CLINICAL CHEMISTRY

(R.R.Z.S.A)
1. Driving force of bicarbonate buffer system Carbon dioxide
2. Screening tests for Cushing’s syndrome 24-hour urinary free cortisol
Overnight dexamethasone suppression test
Salivary cortisol test
3. Confirmatory tests for Cushing’s syndrome Low-dose dexamethasone suppression test
Midnight plasma cortisol
CRH stimulation test
4. Tissues that secrete hormones Ex. anterior pituitary, thyroid and parathyroid
5. Recently proposed new marker for the early Cystatin C
assessmentof changes to the glomerular
filtration rate
6. Most commonly used as monochromators Diffraction grating (SPECTROPHOTOMETER)
Filter paper (FLUOROMETER)
7. High WBC count = Substantial decreased Leukocytosis can lead to excessive glycolysis
glucose
8. Therapeutic drug monitoring Measuring serum or plasma concentrations at indicated times after
(TDM) administration (PEAK level, TROUGH level or both, depending on the
particular need), useful information can be generated allowing the
clinical staff to adjust dosage and increase benefit and safety
for the patient

9. Metabolite of cocaine Benzylecgonine

10. Pronounced elevation of AST C - Circulatory collapse (shock)
(≥ 5x than normal) A - Acute pancreatitis
M - Myocardial infarction
A - Acute hepatocellular damage
I –Infectious mononucleosis
11. Decreased anion gap of <10 mmol/L Decrease in the unmeasured anions
(ADIC) Increase in unmeasured cations
12. Antitussive drug Codeine(cough suppressant)
13. Specimen for drug testing Drug of abuse: urine / TDM: serum, plasma
14. Indication of relative concentration Dilution
15. Ratio of bicarbonate to carbonic acid 20:1
16. Classification of azotemia Pre-renal, renal and post-renal
17. Glucose is metabolized at room temp 7 mg/ dL/ hour
18. Glucose is metabolized at 4oC 2 mg/ dL / hour
19. Maintains electric neutrality Chloride
20. Calcium regulation PTH, calcitonin, vitamin D
21. Cholesterol and TAG in hypothyroidism Increased cholesterol and Triglycerides
22. Cholesterol and TAG in hyperthyroidism Decreased cholesterol and Triglycerides
23. Definition of hypoglycemia Defined as blood glucose level <50 mg/dL
24. Blood pressure cuff as tourniquet 60 mmHg
25. Production of alpha-fetoprotein Fetal liver
26. Specimen for newborn screening Blood spot collection
27. Important use of serum protein electrophoresis Detection of monoclonal gammopathies such as
M.myeloma
28. Low CV % High precision
29. 10% contamination with 5% dextrose will increase By 500 mg/dl
glucose in a blood sample
30. Basal state collection Early in the morning
31. Instrument having 2 monochromators Fluorometer
32. Instrument having 2 photodetectors Spectrophotometer- DOUBLE-BEAM IN SPACE
33. Color of flame Sodium - yellow
Potassium - violet
Magnesium - blue
Lithium, Rubidium - red

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34. BMI of obese ≥ 30 kg/m2
35. Potentiometry pH and pCO2
36. Amperometry, polarography pO2
37. Most potent estrogen E2 or estradiol
38. Hypersecretion of growth hormone in adults Acromegaly
39. Relationship of T3 and T3 uptake Directly proportional
40. Relationship of T3 uptake test and TBG Indirect or inversely proportional
41. Floating beta lipoprotein β– VLDL
42. Sinking pre beta lipoprotein Lp(a)
43. OGTT Patient should be ambulatory, unrestricted
diet of 150g CHO/ day for 3 days prior to
testing; fasting of 8 to 14 hours
44. Normal BUN to creatinine ratio 10 to 20:1
45. Danger of kernicterus level 20 mg/dL
46. Bilirubin level interfering assays for albumin, 430 mmoL/l (25 mg/L)
cholesterol and total protein
47. Beta gamma bridging pattern in electrophoresis Liver Cirrhosis,
Usage of plasma sample (due to
fibrinogen/fibrin that causes pseudo-beta
gamma bridging )
48. Copper reduction method for glucose Nelson-Somogyi (arsenomolybdic acid)
Folin-Wu (phosphomolybdic acid)
Neocuproine, Benedict’s metod
49. Sodium in DM or hyperglycemia Decreased sodium due to polyuria
50. Reference method for measuring ALP Bowers and McComb
51. Conditions involving female reproductive hormones PCOS: polycystic ovary syndrome
Hirsutism
Infertility
52. Light source for AAS Hallow cathode lamp
53. Comparing patient present result to previous Delta check
results
54. Low temperature storage LD4 and LD5 decrease; ALP increases
55. Patency of biliary ducts, hepatocellular Ratio of direct and total bilirubin
metabolism
56. Overall capacity to transport bile Serum bilirubin level
57. Overall patency of biliary ducts Serum bile acids(salts)
58. Abnormality of bile duct epithelium Serum alkaline phosphatase (ALP)
59. Substrate in Cherry-Crandall (lipase) Olive oil , triolein, or fats
60. Routinely measured electrolytes Sodium, potassium, chloride and bicarbonate
61. Effect of fever to pO2and pCO2 pO2 decreased by 7%
pCO2 increased by 3%
62. Paracetamol/ acetaminophen Hepatotoxic / poison
63. Increased alpha2-globulin Nephrotic syndrome
64. Based on fragmentation and ionization of Massspectrometry
molecules
65. Vancomycin Red man syndrome
66. Aminoglycoside adverse reaction Nephrotoxic and ototoxic
67. Specimen for POCT of DM patients Capillary blood
68. Chemical spills and exposure: when skin contact Best first aid is to flush the area with
occurs large amounts of water FOR AT LEAST 15
MINUTES, then seekmedical attention
69. Counterbalance/ counter ion of sodium Chloride
70. Response of any given patient to drug treatment Age, physical condition and genetic make-up
is highly individual and variable Patients differ response to same medication
71. 135 mEq/L sodium (Na+) 135 mmol/L, conversion factor is 1
72. Antitussive drug Codeine
73. No longer used (obsolete) chemical method for Nelsone somogyi
glucose
74. Fasting hours required for lipid profile Minimum of 12 hours, range 12 to 14 hours
75. The highest protein level in lipoproteins HDL
76. In SPE, what is the farthest protein to the anode Albumin
77. Method for the assay of creatinine that is non Colorimetric: endpoint
specific
78. Calcium Is regulated/affected by PTH, Calcitonin, and vitamin D

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79. Most abundant protein Albumin
80. AFP is produced in Fetal liver and yolk sac
81. Method for drug detection/quantification GC/MS (GOLD STANDARD FOR DRUG TESTING)
82. Creatinine clearance test Index of overall renal function
83. B2 microglobulin Appears in the urine when reabsorption is
incomplete because of proximal tubular
damage, as in acute kidney injury
84. Heparin for most chemistry tests Lithium heparin
85. A progressive and irreversible loss of renal Chronic renal failure
function, results from several disease entities
86. Hypoglycemia Blood glucose level less than 50 mg/dl
87. Gestational diabetes patients develop diabetes Within 5 to10 years
88. Performed routinely to monitor glucose control Glycosylated hemoglobin
89. Lock and Key (Emil fischer) The shape of the key (substrate) must fit
into the lock (enzyme)
90. Hypersecretion of growth hormone in adults Acromegaly
91. Cretinism Hyposecretion of thyroxine in children
92. Air displacement pipet Relies on piston for suction to draw sample
into disposable tip; the piston does not
come in contact with the liquid
93. Lean Six sigma DMAIC (Define, measure analyze, Improve and
control ) methodology
94. Most common abused drug Grain alcohol (Ethanol)
95. Associated with blindness Wood alcohol (Mehtanol)
96. Rubbing alcohol Isopropanol
97. Mercury Amalgamate: mix or merge with other
substances
98. Lysergenic acid diethylamide (LSD, lysergide) ―Undulating vision ; ―bad trip‖ –panic
depression

