PART IVE: LAB TEST (BLOOD CHEMISTRY 1)

Proverbs 16:3

BUN (8-17 mg/dL)

Increases in the blood thru renal dysfunction, high protein intake, and upper GI bleeding

8-17 mg/dL

Reference Standard of BUN = _____ mg/dL

Cystatin C (0.62-1.15 mg/L)

increases in the blood thru renal dysfunction

0.62-1.15 mg/L

Reference Standard of Cystatin C = _____ mg/dL

Creatinine Clearance

[CREATININE]

For dose adjustment in renally impaired patients

Creatinine Kinase

[CREATININE]

An enzyme that catalyzes transfer of phosphate groups

Creatinine Kinase

[CREATININE]

An enzyme that is primarily found in tissues that consume high ATP

Creatinine Kinase

[CREATININE]

An enzyme that increases in biliary obstruction, Paget's disease, hyperparathyroidism, osteomalacia

• Biliary obstruction

• Paget's disease

• Hyperparathyroidism

• Osteomalacia

[CREATININE]

Creatinine Kinase is an enzyme that increases in _____ [4]

CK-BB (CK1)

[Creatinine Kinase]

Stroke → _____

a. CK-BB (CK1)

b. CK-MB (CK2)

c. CK-MM (CK3)

CK-MB (CK2)

[Creatinine Kinase]

Myocardial Infarction → _____

a. CK-BB (CK1)

b. CK-MB (CK2)

c. CK-MM (CK3)

CK-MM (CK3)

[Creatinine Kinase]

Rhabdomyolysis → _____

a. CK-BB (CK1)

b. CK-MB (CK2)

c. CK-MM (CK3)

CK-MM (CK3)

[Creatinine Kinase] Rhabdomyolysis

Jaundice

[CREATININE]

Indication: Yellowing of skin and eyes

Alkaline Phosphatase

[CREATININE]

Checks the presence of jaundice

Acid Phosphatase

[CREATININE]

A high concentration of this is found in victims of sexual assault

Lactate Dehydrogenase

[CREATININE]

An enzyme that rarely measured because of the lack of tissue specificity

Lactate Dehydrogenase

[CREATININE]

An enzyme that is often elevated in damages to the liver, skeletal muscle and kidneys, megaloblastic and immune hemolytic anemias, and in intravascular hemolysis

Troponin I and T

[Blood Chemistry]

Regulatory proteins that control the calcium-mediated interaction between actin and myosin in cardiac muscle

Troponin I and T

[Blood Chemistry]

Comparable in diagnostic and prognostic efficacy

Troponin I and T

[Blood Chemistry]

Offer extremely high cardiac tissue specificity and clinical sensitivity for myocardial necrosis

Aspartate transferase (AST), Alanine Transferase (ALT)

[Blood Chemistry]

Raised in all forms of viral/ non-viral, acute/ chronic liver disease; acute viral, drug-induced, alcohol related and ischemic liver damage; non-alcoholic fatty liver disease

Bilirubin

[Blood Chemistry]

Breakdown product of hemoglobin

• albumin

• liver

[Blood Chemistry]

Bilirubin is bound in _____and conjugated in the_____

Bilirubin

[Blood Chemistry]
_______ may indicate jaundice if elevated above 50 mmol/L.

50 mmol/L

[Blood Chemistry]

Bilirubin may indicate jaundice if elevated above______mmol/L.

jaundice

[Blood Chemistry]
Bilirubin may indicate_____ jaundice if elevated above 50 mmol/L.

Alkaline Phosphate

[Bilirubin]

Checks bile ducts, placenta, kidneys and bones for gallstones, Vit. D deficiency, and Paget's disease

Acid Phosphatase

[Bilirubin]

Forensic presumptive test for semen

Acid Phosphatase

[Bilirubin]

Use for sexual assaulted patient

Acid Phosphatase

[Bilirubin]

_______

• Prostate-specific antigen that is secreted by prostate gland into seminal fluid

• high levels in BPH and prostate cancer.

Amylase and Lipase

[Blood Chemistry]

Pancreatic enzymes synthesized primarily in the pancreas and salivary glands

Amylase

[Amylase or Lipase]

_____-

• Found in the serum/urine

• Most important test in cases of suspected acute pancreatic disease

Lipase

[Amylase or Lipase]

May be released in blood in large amounts due to the destruction of pancreatic cells.

liver

Albumin is produced in________

Albumin

Use for liver and kidney health assessment

Hypoalbuminemia

[ALBUMIN]

Hypoalbuminemia or Hyperalbunemia

_____

• can be caused by liver disease, malnutrition, protein wasting nephropathy

• resulting to edema and ascites

• liver disease

• hemolysis

• kernicterus

[ALBUMIN]

Hyperalbunemia is by _____ [3]

Fasting Blood Sugar (<100 mg/dL)

_____

• for measuring blood glucose

• 8-12 hours of fasting; diagnosis

<100mg/dL

Reference standard for Fasting Blood Sugar is _____ mg/dL

HbA1C (<5.7%)

