exammmm

• GFR can be calculated using:

  1.) inulin

  2.) CREATENINE

  3.) Crystatin C
• creatine clearance should not be used in patients with fluid overload, extremes of age, AKI
• albumin in urine is an indicator of glomerular integrity of the kidneys
• glucose in the urine = renal dysfunction or DM
• low molecular weight proteins in urine = renal tubular damage
• urinalysis:

  • proteins - renal tubular function
  • glucose - renal tubular function / DM
  • ketones - DM DKA
  • Nitrites - UTI
  • Leukocytes - UTI
  • Haemoglobin - bleeding in urinary tract
  • Bilirubin - liver disease
  • Blood - intake or lysed RBC
• pre-renal AKI

  • blood = urea > createnine
  • urine = low sodium, high osmolality
• intrinsic AKI

  • blood = plasma urea & createnine
  • urine = high sodium
• CKD

  • blood = increased urea, createnine [H+], decreased H2C03, decreased sodium
  • decreased GFR, constant osmolality
• diagnosis of DM

  symptoms (polyuria and polydipsia) + random blood glucose measurement > 11.1
• IFG -> IGT -> DM
• c-peptide is released in equal amounts to insulin

  IF DM1 = c-peptide will be 0

  IF DM2= presence of c-peptide
• DKA

  • hyperglycaemia (high glucose, low insulin)
  • vomitint, fluid depletion
  • High levels of ketones
• Hyperosmolar Hyperglycaemic State

  • type 2 DM
  • gradual onset of symptoms
  • dehydration, neurological symptoms
  • no ketones
• diabetic neuropathy

  • microalbuminuria
• hypoglycaemia

  1. insulin induced (missed meal)
  2. insulinoma (high insulin)
  3. alcohol induced (increased insulin)
  4. sepsis (cytokines -> insulin)
• TSH indicated thyroid function
• hyperthyroidism:

  • low TSH, increased fT3/fT4
  • graves disease
  • Thyroid nodule
• hypothyroidism:

  • Hashimoto's thyroiditis, iodine deficiency
  • elevated TSH, decreased fT4 (later stages = fT3)
• micro/macro/normocytic anemia = MCV
• Hb abnormalities:

  • structural = abnormal Hb subunit
  • thalessemia.= decreased genes hB subunit
  • alpha/bega
• Sickle cell disease:

  • decreased hematocrit
  • presence of sickle cells in blood smear
  • anemia symptoms
• thalassemia

  • microcytic anemia
  • RBC increased