Chem Unit 3 Flashcards
1
Q
Proteins are too large to fit through what in the kidney?
A
Glomerular membrane
2
Q
Where are proteins reabsorbed in the kidney?
A
Proximal Convoluted Tubules
Descending Loop of Henele
3
Q
Where are proteins synthesized?
A
Liver
4
Q
What proteins are made outside of the liver?
A
Factor 8
Antibodies
Hemoglobin
Peptide hormones
5
Q
What do proteins provide?
A
Oncotic pressure
6
Q
What is the most prevalent plasma protein?
A
Albumin
7
Q
What is the function of albumin?
A
-Buffer for acid
-Increase plasma oncotic pressure to keep fluid in the intravascular space
-Provide a binding site for hormones so they aren’t activated
8
Q
What produces immunoglobulins?
A
Plasma cells
9
Q
What produces Hemoglobin?
A
RBCs
10
Q
How do proteins separate in electrophoresis?
A
Size and charge
11
Q
What is the reference range for Serum Total Protein?
A
6.0 - 8.3 g/dL
12
Q
What does Serum Total Protein assess?
A
Pathology
Adequate nutrition
13
Q
What is the primary function of Albumin?
A
Maintains oncotic pressure
(binds to things as well)
14
Q
What is the largest peak on Electrophoresis?
A
Albumin
15
Q
What protein migrates the fastest on Electrophoresis?
A
Albumin
16
Q
If there is physical injury what happens to albumin?
A
Increased catabolism
17
Q
What are the reasons for decreased synthesis of Albumin?
A
Primary- liver disease
Secondary- malabsorption/malnutrition
18
Q
What causes an increased loss of Albumin?
A
Renal Protein Loss
19
Q
What is the most common Alpha 1 protein called?
A
Antitrypsin (AAT)
20
Q
What is the role of AAT?
A
remove free elastase from circulation
21
Q
What can an AAT deficiency cause?
A
Emphysema
Cirrhosis
22
Q
What are other Alpha 1 proteins?
A
A1-Acid Glycoprotein
Alpha Fetoprotein
A1-Antichymotrypsin
23
Q
What Globulin is a carrier of cationic drugs?
A
A1-Acid Glycoprotein
24
Q
What is the major glycoprotein released in inflammation?
A
A1-Acid Glycoprotein
25
What globulin is found between the A1 and A2 zones on electrophoresis?
A1-Antichymotrypsin
26
What are the Acute Phase Reactants?
A1-Antitrypsin
Haptoglobin
CRP
Prealbumin/Transthyretin
27
What is the role of haptoglobin?
Prevents hemoglobin from being removed in the glomeruli
28
When is haptoglobin increased?
Inflammation
Intravascular hemolysis
smoking
29
What are the Alpha 2 globulins
Haptoglobin
Ceruloplasmin
A2-Macroglobulin
30
What does A2-Macroglobin inhibit?
Protease Inhibitor
-Complement
-Coagulation
-Fibrinolytics
31
What condition will we see a large increase in A2-Macroglobulin?
Nephrotic Syndrome
32
What conditions will we see a decrease in A2-Macroglobulin?
Pancreatitis
RA
Multiple Myeloma
33
What are the main Beta-globulins?
Transferrin
CRP
Fibrinogen
Complement
C3, C4
Hemopexin
B-lipoproteins
B-Microglobulin
34
What are gamma globulins also known as?
Antibodies
35
What is the equation for Globulin?
Total Protein - Albumin
36
What is the normal range for Albumin/Globulin Ratio?
1.1 - 1.5
37
What does low total protein suggest?
Liver failure
Glomerular failure
malnutrition/malabsorption
38
What does elevated protein suggest?
Chronic inflammatory states
Autoimmune diseases
Cancers
39
What does a low A/G ratio <1.1 mean?
More globulins than albumin
1. Multiple myeloma
2. cirrhosis
3. Nephrotic syndrome
40
What does a high A/G ratio >1.5 mean?
