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57 Cards in this Set

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  • Back
Creatine kinase
Associated w/ ATP regeneration
Biggest fxn is in muscle cells where it stores high energy creatine phosphate
Considered a sensitive indicator for AMI
CK-MB usually <6% of total CK. Values greater is dx for AMI
Following AMI, CK-MB levels rise w/in 4-8hrs, peak at 12-24hrs, then return to normal w/in 48-72hrs
Lactate dehydrogenase
Very high concentrations in heart, liver, skeletal muscle, kidney, and RBCs
Highest LD: viral hepatitis, cirrhosis, AMI, pulmonary infarct, skeletal muscle disorders, leukemias
High levels: pernicious anemia
In AMI, levels rise w/in 12-24hrs, peak at 48-72hrs, then remain elevated for 10 days
Troponin
Three proteins that bind to thin filaments of striated muscle and regulate muscle contraction
TnT is used as AMI indicator b/c conc. starts to rise w/in 4hrs
Remains elevated for 10-14 days
Essentially absent from most normal serum
B-type natriuretic peptides (BNP)
Response to abnormal heart wall stress
Elevated in majority of pts w/ acute congestive heart failure
Kupffer cells
Phagocytic macrophages that line sinusoids
Lobule
Cord of hepatocytes from central vein
Sinusoid
Vascular space b/t lobules
Prehepatic jaundice
Occurs when large amt of bilirubin is brought to liver for metabolism
Unconjugated hyperbilirubinemia is characterstic of this condition
Occurs when there is hemolysis (hemolytic anemia), increased RBC turnover, or neonatal physiologic jaundice
Hepatic jaundice
Occurs when liver cells cannot take up or conjugate bilirubin or secrete too much bilirubin
Gilbert syndrome
Cells cannot take up bilirubin
Pts have mild icterus and bilirubin <3mg/dL, which is unconjugated
Crigler-Najjar
Complete absence (Type I) or decreased (Type II) uridyldiphosphate glycuronyl transferase
No or little conjugated bilirubin is formed
Dublin-Johnson’s and Rotor’s syndrome
Characterized by conjugated hyperbilirubinemia d/t defective liver cell excretion of bilirubin
Posthepatic jaundice
Occurs when obstruction blocks flow of bile into intestines
Serum conjugated bilirubin increases, conjugated bili is found in urine, and stool is clay-colored
Jaundice
Yellow discoloration of skin and sclera d/t excess bili (>2-3 mg/dL)
Kernicterus
Elevated bili levels that affect CNS in infants, resulting in mental retardation
Hypercarotenemia
Skin discoloration d/t elevated vit A levels
Cirrhosis
Result of chronic scarring of hepatocytes, turning them into nodules
Alcoholism causes micronodular cirrhosis
Other causes include hemochromatosis
A cirrhotic liver causes portal hypertension, resulting in splenomegaly, esophageal varices, reduced synthesis of proteins and clotting factors, and accumulation of ascites in abdomen
Esophageal varices can rupture, resulting in life-threatening hemorrhage
Reye’s syndrome
Symptoms: encephalopathy, seizures or coma, and abnormal liver fxn tests d/t hepatic destruction
Usually occurs after a viral infection (varicella or influenzae) and aspirin therapy (mainly in children)
Hepatitis A
RNA virus. Fecal-oral
Hepatitis B
DNA virus. Transmitted by body fluids, especially serum
Hepatitis C
RNA virus. Infection by serum; injection drug use and transfuion are common means of infection
Hepatitis E
RNA virus w/ clinical course similar to hep A. Fecal-oral route.
Growth hormone
Controlled by hypothalamus, GHRH, and stomatosomatostatin. Secreted by anterior pituitary.
Increased levels:
Children: giant
Adults: acromegaly
Decreased levels:
Children: pituitary dwarfism
Adults: decreased muscle mass, increased body fat, and decreased bone density
Prolactin
Secreted by anterior pituitary. Initiation and maintenance of lactation
Posterior pituitary
Hormones released are synthesized in hypothalamus, then secreted by posterior pituitary
Antidiuretic hormone (ADH, vasopressin)
Makes DCT and CT of kidney permeable to water.
Increases plasma osmolality and decreases blood volume and blood pressure
Decreased levels: diabetes insipidus resulting in severe polyuria and polydipsia
Oxytocin
Stimulates contractions during delivery and causes ejection of milk
Parathyroid hormone
Increases serum calcium level by increasing calcium resorption from bone, stimulating calcium retention in renal tubules, and increasing Vit D production in kidney
Hyperparathyroidism
Primary: Increased PTH released from pituitary adenoma
• Kidney stones; increased calcium resorption from bone
Secondary: increased PTH secretion d/t decreased serum Ca and hyperplasia of parathyroid glands
• Causes vit D deficiency and chronic renal failure and can lead to severe osteoporosis
Tertiary: Pts w/ secondary develop parathyroid adenoma
Hypoparathyroidism
Severe hypocalcemia and altered neuromuscular activity (tetany).
