Exam #1: CMP

Question 1

What are the four primary causes of hyperglycemia?

Answer 1

• DM
• IV dextrose infusion
• Drugs (i.e. steroids)
• Stress

Question 2

What is the primary cause of hypoglycemia?

Answer 2

Insulin overdose

Question 3

What are the three primary causes of HIGH BUN?

Answer 3

• Primary renal diseases
• Dehydration
• Upper GI bleed

Question 4

What are the three primary causes of LOW BUN?

Answer 4

• Severe primary liver diseases
• Overhydration
• Low protein diets

Question 5

What does Creatinine have an inverse relationship with?

Answer 5

GFR

Question 6

What is the primary renal function measurement?

Answer 6

Creatinine (Cr)

Question 7

What is the most common cause of HIGH Cr?

Answer 7

AKI

Question 8

What is BUN/Cr Ratio helpful in determining?

Answer 8

Cause of AKI

Question 9

What lab test is an indirect measurement of bicarbonate (HCO3-)?

Answer 9

Carbon Dioxide (CO2)

Question 10

What is high Total Protein with high Globulin indicative of?

Answer 10

Multiple Myeloma

- “M spike” on SPEP, Bence-Jones proteins

Question 11

What are “M spike” on SPEP, Bence-Jones proteins associated with?

Answer 11

Multiple Myeloma

Question 12

What is the primary cause of HIGH Albumin?

Answer 12

Dehydration

Question 13

What are the three primary causes of LOW Albumin?

Answer 13

• Liver disease
• Protein-losing enteropathies
• Nephrotic Syndrome = edema

Question 14

What test reflects the synthetic function of the liver?

What other two tests can also can also reflect synthetic function of the liver?

Answer 14

Albumin

- Also PT/INR and platelet count

Question 15

What is a HIGH ALP indicative of?

Answer 15

Biliary obstruction

Question 16

What is an ISOLATED high ALP (no other abnormal liver tests) indicative of?

Answer 16

BONE pathology

- Physiologic growth in children/adolescents

Question 17

What test can be used to differentiate between liver and bone pathology?

Answer 17

ALP Isoenzymes

Question 18

Which lab test has an inverse relationship with Phosphorus (PO4)?

Answer 18

Calcium (Ca2+)

Question 19

Which lab test has an inverse relationship with Calcium (Ca2+)?

Answer 19

Phosphorus (PO4)

Question 20

Which form of Calcium (Ca2+) is the most accurate measurement of serum calcium?

Answer 20

Ionized (50%)

Question 21

Why is it that if if serum Albumin is low, Calcium (Ca2+) will also likely be low?

Answer 21

40% of Calcium (Ca2+) is bound to Albumin

Question 22

What electrolyte is influenced by PTH, calcitonin, Vitamin D, GI and renal involvement?

Answer 22

Calcium (Ca2+)

Question 23

What are the two primary causes of HIGH Calcium (Ca2+)?

Answer 23

• Primary hyperparathyroidism

- Malignancy

Question 24

What is nephrolithiasis, constipation, decreased NM excitability, CV issues indicative of?

Answer 24

Hypercalcemia

Question 25

What are the two primary causes of LOW Calcium (Ca2+)?

Answer 25

- Hypoalbuminemia | - Hypomagnesemia

Question 26

What is increased NM excitability (paresthesias, Chvostek’s, Trousseau’s), prolonged QT indicative of?

Answer 26

Hypocalcemia

Question 27

What is tap CN VII against bone anterior to ear = facial muscles contract, and what is it a sign of?

Answer 27

Chvostek’s sign | - Sign of Hypocalcemia

Question 28

What is occlude brachial a. for 3 minutes with BP cuff = carpal spasms, and what is it a sign of?

Answer 28

Trousseau’s sign | - Sign of Hypocalcemia

Question 29

What are the three primary causes of HIGH Phosphorus (PO4)?

Answer 29

- Renal failure (ESRD) - Hypoparathyroidism - Hypocalcemia

Question 30

What are the four primary causes of LOW Phosphorus (PO4)?

Answer 30

- Malnutrition/malabsorption - Hyperparathyroidism - Cellular shift (Insulin) - Cellular shift (refeeding)

Question 31

What is muscle weakness and rhabdomyolysis, seizures if severe indicative of?

Answer 31

LOW Phosphorus (PO4)

Question 32

What electrolyte is intimately tied to Ca2+ and K+?

Answer 32

Magnesium (Mg2+)

Question 33

What two electrolytes is Magnesium (Mg2+) intimately tied to?

Answer 33

Ca2+ and K+

Question 34

What is a common treatment of HIGH Magnesium (Mg2+)?

Answer 34

Loop diuretics

Question 35

What is cardiac arrhythmias (Torsades de pointes), increased NM excitability indicative of?

Answer 35

LOW Magnesium (Mg2+)

Question 36

What is decreased DTRs, bradycardia, hypotension indicative of?

Answer 36

HIGH Magnesium (Mg2+)

Question 37

Chloride (Cl-) is associated with shifts in what two electrolytes?

Answer 37

- Sodium (Na+) | - Bicarbonate (HCO3-)

Question 38

If Albumin is HIGH, what is the likely abnormality seen with Globulin, and why?

Answer 38

Globulin will be LOW | - Compensation to keep Total Protein normal

Question 39

Besides Albumin, which two other lab tests can be used to evaluate synthetic liver function?

Answer 39

- PT/INR | - Platelet count

Question 40

Generally, what two disorders is Globulin used to evaluate?

Answer 40

- CA | - Immune disorders

Question 41

Why is ALP associated with cholestatic pattern?

Answer 41

It is excreted in bile, so if there is an issue with the bile ducts, ALP will be elevated

Question 42

What three conditions is UNconjugated hyperbilirubinemia associated with?

Answer 42

- Hemolysis - Gilbert's Syndrome - HF

Question 43

If a patient has Hypercalcemia, which three symptoms may they present with?

Answer 43

- Decreased NM excitability (weak, lethargic) - Nephrolithiasis - Constipation

Question 44

If Hypocalcemia diagnosis is unsure, which lab should you check?

Answer 44

Serum ionized calcium (50% of Ca2+ is ionized)

Question 45

If Hypercalcemia diagnosis is unsure, which lab should you check?

Answer 45

REPEAT Ca2+ first | - Also check serum PTH