More albumin than globulins
1. leukemias
2. genetic immunoglobulin deficiencies
41
What is the role of prealbumin/transthyretin
Transport protein
42
Nephrotic Syndrome
43
Acute Phase Reactants
44
Multiple Myeloma
45
What increases in the urine of multiple myeloma patients?
Bence-Jones proteins
(immunoglobulin light chains)
46
What reflect tubular disorders in the kidneys?
Elevated B2-Microglobulin
47
What are the main causes of hyperproteinuria?
Glomerular damage
Post-Streptococcal Glomerulonephritis
48
Mnemonic for clinical signs of Post-Streptococcal Glomerulonephritis?
Sore throat
Pee coke
Face bloat
49
NephrItic syndrome symptoms
Hematuria
Oliguria
Azotemia
Hypertension
*focuses on Inflammation
50
NephrOtic syndrome symptoms
Massive proteinuria
Hypoalbuminemia
Edema
Hyperlipidemia/hyperlipiduria
*focuses on prOteinuria
51
What is multiple myeloma?
Cancer of the plasma cells
**uncontrolled hyperproduction of immunoglobulin
52
What does multiple myeloma lead to?
-Pathological fractures and hypercalcemia
-Decreased A/G ratio
-low A2-macroglobulin
-high B2-microglobulin
53
Symptoms of multiple myeloma
Bone pain
Hypercalcemia
Proteinuria
54
What syndrome causes frothy urine
Nephrotic syndrome
55
What globulin is increased in nephrotic syndrome
A2-macroglobulin
56
What is the clinical giveaway for hypoproteinemia?
Ascites
57
What can cause hypoproteinemia?
Hemodilution
decreased production
increased protein loss
inadequate nutrition
water intoxication
nephrotic syndrome
liver failure
58
What does a peak in A2 region signify?
Acute phase reactants
59
What does the Biuret reagent contain?
1. NaOH for alkalinity
2. NaK tartrate
3.Potassium Iodide
4. CuSO4
60
What does the Biuret method interact with to form a purple color
In an Alkaline medium
Cupric ions (Cu2+) interact with peptide bonds
61
What does biuret method assess?
The presence of peptide bonds
62
What are the testing methods for protein
Refractometry
Dye-binding
63
How does the protein dye-binding method work
Coomassie blue is in acidic solution. it binds with protein and increases the absorbance at 595 nm
64
What is the reference range for albumin?
3.5 - 5.0 g/dL
65
What are the dyes used to test for albumin?
Bromcresol green (BCG)
Bromcresol purple (BCP)
66
What does the urine dipstick use to test for protein?
tetrabromphenol blue at 3 pH
67
How does gas chromatography separate proteins?
based on differential affinity between the liquid phase migrating up a gel plate and the gel on the plate
68
What is known as black diapers
Alkaptonuria
69
What is alkaptonuria
Body is unable to break down tyrosine and phenylalanine resulting in a buildup of Homogentisic acid.
70
What are the divalent amino acids
Cystine
Lysine
Arginie
Ornithine
71
What amino acid can result in kidney stones
Cystine
72
What happens in Cystinuria
Kidneys can't reabsorb the divalent amino acids
73
What is the defect in cystinuria
In the amino acid transport system
74
What are the essential BCAAs
Leucine
Isoleucine
valine
75
What is Maple Syrup Urine Disease (MSUD)
Can't break down branched chain amino acids
76
What is MSUD deficient in
Branched Chain Keto-acid Dehydrogenase Complex (BCKDC)
77
What is the treatment for MSUD
Change diet. Must restrict BCAAs
78
What disorder causes a mousy urine odor
Phenylketonuria (PKU)
79
What disorder can cause mental retardation?
PKU
80
What can not be metabolized in PKU?
Phenylalanine
-an essential AA
81
What are the Non-Protein Nitrogens in our blood?
Urea Nitrogen
Uric acid
Creatinine
Ammonia
82
What are the % breakdowns of NPN in our blood?
45% is Urea
20% is Uric acid
5% Creatinine
.2% Ammonia
83
What does BUN come from?
catabolism of proteins
84
What is BUN directly related to
hydration status
GFR
85
What is the equation for Urea
BUN X 2.14
86
What is Prerenal Azotemia
caused by:
dehydration
impaired blood flow to the kidneys
increased protein catabolism
87
BUN is inversely correlated with
glomerular filtration rate and renal plasma flow
88
What is renal azotemia
Acute renal failure
89
What is azotemia
elevated creatinine in the blood
90
What is postrenal azotemia
obstructive renal disease
91
What is the reference range for BUN
7-18
92
How long is BUN stable for at RT
4 hours
93
What is the biproduct of the BUN urease method
2 NH4 + CO3-
94
What is Diazine detected at
540 nm
95
What is the Diacetyl (Fearon) Reaction
Urea + Diacetyl with Heat = Diazine + 2 H2O
96
What is the Range for the BUN:Creat Ratio
10:1 to 20:1
97
An increased BUN:Cr ratio indicates?
Prerenal azotemia
98
A decreased BUN:Cr ratio indicates?
Intrarenal azotemia
99
Normal BUN:Cr ratio is seen in what azotemia?
postrenal
100
What AA are Creatinine synthesized in the liver with?
Arginine
Glycine
Methionine
101
In renal disease, excretion of what is decreased?
Creatinine
102
BUN/Cr >30 is usually
Prerenal renal failure
103
BUN/Cr > 40 is definitely what
Prerenal
104
What is the Jaffe Reaction
Creatinine and picric acid in alkaline solution
105
What is the Jaffe Reaction used to measure?
Creatinine
106
What interferes with the Jaffe Reaction
Glucose
Uric Acid
Ascorbic Acid
Acetone
Ketoacids
Cephalosporins
107
Reference Range for Creatinine
Men 0.9 -1.2
Women 0.6 - 1.1
108
What is Lesch-Nyhan Syndrome deficient in?
HGPRT
hypoxanthine-guanine phosphoribosyltranferase
109
What is elevated in Lesch-Nyhan Syndrome
Uric Acid
110
Symptoms of Lesch-Nyhan Syndrome
Mental Retardation
Muscle fasciculations
Self-mutilation
111
Tumor-Lysis Syndrome is caused by
Cytotoxic Chemotherapy
112
What is the result of Cytotoxic Chemotherapy
The rapid killing of cells results in DNA damage and Uric Acid production is increased
113
How does malignancies increase Uric Acid?
Rapid formation of cells but they die off quickly resulting in DNA damage and the release of Uric Acid
114
What method is used for Uric Acid?
Xanthine oxidase
115
What is the Xanthine Oxidase method?
Adenine + Guanine are catabolized to Xanthine
+ Xanthine Oxidase
=Uric Acid
116
What are our sources of Uric Acid?
Diet
Endogenously by breaking down cells and destruction of DNA
117
How does our body remove Uric Acid?
Excreted by kidneys
Degraded in GI Tract
118
What crystals cause Gout
Monosodium Urate crystals
119
What is podagra
Pain on the big toe from gout
120
Factors that contribute to Gout
Alcohol
high protein diet
stress
surgery
diuretics
121
What is Uremia
Increased in Urea and creatinine that results in renal failure
122
What can cause Uremic Frost on patient's skin
Elevated levels of Uric Acid in the blood
123
What is the color method for Uric Acid
PTA method
124
What is the reaction for PTA method
Phosphotungstic Acid + Uric Acid reacting with Na2CO3
=
Allantoin + CO2 + Tungsten Blue
125
What is the enzymatic method for Uric Acid
Uricase Method
126
What is the reaction for Uricase Method
Uric Acid with Uricase
=
Allantoin + H2O2 + CO2
=
H2O2 + 4-Aminoantipyrine with peroxidase
=chromogen
127
What electrodes are used to assess acid-base disorders?
Clarke
Severinghaus
pH electrodes
128
What does the Clarke electrode assess?
pO2
129
What does the Severinghaus electrode assess?
pCO2
130
What does the pH electrode assess?
pH
131
What electrodes are potentiometric?
pH and Severinghaus (pCO2)
132
What electrode is amperometric?
Clarke (pO2)
133
What measures the O2 reduced in a sample for the amperometric electrode?
microammeter
134
What does the ammeter measure?
current or the movement of electrons
135
What is acidosis
increase of H+ in the body
136
what is acidemia
increase of H+ specifically in the blood
137
What is alkalosis
increases of HCO3- in the body
138
Reference Range for pH
7.35 - 7.45
139
Reference Range for pCO2
35 - 45
140
Reference Range for pO2
90 - 100
141
Reference Range for HCO3
22 - 28
142
Hyperventilation causes?
Respiratory alkalosis
-Breathing off all their CO2
143
What disorders cause respiratory acidosis
Emphysema
Pneumonia
Bronchiectasis
Atelectasis
ARDS
Pulmonary Edema
144
What disorders cause metabolic alkalosis
Hypercortisolism
Adrenal Hyperplasia
Diuretics
145
What disorders cause metabolic acidosis
Acute kidney injury
Diabetes
Salicylate Toxicity
Lactic Acidosis
146
What is pKa
Dissociation constant of an acid
**how tightly the base will hold on to the Hydrogen ion
147
What enables CO2 and H2O to come together to form BiCarb
Carbonic anydrase
148
What are the 3 primary ways that CO2 can travel in blood
1. Dissolved in plasma
2. Carried in the RBC
3. Dissolved bicarbonate
149
What is the ratio our body uses to keep pH at 7.4
20 bicarbonate to 1 carbonic acid
150
What is a secondary function of Hemoglobin and ALL other proteins?
Mop up excess hydrogens
151
Variables that favor Oxygen unloading into the tissues
1. Increased CO2
2. Acidosis
3. Increased DPG
4. Exercise
5. Increased temperature
152
What does a right shift in regards to O2 mean
Easier to unload the O2 into the tissues
153
What is a K+ shift?
When there is an excess of H+ surrounding the cell, the cell will accept the H+ in exchange for K+
154
What is a Cl- shift?
In acidosis, HCO3- moves out of the cell and Cl- moves in
155
In acidosis what is decreased
HCO3-
156
In alkalosis what is increased
HCO3-
157
What is a buffer
A solution that resists changes in pH when acid or base is added to it
158
What are the primary buffer systems in our body
1. Bicarbonate buffer
2. Protein buffer
3. Hemoglobin buffer
4. Phosphate buffer
159
What is hypoxia
We are breathing in less O2 than we need
160
What is hypoxemia
Low levels of O2 in our blood
161
What is the Henderson-Hasselbalch Equation
pH = pKa +log10 (A-/HA)
**Base over conjugate acid
pH = pKa +log10 (B/BH+)
162
What is the Bicarbonate Buffer System Chemical Equation?
HCO3 (Bicarbonate)
<---------->
H2CO3 (Carbonic Acid)
<----------->
H2O and CO2
163
What is the most important buffer system
Bicarbonate
164
What does the Hemoglobin Buffer System do?
Binds CO2 to an amino acid terminal of the protein
165
What does the Protein Buffer System do?
Terminal amino acids provide buffering capacity
166
What is Amphoteric compounds
Amino acids that are able to act as a base and an acid
167
What is the Phosphate Buffer System
-2,3 DPG enable the kidneys to excrete H+
-Helps unload O2 into the tissues by binding to deoxygenated Hgb and stabilizing it
168
Metabolic compensation controls?
Bicarbonate concentration by the kidneys
-Occurs after a few days
169
Respiratory compensation controls?
pCO2 concentration by the lungs
-occurs immediately
170
Role of Kidneys in Acid-Base Balance
1. NH3 production and NH4+ secretion in the urine
2. Na-H exchange pumps
3. Conservation of filtered H2CO3
171
What is more acidic than the blood within the kidney?
tubular lumen
172
How is NH4+ created
NH3 bind with H+ in the urine filtrate
173
What is Respiratory Compensation
How we breath to try and stabilize the acid-base disturbance
**Controlling the level of pCO2 in the blood
174
How does the body handle Metabolic acidosis with respiratory compensation?
