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Findings > Blood Chemistry > Flashcards

Blood Chemistry Flashcards

1
Q

Acute-Phase Reactants #1

Subtypes (2), Def’n, Induced By (4)?

A
  • Positive / Upregulated
  • Negative / Downregulated

Factors whose serum conc change in response to infl. Produced by Liver.

IND BY:

  • IL-1
  • IL-6
  • TNF-a
  • Interferon-y
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2
Q

Acute-Phase Reactants #2- POSITIVE / UPREGULATED (5)

A
  • Amyloid A
  • C-reactive protein
  • Ferritin
  • Fibrinogen
  • Hepcidin
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3
Q

Acute-Phase Reactants #3- NEGATIVE / DOWNREGULATED (2)

A
  • Albumin

- Transferrin

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4
Q

“Dry BM Tap”

Def’n, Seen In?

A

Hypocellular BM with fatty infiltration.

SEEN IN:
- Aplastic Anemia

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5
Q

ACE

↑Seen In (4)?

A

↑SEEN IN:

  • Gaucher Disease
  • Leprosy
  • Sarcoidosis
  • Primary Biliary Cirrhosis
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6
Q

Acetyl-CoA

↑Seen In (2), Conseq of ↑?

A

↑SEEN IN: ↓Oxaloacetate

  • Prolonged starvation (need for Gluconeogenesis -> depletion of Oxaloacetate)
  • Alcoholism (excess NADH -> shunting of Oxaloacetate -> Malate)

CONSEQ = shunting of glucose + FFA -> production of ketone bodies.

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7
Q

AFP (in maternal blood or amniotic fluid)

↑Seen In (6),↓Seen In?

A

↑SEEN IN:

  • Dating error
  • Anencephaly
  • Neural Tube Defects (esp Spina Bifida)
  • Yolk Sac Tumor
  • HCC / Hepatoma + other liver tumors
  • Ataxia-Telangiectasia

↓SEEN IN:
- Autosomal Trisomies (Down, Edwards, Patau Sx)

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8
Q

Albumin

↓Seen In (5)?

A

↓SEEN IN:

  • Kwashiorkor (↓ protein intake)
  • Cirrhosis / Portal Htn
  • Malabsorption Sx (poo it out)
  • Nephrotic Sx (pee it out)
  • 3rd degree Burn (plasma loss from skin)
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9
Q

Aldosterone

↑Seen In?

A

↑SEEN IN:

- Renal Failure

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10
Q

Alkaline Phosphatase (ALP)

↑Seen In (5)?

A

↑SEEN IN:

  • OsteoBLASTIC mets (hyperactivity of osteoblasts)
  • Hyperparathyroidism (Excess PTH -> Bone RESORPTION)
  • OBSTRUCTIVE Liver disease / Biliary Tract Obstruction or HCC
  • 2ry Biliary Cirrhosis
  • Placental disease
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11
Q

Leukocyte ALP

↑Seen In,↓Seen In?

A

↑SEEN IN:
- Leukemoid Rx (mature cells)

↓SEEN IN:
- CML (immature granulocytes)

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12
Q

Alanine Aminotransferase (ALT)

↑Seen In?

A

↑SEEN IN:
Liver damage
** ALT > AST in Viral Hep **

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13
Q

Aldolase

↑Seen In?

A

↑SEEN IN:

- Duchenne Muscular Dystrophy

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14
Q

Ammonia

↑Seen In (2)?

A

↑SEEN IN: (Hyperammonemia)

  • Hereditary (eg Urea Cycle enzyme def)
  • Acquired (eg Liver dz- cirrhosis, portal htn)
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15
Q

Amylase

↑Seen In (4)?

A

↑SEEN IN:

  • Salivary disease
  • Mumps
  • Acute Pancreatitis
  • Pancreatic Pseudocyst (PERSISTENTLY↑Amylase)
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16
Q

Aspartate Aminotransferase (AST)

↑Seen In (2)?

A 
↑SEEN IN:
- MI (Acute)
- Liver disease
*** AST > ALT in Alcoholic Hep *** (ratio usually > 1.5)
THINK: "Make a toAST with alcohol"
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17
Q

Bradykinin

Action, Stim By, Conseq of ↑(2)?

A

Potent vasodilator.

STIM BY: ACE Inhibitors (inhibit its inactivation).

CONSEQ OF ↑:

  • Cough
  • Angioedema
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18
Q

C-Reactive Protein

Action,↑Seen In?

A

Opsonin (fixes complement + facilitates phag).

↑SEEN IN: Ongoing Infl

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19
Q

Ca #1

↑(Hypercalcemia) Seen In (9: 8 + 1 Drug),
↓(Hypocalcemia) Seen In (9)?

A

↑SEEN IN: Bone RESORPTION. PTH, Vit D.

