Term
| What is the single best index of functioning renal mass? |
|
Definition
GFR (about 125 mL/min)
exogenous markers: inulin
endogenous markers: urea and creatinine |
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Term
| what is the normal range of BUN? |
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Definition
8-20 mg/dL
not an ideal marker of GFR (used to aid assessment of hydration status, renal function, protein tolerance and or catabolism) |
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Term
|
Definition
| 0.7- 1.2 mg/dL--> should not be used alone to assess the level of kidney function. |
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Term
| What almost always indicates worsening of renal function? |
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Definition
| rise in SCr (increased caused by: dehydration, renal dysfunction, urinary tract obstruction, excess exercise, meds causing nephrotoxicity) |
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Term
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Definition
| suspect V depletion and pre-renal |
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Term
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Definition
| suspect intrinsic renal damage |
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Term
| C-G equation is used to primarily do what? |
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Definition
| predict CrCl, not GFR; used primarily to adjust med dosage (MDRD is not used to adjust med dosages) and used to assess renal function in adult pts w/ stable serum Cr at SS. |
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Term
| FENA test is used for what and how do you interpret <1, 1-2, and >2%? |
|
Definition
used to distinguish causes of sudden oliguria or azotemia
Pre-renal causes (<1%)-- V depletion
Indeterminate (1-2%)
Intra-renal causes (>2%) ex acute tubular necrosis |
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Term
| Normal pH of arterial blood and lower and higher pH terms |
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Definition
7.36- 7.44
lower pH= acidemia
higher pH= alkalemia |
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Term
| what maintains acid-base homeostasis? |
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Definition
|
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Term
| what is the principal rule of the lungs? |
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Definition
| regulation of PaCO2 and oxygenate blood |
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Term
| principal role of kidneys? |
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Definition
| regulation of HCO3 conc and excretion of non-volatile acids produced by the body (primarily occurs in the distale tubule) |
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Term
| Arterial pH is the 1st value to consider with acid-base status; what is the normal range? |
|
Definition
7.36-7.44
lower is acidemia and higher is alkalemia |
|
|
Term
|
Definition
36-44 mmHG
demonstrate the adequancy of lung function in excreting CO2 (elevation indicates inadequate ventilation) |
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Term
|
Definition
| 80-100 mmHg (demonstrates the level of oxygenation of arterial blood) |
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Term
| Reduced pO2 with elevated pCO2 indicates? |
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Definition
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Term
| Reduced pO2 with low or normal CO2 indicates? |
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Definition
|
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Term
| What is the normal range of serum bicarbonate? |
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Definition
|
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Term
| An anion gap results in what? |
|
Definition
metabolic acidosis; AG= Na -(Cl + HCO3)
Normal AG is 3-11 mEq/L |
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Term
| What is a non-anionic gap acidosis? |
|
Definition
| conditions that cause metabolic acidosis by either prod of HCL or by excessive loss of bicarb (AG is normal) |
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|
Term
| what is the normal range of serum lactate? |
|
Definition
|
|
Term
| Normal venous partial pressure of O2? |
|
Definition
| > or equal to 70mmHg (lower values indicate that tissues are extracting higher fractions of O2 than normal--> pulling it out on the venous side) |
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Term
| which acid base compensation is slow and which is quick? |
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Definition
| renal comp occurs slowly and pulmonary comp occurs quickly |
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Term
| when does hypoglycermia occur? |
|
Definition
|
|
Term
| what are the reference ranges for FPG? |
|
Definition
<100= normal
>100 and <126 is prediabetes
>126 is Diabetes
Best screening test! |
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Term
| What is abnormal for 2-hr postprandial glucose? |
|
Definition
>180 for diabetics
>200 = diabetes |
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|
Term
|
Definition
>200 at 2 hr PG= provisional diagnosis for diabetes
140-200 = prediabetes
drink 75 g of glucose in 5 min |
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Term
| Glycosylated Hemoglobin or AIC reference range? |
|
Definition