99. Assay for Creatinine 1. Simple nonspecific method

Colorimetric : endpoint

2. Rapid and with increased specificity

Colorimetric: Kinetic, Jaffe

3. Measures ammonia colorimetrically or with ion selective

electrode
Enzymatic: UV
100. Assay for Urea Nitrogen 1. Inexpensive but lacks specificity
Colorimetric, diacetyl

2. Greater specificity, more expensive and measure ammonia

formation
Enzymatic
101. Assay for Uric Acid 1. Problems with turbidity
Colorimetric: Phosphotungstic acid method/
caraway method

2. Needs special instrumentation and optical cells

Enyzmatic: UV

3. Prone to interference by reducing substances

Enyzmatic: H2O2
102. Modified Allen’s test Assess collateral circulation before collecting a blood
specimen from the radial artery
103. Lithium Heparin Anticoagulant of choice in clinical chemistry with least
interference in analysis
104. OGTT patient preparation Ingest at least 150g of CHO for 3days
105. Glycosylated Hemoglobin Performed routinely to monitor glucose control
106. 5 to 10 years (10yrs) Patient with Gestational diabetes may develop DM after
107. Minor lipoproteins IDL and Lp(a)

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108. Major lipoproteins LDL, HDL, VLDL, Chylomicrons
109. Abnormal lipoproteins Beta-VLDL(Floating beta-Lipoprotein), Lipoprotein X
110. Apo A-1 Major structural apolipoprotein in HDL
111. Apo B-100 Major structural apolipoprotein in LDL AND VLDL
112. Apo B-48 Major structural apolipoprotein in CHYLOMICRONS
113. > 60mg/dl HDL Level protective against heart disease
114. <40mg/dl HDL level Major risk for heart disease
115. HDL of 60mg/dl Negative risk factor for coronary heart disease
116. HDL of ≤40mg/dl Positive risk factor for coronary heart disease
117. Lp(a) Sinking pre-Beta-Lipoprotein
118. Increase Effect of growth hormone to blood glucose level
119. Cushing’s disease Increase in cortisol caused by excessive development and
activity of pituitary gland. (Increase both ACTH AND
CORTISOL)
120. acromegaly Hypersecretion of growth hormones in adults
121. Gigantism Hypersecretion of growth hormones in children
122. NCEP GUIDELINES FOR ACCEPTABLE MEASUREMENT
ERROR Cholesterol CV of ≤3%
Triglycerides CV of ≤5%
HDL and LDL CV of ≤4%
123. Recommended Cut off points for serum
cholesterol Age (Years) Moderate Risk High Risk
2-19 >170 mg/dl >185 mg/dl
20-29 >200 mg/dl >220 mg/dl
30-39 >220 mg/dl >240 mg/dl
40 and over >240 mg/dl >260 mg/dl
124. Growth
hormone
disorders Condition Screening Confirmatory
test Acromegaly (GH excess) Somatomedin C or glucose suppression
insulin-like growth test- OGTT (75g
factor 1 (IGF-1) glucose)
Dwarfism (GH deficiency) Physical activity test Insulin Tolerance
(exercise test) test-=Gold Standard

Arginine stimulation
test- 2ndconfirmatory
test
125. Cortisol
disorders
test Condition Screening Confirmatory
Cushing’s syndrome/ -24-hour urinary free -Low-dose dexamethasone
cortisol suppression test
Hypercorticolism
-Overnight dexamethasone -Midnight plasma cortisol
suppression test
-CRH stimulation test
-Salivary cortisol test
Addison’s disease/ -ACTH stimulation test Insulin tolerance test
Hypocorticolism
-Cosyntropin stimulation test
126. Aldosterone
disorders test Condition Screening confirmatory
Conn’s disease / Plasma -saline suppression
Hyperaldosteronism aldosterone/plasma
renin ratio -oral sodium loading

-Fludrocortisone
suppression test

-Captopril challenge test

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 Condition Tests
Hypoaldosteronism Furosemide stimulation test (+) result; low
aldosterone levels
Saline suppression test– (+) result; high
aldosterone levels

127. ACTH Test to differentiate Cushing’s syndrome from Cushing’s disease

Cushing’s disease =Increase ACTH and cortisol

Cushing’s syndrome = decrease ACTH ,Increase cortisol
128. Forward reaction for CK Tanzer Gilvarg
129. Reverse reaction for CK Oliver Rosalki
130. Forward reaction for LDH Wacker
131. Reverse reaction for LD Wrobleuski and LaDue
132. Enzyme specificity
High Specificity ACP RBC, prostate
ALT Liver
Amylase Pancreas, salivary gland
Lipase Pancrease
Moderate AST Liver, heart, Skeletal
Specificity muscles
CK Heart, Skeletal muscles,
brain
Low specificity ALP Liver, Bone, kidney
LD All tissues

133. Enzyme classification

Class Function EXAMPLES
Oxidoreductases Catalyze the removal or LDH, MDH, ICD. G6PD
addition of electrons
Ex: ends with
dehydrogenase or
oxidase
Transferases Catalyze the transfer of CK, AST, ALT ,OCT
a chemical group other
than hydrogen from one Ex: ends with kinase
substrate to another or transferase
Hydrolases Catalyze hydrolysis or Esterases: ACP,ALP
splitting of a bond by Peptidases: Trypsin,
the addition of water Pepsin, LAP
Glycosidase: AMS,
galactosidases
Lyases Catalyze removal of Glutamate
groups from substrates decarboxylase,
without hydrolysis. The pyruvate
product contains double decarboxylase,
bonds aldolase

Ex: ends with

decarboxylase
Isomerases Catalyze the Glucose phosphate
intramolecular isomerase
arrangement of the
substrate compound
Ligases Catalyze the joining of Glutathione
two substrate molecules, synthetase
coupled with breaking of Synthase
the pyrophosphate
bondind ATP

134. Isoenzyme Multiple forms of the same enzyme catalyzing the same chemical reaction

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135. GGT Enzyme marker for occult alcoholism
136. Cholinesterase Enzyme that the significant value is decrease
137. Direct/linear Relationship of T3 and T3 uptake test
138. Inverse Relationship of T3 uptake and TBG
139. TSH -Diagnostic test to differentiate Primary and secondary
Hypo/Hyperthyroidism
-Most important thyroid function test
-best method for detecting clinically significant thyroid
dysfunction
140. Thyroid disorders Primary 2ndary Tertiary
hypothyroidism Hypothyroidism Hypothyroidism
(Hashimoto’s
disease)
TSH INCREASE DECREASE DECREASE
T3/T4 DECREASE DECREASE DECREASE
T3 uptake DECREASE DECREASE DECREASE
TBG INCREASE INCREASE INCREASE

Primary 2ndary Tertiary

hyperthyroidism Hyperthyroidism Hyperthyroidism
(Grave’s disease)
TSH DECREASE INCREASE INCREASE
T3/T4 INCREASE INCREASE INCREASE
T3 uptake INCREASE INCREASE INCREASE
TBG DECREASE DECREASE DECREASE

