Glossary of Arcadia Clin Dx exam II - CHEMISTRY ppt
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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)
- when do you see an INCREASE in ALT?
- -cirrhosis, hepatic
- 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
- when do you see an increase in Alk-Phos?
- active bone formation, osteomalacia, Paget's ,rickets (vit D drficiency)
intrahepatic and extrahepatic duct disorders
- normal value range for alkaline phosphatase
- 30-85 U/L
- gamma-glutamyl transferase
no longer used in the liver fx panel
-indicator of ETOH use
- T/F, elevated number of Alk/Phos is a warning sign of bad things to come in young kids
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
- 6.4-8.3 g/dl, most significant contributor to osmotic pressure
abnl levels can = ascites, edema
- indicator of ETOH use and "obstructive enzyme"
- see increase TOTALPRO (PROTEIN) count in ?
- multiple myeloma
- 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
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
what are they
building blocks of
-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)
-TG 35-160 mg/dl
- normal <130,
contains the majority of PLASMA CHOLESTEROL
-diets high in SAT fats and chod incr LDL
- which lipid accounts for 75% of plasma cholesterol?
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
- normal 3.5-5.0
role in pH, cell growth, nucleic acid and PRO synthesis
can see FLAT T WAVES AND U WAVES
CLINICAL MANIFESTATIONS - neuromsuclea
can result in dysrrhythmia
caused by low in diet, poor uptake, alkalosis
- due to high uptake, cell lysis, infx, dehydration and acidosis
- nl = 136-145 mEq/L
panic <120 or >160
fx= maintain ECF
- what can affect the Na+ values?
natriuretic hormone andd ADH
it is THE MC e'-lite disturbance
- 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
- 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
- reabsorption of Na+ by kidneys
- natriuetic hormone
- increases renal losses of Na,
- anti-diuretic hormone, controls the reabsorption of waer at distal tubules of kidney
- neuro sxns = agitation, restlessness, thirst, mania, convulsions
see H2o loss, Cushings syndrome
- nl = 9.0-10.5mg/dl
bound to albumin
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
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