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Vis Dis > Biochemical Profile 3 > Flashcards

Biochemical Profile 3 Flashcards

1
Q

where is most alkaline phosphatase found?

A 
liver
bone
biliary tract epithelium
placenta
interstital mucosa
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2
Q

ALP is importnat for what?

A

detecting liver and bone disorders

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3
Q

alkaline phosphatase is increased in?

A 
intrahepatic and extrahepatic obstructions
biliary disease
cirrhosis
tumors
hepatitis
liver mets
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4
Q

elevated ALP in the bone is associated with?

A

new bone growth (increased osteoblastic activity)

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5
Q

alkaline phosphatase is high in?

A

adolescents
pathological new bone growth (metastasis, paget’s, bone disease, healing fracutres)
HPT

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6
Q

alkaline phosphatase is decreased in

A

hypothyroidism

pernicious anemia

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7
Q

if you have anxray with accentuated trabeculation, what tests might you need to run?

A

baseline alkaline phosphatase test
bone scan
xray hot spots

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8
Q

what do people with paget’s need?

A

an MRI to see if the basilar invagination is affecting them

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9
Q

if you saw one large blob on an xray, what are the ddx?

A

bone island
blastic mets
fibrous dysplasia

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10
Q

chondrocalcinosis etiologies

A

3 Cs
cartilage degeneration
crystal deposition (primary CPPD, gout)
cation disease (hemochromatosis, hyperparathyroidism, Wilson’s disease)

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11
Q

if you had an 11 year old girl with a circular density near the epiphyseal part of the bone, what are the ddx? what labs would you want to perform?

A

osteosarcoma, bone island

alkaline phosphatase

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12
Q

acid phosphatase is normally found in?

A

liver
RBCs
platelets
bone marrow

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13
Q

highest levels of acid phosphatase are in?

A

prostate gland

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14
Q

elevated levels of acid phosphatase from the prostate indicate?

A

prostate cancer that has metastasized beyond the prostate capsule to toehr part of the body (bone)
can also be seen in multiple myeloma, benign prostatic hypertrophy, recent prostate examination

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15
Q

describe prostate specific antigen

A

glycoprotein
detected in all males
elevated levels are seen in prostate cancer

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16
Q

PSA levels are elevated in?

A

benign prostatic hypertorphy
prostatitis
between 4 and 10 ng/mL is suspicious
a high jump in PSA is a good indicator of PSA

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17
Q

PSA velocity

A

change in PSA level over time

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18
Q

PAP and PSA

A

markedly elevated with elevated alkaline phosphatase indicates prostate cancer with metastasis to bone

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19
Q

LDH

A

total not specific indicator for any one disease

disease affects cells that contain LDH, the cell lyse and release LDH

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20
Q

GGTP

A

highest concentrations in liver and biliary tract
lesser concentration in kidneys, spleen, heart
detects liver cell dysfunction

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21
Q

GGTP is not elevated in?

A

bone disease

22
Q

elevated GGTP and ALP indicates

A

hepatobiliary disease

23
Q

GGTP is sensitivie for?

A

chronic alcohol ingestion and is the most sensitivie for alcohol induced liver disease

24
Q

AST/SGOT

A

used for suspected coconary occlusive heart disease or

suspected hepatocellular disease

25
Q

which is more sensitivie for heart? liver?

A

heart: AST/SGOT
liver: ALT/SGPT

26
Q

liver panel

A 
ADT/SGOT (heart)
ALT/SGPT (liver)
Alkaline phosphatase (liver and bone)
GGTP (liver)
protein (liver)
bilirubin
BUN elevated (kidney)
BUN decreased (liver)
UA would also be helpful
27
Q

calcium

A

99% in bone and involved with neurotransmission an dmuscular contraction

28
Q

phosphorous

A

80-85% in bone

29
Q

magnesium

A

50-60% in bone
cofactor for enzymes
activator for some enzymes
neurotransmission and muscular contraction

30
Q

hypercalcemia

A 
muscle weakness
disorientation seen with skeletal metastasis
HPT
multiple myeloma
hyperthyroidism
renal transplant
31
Q

hypocalcemia

A 
tetany
hypoalbuminemia (alcoholics)
renal failure
vitamin D deficiency
hypoparathyroidism
32
Q

most common cause of hypercalcemia, second?

A

MC: primary hyperparathyroidism

2nd MC malignancy

33
Q

S/S of hypercalcemia

A 
constipation
nausea
loss of appetite
extreme thirst
dehydration
tired
weak
sleepy
confused
coma
34
Q

xray finding for HPT?

A

aco-osteolysis

35
Q

primary HPT

A 
most common type
parathyroid adenoma in 90%
carcinoma, hyperplasia, ectopic PTH producing tumors
elevated parathormone levels
hypercalcemia
hypophosphatemia
36
Q

secondary HPT

A

complication of chronic renal disease
persistent loss of calcium and phosphorous
stimulates PTH release (calcium low to normal)
hyperphosphatemia (kidneys can’t extrete it as well)

37
Q

tertiary HPT

A

dialysis patients
parathyroid gland acts independent of serum calcium levels
high PTH and calcium

38
Q

s/s of HPT

A 
30-50 women
bone pain
fractures
weakenss
lethargy
polydipsia
polyuria
muscle weakness
hypotonia
renal stones
pancreatitis
elevated alkaline phosphatatse
elevated PTH
hypercalcemia in primary
normal to low calcium in secondary
39
Q

parathormone

A

stimulates osteoclasts, which reabsorb bone and release calcium and phosphorous ion into the blood stream
increases calcium absorption through small intestine

40
Q

radiologic findings associated with HPT

A 
osteopenia
subperiosteal resorption
distal tuft resorption
accentuated trabeculation
brown tumors
loss of cortical definition
soft tissue calcification
dystrophic, physiological calcification
41
Q

what is the most definitive radiographic sign of HPT?

A

subperiosteal resorption

42
Q

where might you see subperiosteal resorption

A

radial margins of middle and proximal phalanges of the 2nd and 3rd digits
widened joint spaces and osteolysis
AC and SI joints
symphysis pubis

43
Q

what spinal radiographic changes do you see in people with HPT?

A

rugger jersey spine

salt and pepper skull

44
Q

you see wide, irregular pubic symphysis. DDX? labs?

A

HPT, infection

CBC, biochemical profile

45
Q

if you see soft tissue calcification, what is the DDX?

A

diabetes

HPT (secondary>primary)

46
Q

hyperphosphatemia

A 
renal failure
hypoparathyroidism
excess vit. D
bone mets
myeloma
cell destruction
47
Q

hypophosphatemia

A

decreased intestinal absorption
increased renal extretion
HPT

48
Q

bone panel

A 
calcium
phosphorus
alkaline phosphatase
uric acid
total proteins 
A/G ratio
serology
CBC/ESR/CRP
(men only) acid phosphatase, PSA
49
Q

hypermagnesemia

A

dehydration
renal insufficiency
uncontrolled diabetes

50
Q

hypomagnesemia

A 
malabsorption
malnutrition
alcoholism
cirrhosis
tetany
muscle weakness
cardiac arrhythemias

Vis Dis (20 decks)

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