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Block 2 - MSK > Lecture 18 - Biochemical Tests > Flashcards

Lecture 18 - Biochemical Tests Flashcards

1
Q

Normal Na+ range

A

136-146 mmol/L

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2
Q

Normal K+ Range

A

3.5-4.6 mmol/L

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3
Q

Normal Cl- range

A

100-110 mmol. L

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4
Q

Normal HCO3- range

A

24-30 mmol/ L

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5
Q

Low Na+ risk

A

Confusion
Seizures,
Coma, death

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6
Q

Syndrome of inappropriate ADH

A
  • elevated serum levels of ADH
  • plasma osmolality low
  • water retention
  • increased ECF volume without edema
  • concentrated urine
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7
Q

Origins of elevated ADH

A
  • ectopic releae from lung

- enhance posterior pituitary release

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8
Q

Other causes of low Na+

A
  • diuretics
  • MDMA
  • Addison’s disease
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9
Q

Treatment options for hyponatremia

A
  • treat cause

- water restriction, urea, demeclocycline, vaptans

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10
Q

Risk for high Na+

A
  • confusion
  • seizures
  • coma
  • death
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11
Q

Diabetes insipidus: High Na+

A

1) cranial diabetes insipidus: serum ADH low, pituitary tumour, surgery, CNS infections
2) NEphrogenic diabetes insipidus: target organ resistance, Serum ADH high

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12
Q

Low K+ risk

A
  • arrythmias

- digoxin toxicity

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13
Q

Clinical contexts of low K+

A
  • diurectics
  • GI K+ losses (diarrhea, vomiting)
  • excessive mineralocorticoid effects
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14
Q

High K+ risk

A
  • arrythmias

- asystole due to depolarization

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15
Q

Clinical contexts of high K+

A
  • inadequate renal excretion
  • addison’s disease (failure of adrenal cortex)
  • Metabolic acidosis: K+ leaves cells
  • Serious tissue injury
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16
Q

PRimary defect in CO2 levels

A
  • elevated CO2: Respiratory acidosis: H+ rises

- decrease CO2: respiratory alkalosis: H+ falls

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17
Q

If primary defect is in H+

A
  • high H+ : Metabolic acidosis: HCO3- falls

- low H+ : Metabolic alkalosis: HCO3- rises

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18
Q

If primary defect is in HCO3-

A
  • decrease HCO3-: Metabolic acidosis

- increased HCO3- : metabolic alkalosis

19
Q

High bicarbonate: metabolic alkalosis

A
  • arterial pH >7.50

- causes; GI acid loss or high level of antacid intake

20
Q

High bicarbonate: chronic respiratoru acidosis: renal comepnsation

A
  • arterial pH
21
Q

Low bicarbonate: metabolic acidosis

A
  • primary abnormality and or excess tissue H+ production
    Causes: normal chloride (diabetic ketoacidosis or lactic acidosis) or high chloride (intestinal bicarbonate loss or chronic renal failure)
22
Q

Low bicarbonate: chronic respiratory alkalosis - renal compensation causes

A
  • hyperventilation
  • hypoxia
  • fever
  • salicylate toxicity
23
Q

Glucose nromal range

A
  • 3.8 - 6.1 mM
24
Q

Low glucose dangers

A
  • loss of consciousness, seizures, brain damage, death
25
Q

Low glucose causes

A
  • drug induced (diabetics on insulin)
  • liver failure
  • insulinoma
26
Q

High glucose: chronically elevated in both type 1 and type 2 diabetics

A
  • accelerated diabetic complications

- prolonged hyperglycemia

27
Q

High glucose in type 1 diabetic

A
  • risk of diabetic ketoacidosis
28
Q

High gluose in type 2 diabetic

A
  • risk of serious dehydration

- risk of hyperosmolar coma

29
Q

Creatinine normal range

A
  • 60 - 120 um

- monitor kidney function

30
Q

High creatinine

A

Dehydration

- renal failure: acute or chronic

31
Q

Urea normal range

A
  • 3-8mmol/L
32
Q

High urea causes

A
  • enhanced protien breakdown

- renal failure

33
Q

Calcium normal range

A

2.2-2.6 mM

34
Q

Three main forms of calcium

A
  • bound to albumin (45%)
  • complexed with organic anions (5%)
  • ionized (50%)
35
Q

Hyperventilation

A
  • lowers CO2 and lowers H+ in blood
  • acute increase in plasma pH
  • negative charge on albumin increase
  • albumin binds more calcium
  • ionized calcium drops
  • dizziness, perioral numbness, paresthesia, tetanic contractions
36
Q

Liver failrue

A
  • albumin synthesis drops
  • plasma albumin drops
  • total calcium drops
  • ionized calcium unchanged
37
Q

Hypocalcemia

A
  • neuromuscular irritability
  • tetany
  • cardiac arrythmias
  • laryngospasm
  • convulsion
  • death
38
Q

Causes of hypocalcemia

A
  • familial or sporadic hypocalcemia
  • hypoparathyroidism or resistance to PTH
  • chronic renal failure
  • impaired vit D metabolism
  • hungry bones
39
Q

Hypercalcemia

A
  • primary hyperparathyoidiusm
  • malignancy
  • familial
  • Vit D intoxication
  • granulomatous disease
40
Q

Total protein normal range

A

60-80 g/l

41
Q

Albumin normal range

A

40-50 g/L

42
Q

Bilirubin normal range

A

0-18 um

  • derived from breakdown of heme
  • elevated bilirubin in enhanced hemolysis or impaired excretion
43
Q

Aminotransferases: AST and ALT

A
  • role in detoxifying aa

- elevated in hepatitis

44
Q

Other enzymes for liver status: ALP, GGT

A
  • ALP: metabolism of organic phosphates
  • GGT: role in aa transport
  • both are elevated in biliary stasis or bile duct obstruction
  • GGT elevated with chronic high ethanol intake

Block 2 - MSK (38 decks)

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