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Clinical Chemistry Principles

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Clinical Chemistry Principles

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  • September 10, 2024
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  • 2024/2025
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TEST BANK for Clinical Chemistry Principles, Techniques, and
Correlations 9th Edition by Michael L. Bishop, Edward P. Fody
_________________is secreted from the Hypothalamus and signals the _________of
the anterior pituitary - ANSWER:thyrotropin releasing hormone; beta cells

The Beta cells of the anterior
pituitary produce ___________
__________________________or Thyrotropin. Growth Hormone, is also involved in
release of _____ - ANSWER:beta cells --> thyroid stimulating hormone;

Growth hormone also involved in release of TSH

TSH stimulates __________
uptake by the thyroid and
activates enzymes which
produce and release___ and ___ - ANSWER:TSH stimulates iodide uptake;
T3 and T4

_____________ are released
into the bloodstream bound to
proteins called ___________
_______________________
(TBP, TBG, TBA, TBPA). - ANSWER:T3 and T4; thyroxine binding proteins

About 35% of circulating ___ converts to ___ each day. 45% converts to ____. -
ANSWER:35% circulating T4 --> T3
45% circulating T4 --> rT3


These are physiologically active and enter cells through receptor sites.
____________ is not physiologically active. - ANSWER:Free T4, Free T3

Reverse T3 isn't active

There is 50x more circulating ___ in plasma than ___ ; but ___ is
3‐4x more potent. - ANSWER:50x more circulating T4 in plasma than T3, but T3 is 3-
4x more potent

If levels of T3 and T4 begin to rise above "normal," a signal is sent
to the __________ which slows down or stops ____ production - ANSWER:pituitary;
TSH

Further, the increase of T3 and T4 activates the hormone

, ________________ in the hypothalamus which slows down release of Growth
Hormone. - ANSWER:SOMATOSTATIN

TSH has two sub units, alpha and beta. ______ gives the hormone specificity. -
ANSWER:TSH BETA subunit gives specificity

What are the 3 routine tests used to evaluate thyroid function? - ANSWER:TSH, Free
T4 (FT4I), Total T4

______ is the best of these tests because of its high clinical
and chemical sensitivity and specificity - ANSWER:TSH (ultrasensitive thyrotropin)

second best thyroid test is - ANSWER:FreeT4 (FT4I)

What tests may still be part of the Thyroid Profile if physicians demand
it, and/or the laboratory does not yet have the instrumentation / protocol for the
direct FT4 test. - ANSWER:Total T4 (TT4) and the Thyroid Hormone Binding Ratio
(THBR)
[or T3 Uptake Test (T3U) leading to a FT4I (index calculation)]

____________________ are not routinely part of a Thyroid Profile, but are readily
accessible, and may be used to investigate or confirm thyroid disorders. -
ANSWER:FT3 / FT3I and FT3


The TSH and FT4 are much less influenced by protein abnormalities, and thus are
better indicators of thyroid health or disease states discussed in next slides. -
ANSWER:TBP (Thyroxine binding proteins)

• Primary hypothyroidism:
TSH,
T4,
FT4/FT4I and FT3 - ANSWER:+ TSH,
- T4,
- FT4/FT4I & FT3

• Secondary hypothyroidism:
TSH,
T4,
FT4/FT4I and FT3 - ANSWER:- TSH,
- T4,
- FT4/FT4I & FT3

• Subclinical hypothyroidism:
TSH,
T4,
FT4/FT4I and FT3 - ANSWER:+ TSH,

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