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Vis Dis > Biochemical Profile 2 > Flashcards

Biochemical Profile 2 Flashcards

1
Q

BUN

A

measures the amount of urea nitrogen in the blood

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2
Q

when is urea formed?

A

in the liver as an end product of protein metabolism

transported to the kidneys for excretion

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3
Q

BUN is related to?

A

metabolic function of the liver and extratory function of the kidneys

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4
Q

azotemia

A

elevated blood levels of BUN

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5
Q

creatinine

A

only renal disorders such as glomerulonephritis, tubular necrosis, reduced renal blood flow and obstruction can elevate serum levels

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6
Q

creatinine is a better indicator for?

A

renal disease

better than BUN

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7
Q

when do creatinine levels rise?

A

they tend to rise later and indicate chronicity

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8
Q

what are the kidney function tests?

A

BUN and creatinine

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9
Q

uric acid

A

a nitrogenous compound that is a product of puine catabolism

extreted by kidney and intestinal tract(to a smaller degree)

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10
Q

hyperuricemia is associated with?

A

gout

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11
Q

uric acid levels may be elevated in?

A 
gout
renal disease
metastasis
multiple myeloma
alcoholism
leukemia
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12
Q

gout of the big toe

A

podagra

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13
Q

xray signs of gout

A

overhanging edge sign

swelling of soft tissues

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14
Q

proteins

A

most significant factor for osmotic pressure

keeps fluids within the vascular space

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15
Q

what are the proteins that make up most of the protein in the body?

A

albumin

globulin

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16
Q

protein in the blood is increased in

A

multiple myeloma
dehydreation
chronic infection
malignancies

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17
Q

protein in the blood is decreased in

A

liver disease
kidney disease
malabsorption

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18
Q

albumin

A

formed in the liver and makes up 60% of the total protein

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19
Q

what does albumin do?

A

helps regulate colloidal osmotic pressure and transports important blood constituents

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20
Q

albumin is a measure of?

A

liver function

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21
Q

albumin levels are decreased in?

A

liver disease
malnutrition
overhydration
inflammatory disease

22
Q

albumin levels are increased in?

A

dehydration

23
Q

how can proteins seem normal, but not?

A

if the albumin is low and globulins are high, then protein total can appear normal

24
Q

changes in the protein ratio can be detected by?

A

albumin/globulin ratio

25
Q

what is the normal A/G ratio?

A

1.0

26
Q

diseases that increase total proteins (particularly globulins), thus reversing the ratio

A

multiple myeloma
malignancy
inflammatory disease

27
Q

a reversed A/G ratio reflects?

A

overproduction of globulins

28
Q

if someone has multiple lytic destructive changes associated with lytic mets or multple myeloma, what tests do you need to order?

A 
CBC
ESR
C-RP
BCP
UA
serum protein electrophoresis
radiographs
specialized imaging
bone marrow biopsy
29
Q

if labs suggest lytic mets, what happens next?

A

bone scan
MRI
biopsy

30
Q

if labs suggest multiple myeloma, what happens next?

A

PEP of urine and blood
skeletal survey
MRI
biopsy

31
Q

common tetrad of multiple myeloma

A 
CRAB
Calcium elevated
Renal disease
Anemia
Bone lesions
32
Q

lab findings for multiple myeloma

A 
hypercalcemia
hypercalciuria
elevated ESR
elevated protein in blood and urine
M spike
Rouleaux formation
normocytic normochromic anemia
reversed A/G ratio
phosphorous normal
alkaline phosphatase usually normal or low
increased BUN and creatinine (kidney dysfunction)
uric acid may be increased
33
Q

what malignancy is purely lytic?

A

multiple myeloma

34
Q

lytic lab results include

A

urine calcium levels increased
serum calcium and phosphate normal or increased
serum ALP normal or increased
normocytic normochromic anemia

35
Q

blastic lab results include

A 
serum calcium usually norma
urine calcium low
ALP increased
acid phosphatase increased
serum phosphorus variable
normocytic normochromic anemia
36
Q

bilirubin

A

mesures excretory function of the liver

37
Q

describe bilirubin metabolism

A

breakdown of RBCs in RES
hemoglobin released from RBCs is broken down into heme and globin
heme–>bilirubin (unconjugated)
liver converts it to conjugated bilirubin

38
Q

jaundice

A

yellow discoloration f tissue due to high levels of bilirubin

39
Q

what dysfunction is it if the unconjugated bilirubin is elevated?

A

hepatocellular dysfunction

40
Q

what dysfunction is it if the conjugated bilirubin is elevated?

A

liver disease

extrahepatic dysfunction

41
Q

bilirubin concentrations are elevated in the blood by?

A

increased production, decreased conjugation
decreased secretion by the liver
blockage of bile duct

42
Q

what do you do when you find elevated total bilirubin

A

check urine
if it is positive for bilirubin, it is direct bilirubin
need liver function tests
if bilirubin is negative, it is indirect bilirubin
means hemolysis, hematoma or Gilbert’s syndrome

43
Q

bilirubin and urobilinogen in the urine for a healthy person

A

bilirubin- normal

urobilinogen- negative

44
Q

bilirubin and urobilinogen in the urine for liver/biliary disease

A

biliruin- increased

urobilinogen- positive

45
Q

bilirubin and urobilinogen in the urine for biliary obstruction

A

bilirubin- absent

urobilinogen- positive

46
Q

bilirubin and urobilinogen in the urine for hemolytic anemia

A

bilirubin- increased

urobilinogen- negative

47
Q

if there is primarily unconjugated hyperbilirubinemia, increased production could mean

A

hemolysis (intravascular or extravascular)
ineffective erythropoiesis
hematomas, pulmonary embolus

48
Q

if there is primarily unconjugated bilirubin, decreased hepetic uptake could mean

A

hereditary diseases

drugs

49
Q

if there is primarily unconjugated bilirubin, decreased glucouronidation coudl mean

A

hereditary disease (gilbert’s syndrome)
physiologic jaundice of a newborn
breast milk jaundice
severe liver disease

50
Q

if there is primarily conjugated hyperbiliruinemia, and there is decreased liver excretion, it could mean

A 
acquired disorders (hepatitis, cirrhosis, drugs and toxins)
or
hepatic malignancy, primary or metastatic
CHF
shock
sepsis
toxemia of pregnancy
hepatic trauma
intrahepatic obstruction
51
Q

if there is primarily conjugated bhyperbilirubinemia, what extrahepatic biliary obstruction could this be?

A 
congenital
acquired
cholecystitis
choledocholithiasis
tumors
infection
or
external compression (structures, pancreatitis/tumor, parasites (ascaris)

Vis Dis (20 decks)

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