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Blood Chemistry Flashcards

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1
Q

Acute-Phase Reactants #1

Subtypes (2), Def’n, Induced By (4)?

A
  • Positive / Upregulated
  • Negative / Downregulated

Factors whose serum conc change in response to infl. Produced by Liver.

IND BY:

  • IL-1
  • IL-6
  • TNF-a
  • Interferon-y
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2
Q

Acute-Phase Reactants #2- POSITIVE / UPREGULATED (5)

A
  • Amyloid A
  • C-reactive protein
  • Ferritin
  • Fibrinogen
  • Hepcidin
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3
Q

Acute-Phase Reactants #3- NEGATIVE / DOWNREGULATED (2)

A
  • Albumin

- Transferrin

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4
Q

“Dry BM Tap”

Def’n, Seen In?

A

Hypocellular BM with fatty infiltration.

SEEN IN:
- Aplastic Anemia

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5
Q

ACE

↑Seen In (4)?

A

↑SEEN IN:

  • Gaucher Disease
  • Leprosy
  • Sarcoidosis
  • Primary Biliary Cirrhosis
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6
Q

Acetyl-CoA

↑Seen In (2), Conseq of ↑?

A

↑SEEN IN: ↓Oxaloacetate

  • Prolonged starvation (need for Gluconeogenesis -> depletion of Oxaloacetate)
  • Alcoholism (excess NADH -> shunting of Oxaloacetate -> Malate)

CONSEQ = shunting of glucose + FFA -> production of ketone bodies.

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7
Q

AFP (in maternal blood or amniotic fluid)

↑Seen In (6),↓Seen In?

A

↑SEEN IN:

  • Dating error
  • Anencephaly
  • Neural Tube Defects (esp Spina Bifida)
  • Yolk Sac Tumor
  • HCC / Hepatoma + other liver tumors
  • Ataxia-Telangiectasia

↓SEEN IN:
- Autosomal Trisomies (Down, Edwards, Patau Sx)

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8
Q

Albumin

↓Seen In (5)?

A

↓SEEN IN:

  • Kwashiorkor (↓ protein intake)
  • Cirrhosis / Portal Htn
  • Malabsorption Sx (poo it out)
  • Nephrotic Sx (pee it out)
  • 3rd degree Burn (plasma loss from skin)
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9
Q

Aldosterone

↑Seen In?

A

↑SEEN IN:

- Renal Failure

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10
Q

Alkaline Phosphatase (ALP)

↑Seen In (5)?

A

↑SEEN IN:

  • OsteoBLASTIC mets (hyperactivity of osteoblasts)
  • Hyperparathyroidism (Excess PTH -> Bone RESORPTION)
  • OBSTRUCTIVE Liver disease / Biliary Tract Obstruction or HCC
  • 2ry Biliary Cirrhosis
  • Placental disease
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11
Q

Leukocyte ALP

↑Seen In,↓Seen In?

A

↑SEEN IN:
- Leukemoid Rx (mature cells)

↓SEEN IN:
- CML (immature granulocytes)

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12
Q

Alanine Aminotransferase (ALT)

↑Seen In?

A

↑SEEN IN:
Liver damage
** ALT > AST in Viral Hep **

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13
Q

Aldolase

↑Seen In?

A

↑SEEN IN:

- Duchenne Muscular Dystrophy

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14
Q

Ammonia

↑Seen In (2)?

A

↑SEEN IN: (Hyperammonemia)

  • Hereditary (eg Urea Cycle enzyme def)
  • Acquired (eg Liver dz- cirrhosis, portal htn)
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15
Q

Amylase

↑Seen In (4)?

A

↑SEEN IN:

  • Salivary disease
  • Mumps
  • Acute Pancreatitis
  • Pancreatic Pseudocyst (PERSISTENTLY↑Amylase)
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16
Q

Aspartate Aminotransferase (AST)

↑Seen In (2)?

A 
↑SEEN IN:
- MI (Acute)
- Liver disease
*** AST > ALT in Alcoholic Hep *** (ratio usually > 1.5)
THINK: "Make a toAST with alcohol"
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17
Q

Bradykinin

Action, Stim By, Conseq of ↑(2)?

A

Potent vasodilator.

STIM BY: ACE Inhibitors (inhibit its inactivation).

CONSEQ OF ↑:

  • Cough
  • Angioedema
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18
Q

C-Reactive Protein

Action,↑Seen In?

A

Opsonin (fixes complement + facilitates phag).

