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PA final EXAM > Basic Metabolic Panel > Flashcards

Basic Metabolic Panel Flashcards

1
Q

What is substances are examined in a Basic Metabolic Panel?

A

Sodium (Na), Potassium (K), Chloride (Cl), Bicarbonate(HCO3), Bile Urea Nitrogen (BUN), Creatinine (CR), Glucose and Calcium (Ca)

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2
Q

What is the term for low serum sodium

A

Hyponatremia

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3
Q

How is Hyponatremia clinically defined

A

Serum sodium

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4
Q

What are the 2 major causes of persistent hyponatremia?

A

SIADH and Reduced effective arterial blood volume due to diuretics, vomiting/diarrhea and decreased tissue perfusion in heart failure or cirrhosis

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5
Q

What are the 3 classifications of hyponatremia

A

Hypovolemic - A decrease in total body water with a great decrease in total body sodium
Euvolemic - Normal body sodium with increase in total body water
Hypervolemic - An increase in total body sodium with even a greater increase in total body water

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6
Q

What are the symptoms of hyponatremia

A

Nausea, dizziness, fatigue, gait disturbances, forgetfulness, confusion, lethargy, and muscle cramps (extra severe

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7
Q

What are three ways hyponatremia is diagnosed

A

Urine Osmolality - Differentiates btwn conditions associated with impaired free water excretion and primary polydipsia
Serum Osmolality - Differentiates btwn true hyponatremia and pseudohyponatremia
Urine sodium concentration - Differentiates btwn hyponatremia secondary to hypovolemia

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8
Q

What is the most common form of hyponatremia

A

Hypotonic hyponatremia

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9
Q

Which can be safely treated more quickly acute or chronic hyponatremia

A

Acute

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10
Q

What is the condition of elevated serum sodium

A

Hypernatremia

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11
Q

What is the most common causes of hypernatremia?

A

1) Failure to replace water losses due to impaired thirst or lack of access to H2O.
2) Intake of salt in excess of H2O
3) Administration of a hypertonic salt solution

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12
Q

What kind of condition is hypernatremia

A

A hyperosmolar condition

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13
Q

How is hypernatremia clinically defined

A

Serum sodium concentration > 145 mEq/L
Severe > 158 mEq/L
> 180 mEq/L associated with a high mortality rate

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14
Q

What population is hypernatremia most found in

A

Elderly who are physically and mentally impaired

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15
Q

What are the clinical manifestations of hypernatremia

A

Lethargy, weakness, irritability, twitching, seizure and coma.
Rapid decrease in brain volume can cause rupture of cerebral veins leaching to hemorrhages in brain and Acute manifestations of the condition can result in demyelinating brain leisions

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16
Q

What condition is due to elevated potassium

A

Hyperkalemia

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17
Q

Why can Hyperkalemia be difficult to diagnose

A

Due to a lack of distinctive signs and symptoms

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18
Q

How is Hyperkalemia clinically diagnosed

A

Mild - 5.5-6.0 mEq/L
Moderate - 6.1-7.0 mEq/L
Severe -

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19
Q

What are the major causes of Hyperkalemia

A

Acute or chronic kidney disease or disorders (Urinary obstruction, Sickle disease, Addisons) or drugs that inhibit the renin-angiotensin-aldersterone axis (diuretics)

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20
Q

How is Hyperkalemia clinically diagnosed

A

Mild - 5.5-6.0 mEq/L
Moderate - 6.1-7.0 mEq/L
Severe -

21
Q

Signs and symptoms of Hyperkalemia

A

Fatigue and weakness, n/v, palpitations, paresthesia, bradycardia, extrasystoles, decreased motor strength, renal failure (edema and skin changes), paralysis (rare)

22
Q

What is essential to diagnose hyperkalemia

A

an EKG

23
Q

How is Hypokalemia clinically defined

A

Defined - serum K+

24
Q

What are some EKG changes associated with Hyperkalemia

A

Widened QRS

Peaked T waves

25
Q

What is the condition of low potassium

A

Hypokalemia

26
Q

How is Hypokalemia clinically defined

A

Defined -

27
Q

What are the signs and symptoms of Hypokalemia

A

Often asymptomatic.
Weakness and fatigue most common
More severe - Muscle cramps and pain, worsening diabetes, hallucinations, delirium, and depression, bradicardia and CV collapse

28
Q

What are EKG changes that can occur with Hypokalemia

A

Change in QT interval

Look for U wave after T wave.

