comprehensive metabolic panel (CMP) Flashcards
glucose-fasting and nonfasting result meanings
Nonfasting:
greater than 200mg/dl indicates diabetes
Fasting:
70-99 mg/dL normal
100-125 mg/dL prediabetes (impaired fasting glucose)
126 mg/dL or higher on more than one test diabetes
Glucose-2-hour oral glucose tolerance test (OGTT)
- how is it done?
- what do results mean?
- samples drawn 2 hours after a 75-gram glucose drink
- less than 140 mg/dL normal
from 140-199 mg/dL prediabetes
equal to or greater than 200 mg/dL on more than one test diabetes
8 reasons for hyperglycemia
acromegaly acute stress (trauma, heart attack, stroke) chronic kidney disease cushing syndrome too much food hyperthyroidism pancreatic cancer pancreatitis
12 reasons for hypoglycemia
Adrenal insufficiency Drinking excessive alcohol Severe liver disease Hypopituitarism Hypothyroidism Severe infections Severe heart failure Chronic kidney (renal) failure Insulin overdose Tumors that produce insulin (insulinomas) Starvation Deliberate use of glucose-lowering products
Calcium-reference range
8.6-10.2 mg/dL
2 of the most common reasons for hypercalcemia, and 3 less common reasons
hyperparathyroidism and cancer (causes release of calcium)
hyperthyroidism, excess vitamin D intake, thiazide diuretics
The most common cause of hypocalcemia, plus 3 less common causes
low blood protein such as albumin, which can result from liver disease or malnutrition. Other causes include not enough vitamin D, hypoparathyroidism, pancreatitis
What is albumin and when should you order albumin?
Albumin is a protein made by the liver; it is 60% of the protein in the blood. It keeps fluid from leaking out of vessels, nourishes tissue, and transports hormones, vitamins, drugs, and calcium throughout body.
Reasons to order it include: routine, or symptoms of liver or kidney disease, unintended weight loss
Causes of low albumin
severe liver disease (it's made in the liver) kidney disease (the kidney is supposed to conserve plasma proteins such as albumin so it isn't lost in the urine, but if the kidneys are damaged or diseased, the lose their ability to conserve proteins). Diseases that damage the kidney such as diabetes and hypertension can cause low albumin.
How does nephrotic syndrome impact the CMP?
Very high amounts of albumin are lost through the kidneys.
In addition to liver disease and kidney disorders, who else is at high risk for low albumin?
People whose GI tract doesn’t absorb nutrients properly and people with prolonged diarrhea.
What is total protein?
Albumin 60% of protein in blood, globulins 40% of protein in blood. The test gives the A/G ratio, which may change in certain conditions.
What might cause low A/G (albumin/globulin ratio)?
overproduction of globulins from multiple myeloma
underproduction of albumin from cirrosis
selective loss of albumin in kidney disease
What might cause high A/G (albumin/globulin ratio)?
genetic deficiency
leukemia
What does blood urea nitrogen (BUN) monitor? Reference range?
kidney function; as kidney function decreases, BUN rises.
Reference range 6-20 mg/dL