Condition T3/T4 TSH

Subclinical Normal Increase
hypothyroidism
Subclinical Normal Decrease
hyperthyroidism

141. Stages of
impairment by Blood Alcohol % Signs and symptoms
ethanol W/V
0.01-0.05 No obvious impairment, some changes observable on performance testing
0.03-0.12 Mild euphoria, decreased inhibitions, some impairment of motor skills
0.09-0.25 Decreased inhibitions, loss of critical judgement, some impairment of motor
skills
0.18-0.30 Mental confusion, dizziness, strongly impaired motor skills (staggering, slurred
speech)
0.27-0.40 Unable to stand or walk, vomiting, impaired consciousness
0.35-0.50 Coma and possible death
142. 0.10% (100mg/dl) Presumptive evidence of driving under the influence of
alcohol
143. BMI
Nutritional status WHO Criteria Cut-OFF ASIAN CRITERIA Cut-
OFF
Underweight <18.5 <18.5
Normal 18.5 to 24.9 18.5 to 22.9
Overweight 25 to 29.9 23 to 24.9
Pre Obese - 25 to 29.9
Obese ≥30 ≥30
Obese type 1 30 to 40 30 to 40
Obese type 2(Morbid) 40.1 to 50 40.1 to 50
Obese type 3(Super) >50 >50

144. X-axis Horizontal,absicca, independent variables

145. Y-AXIS Vertical, ordinate, Dependent variables

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146. T-Test Accuracy, Mean
147. F-test Precision, SD
148. Inverselyproportional Relationship of %CV to precision
149. Point of care testing Alternative site testing, Near-patient test, decentralized testing,
bedside testing, or ancillary testing
150. Osmolality test Test used to investigate pseudohyponatremia
151. Calcium and magnesium Electrolytes involved in coagulation
152. Hyponatremia due to increase
sodium loss a. Hypoadrenalism
b. Potassium deficiency
c. Diuretic use
d. Ketonuria
e. Salt-losing nephropathy
f. Prolonged vomiting or diarrhea
g. Severe burns
153. Hyponatremia due to increase
water retention a. Renal failure
b. Nephrotic syndrome
c. Hepatic cirrhosis
d. Congestive heart failure
154. Hyponatremia due to water
imbalance a. Excess water intake
b. SIADH
c. Pseudohyponatremia
155. Hypernatremia due to excess
water loss a. Diabetes insipidus
b. Renal tubular disorder
c. Prolonged diarrhea
d. Profuse sweating
e. Severe burns
156. Hypernatremia due to decrease a. Older persons
water intake b. Infants
c. Mental impairment
157. Hypernatremia due to increase a. Hyperaldosteronism
intake or retention b. Sodium bicarbonate excess
c. Dialysis fluid excess
158. Causes of
Hyperkalemia Due to decreased renal -Acute or chronic renal failure
excretion (GFR <20 mL/min)
-Hypoaldosteronism
-Addison’s disease
-Diuretics

Due to Cellular shift -Acidosis

159. CAUSES OF HYPOKALEMIA
-Muscle/cellular injury
-Chemotherapy
-Leukemia
-Hemolysis
Due to Increased intake -Oral or intravenous potassium
replacement therapy
Artifactual /Psuedo -Sample hemolysis
-Thrombocytosis
-Prolonged tourniquet use or
excessive fist clenching
Due to gastrointestinal -Vomiting
loss -Diarrhea
-Gastric suction
-Intestinal tumor
-Malabsorption
-Cancer therapy—chemotherapy,
radiation therapy
-Large doses of laxatives

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 Due to renal loss -Diuretics—thiazides,
mineralocorticoids
-Nephritis
-Renal tubular acidosis
-Hyperaldosteronism
-Cushing’s syndrome
-Hypomagnesemia
-Acute leukemia
Due to cellular shift Alkalosis
Insulin overdose
Due to decreased intake -
160. <135mg/dl Sodium level that indicates Hyponatremia
161. >145mg/dl Sodium level that indicates Hypernatremia
162. Critical values
Hypernatremia 160 mmol/L
Hyponatremia 120 mmol/L
Hyperkalemia 6.5 mmol/L
Hypokalemia 2.5 mmol/L

163. Sodium primary extracellular cation in the human body and is

excreted principally through the kidneys.
164. Potassium main intracellular cation in the body
165. Chloride the principal extracellular anion and is involved in the
maintenance of extracellular fluid balance.
166. Calcium the second-most predominant intracellular cation, is the
most important inorganic messenger in the cell
167. Potassium Electrolyte that serves as an integral part of the
transmission of nerve impulses
168. Sodium Electrolyte that has in relation of regulation of water
level in the body , and osmotic pressure
169. Chloride Electrolyte that serve as an enzyme activator for amylase
170. bicarbonate the second most abundant anion in the Extra Cellular Fluid
171. chloride Electrolyte that maintains electroneutrality through the
chloride shift
172. chloride shift Bicarbonate diffuses out of the cell in exchange for
chloride to maintain ionic charge neutrality within the cell
173. GI tract, Kidney, Bone Organ systems that regulates Calcium and phosphorous metabolism
174. Increase Effect of high bilirubin and Hemoglobin level in ACP measurement
175. bicarbonate major component of the buffering system in the blood
176. Components of the Bicarbonate, Carbon dioxide, Carbonic acid, Water, and protons
buffering system

177. Major Functions of

electrolytes Volume and osmotic regulation Na, Cl, K
Regulation of ATPase ion pumps Mg
Myocardial rhythm and contraction K,Mg, Ca
Cofactors of enzyme activation Mg, Ca, Zn
Blood coagulation Mg, Ca
Acid-Base balance K, Cl, HCO3
Production and used of ATP from Phosphorus/Phosphate,
glucose Mg
Neuromuscular excitability Mg, K, Ca

178. Anion gap Serve as a quality control in measurements of

electrolytes

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179. Increase ANION GAP (MUDPHILES)
M- methanol poisoning
U-Uremia
D-Diabetic Ketoacidosis
P- Phosphate/paracetamol/paraformaldehyde
H-Hypernatremia
I-Instrument error / Iron / Isoniazid/ Inborn error of
metabolism
L-Lactic acidosis
E-Ethanol /ethylene glycol poisoning
S-salicylate poisoning

180. Decrease anion gap Decrease unmeasured anion, Increased Unmeasured cation
(HHM)
H- Hypoalbuminemia
H-Hypercalcemia
M-Multiple myeloma

181. albumin -major/general transporter

-most anodic protein
-negative acute phase reactants
-maintains osmotic pressure
-marker of malnutrition
-most predominant protein
182. Troponin I Most specific AND REFERENCE cardiac marker for ACUTE
MYOCARDIAL INFARCTION
183. myoglobin 1st cardiac marker to increase in A.M.I
184. Na, K, Cl, and Bicarbonate Routinely measured electrolytes , component of electrolyte
profile
185. Ethosuximide (1st answer) The drug of choice for treating PETIT-MAL(absence
186. Valproic acid (2nd answer if wala seizures)
yung ethosuximide)
187. Capillary puncture/capillary Sample used for glucose monitoring done or performed by
blood patients
188. Dilution Indicative of relative concentration
189. percentage Refers to parts per 100
190. Triglycerides, Total cholesterol, LDL-C may be computed/calculated from the measurements of
and HDL
*Note = VLDL NOT included in the
computation
191. QC errors
Random Errors Systematic errors
a. Mislabeling a sample a. Improper calibration
b. Pipetting errors b. Deterioration of
c. Improper mixing of sample reagents
and reagent c. Sample instability
d. Voltage fluctuations not d. Instrument drift
compensated for by e. Changes in standard
instrument circuitry, and materials
e. Temperature
fluctuations/variations
f. Instrument instability
g. Reagent variation
h. Handling techniques, and
operator variables

