Biochemistry Exam Study Notes
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Questions and Answers

What does an elevated BUN level primarily indicate?

  • Increased kidney function
  • Increased uric acid levels
  • Decreased kidney function or dehydration (correct)
  • Increased hydration levels

What does a declining eGFR primarily signify?

  • Improved kidney perfusion
  • Increased kidney filtering capacity
  • Loss of kidney function (correct)
  • Normal kidney function

Which of the following abnormalities could signal kidney dysfunction through electrolyte levels?

  • Normal potassium with decreased sodium
  • Correct bicarbonate levels
  • Increased calcium only
  • Abnormal levels of sodium, potassium, or calcium (correct)

Which urine constituent is specifically indicative of multiple myeloma?

<p>Presence of Bence Jones proteins (D)</p> Signup and view all the answers

Which laboratory finding is most indicative of acute pancreatitis?

<p>Elevated serum amylase levels (A)</p> Signup and view all the answers

What does urine osmolality reflect about kidney function?

<p>Kidney's ability to concentrate urine (A)</p> Signup and view all the answers

Which acid-base disorder is characterized by decreased bicarbonate in the extracellular fluid?

<p>Metabolic acidosis (D)</p> Signup and view all the answers

What is the expected result of a fecal pancreatic elastase 1 test in a patient with pancreatic insufficiency?

<p>Low levels (D)</p> Signup and view all the answers

What is a common cause of peptic ulcers?

<p>Helicobacter pylori infection (D)</p> Signup and view all the answers

What might be a cause of metabolic alkalosis?

<p>Loss of H+ due to vomiting (A)</p> Signup and view all the answers

What laboratory finding is typically associated with metabolic acidosis?

<p>Low bicarbonate levels (B)</p> Signup and view all the answers

What type of test uses urea labeled with carbon-13 to detect Helicobacter pylori?

<p>Urea breath test (B)</p> Signup and view all the answers

Which of the following tests is used to diagnose pancreatic insufficiency by measuring stool fat content?

<p>Fecal fat test (B)</p> Signup and view all the answers

What is the primary purpose of a bone marrow aspiration and biopsy in diagnosing leukemia?

<p>To determine the type of leukemia and assess blast cells (A)</p> Signup and view all the answers

Which assessment indicates pancreatic insufficiency when the pancreatic response to secretin and cholecystokinin is decreased?

<p>Secretin-cholecystokinin test (D)</p> Signup and view all the answers

Which test is performed to identify the presence of specific gene mutations relevant to leukemia treatment?

<p>Molecular Testing (B)</p> Signup and view all the answers

What is a common symptom of peptic ulcers caused by Helicobacter pylori?

<p>Stomach pain (B)</p> Signup and view all the answers

What distinguishes leukemia from lymphoma?

<p>Leukemia affects the bone marrow and blood, while lymphoma involves the lymphatic system. (C)</p> Signup and view all the answers

Which method involves examining the stomach and duodenum using a flexible, lighted tube?

<p>Gastroscopy (A)</p> Signup and view all the answers

What is a common biochemical test for diagnosing iron-deficiency anemia?

<p>Total Iron Binding Capacity (TIBC) (C)</p> Signup and view all the answers

Which test helps in distinguishing between different types of leukemia?

<p>Immunophenotyping (D)</p> Signup and view all the answers

What does a peripheral blood smear primarily evaluate?

<p>Blood cell morphology and identification of leukemia cells (D)</p> Signup and view all the answers

What is the hallmark of acute leukemia?

<p>Presence of blast cells (B)</p> Signup and view all the answers

Which of the following conditions describes thrombocytopenia?

<p>Low platelet count leading to bleeding problems (D)</p> Signup and view all the answers

What does an elevation of ALT levels in the blood typically indicate?

<p>Damage to liver cells (A)</p> Signup and view all the answers

Which enzyme is less specific to liver damage compared to ALT?

<p>Aspartate Aminotransferase (AST) (D)</p> Signup and view all the answers

What does an increase in Alkaline Phosphatase (ALP) levels generally suggest?

<p>Blockage or inflammation in bile ducts (A)</p> Signup and view all the answers

What does elevated unconjugated bilirubin typically indicate?

<p>Hemolysis or impaired liver function (A)</p> Signup and view all the answers

Which of the following describes the primary function of Albumin in the body?

<p>Transporting substances and maintaining blood volume (A)</p> Signup and view all the answers

In which condition would you expect elevated levels of AST in the blood?

