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Diagnostic Medicine > BMP/CMP > Flashcards

BMP/CMP Flashcards

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1
Q

BMP components

A

3 substances;
glucose
BUN
creatinine
5 electrolytes
sodium
potassium
bicarb
chloride
calcium

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2
Q

What’s a normal glucose level

A

75-105

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3
Q

What can elevated glucose cause?

A

blurred vision, headaches, polyuria/polydipsia/polyphagia, coma, death

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4
Q

What can decreased glucose cause?

A

AMS, dizzy, seizures
draw labs below site where IV dextrose running

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5
Q

BUN measures what

A

amount of urea nitrogen in the blood

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6
Q

What is a critical BUN measure?

A

> 80 = severe renal impairment

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7
Q

When is BUN increased?

A

dehydration, GI bleed, crush, renal failure, ureteral/urethral obstruction, starvation, burns, shock, high protein diet, meds (allopurinol, AGs, cephs, propanolol, lasix, aspirin)

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8
Q

When is BUN decreased?

A

overhydration, liver failure, pregnancy, nephrotic syndrome

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9
Q

What is a normal BUN range?

A

9-23

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10
Q

What’s normal BUN for adults

A

10-20

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11
Q

What’s normal for children and infants BUN?

A

5-18

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12
Q

What’s a normal newborn BUN?

A

3-12

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13
Q

Creatinine is a marker for

A

impaired renal function

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14
Q

What’s a normal range of creatinine for males

A

.7-1.3

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15
Q

What’s a normal range of creatinine for females

A

.5-1.1

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16
Q

creatinine: <2y

A

.1-.4

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17
Q

creatinine: 2-<6y

A

.2-.5

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18
Q

creatinine: 6-<10y

A

.3-.6

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19
Q

creatinine: 10y - <18y

A

.4-1

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20
Q

creatinine: 18y-<41y

A

female .5-1,, male .6-1.2

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21
Q

creatinine: 41y-<61y

A

female .5-1.1, male .6-1.3

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22
Q

creatinine: >61

A

female .5-1.2, male .7-1.3

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23
Q

What can elevated creatinine be caused by

A

glomerulonephritis, pyelonephritis, rhabdomyolysis, urinary obstruction, dehydration

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24
Q

What can decreased creatinine be caused by

A

low muscle mass (muscular dystrophy, myasthenia gravis)

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25
ideal BUN:creatinine ratio
10:1 and 20:1
26
doubling of creatinine =
50% reduction in GFR
27
Normal sodium range
132-146
28
Hypernatremia =
TBI
29
Hyponatremia =
CHF, meds (thiazides), psychogenic polydipsia, SIADH
30
What's a critical sodium range?
<120
31
What's a normal potassium range?
3.5-5.5
32
What can hypokalemia cause?
arrhythmias, muscle pain, hyporeflexia, N/V, orthostatic HOTN
33
What are critical potassium values?
<2.5 or >6.5
34
Most common cause of hyperkalemia
renal failure
35
What meds can cause hyperkalemia
ACEI, ARBS
36
What's a normal bicarb range?
22-29
37
Decreased bicarb
metabolic acidosis, respiratory alkalosis
38
Increased bicarb
metabolic alkalosis, respiratory acidosis
39
normal chloride
99-109
40
decreased chloride =
impending renal dysfunction, diuretics
41
Elevated chloride =
excess diuresis
42
If sodium is high, ___ is high
chloride
43
every 100 rise in glucose
1.4 drop in sodium
44
What are critical chloride values?
<75 and >126
45
What's a normal calcium range?
8.6-10
46
What's a critical calcium level?
>12
47
decreased calcium =
renal insufficiency, hypomagnesemia, decreased parathyroid hormone, massive blood transfusion
48
increased calcium =
hyperparathyroidism, thyroid tumor, high intake supplements
49
Normal GFR
90-120 <60 = renal impairment
50
Normal magnesium
1.3-2.1 elevated - renal defect, severe dehydration, supplement, aspiration of sea water decreased - GI distress, V/D, cirrhosis, pancreatitis
51
Normal phosphate
2.3-4.7 elevated - hypoparathyroidism and renal failure decreased - nutritional disorders + hyperparathyroidism
52
BMP includes:
total protein, bilirubin, albumin liver enzymes - alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate aminotransferase (AST)
53
What's a normal total protein?
6-8 composed of albumin + immunoglobulins fluctuates w/ albumin
54
What's a normal albumin?
3.5-5 decreased = increased protein catabolism, production, edema, hypoalbuminemia increased = dehydration
55
Normal bilirubin
.2-1 elevated = liver disease, biliary tract obstruction, RBC hemolysis
56
critical bilirubin level
>12 adults, <15 newborn
57
normal direct bilirubin
.1-.3
58
normal indirect bilirubin
.2-.8 (most)
59
When should you test bilirubin
liver function, hemolytic anemia, newborn jaundice
60
Jaundice results when bilirubin is
>2.5 >15 needs immediate treatment
61
Increased direct bilirubin --
gallstones extrahepatic duct obstruction extensive liver mets dubin-johnson syndrome rotor syndrome
62
increased indirect bilirubin--
erythroblastosis fetalis transfusion reaction sickle cell anemia hemolytic anemia/jaundice, pernicious anemia hepatitis, cirrhosis, sepsis
63
normal alkaline phosphatase
30-120
64
When do you check alkaline phosphatase?
liver diseases or bone diseases 1 = liver 2= bone ** most sensitive test to detect mets to liver **
65
ALP is elevated with
cirrhosis biliary obstruction mets to bone healing fracture osteomalacia paget disease RA sarcoidosis
66
ALP is decreased with
malnutrition pernicious anemia scurvy hypophosphatemia
67
Normal aspartate aminotransferase
10-30 0-5d = 35-140 <3y = 15-60 6-12y = 10-50 12-18y=10-40 adults = 7-40 evaluating hepatocellular disease
68
AST is elevated 8 hours after
injury peak = 24-36 hours returning 3-7 days
69
When is AST elevated?
liver damage, alcoholic cirrhosis, hepatitis, cancer, mono, seizures, heat stroke, severe burns acute hepatitis 20x acute extrahepatic obstruction 10x
70
When is AST decreased?
acute renal disease, beriberi, DKA, chronic renal dialysis, pregnancy
71
What's a normal alanine transaminase?
10-40 for hepatobiliary disease, predom. in liver
72
When is ALT elevated?
hemolytic anemia (definitive lab), liver damage, alcoholic cirrhosis, hepatitis, cancer, pancreatitis, mono, shock
73
AST: ALT ratio >1 <1
>1 - alcoholic cirrhosis (esp >3:1), liver congestion, tumor <1 = acute hepatitis, viral, mono
74
normal lactate
.5-1.5 elevated - >2, perfusion + oxygenation is not adequate decreased - slow to respond
75
normal lactate dehydrogenase
100-200
76
used for assessing tissue damage and cancer severity
LDH
77
carboxyhemoglobin (COHb)
higher in smokers, normal 2% apply oxygen
78
normal amylase
27-131 decreased in CF
79
normal lipase
31-186 elevated in bile duct obstruction, biliary disease
80
normal d-dimer
<500 elevated in inflammation, PE, injury, infection, cancer
81
normal anion gap
8-16 increased = presence of unmeasured anions

Diagnostic Medicine (8 decks)

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