Chapter 5: Clinical: Biochemical, Physical, and Functional Assessment Flashcards
analyte
A substance whose chemical constituents are being identified and measured
basic metabolic panel (BMP)
A test that includes eight different measurements. It provides information about your metabolism
comprehensive metabolic panel (CMP)
A blood test with 14 different measurements. It is often used to evaluate liver function, kidney function, and nutrient levels
complete blood count (CBC)
A blood test that provides the count of the cells in the blood and description of the RBCs
differential count
A blood test that gives the relative percentage of each type of white blood cell and also helps to reveal abnormal white blood cell populations (eg, blasts, immature granulocytes, and circulating lymphoma cells in the peripheral blood)
urinalysis
Testing of the urine. Used as a screening or diagnostic tool to detect substances or cellular material in the urine associated with different metabolic and kidney disorders.
dehydration
Excessive loss of water and electrolytes often from vomiting; diarrhea; excessive laxative abuse; diuretics; fistulas; GI suction; polyuria; fever; excessive sweating; or decreased intake caused by anorexia, nausea, depression or limited access to fluids
edema
Overhydration. Occurs when there is an increase in the extracellular fluid volume. The fluid shifts from the extracellular compartment to the interstitial fluid
inflammation
A protective response by the immune system to infection, acute illness, trauma, toxins, many chronic diseases, and physical stress
positive acute-phase reactants
Inflammation markers that exhibit significant changes in serum concentration during inflammation. Positive acute phase reactants are upregulated, and their concentrations increase during inflammation.Positive acute phase reactants include procalcitonin, C-reactive protein, ferritin, fibrinogen, hepcidin, and serum amyloid A.
negative acute-phase reactants
Inflammation markers that exhibit significant changes in serum concentration during inflammation. Negative acute phase reactants are downregulated, and their concentrations decrease during inflammation.Negative acute phase reactants include albumin, prealbumin, transferrin, retinol-binding protein, and antithrombin
C-reactive protein (CRP)
A nonspecific marker of inflammation that may help estimate and monitor the severity of the illness
high-sensitivity CRP (hs-CRP)
A more sensitive measure of chronic inflammation seen in patients with atherosclerosis and other chronic disease
ferritin
A positive acute-phase protein, meaning that synthesis of ferritin increases in the presence of inflammation. Ferritin is not a reliable indicator of iron stores in patients with acute inflammation, uremia, metastatic cancer, or alcoholic-related liver diseases
erythrocyte sedimentation rate (ESR)
Reflects the rate at which RBCs settle into columns or stacks in saline or plasma within a given time period
albumin
Responsible for transport of major blood constituents, hormones, enzymes, medications, minerals, ions, fatty acids, amino acids and metabolites
prealbumin (PAB) aka transthyretin (TTHY)
Hepatic protein transported in the serum as a complex of retinol-binding protein and vitamin-A. It transports the thyroid hormones triiodothyronine and thyroxine (T4), along with T4-binding globulin.
retinol-binding protein (RBP)
A small plasma protein that does not pass through the renal glomerulus because it circulates in a complex with PAB
retinol
An animal form of Vitamin A. Retinol is converted from retinyl palmitate which is found in beef, chicken liver, eggs, fish liver oils, and dairy products including whole milk, whole mild yogurt and cottage cheese, butter, and cheese. (The plant based Vitamin A source is beta-carotene.) Vitamin A is essential to vision, especially night vision, bone and tooth development, reproduction, skin and mucous membranes
transferrin
A globulin protein that transports iron to the bone marrow for production of hemoglobin
hemoglobin (HgB)
A protein inside red blood cells that carries oxygen from the lungs to tissues and organs in the body and carries carbon dioxide back to the lungs
hematocrit (Hct)
The ratio of the volume of red blood cells to the total volume of blood
microcytic anemia
The presence of small, often hypochromic, red blood cells in a peripheral blood smear and is usually characterized by a low MCV (less than 83 micron 3). Iron deficiency is the most common cause of microcytic anemia.
macrocytic anemia
A type of anemia that causes unusually large red blood cells. Like other types of anemia, macrocytic anemia means that the red blood cells also have low hemoglobin. Generally caused by either folate or vitamin B12 deficient erythropoiesis.
