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Clinical Chem II spring > Geriatric and Pediatric Chemistry > Flashcards

Geriatric and Pediatric Chemistry Flashcards

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1
Q

T/F in 2010 there was a dec in population 65 and older

A

false there was a 34% increase

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2
Q

What year did life expectancy go down? Why? Approx ages?

A

2021 went down 1 year

covid

females: 80
Males: 75

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3
Q

T/F there is notable growth in populations 65+ and shrinking in 14yrs

A

true because less people are having kids

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4
Q

Gerontology

A

study of aging

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5
Q

Geriatrics

A

clinical medicine focusing on care of aged pts

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6
Q

General changes in aging

Muscle

A

Total body muscle mass decreases with age, strong genetic component

Decreased creatinine production

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7
Q

General changes in aging
Bone

A

total bone density decreased, much more dramatic in women post menopause

serum calcitonin increased
PTH increased

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8
Q

GI system general changes in aging
ag…
what is low production?
increased?
decreased? v/c/a

A

atrophic gastritis, low stomach acid production

increased malnutrition
decreased VIT B12, Calcium/Albumin

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9
Q

General changes in aging
Urinary
causes
what is decreased in size?
increased?
decreased?

A

golmerulous diseases, decreased kidney size, Dec GFR

increases EPO, ANP, BNP
Decreased renin, response to ANP

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10
Q

Gen changes in aging
Immune system
what shrinks?
increased?
decreased?

A

thymus shrinks
increased ANAs
decreased T/B cells, HSC, thymosin

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11
Q

Gen changes aging
endocrine system
what is normal?
slightly inc?

increased?
decreased:g/p/a

A

ACTH norm, epinephrine norm, TSH slight inc

increased noepinephrine
decreased GH, Peak melatonin, aldosterone

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12
Q

Gen changes in aging
Sex hormones

A

menopause (before geriatric age) decreased estrogen/progrestrogen

andropause - decreased testosterone

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13
Q

Gen changes in aging
Glucose metabolism
what is unchanged?
what is likely to manifest illness with???

A

insulin secretion unchanged
genetic type 2 likely to manifest illness with increased age, bmi lack of excersise

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14
Q

Lab testing w age
Muscle

A

muscle decreases with age, creatinine slight increase w decreased renal function

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15
Q

Lab testing with age
Bone
o
lack of?
hypo?

needs?

low…
increased

A

osteoporosis, lack of sex hormones, hypogonadism

needs calcium/VitD

low serum calcium and increased PTH/calcium loss increases ALP

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16
Q

Lab testing w age
GI
increased: c/g/f
decreased:f/t/a/t

A

increased CRP
GGT
Fibrinogen

decreased ferritin, transferrin, ALB, TP

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17
Q

Lab testing w age
Urinary
enlarged?
increased?
obstruct?

A

enlarged prostate
increased PSA, urinary obstruction

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18
Q

Lab testing w age
Immune
induced?

A

infection induced morbitity/mortality

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19
Q

Lab testing w age
Endocrine
increased: a/e/p/t/a

decreased: D/I/G/A

A

increased ANP/EPO/PTH/TSH AHD/AVP

decreased DHEA, IGF-1, GH, aldosterone

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20
Q

Lab testing w age
Glucose metabolism

A

insulin sensitivity decreases
prevelence in type 2 diabetes

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21
Q

Refrence ranges with geriatrics

most common?
death due to?

A

gender specific and age specific, little data for approporiate age specific ref ranges for older adults (most are not considered normal)

Most common hypertension/cholesterol

death due to covid/heart disease

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22
Q

Age associated changes in drug absorption

Absorption

Distribution

A

absorption: rate of abs slows w age

distribution: highly water sol drugs tend to be more conc because decreased body water

23
Q

Age associated changes in drug absorption

Metabolism

Elimination

A

Metab: hepatic blood flow/mass decrease w age/liver response

Elim: renal flow/mass dec gradual dec in GFR

24
Q

Atypical presentations of common disease

A

multiple coexisiting/interacting problems

excersice increases lifespan and improves quality of life in old people

25
Q

Neonates/baby clinical chem

respiration

A

infant at birth initiates active respiration

26
Q

Neonates/baby clinical chem

Growth

A

at birth baby is 3.2 kg, below 10th percentile is small

27
Q

Neonates/baby clinical chem

Organ development
what matures during the first yr of life

A

GFR and renal tube function mature during first year of life

28
Q

Neonates/baby clinical chem

Premature/immature

intra….
pre programed for

A

intrauterine development pre programmed for 38-40 wks of gestation

29
Q

Neonates/baby clinical chem

Phlebotomy
blood collection from infants is complicated by?