Decrease levels of pCO2 by breathing faster
175
How does the body handle Metabolic Acidosis with respiratory compensation?
Increase the levels of pCO2 by breathing slower
176
How do we tell if there is partial compensation?
-pH is outside 7.35 - 7.45
-pCO2 is indicating 1 direction
-HCO3- is indicating another
177
What is Metabolic Compensation?
The kidney's response to help stabilize the acid-base disturbance.
178
How does our body handle Respiratory acidosis with metabolic compensation?
Increase the levels of HCO3-
179
How does our body handle Respiratory alkalosis with metabolic compensation?
Decrease the levels of HCO3-
*getting rid of CO2
180
What is caused by an overabundance of hydrogen ions caused by decrease in bicarb
Metabolic Acidosis
181
When do we see Metabolic acidosis?
Lactic acidosis
Cancer
overdose of tylenol, ethanol, aspirin
182
In Metabolic acidosis how do we see Bicarb and pCO2?
Low Bicarb
normal to decreased pCO2
183
What is caused by low concentration of hydrogen ions caused by increase in Bicarb?
Metabolic Alkalosis
*usually caused by an increase in Bicarb
184
When do we see Metabolic Alkalosis
Hyperaldosteronism
Gastric fluid losses (vomitting)
Antacid overdose
185
In Metabolic alkalosis how do we see Bicarb and pCO2
High bicarb
normal to increased pCO2
186
When do we see an overabundance of H+ caused by increase of CO2
Respiratory Acidosis
187
When do we see respiratory acidosis
Respiratory insufficient
-emphysema
188
What are Bicarb and pCO2 levels in respiratory acidosis
High pCO2
Normal to increase Bicarb
189
What is it called when alkalosis is caused by a decrease in pCO2 bc the patient is hyperventilating?
Respiratory Alkalosis
190
In respiratory alkalosis how is the Bicarb and pCO2?
low pCO2
normal to decreased Bicarb
191
What causes a right shift on O2 dissociation curve?
CO2
Acidosis
2,3 BPG
Exercise
Increased Temp
192
In Blood Gas analysis what is calculated?
HCO3
193
How frequent is Calibration needed for Blood gases?
2 points every 8 hrs
1 point every 4 hr
194
Why do we need to calibrate blood gases so frequently?
Electrodes drift over time
195
What are the fat soluble Vitamins?
A
D
E
K
196
Liver stores what vitamins and minerals
Vitamins
A
B12
D
E
K
Minerals
Copper
Iron
197
Where is Thiamine stored
RBC
198
Vitamin A is also known as
Carotenoid
Beta-carotene
Retindoid
199
What is Vitamin A crucial for
vision
200
What does a deficiency in Vitamin A cause
Keratomalacia
-retinal epi defect that causes blindness
201
How do we test for Vitamin A
HPLC
202
What is on our skin that turns to Vit D from UVs
Cholecalciferol
203
Once Vit D gets to the liver what is it changed into
25-hydroxylated Vit D
204
What does 25- hydroxy Vit D become once it is in the kidney
1,25-hydroxylated Vit D
205
What is the active form of Vit D
1,25-dihydroxy Vit D
206
How does Vit D effect Calcium
Increases it in the body
207
If we do not get enough Vi D as a child, what can they develop?
Rickets
208
Vit D deficiency causes
osteoporosis
osteomalacia
osteopenia
209
What vitamin inhibits Platelet aggregation
Vit E
210
What is Vit E also known as
alpha-tocopherol
211
What is Vit E incorporated into
VLDL
212
What does Vit E function as?
