Chemistry

Steps

1. 1Glucose and the diabetes criteria16 min · Classify a glucose or HbA1c result using the ADA limits and confirmation rule · Match each glucose pathway to energy release, glucose storage, or new glucose synthesis · Choose prompt separation, an ice slurry, or an inhibitor tube to stop glucose loss
2. 2HbA1c and ketones14 min · Recognize when red-cell changes make an HbA1c disagree with the glucose history · Choose a ketone test that detects beta-hydroxybutyrate in suspected DKA
3. 3Lipoproteins and LDL cholesterol16 min · Choose a valid LDL-C or non-HDL-C result when triglycerides are too high for Friedewald · Match each lipoprotein particle to the lipid it carries and where that lipid comes from · Tell a high-LDL type IIa lipid profile from a triglyceride-rich profile
4. 4Bilirubin and porphyrins18 min · Match each bilirubin fraction to a step in production, conjugation, or excretion · Explain a persistent direct-reacting bilirubin during recovery · Check light protection and interference before releasing a bilirubin result · Choose the first porphyria test for acute attacks, blistering, or painful photosensitivity
5. 5Enzyme rates and inhibitors14 min · Predict how enzyme reaction rate changes as substrate concentration rises · Tell competitive from noncompetitive inhibition by their effects on Km and Vmax
6. 6Liver, bone and pancreas enzymes15 min · Tell a hepatocellular from a cholestatic pattern using AST, ALT, ALP, and GGT · Judge an amylase or lipase rise against its nonpancreatic causes and time course
7. 7Proteins and electrophoresis15 min · Tell a broad polyclonal gamma increase from a narrow monoclonal peak on electrophoresis · Add immunofixation and free light chains to electrophoresis for a suspected M-protein
8. 8Creatinine, eGFR and ammonia16 min · Recognize when a creatinine eGFR needs a cystatin C equation or a measured GFR · Calculate fractional sodium excretion using paired concentrations · Keep an ammonia specimen on ice and centrifuge it cold without delay · Check assay limits or use another method for a creatinine on an icteric specimen
9. 9Timed urine and creatinine clearance15 min · Calculate total excretion from concentration and a complete timed collection · Calculate measured creatinine clearance from timed urine flow · Convert a measured clearance between absolute and BSA-indexed reporting
10. 10Troponin and tumor markers15 min · Tell myocardial injury from infarction by troponin level, rise or fall, and ischemia · Use a tumor marker only to monitor a known cancer or screen a targeted group
11. 11Blood gas specimens and oxygen content15 min · Confirm arterial or venous source and inspired oxygen before interpreting a blood gas · Predict how room-air exposure changes a blood-gas specimen · Recognize how excess liquid heparin dilutes a blood-gas specimen · Calculate oxygen content using hemoglobin concentration and the stated saturation
12. 12The primary acid-base disorder12 min · Tell acidemia from acidosis and alkalemia from alkalosis · Identify the primary acid-base process from pH, pCO₂, and bicarbonate
13. 13Compensation and mixed disorders16 min · Calculate the Winters expected pCO₂ and compare it with the measured pCO₂ · Calculate the expected bicarbonate for an acute or chronic respiratory disorder · Recognize a mixed disorder despite a near-normal pH
14. 14Sodium, water and potassium17 min · Use measured osmolality to tell hypotonic hyponatremia from pseudohyponatremia · Calculate an osmolal gap using the stated formula and units · Distinguish potassium redistribution from a change in total-body stores · Decide whether to release or recollect a hemolyzed potassium specimen
15. 15Total CO₂, calcium, magnesium and phosphate16 min · Recognize CO₂ escape from an uncapped tube behind a low total CO₂ · Choose between total and ionized calcium when albumin or pH is abnormal · Check magnesium when hypokalemia does not correct · Tell a phosphate shift into cells from renal or dietary phosphate loss
16. 16The anion gap and lactate17 min · Calculate an anion gap using the stated potassium convention · Correct an anion gap for albumin under the stated convention · Calculate a delta ratio using compatible gap and bicarbonate baselines · Check a raised lactate for processing delay, glycolate interference, and nonhypoxic causes
17. 17The thyroid axis and immunoassay pitfalls16 min · Locate an endocrine defect in the gland or pituitary from target and regulating hormones · Classify a TSH and free T₄ pattern after checking dose timing, binding, and interference · Test a discordant hormone immunoassay by dilution, blocking reagent, or another platform
18. 18Cortisol, sex hormones and the mineral panel17 min · Confirm draw time, posture, and chilling for cortisol, renin, and ACTH specimens · Read a cortisol result against the limits of its timed draw or dynamic test · Read FSH, LH, estradiol, and progesterone against the interval for cycle day and age · Judge whether a PTH fits the calcium, phosphate, vitamin D, and kidney results
19. 19Vitamins, trace elements and nutrition markers15 min · Match a vitamin question to a direct, functional, or metabolite measurement · Choose metal-free tubes, stoppers, and pipette tips for a trace-element specimen · Tell inflammation or protein loss from malnutrition behind a low albumin or prealbumin
20. 20Drug screens and toxic alcohols16 min · Tell a presumptive immunoassay drug screen from GC-MS or LC-MS/MS identification · Predict how osmolal and anion gaps change as a toxic alcohol is metabolized
21. 21Drug levels and overdose timing16 min · Confirm dose and draw time before comparing a drug level with its trough or peak target · Recognize when binding changes make a total drug level understate the free drug · Decide whether an acetaminophen level can be plotted on the nomogram

What you'll be able to do