    • 1ry Hyperparathyroidism (excess PTH)
  • Hypervitaminosis D + Williams Sx (↑sensitivity to Vit D)
  • Hyperthyroidism (due to bone resorption)
  • Diabetes Insipidus
  • Multiple Myeloma + Bone Mets
  • Sarcoidosis
  • Bartter Sx
  • RTA Type 1
  • Hydrochlorothiazide

↓SEEN IN: Calcitonin.

  • 2ry Hyperparathyroidism
  • Hypoparathyroidism (ie comp of prior neck surgery) / Pseudohypoparathyroidism / Parathyroid Aplasia (ie 22q11 Sx)
  • Vit D def
  • Low Albumin (↓in TOTAL Ca)
  • HYPOMg (Mg needed for PTH release +↓Mg causes more Ca loss in urine)
  • Thyroid Medullary Carcinoma (excess Calcitonin)
  • Acute Pancreatitis (Ca consumed during saponification in fat necrosis)
  • Osteopetrosis
  • Osteomalacia / Rickets
  • DiGeorge Sx (Thymic aplasia ->↓PTH)
  • Renal Failure in
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20
Q

Ca #2- Disturbance PRES

Low serum conc -> (6, incl 1 CV)?
High serum conc -> (5 Categories)?
* “Stones, Bones, Groans, Psych Overtones” *

A
  • THINK: neural hyperexcitability + twitching*
  • Facial N hyperexcitability (Chvostek sign)
  • Irritability, Seizures
  • Numbness (ie perioral) + Tingling
  • Tetany (Trousseau sign)
  • Carpopedal spasm
  • QT PROLONGATION (can -> arrhythmia)

THINK: slow + lethargic
- Neuro: Lethargy + stupor + confusion
- CV: QT SHORTENING + Htn
- Renal: Nephrolithiasis, Nephrogenic DI, Renal insuf
- Ab: Ab pain + Constipation + Anorexia + Nausea/Vomiting
+ Peptic Ulcers (Ca stim Gastrin)
- Osteo: Bone pain + Osteoporosis

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21
Q

CK-MB

↑Seen In (2)?

A

↑SEEN IN:

  • MI (Rises after 4-6 hrs, peaks at 24 hrs, elevated for 48 hrs)
    - EARLY (2-8 hrs)
    - Reinfarction
  • Skeletal Muscle injury (SEVERE)
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22
Q

Ceruloplasmin

↓Seen In?

A

↓SEEN IN:

- Wilson’s Dz

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23
Q

Cholesterol

Hypo- Causes, Hyper- Causes (4)?

A

HYPO CAUSES:
- Hyperthyroidism

HYPER CAUSES:

  • Biliary Tract Obstruction (with xanthomas)
  • 2ry Biliary Cirrhosis
  • I-hyperchylomicronemia
  • Familial Hypercholesterolemia:
    - Heterozygotes: ~300 mg/dL
    - Homozygotes (very rare): >700 mg/dL
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24
Q

Cl

Hypochlorhydria Causes / Seen In?

A

HYPO CAUSES:
- Low Gastric acid: VIPoma
- Inhib of Gastrin ->↓production of Gastric acid:
Somatostatinoma

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25
Q

Clotting Factors

↓Seen In?

A

↓SEEN IN:

- Cirrhosis / Portal Htn

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26
Q

Cyclooxygenase (COX)

Action, Inhib By (3)?

A

Arachidonic acid -> Endoperoxides.

INHIB BY:

  • Aspirin (IRREVERSIBLE inhib by acetylation)
  • Acetaminophen (REVERSIBLE inhib): mostly in CNS, inactivated peripherally
  • NSAIDS (REVERSIBLE inhib)
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27
Q

COX-2

Locations (2), Action, Inhib By?

A
  • Vascular endothelium
  • Infl Cells

Mediates infl + pain.

INHIB BY: COX-2 Inhibitors (Celecoxib)

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28
Q

Copper (Cu)

Roles,↓Seen In?

A

ROLES:
- Cofactor for Lysyl Oxidase

↓SEEN IN:
- Menkes Dz (connective tis dz)

29
Q

Creatine Phosphokinase (CPK)

↑Seen In?

A

↑SEEN IN:

- Duchenne Muscular Dystrophy

30
Q

Elastase-1

Inhib By,↑Seen In (2)?

A

INHIB BY: a1-antitrypsin

↑SEEN IN:

  • Emphysema (a1-antitrypsin def -> excess activity)
  • Acute Pancreatitis
31
Q

Estriol

↓Seen In (2)?

A

↓SEEN IN:

  • Down Sx
  • Edwards Sx
32
Q

Glucose

Normal Value, 
Hyperglycemia Causes (3 + 1 Drug), Hypoglycemia Causes (3)?
A

NORMAL = 70-120 mg/dL.

