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Chem 2 Exam 3 > Geriatric/Pediatric Clinical Chemistry > Flashcards

Geriatric/Pediatric Clinical Chemistry Flashcards

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1
Q

Since 2010, there has been a 34% increase in population 65 and older
Makes up 15.2% of the population

A

Aging in America

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2
Q

What is Gerentology

A

the study of aging

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3
Q

Define Geriatrics

A

the subspecialty of clinical medicine that focuses on care of the aged

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4
Q

True or False

Total body muscle mass decreases with age—rate and extent have strong genetic component

A

True

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5
Q

True or False

total creatinine production decreases with age

A

True

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6
Q

True or False

Total bone density and mass decrease with age

A

True and much more dramatic for women post-menopause

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7
Q

Serum calcitonin and PTH __________ with age

A

Serum calcitonin increase; PTH increases (affects bone metabolism)

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8
Q

Atrophic gastritis and low gastric acid production can both increase with age - what are the side effects of this?

A

Increased malnutrition
Vit B12 deficiency and decreased: calcium, iron absorption, albumin

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9
Q

Do EPO, ANP, and BNP increase or decrease with age??

A

Increase

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10
Q

Does renin, and responsiveness to ANP increase or decrease with age?

A

Decrease

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11
Q

Acid/base, water and electrolyte levels normal under optimal conditions but physiologic reserve is _____________ with age

A

diminished

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12
Q

Number of functional glomeruli decreases with age and this does what to the kidney size and weight?

A

Decreases the size and weight of Kidney

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13
Q

When the GFR declines with age, the ___________________ is reduced

A

renal blood flow

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14
Q

True or False

Kidneys concentrating ability increases with age.

A

False - it declines with age

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15
Q

The thymus shrinks but their is an ___________ in ANA’s with age.

A

increase

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16
Q

Is there an increase or decrease in thymosin, T-cell function, B-cell function and hematopoietic stem cells as someone ages??

A

Decrease

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17
Q

Do ACTH and epinephrine levels increase or decrease with age??

A

Neither - they remain stable

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18
Q

Do these increase or decrease with age?

TSH

Norepinephrine Secretion

GH, Peak Melatonin and aldosterone

A

TSH - can have slight increase

Norepinepherin Secretion - increases

GH, Peak Melatonin and Aldosterone - decreases

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19
Q

What hormones decrease due to menopause (before “geriatric” age)??

A

decrease in estrogen, progesterone

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20
Q

What hormone decreases during andropause?

A

decrease in testosterone

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21
Q

What happens to glucose metabolism as you age??

A

Insulin secretion unchanged

Individuals with genetic predisposition to type 2 more likely to manifest illness (Increasing age, BMI, lack of exercise)

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22
Q

Effects of aging on Muscle Laboratory Testing

A

Decrease with age, renal function decreases

Creatinine levels correlate to both so may be the same or slightly increased even when renal function has significantly decreased

23
Q

Effects of aging on the laboratory testing of bone

A

Osteoporosis-lack of sex hormones and hypogonadism
Need adequate calcium and vitamin D to maintain bone density
Inadequate calcium absorption leads to low serum calcium and increased PTH which then increases calcium loss from bones which increases ALP levels

24
Q

What is this a description of??

Age related changes with the liver analytes
Increased: CRP, GGT, fibrinogen
Decreased: Ferritin, transferrin, albumin, total protein

A

Effects of aging on the laboratory tests of the gastrointestinal system

25
Q

Effects of age on Lab Testing of Urinary System

A

Enlargement of prostrate–Increase in prostate specific antigen (PSA) , can also cause urinary obstruction

26
Q

Effects of age on the Lab Testing of immune system

A

As age increases-so does infection-induced morbidity and mortality

27
Q

What are these results describing?

Increased hormone level: ANP, EPO, PTH, TSH may slightly increase, ADH/AVP

Decreased hormone level: DHEA, IGF-1, GH, aldosterone

A

The effects of aging on the lab testing of the endocrine system

28
Q

What happens to the sex hormones as a person ages?

A

All levels decrease: testosterone, estrogen, progesterone

29
Q

Glucose Metabolism lab testing as a person ages

A

Insulin sensitivity decreases—increased prevalence of type 2 diabetes

30
Q

Age-Associated Changes in Drug Metabolism:

Absorption

A

The rate of drug absorption slows with aging

31
Q

Age-Associated Changes in Drug Metabolism:

Distribution

A

Highly water-soluble drugs tend to be more concentrated.

Due to decreased body water

32
Q

Age-Associated Changes in Drug Metabolism:

Metabolism

A

Hepatic blood flow and hepatic mass decrease with age.
The liver is responsible for the majority of drug metabolism

33
Q

Age-Associated Changes in Drug Metabolism:

Elimination

A

Renal blood flow and renal mass decrease with age.

