Med 150

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Author:
masonsmom2012
ID:
212011
Filename:
Med 150
Updated:
2013-04-07 17:30:43
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Chemistry
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Chemistry
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  1. Electrolytes:
    Na, K, Cl, CO2
  2. Sodium (Na)
    • 135-146 mmol/L
    • major extracellular cation
    • decreaseswith fluid loss- vomiting and dirrhea
  3. Chloride (Cl)
    • 98-108 mmol/L
    • extracelluar
    • chloride shift (O2, CO2 exchange)
  4. Potassium (K)
    • 3.5-5.3 mmol/L
    • major intracelluar cation
    • any abnormal value is a critical value
    • affects muscle function esp the heart
    • decreases with nausea and diuretics
    • cannot be absorbed by the kidneys
    • NO amount of hemolysis is acceptable
  5. Proteins
    • Albumin- 60% of serum proteins, critical to maintaining fluid balance, 3.5-5.0 g/dl
    • Globulins- 40%, antibodies, coag proteins, enzymes, and transport of iron
    • Total serum protein- provides info about state of hydration, nutrition, aand liver function, 6.0-8.5 g/dl
  6. CO2
    • 22-28 mmol/L
    • buffer syst
    • changes affected by respirations
    • pneumonia, COPD
  7. Minerals
    • Ca- 8.5-10.5 mg/dl
    • Active Ca is for blood coag and muscles
    • decrease= tetany and seizures
    • Phos- levels influenced by Ca, 2.5-4.5 mg/dl
    • supply energy to body, inc. in bone lesion,kids
    • Mg- use related to Ca levels
    • Fe- necessary for Hgb snthesis, 80-160g/dl
  8. Renal Function test
    • Creat Clearance- 24hr urine
    • BUN- 8-18 mg/dl
    • Uric acid- 3.65-8.0 mg/dl
  9. Creatinine Level
    • 0.7-1.4 mg.dl
    • Test for overall kidney function
    • muscle waste product cleared by kidneys
    • NOT effected by diet
  10. BUN (blood, urea, nitrogen)
    • 8-18 mg/dl
    • IS effected by a pt diet, hormones and kidney function
  11. Liver
    • makes plasma proteins (albumin, chlos, lipo, coag proteins)
    • stores iron, glycogen, vitamins, and others
    • destroys old blood cells, and recycles components of Hgb
  12. Liver Function Test
    Total Bilirubin and Enzymes
  13. Total Bilirubin
    • 0.1-1.2 mg/dl adults             
    • 10 mg/dl in newborns
    • waste product of Hgb destructionalways protect from light
  14. Enzymes
    • ALP- liver and BONE, 39-117 U/L
    • ALT- liver, 3-30 U/L
    • AST- liver and heart, 6-33 U/L
    • GGT- most specific for liver, 1st and fastest to rise, 11-50 U/L
    • LD- liver and muscle, 125-290 U/L
  15. Cardiac Test
    • 10-100 U/L
    • CK- level related to muscle mass
    •        Ckmb and Troponin
    • Lipids- used to assess cardiac health
    •         Choles-<200 mg/dl
    •         HDL- >50
    •         LDL- <100
    •         Trig- 10-190
  16. Carbohydrate Metab: Glucose
    • 65-110mg/dl
    • 180 renal threshold
    • fasting vs 2hr
    • bi-hormonal, insulin and glucagon
  17.                   Isles of Langerhans
         alpha cells                       beta cells
    into glucogon                    into insulin
    which > glucose              which < glucose
    by converting glycogen    1. moving glucose
    back to glucose                 into cells
                                      2. storing glucose as
                                      glycogen in liver and
                                      muscles
                                      3. storing glucose as
                                       trig's in fat cells
  18. Throid
    • T3- hormones produced by throid, 60-160
    • T4- 5.5-12.5 g/dl
    • TSH- influences T4 production, 0.4-4.5
  19. TDM
    • theraputic drug monitoring
    • must know dose, route, time
    • peak- when drug is most in the system
    • trough- when drug is lowest
    • digoxin, dilantin, theophylline= 3most common
  20. Amino Glycasides
    • will often be TDM's
    • Gentamycin, tobramycin, amikacin
  21. Specimen Care
    • serum should be seperated from cells within 1 hr
    • refridgerate- 2-8 degrees C
    • fasting is the best specimen
  22. Types of Specimens
    • Blood (most common)
    • Urine
    • CSF, synovial, pleural and pericardial
  23. Problems associated with specimens:
    hemolysis, hemoconcentration, overcentrifugation, evaporation, contamination, aging.
  24. PSA
    prostate specific antigen
  25. Pancreatic enzymes
    • amylase increased in early acute pancreatitis
    • Lipase found in pancreas not in saliva
  26. Basic Metabolic Panel (BMP)
    • Electrolytes- Na, K, Cl, CO2
    • Renal- BUN and/or Creatinine
    • Glucose
  27. Comprehensive Metabolic Panel (CMP)
    like basic but add liver test, and maybe some for other body systems
  28. Blood Occult Test
    • -Guiac is the type of paper used
    • -Peroxidase is the chemical liquid used for reaction
    • - this test is testing for iron in specimen

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