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Flashcards in Clinical Biochem Deck (39)
1

major ECF cation

sodium

2

hyponatremia

low sodium (water retention)

3

hypernatremia

high sodium (most likely dehydration)

4

major ICF cation

potassium

5

hypokalemia

low potassium

6

hyperkalemia

high potassium (renal insufficiency)
- may trigger cardiac arrest with no warning
- affects muscle function

7

buffer system controlled by lungs and kidneys

bicarbonate- CO2
- acid/base balance
- monitored for diabetic ketoacidosis, glucose, pH, and electrolyte concentration

8

- mostly in bones
- also a 2nd messenger
- affects muscular and neuronal function

calcium

9

hypercalcemia

high calcium
- problems or degradation of bones

10

hypocalcemia

low calcium
- hormonal disturbances

11

stored in bones

phosphate

12

hyperphosphatemia

high phosphate
indicative of degenerative bone disease

13

hypophosphatemia

low phosphate
- can impair glucose metabolism
- possible renal failure

14

If kidney function is impaired, what will the serum and urine levels of urea/creatinine?

serum - high
urine - low

15

When is BUN high a potential problem?

When protein intake and catabolism are normal and BUN is high

16

- insensitive marker
- measure of kidney function
- it is released at a constant rate

creatinine

17

end product of purine degradation

uric acid

18

high uric acid value is indicative of what?

sign of kidney problems and predispose to gout

19

conjugated to glucuronic acids and water soluble

direct bilirubin

20

unconjugated to glucuronic acid
not water-soluble

indirect bilirubin

21

When will you find proteins in urine?

proteins in urine is not normal
- it's indicative of decreased kidney function

22

- made by liver
- binds to hydrophobic molecules
- binds calcium
- maintains oncotic pressure

Albumin

23

low albumin
manifest as edema
- water is drawn out of serum and into tissues
- common cause is liver disease

hypoalbuminemia

24

If globulin is found in the serum, what is it indicative of?

impaired immune system function

25

- secreted by liver
- marker for acute metabolic response to injury

c-reactive protein
- should rise 6 hours after injury, peaking at 48 hours and decay slowly
*sudden in rise in CRP indicate complications in healing process

26

Which heart muscle enzyme is most sensitive marker for MI and can be detected very early?

troponins

27

heart muscle enzyme myoglobin

first to release after MI
not heart muscle specific
just indicate there's muscle damage

28

What's the order in which heart muscle enzymes appear after MI?

soonest to latest:
myoglobin, troponins, creatine kinase, AST, LDH

29

alkaline phosphatase

indicative of bone and liver disease

30

how to differentiate between bone and liver disease if alkaline phosphatease is found?

Liver disease will accompany with high levels of bilirubin
Bone disease will not have high bilirubin

31

When suspecting liver damage, what test should be used to confirm?

bilirubin concentration

32

glucose in urine

hyperglycemia

33

bilirubin in urine

obstruction of bile duct

34

ketones in urine

uncontrolled diabetes or starvation

35

proteins in urine

glomerular disease but need rule our that it's not blood or leukocytes

36

What does a basic metabolic panel test for?

kidney function
blood suar
acid/base balance
electrolyte balance

37

What does a hepatic function panel test for?

Bilirubin
ALT and AST
Alkaline phosphatase

38

What type of test is this?
- serum urea (BUN)
- serum creatine
- serum Na+, K+, CO3-
- excretion of Na+ and K+ in urine
- urine osmolality

Kidney function test

39

What tests are used for management of diabetes?

HbA1c - glycation of glucose
- reflects glycemia control of past few months
Proteinuria - onset of diabetic nephropathy
C-peptide - indication of endogenous production of insulin