Results in gradual decline in GFR

34
Q

This can improve quality of life, increase life span, as well as prevent depression, diabetes, heart disease, cancer, and osteoporosis

A

Exercise: Maintaining physical activity improves physical strength and fitness, as well as balance

The successful management of aging requires proper nutrition in addition to regular exercise

35
Q

At birth, the normal infant rapidly adapts by ___________________________

A

initiating active respiration

36
Q

How much does the average baby weigh when delivered at term??

A

A baby delivered at term weighs about 3.2 kg. A baby whose birth weight is below the 10th percentile for gestational age is considered small for gestational age.

37
Q

Are most baby’s organs fully developed at birth?

A

No - Glomerular filtration rate (GFR) of the kidney and renal tubular function mature during the first year of life

38
Q

What issues have prevented the introduction of full-scale automation in pediatrics?

A

Samples in tubes of many different sizes, varying from standard adult tubes to small pediatric tubes or microtainers

Evaporation of sample from open tubes

39
Q

Primary maintenance of blood gas and pH homeostasis following birth requires what??

A

Requires that the lungs and kidneys be sufficiently mature to regulate acid and base metabolism.

40
Q

What are the 2 distinct types of cells that the lungs express at 24 weeks of gestation??

A

Type 1 pneumocytes—responsible for gas exchange

Type 2 pneumocytes—responsible for secretion of surfactant (contains the phospholipids lecithin and sphingomyelin)

41
Q

What is required for the lungs to expand and the transfer of blood gases following delivery??

A

Surfactant

42
Q

What is the failure to excrete CO2 and the levels rise causing respiratory acidosis??

A

Respiratory Distress Syndrome (RDS)

43
Q

Why is anaerobic collection a challenge for testing blood gases and pH in neonates and infants??

A

Because the sample must must be free flowing from a heelstick and sealed quickly. Processed very quickly too.

44
Q

What are these?

The causes of hypernatremia (sodium >145 mmol/L) and hyponatremia (sodium <130 mmol/L)

Both must be treated to prevent seizures

A

Disorders Affecting Electrolytes and Water Balance

45
Q

Nitrogenous End Products asMarkers of Renal Function

In contrast to the high neonatal ammonia levels, creatinine and uric acid levels are lower in newborns.

A

Creatinine concentrations increase with muscle mass

Creatinine clearance test not typical—difficult to collect

eGFR used—slightly different formula than adults

Cystatin C is a potential newer test, not routinely used yet

46
Q

Normal bone growth, which parallels body growth, requires integration of calcium, phosphate, and magnesium metabolism with endocrine regulation from vitamin D, parathyroid hormone (PTH), and calcitonin.

A

Lack of Vit D can cause rickets.
98% of total body calcium is in the bone

47
Q

Define hypocalcemia

A

Hypocalcemia is defined as total serum calcium below 7.0 mg/dL or ionized calcium below 3.0 mg/dL.

48
Q

This system is essential for regulating mineral and carbohydrate metabolism

A

Hypothalamic–Pituitary–Adrenal Cortex System

49
Q

Hypothalamic–Pituitary–Thyroid System

What secretes thyrotropin-releasing hormone (TRH), a 3-amino-acid peptide, into the portal blood system between the hypothalamus and anterior pituitary.

A

The hypothalamus

50
Q

The hypothalamus secretes WHAT two regulatory hormones that affect growth??

A

GH inhibiting factor (somatostatin), GH releasing hormone

51
Q

Endocrine Control of Sexual Maturation

The hypothalamus secretes a 10-amino-acid peptide called gonadotropin-releasing hormone (GnRH) into the portal blood system

A

But this is suppressed in infants and young children

52
Q

Describe some components of Neonatal and Infant Antibody Production

A

The human fetus synthesizes a small amount of IgM and, to a lesser degree, IgA

53
Q

Transient hypogammaglobulinemia of infancy may occur because of

A

Prematurity or, in certain infants, may be a result of delayed onset of immunoglobulin production of unknown etiology.

(Severe Combined Immune Deficiency—lack both humoral and cellular pathways for killing bacteria and viruses (boy in the bubble))

54
Q

What is the importance of the list below - what does it symbolize?

Phenylketonuria
Steroid 21-hydroxylase deficiency
Sickle cell disease
CF
Galactosemia (in some states and countries)

A

Newborn Screening for Whole Populations

Certain inherited diseases are sufficiently common in the population to be considered candidates for whole population screening.

Chem 2 Exam 3 (6 decks)

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