| >7% is poor glucose control (indicative of glucose control during preceding 2-3 mths (lifespan of RBC is 90 days) - fasting is not required |
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|
Term
|
Definition
converts A1C to an est avg glucose that is more refined and accurate
eAG= (28.7 x HbA1c)- 46.7 |
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|
Term
| Fructosamine reference range? |
|
Definition
<285= normal
protein with glucose complex (not with erythrocytes like A1c--> which is over 2-3 mths); this correlates control over 2-3 WEEKS (alerts deteriorating control earlier) |
|
|
Term
|
Definition
0.8- 1.5 ng/dL
used in conjunction with TSH |
|
|
Term
| normal range of total serum T4? |
|
Definition
| 4-12.5 ug/dL (both bound and free) |
|
|
Term
| normal range of serum triiodothyronine (T3) resin uptake (T3RU)? |
|
Definition
25-34%; estimates the # of binding sites on thyroid-binding protein occupied by T3
high= low thyroid binding protein
low= high thyroid binding protein |
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|
Term
| normal range of free T4 index? |
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Definition
| 1-4 units --> how much T4 is present compared to the thyroxin binding globulin |
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|
Term
| Normal range of total serum T3? |
|
Definition
| 78-195 ng/dL or 1.2-3 nmol/L; primarily used to indicate hyperthyroidism(not reliable for hypo) |
|
|
Term
|
Definition
0.25- 6.7 uU/mL
Rise in TSH indicates that pituitary gland's response to low circulating thyroid hormone--> 1st sign of thyroid failure |
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|
Term
| Normal range of TRH stim test? |
|
Definition
| TSH rise of 5uU/mL over baseline is normal. Measures the ability of exogenous TRH to stim pituitary to release TSH. |
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|
Term
| Normal range of Radioactive Iodine Uptake Test |
|
Definition
12-20% uptake at 6 hr
High uptake= hyperthyroidism
low uptake= hypothyroidism
CI in pregnancy |
|
|
Term
| Diagnosis of autoimmune thyroid disorder |
|
Definition
Antithyroid Ab;
Ab> 1:1000 are associated with Hashimoto's throiditis or Grave's disease |
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|
Term
| reference range of albumin |
|
Definition
|
|
Term
| reference range of prealbumin |
|
Definition
| 16-40 mg/dl (commonly used to assess nutrition); half life of 2 days (opposed to albumin which was 20 days) |
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|
Term
| reference range of Globulin |
|
Definition
2.3 g/dl (20-30 g/L); total protein- albumin = globulin
total protein just used to assess globulin (RR is 5.5-8.3 g/dl) |
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|
Term
| Reference range of prothrombin time? |
|
Definition
| 10-13 sec; elevated in severe hepatic impairment |
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|
Term
| reference range of uncong bilirubin (indirect) |
|
Definition
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|
Term
| What tests are used for measurement of cholestasis? |
|
Definition
| ALP (4 times than normal suggests cholestatic disorder--> 80% comes from liver and bone) and GGTP (helps determine if ALP elevation is from hepatic origin; no origin in bone or placenta; most sensitive, but poor specificty) |
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Term
| What tests are used to determine hepatocellular injury? |
|
Definition
| AST (RR= 8-42 IU/L), ALT (RR= 3-30 IU/L), LDH (RR= 100-125 IU/L) and Ammonia (RR= 30-70 g/dl) |
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|
Term
| Reference range of amylase and lipase |
|
Definition
Amylase: 44-128 IU/L
Lipase: <1.5 unit/mL |
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|
Term
| What is the reference range of ESR and the purpose? |
|
Definition
Males: 0-10 mm/hr
Females: 0-20 mm/hr
Acute inflammation (confirm diagnosis)
Increased ESR indicates need for more aggressive therapy (decreased means decrease in systemic inflammation) |
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|
Term
| Reference range of serum uric acid? |
|
Definition
3.4- 7 mg/dL (males)
2.4- 6 mg/dL (females) |
|
|
Term
| What is the target plasma conc of Phenytoin? |
|
Definition
10-20 mg/L
*Half life is 6-60 hours
*SS is not attained for as long as 3 wks
*Monitor levels before SS for toxicity |
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|
Term
| What is the trough and peak goal of Vancomycin? |
|
Definition
trough: 5-10 mg/L (draw 0.5- hr before next dose)
peak: 30-40 mg/L (draw 2-3 hrs after dose) |
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Term
| What is the goal range of digoxin and when do you draw levels? |
|
Definition
Goal range: 0.5-2.0 ug/L
HF: 0.5-1.0 ug/L
AFib: 0.8- 1.5 ug/L
Draw level at least 6 hrs after dose |
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Term
| The amount of air breathed in or out during normal respiration? |
|
Definition
|
|
Term
| the amount of air left in the lungs after maximal exhalation? |
|
Definition
|
|
Term
| the amount of air that can be forced out of the lungs after a maximal inspiration? |
|
Definition
|
|
Term
| amount of additional air that can be breathed out after the end exp level of normal breathing? |
|
Definition
| Expiratory reserve volume |
|
|
Term
| What is the effect of obstructive and restrictive disease on the FEV1:FVC ratio? |
|
Definition
Obstructive: decreased ratio
Restrictive: normal ration (sometimes increased)
normal value is above 70-75% (age dependent) |
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