Biochemical Profile 1

Question 1

define biochemical profile

Answer 1

a group of select tests that can screen for certain conditions
normal or reference values vary from lab to lab
pattern of abnormal values provide data from arriving at a diagnosis

Question 2

glucose

Answer 2

primary energy source

Question 3

blood glucose levels are held in a constant range by?

Answer 3

regulatory hormones and metabolic activity

Question 4

what increases blood glucose levels?

Answer 4

glucagon
epinephrine
growth hormone ACTH
cortisol

Question 5

what is the classic hyerglycemic disorder?

Answer 5

diabetes mellitus

Question 6

complications of diabetes mellittus

Answer 6

retinopathy
renal failure
neuropathy
atherosclerosis

Question 7

how long does someone need to fast in order to get a fasting blood glucose?

Answer 7

10-14 hours

Question 8

What is the normal fasting blood glucose range?

Answer 8

70-99 mg/dl

Question 9

what is the prediabetes fasting blood glucose range?

Answer 9

100-126 mg/dl

Question 10

what are the types of hyperglycemias?

Answer 10

diabetes mellitus
acute stress response
cushing's syndrome
pheochromocytoma
renal failure
acromegaly
pancreatitis

Question 11

what are the types of hypoglycemia?

Answer 11

insulin overdose
pancreatic islet cell tumor
starvation
liver disease
addison's disease
hypothyroidism

Question 12

symptoms of diabetes

Answer 12

polydipsia
polyuria
polyphagia
fatigure
weight loss
blurred vision
slow healing
dizziness
nausea

Question 13

when is a fasting blood glucose recommended?

Answer 13

increased thirst
frequent urination
fatigue
blurred vision
slow healing wounds or infections
sweating
hunger
trembling
anxiety
confusion
blurred vision

Question 14

if diabetes is suspected, what tests should be done?

Answer 14

glucose tolerance test

A1C

Question 15

describe an oral glucose tolerance test

Answer 15

used if diabetes is suspected
usually a 2 hour test
patient fasts, then FBS is taken and then the patient is given an oral glucose load
the blood glucose is taken at 30 min, 1 hr and 2 hours (sometimes 3 and 4 hours latera too)

Question 16

where should your blood glucose be after 2 hours of doing a glucose tolerance test?

Answer 16

<140

Question 17

what are the values noted for 2 hour glucose tolerance test?

Answer 17

after 2 hours..
normal <140
prediabetes 140-199
diabetes >200

Question 18

HbA1C test

Answer 18

blood test used to determine how well a patient’s diabetes/blood sugar levels are being controlled
HbA1C provides an average of your blood sugar control over 6 to 12 weeks

Question 19

what is the gold standard for diagnosing diabetes?

Answer 19

A1C assay

Question 20

what are the values for a HbA1C

Answer 20

normal <5.7
prediabetes 5.7-6.4
diabetes >6.5

Question 21

what would the different glucose test results be for a diabetic

Answer 21

FBG >126 mg/dl
on 3 different occasions
OGTT >200mg/dl
>6.5 A1C
glycosuria when the renal threshold value is >180mg
RTV may rise in some diabetics

Question 22

what would the different glucose test results be for a normal person?

Answer 22

FBG 70-99
OGTT (2hr) <140
AlC <5.7

Question 23

s/s of type 1 diabetes mellitus

Answer 23

insulin dependent
polyuria, polydipsia, hyperglycemia
MC seen in juveniles
circulating insulin is absent
plasma glucagon is elevated
autoimmune destruction of pancreatic islet beta cells
dependent on exogenous insulin to sustain life

Question 24

s/s of type 2 diabetes mellitus

Answer 24

non insulin dependent
MC type over 40 and obese, family history
polyuria, polydipdia, hyperglycemia
circulating insulin is present but inadequate in times of increased need
insulin resistance or decreased amounts
may be controlled by diet, lifestyle, exercise, maybe oral hypoglycemic agents

Question 25

what happens to the baby in gestational diabetes?

Answer 25

the extra blood glucose goes through the placenta and to the baby, since there is more eneergy than needed for the baby, the baby stores the energy as fat

Question 26

if you see blood vessels on a foot xray, what are the ddx?

Answer 26

diabetes | hpt

Question 27

diabetic coma

Answer 27

``` diabetic ketoacidosis shortage of insulin glycosuria, ketonuria, hyperglycemia polyuria polydipsia fatigue vomiting mental stupor, can progress to coma rapid breathing fruity breath odor ```

Question 28

hypoglycemia

Answer 28

low blood glucose (>70mg/dl) more common in a diabetic patient anxiety, sweating, palpitations, tremor, hunger if it gets to the CNS, lethargy, headaches, confusion, visual disturbances, convulsions, coma

Question 29

what if hypoglycemia occurs in a non diabetic patient?

Answer 29

is it fasting hypoglycemia or postprandial?

Question 30

postprandial/reactive hypoglycemia

Answer 30

occurs within 4 hours after meals | can occur immediately after a meal

Question 31

fasting/postabsorptive hypoglycemia

Answer 31

often related to an underlying disease, various medications (50mg/dL)

Question 32

symptoms of hypoglycemia in non diabetic patients

Answer 32

``` hunger sweating shakiness dizziness light headedness sleepiness confusion difficulty speaking anxiety weakness ```

Question 33

whipple's triad

Answer 33

symptoms known or likely to be caused by hypoglycemia low plasma glucose level signs and symptoms of hypoglycemia resolution of symptoms once glucose level rises

Question 34

what can fasting hypoglycemia be due to?

Answer 34

some underlying disease medication, alcohol, illness excess insulin or carb deprivation tumors (insulinoma, insulin overdose in a diabetic) hormonal deficiencies hepatic and renal disease may need a 5 or 6 hour glucose tolerance test with measurements hourly

Question 35

how to relieve postprandial hypoglycemia

Answer 35

eat small meals and snacks every 3 hours | exercise regularly

Question 36

what serological tests would be helpful in determining the etiology of glomerulonephritis?

Answer 36

anti streptolysin O-titer test | ANA

Question 37

your patient has a suspected chancre in his genital region. Which of the following tests would be most helpful to determine the etiology?

Answer 37

darkfield exam

Question 38

what test would be helpful if a person has mono?

Answer 38

rapid mono test

Question 39

your patient has unilateral sacroiliitis, what tests should you order?

Answer 39

sed rate HLA B27 CBC

Question 40

your patient with unilateral sacroiliitis has a CBC WNL, HLA B27 test was positive, sed rate was elevated. Most likely diagnosis?

Answer 40

reactive arthritis/reiter's

Question 41

your patient might have SLE, what test would be most helpful?

Answer 41

ANA