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Clinical Chemistry > Geriatric/Pediatric > Flashcards

Geriatric/Pediatric Flashcards

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1
Q

Notable growth in ____ y/o population and shrinking in __ ___ y/o population

A
  • 65+
  • 14
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2
Q

Gerontology

A

Study of aging

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3
Q

Geriatrics

A

Subspecialty of clinical medicine focusing on caring for the aged

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4
Q

How does CRP change with age?

A

Increases

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5
Q

How does albumin change with age?

A

Decreases

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6
Q

How do muscle mass and total creatinine production change with age?

A
  • Both decrease
  • Rate and extent of muscle mass loss have strong genetic component
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7
Q

How does total bone density change with age?

A

Decreases
Much more dramatic for women post-menopause

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8
Q

How do serum calcitonin and PTH change with age (bone metabolism)?

A

Both increase

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9
Q

Which GIT issues increase with age?

A
  • Atrophic gastritis
  • Low gastric production
  • Increased malnutrition
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10
Q

Which vitamin/mineral/protein deficiencies worsen with age?

A
  • Vit B12 deficiency
  • Decreased calcium
  • Decreased iron absorption
  • Decreased albumin
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11
Q

How do the following change with aging?
Number of functional glomeruli
GFR/renal blood flow
Kidney concentrating ability
Acid/base, water, electrolyte levels

A

All decrease!!

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12
Q

Which urinary system hormones increase with age?

A

EPO, ANP (atrial natriuretic peptide), and BNP (b-type natriuretic peptide)

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13
Q

Which urinary system hormones decrease with age?

A

Renin and responsiveness to ANP

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14
Q

What happens to the thymus with age?

A

Shrinks

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15
Q

What immune substance increases with age?

A

ANAs (anti-nuclear antibodies)

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16
Q

What immune substances decrease with age?

A
  • Thymosin
  • T-cell and B-cell function
  • Hematopoietic stem cells
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17
Q

Which endocrine system hormones usually remain stable with age?

A
  • ACTH
  • Epinephrine
  • TSH (but may slightly increase)
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18
Q

Which endocrine system hormones usually increase with age?

A
  • Norepinephrine secretion
  • ANP
  • PTH
  • ADH/AVP
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19
Q

Which endocrine system hormones usually decrease with age?

A
  • GH
  • Peak melatonin
  • Aldosterone
  • DHEA
  • IGF-1
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20
Q

How does glucose metabolism change with age?

A
  • Insulin secretion does not change BUT insulin sensitivity decreases
  • People with genetic predisposition to Type 2 diabetes more likely to manifest illness (increasing age, BMI, lack of exercise)
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21
Q

What are some factors that impact interpretation of lab results for elderly population?

A
  • Exercise type/duration
  • Meds
  • Mobility
  • Nutritional status
  • Personal habits
  • Presence of chronic/subclinical disorders
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22
Q

What factor correlate with muscle mass and renal function?

A

Creatinine levels

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23
Q

Osteoporosis due to

A

lack of sex hormones and hypogonadism

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24
Q

Inadequate calcium absorption leads to ____________________________

A

low serum calcium and increased PTH, which then increases calcium loss from bones -> increases ALP

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25
Q

Which GIT substances increase with age?

A

CRP, GGT, and fibrinogen

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26
Q

Which GIT substances decrease with age?

A

Ferritin, transferrin, albumin, and total protein

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27
Q

Enlargement of prostate leads to

A

Increase in prostate specific antigen (PSA), which can cause urinary obstruction

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28
Q

How doe sex hormones (testosterone, estrogen, and progesterone) change with age?

A

All decrease

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29
Q

How does increase in age affect drug absorption, distribution, metabolism, and elimination?

A
  • Absorption=rate slows
  • Distribution=highly water-soluble drugs tend to be more concentrated due to decreased body water
  • Metabolism=hepatic blood flow/mass decrease
  • Elimination=renal blood flow/mass decrease -> decline in GFR
30
Q

Which factor was emphasized to have a big impact on increased lifespan and quality of life in geriatrics?

A

Exercise

31
Q

A baby delivered at term weighs about __

A

3.2 kg

32
Q

A baby whose birth weight is below the ___ percentile for gestational age is considered small

A

10th

33
Q

Organ development at birth

A

Most organs are not fully developed

34
Q

GFR and renal tubular function at birth

A

Both mature during the first year of life

35
Q

Normal intrauterine development time period

A

38-40 weeks of gestation

36
Q

Infant phlebotomy complicated by which factors?

