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MMSC407 Exam 3 Revised Study Solutions, Exams of Clinical chemistry

Virginia State University (VSU)Clinical chemistry

MMSC407 Exam 3 Revised Study Solutions

Typology: Exams

2025/2026

Available from 12/25/2025

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MMSC407 Exam 3 Revised Study Solutions
1.
Blood
gases:
Clinical
management
of
respiratory
and
metabolic
disorders
2.
Respiratory Blood Gases: pCO2, primary
organ lungs
Compensatory mechanism for metabolic
disorders
3.
Metabolic Blood Gases: HCO3-, mostly gets worked out in
kidneys
Compensatory mechanism for respiratory disorder
4.
pCO2:
[MEASURED
PARAMETER]
(no
calculations
necessary)
Partial pressure of CO2 gas; regulated by
lungs respiratory component of acid base
balance
5.
pO2:
[MEASURED
PARAMETER]
Partial
pressure
of
O2
gas
6.
ctCO2: (Total
CO2)
[CALCULATED
PARAMETER]
pf3
pf4
pf5
pf8
pf9
pfa
pfd
pfe
pff
pf12
pf13
pf14
pf15
pf16
pf17
pf18
pf19

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MMSC407 Exam 3 Revised Study Solutions

  1. Blood gases: Clinical management of respiratory and metabolic disorders
  2. Respiratory Blood Gases: pCO2, primary organ lungs Compensatory mechanism for metabolic disorders
  3. Metabolic Blood Gases: HCO3-, mostly gets worked out in kidneys Compensatory mechanism for respiratory disorder
  4. pCO2: [MEASURED PARAMETER] (no calculations necessary) Partial pressure of CO2 gas; regulated by lungs respiratory component of acid base balance
  5. pO2: [MEASURED PARAMETER] Partial pressure of O2 gas
  6. ctCO2: (Total CO2) [CALCULATED PARAMETER]

2 / 25 Sum of HCO3 and H2CO3 concentrations

  1. ctCO2 - H2CO3 concentration: dissolved CO2 (dCO2)
  2. ctCO2 - dCO2 calculation: pCO2 X 0. (may change if someone has fever, assume during these calculations patient has normal body temp) Solubility coeflcient of CO2 in blood at 37oC
  3. ctCO2 equation: ctCO2 = cHCO3 + cdCO
  4. Buffer Base: [CALCULATED PARAMETER] The sum of the concentration of all the butter anions in blood
  5. The blood buffers are:: HCO3 / H2CO3 = 5% HPO4/ H2PO4 = 1% *Hemoglobin = 80% Plasma Proteins = 14% *If hemoglobin is dysfunctional, acid base balance will be off
  6. Blood buffer % - HCO3 / H2CO3: 5%
  7. Blood buffer % - HPO4/ H2PO4: 1%
  8. Blood buffer % - Hemoglobin: 80%
  9. Blood buffer % - Plasma Proteins: 14%

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  1. pH calculation for in vivo blood: pH = pk + log HCO3 [(20) Metabolic] + H2CO3 [(1)Respiratory] (pk =6.1 dissociation constant... start out with AT LEAST 6.1)
  2. Reference range for pCO2 - arterial: 35-45 mmHg
  3. Reference range for pCO2 - venous: 38 - 50 mmHg
  4. Reference range for pO2: 83-100 mmHg (arterial)
  5. Reference range for pH: 7.35 - 7.
  6. Reference range for ctCO2: 22 - 29 mmol/L
  7. Allen Test: (Used for arterial blood gasses) Must perform before collecting blood; check radial artery circulation before drawing; take immediately to the lab
  8. Allen Test drawing complications: Thrombosis Hemorrhage - must hold site for 15 minutes
  9. Arterial Blood Sample Process: 1) Syringe and needle (Heparinized)
  1. Not less than 45o angle
  2. Anaerobic collection

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  1. Mix well before analyzing
  2. NO tourniquet
  3. Radial or brachial arteries
  1. Collection issues: Exposure of arterial Blood sample to atmospheric air; improperly processed specimens
  2. Exposure of arterial Blood sample to atmospheric air will cause pH to:: IN- CREASE (more alkaline)
  3. Exposure of arterial Blood sample to atmospheric air will cause pCO2 to:: DE- CREASE
  4. Exposure of arterial Blood sample to atmospheric air will cause pO2 to:: IN- CREASE
  5. pO2 values over 158 mmHg after exposure of arterial Blood sample to atmospheric air will:: LOSE pO
  6. Arterial Blood specimens not processed immediately will cause pH to:: (due to glycolysis) DECREASE (more acidic)
  7. Arterial Blood specimens not processed immediately will cause pCO2 to:: (due to glycolysis) INCREASE

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  1. Hypercapnia pCO2 value: > 50 mmHg
  2. Hypoventilation causes:: Decease in Alveolar Ventilation Emphysema*(COPD) Bronchopneumonia Asthma Decrease in the respiratory control center Decrease in Mechanical/Neuromuscular control of breathing Crushed Chest Decreased cardiac output
  3. Hypoventilation Treatment: ventilate
  4. The rate of gas exchange across the respiratory membrane depends upon:- : Surface area of the respiratory membrane. Thickness of the respiratory membrane. Solubility of the gas. Ditterence in partial pressure of the gas on BOTH sides of the membrane.
  5. Hypocapnia (Blood pCO2): DECREASED CO2 Caused by Hyperventilation

8 / 25 It causes: Respiratory Alkalosis

  1. Hypocapnia pCO2 value: < 35 mmHg
  2. Hyperventilation is caused by:: Secondary to hypoxemia (ex. High altitudes) Salicylate poisoning Temperature/fever hysteria/anxiety/chronic pain

10 / 25 oxygen in the blood Below 40 mmHg DECREASE in alveolar ventilation DECREASE in mechanical/neuromuscular control of breaking

  1. ISE's for Blood pO2: Cathode: Platinum wire enclosed in glass Anode: Ag/AgCl wire pO2 membrane pO2 electrolyte solution Voltage Source Ammeter*
  2. Polarography for Blood pO2: Supplying a constant voltage to an electrode and monitoring the current change (amps) as oxygen is reduced at the cathode.
  3. pO2 saturation: A ratio, expressed as a percentage of the volume of oxygen bound to Hemoglobin. Reference Value: 95 - 98% It is useful for predicting the amount of oxygen that is available for tissue perfusion and also helps determine the ettectiveness of oxygen therapy.
  4. Co-oximeter: a blood gas analyzer that (in addition to the status of gas tensions provided by traditional

11 / 25 blood gas measurements) measures concentrations of oxygenated hemoglobin (oxyHb), deoxygenated hemoglobin

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  1. Metabolic Acidosis: decreased bicarbonate
  2. Metabolic Alkalosis: increased bicarbonate
  3. Respiratory Disorders: Primary Change in pCO2 pCO2 is primarily acidic Causes: Respiratory Acidosis Respiratory Alkalosis
  4. Respiratory Acidosis: increased pCO
  5. Respiratory Alkalosis: decreased pCO
  6. Reference Ranges for Acid Base Problems - pH: 7.35-7.
  7. Reference Ranges for Acid Base Problems - pCO2: 35-45 mmHg
  8. Reference Ranges for Acid Base Problems - HCO3: 21-28 mmol/L
  9. Classifying Acid Base test as Acid - pH: <7.
  10. Classifying Acid Base test as Alkaline - pH: >7.
  11. Classifying Acid Base test as Acid - pCO2: >45 mmHg
  12. Classifying Acid Base test as Alkaline - pCO2: <35 mmHg

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  1. Classifying Acid Base test as Acid - HCO3: <21 mmol/L

