Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Diagnostic M.'s Sara Peer mentor > Clinical Chemistry > Flashcards

Clinical Chemistry Flashcards

(129 cards)

Start Studying
1
Q

What should you use to palpate the area to feel for a vein when performing a venipuncture?

A

Tip of index finger on non-dominant hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is serum?

A

A plasma specimen that clotting factors are added to and anything that doesn’t clot is serum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is in the plasma of blood?

A

92% Water
7% Proteins = albumin, globulins, fibrinogen, regulatory proteins
1% Other Solutes = electrolytes, nutrients, respiratory gases, and waste products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What can cause a high value for potassium?

A

Hemolysis of blood sample

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How are individual electrolyte ions measured?

A

With ion selective electrodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where in the blood can electrolytes be found?

A

Serum or plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are ion selective electrodes?

A

A transducer that converts the activity of a specific ion dissolved in solution into an electrical potential which can be measured by voltemeter

It contains a thin membrane across which only the intended ion can be transported

The transport of ions from high concentrations to low concentrations through selective binding sites within the membrane creates a potential difference resulting in an electrical potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the control for ion selective electrodes?

A

External reference electrode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the solution for ion selective electrodes?

A

serum or plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is spectrophotometry?

A

Measures change in light absorbance at certain wave lengths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is an Enzyme Linked Immunoabsorbent Assay (ELISA)?

A

Detects serum antibody or antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a critical value?

A

any test result that may required rapid clinical attention to avert significant patient morbidity or mortality

Lab will notify provider immediately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a Comprehensive Metabolic Panel (CMP)?

A

Basic Metabolic Panel (BMP) + Calcium + Liver Function Studies (LFTs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is in a Basic Metabolic Panel?

A 
Serum Sodium
Serum Potassium
Chloride
CO2 - blood gas
Blood Urea Nitrogen (BUN)
Creatinine
Glucose - blood sugar
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are other names for a basic metabolic panel?

A

CHEM-7

SMA7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does Serum Sodium reflect?

A

Changes in water balance rather than sodium balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the functions of serum sodium?

A

Maintain osmotic pressure of extracellular fluid
Acid-base Balance
Neuromuscular Function
Absorption of glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the causes of Hyponatremia?

A

Hypervolemic hyponatremia (Na is diluted) = CHF

Hypovolemic hyponatremia = dehydration (overall volume depletion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the causes of Hypernatremia?

A

Hypervolemic hypernatremia = CHF

Hypovolemic Hypernatremia (Na is concentrated) = Dehydration (free water deficit)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the first symptom of Hyponatremia?

A

weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the symptoms when Na levels RAPIDLY DROP from 140 to 130 mEg/L?

A 
Thirst
Impaired Taste
Anorexia
Dyspnea on exertion
Fatigue
Dulled sensorium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the symptoms when Na levels drop from 130 to 120 mEq/L?

A

Severe GI symptoms
vomiting
Abdominal cramps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the symptoms when Na levels drop below 115 mEq/L?

A 
Confusion
Lethargy
Muscle twitching
Convulsions
Coma
Stupor (brain stem herniation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What occurs when Na levels are between 110-115 mEq/L?