A
  • Patient size
  • Inability for patient to communicate
37
Q

Which type of testing plays an important/expanding role in pediatric practice?

A

Point-of-care testing (POCT) aka near-patient testing

38
Q

POCT factors to be considered

A
  • Turnaround time
  • Evaluation of POCT devices
  • Device limitations for pediatric use
39
Q

Primary maintenance of blood gas and pH homeostasis following birth requires what to regulate acid-base metabolism?

A

Sufficiently mature lungs and kidneys

40
Q

Which cells does the lung express at 24 wk of gestation and what are their functions?

A
  • Type 1 pneumocytes = gas exchange
  • Type 2 pneumocytes = secrete surfactant containing lecithin and sphingomyelin
41
Q

Why is surfactant important for the lungs?

A

Necessary for the lungs to expand and transfer blood gases after delivery

42
Q

Respiratory Distress Syndrome (RDS)

A

Failure to excrete CO2 and the levels rise -> causing respiratory acidosis

43
Q

Blood gas measurement in neonates

A
  • Non-invasive transcutaneous devices measure oxygen and CO2 status
  • Some analyzers take small capillary samples in pediatric settings
44
Q

Anaerobic collection from neonates

A

Must be free-flowing from heelstick and sealed/processed fast

45
Q

What other analytes can blood gas analyzers measure for neonates?

A
  • Lactate
  • Urea
  • Bilirubin
  • Creatinine
46
Q

Advantages and disadvantages of blood gas analyzer measuring lactate, urea, bilirubin, and creatinine?

A
  • Advantage = smaller blood volume needed
  • Disadvantage = can’t tell if sample is hemolyzed
47
Q

Disorders that cause hypernatremia and hyponatremia must be treated in neonates to prevent ___

A

Seizures

48
Q

Cause of physiologic jaundice in neonates

A

Failure of immature liver to properly metabolize bilirubin

49
Q

Which organ plays an essential role in energy metabolism for the whole body?

A

Liver

50
Q

Blood glucose homeostasis/hepatic metabolism of glucose are maintained by which hormones?

A
  • Glucagon
  • Cortisol
  • Epinephrine
  • IGF
51
Q

Type 1 diabetes previously called ___

A

juvenile

52
Q

Type 2 diabetes cases ____

A

have grown tremendously in the last 30 years

53
Q

Which organ plays a central role in nitrogen metabolism?

A

Liver

54
Q

Liver synthesizes which proteins?

A
  • albumin
  • transferrin
  • complement clotting factors
55
Q

Liver metabolism of breakdown products turn into ___

A
  • ammonia
  • urea
  • creatinine
  • uric acid
56
Q

Blood ammonia levels are typically higher in which age group compared to which other age group?

A

Higher in newborns than older kids

57
Q

Which is a potential new test, not routinely used yet, for testing renal function in neonates?

A

Cystatin C

58
Q

Creatinine and uric acid levels in newborns

A

Lower

59
Q

Lack of Vit D can cause

A

Rickets

60
Q

Normal bone growth requires integration of which elements?

A
  • calcium
  • phosphate
  • magnesium
61
Q

Normal bone growth requires endocrine regulation from which hormones?

A
  • Vit D
  • PTH
  • Calcitonin
62
Q

Hypothalamus secretes which hormone in the thyroid system?

A

TRH

63
Q

Adrenal cortex system regulates

A

Mineral and carb metabolism

64
Q

Hypothalamus secretes which two regulatory hormones that affect growth?

A
  • GH-inhibiting factor (somatostatin)
  • GHRH
65
Q

Hypothalamus secretes which sexual maturation hormone?

A

GnRH (suppressed in infants and young children)

66
Q

Human fetus synthesizes which Ab?

A

Small amount of IgM and IgA to lesser extent

67
Q

How does prematurity affect infant immunity?

A

Transient hypogammaglobinemia

68
Q

Severe combined immune deficiency (SCID)

A

Lack both humoral and cellular immunity (boy in bubble)

69
Q

Common genetic disease within Caucasian population in the US

A

Cystic fibrosis

70
Q

Newborn screening tests

A
  • PKU
  • Steroid 21-hydroxylase deficiency
  • Sickle cell disease
  • CF
  • Galactosemia (some states/countries)
71
Q

Theophylline is metabolized to ___ in neonates but not adults

A

Theophylline

Clinical Chemistry (21 decks)

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