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Flashcards in Basic Metabolic Panel Deck (48):
1

What is substances are examined in a Basic Metabolic Panel?

Sodium (Na), Potassium (K), Chloride (Cl), Bicarbonate(HCO3), Bile Urea Nitrogen (BUN), Creatinine (CR), Glucose and Calcium (Ca)

2

What is the term for low serum sodium

Hyponatremia

3

How is Hyponatremia clinically defined

Serum sodium

4

What are the 2 major causes of persistent hyponatremia?

SIADH and Reduced effective arterial blood volume due to diuretics, vomiting/diarrhea and decreased tissue perfusion in heart failure or cirrhosis

5

What are the 3 classifications of hyponatremia

Hypovolemic - A decrease in total body water with a great decrease in total body sodium
Euvolemic - Normal body sodium with increase in total body water
Hypervolemic - An increase in total body sodium with even a greater increase in total body water

6

What are the symptoms of hyponatremia

Nausea, dizziness, fatigue, gait disturbances, forgetfulness, confusion, lethargy, and muscle cramps (extra severe

7

What are three ways hyponatremia is diagnosed

Urine Osmolality - Differentiates btwn conditions associated with impaired free water excretion and primary polydipsia
Serum Osmolality - Differentiates btwn true hyponatremia and pseudohyponatremia
Urine sodium concentration - Differentiates btwn hyponatremia secondary to hypovolemia

8

What is the most common form of hyponatremia

Hypotonic hyponatremia

9

Which can be safely treated more quickly acute or chronic hyponatremia

Acute

10

What is the condition of elevated serum sodium

Hypernatremia

11

What is the most common causes of hypernatremia?

1) Failure to replace water losses due to impaired thirst or lack of access to H2O.
2) Intake of salt in excess of H2O
3) Administration of a hypertonic salt solution

12

What kind of condition is hypernatremia

A hyperosmolar condition

13

How is hypernatremia clinically defined

Serum sodium concentration > 145 mEq/L
Severe > 158 mEq/L
> 180 mEq/L associated with a high mortality rate

14

What population is hypernatremia most found in

Elderly who are physically and mentally impaired

15

What are the clinical manifestations of hypernatremia

Lethargy, weakness, irritability, twitching, seizure and coma.
Rapid decrease in brain volume can cause rupture of cerebral veins leaching to hemorrhages in brain and Acute manifestations of the condition can result in demyelinating brain leisions

16

What condition is due to elevated potassium

Hyperkalemia

17

Why can Hyperkalemia be difficult to diagnose

Due to a lack of distinctive signs and symptoms

18

How is Hyperkalemia clinically diagnosed

Mild - 5.5-6.0 mEq/L
Moderate - 6.1-7.0 mEq/L
Severe -

19

What are the major causes of Hyperkalemia

Acute or chronic kidney disease or disorders (Urinary obstruction, Sickle disease, Addisons) or drugs that inhibit the renin-angiotensin-aldersterone axis (diuretics)

20

How is Hyperkalemia clinically diagnosed

Mild - 5.5-6.0 mEq/L
Moderate - 6.1-7.0 mEq/L
Severe -

21

Signs and symptoms of Hyperkalemia

Fatigue and weakness, n/v, palpitations, paresthesia, bradycardia, extrasystoles, decreased motor strength, renal failure (edema and skin changes), paralysis (rare)

22

What is essential to diagnose hyperkalemia

an EKG

23

How is Hypokalemia clinically defined

Defined - serum K+

24

What are some EKG changes associated with Hyperkalemia

Widened QRS
Peaked T waves

25

What is the condition of low potassium

Hypokalemia

26

How is Hypokalemia clinically defined

Defined -

27

What are the signs and symptoms of Hypokalemia

Often asymptomatic.
Weakness and fatigue most common
More severe - Muscle cramps and pain, worsening diabetes, hallucinations, delirium, and depression, bradicardia and CV collapse

28

What are EKG changes that can occur with Hypokalemia

Change in QT interval
Look for U wave after T wave.

29

Chloride's role in the body

Plays an important role in acid/base balance and with sodium maintains H2O balance and serum osmolality

30

What are the normal and critical values of chloride

Normal - 98-106 mmol/L
Critical - 120 mmol/L

31

What is the condition of high/low chloride levels

Hyperchloremia/Hypochloremia

32

What can cause Hyperchloremia

Renal failure, nephrotic syndrome, dehydration, hyperparathyroidism, diabetes insipidus, respiratory alkalosis, hyperadrenocorticism and certain drugs

33

What can cause Hypochloremia

V/d, renal failure with salt deprivation, overtreatment of diuretics, diabetic ketoacidosis, SIADH, water intoxication , adrenal insufficiency, hyperaldeosteroidism, metabolic alkalosis and certain drugs (laxative, diuretics, and corticosteroids

34

What does the level of Bicrobonate (HCO3-) indicate

The concentration of H+ ions (or the bicarbonate level)

35

What does Bicarbonate usually counterbalanced by

a change of chloride

36

What conditions can indicate an elevated or decreased bicarbonate level

Elevated - Metabolic alkalosis and respiratory alkalosis
Decreased - Respiratory acidosis and metabolic acidosis

37

What is the Anion Gap a measurement of?

It represents the difference btwn unmeasured cation and anions... AG = (Na+)-{(HCO3 + Cl-)}

38

What conditions can show a rise in the Anion gap

Acidosis, renal failure and ingestion of certain toxins

39

What does the BUN level reflect?

The function of the liver and/or the kidneys

40

What is the normal BUN reference range?

3-20 mg?dL

41

What do BUN levels vary inversely with...

Glomerular filtration levels (GFR)

42

What are the normal glucose reference ranges

Fasting plasma glucose - 70/99 mg/dL
Postparandial plasma glucose at 2hrs. -

43

What is the reason to monitor levels of creatinine?

It's important in assessing renal function. in blood it is a marker of glomerular filtration rate

44

What are the normal reference ranges for creatinine?

Adult males: 0.5-1.2 mg/dL
Adult females - 0.4 - 1.1 mg/dL
Children (up to 12 y.o) - 0.0 - 0.7 mg/dL

45

What are reasons for low/high serum creatinine levels

Low
1) Low muscle mass
2) Increased glomerular rates (GFRs)
High
1) Decreased GFR (due to acute kidney injury or chronic kidney disease)

46

What are the normal glucose reference ranges

Fasting plasma glucose - 70/99 mg/dL
Postparandial plasma glucose at 2hrs. -

47

What are the reference ranges for diabetes mellitus

- Fasting plasma glucose -> 125 mg/dL
- Postparandial plasma glucose at 2hrs. - > 200mg/dL
- Random plasma glucose - > 200 mg/dL
- Impaired fasting glucose : Fasting glucose of 100-125 mg/dL
- Impaired glucose tolerance testing: Postprandial glucose at 2 hours of 140-200 mg/dL

48

What are the reference ranges for hypoglycemia

Value less than 60 mg/dL