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CSMLS chemistry Exam Study Guide.
Chilled Samples - answer✔ACTH, lactic acid, ammonia, blood gases, acetone, gastrin, glucagon,
pyruvate, renin
Protect samples from light - answer✔bili, carotene, erythrocyte protoporphyrin, vitamin A, vitamin B12
Warm Samples - answer✔Cold agglutinins, cryoglobulins
Fasting samples - answer✔Fasting blood sugar, triglycerides, lipid panel, gastrin, insulin
Formalin pigment - answer✔Aka acid formalin hematin. Brown, granrular, doubly refractile deposit
Remove with picric acid after 100% alcohol in rehydration step. Tissue will be yellow. Remove yellow
discolouration with RTW (30min), acid alcohol + wash in RTW, prolonged alcohol wash and lithium
carbonate in 70% alcohol
Mercury Pigment - answer✔Dark brown to black crystals.
Remove during dehydration: 20mL of strong alcoholic iodine
From sections: bring to water, place in 0.5% alcoholic iodine or gram's iodine, rinse with water, place
into sodium thiosulphate until brown discolouration gone.
Hematoxylin - answer✔Not a true dye. Must be oxidized to hematein (ripened by exposure to
atmospheric oxygen, sodium iodate, mercuric oxide, potassium permanganate)
Hematein - answer✔Weak, anionic dye. Oxidation product of hematoxylin, active coloring agent
Little affinity for tissue, but becomes strong dye when combined with metallic mordant (alum salts, iron
salts)
Hematoxylin Differentiation - answer✔Uses 1% HCL in 70% ethanol (acid alcohol). H+ ions compete with
mordant for tissue groups. Alumnium-hematein is red and soluble pH <5. Blue insoluble lake in pH>5
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Cytoplasm and connective tissue will be colorless.
Nuclei will be RED with sharp nuclear detail.
- MUST use BLUEING Agent (alkali reagent) to reverse discolouration (Scott's TW)
Decolorization - answer✔Removal of excess stain macroscopically
Differentiation - answer✔Controlled removal of excess stain microscopically
Eosin - answer✔Cytoplasmic stain.
- pH 7 = negatively charged
- pH <6 can stain proteins
- pH< 4= decreased negative charges because molecule converts to free acid, muddy tissues
RBC = dark pink, Muscles = pink, collagen = light pink
Casts - answer✔fibrous or protein materials found in the urine with renal disease or another
abnormality
- Formed in the lumen of the distal convoluted tubule and collecting duct
- Major constituent = uromodulin ( tamm horsfall protein)
- Factors that influence cast formation: decreased pH, decreased output, Increased solute concentration
(SG), increased protein
Renal tubular cell casts - answer✔Most significant, round, eccentric nucleus, larger than WBC.
- Tubular necrosis, renal tubules
transitional epithelial cast - answer✔Round/pear shape, central nucleus
- Renal carcinoma, renal pelvis, bladder, upper urethra
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Creatinine clearance formula - answer✔= U (concentration of urine creatinine - mg/dL) * V ( volume of
urine in mL/time in minutes) / P (concentration of plasma creatinine mg/dL)
Hemolysis - answer✔K+ Inc
LD Inc
Aldolase (ALD) inc
Acid phosphatase (ACP) increased
Mg++ Increased
PO4 increased
Hgb increased = may show extra band
Iron increased
Klamp the leak
Serum red top - answer✔For most chemistry tests
Plasma - answer✔Heparin better than oxalate, EDTA, citrate
Potassium oxalate - answer✔An anticoagulant commonly used with the antiglycolytic agent sodium
fluoride.
For glucose test (slows glycolysis)
EDTA tube - answer✔Used for cell counts and differential and Hb1Ac
NOT FOR Na+/K+ or Ca++ (chelated calcium - false negative)
CSF glucose - answer✔2/3 (60-65%) of plasma glucose levels
2.2-3.9 mmol/L
Plasma Glucose (fasting) RI - answer✔4.1-5.6 mmol/L
<5.6 mmol/L = normal
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>7.0 mmol/L = diabetic
Sodium Serum (na+) RI - answer✔136-145 mmol/L
Triglycerides - answer✔<1.70 mmol/L
Primary form of lipid storage. Transported by chlyomicrons (exogenous) and VLDL (endogenous)
Enzymatic methods measurement. Involve liberation of glycerol by lipase. Glycerol contamination from
stoppers of evacuation tubes or ingestion of glycerol-coasted medication can cause falsely elevated
results
BUN (urea) RI - answer✔2.1-7.1 mmol/L
Troponin I RI - answer✔< 27 ng/L
Potassium serum (K+) RI - answer✔3.5-5.1 mmol/L
Magnesium Serum (Mg) RI - answer✔0.66-1.07 mmol/L
Total Calcium (Ca2+) RI - answer✔2.15-2.55 mmol/L
Free calcium (ca2+) RI - answer✔1.15-1.33 mmol/L
Total bilirubin serum RI - answer✔5-21 umol/L
conjugated = 0-4 umol/L
unconjugated = <17 umol/L
Insulin - answer✔Hormone produced from beta cells of islets of langerhans of pancreas.
Decreased serum glucose. Stimulates glucose uptake by cells
Glucagon - answer✔Hormone produced from alpha cells of islets of pancreas.
Stimulates glycogenolysis (breakdown of glycogen -> glucose)
GAG CHET - answer✔All cause increase in serum glucose