192. Appearance of plasma in association

with TAG level Clear TAG <200mg/dl
Hazy or Turbid TAG >300mgd/dl
Opaque or Milky TAG >600mg/dl

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193. STANDING PLASMA TEST
1. Chylomicrons = accumulate as a floating creamy
layer
2. VLDL = Plasma sample remains turbid after standing
overnight
194. MONITOR HBA1C and Fructosamine values are used to glucose levels
195. below 400mg/dL or (4.52 mmo/L) The fridewald formula is valid only if the TAG level
is

196. >600mg/dl TAG level greater than hinders the usage of LDL-C
methods(inaacurate)
197. Liquid nitrogen Most widely used cryogenic fluid in laboratory

198. Hazards associated with Liquid 1. Fire or explosion

nitrogen or cryogenic materials 2. Asphyxiation
3. Pressure buildup
4. Embrittlement of materials
5. Tissue damage similar to thermal burns
199. standard Material of known composition available in a highly
purified form / known analyte with same concentration
200. control Material with physical and chemical properties closely
resembling the test specimen and containing pre-
analyzed concentrations of the substances being
measured
201. Transaminases(ALT and AST) Test that conveys information on hepatocellular damage
and necrosis
202. Analytes affected by Hemolysis PAPAALAM Ca Iwan Ko?

Potassium, ammonia, phosphorus ,AST, ALT,LD, ACP,

Magnesium,catecholamines, iron, CK
203. Effect of marked hemolysis in Sodium Decrease sodium level due to dilutional effect
204. Quadruple test for down syndrome
Test Significant level in DS
AFP Decrease
Estriol(E3) Decrease
Inhibin A Increase
HcG Increase
205. Analytes that shows circardian or
diurnal variation CAPAI GAPI:D
✓ Cortisol, ACTH, Plasma renin activity,
Aldosterone, insulin, growth hormone,
ACP,Prolaction, and Iron
206. Cardiac troponins Gold standard in the diagnosis of Acute coronary syndrome
207. Immunochemical and Two basic techniques involved in measuring drugs, whether
Chromatographic methods drug of abuse or therapeutic drugs
208. Marijuana Oldest and most widely used mind altering drug
209. Enzyme: First order Reaction rate is directly proportional to the substrate
kinetics concentration
210. Enzyme: Zero order kinetics Reaction rate is directly proportional to enzyme concentration
211. Transporters
Transporter protein Substance transported
Orosomucoid/A1- acid glycoprotein Progesterone
A1-antichymotrypsin PSA(Prostate specific Ag)G
Gc-Globulin Vitamin D /cholecalciferol
haptoglobin Free hemoglobin
hemopexin Free heme
ceruloplasmin copper
Transferrin/siderophilin Iron (ferric iron)
TBG(Thyroid binding globulin T3 and T4
Prealbumin/Transthyretin Retinol (vitamin A),T3 , and T4

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212. Analytes with its
active metabolite Analyte Metabolite
Amitriptyline Nortriptyline
Cocaine Benzylecgonine
Dopamine HVA(homovanillic acid)
Epinephrine VMA(Vanillylmandelic acid)
Heroin Morphine
marijuana tetrahydrocannabinol
norepinephrine VMA(Vanillylmandelic acid)
Primidone Phenobarbital
Procainamide NAPA(N-acetly procainamide)
Serotonin 5-HIAA(Hydroxy indole acetic
acid)

213. FORMULAS/EQUATIONS
ANION GAP (Na + K) – (HCO3 + Cl) or Na –(HCO3+Cl)
osmolality 2(Sodium) + (glucose/20) + (BUN/3) or

1.86(Sodium) + (Glucose/18) + (BUN/2.8)+ 9

FRIDEWALD LDL-C = Total cholesterol- HDL –(TAG/2.175 mmol/L)
FROMULA OF LDL-C = Total cholesterol – HDL –(TAG/5 mg/dl)
LDL-C
DeLong LDL-C = Total cholesterol- HDL –(TAG/2.825 mmol/L)
FORMULA OF LDL-C = Total cholesterol – HDL –(TAG/6.5 mg/dl)
LDL
Handerson- Ph = pKa + log (Bicarbonate/carbonic acid)
hasselbach *note!!! pKa value is 6.1

214. ORDER OF NPN SUBSTANCES ACCORDING TO ITS Uh! Ah ! Uh! Ca! Ca! AH!
CONCENTRATION (Highest to lowest)
Urea, Amino acid, Uric acid, Creatinine,
creatine, Ammonia

215. Urea Non protein nitrogenous substance that

constitutes almost half of the total NPN
216. Anticoagulant of choice for blood gas Lithium Heparin
analysis

217. ACID BASE

BALANCE ACID BASE DISODER COMPENSATION CAUSE
RESPIRATORY ACIDOSIS RETENTION OF BICARBONATE Hypoventilation
RESPIRATORY ALKALOSIS SECRETION OF BICARBONATE Hyperventilation
METABOLIC ACIDOSIS HYPERVENTILATION Excess H+ production
METABOLIC ALKALOSIS HYPORVENTILATION Excess H+ loss, Excess
alkali intake
218. Hyperventilation 1. Causes respiratory alkalosis
2. Compensation for Metabolic acidosis
3. Carbon dioxide is exhaled faster
219. MEASURES OF CENTER
Mean Commonly called the average, most commonly used measure
of center
Median Middle point of the data and is often used with skewed
data
Mode Most frequently occurring value in a dataset. Although it
is seldom used to describe data, it is referred to when
in reference to the shape of data, a bomodal
distribution, for example

