CMP (Quiz 2)

what is the purpose of a CMP?

snapshot of blood chemistry

how the body is using energy

quick check on liver and kidneys

what areas are checked in a CMP?

glucose, calcium, proteins, electrolytes, kidney and liver

what is the difference between a basic metabolic panel and a CMP?

liver function, basic and general metabolic function

what does elevated glucose levels often indicate?

diabetes

what other conditions might lead to elevated blood glucose?

excessive food intake

acute physiological stress

endocrine disorders

what fasting blood glucose range is normal?

70-99 mg/dL

what fasting blood glucose range is pre diabetic?

100 to 125 mg/dL

what fasting blood glucose range is diabetes?

126 and above

what percent of blood proteins is albumin?

60

if there is a decrease in production of albumin or globin due to malnutrition, cancer or severe liver disease what happens to total protein levels?

the decrease

if there is in increase in the breakdown or loss of protein due to kidney disease, what happesn to the total portein value?

decreases

if a patient has and increase or expanded volume of plasma from something like CHF, what happens to total protein levels?

they decrease

what conditions may cause total protein levels to increase?

increase production of proteins do to inflammatory disorders

decrease in volume of plasma due to dehydration

what conditons may cause hypercalcemia?

diseases that cause bone turnover such as cancer or parathyroid diseases

what diseases may cause hypocalcemia?

liver disease causing low albumin, malnutriton or malabsorption

what are the follow up tests for calcium?

total calcium and ionized Ca

what are the electrolytes measured in a CMP?

sodium, potassium, chloride and bicarbonate/CO2

what may cause hyponatremia?

decreased Na intake

increased Na losses

increased fluid intake and or retention

decreased body water loss

what does hyponatremia reflect?

an excess of total body water relative to total body sodium content

what may an absolute loss of sodium be due to?

decreased intake coupled with its continual excretion in the urine

what are examples of conditions that may cause an absolute loss of sodium?

excessive sweating, diarrhea, use of diuretics, addison’s disease, excessive production of urine

what may be a cause of a relative decrease in blood sodium?

an imbalance of sodium in one of the body’s other fluid compartments or from an increase in total body water

what conditions may cause a relative decrease in blood sodium?

water retention related to edema or CHF, liver failure, kidney failure, intake of hypotonic solutions

what does hyponatreimus cause at the cellular level?

cellular swelling

what is hypernatremia?

an increase in serum sodium concentration caused by a decrease of total body water relative to solute

what may cause hypernaterima?

impairment of thirst mechanism or lack of access to fluids causing dehydration

increased sodium intake

decreased sodium loss due to cushing’s

increased body water loss from decrease in ADH or sweating

what is hypokalemia?

decreased intake of potassium or excessive losses of potassium in the urine or GI tract

what are possible causes of an absolute loss of potassium?

vomiting, diarrhea or renal loss

what is the cause of a relative decrease in potassium?

insulin-dependent diabetes

what population is hyperkalemia seen in most commonly?

hospitalized patients as a result of severe disease and or medications used to manage those disease

what medications may cause hyperkalemia?

ACE inhibitors or angiotensin receptor blocers for blood pressure

what does chloride do?

helps to regulate the acid/base balance and fluid levels, usally correlates with sodium levels

what will cause a proportional loss of sodium and chloride?

loss of free water or gain of electrolyte rich fluid

if chloride is gained or lost in excess of sodium, what is inidcated?

metabolic acidosis or alkalosis

what is the cause of hypochloremia?

defective renal tubular absorption

what can lead to hypochloremia?

vomiting, diarrhea and metabolic acidosis

what can cause hyperchloremia?

dehydration

excessive intake (dietary saly NaCl)

CHF

cycstic fibrosis

does addison’s disease cause low or high bicarbonate levels?

low

does chronic diarrhea cause low or high bicarbonate levels?

low

does diabetic ketoacidosis cause low or high bicarbonate levels?

low

does metabolic ketoacidosis cause low or high bicarbonate levels?

low

does compensated respiratory alkalosis cause low or high bicarbonate levels?

low

does shock cause low or high bicarbonate levels?

low

does kidney disease cause low or high bicarbonate levels?

low

does ethylene glycol or methanol poisioning cause low or high bicarbonate levels?

low

does salicylate (aspirin) overdose cause low or high bicarbonate levels?

low

does diarrhea cause low or high bicarbonate levels?

low

does severe prolonged vomiting cause low or high bicarbonate levels?

high

does lung disease like COPD cause low or high bicarbonate levels?

high

does Cushing syndrome cause low or high bicarbonate levels?

high

does metabolic alkalosis cause low or high bicarbonate levels?

high

what are the kidney tests of a CMP?

BUN and creatinine

what other tests may be included for kidney function but are not part of the normal CMP?

BUN/creatinine ration and GFR

what are the liver tests of a CMP?

alkaline phosphatase (ALP)

alanine amino transferase (ALT, SGPT)

aspartate amino transferase (AST, SGOT)

billirubin