D/t injury to the glands during surgery or removal of glands
Pseudohypoparathyroidism
Hereditary. End organs are resistant to PTH. Patients have round faces and deformities of hand bones
Hyperthyroidism
Symptoms: heat interolerance, tachycardia, weight loss, weakness, emotional lability, and tremor

Decreased TSH
Increased T4, free (unbound) T4 (FT4), and T3
Graves’ disease
Hyperthyroidism caused by circulating antibodies to TSH receptor
Hypothyroidism
Cold sensitivity, dry skin, and muscle weakness
Increased TSH
Decreased T4 and FT4
Zona glomerulosa
Outermost layer of adrenal cortex. Secretes mineralcorticoids w/ aldosterone the major hormone. Controlled by renin-angiotensin axis
Renin-angiotensin axis
Low sodium levels or low renal pressure:
Renin produced by kidney, acts on angiotensin to produce angiotensin I, which is converted to angiotensin II, which stimulates secretion of aldosterone (potent vasoconstrictor)
Aldosterone
↑ renal tubular retention of Na+ and ↑ excretion of K+
Zona fasciculate
Second layer of adrenal cortex. Secretes glucocorticoids w/ cortisol as major hormone
Hypercortisolism
Cushing’s syndrome. Weight gain in face, neck, shoulders, and abdomen (including “buffalo hump” at base of neck), muscle wasting, and hyperglycemia
Hypocortisolism
Addison’s disease. Primary adrenal disease or secondary to pituitary hypofunction.
Primary adrenal disease: atrophy of the gland
o Symptoms include weight loss, weakness, and GI problems
o Adrenal insufficiency: low sodium, bicarbonate, glucose; high potassium, BUN
Zona reticularis
Third layer of adrenal cortex. Secretes sex steroids.
Adrenal medulla
Produces catecholamines: dopamine, norepinephrine, and epinephrine
Function of epinephrine and norepinephrine
Mobilize energy stores and increase heart rate, blood sugar, and blood pressure. Also inhibit insulin.
Hormone changes in female reproductive cycle
FSH promotes growth of follicles and increase in estrogen in first part of cycle
Rising estrogen levels decrease FSH, but cause LH to be released
LH trigger ovulation causing estrogen and LH levels to decrease rapidly
The follicle becomes the corpus luteum to degenerate, and decreases estrogen and progesterone lvls
Menstruation results, then cycle repeats
Progesterone
Prepares uterus for pregnancy and breast for lactation
Turner’s syndrome
A genetic defect when ovaries do not develop properly; patients are sterile
β-hCG
Secretion maintains progesterone synthesis by corpus luteum in early pregnancy
The placenta takes over to maintain pregnancy
Levels are useful in detecting ectopic pregnancy, spontaneous abortion, multiple fetuses, and dx/monitoring of hCG-producing tumors
Testes
FSH stimulates spermatogenesis
LH stimulates production of testosterone from Leydig’s cells
Klinefelter’s syndrome
Patient possesses an extra X chromosome (XXY)
Zollinger-Ellison syndrome
Elevated gastrin level accompanied by gastric hyperacidity
Serotonin
Secreted by argentaffin cells in GI tract
Function: binds platelets and is released during coagulation
Cystic fibrosis
Dysfunction of mucus and exocrine glands of the body
Blocks pancreatic secretions from entering duodenum
Islet cell tumor
In beta cells, result is hyperinsulinemia
In alpha cells, result is gastrinoma or Zollinger-Ellison syndrome
Chronic pancreatitis
Excessive alcohol consumption
Increased amylase, lipase, and trigs, hypercalcemia, and hypoproteinemia
Fecal fat
Mix small amt of stool w/ fat-soluble stain (ie. Sudan III) and look for orange-red colored oil droplets
Indicates there is undigested fat (neutral fats, triglyceride) in stool
Amylase
Values rise w/in a few hours of onset of symptoms, peak in 24hrs, then return to normal in 3-5 days
Elevated in mumps, cholecystitis, hepatitis, cirrhosis, and ruptured ectopic pregnancy
Lactose tolerance test
Lactase cleaves lactose into glucose and galactose
Patient ingests 50g lactose, then blood specimens obtained at 0, 30, 60, and 120 minutes
Blood glucoses are done, and increase in blood glucose level of 30mg/dL or more is positive for lactase