↑SEEN IN: Ongoing Infl

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19
Q

Ca #1

↑(Hypercalcemia) Seen In (9: 8 + 1 Drug),
↓(Hypocalcemia) Seen In (9)?

A

↑SEEN IN: Bone RESORPTION. PTH, Vit D.

    • 1ry Hyperparathyroidism (excess PTH)
  • Hypervitaminosis D + Williams Sx (↑sensitivity to Vit D)
  • Hyperthyroidism (due to bone resorption)
  • Diabetes Insipidus
  • Multiple Myeloma + Bone Mets
  • Sarcoidosis
  • Bartter Sx
  • RTA Type 1
  • Hydrochlorothiazide

↓SEEN IN: Calcitonin.

  • 2ry Hyperparathyroidism
  • Hypoparathyroidism (ie comp of prior neck surgery) / Pseudohypoparathyroidism / Parathyroid Aplasia (ie 22q11 Sx)
  • Vit D def
  • Low Albumin (↓in TOTAL Ca)
  • HYPOMg (Mg needed for PTH release +↓Mg causes more Ca loss in urine)
  • Thyroid Medullary Carcinoma (excess Calcitonin)
  • Acute Pancreatitis (Ca consumed during saponification in fat necrosis)
  • Osteopetrosis
  • Osteomalacia / Rickets
  • DiGeorge Sx (Thymic aplasia ->↓PTH)
  • Renal Failure in
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20
Q

Ca #2- Disturbance PRES

Low serum conc -> (6, incl 1 CV)?
High serum conc -> (5 Categories)?
* “Stones, Bones, Groans, Psych Overtones” *

A
  • THINK: neural hyperexcitability + twitching*
  • Facial N hyperexcitability (Chvostek sign)
  • Irritability, Seizures
  • Numbness (ie perioral) + Tingling
  • Tetany (Trousseau sign)
  • Carpopedal spasm
  • QT PROLONGATION (can -> arrhythmia)

THINK: slow + lethargic
- Neuro: Lethargy + stupor + confusion
- CV: QT SHORTENING + Htn
- Renal: Nephrolithiasis, Nephrogenic DI, Renal insuf
- Ab: Ab pain + Constipation + Anorexia + Nausea/Vomiting
+ Peptic Ulcers (Ca stim Gastrin)
- Osteo: Bone pain + Osteoporosis

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21
Q

CK-MB

↑Seen In (2)?

A

↑SEEN IN:

  • MI (Rises after 4-6 hrs, peaks at 24 hrs, elevated for 48 hrs)
    - EARLY (2-8 hrs)
    - Reinfarction
  • Skeletal Muscle injury (SEVERE)
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22
Q

Ceruloplasmin

↓Seen In?

A

↓SEEN IN:

- Wilson’s Dz

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23
Q

Cholesterol

Hypo- Causes, Hyper- Causes (4)?

A

HYPO CAUSES:
- Hyperthyroidism

HYPER CAUSES:

  • Biliary Tract Obstruction (with xanthomas)
  • 2ry Biliary Cirrhosis
  • I-hyperchylomicronemia
  • Familial Hypercholesterolemia:
    - Heterozygotes: ~300 mg/dL
    - Homozygotes (very rare): >700 mg/dL
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24
Q

Cl

Hypochlorhydria Causes / Seen In?

A

HYPO CAUSES:
- Low Gastric acid: VIPoma
- Inhib of Gastrin ->↓production of Gastric acid:
Somatostatinoma

