History and Developments in Clinical Chemistry
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Questions and Answers

What is the name of the analytic technique that measures the amount of light scattered by particles in a solution?

  • Nephelometry (correct)
  • Spectrometry
  • Chromatography
  • Electrophoresis

    • What are the angles at which measurements are made in nephelometry?

  • 0 to 180 degrees
  • 5 to 90 degrees (correct)
  • 90 to 180 degrees
  • 0 to 5 degrees

    • Which of the following substances can cause a falsely decreased glucose oxidase yield?

  • Ascorbic acid
  • Bilirubin
  • Uric acid
  • All of the above (correct)

    • What is the best glucose tolerance test (GTT) for patients with gastrointestinal disorders such as malnutrition?

    <p>Intravenous GTT (IVGTT)</p> Signup and view all the answers

    Which chain of hemoglobin is measured by HbA1c?

    <p>Beta chain</p> Signup and view all the answers

    What is the normal C-peptide to insulin ratio?

    <p>5-15:1</p> Signup and view all the answers

    Which analyte is tested in hepatic failure?

    <p>Ammonia (Berthelot)</p> Signup and view all the answers

    In which lipoproteins is Apo-E found?

    <p>All of the above</p> Signup and view all the answers

    What is the most insoluble lipid?

    <p>Triglycerides (TAG)</p> Signup and view all the answers

    What is the method used to measure the L/S ratio?

    <p>TLC + Densitometric quantitation</p> Signup and view all the answers

    What does FLM stand for in the context of fetal lung maturity?

    <p>Fetal Lung Maturity</p> Signup and view all the answers

    What is the function of Apo A1?

    <p>Both A and B</p> Signup and view all the answers

    Which of the following lipoproteins has the highest cholesterol content?

    <p>LDL</p> Signup and view all the answers

    What is the highest protein content in the human body?

    <p>HDL</p> Signup and view all the answers

    What is the highest TAG content in the human body?

    <p>CM</p> Signup and view all the answers

    What is the highest phospholipid content in the human body?

    <p>HDL</p> Signup and view all the answers

    Which type of HDL is more active in removing cholesterol from cells?

    <p>Discoid HDL</p> Signup and view all the answers

    What is the shape of HDL when it acquires cholesterol from cells?

    <p>Spherical</p> Signup and view all the answers

    What is the process of spherical HDL transforming into discoid HDL called?

    <p>Reverse cholesterol transport</p> Signup and view all the answers

    Which method uses creatinine with a positive color as red orange tautomer?

    <p>Folin Wu method</p> Signup and view all the answers

    Which method is the true measure of creatinine?

    <p>Stable Jaffe</p> Signup and view all the answers

    What is the major inhibitor of urease?

    <p>All of the above</p> Signup and view all the answers

    Which BUN method uses a yellow diazine derivative?

    <p>DAM</p> Signup and view all the answers

    Which reagent is utilized to measure ammonia in the urease method?

    <p>Berthelot</p> Signup and view all the answers

    Which method is the simplest and most specific uric acid method?

    <p>Uricase</p> Signup and view all the answers

    What is the most common treatment for hyperuricemia?

    <p>Allopurinol</p> Signup and view all the answers

    Which principle focuses on reducing variability and using the terms define, measure, analyze, improve, and control?

    <p>Lean Six Sigma</p> Signup and view all the answers

    What does the acronym CQI stand for?

    <p>Continuous Quality Improvement</p> Signup and view all the answers

    What is the shape of the Gaussian curve?

    <p>All of the above</p> Signup and view all the answers

    What does the acronym TQM stand for?

    <p>Total Quality Management</p> Signup and view all the answers

    What is the most common characteristic of a Gaussian curve?

    <p>It is seen when a data set is accurately described by the standard deviation and mean.</p> Signup and view all the answers

    What is the chemical formula for phosphate?