A

Likely to cause severe and sometimes irreversible neurologic damage like cerebral edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How do you treat hyponatremia?
Treat the underlying cause! If patient is dehydrated = hydrate them If patient is fluid overloaded = diurese
26
What is IV normal saline (IVNS)?
0.9% NaCl Called "Isotonic saline" but is actually inc. Na conc. and volume expanding Treats dehydration
27
What is IV1/2NS?
0.45% NaCl Closer to isotonic Maintenance fluid
28
What is Lactated Ringers (LR)?
Contains NaCl, sodium lactate, KCl, CaCl in water Used in trauma and surgery
29
What is hypertonic saline?
3% NaCl Used for sudden precipitous drops in sodium like in a marathon runner
30
What are the symptoms of Hypernatremia?
``` Dry mucous membranes Thirst Agitation Restlessness Hyperreflexia Mania Convulsions ```
31
What is the treatment for Hypernatremia?
Administer "free water" in the form of dextrose 5% in water Cannot administer free water because it will cause hemolysis, so you must include dextrose
32
What are the dangers of correcting sodium too rapidly?
1) Central pontine myelinolysis = confusion, encephalopathy, lethargy, weakness, and paralysis 2) Cerebral edema 3) Brain stem herniation Last two are associated with Hyponatremia only
33
What is Central pontine myelinolysis?
Destruction of myelin covering nerve cells in the brainstem
34
What are the normal levels of sodium?
135-145 mEq/L
35
What are the normal levels of K?
3.5 - 5.0 mEq/L
36
What are the functions of serum potassium?
Maintain intracellular osmolality Acid base balance Transmission of nerve impulses Essential to skeletal, cardiac, and smooth muscle function
37
What mechanisms regulate potassium?
Insulin | Kidneys
38
How does insulin regulate potassium?
Ingested potassium rapidly enters portal circulation and stimulates the pancreas to release insulin Elevated insulin stimulates cells to allow glucose to enter and potassium follows into the cells
39
How do the kidneys regulate potassium?
Excess potassium is excreted by the kidneys and eliminated in the urine
40
What causes Hypokalemia?
Inadequate intake Excessive losses = GI, renal, or skin burns Redistribution into cells
41
What causes hyperkalemia?
Decreased renal elimination***MOST COMMON*** Excessively rapid administration Movement of potassium from inside the cell to outside the cell like when there is trauma
42
What are the signs and symptoms of Hypokalemia?
``` Weakness Muscle Cramps Paralysis EKG changes Cardiac arrhythmias = Afib Paralytic ileus ```
43
What are the signs and symptoms of Hyperkalemia?
``` Weakness Muscle Cramps Paresthesias EKG changes Cardiac arrhythmias Intestinal cramping ```
44
What is the normal level of Chloride in the blood?
98-106 mEq/L
45
What is the function of chloride?
Maintains electrical neutrality by binding to positively charged ions
46
What is Chloride an indicator of?
Hydration status
47
What are the normal levels of Carbon dioxide in the blood?
23-30 mEq/L
48
What is most CO2 in the form of in the serum?
Bicarbonate
49
What does CO2 indicate?
pH status
50
What is the anion gap?
The difference between the primary measured cations and the primary measured anions in serum (Na+ + K+) - (Cl- + HCO3-)
51
What is a normal anion gap level?
8-16 mEq/L
52
What are the serum cations?
Serum Sodium | Serum Potassium
53
What are the serum anions?
Chloride | Bicarbonate
54
What is BUN directly related to?
Excretory function of the kidney
55
What can make the BUN levels increase?
Changes in protein levels Excessive upper GI bleeding
56
What do BUN and Creatinine levels primarily measure?
Kidney function
57
What are normal levels of BUN?
10-20 mg/dL
58
What is azotemia?
Elevated BUN levels
59
What is prerenal azotemia?
Elevated BUN as result of kidney dysfunction form hypoperfusion
60
What is postrenal azotemia?
Elevated BUN levels as a result of post renal obstruction
61
What are normal creatinine levels?
0.6-1.2 mg/dL
62
What is creatinine used to indicated?
Approximates renal function GFR
63
What is a BUN:Creatinine ratio of > 20:1 suggestive of?
Dehydration
64
What are normal fasting glucose levels?
70-110 mg/dL
65
What are normal random glucose levels?
< 200 mg/dL
66
What are critical values of glucose levels?
<50 or >450 mg/dL
67
What are glucose levels controlled by?
Insulin and glucagon
68
What is the function of insulin?
Drives glucose into target cells to be metabolized into glycogen
69
What are causes of Hypoglycemia?
Starvation Insulinoma Hypopituitarism/Hypothyroidism
70
What are the causes of Hyperglycemia?
Insulin resistance Diabetes Acute stress response like with infections, burns, or surgery
71
How is calcium distributed in the blood?
15% bound to organic and inorganic anions 40% bound to albumin 45% physiologically active ionized (free) Calcium
72
What must you do to the levels of Ca provide by the lab?
Need to correct the calcium value Corrected Ca = measured total [Ca] + (0.8 x (4.0 - [albumin]))
73
What causes Hypocalcemia?
Impaired ability to mobilize calcium from bone = hypoparathyroidis Decrease intake or absorption = Vit. D deficiency Abnormal renal losses = hyperphosphatemia
74
What causes Hypercalcemia?
Excessive intake = Vit. D toxicity Increased bone resorption = hyperparathyroidism Decreased elimination
75
What are the signs and symptoms of Hypocalcemia?
