Clinical Biochem

Question 1

major ECF cation

Answer 1

sodium

Question 2

hyponatremia

Answer 2

low sodium (water retention)

Question 3

hypernatremia

Answer 3

high sodium (most likely dehydration)

Question 4

major ICF cation

Answer 4

potassium

Question 5

hypokalemia

Answer 5

low potassium

Question 6

hyperkalemia

Answer 6

high potassium (renal insufficiency)

• may trigger cardiac arrest with no warning
• affects muscle function

Question 7

buffer system controlled by lungs and kidneys

Answer 7

bicarbonate- CO2

• acid/base balance
• monitored for diabetic ketoacidosis, glucose, pH, and electrolyte concentration

Question 8

• mostly in bones
• also a 2nd messenger
• affects muscular and neuronal function

Answer 8

calcium

Question 9

hypercalcemia

Answer 9

high calcium

- problems or degradation of bones

Question 10

hypocalcemia

Answer 10

low calcium

- hormonal disturbances

Question 11

stored in bones

Answer 11

phosphate

Question 12

hyperphosphatemia

Answer 12

high phosphate

indicative of degenerative bone disease

Question 13

hypophosphatemia

Answer 13

low phosphate

• can impair glucose metabolism
• possible renal failure

Question 14

If kidney function is impaired, what will the serum and urine levels of urea/creatinine?

Answer 14

serum - high

urine - low

Question 15

When is BUN high a potential problem?

Answer 15

When protein intake and catabolism are normal and BUN is high

Question 16

• insensitive marker
• measure of kidney function
• it is released at a constant rate

Answer 16

creatinine

Question 17

end product of purine degradation

Answer 17

uric acid

Question 18

high uric acid value is indicative of what?

Answer 18

sign of kidney problems and predispose to gout

Question 19

conjugated to glucuronic acids and water soluble

Answer 19

direct bilirubin

Question 20

unconjugated to glucuronic acid

not water-soluble

Answer 20

indirect bilirubin

Question 21

When will you find proteins in urine?

Answer 21

proteins in urine is not normal

- it’s indicative of decreased kidney function

Question 22

• made by liver
• binds to hydrophobic molecules
• binds calcium
• maintains oncotic pressure

Answer 22

Albumin

Question 23

low albumin
manifest as edema
- water is drawn out of serum and into tissues
- common cause is liver disease

Answer 23

hypoalbuminemia

Question 24

If globulin is found in the serum, what is it indicative of?

Answer 24

impaired immune system function

Question 25

• secreted by liver

- marker for acute metabolic response to injury

Answer 25

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

Question 26

Which heart muscle enzyme is most sensitive marker for MI and can be detected very early?

Answer 26

troponins

Question 27

heart muscle enzyme myoglobin

Answer 27

first to release after MI
not heart muscle specific
just indicate there’s muscle damage

Question 28

What’s the order in which heart muscle enzymes appear after MI?

Answer 28

soonest to latest:

myoglobin, troponins, creatine kinase, AST, LDH

Question 29

alkaline phosphatase

Answer 29

indicative of bone and liver disease

Question 30

how to differentiate between bone and liver disease if alkaline phosphatease is found?

Answer 30

Liver disease will accompany with high levels of bilirubin

Bone disease will not have high bilirubin

Question 31

When suspecting liver damage, what test should be used to confirm?

Answer 31

bilirubin concentration

Question 32

glucose in urine

Answer 32

hyperglycemia

Question 33

bilirubin in urine

Answer 33

obstruction of bile duct

Question 34

ketones in urine

Answer 34

uncontrolled diabetes or starvation

Question 35

proteins in urine

Answer 35

glomerular disease but need rule our that it’s not blood or leukocytes

Question 36

What does a basic metabolic panel test for?

Answer 36

kidney function
blood suar
acid/base balance
electrolyte balance

Question 37

What does a hepatic function panel test for?

Answer 37

Bilirubin
ALT and AST
Alkaline phosphatase

Question 38

What type of test is this?

• serum urea (BUN)
• serum creatine
• serum Na+, K+, CO3-
• excretion of Na+ and K+ in urine
• urine osmolality

Answer 38

Kidney function test

Question 39

What tests are used for management of diabetes?

Answer 39

HbA1c - glycation of glucose
- reflects glycemia control of past few months
Proteinuria - onset of diabetic nephropathy
C-peptide - indication of endogenous production of insulin