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220. Associated with LOW OR
INVERTED Albumin/Globulin
ratio
221. List of some analytes
and its respective
Reference method
222. 10 to 15%
223. PARTS OF POSITIVE DISPLACEMENT
PIPET
224. Liver
225. Organs sensitive to ethanol abuse
226. Sodium and Chloride
227. Most potent estrogen
228. Posterior pituitary gland
229. Albumin
230. Gamma
globulins/antibodies
231. Example of CNS
depressants
232. SYSTEMATIC ERROR
233. Normal Gaussian curve
234. pseudohyponatremia
235. The hormones that assist in controlling
protein synthesis
236. The hormones that assist in controlling
protein catabolism
237. Condition associated with increased
Prealbumin/Transthyretin
238. B-Natriuretic PePtide
239. Fibronectin
I.K. Aytona
1. Nephrotic syndrome
2. Multiple myeloma
3. Liver cirrhosis
ANALYTE REFERENCE METHOD
HBa1c HPLC
PROTEIN KJELDAHL
GLUCOSE HEXOKINASE
LIPOPROTEINS ULTRACENTRIFUGATION
CHOLESTEROL ABELL KENDALL
TRIGLYCERIDE MODIFIED VAN HANDEL
GLOMERULAR FILTRATION RATE INULIN CLEARANCE TEST
NPN SUBSTANCES (BUN, URIC ACID, ISOTOPE DILUTION MASS
CREATININE) SPECTROMETRY (IDMS)
DRUG TESTING GAS CHROMATOGRAPHY/MASS
SPECTROMETRY (GC/MS)
NEW BORN SCREENING TANDEM MS/MS
ALP BOWERS AND MCCOMB
CALCIUM , MAGNESIUM and AAS(ATOMIC ABSORTION
ELECTROLYTES SPECTROSCOPY)
Amylase Saccharogenic method
Lipase Cherry crandal method
ACP Roy and Hillman
Alcohol testing Chromatography
Electrode in Ph Calomel and silver-silver
electrode
Whole blood glucose is lower than serum glucose
Piston, piston seal,Capillary,shaft, hypodermic needle
Most sensitive organ associated with ethanol abused
LIVER, stomach, GI tract, CNS (brain), Pancreas
Electrolytes that provides that largest contribution of serum
osmolality
Estradiol (E2)
Endocrine gland that secretes that ADH and Oxytocin
In electrophoresis, the protein that migrates closest to the
anode(positive charge)
In electrophoresis, the protein that migrates closest to the
cathode(negative charge)
-Barbitrurates (phenobarbital)
-Benzodiazepines (valium/diazepam)
-Methaqualone
It is an error that influences observations consistently in one
direction (constant difference)
MEAN=MEDIAN=MODE
Hyperlipidemia and Hyperproteinemia will cause
thyroxine, growth hormone, insulin, and
testosterone.
glucagon and cortisol
patients receiving steroids, in alcoholism, and
in chronic renal failure
marker for congestive heart failure.
A glycoprotein composed of two nearly identical subunits. Although
fibronectin is the product of a single gene, the resulting protein
can exist in multiple forms due to splicing of a single pre-mRNA.
The variants demonstrate a wide variety of cellular interactions,
including roles in cell adhesion, tissue differentiation, growth,
and wound healing. Fetal fibronectin (fFN) is a glycoprotein used to
help predict the short-term risk of premature delivery. Plasma
fibronectin has been used as a nutritional marker.
Page 12
240. Adiponectin is a 247–amino acid fat hormone composed of an N-terminal collagen-
like domain and a C-terminalglobular domain produced by adipocytes.
Recent studies have shown an inverse correlation between body mass
index (BMI) and adiponectin values. Lower levels of adiponectin
correlate with an increased risk of heart disease, type 2 diabetes,
and metabolic syndrome, and obesity
241. Beta-Trace Protein Recently, it was verified that BTP was established as an accurate
marker of CSF leakage.
Reported recently as a potential lmarker in detecting impaired renal
function, although no more sensitive than cystatin C.
Apromising marker in the diagnosis of perilymphatic fluid fistulas.
242. Cross-linked C- Cross-linked C-telopeptides (CTXs) are proteolytic fragments of
telopeptides collagen I formed during bone resorption (turnover). CTX is a
biochemical marker of bone resorption that can be detected in serum
and urine
243. Cystatin C Cystatin C, a low-molecular-mass protein with 120 amino acids, is a
cysteine proteinase inhibitor. It is produced and destroyed at a
constant rate, making it a recently proposed new marker for the
early assessment of changes to the glomerular filtration rate.
Cystatin C levels are not affected by muscle mass, gender, age, or
race unlike creatinine, nor are they generally affected by most
drugs, infections, diet, or inflammation.
244. Amyloids Amyloids are insoluble fibrous protein aggregates formed due to an
alteration in their secondary structure known as Beta-pleated
sheets. Amyloid characteristically stains with Congo red. It can be
used as supplemental tests to help differentiate a diagnosis of
Alzheimer disease from other forms of dementia. (Increase in
Alzheimer Disease)
245. High-sensitity CRP High-sensitivity CRP (hsCRP) is the same protein but is named for
the newer, monoclonal antibody–based test methodologies that can
detect CRP at levels below 1 mg/L. The hsCRP test determines risk of
CARDIOVASCULAR DISEASES. High levels of hsCRP consistently predict
recurrent coronary events in patients with unstable angina and AMI.
246. Negative acute phase -decreases during inflammation
reactants Transferrin, Albumin, Pre-Albumin
247. At least 20mg/dl bilirubin Danger level of kernicterus
248. Blood pH
Normal 7.35 to 7.45
Alkalemia Above 7.45
acidemia Below 7.35
average 7.40
Arterial blood 7.45
Venous blood 7.35
249. Peak Highest concentration of drug in blood obtained in the dosing interval

*blood should be collected an hour after the dose of drug

250. Through Lowest concentration of drug in blood obtained in the dosing interval

*blood should be collected 30 minutes before the next dose

251. Microalbuminuria Earliest indication of Diabetic nepropathy
252. RENIN
Increased in RESPONSE TO Low plasma sodium level, hypotension(low
blood pressure), and low blood volume
Effect Will lead to hypertension(Increase BP)
253. Liver disease The most common cause of abnormal ammonia metabolism
254. Male hypogonadism
Primary hypogonadism Secondary
Hypogonadism
Testosterone Decrease Decrease
LH and FSH Increase Decrease
255. Acid Substance that can yield a hydrogen ion or hydronium ion when
dissolved in water
-Hydrogen Donator

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256. Base Substance that can yield hydroxide ion (OH)when dissolved in water
-Hydrogen acceptor

257. Colligative properties Freezing point , vapor pressure, osmotic pressure, boiling point

• For every 1 molecule added in a solution

Increases osmotic pressure, boiling point
Decreases Freezing point, vapor pressure

• Increase osmolality will lead to -→

Decrease Freezing point and vapor pressure

258. vapor pressure the pressure at which the liquid solventis in equilibrium with the
water vapor
259. Freezing point the temperature at which the vapor pressures of the solid and liquid
phases are the same
260. boiling point temperature at which the vapor pressure of the solvent reaches one
atmosphere
261. osmotic pressure the pressure that opposes osmosis when a solvent flows through a
semipermeable membrane to establish equilibrium between compartments
of differing concentration
262. errors
Random errors(ODD numbers) Systematic errors (EVEN numbers)
12s , 13s , R4s 22s , 41s, 10x
263. wavelength of non-
ionizing radiation Wavelength – is the distance between two successive peaks and it is
expressed in terms of nanometer(nm)

Radiation Wavelength Light source examples

UV (Ultra violet <400nm Deuterium lamp, mercury arc,
spectrum) xenon lamp, hydrogen lamp
Visible spectrum 400-700nm Tungsten lamp, xenon lamp,
mercury arc
Infrared region >700nm Merst glower and Globar
(silicone carbide)
264. VERY SHORT WAVELENGTH OF UV LIGHTS
265. CIRRHOSIS Irreversible scarring, fibrosis , and destruction of the normal
liver architecture
From normal liver architecture to abnormal nodular architecture

Note!
80% of the liver should be damaged to abolish its function
266. Neonatal jaundice A neonate bilirubin above 28 should be reported immediately
Newborns appear jaundiced when bilirubin level is >7mg/dl (Manual of
Neonatal care by John Cloherty)
267. Spectrophotometers Instrument that uses monochromatic light diffraction gratings
268. photometers Uses glass filters and interference filters
269. spectrophotometers Uses diffraction gratings and prisms
270. measures of dispersion Range, SD, and CV
271. Indicates the extent of variation of the Range, SD, and CV
observations
272. Criteria for Fasting Plasma Glucose Non diabetic = <100mg/dl
Impaired Plasma Glucose = 100-125 mg/dl
Diabetes Mellitus = ≥126 mg/dl

273. Criteria for Oral Glucose tolerance Test Normal/Non diabetic = 2hr plasma glucose <140mg/dl
Impaired GTT = 2hr plasma glucose 140-199mg/dl
Diabetes Mellitus = 2hr plasma glucose ≥200mg/dl

