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40 Cards in this Set

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this test is specific to hepatocellular disease and more specific than AST
ALT (SGPT)
test used for Paget's disease?
alkaline phosphatase
normal value range for ALT (SGPT)
5-35U/L
when do you see an INCREASE in ALT?
-cirrhosis, hepatic
-ischemia/necrosis
-hepatotoxic drugs
-SEVERE BURNS
MI, CHF
pancreatitis,
mononucleosis
HoTN
ALT/AST ratio is <1 in ?
ETOH cirrhosis, liver congestion, metastatic tumor
ALT/AST ratio is >1 in?
acute hepatitis
alkaline phosphophatase
sensitive marker for liver metastasis
found in rapidly dividing cells
excreted in bile
seen in osteoblastt cells
KUPFFER cells
when do you see an increase in Alk-Phos?
active bone formation, osteomalacia, Paget's ,rickets (vit D drficiency)
biliary cirrhosis
intrahepatic and extrahepatic duct disorders
prostate cancer
normal value range for alkaline phosphatase
30-85 U/L
GGT
gamma-glutamyl transferase
no longer used in the liver fx panel
-"obstructive enzyme"
-indicator of ETOH use
T/F, elevated number of Alk/Phos is a warning sign of bad things to come in young kids
FALSE
an elevated count is NORMAL because their bones are growing
how do you identify the source of presence of ALK-PHOS
heat fractionated to differentiate b/t bone, liver, placenta, kidney cells
PROTEIN
nl values
general info
6.4-8.3 g/dl, most significant contributor to osmotic pressure
abnl levels can = ascites, edema
indicator of ETOH use and "obstructive enzyme"
GGT
see increase TOTALPRO (PROTEIN) count in ?
multiple myeloma
Waldenstrom's lymphoma
Chronic inflammation
sarcoidosis
viral illnesses
see a decrease in TOTAL reported PRO in?
malnutrition, anorexia, IBD, Hodgkin's other leukemia
decreased osmotic pressure results in
ascites, edema
how much hepatic fx is lost before urea production or aa regulation disturbance?
>90% fx loss
Albumin
Nl range
half-life
what is it used to detect?
3.5-5.0 g/dl
12g manufactured dailyin liver w/ 1/2 life of 14-20 days
-pre-albumin,1/2 life = 2 days and is MORE reflective of acute process
used to check for MALNUTRITION & HEPATIC DYSFX
Globulins
range
what are they
where made
2.3-3.4g/dl
building blocks of
-Ab
-Glycoproteins
-compement
-clotting factors
-acute-phase reactant proteins
made in the LIVER and mostly in RETICULOENDOTHELIEAL system
what idoes a NL lipid panel look like?
-total chol = <200
-LDL <130 mg/dl(<100 in pt w/ CAD or DM)
-HDL >45mg/dl
-TG 35-160 mg/dl
LDL
normal <130,
high >240
contains the majority of PLASMA CHOLESTEROL
-diets high in SAT fats and chod incr LDL
which lipid accounts for 75% of plasma cholesterol?
LDL
HDL accounts for 25% circulating chol
the two most important electrolyte values are Na+ and K+, what are their NORMAL value ranges?
K+ = 3.5-5.0 mEq/L
critical value <2.5
Na+ = 136-145mEq/L
(avg is ~140)
critical value:<120 or >160
potassium
range
role
normal 3.5-5.0
role in pH, cell growth, nucleic acid and PRO synthesis
hypokalemia
<2.5
can see FLAT T WAVES AND U WAVES
CLINICAL MANIFESTATIONS - neuromsuclea
can result in dysrrhythmia
caused by low in diet, poor uptake, alkalosis
hyperkalemia
due to high uptake, cell lysis, infx, dehydration and acidosis
sodium
range
fx
nl = 136-145 mEq/L
panic <120 or >160
fx= maintain ECF
what can affect the Na+ values?
aldosterone
natriuretic hormone andd ADH
it is THE MC e'-lite disturbance
hyponatremia
decreased intake, increased loss
<125 wkness, confusion, lethary
<115 may progress to stupor/coma
what are the three types of hyponatremia?
hypovolemia = n/v/d/diuretics
hypervolemia= CHF,edema,ascites, IV fluids
Euvolemic (SIADH)
pseduohyponatremia
can be caused by increase in
-lipids(nl plasma osmolality)
protein (nl osmolality)
severe hypoglycemia (see increased plasma osmolality)
Pontine myelinolysis
hypertonic saline soln - if give too much Na - salt sits on outside of brain
>12mEq/L is risk
aldosterone
reabsorption of Na+ by kidneys
natriuetic hormone
increases renal losses of Na,
ADH
anti-diuretic hormone, controls the reabsorption of waer at distal tubules of kidney
hypernatremia
neuro sxns = agitation, restlessness, thirst, mania, convulsions
see H2o loss, Cushings syndrome
calcium
nl = 9.0-10.5mg/dl
3 forms
free/ionized
bound to albumin
with anions
MOST ABUNDANT DIVALENT CATION
99% bone as hydroxyapaptite
1% in teeth, soft tissue, plasma and cells
3 forms of calcium
50% free or ionized
40% bound to albumin
10% with anions
which form of Ca+2 is filterable by the glomerulus? and which form is the physiologically active form?
only the ionized and anion-bound are filterable and only the ionized is physiologically active