT ANSWER-- Hepatic failure (Severe liver disease) - Reye's disease (associated with salicylate ingestion) Most common analytical method for ammonia - CORRECT ANSWER-Enzymatic method (Glutamate dehydrogenase) What is used in the spectrophotometric method for ammonia - CORRECT ANSWERBromphenol blue A creatinine clearance test is performed. The 24-hour urine volume is 770 mL; serum creatinine is 2.0 mg/dL and urine creatinine is 240 mg/dL. What is the clearance, assuming average body surface area? - CORRECT ANSWER-GFR = ([UCr x V]/SCr)/1440 (1440 minutes in 24 hours) GFR =[(240 x 770)/2.0]/1440