Lab Medicine-Metabolic Panel Flashcards
What labs are included in the BMP?
- Sodium
- Potassium
- Chloride
- Carbon Dioxide
- Glucose
- BUN
- Creatinine
- Calcium
What labs are included in CMP that are not included in the BMP?
- Alkaline Phosphatase
- Bilirubin, Total
- AST (SGOT)
- ALT (SGPT)
- Protein, Total
- Albumin
What labs can be run to assess kidney function?
- BUN
* Creatinine
What labs can be run to assess electrolytes?
- Sodium
- Potassium
- Chloride
- Carbon Dioxide
Normal range of Sodium?
135-145 mEq/L
Critical Range of Sodium?
155 mEq/L
Name 3 factors that regulate sodium balance
- Aldosterone
- Natriuretic Hormone
- Antidiuretic Hormone
(All assist kidney to maintain appropriate levels of free water)
Symptoms of hyponatremia?
weakness confusion lethargy stupor coma
Symptoms of hypernatremia?
dry mucous membranes thirst agitation restlessness hyperreflexia mania convulsions
Cushing syndrome and hyperaldosteronism can lead to an increase in which electrolyte?
Sodium
Name three drugs that can lead to an increase in serum sodium levels.
- Steroids
- Licorice
- Oral Contraceptives
Name 4 types of drugs that can lead to a decrease in serum sodium levels.
- thiazide diuretics
- ACE inhibitors
- SSRIs
- Antipsychotics
Name the predominant extracellular cation +
Sodium
Name the major intracellular cation +
Potassium
What is the primary concern of an abnormal K+ level?
arrhythmia
Normal range of potassium?
3.5-5.0 mEq/L
Critical values for Potassium?
6.0 mEq/L
Symptoms of hyperkalemia?
- arrhythmias
- abdominal cramps
- N/V/D
Hemolysis can lead to an elevation in which electrolyte?
*hemolysis
Symptoms of hypokalemia?
- weakness
- paralysis
- hyporeflexia
- ileus
- arrhythmias
Which drugs can lead to an increase in potassium serum levels?
- K+ salts
- K+ sparing diuretics
- NSAIDS
- ACEIs
- ARBs
Low magnesium can lead to a decrease in low serum levels of which electrolyte?
potassium!
Check Mg if you are unable to correct for low K+
Which drugs can lead to a decrease in serum potassium levels?
- loop diuretics
- thiazides
- corticosteroids
- laxative abuse
Name the major extracellular anion (-)
Chloride
Normal range of Chloride?
98-107 mEq/L
Critical values for Chloride?
120
Symptoms of hypochloremia?
- Hyperexcitability of nerves and muscles
- Shallow breathing
- Tetany
- Hypotension
Symptoms of hyperchloremia?
- lethargy
- weakness
- deep breathing
Drugs that can lead to an increase in serum chloride levels?
- Corticosteroids
- NSAIDS
- Acetazolamide
- TPN high in Cl
Drugs that can lead to a decrease in serum chloride levels?
*Diuretics
Most of the body’s carbon dioxide is in the form of what?
bicarbonate (HCO3-)
measured as as serum bicarbonate level
Normal range of carbon dioxide?
22-28 mEq/L
Critical values for carbon dioxide?
40 mEq/L
Salicylate toxicity and ethylene glycol poisoning can both lead to a decrease in serum levels of what?
Carbon Dioxide
Glucose levels are controlled by _________ and ____________.
insulin and glucagon
Normal range of glucose?
60-110 mg/dL
Critical values for glucose?
500 mg/dL
Name the end product of protein metabolism and digestion that is formed in the liver and excreted by the kidney.
BUN (Blood Urea Nitrogen)
What lab serves as an index of function of both the liver and kidney?
BUN (Blood Urea Nitrogen)
What lab serves as an indirect and rough measurement of renal function?
BUN (Blood Urea Nitrogen)
Normal Range of BUN?
8-20 mg/dL
Critical level for BUN?
> 100 mg/dL
Creatinine is a measure of function of which organ?
kidney
Serum creatinine levels are affected by ________ __________.
muscle mass
Normal range for serum creatinine?
0.6-1.2 mg/dL
Critical value for serum creatinine?
7 mg/dL
What is the BUN:Cr ratio?
10:1
If >20:1, consider pre-renal causes of azotemia such as dehydration or GI bleed
Which mineral is used to evaluate parathyroid function?
Calcium
This mineral should be monitored in patients with kidney injury, hyperparathyroidism and various malignancies
Calcium
Normal range of serum calcium?
8.5-10.5 mg/dL
Critical values for calcium?
13.5 mg/dL
Symptoms which may indicate hypercalcemia?
- anorexia
- n/v
- somnolence
- coma
- shortened QT interval
Symptoms which may indicate hypocalcemia?
- nervousness
- excitability
- tetany
- prolonged QT interval
If albumin is low, the ___________ level will also be low.
calcium
Equation for corrected calcium?
Calcium = [0.8 x (normal albumin-patient’s albumin)] + serum Calcium level
Note: default normal albumin is 4
What is ionized Calcium?
“Free” calcium flowing in blood not attached to proteins.
Name a few drugs that may lead to an increase in serum calcium levels.
- Tamoxifen
- Estrogen
- Progesterone
- antacids
- Chronic diuretic use (thiazides)
- Lithium
