Lecture MT 2 Review Flashcards
What ABG parameter measures the amount of hemoglobin that is bound with oxygen?
oxygen saturation
The clinical significance of increased oxygen saturation is ____
hyperventilation
The clinical significance of decreased oxygen saturation is ____
hypoxia
(anemia, abnormal Hgb)
____ is caused by an absolute PCO2 deficit.
respiratory alkalosis
What is the kidneys’ most significant effect on arterial blood pH?
- alter rate of HCO3- reabsorption
- exchange H+ ions
- alter ammonia production
What ABG parameter increases to show respiratory compensation of metabolic alkalosis?
PCO2
____ is an absolute HCO3- deficit resulting in decreased pH and HCO3- (base deficit)
metabolic acidosis
What are 2 main causes of metabolic acidosis?
- ketoacidosis (^acid production)
- renal failure (less excretion of H+ ions)
During internal respiration, hgb and HCO3- move out of RBCs in exchange for Cl- moving in, called ____
chloride shift
(Cl- moving out during external respiration = reverse chloride shift)
What screening test for gestational diabetes is performed at 24-28 weeks of gestation?
1-hr PP (post prandial; 50g glucose orally)
(normal = <140mg/dL)
What hormone is produced by pancreatic a-cells in response to decreased blood glucose (or insulin), and is the principle hormone to increase blood glucose?
glucagon
Glucagon stimulates liver ____
glycogenolysis
(and gluconeogenesis)
The process of glycogen formation from glucose is called ____
glycogenesis
What test is an index of long-term plasma glucose control?
HgbA1C
(screen for, monitor, & Dx diabetes mellitus or pre-diabetes)
What are 2 other names for HgbA1C?
- glycated hemoglobin
- glycosylated hemoglobin
What is the fasting blood glucose (FBG) criteria for prediabetes?
100 - 125 mg/dL
Insulin deficiency due to autoimmune destruction of pancreatic beta-cells is called ____
Type I / IDDM (insulin dependent diabetes mellitus)
Patients with type I diabetes are dependent on ____ insulin to sustain life and prevent ____
- exogenous (analogue)
- DKA (diabetic ketoacidosis)
Decreased insulin production and/or increased peripheral insulin resistance is called ____
Type II / NIDDM (non-insulin dependent diabetes mellitus)
Hyperosmolar coma is mostly associated with ____
type II diabetes
(dehydration, slow onset, ^^osmolality)
Diabetic ketoacidosis is mostly associated with ____
type I diabetes
The mathematical calculation of the difference between the concentration of measured cations and measured anions in serum is called ____
anion gap
Anion gap is particularly helpful in the diagnosis of ____
metabolic acidosis
Renal failure, acidosis, dehydration, and diabetic ketoacidosis can all lead to ____
hyperkalemia
Name 2 important causes of hyperosmolality.
- dehydration
- hyperglycemia (diabetes mellitus)
Potassium moves into cells in response to increased ____
insulin
(insulin drives both K+ and glucose into cell, can cause hypokalemia)
What is the major intracellular cation?
potassium
(Cats like salty bananas)
What is the major extracellular cation?
sodium
(Cats like salty bananas)
What are the 4 main contributors to plasma/serum (urine) osmolality?
- sodium
- chloride
- urea (BUN)
- glucose
Lipids must be transported to storage sites or for use within transport packets via ____
lipoproteins
(chylomicrons)
VLDLs contain Apo C, which release ____, which hydrolyzes triglycerides
LPL (lipoprotein lipase)
What is the typical pattern of serum cardiac enzymes/proteins in the criteria for AMI diagnosis?
rise, peak, return to normal reference range
The initial rise, peak and return to normal, characteristic to each cardiac marker is termed ____
diagnostic window
What is now the “gold standard” for early diagnosis of AMI?
troponins
(used to be CK isoenzymes)
Increased ____ can precipitate pancreatitis.
triglycerides
____ are key elements in cell membranes, myelin, and surfactant.
phospholipids
What are the 2 most prominent lipids found in plasma?
cholesterol
triglycerides
What enzyme is elevated in the blood whenever osteoblastic activity increases?
alkaline phosphatase (ALP)
(found in bone & liver)
What is the most commonly measured vitamin D metabolite?
calcitriol
What are the 2 most common causes of hypercalcemia?
- hyperparathyroidism
- hypercalcemia of malignancy
(plasma levels >10.5 mg/dL)
What is the most common cause of hyperphosphatemia?
renal failure
What is the only physiologically/biologically active form of calcium?
free or ionized
____ correlates well with disease activity and is used to monitor therapy for Paget’s disease?
alkaline phosphatase (ALP)
(^ALP, normal Ca & PO4)
- What is the acid-base status?
- Is this condition respiratory or metabolic?
- Is this acid-base balance uncompensated, partially compensated, or fully compensated?
_pH = acidosis
^PCO2 = respiratory
- ^HCO3 = partially compensated (metabolic, pH still not normal)
What is the typical blood-gas profile in this acid-base imbalance?
_HCO3 = metabolic
_pH = acidosis
What additional test could be used to evaluate the patient’s average glucose level for the past 6 to 8 weeks to determine the patient’s compliance with diet and insulin recommendation?
Hgb A1C
According to NCEP, at what level is LDL considered a risk factor for atherosclerosis and CAD?
> 160 mg/dL
What lab test can detect low levels of inflammation (chronic) and can be used as a predictor of risk for AMI and stroke?
High sensitivity CRP (hsCRP)
What are the NCEP age related risk factors for males and females?
Male >45yrs
Female >55yrs
Cardiac muscle contains which CK isoenzymes? Which is the most cardiac specific?
- CK-MB
- CK-BB
- CK-MM
Which cardiac marker did we learn about that because of its small size, is the first to be released from damaged myocardial cells and will show elevation in the serum/plasma the soonest?
Myoglobin
(Troponin is still the gold standard)
What Hgb A1C result is consistent with:
1. diabetes
2. Pre-diabetes
3. Normal
Diabetes >/= 6.5%
Pre-diabetes 5.7 - 6.4%
Normal 4.0 - 5.6%