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25
Clotting Factors ↓Seen In?
↓SEEN IN: | - Cirrhosis / Portal Htn
26
Cyclooxygenase (COX) Action, Inhib By (3)?
Arachidonic acid -> Endoperoxides. INHIB BY: - Aspirin (IRREVERSIBLE inhib by acetylation) - Acetaminophen (REVERSIBLE inhib): mostly in CNS, inactivated peripherally - NSAIDS (REVERSIBLE inhib)
27
COX-2 Locations (2), Action, Inhib By?
- Vascular endothelium - Infl Cells Mediates infl + pain. INHIB BY: COX-2 Inhibitors (Celecoxib)
28
Copper (Cu) Roles,↓Seen In?
ROLES: - Cofactor for Lysyl Oxidase ↓SEEN IN: - Menkes Dz (connective tis dz)
29
Creatine Phosphokinase (CPK) ↑Seen In?
↑SEEN IN: | - Duchenne Muscular Dystrophy
30
Elastase-1 Inhib By,↑Seen In (2)?
INHIB BY: a1-antitrypsin ↑SEEN IN: - Emphysema (a1-antitrypsin def -> excess activity) - Acute Pancreatitis
31
Estriol ↓Seen In (2)?
↓SEEN IN: - Down Sx - Edwards Sx
32
Glucose ``` Normal Value, Hyperglycemia Causes (3 + 1 Drug), Hypoglycemia Causes (3)? ```
NORMAL = 70-120 mg/dL. HYPER CAUSES: - Diabetes Mellitus / Diabetic Ketoacidosis - Hyperthyroidism (due to↑gluconeogenesis + glycogenolysis) - Vitamin B3 (Niacin) Excess - Hydrochlorothiazide HYPO CAUSES: - Reye's Sx - Hepatoma / HCC and other liver tumors - Carnitine def (F.A Metab dz) -> ("hypoketoic hypoglycemia")
33
Estrogen ↑Seen In?
↑SEEN IN: | - Cirrhosis / Portal Htn
34
Fibrillin Def'n / Role, Seen In?
Glycoprotein that forms sheath around Elastin. SEEN IN: - Marfan Sx (Fibrillin defect)
35
Inhibin-A ↑Seen In,↓Seen In?
↑SEEN IN: - Down Sx ↓SEEN IN: - Edwards Sx (↓or normal)
36
Hepcidin Action, Seen In?
Prevents release of Fe bound by Ferritin -> Anemia. SEEN IN: - Anemia of Chronic Dz
37
HCG ↑Seen In (3),↓Seen In (2)?
↑SEEN IN: - Down Sx - Hydatidiform Mole - Choriocarcinoma ↓SEEN IN: - Edwards Sx - Patau Sx
38
Lactate ↑Seen In?
↑SEEN IN: | - Von Gierke Dz
39
Lactate Dehydrogenase (LDH) - > Simple↑LDH (2)? - > LD1 > LD2 (3)? - > High LD1 + LD5 (2, COMP for each)? - > High LD4 + LD5 (2)?
- TTP - Ovarian Dysgerminoma - MI (Acute, EARLY) - Hemolysis - Renal infarction - Acute MI comp by Liver Congestion - Megaloblastic Anemia comp by Alcoholic Liver Disease - Liver damage - Skeletal Muscle damage * THINK: LD1↑in liver Dz, LD4↑in liver DAMAGE, LD5↑in BOTH DZ + DAMAGE.
40
LDL ↑Seen In?
↑SEEN IN: | - Familial Hypercholesterolemia
41
Leukotriene B4 (LTB4) Action?
Neutrophilic chemotactic agent.
42
Leukotriene (LT) C4, D4 + E4 Actions (3), Inhib By?
- Vasoconstriction - Smooth muscle contraction /↑muscle tone (ie -> Bronchoconstriction) -↑vascular permeability INHIB BY: -lukast
43
Lipase
↑SEEN IN: - Acute Pancreatitis * Lipase more specific for pancreatic DAMAGE *
44
Lipids ↑(Hyperlipidemia) Seen In?
↑SEEN IN: | - Hydrochlorothiazide
45
Lipofuscin Def'n, Mech of Formation?
Yellow-brown "wear and tear" pigment assoc w normal aging. FORMATION: Auto-phagocytosed organelle memb -> Oxidation + Polymerization
46
Mg- Disturbance PRES Low serum conc -> (2)? High serum conc -> (6)?
- Tetany - Torsades de Pointes - ↓DTRs - Hypotension - Bradycardia - Lethargy - Hypocalcemia
47
Myoglobin
MI (EARLY) *** Nonspecific ***
48
Nitric Oxide Effects?
EFFECTS: VASODILATOR | - Hypotension
49
Plasma Proteins ↑Seen In?
↑SEEN IN: | - Inflammation (Acute or Chronic)
50
PGA2 (Thromboxane) Actions (3)? *THINK: Opposite in every way to other 'members' of Endoperoxide family.*
- ↑vascular tone - ↑bronchial tone - ↑platelet aggregation
51
Prostaglandin E1 (PGE1) Actions (3), Release Stim by, Inhib by?
