Transcript Basic Clinical Chemistry

Basic Clinical Chemistry
Protein
• Two major groups
–(
)
• Made in (
)
• Serve as transport proteins
• Help maintain fluid balance in the body
–(
)
• Ex: antibodies, blood coagulation proteins, enzymes, an
proteins that transport iron
Total Serum Protein
• Normal (
) g/dL
• Represents sum of many different proteins
• Can give info on:
– Hydration
– Nutrition
–(
) function
(
• (
) g/dL
• Hypoalbuminemia
– Liver disease
– Starvation
– Protein loss- skin, kidneys, GI tract
)
Electrolytes
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Sodium- (
Potassium- 3.5- 5.4
Chloride- (
Bicarbonate- 22-28
)
)
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Lethargy
Confusion
Irritability
Seizures
Tachycardia
(
)
Dry oral mucosa
)
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Confusion
Convulsions
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)
Headache
Loss of appetite
Muscle spasms
Muscle weakness
(
)
N/V
)
(
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Nausea
Fatigue
Muscle weakness
(
)
Bradycardia
Can result in cardiac death
)
Hypokalemia
• Mild- often (
• Severe
– Muscle weakness
– Myalgia
– Muscle cramps
– Constipation
– arrhythmia
–(
)
)
Mineral Metabolism
• (
)- 8.7-10.5
– Highest in concentration
– Most is in (
)
– Required for proper blood coagulation and normal
neuromuscular excitability
Hypercalcemia
• “Moans, stones, groans, bones”
• Moans
– Constipation
–(
– Abdominal pain
)
• Stones
– Kidney stones
• Groans
– Confusion
–(
– depression
)
Hypercalcemia
• Bones
– Aches and pains
–(
)
– Curving of spine
Phosphorus

(
)
Iron
• 65-165
• Deficiency leads to anemia
KIDNEY FUNCTION
(
)
• 0.7-1.4
• Waste product of creatine phosphate
– Substance stored in muscle and used for energy
• Excreted by (
)
• Not affected by diet or hormone levels
• Increases with impairment of urine formation
or excretion
(
)
• (
)
• Blood urea nitrogen
• Influenced by diet, hormones, and kidney
function
• Low- starvation, pregnancy, low-protein diet
• High- high-protein diet, after steroid
administration, kidney disease
Uric Acid
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(
)
Excreted by kidneys
Used to diagnose (
)
Also increases after radiation/chemo
LIVER FUNCTION
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)
Total serum 0.1-1.2
Waste product from the breakdown of Hgb
Formed in (
) and excreted in (
)
Measured to monitor liver or gall bladder
dysfunction
Liver Enzymes
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Increase usually means injury to tissue
ALP
LDH
GGT
ALT
AST
Cardiac Function
• (
help diagnose MI
)(CK)- measured to
– Released from damaged heart muscle
• Peaks in 24 hours
• Returns WNL within 3-4 days
• (
)
LIPIDS
(
)
• Total serum- below 200 mg/dL
• (
)- 10-190 mg/dL
– Blood to be tested should be collected when
patient has been fasting for 12-14 hours
• Hyperlipidemia- high triglycerides
Thyroid Function
• Thyroxine- T4
• Triiodothyronine- T3
• Thyroid Stimulating Hormone- TSH
– Released by (
– Regulates hormone activity
–(
)
)
Hyperthyroidism
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Nervousness
Irritability
Increased Perspiration
(
)
Weight loss
Intolerance to (
hyperactivity
)
Hypothyroidism
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Weight gain
Coarse, dry hair
Hair loss
(
) intolerance
(
)
Depression
Irritability
Fasting Blood Glucose
• (
) mg/dL- serum
• Usually obtained before breakfast after not
eating for at least (
)
Oral Glucose Tolerance Test
• Fasting blood glucose sample is drawn
• Patient then consumes a beverage containing a
standard glucose dose
• Samples are collected at set intervals (30 min,
1,2, and 3 hrs) after beverage is consumed
• Used to confirm dx of diabetes
• Used often in (
)
• 1- hour (
)
• 2-hour less than 140
• 3-hour at or below fasting level
Hypoglycemia
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(
)
Faintness
Weakness
Hunger
Diaphoresis
Visual disturbance
(
)
Personality changes
Hyperglycemia
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Confusion
Coma
Nausea
Intense thirst
Dry flushed skin
Weak (
)
(
)
• Tells the dr how well the patient’s blood glucose is
controlled
• Less than 7% is ideal
• Correlates to their average (
)
Hemoglobin A1c %
Average blood glucose
4
61
5
92
6
124
7
156
8
188
9
219
10
251