____-

• also known as “Glycated Hemoglobin”

• 2-3 months blood glucose; diagnosis

Glycated Hemoglobin

HbA1C is also known as ________

HbA1C (<5.7%)

More accurate than Fasting Blood Sugar

<5.7%

Reference standard for HbA1C is _____%

<200 mg/dL

[Lipid Profile]

Reference standard for HbA1C Total Cholesterol is ______ mg/dL

<130 mg/dL

[Lipid Profile]

Reference standard for Low Density Lipoprotein (LDL) is _______ mg/dL

Statins

[Lipid Profile]

1st line for LDL

• M: >40 mg/dL

• F: >50 mg/dL

[Lipid Profile]

Reference standard for High-Density Lipoprotein (HDL) is ____ [2]

• Niacin

• Fibrates

[Lipid Profile]

Treatment for HDL [2]

<150 mg/dL

[Lipid Profile]

Reference standard for Triglycerides is _______

• Fibrates

• statins

• Niacin

[Lipid Profile]

Treatment for Triglycerides [3]

TRUE

TRUE OR FALSE

HIGH total cholesterol is treated with the 1st line drug “statins

TRUE

TRUE OR FALSE

High HDL means better blood flow(perfusion)

Metabolic Syndrome (Syndrome X)

Cluster of conditions that significantly increase the risk of heart disease, stroke, and type 2 DM

• High Blood Pressure (HBP)

• High blood sugar

• Excess belly fat

• High TG

• Low HDL

Syndrome X

Metabolic Syndrome is also known as _____

• HBP

• High blood sugar

• Excess belly fat

• High TG

• Low HDL

📌NOTE: if 3 are check out of 5 you have matabolic syndrome

Metabolic Syndrome (Syndrome X) are cluster of conditions that significantly increase the risk of heart disease, stroke, and type 2 DM these include ____[5]

Uric Acid

Product of purine metabolism

• acute attack

• gouty arthritis

Uric Acid deposition usually precipitates an _______ or _____

• Red meats

• Peanuts

• Oats

Example of Foods that increases Uric Acid [3]

Immunoglobulins

Are antibodies produced by B-lymphocytes

Immunoglobulins

Are antibodies that occur in infections, chronic liver and autoimmune diseases

D-dimer

degradation products of fibrin clots

coagulation

D-dimer increased levels in blood are associated with _____

D-dimer

________- are used to detect venous Thromboembolism

venous Thromboembolism

D-dimer are used to detect ________

• Erythrocyte Sedimentation Rate

• C-reactive protein

• Procalcitonin

Inflammatory Markers [3]

Erythrocyte Sedimentation Rate

[Inflammation Markers]

Measures the rate of RBC settling of whole, uncoagulated blood over time

Erythrocyte Sedimentation Rate

[Inflammation Markers]

Increased levels may indicate inflammation, infection, tissue necrosis, malignancy, rheumatoid collagen disease.

• inflammation

• infection

• tissue necrosis

• malignancy

• rheumatoid collagen disease

[Inflammation Markers]

Erythrocyte Sedimentation Rate increased levels may indicate _____ [5]

C-reactive protein

[Inflammation Markers]

Acute phase protein (instigated by tissue damage, infection, inflammation and malignancy).

C-reactive protein

[Inflammation Markers]

_______- is instigated by tissue damage, infection, inflammation, and malignancy

• tissue damage

• infection

• inflammation

• malignancy

[Inflammation Markers]

C-reactive protein is instigated by ____ [4]

Procalcitonin

[Inflammation Markers]

A polypeptide and a bloodstream biomarker used as an early predictor of sepsis

Prostate-specific antigen (PSA)

[Tumor Markers]

Primary Malignancy: Prostate

• Prostate-specific antigen (PSA)

• CA 125

• Human chorionic gonadotropin (HCG)

[Tumor Markers]

______[3]

Clinical Application:

• Primary screening

• Determining prognosis

• Monitoring therapy

CA 125

[Tumor Markers]

Primary Malignancy: Ovarian

CA 19-9

[Tumor Markers]

Primary Malignancy: Pancreatic

CA 19-9 & CA 15-3

[Tumor Markers]

Clinical Application: Monitoring therapy

CA 15-3 & Human epidermal growth factor receptor 2 (HER 2)

[Tumor Markers]

Primary Malignancy: Breast

Human chorionic gonadotropin (HCG)

[Tumor Markers]

Primary Malignancy: Trophoblastic

Human epidermal growth factor receptor 2 (HER 2)

[Tumor Markers]

Clinical Application: Predicting response to therapy

Alpha-fetoprotein (AFP)

[Tumor Markers]

Primary Malignancy: Hepatocellular

Alpha-fetoprotein (AFP)

[Tumor Markers]

Clinical Application: Primary screening and monitoring therapy

Pepsinogen

[Tumor Markers]

Primary Malignancy: Gastric

Pepsinogen

[Tumor Markers]

Clinical Application: Primary screening