Hematology Writing Exam 2

TO BE ADDED AND ANSWERED

CHEMICAL PATHOLOGY WRITING EXAM 1

Question 2: discuss the renal function and liver function test; assayed analytes in each profile, their
reference ranges and the different specimen and samples required for each test

ANS: Blood panel testing are a group of tests that are done to measure, analyze and even detect various
things in the body such as the functioning of body organs. Renal and Liver test for example are two of
the most widely used tests done in a blood panel testing.

Both these tests can detect liver disease, jaundice, cirrhosis of the liver, and urinary tract infections –
just to name a few. Renal function tests are a group of tests that are performed together to evaluate the
renal function. A typical Renal function test usually requires a 24-hour urine sample and/or a blood test.

The assayed analytes of the Renal function test can be categorized into two main groups – the test for
the glomerular function and the test that measures tubular function. With that being said, some tests
that are typically a part of the renal function test panel are:

- Urine examination: screens for the presence of protein and blood in the urine. This examination
consists of both a macroscopic and microscopic examination of the urine sample being used.
- Serum creatinine: This test is usually done with a blood sample, and it determines whether
creatinine is building up in the blood – that is if the creatinine level is greater than 12 mg/dL (for
women) and 1.4 mg/dL (for men) it would be an indication that there is an issue with the kidney.
- BUN: the blood urea nitrogen test as the name suggest examines for waste products specifically
nitrogen in the blood. The normal BUN level ranges between 7-20 mg/dl.
- Estimated Glomerular Filtration Rate: Glomeruli are tiny filters in the kidneys, and the eGFR is a
calculation of how much blood they are filtering every minute; normal ranges are between 90 to
120 mL/min/1.73 m2.

The liver function test on the other hand are blood tests used to help diagnose and monitor liver disease
or damage. Some of the liver function tests look for enzymes that would be seen in the blood only when
the liver is damaged or has a disease; while other tests check that the organ is working properly.

The most performed liver function blood tests include:

- Alanine transaminase (ALT) test: This test measures an enzyme found mostly in the liver that is
released into the bloodstream after acute liver cell damage. The normal range is between 4 to
36 U/L.
- Aspartate transaminase (AST) test
- Serum albumin test: This test measures the levels of bilirubin in the blood. The normal reference
range is 3.4 to 5.4 g/dL.

Both the kidneys and the liver work together to aid in the removal of waste products from the body.
Hence both the renal function test and the liver function test can and will detect any possible
problems in the body.
 Question 3: Explain in detail the excretion of bilirubin in urine

ANS: Bilirubin and Urine are both waste products that should/ are excreted from the body. Bilirubin
is a yellow pigment that is found in bile – a fluid produced by the liver and stored in the gallbladder.
Bilirubin isn’t usually seen in a normal urine sample but once it is seen it is an indication of a
problem.

Bilirubin is formed by the breakdown of hemoglobin which metabolizes into individual components
– heme and globin. Globin is further broken down into amino acids which are recycled into the
bloodstream; while heme is broken down into iron and biliverdin – the iron will be recycled while
the biliverdin is reduced to make unconjugated bilirubin.

The unconjugated bilirubin then binds to albumin which is later transported to the liver.
Unconjugated bilirubin in the liver, is added to glucuronic acid by glucoronyl transferase – an
enzyme. This addition then forms soluble conjugated bilirubin which is later excreted into the
duodenum in bile.

In the intestines bacterial enzymes dissect the conjugated bilirubin to release unconjugated bilirubin
which is reduced to urobilinogen. Urobilinogen that is bonded to albumin is then excreted in the
urine.

Question 4: clearly draw and label components of the spectrophotometer

<<DRAW ON GOOGLE DOCS THEN JUST COPY >>

4b. Describe in full detail the working concept of flame-photometer

CHEMICAL PATHOLOGY WRITING EXAM 2

  Question 1: Discuss the six endocrine glands, there function in the body, disease states
associated with each gland, the analytes that are assayed in the medical laboratory for each
endocrine.

 Question 3: Explain with relevant examples the differences between metabolic and respiratory
acidosis and alkalosis.

3b. Describe how each term is produced in the body.

 Question 4: what are enzymes and mention their major function in the human system.

4b. describe five classifications of examples

4c. mention different types of isoenzymes found in the following enzymes and their location in the body

i. CK/CPK
ii. LDH
iii. ALKALINE PHOSPHATASE