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CV487 > Lab values > Flashcards

Lab values Flashcards

1
Q

Normal sodium ranges

A

135-145mmol/L

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2
Q

Sodium functions in the body

A

-Regulates extracellular osmotic forces (water balance & ECF volume)
-Maintains neuromuscular irritability for conduction of impulses (with K+ & Ca+)
-Regulates acid-base balance (Na+ HCO3- and Na+ phos)
-Balance mediated by aldosterone (end product of RAAS)

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3
Q

Na+ functions in the body + when it is low…

A

-When Na+ is low, renin is released and stimulates aldosterone I, ACE is released in pulmonary vessels which converts angiotensin I to II causing vasoconstriction
-Vasoconstriction increases BP and restores renal perfusion, aldosterone promotes Na+ and water reabsorption

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4
Q

Aldosterone + K+

A

Aldosterone stimulates secretion and excretion of K+

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5
Q

Hypernatremia + hypovolemia

A

->145 mmol/L
-Hypovolemic: Loss of Na+ (loop diuretics, osmotic diuresis (hyperglycemia in uncontrolled diabetes), GI losses, kidneys cannot concentrate urine

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6
Q

Hypernatremia + euvolemic

A

-Euvolomic: Loss of free water with a normal body Na+ concentration

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7
Q

Hypernatremia + hypervolemia

A

-Hypervolemic: Too much water and increased Na+ levels, over secretion of ACTH (adrenocorticoropic hormone) or aldosterone

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8
Q

Hypernatremia clinical manifestations

A

-Shrinking of brain cells, aMembrane potentials
-Weakness, lethargy, muscle twitching, hyperreflexia, confusion, coma, and seizures
-Chlorine follows Na+ (hypernatremia-hyperchloremia)

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9
Q

Hypernatremia ECF effects

A

-Hypervolemia/hypovolemia
-Neuromuscular

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10
Q

Hypernatremia ICF manifestations

A

Thirst, decreased urine output, fever and shrinkage of brain cells

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11
Q

Hypervolemia effects caused by hypernatremia

A

Increased BP, bounding pulse, venous distention, edema & weight gain

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12
Q

Neuromuscular effects caused by hypernatremia

A

-Muscle weakness
-Seizures

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13
Q

Hypovolemia effects caused by hypernatremia

A

-Weight loss, weak pulses & tachycardia
-Orthostatic hypotension

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14
Q

Hyperglycemia effects caused by hypernatremia

A

-Polyuria, polydipsia, hypovolemia, weight loss
-Late hypernatremia

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15
Q

Hyponatremia

A

-<135 mmol/L
-Hypovolemic: Loss of body fluid and Na+
-Euvolemic: Loss of Na+ without significant loss of water ie. SIADH, hypothyroidism, pneumonia, glucocorticoid deficiency)
-Hypervolemic (water intoxication): Dilutes Na+

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16
Q

Hypontatremia ECF & ICF effects

A

-Extracellular hypovolemia increases intracellular water: Edema, brain cell swelling, irritability, depression & confusion
-Extracellular hypovolemia increases systemic cellular edema, weakness, anorexia, nausea and diarrhea

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17
Q

Hyponatremia & water excess (ECF & ICF effects)

A

-ECF effects: Volume expands with hypovolemia
-ICF effect: Edema

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18
Q

Potassium

A

-3.3-5.1mmol/L
-Role in neuromuscular function
-Increased K+ stimulates insuline, aldosterone, and epinephrine secretion
-Aldosterone promotes renal secretion
-Kidneys regulate K+
-Maintained by Na+K+ active transport system which plays a role in conduction

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19
Q

Potassium and insulin

A

-K+ is required for glycogen deposition in liver and skeletal muscles
-Insulin contributes to plasma level regulation by stimulating the Na+K+ pump which moves K+ into the liver and muscles with glucose
-Intracellular movement of K+ prevents acute hyperkalemia meaning insulin can treat hyperkalemia

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20
Q

Facilitators of potassium out of cells

A

-Insuline deficiency, aldosterone deficiency, acidosis, and exercise

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21
Q

Hypokalemia (<3.3mmol/L) effect on body systems

A

-CV: Dysrhthmias: Peaked P waves, prolonged QT interval, depressed ST interval, and flattened T & U waves. Cardiac arrest, weak and irregular pulse, orthostatic hypotension
-Nervous: Lethargy, fatigue, confusion and paresthesia
-GI: N/V, decreased motility, distention, and ileum
-Kidney: Water loss, unconcentrated urine, production of ammonia and ammonium, kidney damage
-Skeletal and smooth muscle: Weakness, flaccid, paralysis, respiratory arrest, constipaton, and bladder dysfunction

22
Q

Hyperkalemia (>5.1mmol/L) effect on body systems

A

-CV: Dysrhythmias (absent P wave, prolonged PR interval, widened QRS complex, peaked T waves), bradycardia, heart block, cardiac arrest
-Nervous: Anxiety, tingling, numbness
-GI: N/V, diarrhea, colicky pain
-Kidney: Oliguria, kidney damage
-Skeletal & smooth muscle: Initially muscles are hyperactive, later weakness and flaccid paralysis

23
Q

Calcium lab values

A

-2.1-2.6mmol/L (total, adult)
-1.9-2.6mmol/L (total)
-1.05-1.30 mol/L (ionized, adult)
-Ionized form is most important physiologically

24
Q

Calcium function

A

-Metabolic processes, structure of bone and teeth, enzymatic cofactor for clotting, hormone secretion and cell receptor function, plasma membrane stability and permeability, impulse transmission, contraction of muscles

25
Q

Factors controlling calcium absorption and excretion

A

Parathyroid hormone, vitamin D, and calcitonin

26
Q

Hypercalcemia (>2.6mmol/L) causes…

A

Hyperparathyroidism; bone metastases with Ca+ resorption from breast, prostate, renal, and cervical cancer, sarcoidosis, excess vitamin D, and tumours that procude PTH

27
Q

Hypocalcemia (>2.1mmol/L) causes…

A

-Inadequate intestinal absorption, deposition of ionized Ca+ into bone and soft tissue, blood administration, decreases in PTH and vitamin D

28
Q

Effects of hypocalcemia

A

Increased neuromuscular excitability

29
Q

Phosphate lab values

A

-0.8-1.5mmol/L (adult)
-1.45-2.10mmol/L (infants and young children)

30
Q

Phosphate functions

A

-Intracellular & extracellular anion buffer in regulation of acid-base balance, muscle contracton (as ATP)

31
Q

Factors controlling phosphate absorption & excretion

A

Parathyroid hormone, vitamin D, and calcitonin

32
Q

Hyperphosphatemia causes…

A

Renal failure with loss of glomerular filtration, chemotherapy that releases phosphate into serum, long-term use of laxatives or enemas containing phosphates

33
Q

Effects of hyperphosphatemia

A

Symptoms related to low Ca+ levels; when prolonged, calcification of soft tissues in lungs, kidneys, and joints

34
Q

Hypophosphatemia (<0.4mmol/L) causes

A

Intestinal malabsorption related to vitamin D deficiency, use of Mg and aluminum containing antacids, ETOH abuse, respiratory alkalosis, hyperparathyroidism

35
Q

Effects of hypophasphatemia

A

Reduced O2 transport and disturbed energy metabolism, leukocyte & platelet dysfunction, deranged nerve & muscle function, irritabilty, confusion numbness, coma, convulsions, respiratory failure, cardiomyopathies, bone resorption

36
Q

Magnesium lab values

A

-0.75-0.95mmol/L (adult)

37
Q

Magnesium function

A

Cofactor in intracellular enzymatic reactions causing neuromuscular excitability, interacts with Ca+ and K+ and has a role in smooth muscle contraction and relaxation, absorbed in the intestine and eliminated by the kidney

38
Q

Hypermagenesmia (>1.25mmol/L) causes

A

Renal insufficiency or failure, intake of magnesium-containing antacids, and adrenal insufficency

39
Q

Hypermagenesmia effects

A

-Skeletal & smooth muscle contraction, excess nerve function, loss of deep tendon reflexes, N/V, hypotension, bradycardia, respiratory distress

40
Q

Hypomagnesmia (<0.75mmol/L) causes

A

Malnutrition, malabsorption syndromes, alcoholism. urinary losses

41
Q

Hypomagnesmia effects

A

Behavioural changes, irritability, increased reflexes, muscle cramps, ataxia, nystagmus, tetany, convulsion, tachycardia, and hypotension

42
Q

Troponin T lab values

A

-Normal; <14 ng/L. Normal for TNT
-Borderline elevation (low level); 15-49 ng/L. Compararble to a TNT level of <0.03 ug/L
-Borderline elevation (mid-level); 50-109 ng/L. Comparable to TNT level of >0.03 ug/L> 0.10 ug/L
-Clear elevation; >109 ng/L. Comparable to a TNT level of > 0.10 ug/L
->=50 ng/L is when further assessment of symptoms

43
Q

Troponin functions

A

-Relaxing protein that forms the troponin-tropomyosin complex for cardiac cells
-Troponin T binds troponin complex to actin and tropomyosin
-Troponin I inhibits ATPase of actomyosin
-Troponin C binding sites for Ca+ ions involved in contraction
-Troponin T and I are released during AMI
-Measured to evaluate if a AMI or other damage has occured

44
Q

Troponin I

A

-Negative: <0.5 mcg/L
-Suspicious of injury: >0.5>2.3 mcg/L
-Positive for myocardial injury: >=2.3 mcg/L

45
Q

Brain natruiretic peptide (NT-pro-BNP) functions

A

-Causes natriuresis
-Elevation indicates HF and may distinguish cardiac vs respiratory dyspnea
-Helps assess severity of HF

46
Q

Brain natriuretic peptide (NT-pro-BNP) lab values

A

-Normal: 0-300 ng/L
-HF is unlikely if it is <300 ng/L
-HF is likely if: >450 ng/L for patients <50 years; >900 for patients 50-75 years; and >1800 ng/L for patients >75 years

47
Q

Creatinine

A

-Waste product produced by protein breakdown
-Released from muscle and excreted by glomerular filtration
-As GFR declines, plasma creatinine increases
-Elevated creatinine indicates decreasing glomerular filtration

48
Q

Creatinine lab values

A

-Normal (males): 55-106 mcmol/L
-Normal (females): 44-97 mcmol/L
-Higher values indicate severe renal disease
-Lower values indicate illnessess associated with decreased muscle mass

49
Q

Blood urea nitrogen (BUN)

A

-Normal: 3.6-9.1 mmol/L
-Reflects glomerular filtration and urine concentrating capacity
-Because urea is filtered through the glomerulus, BUN levels increase as glomerular filtration decreases
-Increased BUN indicates dehydration and renal failure
-May increase as a result of altered protein intake and catabolsim
-Lower levels could indicate overhydration or advanced liver disease

50
Q

C-reactive protein

A

-Inflammatory marker
-Acute phase reactant or protein synthesized in the liver
-Associated with CAD, smoking, obesity, and diabetes
-Higher risk for CAD with elevated LDL

CV487 (15 decks)

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