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A Proteins are amphoteric owing to ionization of acidic and basic side chains of amino acids medications keppra buy generic chondroitin sulphate 400mg. When the pH of the solution equals the isoelectric point (pI) symptoms 6 days before period cheap chondroitin sulphate 400mg with mastercard, the protein will have no net charge and is insoluble medicine lodge ks cheap chondroitin sulphate 400 mg with amex. When the pH of the solution is above the pI symptoms checklist generic chondroitin sulphate 400mg overnight delivery, the protein will have a net negative charge. Increasing the strength of the field by increasing voltage (or current) increases migration. Counterions (cations) in the buffer move with the proteins, reducing their electromagnetic attraction for the anode. When voltage is applied the cations migrate to the cathode, creating an osmotic force that draws H2O with them. C Movement of proteins is dependent upon the presence of a salt bridge that allows current to flow via transport of ions to the electrodes across the support medium. If the salt bridge is not intact, there will be no migration, even if voltage is maintained across the electrodes. For agarose and cellulose acetate, heat causes evaporation of solvent from the buffer. Evaporation of solvent from the surface of the medium Chemistry/Apply principles of basic laboratory procedures/Electrophoresis/3 15. Because albumin is fastest, it has the greatest net negative charge and lowest pI (about 4. Chemistry/Apply knowledge of fundamental biological characteristics/Electrophoresis/1 5. High-resolution procedures detect monoclonal and oligoclonal bands at a lower concentration B. Rheumatoid arthritis Chemistry/Correlate clinical and laboratory data/ Electrophoresis/2 the molecular weight of a protein D Transferrin, lipoprotein, C3, and C4 are the dominant proteins in the -globulin region. Plasma is not used for protein electrophoresis because fibrinogen will produce a band resembling a small monoclonal protein in the beta region. C Hepatic cirrhosis produces a polyclonal gammopathy associated with a high IgA level. Malignancy and rheumatoid arthritis produce polyclonal gammopathies classified as chronic inflammatory or delayed response patterns. Multiple myeloma produces a zone of restricted mobility usually in the, but sometimes in the - or 2-region. The smaller proteins become trapped in the pores of the gel and migrate more slowly. A Oil Red O and Sudan Black B stain neutral fats and are used to stain lipoproteins as well as fat in urine or stool. Coomassie Brilliant Blue is more sensitive than Ponceau S or Amido Black, and all three stains have slightly greater affinity for albumin than globulins. Which of the following serum protein electrophoresis results suggests an acute inflammatory process Albumin Decreased Normal Decreased I ncreased 1 Increased Increased Increased Increased 2 Decreased Normal Normal Normal Increased Increased Increased Normal Normal Increased Increased Increased 24. Levels correlate with glomerular injury in patients with diabetes mellitus Chemistry/Apply knowledge of fundamental biological characteristics/Nutrition markers/1 associated with an acute inflammatory pattern Hepatitis Chemistry/Correlate clinical and laboratory data/ Electrophoresis/2 densitometric tracing most likely indicates: A. C Acute inflammation is characterized by increased production of acute phase proteins.

D Neutrophils are highly phagocytic and release lysozymes medicine 79 discount chondroitin sulphate 400 mg online, peroxidase treatment lupus discount chondroitin sulphate 400 mg with mastercard, and pyrogenic proteins medicine vs surgery cheap chondroitin sulphate 400 mg mastercard. Eosinophils migrate to sites where there is an allergic reaction or parasitic infestation treatment zamrud chondroitin sulphate 400 mg for sale, releasing peroxidase, pyrogens, and other enzymes, including an oxidase that neutralizes histamine. If a patient has a reticulocyte count of 7% and an 5 Hct of 20%, what is the corrected reticulocyte count B In anemic states, the reticulocyte percentage is not a true measure of reticulocyte production. The following formula must be applied to calculate the corrected (for anemia) reticulocyte count. A Osmotic fragility is decreased when numerous sickle cells and target cells are present and is increased in the presence of spherocytes. The osmotic fragility test is increased in the presence of spherocytes, whereas this test is decreased when sickle cells, target cells, and other poikilocytes are present. A decreased osmotic fragility test would be associated with which of the following conditions Centrifugal force for microhematocrit determination should be 12,000 g for 5 min in order to avoid error caused by trapped plasma. The Miller disk is a reticle (grid) that is placed in the eyepiece of the microscope and divides the field into two squares, one being nine times larger in size than the other. What staining method is used most frequently to stain and manually count reticulocytes Cytochemical staining Hematology/Apply knowledge of standard operating procedures/Reticulocytes/1 20. Supravital staining with new methylene blue is used to identify the reticulocytes. Two electrodes suspended in isotonic solutions are separated by a glass tube having a small aperture. A vacuum is applied, and as a cell passes through the aperture it impedes the flow of current and generates a voltage pulse. Given the following values, which set of red blood 7 cell indices suggests spherocytosis C Spherocytes have a decreased cell diameter and volume, which results in loss of central pallor and discoid shape. It depends upon both the mean (average value) and dispersion of results and is most influenced by reproducibility or precision. D Deoxyhemoglobin is the physiological Hgb that results from the unloading of oxygen by Hgb. A Acidosis is associated with a shift to the right of the oxyhemoglobin dissociation curve and, therefore, increased oxygen release (decreased affinity of Hgb for oxygen). Hgb S and Hgb C do not change the affinity of oxygen for hemoglobin; however, many hemoglobinopathies do. For example, Hgb Kansas causes a right shift and Hgb Chesapeake causes a left shift of the oxyhemoglobin dissociation curve. Absolute granulocytopenia is usually present; however, lymphocyte production is less affected. What is the major type of leukocyte seen in the peripheral smear of a patient with aplastic anemia Eosinophil Hematology/Correlate clinical and laboratory data/ Leukocytes/Aplastic anemia/1 percentage (range) in the adult population C the normal adult percentage of lymphocytes in a white cell differential is between 20% and 44%, although normal ranges vary by institution, patient population, and testing methodology.

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Agglutination of red cells by the antibody often causes peripheral circulation abnormalities medicine cabinet shelves buy chondroitin sulphate 400 mg on line. Intravascular hemolysis occurs in some of the syndromes medicine prescription buy 400 mg chondroitin sulphate amex, in which the complement sequence is completed on the red cell surface medications covered by medicaid buy chondroitin sulphate 400mg online. Low serum levels of complement in other case may help to protect the patient from a more sever clinical disease treatment 3rd degree burns 400 mg chondroitin sulphate overnight delivery. Paroxysmal cold hemoglobinuria this rare disease, characterized by hemoglobinuria following cold exposure, is caused by an IgG autoantibody to the red cell antigen P. This DonathLandsteiner autoantibody is unique in that it binds to red cells at cold temperatures, in contrast to other IgG antibodies. Furthermore, it binds complement well, and brisk hemolysis results when the cells are warmed and the complement sequence proceeds to completion. Drug induced immune hemolytic anemias Four pathophysiologic mechanisms account for most cases of drug-induced red cell sensitization and positive 293 Hematology direct Coombs test. The drug-induced problem may result in serious hemolytic anemia on the one hand, or a laboratory abnormality without clinical sequelae on the other. Although the drug coating by itself is not harmful, some patients develop high-titer antipenicillin IgG antibodies, which can react with the coated red cells. The coombs test is positive due to the presence of IgG; complement is not usually found. The immune complexes often activate complement, and an abrupt and lifethreatening intravascular hemolytic anemia may 294 Hematology develop. The coombs test is positive for complement; the immune complexes themselves do not bind firmly to the cell. The direct Coombs test is usually strongly positive with IgG; complement is rarely found. Cephalosporins: Membrane modification these drugs cause a positive direct Coombs test through a non-immunologic mechanism. Cephalothin and other cephalosporins are capable of altering the red cell membrane so that proteins, including complement and an assortment