Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Lab Med > Exam 1: CMP > Flashcards

Exam 1: CMP Flashcards

1
Q

What 3 things can cause hypoglycemia?

A

Drugs, starvation, and endocrine disorders (Addisons and Hypopituitarism)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What two endocrine disorders can cause hyperglycemia?

A

Cushing and acromegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is BUN?

A

A byproduct of protein metabolism

-BUN test indirectly measures the metabolic function of liver and excretory function of the kidney.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Is BUN increased or decreased in primary liver disease?

A

Decreased secondary to decreased urea synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Is BUN increased or decreased in primary renal disease?

A

Increased, secondary to reduced urea excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does hydration status affect BUN?

A

Dehydration concentrates BUN, so the level increases.

Overhydration dilutes BUN so the level decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do GI bleeds affect BUN?

A

Blood overloads the gut with protein so levels increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does protein intake affect BUN?

A

Low protein diet decreases BUN and high protein diet increases BUN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is creatinine?

A

A catabolic product of creatine phosphate that is excreted entirely by the kidney, thus a measurement of renal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Creatinine has an inverse relationship with what?

A

GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What differentials can cause increased creatinine?

A

AKI, chronic kidney disease, rhabdomyolysis, and dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What differentials can cause decreased levels of creatinine?

A

Debilitation, muscular dystrophy, and myasthenia Travis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is BUN/Creatinine ratio helpful in determining?

A

Cause of AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a normal BUN/Cr ratio?

A

10-20/1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 3 causes of AKI?

A

Prerenal, intrinsic renal, and post renal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What conditions cause prerenal AKI?

A

Hypovolemia, CHF, and change in vascular resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What conditions cause intrinsic AKI?

A

Acute tubular necrosis from IV contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What conditions cause postrenal AKI?

A

Urethral stones, bladder outlet obstruction, BPH, and urethral stricture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Shifts in chloride levels usually accompany shifts in ** and **

A

Sodium and bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

CO2 is an indirect measurement of what?

A

Bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

You use fractionation of total protein to diagnose, monitor, and evaluate what conditions?

A

Liver disease, edematous states, protein losing conditions, nutrition status, immune disorders, and cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does the measure of albumin reflect?

A

Synthetic function of the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does albumin do?

A

-Maintains osmotic pressure by keeping fluid within the vascular space and transporting hormones, enzymes, and drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where is globulin produced?

A

Mainly bone marrow and lymph tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the 3 groups of globulins?

A

Alpha, beta, and gamma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

When is globulin normally elevated?

A

When albumin is low to maintain normal total protein levels?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What makes up total protein?

A

Albumin + globulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What conditions can cause hypoalbuminemia?

A

Liver disease, protein losing enteropathies, protein losing nephropathies (Nephrotic syndrome), burns, malnutrition, and inflammatory disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What condition can result in normal total protein with low albumin and normal/increased globulin?

A

Chronic liver disease and collage vascular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What condition can cause increased total protein with increased globulin fraction?

A

Multiple myeloma (M spike and bence jones proteins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What labs will be elevated if the condition in hepatocellular in pattern?

A

There is injury to the hepatocytes = elevated ALT and AST

32
Q

What labs will be elevated if the condition is cholestatic in pattern?

A

There is injury to the bile ducts and/or bile flow = elevated ALP and total bili

33
Q

Where is AST found?

A

Liver, cardiac and skeletal muscle, kidney, and brain

34
Q

Where is ALT found?

A

Predominantly in the liver, small quantities in kidneys and cardiac and skeletal muscle

35
Q

Is AST or ALT more specific to the liver?

A

ALT

36
Q

Where is ALP found?

A

Predominantly in the liver, biliary tract, and bone

37
Q

If ALP is the only elevated enzyme, what is the likely source?

A

Bone

38
Q

What conditions can increase ALP?

A

Conditions that obstruct the flow of bile because it is excreted in the bile

39
Q

What makes up total bilirubin?

A

Unconjugated (indirect) and conjugated (direct)

40
Q

If AST and ALP are more elevated than ALP, what does that indicate, including differentials.

A

A hepatocellular process such as liver drug toxicity, viral hepatitis, alcoholic liver disease, NAFLD, cirrhosis, liver tumor, and genetic liver disorders

41
Q

If ALP is more elevated than AST and ALP, what does that indicate?

A

Cholestatic process, such as biliary obstruction, hepatitis, cirrhosis, liver CA, and drug toxicity.

42
Q

What is the most frequent extrahepatic source of ALP and what conditions cause this?

A

Bone is the most frequent source of elevated ALP, caused by physiologic growth, healing fracture, bone metastasis, etc.

