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diagnostic methods > clinical chemistry > Flashcards

clinical chemistry Flashcards

(54 cards)

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1
Q

what is the difference between plasma and serum

A

plasma has clotting factors, serum does not

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2
Q

ion selective electrodes

A
  • converts activity of specific ion dissolved in a solution to an electrical potential
  • measured by voltemeter
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3
Q

spectrophotometry

A

measures change in light absorbance at certain wave length

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4
Q

enzyme linked immunosorbet assay (ELISA)

A

detects serum antibodies or antigens

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5
Q

critical value

A
  • any test result that may require rapid clinical attention to avoid pt morbidity or mortality
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6
Q

what studies make up a comprehensive metabolic panel (CMP)?

A
  • basic metabolic panel (BMP)
  • calcium
  • liver function tests
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7
Q

what is measured in a basic metabolic pannel?

A
  • Na
  • K
  • Cl
  • CO2
  • BUN
  • creatinine
  • glucose
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8
Q

serum sodium

A
  • reflects changes in water balance
  • makes up 90% of extracellular solutes
  • strong cation
  • normal levels = 135-145 mEq/L
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9
Q

functions of sodium

A
  • maintain osmotic pressure of extracellular fluids
  • acid base balance
  • neuromuscular function
  • absorption of glucose
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10
Q

hyponatremia

A
  • first sx occur at less than 125 mEq/L
  • less than 115 causes confusion, lethargy, muscle twitching, convulsions, coma, brain stem herniation
  • 110-115 likely to cause severe and irreversible neurological damage
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11
Q

treatment of hyponatremia

A
  • treat underlying cause
  • dehydrate -> hydrate
  • fluid overload -> diurese
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12
Q

normal saline

A
  • 0.9% NaCl
  • isotonic saline
  • treats dehydration
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13
Q

IV1/2NS

A
  • 0.45% NaCl

- used as maintenance fluid

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14
Q

lactated ringers

A
  • contain NaCl, sodium lactate, KCl, CaCl in water

- used in trauma, surgery

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15
Q

hypertonic saline

A
  • 3% NaCl
  • used for sudden precipitous drops in Na
  • i.e. marathon runners
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16
Q

treatment of hypernatremia

A
  • admin free water with 5% dextrose (D5W)
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17
Q

why cant you administer just free water for hypernatremia

A
  • will cause hemolysis

- water will flood cells through osmosis

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18
Q

why cant you correct sodium too rapidly?

A
  • central pontine myelinolysis
  • cerebral edema
  • brain stem herniation
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19
Q

central pontine myelinolysis

A
  • destruction of myelin covering nerve cells in brainstem
  • confusion, encephalopathy, lethargy
  • weakness, paralysis
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20
Q

main functions of serum potassium

A
  • maintain intracellular osmolality
  • acid-base balance
  • transmission of nerve impulses
  • essential to skeletal, cardiac, and smooth muscle function
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21
Q

when can you get falsely elevated K

A
  • hemolysis

- common complication of collecting blood samples

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22
Q

how does insulin regulate potassium

Study These Flashcards
A
  • K enters portal circulation
  • stimulates release of insulin
  • glucose enters cell
  • K follows into cell
23
Q

how is potassium excreted

Study These Flashcards
A

by kidneys in urine

24
Q

causes of hypokalemia

Study These Flashcards
A
  • inadequate intake (Diet)
  • excessive losses i.e. diarrhea, kidneys, burns
  • redistribution into cells i.e. insulin
25
causes of hyperkalemia
- decreased renal elimination (most common) - excessive rapid administration - movement of K from inside the cell to outside i.e. trauma
26
signs/sx of hypokalemia
- weakness, muscle cramps, paralysis - EKG changes and arrhythmias - paralytic ileus
27
signs/sx of hyperkalemia
- weakness, muscle cramps, paresthesias - EKG changes and arrhythmias - intestinal cramping
28
chloride
- normal is 98-106 - maintain electrical neutrality by binding to pos charged ions - indicator of hydration tatus
29
carbon dioxide
- in serum most is bicarb - normal is 23-30 - assists in eval of pH
30
anion gap
- difference between the primary cations and anions in serum | - AG is normally 8-16
31
cations measured for anion gap
- sodium | - potassium
32
anions measured for anion gap
- chloride | - bicarb
33
blood urea nitrogen (BUN)
- directly related to excretory fn of kidneys - if kidneys aren't excreting properly then BUN will rise - changes in protein levels can change BUN
34
how is urea formed?
- proteins broken down into AA - free ammonia formed - ammonia molecules combine to form urea
35
azotemia
elevated BUN levels
36
prerenal azotemia
elevated BUN as result of kidney dysfunction from hypoperfusion
37
postrenal azotemia
- elevated BUN as result of post renal obstruction
38
creatinine
- normal is 0.6- 1.2 - used to approximate renal function - BUN:Cr ratio of >20:1 indicates dehydration
39
normal glucose levels
- fasting= 70-110 - random <200 - critical is <50 or >450
40
calcium
- 40% bound to albumin - 15% bound to anions - 45% physiologically active ionized calcium - need to get corrected calcium level to account for albumin bound Ca
41
causes of hypocalcemia
- impaired ability to mobilize Ca from bone i.e. hypoparathyroidism - decreased intake or absorption i.e. vit d def - abnormal renal losses i.e. hyperphophatemia
42
causes of hypercalcemia
- excessive intake - increased bone resorption i.e. hyperparathyroidism - decreased elmination
43
signs and sx of hypocalcemia
- paresthesias - skel muscle cramps - tetany - hyperreflexia - cardiac arrhythmias (prlonged QT) - bone fx
44
signs and sx of hypercalcemia
- kidney stones - anorexia, N/V - muscle weakness, atrophy - lethargy, coma - EKG changes (shortened QT) - HTN
45
LFTs
- albumin - total protein - ALP- resides in walls of bile ducts - ALT - AST - total bilirubin, direct bilirubin, indirect bilirubin
46
AST to ALT ratio
- ALT normally higher than AST | - AST to ALT ratio of 2:1 suggests alcoholic liver disease
47
labs for acute pancreatitis
- elevated amylase - elevated lipase - elevated amylase/creatinine clearance
48
labs for chronic pancreatitis
- amylase, lipase, and amylase/lipase clearance can all be variable
49
diagnosing pancreatitis
- lipase assays are best markers - amylase peaks in 48 hours, normalizes in 5-7 days - lipase doesn't normalize for 8-14 days
50
lactic acid
- quantifies degree of tissue hypoxia | - correlated with severity of illness
51
cardiac biomarkers
- Troponin I and II (preferred) - CK-MB and total CK - if CK:CK-MB ratio is > 1.5 it indicates potential cardiac injury
52
why use arterial blood gas
- determine acid- base balance | - determine oxygen status
53
C/I to ABG
- no pulse - cellulitis or compromised skin - no ulnar A - AV fistula - coagulopathy - must do Allen test before performing ABG
54
what does ABG report include
- pH - PCO2 controlled by lungs - HCO3 controlled by kidney, is the metabolic component

diagnostic methods (6 decks)

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