HYPER CAUSES:

  • Diabetes Mellitus / Diabetic Ketoacidosis
  • Hyperthyroidism (due to↑gluconeogenesis + glycogenolysis)
  • Vitamin B3 (Niacin) Excess
  • Hydrochlorothiazide

HYPO CAUSES:

  • Reye’s Sx
  • Hepatoma / HCC and other liver tumors
  • Carnitine def (F.A Metab dz) -> (“hypoketoic hypoglycemia”)
33
Q

Estrogen

↑Seen In?

A

↑SEEN IN:

- Cirrhosis / Portal Htn

34
Q

Fibrillin

Def’n / Role, Seen In?

A

Glycoprotein that forms sheath around Elastin.

SEEN IN:
- Marfan Sx (Fibrillin defect)

35
Q

Inhibin-A

↑Seen In,↓Seen In?

A

↑SEEN IN:
- Down Sx

↓SEEN IN:
- Edwards Sx (↓or normal)

36
Q

Hepcidin

Action, Seen In?

A

Prevents release of Fe bound by Ferritin -> Anemia.

SEEN IN:
- Anemia of Chronic Dz

37
Q

HCG

↑Seen In (3),↓Seen In (2)?

A

↑SEEN IN:

  • Down Sx
  • Hydatidiform Mole
  • Choriocarcinoma

↓SEEN IN:

  • Edwards Sx
  • Patau Sx
38
Q

Lactate

↑Seen In?

A

↑SEEN IN:

- Von Gierke Dz

39
Q

Lactate Dehydrogenase (LDH)

  • > Simple↑LDH (2)?
  • > LD1 > LD2 (3)?
  • > High LD1 + LD5 (2, COMP for each)?
  • > High LD4 + LD5 (2)?
A
  • TTP
  • Ovarian Dysgerminoma
  • MI (Acute, EARLY)
  • Hemolysis
  • Renal infarction
  • Acute MI comp by Liver Congestion
  • Megaloblastic Anemia comp by Alcoholic Liver Disease
  • Liver damage
  • Skeletal Muscle damage
  • THINK: LD1↑in liver Dz, LD4↑in liver DAMAGE,
    LD5↑in BOTH DZ + DAMAGE.
40
Q

LDL

↑Seen In?

A

↑SEEN IN:

- Familial Hypercholesterolemia

41
Q

Leukotriene B4 (LTB4)

Action?

A

Neutrophilic chemotactic agent.

42
Q

Leukotriene (LT) C4, D4 + E4

Actions (3), Inhib By?

A
  • Vasoconstriction
  • Smooth muscle contraction /↑muscle tone
    (ie -> Bronchoconstriction)
    -↑vascular permeability

INHIB BY: -lukast

43
Q

Lipase

A

↑SEEN IN:

  • Acute Pancreatitis
  • Lipase more specific for pancreatic DAMAGE *
44
Q

Lipids

↑(Hyperlipidemia) Seen In?

A

↑SEEN IN:

- Hydrochlorothiazide

45
Q

Lipofuscin

Def’n, Mech of Formation?

A

Yellow-brown “wear and tear” pigment assoc w normal aging.

FORMATION:
Auto-phagocytosed organelle memb ->
Oxidation + Polymerization

46
Q

Mg- Disturbance PRES

Low serum conc -> (2)?
High serum conc -> (6)?

A
  • Tetany
  • Torsades de Pointes
  • ↓DTRs
  • Hypotension
  • Bradycardia
  • Lethargy
  • Hypocalcemia
47
Q

Myoglobin

A

MI (EARLY) ** Nonspecific **

48
Q

Nitric Oxide

Effects?

A

EFFECTS: VASODILATOR

- Hypotension

49
Q

Plasma Proteins

↑Seen In?

A

↑SEEN IN:

- Inflammation (Acute or Chronic)

50
Q

PGA2 (Thromboxane)

Actions (3)?

THINK: Opposite in every way to other ‘members’ of Endoperoxide family.

A
  • ↑vascular tone
  • ↑bronchial tone
  • ↑platelet aggregation
51
Q

Prostaglandin E1 (PGE1)

Actions (3), Release Stim by, Inhib by?

A
  • Keeps PDA open
  • Dilates Afferent Arteriole
  • Produces stomach mucus

Release Stim By: Loop Diuretics

INHIB BY: NSAIDs

52
Q

Prostacyclin (PGI2)

Actions (4)?

A
  • ↓vascular tone
  • ↓bronchial tone
  • ↓uterine tone

-↓platelet aggregation

53
Q

PGE2 + PGF2A

Actions (3)?

A
  • Vasodilation
  • Bronchodilation
  • Uterine contraction / ↑uterine tone (-> labor induction)
54
Q

Phenylalanine

↑Seen In?

A

↑SEEN IN:

- Phenylketonuria (PKU)

55
Q

Phosphate

↑Seen In (3),↓Seen In (2)?