``` Paresthesias Skeletal muscle cramps Tetany (muscle spasms) Hyperreflexia Cardiac arrhythmias (prolonged Qt interval) Bone fractures ```
76
What are the signs and symptoms of Hypercalcemia?
``` Kidney stones Anorexia, vomiting, nausea Muscle weakness/atrophy Lethargy/coma EKG changes (shoreted Qt interval) Hypertension ```
77
What are the liver function tests?
``` Albumin Total protein Alkaline phosphatase (ALP) Alanine aminotransferase (ALT) Aspartate aminotransferase (AST) Total bilirubin Direct bilirubin Indirect bilirubin ```
78
What are the normal values of total protein?
60-80 g/L
79
What are the normal values of total bilirubin?
< 20 micromol/L
80
What are the normal values of total bilirubin?
5-40 IU/L
81
What are the normal ALT levels?
5-40 IU/L
82
What are the normal ALP levels?
30-130 IU/L
83
What are the normal albumin levels?
35-50 g/L
84
How is bilirubin formed?
Breakdown of hemoglobin and then conjugated in liver
85
What is total bilirubin a count of?
Indirect bilirubin = unconjugated | Direct bilirubin = conjugated
86
What does indirect bilirubin indicate?
hemolysis
87
What does direct bilirubin indicate?
liver and biliary conditions
88
What does an AST to ALT ration of > 2:1 suggest?
Alcoholic liver disease
89
What are the normal values of Amylase?
25-125 U/L
90
What are the normal levels of lipase?
10-140 U/L
91
What tests can be used to indicate acute pancreatitis if increased?
Serum Amylase Serum Lipase Amylase/Creatinine Clearance
92
What tests can be used to indicate chronic pancreatitis if levels are normal, increased, or decreased?
Serum amylase Serum lipase Amylase/creatinine clearance
93
What was the old way of diagnosing pancreatitis?
If amylase was > 3X the upper limit of normal
94
What do we currently use to diagnose pancreatitis and why?
Lipase levels because amylase levels will ris eand fall over a shorter period of time so it was more likely to miss amylase elevation than lipase elevation Also lipase has a relatively greater pancreas specficity than amylase
95
What are the normal lactic acid levels?
0.5 - 1 mmol/L in healthy individuals
96
What is the expected normal of lactic acid levels in those with critical illness?
< 2 mmol/L
97
What levels of lactic acid are associated with metabolic acidosis?
> 5 mmol/L
98
What does lactic acid quantify?
Degree of tissue hypoxia
99
When are lactic acid levels increased?
Shock Vascular occlusion Ischemic bowel Elevated in anaerobic metabolism
100
What do troponin I and T indicate?
Relatively specific and sensitive biomarkers of cardiac injury Preferred serologic test for evaluation of ACS
101
What is total creatine kinase?
Total of all CK isoenzymes
102
Where is CK-BB (CK1) found?
Brain and Lung
103
Where is CK-MB (CK2) found?
Myocardial cells | Small amount in skeletal muscle
104
Where is CK-MM (CK3) found?
Skeletal muscle
105
What does a total CK:CK-MB ratio > 1.5 indicate?
potential cardiac injury
106
What are troponin assays?
Sensitive used in the US Highly sensitive used in Europe, Canada, Australia, and New Zealand
107
What are the pros to high sensitivity troponin assays?
Detects MI earlier
108
What are the cons of high sensitivity troponin assays?
Also detects troponin elevation in chronic disease There's no clear threshold Risk of unnecessary procedures
109
What is the elevation period of CK-MB?
Starts to rise = after 3-6 hours Peaks = 12-24 hours Returns to normal = 24-48 hours
110
What is the elevation period of Troponin T?
Starts to rise = after 2-6 hours Peaks = 10-24 hours Returns to normal = 10 days
111
What is the elevation period of Troponin I?
Starts to rise = after 2-6 hours Peaks = 10-24 hours Returns to normal = 4 days
112
What is arterial blood gas a measurement of?
Patient's respiratory and metabolic state Allows us to evaluate gas exchange in the lungs
113
What are the two key things that arterial blood gas gives us?
Acid-base balance Oxygen status
114
What must you perform prior to performing an arterial blood draw?
Allen's test to ensure collateral circulation
115
What are the contraindications for performing an arterial blood gas?
``` No pulse Cellulitis or compromised skin No ulnar artery AV fistula Coagulaopathy ```
116
Where can arterial blood be obtained from?
Anywhere there is a strong pulse
117
What should you do after performing an arterial blood gas draw?
Apply pressure to site for 3-5 minutes or longer if they have a bleeding disorder or are on an anti-coag Place sample on ice and rush to chemistry lab
118
What will be included in the arterial blood gas report?
pH PCO2 HCO3-
119
What is the normal pH of the blood?
7.35-7.45
120
What is the normal pCO2?
35-45
121
What is the normal HCO3-?
22-26
122
What is metabolic acidosis?
Base ions are lost
123
What is Respiratory acidosis?
reduced ventiliation causing an increase in pCO2
124
What is Metabolic alkalosis?
Acid hydrogen ions are lost; HCO3- ions are relatively high
125
What is Respiratory alkalosis/
CO2 is blown off
126
What causes metabolic acidosis?
Ketoacidosis Lactic acidosis Diarrhea Renal Failure
127
What causes Respiratory Acidosis?
Trauma COPD Oversedation
128
What causes Metabolic alkalosis?
Hypokalemia Hypochloremia High volume gastric suction
129
What causes Respiratory alkalosis?
Hypoxemia CHF CO poisoning Pulmonary embolism

Diagnostic M.'s Sara Peer mentor (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions