Clin Chem Exam 3

Front 1

CATIONS

Back 1

Positively Charged Molecules

(Na+, K+, Ca+, Mg+)

Front 2

ANIONS

Back 2

Negatively Charged Molecules

(HCO3-, Cl-)

Front 3

SERUM OSMOLALITY NORMAL

Back 3

275-295mOsm/kg

(300-900 urine)

Front 4

ANTICOAGULANTS

Back 4

Sodium EDTA, Sodium Heparin, Sodium Citrate

(Bad for electrolyte draw)

Front 5

DIABETES INSIPIDUS

Back 5

Disease where kidneys and ADH do not work together properly

Front 6

CENTRAL DI

Back 6

ADH not being made/secreted

Treatment: ADH

Front 7

NEPHROGENIC DI

Back 7

Kidneys not responding to ADH production

Treatment: drink lots of water!

Front 8

OSMOLAR GAP NORMAL

Back 8

10-15

Front 9

INCREASED OSMOLAR GAP

Back 9

Alcohols/low molecular weight substances

Front 10

ANION GAP

Back 10

#Cations-#Anions

(difference between charges in body)

Front 11

DECREASED ANION GAP

Back 11

Myeloma

(if negative; this is a machine error!)

Front 12

INCREASED ANION GAP

Back 12

From acidosis

(increased Sodium; increased positive charges)

Front 13

SODIUM

Back 13

MOST ABUNDANT EXTRACELLULAR CATION

135-145

(Impacts the plasma volume)

Front 14

HYPONATREMIA

Back 14

Sodium <130 by renal or non-renal losses

Front 15

HYPONATREMIA OVER-CORRECTION

Back 15

Added salt will attract water...even water from brain....pull it off = death

Front 16

PESUDOHYPONATREMIA

Back 16

Sodium not actually low; use direst ISE

Front 17

HYPERNATREMIA

Back 17

Sodium >150 by renal or non renal gains

Front 18

POTASSIUM

Back 18

MAJOR INTRACELLULAR CATION

3.5-5.5

(30x more inside cells than out)

Front 19

HYPOKALEMIA

Back 19

Potassium <3.0

Associated with Alkalosis

Front 20

HYPERKALEMIA

Back 20

Potassium >6.0

Associated with Acidosis

Front 21

RENAL HYPERKALEMIA

Back 21

GFR<20; decreased kidney function

Front 22

CELLULAR HYPERKALEMIA

Back 22

Caused by:

Leukemia/muscle injury: shift in cell production

Front 23

GI HYPERKALEMIA

Back 23

Caused by:

Increased potassium intake coupled with poor renal function

Front 24

PSEUDOHPYERKALEMIA

Back 24

Caused by:

-Hemolysis: (cell lysis letting K+ out)

-Thrombocytosis: (platelets filled with K+)

-Turniquet: (prolonged use)

Front 25

TUMOR LYSIS SYNDROME

Back 25

Potassium is leaking out of the cells that are being killed and causing increased serum levels

Front 26

RENAL TUBULAR ACIDOSIS

Back 26

Cannot reabsorb enough bicarbonate

Front 27

BICARBONATE

Back 27

Second highest EXTRACELLULAR ANION

Front 28

CHLORIDE

Back 28

MAJOR EXTRACELLULAR ANION

98-108

(maintains electrical neutrality)

Front 29

MAGNESIUM

Back 29

Coupled anion with calcium for muscles

-regulated by kidney and PTH

Front 30

VITAL HORMONES

Back 30

Cortisol, Insulin and T4

Front 31

FOLLICLES

Back 31

Line the outside of Thyroid; need iodine

Front 32

TSH

Back 32

Thyroid Stimulating Hormone; produce T3/T4

Front 33

TOTAL THYROXINE

Back 33

Total T4: measure of what has been picked up by TBG and what is free in blood

Front 34

FREE THYROXINE

Back 34

Measure of T4 that is not bound to proteins

Front 35

DEIONIDASE

Back 35

Enzyme that converts T4 to T3

Front 36

THYROGLOBULIN

Back 36

Stores thyroid hormones

Front 37

T3

Back 37

The active form of thyroid hormone;

Present in 1000x less than T4

Front 38

HASHIMOTOS THYROIDITIS

Back 38

Hypothyroidism: measured TPO & Tg Antibody

Destroys the thyroid gland

Decreased T4/T3

Increased TSH from feedback to pituitary

Dry skin, dry hair, slow speech

Give patients T4

Front 39

GRAVES DISEASE

Back 39

Hyperthyroidism: antibody mimics TSH

Increased T3/T4

Decreased TSH by feedback

Weightloss, heat intolerance

Give Patients I131

Front 40

HPA AXIS

Back 40

Hypothalamus, pituitary, Adrenal (ACTH), cortisol

Front 41

CORTISOL

Back 41

Steroid hormone: needed for stress response, increasing blood glucose levels, immune system suppression....

