Physical Diagnosis 3 Flashcards
Acid Phosphatase (PAP)
enzyme is present minimally in many tissues but 100 times higher in the prostate than any other tissue. it is also found in seminal fluid. it is released into the blood stream in metastatic carcinoma of the prostate, when the capsule breaks
increased acid phosphatase
prostatic carcinoma**
any carcinoma metastasis to bone
hyperparathyroidism
prostate specific antigen (PSA)
enzyme which is localized in normal prostatic epithelial cells and prostatic carcinoma cells. 80% of men with prostatic carcinoma have a significant increase in PSA
best prognostic indicator for monitoring reoccurance of cancer and best to detect effectiveness of therapy
PSA and acid phosphatase
increases early detection of prostatic cancer
what is the most reliable test for prostate cancer?
digital rectal exam
A/G ratio
represents serum albumin level divided by the serum globulin level; approximately 2:1
reversed in multiple myeloma
Alkaline phosphatase
enzyme found in many tissues, especially bone and liver. it is termed alkaline because this enzyme functions best at a pH of 9, and is associated with liver and osteoblastic activity. children normally have an alkaline phosphatase value 5 times that of your average healthy adult
alkaline phosphatase is increased in
osteoblastic lesions (broken bone, liver), hepatic disease, hyperparathyroidism
amylase
pancreatic enzyme that splits starch. high values often indicate pancreatitis. most common cause of pancreatitis are alcoholism and cholelithiasis
amylase is increased in
acute pancreatitis
ANA (FANA)
fluorescent antinuclear antibody test is used to demonstrate the presence of antibodies that lead to the production of the LE cell. there are two ANA that are significant in SLE (anti-DNA and anti-DNP
anti-DNP
usually present in patients with various collagen diseases
anti-DNA
strong evidence for the presence of SLE
ANA (FANA) results
positive doesn’t definitely indicate SLE
a negative definitely rules it out
ASO titre
one of a group of serologic procedures that demonstrates that the patient has reacted to an infection by group A streptococci. It measures the amount of antibodies present
ASO titre increase in
acute glomerulonephritis
rheumatic fever
BUN
chief end product of amino acid metabolism, formed by the liver. it is excreted in urine and comprises of about 1/2 of urinary solids
BUN increased in..
decreased..
increased in renal disease
decreased in hepatic disease
calcium (serum)
calcium, as well as phosphorus, are stored in the bone and are constantly exchanged with blood and tissue fluids: vitamin D and parathromone influence this process. vitamin D is needed to intestinal absorption of calcium. parathromone increases the rate of bone destruction with mobilization of calcium and phosphorus from bone. 99% of the calcium in the body is found int eh bones and teeth. the ionized form of calcium functions in the activation of enzymes in the blood clotting, in muscle contraction and in the transmission of nerve impulses. a decreased serum level causes tetany
increased calcium in
decreased in..
hyperparathyroidism, bone metastasis
hypoparathyroidism, acute pancreatitis, renal failure
CPK
present almost exclusively in skeletal muscle, heart muscle, and in brain tissue. it enters the circulation quickly after atrophy or necrosis of the cells. it is one of the most valuable tests to indicate the occurrence of an MI
CK-MB (heart attack), CK-BB (stroke), CK-MM (muscular dystrophy)
creatinine
end product of the normal metabolism of phosphocreatine usitilized for muscle energy. it is a nitrogenous compound secreted in the urine. this level does not vary with diet, so it is a very valuable indicator of kidney function
increased creatinine in
decreased in
increased in renal disease
decreased in muscular dystrophies
CRP
not normally present in a patient’s blood. it appears in the presence of inflammation and is an earlier indicator of inflammation than an ESR. it is best used to evaluate the course and severity of tissue necrosis