Antioxidant
213
How is Vit E excreted
Transported in bile but can be excreted in urine and bile
214
How do we measure Vit E
HPLC
215
Where is Vit K absorbed
Small intestines
216
What is the function of Vit K
Promote blood coagulation
Factors:
7, 9, 10, 2
217
What happens in Vit K deficiency
Malabsorption
Bile duct obstruction
pancreatitis
liver failure
218
What disease is from a deficiency in Vit C
Scurvy
219
How do we get Vit C
Citrus fruits
veggies
tomatoes
potatoes
220
What is the function of Vit C
Antioxidant
Iron Absorption
biosynthesis of carnitine
conversion of dopamine to norepinophrine
221
Symptoms of Scurvy
Bleeding
Petechiae
Bloody adrenal glands
222
Too much Vit C causes
Elevated ALT, LD, Uric Acid
Kidney stones
223
Thiamine deficiency causes what 3 disorders
Dry beriberi
wet beriberi
Wernike-Korsakoff syndrome
224
What are the symptoms of dry beriberi
Primarily neurological symptoms
225
What are the symptoms of Wet beriberi
Heart failure
Edema
226
Symptoms of Wekike-Korsakoff syndrome
Horizontal nystagmus
cerebral ataxia
mental impairment
**long term alcoholism
227
What Vitamin is a cofactor for enzymes to work
B1 (Thiamine)
228
What vitamin is for DNA synthesis
B12
(Cyanocobalamin)
229
What vitamin needs intrinsic factor to be absorbed in the ileum
B12
230
<3.0 serum albumin suggests
malnutrition
231
<15 prealbumin suggests
protein depletion
232
<200 TIBC suggests
protein depletion
233
<0.6 Creatinine suggests
Lack of muscle mass
High urine flow rate
234
<6.0 BUN suggests
Inadequate protein intake
235
How do we measure vitamins
HPLC
236
What are the main organs in Calcium homeostasis
Small intestine
Kidneys/liver
Skeleton
237
How much of calcium is protein bound in the serum
40-50%
238
How does PTh effect Calcium
Increase the circulating ionized Ca
239
How does Vit D effect Calcium
increase total body Ca
240
How does Calcitonin effect Calcium
Decrease circulating Ca
241
Where does Calcitonin come from
Thyroid C-cells
242
What is the main role of Calcitonin
Responds to elevated calcium levels and puts the calcium in the bones
243
How does PTH increase calcium
-Harvests from bones
-Increase kidney reabsorption
-Removes PO4 from blood
-Increase intestinal absorption
244
What are the renal effects of PTH
Conserve Ca and lose PO4
245
What does PTH stimulate
1-hydroxylation of 25-hydroxy Vit D in the kidney to the active form 1,25-hydroxy Vit D
246
Calcium correction for hypoalbuminemia
Corrected total=
Measured Ca +
(Normal albumin - Patient albumin)
x 0.8
247
The 3 methodologies for Calcium
1. Colorimetric analysis
2. Atomic Absorption spectrophotometry
3. Indirect potentiometry
248
What will chelate Ca and give a false low value
EDTA
249
What are the 6 main causes of Hypocalcemia
1. PTH deficiency
2. PTH resistance
3. Vit D deficient
4. Deficiencies in bone Mineralization
5. Renal
6. Metastatic
250
Other Causes of Hypocalcemia
Renal failure
Hypomagnesemia
Sepsis
Extreme physical exertion
251
Causes of Hypercalcemia
-Cancer
-Hypercalcemia of Malignancy
-Renal failure
-Immobilization
-Thiazide diuretics
-Lithium
-Vit D toxicosis
252
2 mechanisms of Hypercalcemia of Malignancy
1. Tumors release PTH-related peptide
2. Osteolytic metases
253
Total Calcium and PTH seen in Secondary HyperPTH
Increased total Ca
Increased PTH
254
Total Calcium and PTH seen in Hypercalcemia of Malignancy
Increased Ca
Decreased PTH
255
Total Calcium and PTH seen in HypoPTH
Decreased Ca
Decreased PTH
256
What is the definition of Electrolyte
small ionizable constituents in the body
257
What is the definition of anion
negatively charged ion
258
What is the definition of Cation
Positively charged ion
259
What are the intracellular ions
K
Ca
Mg
260
What are the extracellular ions
Na
Cl
HCO3
261
How do we get the Anion Gap
Measured Cations and measured anions
262
What are the trace elements
Iron
Copper
Zinc
263
How does our body move proteins
Oncotic pressure
264
How does our body move ions
Osmotic pressure
265
Where does most electrolyte regulation occur
Kidneys
266
Where is Na reabsorbed
Proximal convoluted tubules
267
What enzyme converts Angiotensinogen to angiotensin 1
Renin
268
Where is angiotensin 1 converted to Angiotensin 2
in the lungs by Angiotensin Converting Enzyme
269
What does AT2 do in the adrenal cortex
Produce aldosterone
270
What does an increased aldosterone level do
More Na is reabsorbed in the distal convoluted tubule in exchange for K
271
AT1 and AT2 are involved in
Vasoconstriction
272
What is phosphorus regulated by
PTH in the kidney
273
What does Phosphorus do to Calcium
binds and decreases the plasma free Calcium concentration
274
What does PTH do to Phosphorus
Trashes it in the kidney
275
What does Vit D do to Phosphorus
increase intestinal absorption
276
How is Copper transported
Ceruloplasmin
277
Where is copper stored
Liver
278
What do elevated levels of copper cause
Neuropathies
hepatitis
279
Decreased Ceruloplasmin is seen in what disease
Wilson disease
280
Osmolarity equation
2 * Na+
BUN/2.8 +
Glucose/18
281
What is the normal osmolarity range
275 - 295 mOsm/L
282
What is the normal Osmolar Gap range
5 - 10 mOsm/L
283
What substances can increase Osmolar Gap
Ethanol
Methanol
Ethylene glycol
isopropanol
Lactate
B-hydroxy butryate
284
What is SIADH
Syndrome of Inappropriate ADH Secretion
285
What happens in SIADH
decreased free water excretion and increased thirst
286
In SIADH what would we expect to see in plasma osmolality
very low <275
287
In SIADH what would we expect to see in urine osmolality
Very high >100
288
What does the free water retention in SIADH do?
Dilutes out electrolytes
289
Electrolytes assessed by ISE
Na
K
Cl
290
What is ISE membrane made of
Valinomycin
291
Hyponatremia can cause<135
Hypovolemia
altered mental status
Orthostatic hypotension
292
What causes hypernatremia >150
Dehydration
Burns
hypertonic saline
293
Causes of hypokalemia <3.5
K shift in treated acidosis
Polyuria
diarrhea
blood dilution
mild dehydration
Lab/sample error
294
Symptoms of hypokalemia
EKG changes
Tachycarrhythmias
Dysrhythmias
295
Causes of hyperkalemia >6.1
Hypoaldosteronism
Extreme dehydration
Hemolysis
296
Symptoms of hyperkalemia
EKG changes
Confusion
Weakness
paralysis
297
Critical values for K
<3
>8
298
Hyperchloremia causes
>108
Dehyrdation
Intake of Cl exceeds output
Alkalosis
299
Hypochloremia causes
<97
Output exceeds intake
Acidosis
300
Dietary sources of Copper
Liver
Kidney
Nuts
Cocoa
301
Copper and Ceruloplasmin are what
Acute phase reactants which increase during stress
302
Purpose of Copper
Metalloprotein and essential for redox reactions
303
What happens in Wilson Disease
Low levels of Ceruplasmin
Lots of copper deposits
304
Where does copper deposit in Wilson Disease cause
Liver Disease
Neurological disease
Psychiatric symptoms
Kayser-Fleischer rings in eyes
305
Reference range for anion gap
7 - 16
306
Anion gap equation
Na -
(Cl + HCO3)
307
Causes of metabolic acidosis with elevated anion gap
Methanol
Uremia
DKA
Paracetamol
Isoniazid
Lactic Acidosis
Ethanol
Salicylates
308
What is Colligative Properties
Properties that are dependent solely upon the concentration of the solvent in solution
309
What occurs when a solute is added to a solution
Boiling point elevation
Freezing point depression
Vapor pressure depression
310
When do we use freezing point depression
Sweat chloride testing in Cystic Fibrosis in neonates
311
What may be falsely low in lipemic samples
Na