A

blood collection from infants is complicated by pt size and ability to communicate

30
Q

Preanalytical concerns infants
choice of?

A

samples in tubes of many sizes, evaporation of sample

choice of analyzer: onyl a few preform multiple procedures on sample volumes

31
Q

POCT in peds
factors:
t
eval
device
analytical

A

expanding in pediatrics
factors:
turn aroundtimes
eval of POCT devices
device limitations for ped use
analytical preformance not as good

32
Q

Reg of blood gas and pH in neonates

A

requires lung/kidney to be sufficiently mature to reg acid/base metabolism

at 24 wks gestational lung expresses two types
Type 1 and Type 2

33
Q

gestational lung cells types
Type 1

Type 2

A

Type 1 pneumocytes: gas exhange

Type 2 pneumocytes: secretion of sufactant (lecthin/sphignomyelin)

34
Q

Surfactant

A

required for lungs to expand and transfer blood gases following delivery

35
Q

RDS

A

failure to excrete CO2 and the levels rise casusing Respiratory Acidosis

36
Q

Blood gas/acid base measurement
what can be measured ? how?

some analyzers can take….
many can measure

A

oxygen can be measured using non invasive transcuaneous (same with CO2)

some analyzers can take small capillaru samples, many can measure lactate, urea, bilirubin/creatininine

37
Q

Disorders affecting electrolytes and water balance
cause of?

must be treated to prevent?

A

cause of hypernatremia/hyponatremia both must be treated to prevent seizures

38
Q

Physiologic jaundice
what is processed slowly?

failure to adequately?

A

pharmocologic agents processed slower in neonates failure to adequately metabolise bilirubin

39
Q

Diabetes
what homeostasis

hepatic met of?

type 1 is…
type 2 significance?

A

blood glucose homeostatsis, hepatic met. of glucose, Type 1 juvenile
type 2 grown quickly in last 30yrs

40
Q

Nitrogen Metabolism
what has central role
metabolic intraconversions of….

synth of:

met breakdown of products of …..:….

A

liver central role

metabolic intraconversions of AA/synth of non essential AA

synth of proteins: ALb/transferrin

Met of breakdwon products of nitrogen turn over: ammonia

41
Q

Blood amonia in children vs newborns

A

Higher in newborns than older children

42
Q

Nitrogenous end products as markers of renal function
high … in neonates, but low…..

what increases w muscle mass

what is typically not done?

what is used?
possible?

A

high ammonia in neonates but low creatninine/uric acid

Creatinine incr w muscle mass
creat clearance not typically done

eGFR used
Cystatin C possible

43
Q

Calium and bone growth
norm growth requires integration
endocrine?

lack of vit D?
total calcium ?

A

normal growth requires integration of calcium/phosph/magnese and endocrine reg from VITD, PTH calcitonin

Lack VITD ricketts
98% total calcium is bone

44
Q

HPTS
what is secreted from where…to?
between?

A

hypothal secretes TRH, 3AA, INTO PORTAL blood system between hypothal and anterior pituitary

45
Q

HPACS
regulates…

A

regulates minerals/carb metabolism

46
Q

Growth factors

A

GH inhibiting factor (somatostatin) GH releasing hormone

47
Q

Sexual maturation
what is supressed in young children/infants?

A

GnRH supressed in infants/young children

48
Q

Basic components of immune system

A

innate and adaptive immune system

49
Q

Components of the immune system

A

skin, phagocytes, B/T cells, APR abs

50
Q

Neonate Ab production
what immunoglobulin classes does a fetus synth?

A

fetus synth small amounts of IgM and tiny amounts of IgA

51
Q

Immune disorders

Hypogammaglob

SCID

A

transient hypogammaglobulina - prematurity delayed onset of Ig production/unknown cause

SCID: Lack of humoral/cellular immunity (boy in bubble)

52
Q

CF

A

caucasions, CFTR gene mutation

53
Q

Newborn screen for populations
p
2
s
c
g

A

phenylketoniria, 21-H deficiency, sicke cell, CF, galacosemia

Clinical Chem II spring (16 decks)

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