Metabolic Profile

Question 1

Basic Metabolic Panel

Answer 1

BMP (chem 8), Na, K, Cl, BUN, creatine, CO2, glucose, Ca

Question 2

Comprehensive metabolic panal

Answer 2

CMP (chem 12), albumin, total protein, alkaline phosphatase, ALT, AST, bilirubin, also includes liver function

Question 3

Na

Answer 3

135-145 meq/L; serum level is primarily determined by volume status

Question 4

Na increased/decreased

Answer 4

Inc: dehydration, polyuria, hyperaldosteronism, drugs; dec: CHF, cirrhosis, vomiting, diarrhea, exercise, excess sweating

Question 5

K

Answer 5

3.5-5 meq/L plasma concentration determines neuromuscular irritabiltiy

Question 6

K increased/decreased

Answer 6

Inc: hemolysis, tissue damage, dehyration, renal failure, ACE inhibitors; Dec: low K intake, vomiting, diarrhea, drugs; check if having cramps; false elevated with hemolysis

Question 7

Cl

Answer 7

important in maintaing normal acid-base balance* and normal osmolality; plays role in bicarbonate

Question 8

BUN

Answer 8

Blood urea Nitrogen; directly related to protein intake and N metabolism and inversely related to excretion of urea; false increase in dehydration

Question 9

Creatinine

Answer 9

.6-1.2 mg/dL; for each 50% reduction in GFR, serum creatinine doubles; acceptible measure of GFR; kidney failure indicator

Question 10

Creatinine increased/decreased

Answer 10

Inc: renal failure, urinary obstruction, nephrotoxic drugs; dec: reduced muscle mass

Question 11

Glucose

Answer 11

closely regulated so that a source of energy is readily available to tissue and so none is excreted in urine

Question 12

Glucose increase/decrease

Answer 12

Inc: diabetes, cushing, chronic pancreatitis, drugs

Question 13

Calcium

Answer 13

regulated by parathyroid hormone and Vit D

Question 14

Liver function tests

Answer 14

AST, ALT, Alkaline phosphatase, bilirubin, albumin

Question 15

Alanine aminotransferase

Answer 15

ALT, SGPT, GPT; 0-35 U/L released w/ tissue damage (liver injury)

Question 16

Aspartate aminotransferase

Answer 16

AST, SGOT, GOT; released in blood when tissue damaged (liver injury)

Question 17

Alkaline Phosphatase

Answer 17

41-133 IU/L; found in liver, bone, intestine, and placenta; can be unreliable

Question 18

Gamma-glutamyl transpeptidase

Answer 18

GGT, 9-85 U/L; enzyme present in liver, kidney and pancreas, elevated in 90% of pts w/ liver disease; induced by alcohol intake (alcoholic liver disease)

Question 19

Bilirubin

Answer 19

product of hemoglobin metabolism, conjugated in liver and excreted in bile, mostly RBCs and circulates with albumin, provide color to bile, feces, and urine; can be toxic

Question 20

Bilirubin increase/decrease

Answer 20

Inc: hepatitis, cirrhosis, biliary tract obstruction, jaundice, fasting, hemolytic disorders, hepatotoxic drugs

Question 21

Indirect bilirubin

Answer 21

due to increase in heme production that overwhelms the conjugation pathway, diminishes conjugation, or failure in hepatocyte uptake; severe jaundice unconjugated form

Question 22

Direct bilirubin

Answer 22

found in urine because portion is able to dissociate from albumin, conjugated form is being formed in hepatocyte, but cannot be transported adequately into bile

Question 23

Albumin

Answer 23

Major component of plasma protein, influenced by nutritional state, hepatic function, renal function and various diseases, major binding protein, in serum indicates liver disease; nutritional assessment

Question 24

Amylase

Answer 24

20-110 U/L; hydrolyzes complex carbs, serum derived primarily from pancreas and increased w/ inflammation or pancreas obstruction

Question 25

Lipase

Answer 25

0-160 U/L/ hydrolysis of glycerol esters and FA; serum may be more reliable than amylase for acute pancreatitis because remains elevated longer

Question 26

Hgb A1C

Answer 26

Weighted to recent glucose levels (previous month)5.7-6.4% indicates high risk for diabetes development; very accurate and quick to determine diabetes

Question 27

Oral glucose tolerance

Answer 27

Used to diagnose gestational diabetes, take 75-100 grams glucola, test at 0, 60 and 120

Question 28

Fecal occult blood screen

Answer 28

measure blood in stool, dietary restrictions to avoid false positive, no vit C to avoid false negative

Question 29

Prostate specific antigen

Answer 29

PSA, 0-4 ng/ml, glycoprotein produced by cell of prostatic ductal epithelium; false positive w/ elderly probable

Question 30

Hepatitis A

Answer 30

Fecal-oral, flu-like illness, elevated AST and ALT, not chronic; IgM detected 1 week after symptoms, IgG after 5 weeks

Question 31

Hepatitis B

Answer 31

Blood, sex; chronic, surface HBsAg signifies active infection, anti- HBsAg usually vaccination; core anti HBc need to be interpreted carefully, indicate infection

Question 32

Window period

Answer 32

time when no surface antigen or antibody, but anti core; Chronic: anti surface and anti core; vaccine: anti surface only

Question 33

Hepatitis B surface antigen

Answer 33

detectable 2-5 weeks before onset of symptoms, persist 1-5 month; first line test, if positive, no other tests

Question 34

Hepatitis B surface antibody

Answer 34

Test detects antibodies to HBV, indicates immune status, not useful for evaluation of acute or chronic

Question 35

Hepatitis B core Antibody

Answer 35

HbcAb, positive about 2 months after exposure to hep B, may indicate chronic or recovery, useful for acute or chronic only if HBsAg is negative

Question 36

Hepatitis B e antigen/antibody

Answer 36

indicate viral infection, loss of HBeAg and gain of HBeAb indicate decrease infection, unreleiable test, but positive test must be considered infectious

Question 37

Hepatitis C

Answer 37

IV drug use, no vaccine

Question 38

Hepatitis C antibody

Answer 38

detects antibody, seroposititviy means previous exposure not necessarily infection, repeat tests