Exam #1: CMP Flashcards
What are the four primary causes of hyperglycemia?
- DM
- IV dextrose infusion
- Drugs (i.e. steroids)
- Stress
What is the primary cause of hypoglycemia?
Insulin overdose
What are the three primary causes of HIGH BUN?
- Primary renal diseases
- Dehydration
- Upper GI bleed
What are the three primary causes of LOW BUN?
- Severe primary liver diseases
- Overhydration
- Low protein diets
What does Creatinine have an inverse relationship with?
GFR
What is the primary renal function measurement?
Creatinine (Cr)
What is the most common cause of HIGH Cr?
AKI
What is BUN/Cr Ratio helpful in determining?
Cause of AKI
What lab test is an indirect measurement of bicarbonate (HCO3-)?
Carbon Dioxide (CO2)
What is high Total Protein with high Globulin indicative of?
Multiple Myeloma
- “M spike” on SPEP, Bence-Jones proteins
What are “M spike” on SPEP, Bence-Jones proteins associated with?
Multiple Myeloma
What is the primary cause of HIGH Albumin?
Dehydration
What are the three primary causes of LOW Albumin?
- Liver disease
- Protein-losing enteropathies
- Nephrotic Syndrome = edema
What test reflects the synthetic function of the liver?
What other two tests can also can also reflect synthetic function of the liver?
Albumin
- Also PT/INR and platelet count
What is a HIGH ALP indicative of?
Biliary obstruction
What is an ISOLATED high ALP (no other abnormal liver tests) indicative of?
BONE pathology
- Physiologic growth in children/adolescents
What test can be used to differentiate between liver and bone pathology?
ALP Isoenzymes
Which lab test has an inverse relationship with Phosphorus (PO4)?
Calcium (Ca2+)
Which lab test has an inverse relationship with Calcium (Ca2+)?
Phosphorus (PO4)
Which form of Calcium (Ca2+) is the most accurate measurement of serum calcium?
Ionized (50%)
Why is it that if if serum Albumin is low, Calcium (Ca2+) will also likely be low?
40% of Calcium (Ca2+) is bound to Albumin
What electrolyte is influenced by PTH, calcitonin, Vitamin D, GI and renal involvement?
Calcium (Ca2+)
What are the two primary causes of HIGH Calcium (Ca2+)?
- Primary hyperparathyroidism
- Malignancy
What is nephrolithiasis, constipation, decreased NM excitability, CV issues indicative of?
Hypercalcemia
What are the two primary causes of LOW Calcium (Ca2+)?
- Hypoalbuminemia
- Hypomagnesemia
What is increased NM excitability (paresthesias, Chvostek’s, Trousseau’s), prolonged QT indicative of?
Hypocalcemia
What is tap CN VII against bone anterior to ear = facial muscles contract, and what is it a sign of?
Chvostek’s sign
- Sign of Hypocalcemia
What is occlude brachial a. for 3 minutes with BP cuff = carpal spasms, and what is it a sign of?
Trousseau’s sign
- Sign of Hypocalcemia
What are the three primary causes of HIGH Phosphorus (PO4)?
- Renal failure (ESRD)
- Hypoparathyroidism
- Hypocalcemia
What are the four primary causes of LOW Phosphorus (PO4)?
- Malnutrition/malabsorption
- Hyperparathyroidism
- Cellular shift (Insulin)
- Cellular shift (refeeding)
What is muscle weakness and rhabdomyolysis, seizures if severe indicative of?
LOW Phosphorus (PO4)
What electrolyte is intimately tied to Ca2+ and K+?
Magnesium (Mg2+)
What two electrolytes is Magnesium (Mg2+) intimately tied to?
Ca2+ and K+
What is a common treatment of HIGH Magnesium (Mg2+)?
Loop diuretics
What is cardiac arrhythmias (Torsades de pointes), increased NM excitability indicative of?
LOW Magnesium (Mg2+)
What is decreased DTRs, bradycardia, hypotension indicative of?
HIGH Magnesium (Mg2+)
Chloride (Cl-) is associated with shifts in what two electrolytes?
- Sodium (Na+)
- Bicarbonate (HCO3-)
If Albumin is HIGH, what is the likely abnormality seen with Globulin, and why?
Globulin will be LOW
- Compensation to keep Total Protein normal
Besides Albumin, which two other lab tests can be used to evaluate synthetic liver function?
- PT/INR
- Platelet count
Generally, what two disorders is Globulin used to evaluate?
- CA
- Immune disorders
Why is ALP associated with cholestatic pattern?
It is excreted in bile, so if there is an issue with the bile ducts, ALP will be elevated
What three conditions is UNconjugated hyperbilirubinemia associated with?
- Hemolysis
- Gilbert’s Syndrome
- HF
If a patient has Hypercalcemia, which three symptoms may they present with?
- Decreased NM excitability (weak, lethargic)
- Nephrolithiasis
- Constipation
If Hypocalcemia diagnosis is unsure, which lab should you check?
Serum ionized calcium (50% of Ca2+ is ionized)
If Hypercalcemia diagnosis is unsure, which lab should you check?
REPEAT Ca2+ first
- Also check serum PTH