of -globulins, are nonspecifically adsorbed. As a result of the presence of these proteins, the direct antiglboulin test is positive. However, the red cell eluate does not react with any other cells, because 295 Hematology the mixture of -globulins does not include any predominantly red cell antigen-specific antibody. The antibody screen is negative because no unusually drugrelated antibodies are present. Hemolytic transfusion reactions the differential diagnosis of a positive direct antiglobulin test includes not just red cell autoantibodies but also alloantibodies-antibodies in the patient directed against foreign red cell antigens. These antibodies are either "naturally occurring," in that individuals acquire them without specific exposure to the red cell antigen, or "immune," form red cell transfusions. For example, a patient whose red cells are group O has anti-A and anti-B in his or her serum. Like many other IgM antibodies, these isoagglutinins are potent complement fixers. The direct Coombs test is positive due complement fixation, but may become negative within hours to days, depending on how rapidly the group a cells are destroyed. The presence of urine hemosiderin beginning 3 to 5 days after the transfusion attests to the recent presence of hemoglobinemia. If the patient then receives an antigenpositive unit, an anamnestic rise in antibody occurs over the next 3 to 21 days. Here, red cell destruction is usually leisurely, since the cells are eliminated only after they are coated with sufficient antibody, which depends on the rapidity with which it is produced. The direct Coombs test on a posttransfusion blood specimen is positive due to IgGcoated transfused red cells. The test becomes negative as the antibody-coated cells are removed from the circulation. Hemolytic disease of the newborn this hemolytic process actually begins in utero to the baby of a mother with IgG red cell antibodies. IgG antibodies readily cross the placenta, as opposed to IgM In the past, many Rh(D)negative women became sensitized to the red cell antigen D at the time of birth of a first Rh-positive child, because at birth it is common for a small volume of fetal cells to enter the maternal circulation.

In gas chromatography symptoms kidney pain generic 400 mg chondroitin sulphate fast delivery, the elution order of volatiles is usually based upon the: A symptoms pulmonary embolism discount 400 mg chondroitin sulphate fast delivery. According to American Diabetes Association these results would be classified as: A symptoms pink eye chondroitin sulphate 400mg without a prescription. Which condition results in metabolic criteria symptoms 3 days before period purchase chondroitin sulphate 400 mg overnight delivery, which result is consistent with a diagnosis of impaired fasting glucose Which enzyme is responsible for the acidosis with severe hypokalemia and chronic alkaline urine In familial dyslipoproteinemia (formerly Chapter 11 Sample Certification (Self-Assessment) Examination 553 Hematology 18. A total of 36 cells were counted in all 9-mm2 squares of a Neubauer-ruled hemacytometer. Which ratio of anticoagulant to blood is ingestion are associated with an increase in oxygen utilization referred to as respiratory burst. Given the following values, which set of red blood cell indices suggests spherocytosis Which anemia has red cell morphology similar to that seen in iron deficiency anemia Which of the following is an appropriate screening test for the diagnosis of lupus anticoagulant Factor V Leiden promotes thrombosis by Which of the following additional laboratory tests would yield informative diagnostic information for this patient Which of the following platelet aggregating agents demonstrates a monophasic aggregation curve when used in optimal concentration Which is most likely a positive Western blot Chapter 11 Sample Certification (Self-Assessment) Examination 41. Serological tests for which disease may give a 555 false-positive result if the patient has Lyme disease Interpret the following description of an immunofixation electrophoresis assay of urine. What antibodies are represented by the nucleolar pattern in the immunofluorescence test for antinuclear antibodies Incubate washed red cells with anti-A1 and Anti-A,B for 30 minutes at room temperature D. How long must a recipient sample be kept in the blood bank following compatibility testing Lewis antibodies are not clinically significant, so any type of blood may be given with warm autoimmune hemolytic anemia Which procedure would help to distinguish between an anti-e and anti-Fya in an antibody mixture A donor was found to contain anti-K using pilot tubes from the collection procedure. Five units are Chapter 11 Sample Certification (Self-Assessment) Examination 64. A 54-year-old man who tested positive for hepatitis C last year, but has no active symptoms of disease no deferral period Which of the following individuals is mother who is O negative and infant who is O positive. No, RhIg is given for term pregnancies only blood at the collection center of the community blood supplier. Can an autologous donor donate blood on Monday, if he is having surgery on Friday What is the principle of the colorimetric cause a false-positive dry reagent strip test for protein Salicylates determined by measuring refractive index and urine osmolality would be most likely to occur: A. Which of the following laboratory results is characteristic of a transudative fluid Which test result would be most conclusive in classifying the fluid as an exudate It functions as a preservative highly selective medium used for the recovery of which bacteria