Clinical Biochem Flashcards
major ECF cation
sodium
hyponatremia
low sodium (water retention)
hypernatremia
high sodium (most likely dehydration)
major ICF cation
potassium
hypokalemia
low potassium
hyperkalemia
high potassium (renal insufficiency)
- may trigger cardiac arrest with no warning
- affects muscle function
buffer system controlled by lungs and kidneys
bicarbonate- CO2
- acid/base balance
- monitored for diabetic ketoacidosis, glucose, pH, and electrolyte concentration
- mostly in bones
- also a 2nd messenger
- affects muscular and neuronal function
calcium
hypercalcemia
high calcium
- problems or degradation of bones
hypocalcemia
low calcium
- hormonal disturbances
stored in bones
phosphate
hyperphosphatemia
high phosphate
indicative of degenerative bone disease
hypophosphatemia
low phosphate
- can impair glucose metabolism
- possible renal failure
If kidney function is impaired, what will the serum and urine levels of urea/creatinine?
serum - high
urine - low
When is BUN high a potential problem?
When protein intake and catabolism are normal and BUN is high
- insensitive marker
- measure of kidney function
- it is released at a constant rate
creatinine
end product of purine degradation
uric acid
high uric acid value is indicative of what?
sign of kidney problems and predispose to gout
conjugated to glucuronic acids and water soluble
direct bilirubin
unconjugated to glucuronic acid
not water-soluble
indirect bilirubin
When will you find proteins in urine?
proteins in urine is not normal
- it’s indicative of decreased kidney function
- made by liver
- binds to hydrophobic molecules
- binds calcium
- maintains oncotic pressure
Albumin
low albumin
manifest as edema
- water is drawn out of serum and into tissues
- common cause is liver disease
hypoalbuminemia
If globulin is found in the serum, what is it indicative of?
impaired immune system function
- secreted by liver
- marker for acute metabolic response to injury
c-reactive protein
- should rise 6 hours after injury, peaking at 48 hours and decay slowly
- sudden in rise in CRP indicate complications in healing process
Which heart muscle enzyme is most sensitive marker for MI and can be detected very early?
troponins
heart muscle enzyme myoglobin
first to release after MI
not heart muscle specific
just indicate there’s muscle damage
What’s the order in which heart muscle enzymes appear after MI?
soonest to latest:
myoglobin, troponins, creatine kinase, AST, LDH
alkaline phosphatase
indicative of bone and liver disease
how to differentiate between bone and liver disease if alkaline phosphatease is found?
Liver disease will accompany with high levels of bilirubin
Bone disease will not have high bilirubin
When suspecting liver damage, what test should be used to confirm?
bilirubin concentration
glucose in urine
hyperglycemia
bilirubin in urine
obstruction of bile duct
ketones in urine
uncontrolled diabetes or starvation
proteins in urine
glomerular disease but need rule our that it’s not blood or leukocytes
What does a basic metabolic panel test for?
kidney function
blood suar
acid/base balance
electrolyte balance
What does a hepatic function panel test for?
Bilirubin
ALT and AST
Alkaline phosphatase
What type of test is this?
- serum urea (BUN)
- serum creatine
- serum Na+, K+, CO3-
- excretion of Na+ and K+ in urine
- urine osmolality
Kidney function test
What tests are used for management of diabetes?
HbA1c - glycation of glucose
- reflects glycemia control of past few months
Proteinuria - onset of diabetic nephropathy
C-peptide - indication of endogenous production of insulin