274. Criteria for DM RBS = ≥200 mg/dl

FBS = ≥126mg/dl
2hrPost Glucose load = ≥200mg/dl
HBA1C = ≥6.5%

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275. ANTI-ASTHMATIC DRUGS/BRONCHODILATORS Theophylline and Theobromine
276. BASAL STATE COLLECTION Blood collection early in the morning before the patient has eaten or become
physically active. This is a good time to draw blood sample because the body is
at rest and food has not been ingested during the night

277. TAM T test = accuracy = Mean

278. SPF F test= precision = SD
279. Leydig cells Testicular cells that produces testosterone
280. Kwashiorkor Acute protein calories malnutrition
281. Marasmus Caused by caloric insufficiency without protein insufficiency so that the serum albumin level
remains normal; there is considerable loss of body weight
282. Disorders related to BILIRUBIN
METABOLISM Gilbert’s syndrome ✓ Bilirubin transport deficit
✓ Characterized by impaired cellular uptake of
bilirubin
✓ Elevated B1

Crigley Najjar Syndrome ✓ Conjugation Deficit

✓ Increase levels of B1
✓ Type 1 Crigle najjar = lacks UDPGT , (+)
KERNICTERUS
✓ Type 2 Crigler Najjar = partial deficiency of UDPGT

Dubin Johnson Syndrome and ✓

Bilirubin Excretion Deficit
Rotor syndrome ✓
Elevated B2
✓
There is an intense dark pigmentation of the liver
(black liver) due to accumulation of lipofuscin
pigment (dubin Johnson)
Lucey Driscoll syndrome ✓ A familial form of uncojugated hyperbilirubinemia
caused by a circulating inhibitor of bilirubin
conjugation
✓ Elevated B1
283. Kernicterus seen in criggler –Najjar syndrome, is the deposition of unconjugated
bilirubin in the brain, particularly affecting the basal ganglia, mainly
the lenticular nucleus, causing severe motor dysfunction and retardation

284. Glass pipet It is a BASIC PIPET

285. At 20 degree celcius Calibration of glass pipet
286. 9 grams dissolved in 1L of How will you prepare 1 liter of NSS using pure Sodium chloride crystals?
water
287. Calibration the comparison of an instrument measure or reading to a known physical
constant.
288. control represents a specimen with a known value that is similar in composition,
for example, to the patient’s blood. Controls are the best measurements
of precision and may represent normal or abnormal test values.
289. Standard are highly purified substances of a known composition. A standard may
differ from a control in its overall composition and in the way it is
handled in the test. Standards are the best way to measure accuracy.
Standards are used to establish reference points in the construction of
graphs (such as the manual hemoglobin curve) or to calculate a test
result.
290. Quality control a process that monitors the accuracy and reproducibility of results through the use of
control specimens
291. Trend A gradual change in the mean
292. Shift An abrupt change in the mean
continuous quality improvement The ongoing process of making certain the correct laboratory result is reported for the
293. (CQI) right patient in a timely manner and at the correct cost is known as
294. Total Quality is a systematic problem-solving approach using visual tools to
Management (TQM) identify the steps in the process for meeting customer satisfaction
of quality care in a timely manner at reduced costs
295. Benchmarking Individual facility COMPARE ITS RESULTS WITH THOSE OF ITS PEERS

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296. UNRESECTABLE In pancreatic adenocarcinoma, 96% of tumors with CA 19-9 levels
>1000 U/ml are considered as UNRESECTABLE (cannot be removed
completely through surgery)
297. Calcium and albumin Significantly affected by a change in posture from supine to a
sitting or standing position
298. Deterioration of Main cause of TREND in Quality control
reagent
299. Improper calibration of Main cause of SHIFT in QC
the instrument
300. Unit of measurements
Measure Unit
Meter (m) Length
Kilogram (kg) Mass
Seconds (s) Time
Mole (mol) Quantity of substance
Ampere (A) Electric current
Kelvin (k) Thermodynamic temperature
Candela (cd) Luminous intensity

301. Absorbance Abc = 2 – log%T

302. Ortho toluidine, and condensation CHEMICAL method for glucose that is still widely
method used
303. Inversely proportional / reciprocal Relationship of Bicarbonate and Chloride
304. Base Dissociable Substance that can accepts Hydrogen ions
305. Acid Dissociable Substance that can accepts Hydroxyl ions
306. Tangier’s disease Disorder characterized by abnormal and decrease HDL
307. >100 mg/dl Blood alcohol level that is considered as legally intoxicated
308. Pituitary gland Master gland
309. Hypothalamus It synthesizes or produces ADH and oxytocin
310. Posterior pituitary gland It stores and secretes ADH and oxytocin
311. Hyposecretion of gonadotrophins results in SEXUAL UNDERVELOPMENT and INFERTILITY
(e.g FSH and LH)
312. Hypersecretion of gonadotrophins Results in SEXUAL PRECOCITY and is usually a result of
(e.g FSH and LH) a brain tumors in the region of hypothalamus
313. Euthyroidism Refers to a normal functioning thyroid gland in the
presence of an abnormal concentration of TBG

314. Arterial blood gas monitoring is the standard for assessing a patient’s
oxygenation, ventilation, and acid-base status. Although ABG monitoring has
been largely replaced by non-invasive monitoring, it is still useful in the
confirmation and calibration of non-invasive monitoring techniques.

315. Serum
protein Increase alpha-2-macroglobulin with Nephrotic syndrome
electrophoresis decrease albumin
patterns Sharp increase in a single immunoglobulin Monoclonal gammopathy
(M spike) , all other fractions are
decrease
Diffuse increase in gamma region Polyclonal gammopathy
Beta gamma bridging( primarily due to Liver Cirrhosis
increase IgA)
Extra band between beta and gamma region Usage of plasma (due to
(pseudo beta gamma bridging) fibrinogen)
Increase beta or unusual band between Hemolyzed specimen
alpha2 and beta
Increase alpha-1 and alpha-2 Acute inflammation
Increase alpha-1, alpha-2 and gamma Chronic inflammation
Decrease alpha-1region Associated with alpha-
1antitrypsin deficiency
(causes emphysema and juvenile
cirrhosis)

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316. Detection of monoclonal Single most important and clinical application of serum
gammopathies (E.g Multiple protein electrophoresis
myeloma)
317. Characteristic of liver Presence of fibrosis, scarring and destruction of normal
cirrhosis liver architecture
318. 80% of the liver should be damaged in cirrhosis to abolish its
function
319. Critical or panic values -Test results that indicate a potentially life-threatening
situation. Patient care personnel must be notified
immediately
- Critical/Panic values are defined as values that are outside
the normal range to a degree that may constitute an immediate
health risk to the individual or require immediate action on
the part of the ordering physician

examples : glucose, Sodium, potassium, total Co2, CALCIUM,

MAGNESIUM,phosphorus, total bilirubin, and blood gases

320. Critical value list

321. Read back policy Person receving critical values must record and read back
patient’s name and critical values. Laboratory must document
person who received information and time of notification.
322. Classification
of azotemia Pre-renal ✓ Due to diminished glomerular filtration with normal renal function
✓ Caused by reduce blood flow, poor perfusion of the kidnesy