A

↑SEEN IN:

  • 2ry Hyperparathyroidism
  • Hypervitaminosis D
  • Renal Failure

↓SEEN IN: ↑PTH

  • 1ry Hyperparathyroidism (↑PTH)
  • Disorders of fructose / galactose metab
56
Q

Phosphate #2- Disturbance PRES

Low serum conc -> (2)?
High serum conc -> (3)?

A
  • Bone loss
  • Osteomalacia
  • Renal Stones
  • Metastatic calcifications
  • Hypocalcemia
57
Q

Potassium (K) #1

↑Seen In (8),↓Seen In (7)?

A

↑SEEN IN:

  • RTA Type 4 + Renal Failure
  • Lysis of cell
  • Acidosis
  • Hyperosmolarity
  • Insulin deficiency
  • b-adrenergic ANTAGONIST
  • Digitalis
  • Addison’s Dz (↓Aldosterone)
  • DKA (however↓INTRACEL K due to↓Insulin)

↓SEEN IN:

  • RTA Type 1 (NO K reabs), Bartter + Gitelman Sx (↓K reabs), Liddle Sx (↑Na reabs)
  • Alkalosis
  • Hypoosmolarity
  • Insulin (↑Na/K ATPase activity) THINK: Insulin moves K INTO cells
  • b-adrenergic AGONIST (↑Na/K ATPase activity)
  • Diuretics (except for K-sparing diuretics)
  • Cushing’s Sx (↑Aldosterone)
  • VIPoma
58
Q

Potassium (K) #2- Disturbance PRES

General -> (2)?
Low serum conc -> (2 changes on EKG) + 1?
High serum conc -> (2 changes on EKG)?

A
  • Arrhythmias (mess with QT interval)
  • Muscle weakness
  • U waves
  • FLATTENED T waves
  • Inhib of ADH’s effect on kidney
  • Wide QRS
  • PEAKED T waves
59
Q

Prostatic Acid Phosphatase (PAP)

↑Seen In?

A

↑SEEN IN:

- Prostatic Adenoma

60
Q

Prostate-Specific Antigen (PSA)

↑Seen In (2:↑in FREE PSA vs↑in TOTAL PSA)?

A

↑SEEN IN:
-↑in FREE PSA in BPH (due to↑# of glands)
-↑in TOTAL PSA (however↓in FREE PSA)
in Prostatic Adenocarcinoma (cancer makes bound PSA)

  • PSA > 10 worrisome at any age *
61
Q

Sodium (Na) #1

↑Seen In,↓Seen In (6)?

A

↑SEEN IN:
- Cushing’s Sx (↑Aldosterone)

↓SEEN IN:

  • Addison’s Dz (↓Aldosterone)
  • SIADH
  • Cystic Fibrosis
  • Hypothyroidism
  • Glucocorticoid underproduction
  • Legionella Pneumonia
62
Q

Sodium (Na) #2- Disturbance PRES

General (ie both) -> (3)?
Low serum conc -> (2)?
High serum conc -> (1)?

A
  • more likely DEPOL (LOW b/c Ca comes in ; HIGH b/c↑Na)
  • Stupor
  • Coma
  • Malaise
  • Nausea
  • Irritability
63
Q

TNF-a

Def’n, Produced By, Induced By (3), Effects (2)?

A

Cytokine that stims ACUTE PHASE rx of infl =
Endogenous Pyrogen.

Produced by Macrophages (mainly).

IND: (TNF in general)

  • Endotoxins
  • Lipid A (in outer memb of Gram - bacteria)
  • Lipoteichoic acid (in cell memb/cell wall of Gram + bacteria)

EFFECTS:

  • Fever
  • Hypotension
64
Q

Triglycerides

↑Seen In?

A

↑SEEN IN: (Dyslipidemia)

- Renal Failure

65
Q

Troponin I

↑Seen In?

A

↑SEEN IN:

  • MI (Rises after 4 hrs, peaks at 24 hrs, elevated for 7-10 days)
    • Most specific + sensitive = Gold Standard*
66
Q

Uric Acid

↑(Hyperuricemia) Seen In (6: 3 and 3)?

A

Due to OVERPRODUCTION of uric acid:

  • Vitamin B3 (Niacin) Excess
  • Gout
  • Lesch-Nyhan Sx

Due to UNDEREXCRETION of uric acid:

  • Von Gierke Disease
  • Tumor Lysis Sx /↑cell turnover
  • Loop Thiazide Diuretics
67
Q

γ-Glutamyl Transpeptidase (GGT)

↑Seen In (2)?

A

↑SEEN IN:

  • Various Liver + Biliary diseases
  • Heavy Alcohol consumption
68
Q

VLDL

↑Seen In?

A

↑SEEN IN:

- Hypertriglyceridemia

Findings (19 decks)

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