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FoundSci Unit 5 > Clinical Biochemistry > Flashcards

Clinical Biochemistry Flashcards

1
Q

What is hyperglycemia and what causes it?

A

Fasting blood glucose is greater than or equal to 7 mmol/L

Causes:
Insuffient insulin action - diabetes
Metabolism under acute stress (transient hyperglycemia)

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2
Q

What is fasting hypoglycemia? What are its symptoms?

A

Blood glucose below 3.5 mmol/L

Symptoms are sweating, tremor, nausea, coma, death

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3
Q

What causes fasting hypoglycemia?

A

Insulinoma - insulin producing beta cell tumors of the pancreas

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4
Q

What is an example of reactive hypoglycemia?

A

Response to stimulus

Insulin-induced - Type 1 Diabetes

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5
Q

What causes neonatal hypoglycemia?

A

Inborn errors of metabolism

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6
Q

What is creatinine and what is it a marker for?

A

Waste product of muscle creatine - depends on person’s skeletal mass

Creatinine release into blood is at constant rate.

Specific marker for kidney disease

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7
Q

What occurs with creatinine during kidney dysfunction?

A

Serum creatinine increases during kidney dysfunction because it is unable to excrete.

Creatinine in urine decreases during kidney dysfunction and can be measured by creatinine clearance test

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8
Q

What is a BUN and what does it reflect?

A

Blood Urea Nitrogen

Less specific indicator of kidney dysfunction

Reflects the balance between amino acid degradation and urea production/excretion

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9
Q

What occurs to BUN during kidney dysfunction and liver damage?

A

Serum BUN increases during kidney dysfunction

Serum BUN decreases during liver damage

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10
Q

What is uric acid?

A

Nitrogen containing waste of purine degradation

Humans cannot degrade uric acid

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11
Q

Hyperuricemia

A

Related to renal excretion problems and purine rich foods like meat, mushrooms, and spinach

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12
Q

What is Gout?

A

Formation of uric acid crystals in joints and tendons. Recurrent acute arthritis and inflammation

Ethanol intoxication, diabetic ketoacidosis, and starvation can exacerbate

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13
Q

What is bilirubin and the two forms?

A

Breakdown product of heme

Unconjugated (indirect) is bound to albumin

Conjugated (direct) with glucuronic acid is water soluble and excrete with bile

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14
Q

What does hyperbilirubinemia result from?

A

Hemolysis - unconjugated, indirect

Liver damage - unconjugated, indirect

Obstruction of the bile duct - conjugated, direct

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15
Q

Bilirubinuria

A

High direct bilirubin in the urine

Pathogical and turns the urine orange to dark amber (post hepatic jaundice)

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16
Q

What is albumin and its functions?

A

Albumin is produced by the liver and functions to transport fatty acids and bilirubin. Maintains the oncotic plasma pressure

17
Q

Hypoalbuminemia

A

Results from liver damage, heart failure, or severe starvation

Leads to edema

18
Q

Where are the different isoforms of alkaline phosphatase (AP) found?

A

Bones

Biliary tract

Liver

18
Q

What are markers for a myocardial infarction?

A

Myoglobin (MG) - early marker

Creatine Kinase (CK-MB) - early marker

Cardiac Troponin - most sensitive marker, rises within hours after MI and sensitivty of troponin is 100% 12 hours after onset of symptoms

AST - mid response marker

Lactate dehydrogenase (LDH) - late response marker

19
Q

What do increased serum levels of alkaline phosphatase indicate?

A

Obstruction of the bile duct most commonly

20
Q

What is gamma-glutamyl transpeptidase a sensitive marker for?

A

Liver disease

High serum gamma-glutamyl transpeptidase indicates liver disease and cholestasis (reduction or stoppage of bile flow)

21
Q

What are the concentration of ALT and AST in the liver and the heart and other muscles?

A

In liver - concentration of ALT and AST are roughly equal

In heart and other muscles - AST is much higher than ALT

22
Q

What does a high serum AST and low ALT indicate?

A

Heart or other muscle damage

23
Q

What does high serum AST and high ALT indicate?

A

Liver damage

24
Q

What is amylase and what does it indicate?

A

Amylase is a digestive enzyme secreted by the pancreas.

High serum amylase indicates acute pancreatitis

High serum lipase confirms the diagnosis

25
Q

What is glycosuria?

A

Glucose in the urine

Can be caused when glucose excretion exceeds kidney reabsorption (diabetes) or the inability of the kidney tubules to reabsorb glucose (renal glucosuria)

26
Q

What is proteinuria or albuminuria?

A

Protein in urine

Can be caused by renal disease (glomerular proteinuria) and uncontrolled diabetes

27
Q

What is ketonuria?

A

Ketones in the urine

Can be caused by diabetic ketoacidosis, alcohol use disorder (alcoholic ketoacidosis), and starvation

28
Q

What is bilirubinuria?

A

Bilirubin in the urine

Pathological finding that indicates biliary obstruction

29
Q

What could cause blood or leukocytes in the urine?

A

Malignancy or UTI

30
Q

What does a kidney function test (KFT) include and what do they indicate?

A

Serum BUN - elevated serum BUN indicates kidney dysfunction

Serum creatinine - elevated serum creatinine indicates kidney dysfunction

Urine creatinine - low creatinine clearance in urine indicates kidney dysfunction

Proteinuria (albuminuria) - Presence of protein (albumin) in urine indicates renal disease or diabetes

31
Q

What is an LFT and what does it include?

A

Liver function test

LFT includes blood analysis of bilirubin, alkaline phosphatase, ALT, AST, and Albumin

32
Q

What does an LFT indicate?

A

Bilirubin - elevated serum bilirubin indicates liver damage, obstruction of bile, or hemolysis

Alkaline phosphatase (AP) - elevated AP levels indicate obstruction of bile

ALT and AST - high serum ALT and AST are markers for liver damage

Albumin - hypoabuminemia is strong indicator of liver damage and also starvation or heart failure

33
Q

What are diabetes tests?

A

Initial diagnosis - High fasting blood glucose (>7 mmol/L)

Monitoring - Glycated hemoglobin HbA1c and C-peptide

Other tests - proteinuria and glucosuria and ketone bodies

34
Q

What is a basic metabolic panel and what does it test?

A

Analysis of kidney function, blood sugar, acid/base, and electrolyte balances.

Tests:
Sodium
Potassium
Chloride
CO2
BUN
Creatinine
Glucose
Calcium

FoundSci Unit 5 (10 decks)

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