    <p>HPO4</p> Signup and view all the answers

    Youden plots are commonly used in:

    <p>PT &amp; EQAS</p> Signup and view all the answers

    The cut-off point for showing an acceptable Youden Index is:

    <p>502</p> Signup and view all the answers

    The total area under a Youden plot is:

    <p>1.0</p> Signup and view all the answers

    A plot that compares results obtained from different labs is called a:

    <p>Youden plot</p> Signup and view all the answers

    A Cusum chart is used for:

    <p>Identifying trends in data</p> Signup and view all the answers

    The degree of flatness or sharpness of a distribution is measured by:

    <p>Kurtosis</p> Signup and view all the answers

    Shewhart charts use control rules and control charts.

    <p>True</p> Signup and view all the answers

    A Shewhart chart is a graphic representation of the acceptable limits of variation.

    <p>True</p> Signup and view all the answers

    Outliers are defined as values that are far from the main set of values.

    <p>True</p> Signup and view all the answers

    The physiologic limit, also known as the linear limit, is referred to as the absurd value

    <p>True</p> Signup and view all the answers

    A test method that utilizes Westgard rules with at least 40 samples is considered a:

    <p>Screening test</p> Signup and view all the answers

    A reference method utilizes Westgard rules with at least 100 samples.

    <p>True</p> Signup and view all the answers

    Lloyds refers to a type of testing where control and patient specimens are assayed, evaluated, and reported together.

    <p>True</p> Signup and view all the answers

    Evacuated tubes are also known as vacutainers.

    <p>True</p> Signup and view all the answers

    The cleaning agent used to remove blood clots is:

    <p>Sodium hydroxide (10%)</p> Signup and view all the answers

    A protein in its isoelectric point is characterized by a net zero charge.

    <p>True</p> Signup and view all the answers

    The Berthelot reaction is used to measure ammonia.

    <p>True</p> Signup and view all the answers

    The identification of Bence Jones protein is best accomplished by:

    <p>Immunofixation electrophoresis</p> Signup and view all the answers

    Some thyroid panels include T3, T4, and TSH for primary hyperthyroidism.

    <p>True</p> Signup and view all the answers

    The most common treatment for hyperthyroidism is radioactive iodine (RAI).

    <p>True</p> Signup and view all the answers

    What is the purpose of a blood gas analysis?

    <p>All of the above</p> Signup and view all the answers

    What does the abbreviation HCO3: (H_{2}CO_{3}) ratio stand for?

    <p>Bicarbonate to carbonic acid ratio</p> Signup and view all the answers

    What is the normal range for the pCO2 level in arterial blood?

    <p>35-45 mmHg</p> Signup and view all the answers

    What does the symbol ↑pO2 = 4 mmHg/2mins or 2 mmHg/min mean?

    <p>The rate of increase in oxygen partial pressure is 4 mmHg every 2 minutes or 2 mmHg every minute</p> Signup and view all the answers

    What is the effect of temperature on blood pH?

    <p>A decrease in temperature causes a decrease in pH</p> Signup and view all the answers

    What are the two main types of bubbles that can form in a blood sample?

    <p>Air bubbles and oxygen bubbles</p> Signup and view all the answers

    What is the normal range for the total CO2 level in arterial blood?

    <p>19-24 mmol/L</p> Signup and view all the answers

    What is the normal range for the pO2 level in arterial blood?

    <p>81 - 100 or 75-100 mmHg</p> Signup and view all the answers

    What are some therapeutic drug groups that can affect blood gas levels?

    <p>Aminoglycosides, digitalis, tricyclic antidepressants, lithium, cyclosporine, tacrolimus</p> Signup and view all the answers

    What are some toxic agents that can be measured in blood?

    <p>All of the above</p> Signup and view all the answers

    What is the main function of AFP, LDH, and hCG?

    <p>All of the above</p> Signup and view all the answers

    What is the normal range for pH in arterial blood?

    <p>7.35 - 7.45</p> Signup and view all the answers

    What is the normal range for pCO2 in arterial blood?

    <p>35 - 45 mmHg</p> Signup and view all the answers

    What is the normal range for total CO2 in arterial blood?

