Biochemical Profile 1 Flashcards
define biochemical profile
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
glucose
primary energy source
blood glucose levels are held in a constant range by?
regulatory hormones and metabolic activity
what increases blood glucose levels?
glucagon
epinephrine
growth hormone ACTH
cortisol
what is the classic hyerglycemic disorder?
diabetes mellitus
complications of diabetes mellittus
retinopathy
renal failure
neuropathy
atherosclerosis
how long does someone need to fast in order to get a fasting blood glucose?
10-14 hours
What is the normal fasting blood glucose range?
70-99 mg/dl
what is the prediabetes fasting blood glucose range?
100-126 mg/dl
what are the types of hyperglycemias?
diabetes mellitus acute stress response cushing's syndrome pheochromocytoma renal failure acromegaly pancreatitis
what are the types of hypoglycemia?
insulin overdose pancreatic islet cell tumor starvation liver disease addison's disease hypothyroidism
symptoms of diabetes
polydipsia polyuria polyphagia fatigure weight loss blurred vision slow healing dizziness nausea
when is a fasting blood glucose recommended?
increased thirst frequent urination fatigue blurred vision slow healing wounds or infections sweating hunger trembling anxiety confusion blurred vision
if diabetes is suspected, what tests should be done?
glucose tolerance test
A1C
describe an oral glucose tolerance test
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)
where should your blood glucose be after 2 hours of doing a glucose tolerance test?
<140
what are the values noted for 2 hour glucose tolerance test?
after 2 hours..
normal <140
prediabetes 140-199
diabetes >200
HbA1C test
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
what is the gold standard for diagnosing diabetes?
A1C assay
what are the values for a HbA1C
normal <5.7
prediabetes 5.7-6.4
diabetes >6.5
what would the different glucose test results be for a diabetic
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
what would the different glucose test results be for a normal person?
FBG 70-99
OGTT (2hr) <140
AlC <5.7
s/s of type 1 diabetes mellitus
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
s/s of type 2 diabetes mellitus
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
what happens to the baby in gestational diabetes?
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
if you see blood vessels on a foot xray, what are the ddx?
diabetes
hpt
diabetic coma
diabetic ketoacidosis shortage of insulin glycosuria, ketonuria, hyperglycemia polyuria polydipsia fatigue vomiting mental stupor, can progress to coma rapid breathing fruity breath odor
hypoglycemia
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
what if hypoglycemia occurs in a non diabetic patient?
is it fasting hypoglycemia or postprandial?
postprandial/reactive hypoglycemia
occurs within 4 hours after meals
can occur immediately after a meal
fasting/postabsorptive hypoglycemia
often related to an underlying disease, various medications (50mg/dL)
symptoms of hypoglycemia in non diabetic patients
hunger sweating shakiness dizziness light headedness sleepiness confusion difficulty speaking anxiety weakness
whipple’s triad
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
what can fasting hypoglycemia be due to?
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
how to relieve postprandial hypoglycemia
eat small meals and snacks every 3 hours
exercise regularly
what serological tests would be helpful in determining the etiology of glomerulonephritis?
anti streptolysin O-titer test
ANA
your patient has a suspected chancre in his genital region. Which of the following tests would be most helpful to determine the etiology?
darkfield exam
what test would be helpful if a person has mono?
rapid mono test
your patient has unilateral sacroiliitis, what tests should you order?
sed rate
HLA B27
CBC
your patient with unilateral sacroiliitis has a CBC WNL, HLA B27 test was positive, sed rate was elevated. Most likely diagnosis?
reactive arthritis/reiter’s
your patient might have SLE, what test would be most helpful?
ANA