29
Q

Chloride’s role in the body

A

Plays an important role in acid/base balance and with sodium maintains H2O balance and serum osmolality

30
Q

What are the normal and critical values of chloride

A

Normal - 98-106 mmol/L

Critical - 120 mmol/L

31
Q

What is the condition of high/low chloride levels

A

Hyperchloremia/Hypochloremia

32
Q

What can cause Hyperchloremia

A

Renal failure, nephrotic syndrome, dehydration, hyperparathyroidism, diabetes insipidus, respiratory alkalosis, hyperadrenocorticism and certain drugs

33
Q

What can cause Hypochloremia

A

V/d, renal failure with salt deprivation, overtreatment of diuretics, diabetic ketoacidosis, SIADH, water intoxication , adrenal insufficiency, hyperaldeosteroidism, metabolic alkalosis and certain drugs (laxative, diuretics, and corticosteroids

34
Q

What does the level of Bicrobonate (HCO3-) indicate

A

The concentration of H+ ions (or the bicarbonate level)

35
Q

What does Bicarbonate usually counterbalanced by

A

a change of chloride

36
Q

What conditions can indicate an elevated or decreased bicarbonate level

A

Elevated - Metabolic alkalosis and respiratory alkalosis

Decreased - Respiratory acidosis and metabolic acidosis

37
Q

What is the Anion Gap a measurement of?

A

It represents the difference btwn unmeasured cation and anions… AG = (Na+)-{(HCO3 + Cl-)}

38
Q

What conditions can show a rise in the Anion gap

A

Acidosis, renal failure and ingestion of certain toxins

39
Q

What does the BUN level reflect?

A

The function of the liver and/or the kidneys

40
Q

What is the normal BUN reference range?

A

3-20 mg?dL

41
Q

What do BUN levels vary inversely with…

A

Glomerular filtration levels (GFR)

42
Q

What are the normal glucose reference ranges

A

Fasting plasma glucose - 70/99 mg/dL

Postparandial plasma glucose at 2hrs. -

43
Q

What is the reason to monitor levels of creatinine?

A

It’s important in assessing renal function. in blood it is a marker of glomerular filtration rate

44
Q

What are the normal reference ranges for creatinine?

A

Adult males: 0.5-1.2 mg/dL
Adult females - 0.4 - 1.1 mg/dL
Children (up to 12 y.o) - 0.0 - 0.7 mg/dL

45
Q

What are reasons for low/high serum creatinine levels

A 
Low
   1) Low muscle mass
   2) Increased glomerular rates (GFRs)
High
   1) Decreased GFR (due to acute kidney injury or chronic kidney disease)
46
Q

What are the normal glucose reference ranges

A

Fasting plasma glucose - 70/99 mg/dL

Postparandial plasma glucose at 2hrs. -

47
Q

What are the reference ranges for diabetes mellitus

A
  • Fasting plasma glucose -> 125 mg/dL
  • Postparandial plasma glucose at 2hrs. - > 200mg/dL
  • Random plasma glucose - > 200 mg/dL
  • Impaired fasting glucose : Fasting glucose of 100-125 mg/dL
  • Impaired glucose tolerance testing: Postprandial glucose at 2 hours of 140-200 mg/dL
48
Q

What are the reference ranges for hypoglycemia

A

Value less than 60 mg/dL

PA final EXAM (9 decks)

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