E.g : dehydration, shock and congestive heart failure

Renal ✓ Characterized by damaged within the kidneys (decrease GFR)
✓ Produced by renal failure, damage to filtering structures of the kidney

e.g : Acute/chronic renal disease, glomerulonephritis, tubular necrosis

Post-renal ✓ Usually the result of urinary tract obstruction (decrease GFR)
✓ Urea level is higher than creatinine due to back diffusion of urea into
the circulation; increased urea and creatinine in blood

e.g : renal stones, cancer or tumors of urinary tract

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323. Uremia or uremic syndrome Toxic condition of very high plasma urea concentration
accompanied with renal failure
324. Food rich in HMMA (OH- Banana, vanilla,tea, coffee
3methoxymandelic acid
325. Ratio Refers to the amount of something in proportion to the amount
of something else
326. Concentration Refers to amount of solute in a given volume of solution
327. Molarity Refers to gram molecular mass or weight of a compound per liter of solution
328. Fluorescence Emmits light in a longer wavelenght and lower energy
329. dispersion Refers to the increase frequency of outliers
330. Age,Sex, and What are the factors that affect TDM?
renal function
-Patient demographics (age, sex, body weight)
-Patient Compliance
-Individuals capacity to distribute/metabolize/excrete the drug (liver and
renal function)
-Genetic factors
-Concomitant disease, Tropical disease and nutritional deficiencies
-Alternative system of medicine
-Ethnic differences and extrapolation of the normal range
-Alcohol & Tobacco use
-Quality of medication and generic formulation
-Control of drug assay
-Medication or sampling errors
-Laboratory errors
-cost effectiveness
331.

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332.
Serum Bilirubin level Overall capacity to transport bile
Ratio of direct and total bilirubin Patency of biliary ducts; hepatocellular metabolism of bilirubin
Serum bile acids (salts) Overall patency of biliary duct
Fecal color and fat content Patency of biliary ducts
Fecal urobilinogen Patency of biliary ducts; quantity bilirubin processed
Urine urobilinogen Patency of biliary ducts; quantity of bilirubin processed; hepatocellular excretory
capacity
Serum ALP and other obstructive enzymes Abnormality of bile duct epithelium
Excretion of BSP Hepatocellular function and patency of the bile ducts
Urine bilirubin Patency of biliary ducts, hepatocellular bilirubin metabolism
333. Horizontal or swinging • Allow the tubes to attain a horizonal position in the
bucket centrifuge centrifuge when spinning and a vertical position whe the
head is not moving
334. Fixed angle or angle • For the fixed angle–head centrifuge, the cups are held in a
head centrifuge rigid position at a fixed angle. This position makes the
process of centrifuging more rapid than with the horizontal-
head centrifuge. There is also less chance that the sediment
will be disturbed when the centrifuge stops.
• Fixed angle–head centrifuges are used when rapid
centrifugation of solutions containing small particles is
needed; an example is the microhematocrit centrifuge
335. cytocentrifuge • A cytocentrifuge uses a very high-torque and low-inertia
motor to spread monolayers of cells rapidly across a special
slide for critical morphologic studies
• An advantage of this technology is that only a small amount
of sample is used, producing evenly distributed cells that
can then be stained for microscopic study.
• It is the slowest centrifuge
• The speed of cytocentrifuge should be checked monthly
(Strasinger)
336. ultracentrifuge • high speed centrifuges used to separate layers of different
specific gravities. They are commonly used to separate
lipoproteins. The chamber is usually refrigerated to counter
heat produced friction
• it is the fastest centrifuge
337. refrigerated centrifuge • available with internal refrigeration temperatures ranging
from -15 °C to -25 °C during centrifugation.
• The temperature of refrigerated centrifuge should be checked
regularly, and the thermometers should be checked
periodically for accuracy
338. Liebermann-Burchardt One step direct method for measuring cholesterol
339. Errors
VARIATIONS / ERRORS
Random error ✓ Present in all measurements ; it is due to chance
✓ A type of error that varies from sample to sample
✓ Errors of variation of techniques
Systemic error ✓ It is an error that influences observations consistently in one direction
(constant difference)
a.C onstant error /Y-intercept
▪ refers to a difference between the target value and the assayed value
▪ it is independent of sample concentration
▪ it exists when there is a continual difference between the comparative
method and the test method regardless of the concentration
b.Proportional / Slope/ Percent error
▪ it results in greater deviation from the target value due to higher sample
concentration

Clerical error ✓ it is the highest frequency of clerical errors occurs with the use of
handwritten labels and requests form

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340. Jaundice Physical sign characterized by a yellow appearance of the skin, mucuous
membrane, and sclera cause by bilirubin deposition. It is usually apparent
clinically when plasma bilirubin level reaches 2 to 3mg/dl(34 to 51umol/L)
341. Enzymes 1. No truly specific enzyme ; all enzymes are found in more than one
tissue
2. Enzyme data cannot be interpreted by itself. We must look at other lab
results and other pertinent clinical information before a diagnosis
can be made
3. Negative or normal results are useful
4. Serial measurements provide most useful data; a single measurement can
be misleading
342. decreased Level of chloride in hyponatremia
343. NPN
substances urea Major end product of protein metabolism
creatinine Major end product of muscle metabolism; directly
proportional to muscle mass
Uric acid Major end product of PURINE and/or nucleic acid metabolism
Ammonia Major end product of AMINO ACID DEAMINATION /METABOLISM

344. ORDER /GRADES

OF REAGENT 1. Analytical reagent
PURITY (PUREST 2. Ultrapure
TO LEAST ) 3. Chemically pure
4. United state pharmacopeia and national formulary
5. Technical or commercial grade
345. Wilson’s Also known as hepatolenticular degeneration
disease - Autosomal recessive disease that results from impaired biliary copper
excretion.
-Increase copper - Due to deficiency or absence of CERULOPLASMIN (copper transport protein
-Decrease - Symptoms include neurologic, cirrhosis of liver, and Kayser-Fleischer
ceruloplasmin rings caused by deposition of copper in cornea

346. Types TAG CHOL LDL VLDL CM FEATURE

FREDRICKSON Type 1 Hyperchylomicronemia High N N N HIGH Low cardiac risk, eruptive xanthoma,
CLASSIFICATI -Familial LPL deficiency recurrent pancreatitis
ON
Type 2a N High High N N High cardiac risk, xanthelasma, tendon
-Familial hypercholesterolemia xanthoma, corneal arcus,
hypothyroidism and nephritic
syndrome
Type 2b – mixed effect High High High High N High Cardiac Risk
-Familial combined
Hyperlipidemia
Type 3 High High N High N Eruptive and palmar xanthomas
Familial Dysbetolipoproteinemia
Type 4 High N N High N Low cardiac risk
Familial Hyperglycedemia
Type 5 High High N High High Low cardiac risk; eruptive xanthoma,
may be associated with pancreatitis.
347. Incorrect regarding to arterial Usage of ETS or vacutainer
blood collection / blood gas analysis
348. Triglycerides and Protein It is used to differentiate VLDL and CHYLOMICRONS from HDL AND LDL
percentage
349. Pronounced (≥5X) elevation of LDH MEGALOBASLTIC ANEMIA, systemic shock and hypoxia, Hepatitis, Renal
infarction
350. Pronounced (≥5X) elevation of CK DUCHENNE’S SYNDROME, polymyositis, Dematomyositis, Myocardial infarction
351. Pronounced (≥5X) elevation of AST Acute hepatitis, Myocardial infarction, Circulatory collapse, Acute pancreatitis,
Infectious mononucleosis
352. Pronounced (≥5X) elevation of ALP Bile duct obstruction(intra and extra hepatic) , Biliary cirrhosis, Osteitis
deformans (Paget’s disease) , Osteogenic sarcoma, Hyperparathyroidism