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  1. Triglyceride structure: glycerol + 3 fatty acids
  2. Phospholipid Structure: glycerol + 2 fatty acids + phosphate group Hydrophilic head and hydrophobic tail
  3. Lipoprotein: bonding of molecules of fat and protein. any of a group of soluble proteins that combine with and transport fat or other lipids in the blood plasma.
  4. Lipoprotein (a): A variant of LDL with an extra protein denoted as apo(a) Lp(a) is identified as an additional risk factor for Coronary Heart Disease and Cerebral Vascular Disease because... it is similar in structure to plasminogen
  5. plasminogen: inactive form of plasmin. is converted into plasmin and binds to fibrin to promote clot lysis.
  6. (Lipoproteins) Chylomicrons/VVLDL: large triglyceride-rich lipoproteins produced in enterocytes from dietary lipids—namely, fatty acids, and cholesterol

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  1. (Lipoproteins) VLDL: Very low-density lipoprotein Transportation of fats from the liver to the peripheral tissues.
  2. (Lipoproteins) LDL: Low density lipoprotein Remnants of very low-density lipoproteins (VLDL) which are supposed to go back into the liver occasionally wander around dropping cholesterol deposits. Often called β- lipoprotein 80% lipid, 20% protein
  3. (Lipoproteins) HDL: High density lipoprotein Transports fats from the peripheral tissue to the liver. Trash pick-up cure: Picks up metabolic trash. Formerly called α-lipoprotein 50% protein and phospholipid
  4. LCAT: enzyme called lecithin-cholesterol acyltransferase
  5. LCAT function: LCAT gene provides instructions for making an enzyme called lecithin- cholesterol acyltrans- ferase (LCAT). This enzyme plays a role in removing cholesterol from the blood and tissues
  6. Lipoprotein Lipase: an enzyme that sits on the outside of cells and breaks apart

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  1. Cardiovascular Disease (CVD): a collective term for various diseases of the heart and blood vessels. Dominant cause of this is atherosclerosis due to the way it narrows the arteries close to the heart and may lead to CVD.
  2. Atherosclerosis Peak Age of Onset: Usually starts in the teens and 20s, and by 30s see changes in most people
  3. Triglyceride significance in lipoproteins: (triglyceride-rich lipoproteins) their function being to transport triglyceride originating in the liver to organs such as adipose tissue for storage, and muscle (including myocardium) to provide energy.
  4. Triglyceride reference range in LDL: Desirable: < 130 mg/dL Borderline High: 130- mg/dL High: >160 mg/dL
  5. Triglyceride reference range in HDL: 40 - 75 mg/dL Healthy level: 50 mg/dL or higher
  6. Clinical significance of LDL: Linked to risk for cardiovascular disease (CVD) Apolipoprotein B as a marker
  7. Clinical significance of HDL: Linked to risk for cardiovascular disease (CVD) Antiinflammatory properties
  8. "good cholesterol": HDL (high density lipoprotein)

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  1. Why HDL is "good cholesterol): absorbs cholesterol in the blood and carries it back to the liver. The liver then flushes it from the body. HIGH levels of HDL cholesterol can LOWER your risk for heart disease and stroke.
  2. "bad cholesterol": LDL (low density lipoprotein)
  3. Why LDL is "bad cholesterol": makes up MOST of your body's cholesterol. HIGHER levels of LDL cholesterol RAISE your risk for heart disease and stroke.
  4. CHD risk ratios: LDL cholesterol INCREASES HDL cholesterol DECREASES
  5. HDL Metabolism: liver efflux
  6. LDL Metabolism: Deposited in tissue
  7. Metabolic Syndrome: A cluster of conditions that increase the risk of heart disease, stroke, and dia- betes. Group of risk factors for the development of cardiovascular disease or diabetes (Type II)
  8. Criteria for Metabolic Syndrome Diagnosis: ELEVATED Waist Circumference. Abdominal obesity carries a higher risk than lower body obesity.