<p>In damage to various tissues including liver and muscle (D)</p> Signup and view all the answers

Which statement about albumin levels is true?

<p>They can significantly decrease in chronic liver conditions. (C)</p> Signup and view all the answers

What is the primary reason ALP is released into the bloodstream?

<p>Bile ducts are blocked or damaged. (C)</p> Signup and view all the answers

Which condition is associated with decreased intestinal absorption of phosphate?

<p>Vitamin D Deficiency (D)</p> Signup and view all the answers

What is a potential cause of hypophosphatemia related to kidney function?

<p>Chronic Alcohol Abuse (B)</p> Signup and view all the answers

Which mechanism is involved in the shift of phosphate into cells during refeeding syndrome?

<p>Insulin Administration (D)</p> Signup and view all the answers

In which condition is hyperphosphatemia likely to occur due to impaired phosphate excretion?

<p>Hypoparathyroidism (A)</p> Signup and view all the answers

How can a high dietary intake affect phosphate levels in the body?

<p>It can lead to hyperphosphatemia. (B)</p> Signup and view all the answers

What role do medications like diuretics play in phosphate disorders?

<p>They enhance phosphate excretion. (A)</p> Signup and view all the answers

Which condition is NOT associated with hyperphosphatemia?

<p>Diuretic Use (B)</p> Signup and view all the answers

What causes the release of phosphate back into the bloodstream during tissue necrosis?

<p>Cellular death (B)</p> Signup and view all the answers

What is a defining characteristic of Respiratory Acidosis?

<p>Elevated pCO2 levels (B)</p> Signup and view all the answers

Which of the following is a common cause of Respiratory Alkalosis?

<p>High altitude (D)</p> Signup and view all the answers

How is the Anion Gap calculated?

<p>[Na+ + K+] - [Cl- + HCO3-] (D)</p> Signup and view all the answers

What does an increased Anion Gap typically indicate?

<p>Metabolic acidosis due to unmeasured anions (D)</p> Signup and view all the answers

Which test measures blood glucose levels after at least 8 hours of fasting?

<p>Fasting Plasma Glucose Test (D)</p> Signup and view all the answers

What is the primary purpose of the Oral Glucose Tolerance Test (OGTT)?

<p>To assess body's glucose regulation after a sugary drink (A)</p> Signup and view all the answers

What pH classification is associated with a high bicarbonate level and elevated pCO2?

<p>Respiratory Acidosis (A)</p> Signup and view all the answers

What might indicate a normal Anion Gap in the context of metabolic acidosis?

<p>Loss of bicarbonate (D)</p> Signup and view all the answers

Flashcards

Metabolic Acidosis

A state where there is a decreased amount of bicarbonate (HCO3-) in the body fluids.

Causes of Metabolic Acidosis

Causes include increased acid production, loss of bicarbonate, or decreased kidney function.

Metabolic Alkalosis

A state where there is an excessive amount of bicarbonate (HCO3-) in the body fluids.

Causes of Metabolic Alkalosis

Causes include loss of hydrogen ions (e.g., vomiting), ingestion of alkali, or potassium deficiency.

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Respiratory Acidosis

A state where there is an increase in carbon dioxide (CO2) in the blood, leading to an acidic pH.

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Causes of Respiratory Acidosis

Causes include conditions that impair lung function or decrease the ability to exhale CO2.

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Respiratory Alkalosis

A state where there is a decrease in carbon dioxide (CO2) in the blood, leading to an alkaline pH.

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Causes of Respiratory Alkalosis

Causes include hyperventilation, anxiety, or certain medical conditions.

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Hypophosphatemia due to Vitamin D Deficiency

Vitamin D deficiency impairs phosphate absorption in the gut, lowering blood phosphate levels.

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Hypophosphatemia due to Malabsorption

Conditions like celiac disease or Crohn's disease can prevent proper phosphate uptake in the intestines, leading to low blood phosphate.

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Anion Gap

A measure that helps determine the acid-base balance in blood by calculating the difference between positively charged ions (cations) and negatively charged ions (anions).

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Hypophosphatemia due to Hypoparathyroidism

Low levels of PTH reduce phosphate reabsorption in the kidneys, causing a drop in blood phosphate.

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Metabolic Acidosis with elevated Anion Gap

A type of metabolic acidosis where the anion gap is elevated due to an increase in unmeasured anions.

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Hypophosphatemia due to Hyperparathyroidism

Excess PTH promotes increased phosphate excretion in urine, reducing blood phosphate levels.

