DIAG 2735 8b - Blood Chemistry Testing

DIAG 2735 8b - Blood Chemistry Testing - Proteins and...

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Proteins and Metabolites Proteins and Metabolites Blood Urea Nitrogen (BUN) Creatinine Uric Acid Protein Electrophoresis Haptoglobin Transferrin Plasma Ammonia
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Blood Urea Nitrogen Blood Urea Nitrogen End product of protein metabolism Converted from ammonia in liver Excreted in kidneys Represents 40-50% of non protein nitrogen
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BUN Levels BUN Levels Normal 8-20 mg/dl Elevation Renal disease (not filtering and excreting) Decreased GFR, azotemia -> uremia -> Burr cells Reduced renal blood flow (with mild polycythemia) Urinary tract obstruction Increased protein catabolism
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Creatinine Creatinine More sensitive test then BUN for renal failure b/c creatinine is found at a constant rate Creatinine is not reabsorbed in kidneys
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Creatinine Creatinine Normal is .8-1.2 mg/dl Urine level dropping indicates pathology In serum, creatinine elevation indicates pathology to at least 50% of the nephrons
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Uric Acid Uric Acid The gout test Men 3.4-7 mg/dl Women 2.3-6 mg/dl Elevated levels of serum uric acid indicates gout
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Protein Electrophoresis Protein Electrophoresis Measures albumin, globulin, and ratio Total protein 6.4-8.3 g/dl Albumin 3.5-5 g/dl Total globulins 2.3-4 g/dl Albumin:globulin ratio should be > 1, if it’s not it might be due to cancer
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Total Protein Elevation Total Protein Elevation Dehydration Plasma volume drops Vomiting/diarrhea Lose lots of electrolytes Chronic infection/ inflammation Cancer Leukemia *Multiple myeloma* A/G ration < 1 b/c globulins are going to increase
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Total Protein Decrease Total Protein Decrease Malnutrition GI disorders Malabsorption Liver disease
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Albumin Level Albumin Level Increase Multiple myeloma switches A/G ratio Decrease See total protein
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Globulins Globulins Increase Multiple Myeloma Decreases with AIDS, thrombocytopenias
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Albumin :Globulin Ratio Albumin :Globulin Ratio Should be greater than 1 Ratio reverses in multiple myeloma Produces lots of globulins Lupus decreases A/G ratio, an autoimmune disease producing lots of antibodies (globulins)
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Haptoglobin (albumin) Haptoglobin (albumin) Produced by liver -> albumin Binds free hemoglobin, keeps it out of plasma Normal value 40-180 mg/dl
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Haptoglobin levels Haptoglobin levels Decreased Acute or chronic hemolysis Severe liver disease Increased Chronic inflammation with tissue destruction Infection
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Transferrin (albumin) Transferrin (albumin) Aka siderophilin Transports iron in blood Test evaluates iron metabolism Usually around 30% saturated
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Transferrin - transfers iron Transferrin - transfers iron Normal 200-400 mg/dl Decreased Liver disease Increased Severe iron deficiency, if you drop iron in a blood sample it’s more active b/c it’s not being used up
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Phenylalanine Phenylalanine Guthrie test
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DIAG 2735 8b - Blood Chemistry Testing - Proteins and...

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