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70 Cards in this Set

  • Front
  • Back
what gives a rough measurement of renal fx
blood urea nitrogen
what is azotemia
increase in nitrogenous products in blood
where can be a problem with BUN
prerenal
renal
postrenal
what can happen in the prerenal that will increase BUN
catabolism of protein
CHF
Shock
dehydration
What are the two main causes of increase BUN in prerenal
decreased blood volume
increased protein
what are the causes if BUN is increased due to renal
chronic bilateral dz.
acute tubular necrosis
what are the causes if BUN is increased due to postrenal
obstruction
ureteral obstruction
BPH
bladder tumors
what is creatinine
by product of creatine phosphate dephosphorylation in skeletal muscle
when is creatinine elevated
renal disorders and affected only minimally by liver function
when does creatinine elevate and what does it suggest
rises later than BUN and slower
suggests chronic problems
what three things is creatinine elevated in
decreased renal function
rhabdomyolysis
gigantism/acromegaly
what is the purpose of NA, K, Cl, CO2
determine acid/base balance
where is Na located
how is it balanced
extracellular
balance maintained by dietary intake and renal excretion
how is Na regulated
aldosterone (conserves Na)
natriuretic hormone (excrete Na)
ADH (balances H2O)
how does hyponatremia occur
decreased intake or increased loss of Na
what could cause hyponatremia
diuretics
vomitting/diarrhea
chronic renal insufficiency
Addisons
excessive H2O
hyperglycemia
CHF
peripheral edema
SIADH
how does hypernatremia occur
increased intake or decreased loss of Na
> 140
what could cause hypernatremia
dietary intake
cushing's
hyperaldosteronism
sweating
diarrhea without rehydration
where is K found
what is K important in
intracellular
important in membrane potentials
minor changes have major effect
how is K regulated
aldosterone decreases level by causing excretion
Na reabsorbed causes K to be lost
alkolosis moves K into cell
acidosis move K out of cell
what are the symptoms of hyperkalemia and what can cause it
nausea, vomitting, diarrhea
increased dietary intake
addison's
hypoaldosteronism
aldosterone inhibiting diuretics
crush
hemolysis
infection
what are the symptoms of hypokalemia and what can cause it
weakness, paralysis, hyporeflexia, ileus
hyperaldosteronism
dietary deficiency
licorice
cushings
where is Cl found and what does it do
extracellular
follows Na to support neutrality
water follows Cl so it affects water balance
aids in acid/base balance
what is CO2 associated with
acid/base balance
what is the anion gap
how is it calculated
difference between cations and anions
used to determine metabolic acidosis
(Na + K) - (Cl + HCO3)
when does the anion gap increase
acidosis
diarrhea
kidney dz
when does the anion gap decrease
alkalosis
vomitting
hyperaldosteronism
when does osmolality decrease
as free H2O blood increases
what happens when there is low osmolality
depresses secretion of ADH
what happens when there is high osmolality
stimulates secreation of ADH
what are the 3 most important solutes in the blood
Na
glucose
BUN
what percentage does albumin makeup
what does albumin measure
when are there decreased levels of albumin
60%
measures liver function
decreased levels when diseased liver cells
what is main purpose of albumin
maintaining osmotic pressures
transport of substances in circulation
increases solubility of materials in blood
what percentage do globulins makeup
40%
what are the alpha 1 globulins
alpha 1 antitrypsin
elevated in inflammation, malignancy, infection
what are the alpha 2 globulins
haptoglobins
prothrombin
what are the beta 1 globulins
lipoproteins
transferrin
what are the beta 2 globulins
fibrinogen
what are the gamma globulins
immunoglobulins (Ab)
what disease shows monoclonal spikes
multiple myeloma
what 2 things does diabetes mellitus result from
abnormal production of insulin
abnormal use of insulin from pancreas
what are the 2 production problems in diabetes mellitus
deficient beta cell insulin production
abnormal release
what are the use problems in diabetes mellitus
-cell receptor dysfunction producing resistance to action of insulin
-abnormalities of non-pancreatic hormones that influence insulin of blood glucose metabolism
what are the characteristic of type 1 DM
onset early
require insulin (severe deficiency)
what are the characteristics of type 2 DM
onset middle age
non-insulin dependant
overweight
what is normal glucose tolerance
-high glucose suppress glycogen conversion to glucose
-epinephrine stimulates opposite process
-glucagon released in hypoglycemia
-cortisol incrase glycogen levels thereby increasing gluconeogenesis
what are the levels during gestational diabetes
fasting > 105
1 hr > 190
2 hr > 165
3 hr > 145
what are the levels for HbA1c test
2-5% = normal glucose
5-6% = well controlled
6-7% = fair controlled
>8% = poor controlled
where do VLDL come from
- carbs in diet
- free fatty acids in body
what is type V hyperlipoproteinemia
mixed triglyceridemia
increase chylomicrons
increase VLDL
what is type IIa hyperlipoproteinemia
common
hypercholesterolemia
increase B globulins
what is type IIb hyperlipoproteinemia
hypercholesterolemia
pre B increase
trigs increase
what is type III hyperlipoproteinemia
hypercholesterolemia
problem with VLDL
what is type IV hyperlipoproteinemia
diabetic
VLDL increase
sugar --> VLDL
what is the source of cholesterol
what are the different levels of cholesterol
animal fat
<200 = low risk
200-400 = high to moderate risk
>240 = high risk
what are the levels for LDL
< 100 = optimal
< 130 = moderate
< 160 = high
what are the risk factors associated with LDL
smoking
age
BP (140/90)
family history
what is associated with HDL
< 40 increased risk of HD
>60 1/2 risk of HD
what should the chol/HDL ration be
less than 4:1
what is the source of triglycerides
ingested fats (chylomicrons)
excess cho converted to VLDL
what are the three big things in acute myocardial infarct
ECG
WBC
ESR
what is granulocytic leukocytosis and when does it occur
10,000-20,000 WBC (PMN) within 12-24 hrs elevated fro week or two
how long does ESR elevate for
3-4 weeks
when does AST first elevate, peak, and normalize
elevate - 12 hrs
peak - 24 hrs
norm - week
when does LDH first elevate, peak, normalize
elevate - 24-48 hrs
peak - 48-72 hrs
norm - 5-10 days
where is CK-BB (CK-1) found
brain and lung
where is CK-MM (CK-3) found
skeletal muscle
where is CK-MB (CK-2) found
when is it elevate, peak, normalize
cardiac muscle
elevate - 3-6 hrs
peak - 24 hrs
norm - 48 hrs
when does troponin T elevate and what does it act like
elevates in 4-6 hrs
acts like CK-2
elevated longer
what does troponin I behave like and when does it normalize
behaves like T
normalize - 3-4 days