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Metabolic Acidosis with normal Anion Gap

A type of metabolic acidosis where the anion gap is normal. This suggests a loss of bicarbonate, often due to conditions like diarrhea or kidney failure.

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Hyperphosphatemia due to CKD

Decreased renal function in CKD leads to reduced phosphate excretion, causing high blood phosphate levels.

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Fasting Plasma Glucose (FPG) Test

A blood test that measures blood glucose levels after an overnight fast (8-12 hours).

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Hyperphosphatemia due to Hypoparathyroidism

Low PTH leads to reduced phosphate excretion in urine, contributing to hyperphosphatemia (high blood phosphate).

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Hyperphosphatemia due to Rhabdomyolysis

Breakdown of muscle tissue releases intracellular phosphate into the bloodstream, leading to hyperphosphatemia.

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Random Plasma Glucose (RPG) Test

A blood test that measures blood glucose levels at any time of day, regardless of the last meal.

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Hyperphosphatemia due to Tissue Necrosis

Cellular death releases phosphate, raising the blood phosphate levels.

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Oral Glucose Tolerance Test (OGTT)

A blood test that involves drinking a sugary drink and then measuring blood glucose levels at intervals to assess how effectively the body regulates glucose.

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Elevated serum amylase levels

Elevated serum amylase levels are commonly observed in acute pancreatitis.

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Elevated serum lipase levels

Elevated serum lipase levels are a key indicator of acute pancreatitis.

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Elevated TAP levels

Elevated trypsinogen activation peptide (TAP) levels suggest acute pancreatitis.

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Fecal Fat Test

A fecal fat test measures the amount of fat in stool, indicating malabsorption.

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Fecal Pancreatic Elastase 1 Test

The fecal pancreatic elastase 1 test measures elastase 1, an enzyme produced by the pancreas, to assess pancreatic insufficiency.

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Secretin-Cholecystokinin test

The Secretin-Cholecystokinin test examines the pancreas's response to hormones, aiding in diagnosing pancreatic insufficiency.

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Trypsinogen Test

The Trypsinogen test measures trypsinogen levels in blood, helping identify pancreatic insufficiency.

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Peptic Ulcers

Peptic ulcers are breaks in the stomach or duodenal mucosa.

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Blast Cells

Immature white blood cells found in high numbers during acute leukemia.

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Anemia in Leukemia

A decrease in red blood cell count and hemoglobin levels, often associated with leukemia.

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Thrombocytopenia in Leukemia

A low platelet count, which can make bleeding more likely.

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Peripheral Blood Smear

A test that involves examining blood cells under a microscope to see their shape and structure.

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Bone Marrow Aspiration and Biopsy

A procedure to obtain a sample of bone marrow, which is crucial for diagnosing leukemia.

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Immunophenotyping

Using antibodies to identify specific types of leukemia cells based on their surface markers.

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Cytogenetic Analysis

Analyzing the chromosomes of leukemia cells for specific genetic abnormalities.

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Iron-Deficiency Anemia

A type of anemia caused by a lack of iron in the blood, essential for hemoglobin production.

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Iron-Deficiency Anemia

The most common type of anemia, caused by insufficient iron.

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Iron Levels, TIBC, Ferritin

Biochemical tests used to investigate iron-deficiency anemia.

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Alanine Aminotransferase (ALT)

An enzyme primarily found in liver cells. Elevated levels indicate liver damage, such as inflammation or hepatitis.

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Aspartate Aminotransferase (AST)

An enzyme similar to ALT, also found in liver cells. Elevated levels can suggest liver damage, but also damage to other organs like kidneys and muscles.

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Alkaline Phosphatase (ALP)

An enzyme primarily associated with cells lining bile ducts. Increased levels often indicate problems with bile flow, known as cholestasis.

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Bilirubin

A byproduct of red blood cell breakdown. The liver processes and eliminates it. Elevated levels can indicate problems with liver function, such as impaired bilirubin processing or red blood cell destruction.

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Albumin

A major protein synthesized by the liver, crucial for maintaining blood volume, transporting substances, and blood clotting. Low levels can indicate liver disease, especially chronic ones.

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What happens to ALT when liver cells are damaged?

ALT is released from liver cells into the bloodstream when they are damaged or destroyed.

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What happens to AST when liver cells or other tissues are damaged?

AST is also released from liver cells when damaged or destroyed. However, it can also be released from other tissues if damaged.

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What happens to ALP when there are problems with bile flow?

ALP is released into the bloodstream when the bile ducts are blocked or damaged, or when there's inflammation or obstruction in the bile ducts.

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Study Notes

Biochemistry Exam Study Notes

  • Week 1:

    • False-positive results indicate a condition is present when it is not.
    • False-negative results indicate a condition is absent when it is present.
    • Sensitivity is the frequency a test correctly identifies patients with the disease.
    • Specificity is how often healthy subjects are correctly identified.
    • Routine urinalysis has three main parts: gross appearance, microscopy, and biochemistry.
    • Gross appearance evaluates urine volume, color, and clarity.
    • Microscopy examines urine for cells, casts, crystals, and bacteria.
    • Biochemistry analyzes urine for components like pH, osmolality, protein, urea, creatinine, and glucose to assess kidney function and potential diabetes.
    • Clinically relevant enzymes include Alanine aminotransferase (ALT), which is primarily located in the liver and kidneys, and indicates damage to hepatocytes, potentially suggesting liver disease. Aspartate aminotransferase (AST) is found in the heart, liver, skeletal muscle, and kidneys, indicating tissue damage in those areas

  • Week 2:

    • Amylase and lipase are primarily located in the pancreas. Elevated levels indicate acute pancreatitis or other pancreatic conditions.
    • Lactate dehydrogenase (LDH) is present in various tissues, including heart, liver, red blood cells, kidneys, brain, lungs, and skeletal muscle. Elevated levels indicate various conditions affecting different organs, including myocardial infarction, pulmonary embolism, and certain cancers.

  • Week 3:

    • Osmolality is a measure of the total number of solute particles per kilogram of solvent.

  • Week 4:

    • Acid-base balance is important. Metabolic acidosis is characterized by decreased bicarbonate. Metabolic alkalosis is characterized by increased bicarbonate. Respiratory acidosis is characterized by high carbon dioxide levels, and respiratory alkalosis is characterized by low carbon dioxide levels.

  • Week 5:

    • Important glucose metabolism tests include: Fasting Plasma Glucose (FPG), Random Plasma Glucose (RPG), Oral Glucose Tolerance Test (OGTT), Glycated Hemoglobin (HbA1c), and Urine Ketone Tests.

  • Week 6:

    • Compare and contrast primary, secondary, and tertiary endocrine diseases.
    • Primary diseases affect the endocrine gland.
    • Secondary diseases involve pituitary dysfunction.
    • Tertiary diseases involve hypothalamic failure which affects the pituitary gland's function.

  • Week 7:

    • Identify important causes of mineral and bone disorders, such as calcium, phosphate, magnesium, and others.
    • The role of calcium, phosphate, and magnesium in the body. The concept of calcium, phosphate, and magnesium disorders, like hypocalcemia, hypercalcemia, hypophosphatemia and others.

  • Week 8:

    • Biochemical tests for diagnosis of blood disorders including, complete blood count (CBC), myoglobin, LDH, BUN, creatinin, and more.
    • Types of leukemia and their characteristics including acute and chronic leukemias and specific examples such as ALL, AML, CLL, and CML.
    • Key tests to aid in diagnosis.

  • Week 9:

    • Important biomarkers for myocardial injury, such as troponin I and T, myoglobin, and creatine kinase MB (CK-MB).
    • The key characteristics and diagnostic tests for different types of anemia, and cardiovascular disorders, such as iron deficiency, pernicious, sickle cell, thalassemias, chronic disease, and others.

  • Week 10:

    • Liver disorders and their importance including, gluconeogenesis, glycogenolysis and glycogenisis processes.
    • Liver function tests: ALT, AST, ALP, bilirubin, PT, GGT, and albumin.

  • Week 11:

    • Pancreatic disorders, including laboratory findings like amylase, lipase, trypsinogen activation peptide (TAP) levels.
    • Key lab tests used to diagnose pancreatic insufficiency, such as fecal fat, fecal pancreatic elastase 1 test, secretin-cholecystokinin test, and trypsinogen test.

  • Week 12:

    • Gastrointestinal disorders.
    • Causes, characteristics, complications, and treatments of IBD, such as ulcerative colitis and Crohn's disease.

  • Week 13:

    • Biochemical Toxicology and poisoning, determining the usefulness of anion gap and osmol gap in toxicology, and the importance of the toxicity of common medications.

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Biochemistry Exam - Week 1 PDF

Description

Prepare for your biochemistry exam with these concise study notes. Covering essential concepts such as false-positive and false-negative results, sensitivity, specificity, and components analyzed in routine urinalysis, these notes are ideal for quick revision. Enhance your understanding of clinically relevant enzymes and their implications for liver and kidney function.

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