Front 42

PRIMARY ADDISONS DISEASE

Back 42

Hypoadrenalism: issue with adrenal itself

Decreased Cortisol

Increased ACTH (by feedback)

Increased MSH, Decreased Aldo

Treat: cortisol replacement therapy

(ACTH test)

Front 43

SECONDARY ADDISONS DISEASE

Back 43

Hypoadrenalism: issue with pituitary

After cortisol treatment pituitary "goes to sleep"

Caused by: coming off of cortisol too quickly

Decreased ACTH (shrunken adrenal)

(ACTH test)

Front 44

ADDISONIAN CRISIS

Back 44

Insufficient adrenal steroid production for the point in time

Decreased Blood pressure

Decreased Blood Sugar

Front 45

PANHYPOPITUITARISM

Back 45

HPA Axis is "off"

Decreased ACTH, Cotrisol...etc

Front 46

ACUTE ADRENAL HYPOFUNCTION

Back 46

Caused by Meningitis

Several hemorrhage impacts adrenal

Front 47

CUSHINGS DISEASE

Back 47

Hyperaldrenalism: pituitary tumor

Increased ACTH, increased Cortisol

Increased Blood Sugar, decreased T Cells

"moonface, buffalo hump..."

(urinary free cortisol test)

Front 48

CUSHINGS SYNDROME

Back 48

Hyperadrenalism: caused by doctor

Giving too much cortisol!

Front 49

HYPERCORTISOLISM

Back 49

Caused by: Adrenal Tumor

Increased Cortisol with Decreased ACTH

Treat: remove the tumor!

Front 50

HYPERALDOSTERONISM

Back 50

Will keep the sodium and remove potassium

Increased Aldo and Sodium

Decreased Renin and Potassium

Treat: remove tumor!

(spot urine test to see K+)

Front 51

CONGENITAL ADRENAL HYPOPLASIA

Back 51

21-OH Deficiency: salt losing type

Defect in enzyme making aldosterone

Backup steroid precursor (andestenedione DHEA)

Ambiguous genitailia & "infant hercules" boys

Front 52

MEDULLA

Back 52

Produces "fight or flight" hormones

Front 53

CATECHOLAMINES

Back 53

Modified amines produced by Medulla

Give instant stress response

(dopa, dopamine, norepinephrine, epinephrine)

Front 54

PHEOCHROMOCYTOMA

Back 54

Adult medulla tumor

Secretes Epinephrine & norepinephrine

Mimics anxiety: panic attacks, weightloss...

(VMA and Metonephrines) in 24 hour urine

Front 55

NEUROBLASTOMA

Back 55

Baby and Kid Medulla Tumor

Secretes Dopamine

Increased HR, BP, diarrhea, spine malignancy

(HVA test)

Front 56

OSMOTIC FORCE

Back 56

Why molecules want to pull water along w them

Front 57

HYPOTONIC SOLUTION

Back 57

Draws salt out of cells so they burst

Lyses them

Front 58

HYPERTONIC SOLUTION

Back 58

Draws water out of cells so they shrivel

Front 59

NEPHRON

Back 59

Combined glomerulus and tubules

1,000,000 per kidney

halves in the body by age 80

Front 60

NEPHROSIS

Back 60

State w/ leaky glomerular basement membrane

Caused by thickening or change in charge

Proteinuria, edema, hypoalbuminuria, waxy cast

Front 61

POST STREPTOCOCCAL GLOMERULONEPHRITIS

Back 61

Antigen/Antibody complex stuck in kidneys

Activates complement

RBC casts, bleeding, "lumpy bumpy"

Front 62

GOOD PASTURES SYNDROME

Back 62

Nephritis caused by Ab directed to GBM

Antigen builds up on membrane

Causes linear "ribbon candy" fluorescence

Front 63

BUN

Back 63

Blood Urea Nitrogen

Should be 8-25

Only increases after 60-70% of nephrons ruined

Front 64

CREATININE:

Back 64

Should be 0.6-1.3

Filtered only in small amounts

Increases only with very low GFR

Front 65

CREATINE

Back 65

Normal muscle energy storage

Increases proportionately to muscle mass

Front 66

UREA

Back 66

Main end product of nitrogen metabolism

Front 67

UREMIA

Back 67

Accumulation of nitrogenous wastes

Protein -> Amino Acids -> Urea

Front 68

AZOTEMIA

Back 68

Nitrogenous waste buildup that is toxic

Due to increased protein catbolism or impaired kidney function

Front 69

PRE-RENAL AZOTEMIA

Back 69

Not enough blood getting to the kidney

-low urine sodium

Front 70

RENAL AZOTEMIA

Back 70

Kidney itself if sick

-high urine sodium

Front 71

POST-RENAL AZOTEMIA

Back 71

Outflow is obstructed (prostate, stone, tumor)

