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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 • • • • Sodium- ( Potassium- 3.5- 5.4 Chloride- ( Bicarbonate- 22-28 ) ) ( • • • • • • • Lethargy Confusion Irritability Seizures Tachycardia ( ) Dry oral mucosa ) ( • • • • • • • • • Confusion Convulsions ( ) Headache Loss of appetite Muscle spasms Muscle weakness ( ) N/V ) ( • • • • • • 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 • • • • ( ) Excreted by kidneys Used to diagnose ( ) Also increases after radiation/chemo LIVER FUNCTION ( • • • • ) 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 • • • • • • 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 • • • • • • • Nervousness Irritability Increased Perspiration ( ) Weight loss Intolerance to ( hyperactivity ) Hypothyroidism • • • • • • • 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 • • • • • • • • ( ) Faintness Weakness Hunger Diaphoresis Visual disturbance ( ) Personality changes Hyperglycemia • • • • • • • ( ) 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