Exam 1: CMP Flashcards
What 3 things can cause hypoglycemia?
Drugs, starvation, and endocrine disorders (Addisons and Hypopituitarism)
What two endocrine disorders can cause hyperglycemia?
Cushing and acromegaly
What is BUN?
A byproduct of protein metabolism
-BUN test indirectly measures the metabolic function of liver and excretory function of the kidney.
Is BUN increased or decreased in primary liver disease?
Decreased secondary to decreased urea synthesis
Is BUN increased or decreased in primary renal disease?
Increased, secondary to reduced urea excretion
How does hydration status affect BUN?
Dehydration concentrates BUN, so the level increases.
Overhydration dilutes BUN so the level decreases
How do GI bleeds affect BUN?
Blood overloads the gut with protein so levels increase
How does protein intake affect BUN?
Low protein diet decreases BUN and high protein diet increases BUN
What is creatinine?
A catabolic product of creatine phosphate that is excreted entirely by the kidney, thus a measurement of renal function
Creatinine has an inverse relationship with what?
GFR
What differentials can cause increased creatinine?
AKI, chronic kidney disease, rhabdomyolysis, and dehydration
What differentials can cause decreased levels of creatinine?
Debilitation, muscular dystrophy, and myasthenia Travis
What is BUN/Creatinine ratio helpful in determining?
Cause of AKI
What is a normal BUN/Cr ratio?
10-20/1
What are the 3 causes of AKI?
Prerenal, intrinsic renal, and post renal
What conditions cause prerenal AKI?
Hypovolemia, CHF, and change in vascular resistance
What conditions cause intrinsic AKI?
Acute tubular necrosis from IV contrast
What conditions cause postrenal AKI?
Urethral stones, bladder outlet obstruction, BPH, and urethral stricture
Shifts in chloride levels usually accompany shifts in ** and **
Sodium and bicarbonate
CO2 is an indirect measurement of what?
Bicarbonate
You use fractionation of total protein to diagnose, monitor, and evaluate what conditions?
Liver disease, edematous states, protein losing conditions, nutrition status, immune disorders, and cancer
What does the measure of albumin reflect?
Synthetic function of the liver
What does albumin do?
-Maintains osmotic pressure by keeping fluid within the vascular space and transporting hormones, enzymes, and drugs
Where is globulin produced?
Mainly bone marrow and lymph tissue
What are the 3 groups of globulins?
Alpha, beta, and gamma
When is globulin normally elevated?
When albumin is low to maintain normal total protein levels?
What makes up total protein?
Albumin + globulin
What conditions can cause hypoalbuminemia?
Liver disease, protein losing enteropathies, protein losing nephropathies (Nephrotic syndrome), burns, malnutrition, and inflammatory disease
What condition can result in normal total protein with low albumin and normal/increased globulin?
Chronic liver disease and collage vascular disease
What condition can cause increased total protein with increased globulin fraction?
Multiple myeloma (M spike and bence jones proteins)