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Vis Dis > Biochemical Profile 1 > Flashcards

Biochemical Profile 1 Flashcards

1
Q

define biochemical profile

A

a group of select tests that can screen for certain conditions
normal or reference values vary from lab to lab
pattern of abnormal values provide data from arriving at a diagnosis

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2
Q

glucose

A

primary energy source

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3
Q

blood glucose levels are held in a constant range by?

A

regulatory hormones and metabolic activity

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4
Q

what increases blood glucose levels?

A

glucagon
epinephrine
growth hormone ACTH
cortisol

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5
Q

what is the classic hyerglycemic disorder?

A

diabetes mellitus

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6
Q

complications of diabetes mellittus

A

retinopathy
renal failure
neuropathy
atherosclerosis

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7
Q

how long does someone need to fast in order to get a fasting blood glucose?

A

10-14 hours

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8
Q

What is the normal fasting blood glucose range?

A

70-99 mg/dl

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9
Q

what is the prediabetes fasting blood glucose range?

A

100-126 mg/dl

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10
Q

what are the types of hyperglycemias?

A 
diabetes mellitus
acute stress response
cushing's syndrome
pheochromocytoma
renal failure
acromegaly
pancreatitis
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11
Q

what are the types of hypoglycemia?

A 
insulin overdose
pancreatic islet cell tumor
starvation
liver disease
addison's disease
hypothyroidism
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12
Q

symptoms of diabetes

A 
polydipsia
polyuria
polyphagia
fatigure
weight loss
blurred vision
slow healing
dizziness
nausea
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13
Q

when is a fasting blood glucose recommended?

A 
increased thirst
frequent urination
fatigue
blurred vision
slow healing wounds or infections
sweating
hunger
trembling
anxiety
confusion
blurred vision
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14
Q

if diabetes is suspected, what tests should be done?

A

glucose tolerance test

A1C

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15
Q

describe an oral glucose tolerance test

A

used if diabetes is suspected
usually a 2 hour test
patient fasts, then FBS is taken and then the patient is given an oral glucose load
the blood glucose is taken at 30 min, 1 hr and 2 hours (sometimes 3 and 4 hours latera too)

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16
Q

where should your blood glucose be after 2 hours of doing a glucose tolerance test?

A

<140

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17
Q

what are the values noted for 2 hour glucose tolerance test?

A

after 2 hours..
normal <140
prediabetes 140-199
diabetes >200

18
Q

HbA1C test

A

blood test used to determine how well a patient’s diabetes/blood sugar levels are being controlled
HbA1C provides an average of your blood sugar control over 6 to 12 weeks

19
Q

what is the gold standard for diagnosing diabetes?

A

A1C assay

20
Q

what are the values for a HbA1C

A

normal <5.7
prediabetes 5.7-6.4
diabetes >6.5

21
Q

what would the different glucose test results be for a diabetic

A 
FBG >126 mg/dl
on 3 different occasions
OGTT >200mg/dl
>6.5 A1C
glycosuria when the renal threshold value is >180mg
RTV may rise in some diabetics
22
Q

what would the different glucose test results be for a normal person?

A

FBG 70-99
OGTT (2hr) <140
AlC <5.7

23
Q

s/s of type 1 diabetes mellitus

A

insulin dependent
polyuria, polydipsia, hyperglycemia
MC seen in juveniles
circulating insulin is absent
plasma glucagon is elevated
autoimmune destruction of pancreatic islet beta cells
dependent on exogenous insulin to sustain life

24
Q

s/s of type 2 diabetes mellitus

A

non insulin dependent
MC type over 40 and obese, family history
polyuria, polydipdia, hyperglycemia
circulating insulin is present but inadequate in times of increased need
insulin resistance or decreased amounts
may be controlled by diet, lifestyle, exercise, maybe oral hypoglycemic agents

25
Q

what happens to the baby in gestational diabetes?

A

the extra blood glucose goes through the placenta and to the baby, since there is more eneergy than needed for the baby, the baby stores the energy as fat

26
Q

if you see blood vessels on a foot xray, what are the ddx?

A

diabetes

hpt

27
Q

diabetic coma

A 
diabetic ketoacidosis
shortage of insulin
glycosuria, ketonuria, hyperglycemia
polyuria
polydipsia
fatigue
vomiting
mental stupor, can progress to coma
rapid breathing
fruity breath odor
28
Q

hypoglycemia

A

low blood glucose (>70mg/dl)
more common in a diabetic patient
anxiety, sweating, palpitations, tremor, hunger
if it gets to the CNS, lethargy, headaches, confusion, visual disturbances, convulsions, coma

29
Q

what if hypoglycemia occurs in a non diabetic patient?

A

is it fasting hypoglycemia or postprandial?

30
Q

postprandial/reactive hypoglycemia

A

occurs within 4 hours after meals

can occur immediately after a meal

31
Q

fasting/postabsorptive hypoglycemia

A

often related to an underlying disease, various medications (50mg/dL)

32
Q

symptoms of hypoglycemia in non diabetic patients

A 
hunger
sweating
shakiness
dizziness
light headedness
sleepiness
confusion
difficulty speaking
anxiety
weakness
33
Q

whipple’s triad

A

symptoms known or likely to be caused by hypoglycemia
low plasma glucose level
signs and symptoms of hypoglycemia
resolution of symptoms once glucose level rises

34
Q

what can fasting hypoglycemia be due to?

A

some underlying disease
medication, alcohol, illness
excess insulin or carb deprivation
tumors (insulinoma, insulin overdose in a diabetic)
hormonal deficiencies
hepatic and renal disease
may need a 5 or 6 hour glucose tolerance test with measurements hourly

35
Q

how to relieve postprandial hypoglycemia

A

eat small meals and snacks every 3 hours

exercise regularly

36
Q

what serological tests would be helpful in determining the etiology of glomerulonephritis?

A

anti streptolysin O-titer test

ANA

37
Q

your patient has a suspected chancre in his genital region. Which of the following tests would be most helpful to determine the etiology?

A

darkfield exam

38
Q

what test would be helpful if a person has mono?

A

rapid mono test

39
Q

your patient has unilateral sacroiliitis, what tests should you order?

A

sed rate
HLA B27
CBC

40
Q

your patient with unilateral sacroiliitis has a CBC WNL, HLA B27 test was positive, sed rate was elevated. Most likely diagnosis?

A

reactive arthritis/reiter’s

41
Q

your patient might have SLE, what test would be most helpful?

A

ANA

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