anemia of chronic and inflammatory disease (ACD)
A type of anemia associated with autoimmune diseases, rheumatic diseases, chronic heart failure, chronic infections, Hodgkin’s disease and other types of cancer, inflammatory bowel disease, kidney disease and other chronic inflammatory conditions, severe tissue injury and multiple fractures. ACD does not respond to iron supplementation.
serum iron
Measures the amount of circulating iron that is bound to transferrin. However, it is a relatively poor index of iron status because of large day-to-day changes, even in healthy individuals
total iron-binding capacity (TIBC)
A direct measure of all proteins available to bind mobile iron and depends on the number of free binding sites on the plasma iron-transport protein transferrin.
homocysteine
An amino acid. Vitamins B12, B6 and folate break down homocysteine to create other chemicals your body needs.
methylmalonic acid (MMA)
A substance produced in very small amounts and is necessary for human metabolism and energy production.
25 hydroxy vitamin D (25[OH]D3)
The major circulating form of vitamin D. Thus, the total serum 25(OH)D level is currently considered the best indicator of vitamin D supply to the body from cutaneous synthesis and nutritional intake.
osteocalcin
A bone turnover marker, may also be used to assess vitamin K status
creatinine
Formed from creatine, found almost exclusively in muscle tissue. Serum creatinine is used along with blood urea nitrogen (BUN) to assess kidney function.
hemoglobin A1C (HgbA1C)
The percent of glycohemoglobin in the blood is related directly to the average blood glucose levels for the preceding 2 to 3 months and does not reflect more recent changes in glucose levels.
anthropometry
Involves obtaining physical measurements of an individual, comparing them to standards that reflect the growth and development of that individual, and using them to evaluate overnutrition, undernutrition, or the effects of nutrition preventions over a period of time
height for age
Used to define shortness or tallness
length for age
Used to define shortness or tallness
weight for age
Reflects body weight relative to age and is influenced by recent changes in health or nutritional status. It is not used to classify children and teens as under or overweight. However, it is important to help explain changes in BMI-for-age in older children.
weight for length
Weight-for-length corresponds to body-mass-index-for-age (BMI) in older children.
body mass index (BMI)
A person’s weight in kilograms divided by the square of height in meters. BMI is an inexpensive and easy screening method for weight category—underweight, healthy weight, overweight, and obesity.
usual body weight (UBW)
Body weight value used to compare a person’s current weight with his or her own baseline weight. The UBW may be a more realistic goal than the ideal body weight for some individuals.
ideal body weight (IBW)
The optimal weight associated with maximum life expectancy for a given height
body composition
A critical component of nutrition assessment and medical status. It is used concurrently with other assessment factors to differentiate the estimated proportions of fat mass, soft tissue body mass, and bone mass
head circumference
Measurements that are useful in children younger than 3 years old, primarily as an indicator of nonnutritional abnormalities
midarm circumference (MAC)
Measured in centimeters halfway between the acromion process of the scapula and the olecranon process at the tip of the elbow
bioelectrical impedance analysis (BIA)
Estimates body composition and cellular activity by measuring the bulk of the electrical impedance in the body
triceps skin fold (TSF)
Measurements that allow indirect determination of the arm muscle area and arm fat area which can be tracked against a standard and used as an assessment of malnutrition
waist circumference (WC)
Obtained by measuring the distance around the narrowest area of the waist between the lowest rib and iliac crest and above the umbilicus using a nonstretchable tape measure
waist to hip ration (WHR)
Divide the waist measurements by the hip measurement. The WHO defines the ratios of greater than 9.0 in men and 8.5 in women as one of the decisive benchmarks for metabolic syndrome and is consistent with findings of research predicting all cause and cardiovascular disease mortality
dual-energy x-ray absorptiometry (DXA)
Measures fat, bone, mineral and fat-free soft tissue.
air displacement plethysmogram (ADP)
Relies on measurements of body density to estimate body fat and fat-free masses
functional medicine
An evolving, evidence-based discipline that sees the body with its mutually interactive systems as a whole, rather than as a set of isolated signs and symptoms
functional nutrition assessment
Acknowledges the web-like interconnectedness of internal physiologic factors and identifies root causes of chronic disease by integrating traditional dietetic practice with nutritional genomics, the restoration of gastrointestinal function, the quelling of chronic inflammation and the interpretation of nutritional biomarkers