-increased kidney pressure, BP, dead tubules

Front 72

ANURIA

Back 72

Cessation of urine flow

Caused by: BOTH kidneys failing

OR the only urethra being blocked

Front 73

SPECIFIC GRAVITY

Back 73

Test indicates tubule ability to concentrat/dilute

Should be 1.010-1.030

Front 74

PLASMA SPECIFIC GRAVITY

Back 74

1.010

Front 75

MAXIMUM SPECIFIC GRAVITY

Back 75

1.030

Front 76

VASODILATION

Back 76

Influences kidney perfusion

Front 77

NSAIDS

Back 77

Inhibit vasodilation

Vasoconstruction squeezes blood vessels

Deadly in elderly with poor kidney function

Front 78

RAAS

Back 78

Renin, Angiotension, Aldosterone System

Front 79

RENIN

Back 79

Enzyme that makes angiotensinogen

Converts to Angiotensin I in lung

Converts to Angiotensin II for Aldosterone

Front 80

SCARRED VESSELS

Back 80

Decreased perfusion, increased relative solute absorption, decreased osmolarity, increased renin, increased alsodteron, increased sodium

Front 81

HYPOTHALAMUS

Back 81

Has osmoreceptors to monitor [salt/solute]

Changes ADH levels

Front 82

ADH

Back 82

Antidiuretic Hormone

Front 83

HYPERTONIC DCT REACTION

Back 83

Too much sodium, sends ADH to stop peeing and retain water to return to isotonic

Front 84

HYPOTONIC DCT REACTION

Back 84

Too much water, stops ADH to increase peeing

Front 85

ESRD

Back 85

End stage Renal Disease: requires dialysis

GFR<15

Front 86

HEMODIALYSIS

Back 86

3x weekly occurance

Requires vascular access

Complications with Staph Epi

Front 87

EXTRA KIDNEY HORMONES

Back 87

1, 24-OH Vitamin D and Erythropoietin

Renal failure requires Epo injections

Front 88

PTH

Back 88

Relied on to regulate calcium levels from kidney

Front 89

PYELONEPHRITIS

Back 89

Kidney infection

With WBC, Bacteria and WBC casts

Front 90

CYSTITIS

Back 90

Bladder infections

With WBC, bacteria but NO WBC casts

Front 91

ACUTE TUBULAR NECROSIS

Back 91

Hypo perfusion causing PCT cells to die

-Dirty brown (granular casts)

-Increased urinary sodium (cant reabsorb)

Front 92

DRUG INDUCED ATN

Back 92

Caused by antibiotics, NSAIDS, diuretics

-Eosinophilia; use Hansel Stain

-IgE

Front 93

GLOMERULOSCLEROSIS

Back 93

Thickened basement membrane of capillary loops; seen in diabetics

-scarring & most common cause of ESRD

-microalbuminura

>30mg/g of creatinine

Front 94

FECUNDABILITY

Back 94

Maximum fertility in life; around age 25

Falls off after 30

Front 95

HIGH RISK PREGNANCY

Back 95

Beyond age 35

Increased Chromosomal & non abnormalities

Autosomal recessive

Front 96

INFERTILITY

Back 96

Inability to conceive after 12 months unprotected sex

Front 97

FSH

Back 97

Follicle stimulating hormone;

develops the follide

Front 98

LH

Back 98

Leutinizing Hormone

Triggers ovulation based on estrogen levels

Front 99

OVULATION

Back 99

Actual release of the egg

Front 100

BASAL BODY TEMPERATURE

Back 100

Changes throughout menstrual cycle

Lowest on last day of follicular (1st) phase

Front 101

ESTROGEN

Back 101

Steroid hormone from ovarian follicle

Changes throughout the cycle

Front 102

E1

Back 102

Estrone: weak hormone

Associated with menopause

Front 103

E2

Back 103

Estradiol:

Associated with reproductive years

FIRST HALF OF CYCLE

Front 104

E3

Back 104

Estriol:

Associated with pregnancy

Front 105

PROGESTERONE

Back 105

Steroid made from cholesterol

SECOND HALF OF CYCLE

-Low without ovulation

Front 106

POST-MENOPAUSE

Back 106

Decreased estradiol

Decreased progesterone

Increased LH/FSH by feedback

Front 107

AROMATASE

Back 107

Converts testosterone into estrogen in women

Front 108

AROMATASE INHIBITORS

Back 108

Used to block receptors in breast cancers

Front 109

HcG

Back 109

Human Chorionic Growth Hormone

Double every 2-3 days during first 12 weeks

Front 110

ORAL CONTRACEPTIVES

Back 110

Inhibits ovulation, alters cervical mucus, alters endometrium, lowers estrogen