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353. Flipped LD pattern (LD1>2) Associated with MYOCARDIAL INFARCTION, RENAL INFARCTION, AND
HEMOLYTIC ANEMIA/HEMOLSYS (E.g Pernicious anemia)
354. 70-75% = Thyroxine binding Major transport protein of Thyroid hormones
globulin(TBG)
355. Epinephrine (80%) PRIMARY HORMONE PRODUCED IN ADRENAL MEDULLA

Note: norepinephrine (20%)

356. WHOLE BLOOD Specimen of choice for Therapeutic drug monitoring of
TACROLIMUS AND CYCLOSPORINE
357. Infectious aerosol / airborne Majority of cases of laboratory related infection is
due to
358. Errors
Pre- analyticalincorrect patient identification, improper patient preparation, incorrect specimen collection
,mislabeled specimen, incorrect order of draw, incorrect used of tubes for blood collection,
incorrect anticoagulant to blood ratio, improper mixing of blood and anticoagulant, incorrect
specimen preservation, mishandled specimen
Analytical errors incorrect sample and reagent volume, incorrect incubation of solution, equipment/instrument
malfunction, improper calibration of equipment
Post analytical unavailable or delayed laboratory results, long turnaround time, incomplete laboratory results,
wrong transcription of the patient’s data and lab results, missing laboratory results
359. Tetrahydrocannabinol (THC) Psychoactive substance of marijuana
360. MOLARITY -is the number of moles of solute per liter of solution

M = Grams of solute
GMW x Vol of sol. (L)

Gram molecular weight – obtained by adding the atomic

weights of the components

NORMALITY -is the number of equivalent weight of solute per liter of

solution

N = Grams of solute
EW x Volume (L)

Equivalent weight (EW) = MW / Valence

MOLALITY -is the amount of solute per 1 kilogram of solvent

m = Grams of solute
MW x Kg of solvent

Dilution -indicative of relative concentration

Dilution = solute
Volume of solution (Total volume)

Temperature
conversions Centigrade to Kelvin = 273 + ‘C

Centigrade to Farenheit =(‘C x1.8 ) +32

Farenheit to Centigrade = (‘F -32 ) x 0.556

361. Firs order kinetics Reaction rate is directly proportional to substrate concentration
362. Zero order kinetics Reaction rate depends only on enzyme concentration
363. Beers law States that the concentration of a substance is directly
proportional to the amount of radiant energy absorbed
364. Example of Mechanical Glasswares, Sharp instrument, Compressed gases, Equipements such
hazards as Centrifuge ,autoclaves, and homogenizers
365. Ethylene glycol Known as anti-freeze agent

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366. cyanide Odor of bitter almonds
367. arsenic Odor of garlic, metallic taste
-strong affinity to keratin
368. 5 to 15mg/dl GLUCOSE MEASUREMENT BY REDUCING METHODS (COPPER REDUCTION METHODS)
ARE erroneously HIGHER than ENZYMATIC Method
369. Von Gierke disease Most common congenital form of glycogen storage disease ;
associated with hyperlipidemia
370.
screening Detection of subclinical disease
diagnosis Confirmation or rejection of clinical disease
monitoring Monitoring progression or response to treatment
prognosis Information regarding the likely outcome of disease
371. SYMPTOMS Subjective evidence of a disease
372. SIGN Objective evidence of a disease
373. SULFURIC ACID-Dichromate mixture Used for cleaning of glasswares
374. Monochromators 1. Glass filters and interference filters are used in photometers
2. Diffraction gratings and prisms are used in spectrophotometers
375. Used to calibrate 1. HOLMIUM OXIDE = for narrow spectral bandwidth instrument
wavelength 2. DIDYNIUM FILTER = for broader bandpass instrument
376. Hallow-cathode lamp Light source used in Atomic absorption spectrophotometer (AAS)
377. Quenching of Excited state of the molecule loses some of its energy by interaction
fluorescence with another component of the reaction
- Major disadvantage in methods based of fluorescence
378. Effect of the
following to 1. Temperature = inversely proportional (Increase temp = decrease
fluorescence fluorescence )
2. Light exposure
379. Fasting Blood Very rough indication of glycogen storage and capacity to synthesize
Gluocse (FBS) glucose
380. Fresh, and chilled Specimen for determination of ammonia level in the body
381. catalytic mechanism E + S = ES = E + P
382. Michaelis-Menten V = V max(S) / Km + S
Hypothesis
383. LD4 & LD5 = Decrease Effects of low temperature storage to LD4/LD5 and ALP
ALP = Increase
384. Tetany Associated with decrease calcium / hypocalcemia
385. <3:1 Desirable LDL:HDL ratio
386. Lipid transport
Transport dietary or exogenous Chylomicrons
Triglycerides
Transport endogenous TAG VLDL
Transport mainly Cholesterol LDL
Reverse transport of cholesterol HLD
387. Urea First metabolite to increase in kidney diseases
*urea is only a rough estimate of renal function and will not show any
significant level of increased concentration until GFR is decreased by
at least 50%
388. Biochemical changes INCREASED =Urea, creatinine, electrolytes (K,Phosphate, Magnesium & H+
in acute kidney disease
and End stage renal DECREASE = Sodium, calcium and bicarbonate
disease
389. Intravenous Route of drug administration that is associated with
100%bioavailability
390. Five pharmacological
parameters that determine Liberation It is the release of drug
serum drug conc. absorption is the transport of drug from the site of
administration to the blood.
Distribution refers to the delivery of the drug to the
tissues.
Metabolism is the process of chemical modification of the
drug by cells
Excretion is the process by which the drug and its
metabolites are excreted from the body.
391. Fasting No food or drink except for water for 8 to 12 hours

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392. NPO NON-per-orem / Nothing by mount
no food or drink allowed (including water)
393. Immunoassay technique Method of choice for individual assay assays of anticonvulsants
394. GC or HPLC Method for multiple drug assays. anticonvulsants
395. Biological
safety cabinet Class I Allows room (unsterilized) air to pass into the cabinet and around the area and material
within, sterilizing only the air to be exhausted; they have negative pressure, are ventilated
to the outside, and are usually operated with an open front
Class II Sterilizes air that flows over the infectious material, as well as air to be exhausted.
Also known as vertical laminar flow type
IIA Self-contained, and70% of the air is recirculated
IIB Exhaust air cabinets is discharged outside the building; selected if radioisotopes, toxic
chemicals, or carcinogens will be used
Class III Completely enclosed and have negative pressure, afford the most protection to the worker;
air coming into and going out of the cabinet is filter sterilized, and the infectious material
within is handled with rubber gloves that are attached and sealed to the cabinet

396. 25mg/dl(430 umol/L) Icteric serum sample is apparent when bilirubin level approaches by
397. >400mg/dl Lactescent serum is apparent when TAG levels exceeds by
398. LABORATORY RESULTS
RELATED TO LIVER Hepatitis High : AST, ALT, LD, ALP, Bilirubin
DISORDER Normal : total protein, albumin, ammonia
CIRRHOSIS High: Bilirubin, ammonia
Low: TOTAL Protein
Normal : AST, ALT, LD
Slightly high : ALP
Biliary High: ALP,Bilirubin
obstruction Normal: Total protein, AST, ALT, LD
Alcoholic High : GGT,AST, Bilirubin, Ketone, TAG, Lipoproteins
liver dis. Low: Glucose, albumin, transferrin

399. Chronic cholestasis Highest value of GGT (>10x) , may be found in due to primary
biliary cirrhosis or sclerosing cholangitis
400. Phenolphthalein Indicator used in assays for Carbon dioxide
*assay as carbon dioxide measure carbon dioxide with ISE and diffuse
carbon dioxide into solution containing Phenolphthalein indicator

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