    <p>19 - 24 mmol/L</p> Signup and view all the answers

    What does the abbreviation HCO3- stand for?

    <p>Bicarbonate ion</p> Signup and view all the answers

    What is the normal range for HCO3- in arterial blood?

    <p>21 - 28 mEq/L</p> Signup and view all the answers

    What is the main function of digoxin?

    <p>To treat heart failure</p> Signup and view all the answers

    What is the main adverse effect of phenytoin?

    <p>All of the above</p> Signup and view all the answers

    What is the normal range for fasting blood sugar (FBS) in mg/dL?

    <p>60-100 and 70-100(best)</p> Signup and view all the answers

    What is the most specific enzyme used for glucose testing?

    <p>Hexokinase</p> Signup and view all the answers

    Which of the following methods is obsolete for glucose testing?

    <p>Benedict's solution</p> Signup and view all the answers

    What is the ketone alternative to insulin?

    <p>Glucagon</p> Signup and view all the answers

    Which hormone regulates estrogen and progesterone production by the corpus luteum?

    <p>LH</p> Signup and view all the answers

    What is the main function of the adrenal cortex?

    <p>Produce all of the above</p> <p>Produce all of the above</p> Signup and view all the answers

    What is the normal range for a 1-hour glucose tolerance test (GTT) in mg/dL above fasting blood sugar?

    <p>20-50</p> Signup and view all the answers

    What is the glycosylated form of hemoglobin?

    <p>HbA1c</p> Signup and view all the answers

    What is the best principle for HbA1c measurement?

    <p>Affinity chromatography</p> Signup and view all the answers

    Which fatty acid contains no double bonds?

    <p>Long-chain fatty acid</p> Signup and view all the answers

    What is the color of the reference solution used in the GTT?

    <p>Yellow</p> Signup and view all the answers

    What is the enzyme that converts alpha-D-glucose to beta-D-glucose?

    <p>Mutarotase</p> Signup and view all the answers

    What is the absorbance wavelength for NADPH?

    <p>340nm</p> Signup and view all the answers

    What is the ketone substitute for glucagon?

    <p>Insulin</p> Signup and view all the answers

    Which of the following hormones is produced by the testes?

    <p>Testosterone</p> Signup and view all the answers

    What is the function of zona reticularis of the adrenal cortex?

    <p>Produce sex hormones</p> Signup and view all the answers

    What is the normal range for fructosamine in µmol/L?

    <p>140-210</p> Signup and view all the answers

    What is the recommended HbA1c cut-off for elderly adults with chronic illnesses?

    <p>≤7.5%</p> Signup and view all the answers

    What is the reference glucose method?

    <p>Glucose oxidase</p> Signup and view all the answers

    Which reducing substance indicator turns blue in the presence of glucose?

    <p>Benedict's solution</p> Signup and view all the answers

    What hormone is produced by the pituitary gland and stimulates the adrenal cortex to produce cortisol?

    <p>ACTH</p> Signup and view all the answers

    Which of the following is NOT a function of cortisol?

    <p>Increasing bone density</p> Signup and view all the answers

    What hormone is produced by the thyroid gland and regulates metabolism?

    <p>T3</p> Signup and view all the answers

    Which of the following hormones is produced by the parathyroid glands and regulates calcium levels in the blood?

    <p>PTH</p> Signup and view all the answers

    What is the main function of aldosterone?

    <p>Promoting the reabsorption of sodium in the kidneys</p> Signup and view all the answers

    Which hormone is produced by the ovaries and is responsible for the development of secondary sex characteristics in females?

    <p>Estrogen</p> Signup and view all the answers

    What is the main function of progesterone?

    <p>Thickening the uterine lining for implantation of an embryo</p> Signup and view all the answers

    Which hormone is produced by the placenta and is used to monitor fetal well-being?

    <p>hCG</p> Signup and view all the answers

    What is the cause of gestational diabetes mellitus (GDM)?