- Keeps PDA open - Dilates Afferent Arteriole - Produces stomach mucus Release Stim By: Loop Diuretics INHIB BY: NSAIDs
52
Prostacyclin (PGI2) Actions (4)?
- ↓vascular tone - ↓bronchial tone - ↓uterine tone -↓platelet aggregation
53
PGE2 + PGF2A Actions (3)?
- Vasodilation - Bronchodilation - Uterine contraction / ↑uterine tone (-> labor induction)
54
Phenylalanine ↑Seen In?
↑SEEN IN: | - Phenylketonuria (PKU)
55
Phosphate ↑Seen In (3),↓Seen In (2)?
↑SEEN IN: - 2ry Hyperparathyroidism - Hypervitaminosis D - Renal Failure ↓SEEN IN: *↑PTH* - 1ry Hyperparathyroidism (↑PTH) - Disorders of fructose / galactose metab
56
Phosphate #2- Disturbance PRES Low serum conc -> (2)? High serum conc -> (3)?
- Bone loss - Osteomalacia - Renal Stones - Metastatic calcifications - Hypocalcemia
57
Potassium (K) #1 ↑Seen In (8),↓Seen In (7)?
↑SEEN IN: - RTA Type 4 + Renal Failure - Lysis of cell - Acidosis - Hyperosmolarity - Insulin deficiency - b-adrenergic ANTAGONIST - Digitalis - Addison's Dz (↓Aldosterone) - DKA (*however↓INTRACEL K due to↓Insulin*) ↓SEEN IN: - RTA Type 1 (NO K reabs), Bartter + Gitelman Sx (↓K reabs), Liddle Sx (↑Na reabs) - Alkalosis - Hypoosmolarity - Insulin (↑Na/K ATPase activity) *THINK: Insulin moves K INTO cells* - b-adrenergic AGONIST (↑Na/K ATPase activity) - Diuretics (except for K-sparing diuretics) - Cushing's Sx (↑Aldosterone) - VIPoma
58
Potassium (K) #2- Disturbance PRES General -> (2)? Low serum conc -> (2 changes on EKG) + 1? High serum conc -> (2 changes on EKG)?
- Arrhythmias (mess with QT interval) - Muscle weakness - U waves - FLATTENED T waves - Inhib of ADH's effect on kidney - Wide QRS - PEAKED T waves
59
Prostatic Acid Phosphatase (PAP) ↑Seen In?
↑SEEN IN: | - Prostatic Adenoma
60
Prostate-Specific Antigen (PSA) ↑Seen In (2:↑in FREE PSA vs↑in TOTAL PSA)?
↑SEEN IN: -↑in FREE PSA in BPH (due to↑# of glands) -↑in TOTAL PSA (however↓in FREE PSA) in Prostatic Adenocarcinoma (cancer makes bound PSA) * PSA > 10 worrisome at any age *
61
Sodium (Na) #1 ↑Seen In,↓Seen In (6)?
↑SEEN IN: - Cushing's Sx (↑Aldosterone) ↓SEEN IN: - Addison's Dz (↓Aldosterone) - SIADH - Cystic Fibrosis - Hypothyroidism - Glucocorticoid underproduction - Legionella Pneumonia
62
Sodium (Na) #2- Disturbance PRES General (ie both) -> (3)? Low serum conc -> (2)? High serum conc -> (1)?
- *more likely DEPOL* (LOW b/c Ca comes in ; HIGH b/c↑Na) - Stupor - Coma - Malaise - Nausea - Irritability
63
TNF-a Def'n, Produced By, Induced By (3), Effects (2)?
Cytokine that stims ACUTE PHASE rx of infl = Endogenous Pyrogen. Produced by Macrophages (mainly). IND: (TNF in general) - Endotoxins - Lipid A (in outer memb of Gram - bacteria) - Lipoteichoic acid (in cell memb/cell wall of Gram + bacteria) EFFECTS: - Fever - Hypotension
64
Triglycerides ↑Seen In?
↑SEEN IN: (Dyslipidemia) | - Renal Failure
65
Troponin I ↑Seen In?
↑SEEN IN: - MI (Rises after 4 hrs, peaks at 24 hrs, elevated for 7-10 days) * Most specific + sensitive = Gold Standard*
66
Uric Acid ↑(Hyperuricemia) Seen In (6: 3 and 3)?
Due to OVERPRODUCTION of uric acid: - Vitamin B3 (Niacin) Excess - Gout - Lesch-Nyhan Sx Due to UNDEREXCRETION of uric acid: - Von Gierke Disease - Tumor Lysis Sx /↑cell turnover - Loop Thiazide Diuretics
67
γ-Glutamyl Transpeptidase (GGT) ↑Seen In (2)?
↑SEEN IN: - Various Liver + Biliary diseases - Heavy Alcohol consumption
68
VLDL ↑Seen In?
↑SEEN IN: | - Hypertriglyceridemia

Findings (19 decks)

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