Normal Creatnine level is what?

What are 3 reasons for a Elevated Creatnine level?

0.6 -1.3 mg/dl

Age
Musculoskeletal disorders
Crush injuries
 

BUN normal Levels?

What level would mark "serious renal fct impairment"

8-20 mg/dL

50-150 mg/dL

-Whare are the 2 tissues that REQUIRE GLUCOSE?

-What Adrenal Gland Dz might Hyperglycemia be indicative of ?

-what Thyroid dz?

-what else would we need to look for to diagnose this thyroid problem?

-Any other dz hyperglycemia MAY be related to?

-RBCs and Brain

-Cushing's Syndrome (too much ACTH(cortisol) produced by pituitary...leads to Insulin resistence)

-Hyperthyroidism

-Look at T3 and T4 levels

-Obesity

For Hypoglycemia...what might be going on? (there are 4 we discussed)?

Addison's Dz

Hypopituiitarism

Insulinoma

Galactosemia (can't turn galactose to glucose)

-What are normal Sodium Levels?

-What is Hyponatremia indicative of?

-What is Hypernatremia indicative of?

135-145 mEq/L

-Diabetic (Every 100 mg/dl of plasma glucose there is a 1.7 mEq/L decrease in sodium
), vomitting, chronic diarrhea, or fluid overload

 - Severe DEHYDRATION

Normal Potassium Levels?

Hypokalemia indicative of?

Hyperkalemia?

-Normal Range 3.5 - 5.0 mEq/L = mM/L

-Hypokalemia:  Vomitting, diarrhea, insulinemia (insuline forces K into cells...along with glucose) Diuretics

-Hyperkalemia:  Tissue breakdown (injury, electrocution) renal failure

Normal Chloride Levels

These levels are higher in what case?

Decreased in what cases?

(Normal Range 95-105 mEq/L = mM/L

Hyperchloremia: Increased in metabolic acidosis associated with prolonged diarrhea
 

Hypochloremia: Decreased in prolonged vomiting, chronic respiratory acidosis, adrenocorticoid insufficiency, burns, drugs
 

What are normal CO2 levels in the BLOOD (mEq/L)

What are the 3 ways blood is carried in the blood?

1)(about 70% – 80%) is converted to bicarbonate ions (HCO3−)

2) is dissolved in the plasma 5% – 10%
3) is bound to hemoglobin as carbamino compounds
 

- Arterial Blood Values

Values
pH:       
PCO2:       
PO2:     

-What does excess heparin do to pCO2 values?

-pH:  7.36 - 7.44

-PCO2:  38-42 mmHg

-P02:  85-100 mmHg 

-It depresses them

-What is Henderson's Equation that spells out the relationship between [H+], [HCO3-] and PCO2 levels

H + = 24 * PaCO2 * HCO3

What is ONLY DIRECT WAY OF MEASSURING GFR.  128 is Normal Range. 

What is normal CrCl range in Males...

In females ....

Immuline Clearance Test

85-125 mL/min/1.73m²

75-115 mL/min/1.73m² 

Type I DM makes up __% of diabetics and is an autoimmune disease

How much insulin do Type I's secrete...?

Do we expect high leveles of C peptide?

Any tendencies?

5-10% (self-Ab present 85-90% of time)

Virtually NONE

None or very little

Prone to DKA (ketoacidosis from breakdown of fats to fight body starvation)

-When do Type II's get Ketosis?

-Plasma Insulin levels?

-Stress or INFECTION

-Normal to HIGH

-WHat autoAB do we look for in Type I DM

-Which Islets produce Glucagon?

-Which produce Insulin?

What is C-peptide a marker for?

-Islet Cell autoantibodies

-Alpha

-Beta

-Insuline levels (C-peptide is a peptide which is made when proinsulin is split into insulin and C -peptide. )

What is the short name for glucose bound to hemoglobin?

What is the formula for figuring BS_avg from this? 

HbA₁C

BS_avg= (HbA₁C * 33.3)-86

 -What group is the Glucose Tolerance test good for?

What are the BS levels for dx DM II for the following tests:

-Random plasma glucose  when there are classical symptoms
-Fasting >8 hrs glucose

-2 hr  plasma glucose after 75 g glucose load
 

 Pts with borderline fasting glucose levels, pregnant women for gestational DM,

-Random plasma glucose >200 mg/dL

-Fasting >8 hrs glucose > 126 mg/dL

-2 hr  plasma glucose > 200 mg/dL after 75 g glucose load

What are normal CALCITONIN levels for EACH GENDER?

If we have high levels of Calcitonin...what should we expect of our Calcium levels?

Normal Range:

4.5 ± 0.7 pg/mL males;

2.7 ± 0.4 pg/mL females

-They be Low

Who organ secretes TSH?

Normal Levels?

What does TSH do?

-Secreted by anterior pituitary

   -(Normal Range 0.4-4.2 µU/L = 0.32-5.0 mU/L)

-Regulates T3/T4
Increased in untreated hypothyroidism

-What 2 dz's will have a positive Thyroid autoAb result?

-Is T3 or T4 the active hormone?

-Normal levels of T3?

-Of T4?

-Grave's (85% positive Ab test) and Hoshimoto's (95%)

-T3

- T3: Normal 260-480 pg/dL

- T4: Normal Range 5-12 µg/dL

What does Calcitrol do?

Normal levels?

High levels could indicate what?

Who secretes it?

Helps Gut sequester Calcium

    Normal Range 70-348 pg/mL 

Increased in Sarcoidosis & Non Hodgkin Lymphoma

The Kidney

Relating to pH...what could High Calcium levels mean?

What is the normal Calcium Range?

Who carries Calcium in the blood?

Acidosis

8.6-10.0 mg/dL 

Albumin (you gotta meassure these levels along with Ca levels)

Normal Range for Phosphorous

What does Insulin due to these levels?

What other electrolyte is Phosphate metabolism linked to?

 What happens to Calcium levels in Kidney dz when Phosphates are retained

Normal Range 2.7-4.5 mg/dL

Lowers them by forcing them into the cell (just like K+)

Calcium

Calcium serum levels are depleted... leads to SECONDARY HYPOTHYROIDISM

T/F...Antacids/EtOH increase intestinal absorption of Phosphorous?

What are normal Mg Levels?

What can wipe out the results of a Mg test?

 What type metabolism is Mg involved in?

False...they decrease it's absorption

Normal Range 1.6-2.6 mg/dL 

Many common lab detergents

Calcium Metabolism (with help of PTH)

Restoring Mg levels from a depleted state to normal may alleviate what thyroid problems?

Normal Levels for PTH?

What does this hormone do?

What 3 ways does it do this?

Hypoparathyroidism

10-65 pg/mL (varies by laboratory) 

Controls Calcium Serum levels

-increase Vit D

-Increase renal tube resorbtion of Ca

-Increase intestinal calcium resorbtion

What is often called "disease of bones, stones, and groans"

What is a key marker for this?

Primary Hyperparathyroidism (Due to inappropriate secretion of PTH (parathyroid hormone) pulling calcium from the bone, reabsorption of urine calcium and promotes absorption of dietary calcium)

High levels of Calcium

What causes Secondary Hyperparathyroidism?