    <p>High levels of HPL</p> Signup and view all the answers

    What condition is indicated by a rapid rise in hCG levels in the first trimester of pregnancy?

    <p>Ectopic pregnancy</p> Signup and view all the answers

    What is the function of ferritin?

    <p>To store iron in the body</p> Signup and view all the answers

    What is the main cause of iron deficiency anemia (IDA)?

    <p>Insufficient iron intake</p> Signup and view all the answers

    What is the main symptom of iron overdose?

    <p>Vomiting</p> Signup and view all the answers

    What is the main cause of hemochromatosis?

    <p>Increased iron absorption from food</p> Signup and view all the answers

    What is the function of JIBC?

    <p>To bind to transferrin and increase its iron-binding capacity</p> Signup and view all the answers

    Which of the following hormones is NOT produced by the pituitary gland?

    <p>T3</p> Signup and view all the answers

    What is the main function of ACTH?

    <p>Stimulates the production of adrenal cortex hormones</p> Signup and view all the answers

    What is the main function of aldosterone?

    <p>Regulates blood pressure</p> Signup and view all the answers

    What is the main function of cortisol?

    <p>Decreases inflammation</p> Signup and view all the answers

    What is the main function of T3?

    <p>Increases metabolism</p> Signup and view all the answers

    Study Notes

    Clinical Chemistry: A Comprehensive Analysis

    Clinical chemistry is a high-impact field that focuses on the study and application of chemical compounds and reactions in the diagnosis, treatment, and management of diseases and conditions. This article will provide an overview of the topic, discussing its history, significant developments, and emerging trends.

    History of Clinical Chemistry

    The establishment of the modern discipline of clinical chemistry can be traced back to the foundation of the journal "Clinical Chemistry" in 1962. Over the past five decades, the field has seen significant progress in laboratory diagnostics, with the journal playing a crucial role in defining the discipline and publishing groundbreaking research.

    Significant Developments in Clinical Chemistry

    Some of the key developments in clinical chemistry include:

    1. High-Sensitivity Cardiac Troponin: The development of high-sensitivity cardiac troponin (cTn) assays has allowed for more accurate diagnosis of heart attacks and other cardiovascular events, enabling timely intervention and improving patient outcomes.

    2. Advancements in Cancer Diagnostics: Techniques such as next-generation sequencing and mass spectrometry have enabled the development of more sensitive and specific cancer diagnostics, improving the detection and management of cancerous conditions.

    3. Lipids, Lipoproteins, and Cardiovascular Risk Factors: Researchers have made significant progress in understanding the role of lipids and lipoproteins in cardiovascular disease, leading to the development of more effective risk assessment and treatment strategies.

    4. Automation in Laboratory Medicine: The automation of laboratory processes has improved the efficiency and accuracy of clinical chemistry analyses, leading to better patient care and outcomes.

    Some of the emerging trends in clinical chemistry include:

    1. Point-of-Care Testing: The development of point-of-care (POC) testing technologies is enabling faster and more accurate results for clinical chemistry analyses, allowing for more informed decision-making in patient care.

    2. Liquid Biopsy: The use of circulating tumor cells (CTCs) as a proxy for tumor tissue is gaining traction in cancer diagnostics and monitoring, offering a less invasive and potentially more accurate alternative to traditional biopsies.

    3. Mini-Reviews and Opinion Papers: The publication of mini-reviews and opinion papers in clinical chemistry journals, such as Clinical Chemistry and Laboratory Medicine (CCLM), is providing valuable insights and perspectives on various aspects of the field.

    Conclusion

    Clinical chemistry has come a long way since its inception, with numerous significant developments and emerging trends shaping the field. As technology continues to advance, the future of clinical chemistry promises to bring even more innovative techniques and approaches to improve patient care and outcomes.

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    Description

    Explore the history, significant developments, and emerging trends in the field of clinical chemistry, including high-sensitivity cardiac troponin assays, advancements in cancer diagnostics, automation in laboratory medicine, point-of-care testing, liquid biopsy, and the publication of mini-reviews and opinion papers.

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