43
Q

What conditions can cause unconjugated bilirubin to be elevated?

A

Hemolysis, impaired hepatic bilirubin uptake (heart failure), and impaired bilirubin conjugation (Gilbert syndrome)

44
Q

What conditions can cause conjugated bilirubin to be elevated?

A

Hepatitis, drugs and toxins, liver infiltration, and biliary obstruction

45
Q

What will the LFTs look like with hepatocellular disease?

A

Disproportionately elevated AST and ALP when compared to ALP

-Serum bili may be elevated

46
Q

What will the LFTs look like with cholestatic disease?

A

Disproportionate elevation in ALP when compared to ALT and AST
-Serum bili may be elevated

47
Q

Calcium has an inverse relationship with ***.

A

Phosphorus

48
Q

Although 99% of the body’s calcium is in bone, where is the majority of the remaining 1%?

A

Free ionized calcium

49
Q

When serum albumin is low, what else will be low?

A

Calcium

50
Q

What accounts for 90% of the cases of hypercalcemia?

A

Primary hyperparathyroidism and malignancy

51
Q

What is the clinical presentation for hypercalcemia?

A
  • Decreased neuromuscular excitability
  • Cardiovascular effects
  • nephrolithiasis, polydipsia, and polyuria
  • constipation, N/V, anorexia
52
Q

What is likely to be seen on EKG in a patient with hypercalcemia?

A

Short QT interval

53
Q

What is the management for hypercalcemia?

A

Management of underlying cause, volume expansion, and calcitonin/bisphosphates

54
Q

What is the most common cause of hypocalcemia?

A

Hypoalbuminemia

55
Q

What should you do if the diagnosis of hypocalcemia is in doubt?

A

Check a corrected calcium (serum ionized calcium)

56
Q

What conditions can cause hypocalcemia?

A

Hypoalbuminemia, hypomagnesemia, hypoparathyroidism, parathyroidectomy, renal failure, and intestinal malabsorption

57
Q

How can hypomagnesemia cause hypocalcemia?

A

Mg deficiency inhibits parathyroid hormone activity, which is associated with refractory hypocalcemia

58
Q

What is the clinical presentation of hypocalcemia?

A
  • Increased neuromuscular excitability
  • paresthesias, hyperactive reflexes
  • Chvosteks sign
  • Trousseaus sign
  • cardiovascular effects
59
Q

What is Chvosteks sign?

A

Tapping of the facial nerve against the bone just anterior to the ear results in contraction of the facial muscles

60
Q

What EKG changes are you likely to see in a patient with hypocalcemia?

A

Prolonged QT

61
Q

What is trousseaus sign?

A

Occluding the brachial artery for 3 minutes with BP cuff results in carpal spasms

62
Q

What is the management for mild hypocalcemia?

A

Oral calcium and possible vitamins D supplementation

63
Q

What is the management for severe and symptomatic hypocalcemia?

A

Give IV calcium Gluconate

64
Q

What is the most important regulatory of serum phosphate?

A

The kidney

65
Q

What conditions can cause hyperphosphatemia?

A

Renal failure (most common), hypoparathyroidism, hypocalcemia, and exogenous phosphorus

66
Q

What conditions can cause hypophosphatemia?

A

Malnutrition, hyperparathyroidism, chronic alcoholism, severe vomiting and diarrhea, and cellular shift

67
Q

What are the two kinds of cellular shift that can cause hypophosphatemia?

A

Insulin: insulin drives electrolytes into the cell

Refeeding syndrome: refeeding a malnourished patient too quickly causes intracellular shift

68
Q

What is the clinical presentation of hypophosphatemia?

A

Muscle weakness, rhadomyolysis, and seizures

69
Q

What two electrolytes are tied to Mg?

A

Calcium and potassium

70
Q

How can hypomagnesemia cause hypocalcemia and hypokalemia?

A

Low Mg inhibits PTH which leads to hypocalcemia. Low Mg also impairs the ability of the kidney to conserve potassium

71
Q

What conditions can cause hypermagnesemia?

A

Renal insuffiency and large Mg load

72
Q

What conditions can cause hypomagnesemia?

A

Malnutrition, severe diarrhea, alcoholism, cellular shift

73
Q

What is the clinical presentation of hypermagnesemia?

A

Decreased DTRs, bradycardia, and hypotension

74
Q

What is the clinical presentation of hypomagnesemia?

A

Neuromuscular excitability and cardiac arrhythmias (Torsades De pointes)

75
Q

What is the management of hypermagnesemia?

A

Cessation of magnesium containing mediations, isotonic fluids and loop diuretics, dialysis, and IV calcium

Clin Lab Med (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions