Clinical biochemistry

• Define Accuracy

  How close to the measured value is the actual value?
• Define Analytical Sensitivity

  How little of the analyte can be detected by the assay?
• Define Analytical Specificity

  How good is the assay at discriminating between the requested analyte and other interfering substances?
• What is a U and E test

  Urea, Creatinine and Electrolytes.
• What is a LFT test

  Liver function test
• What is in these blood test tubes and what are they used for.

  X.

  A) No anticoagulant

  B) Serum

  C) Clot forms

  D) Serum seperating gel

  E) serum

  F) Clot forms

  G) EDTA anticoagulant

  H) Plasma

  I) Blood and lipid analysis

  J) Lithium heparin anticoagulant

  K) Plasma

  L) Flouride oxalate

  M) Plasma

  N) Preserves glucose and lactate

  O) Heparinized syringe

  P) Arterial blood

  
• What substances can be tested for the patients fluid and electrolyte balance or renal function

  Sodium.

  Potassium.

  Urea.

  Creatinine.

  Chloride.

  Bicarbonate ions.
• What is the main function of the kidney

  To regulate the extracellular fluid volume and electrolyte balance.

  To facilitate the excretion of waste products and selective reabsorption.
• What produces urea

  The liver via the breakdwon of protein.
• What produces creatinine

  It is a breakdown product of creatine in the muscles.
• What does a low GFR cause

  An increase is serum Urea, Creatinine and sodium. This is because less filtration is occurring and is indicative of kidney function disorders.
• What is vasopressin

  Anti-diuretic hormone.
• What two hormones are involved in sodium and water reabsorption

  Vasopressin and Aldosterone.
• Where is ADH released

  Pituitary gland
• Where is aldosterone released

  Adrenal Cortex
• What is the effect of vasopressin

  Causes water reabsorption in the collecting ducts.
• What is the effect of aldosterone

  Causes reabsorption of sodium in the distal convoluted tubule
• What is the standard range for serum sodium

  135 - 145 mmol/l
• What is the standard range for potassium in the blood

  3.4 - 4.9 mmol/l
• What is the measurement in hypernatreamia

  Na > 145
• What causes hypernatraemia

  Dehydration.

  Excess sodium intake.

  Renal failure.
• What are the clinical findings in hypernatraemia

  Decrease in BP due to water depletion.

  Or an increase BP due to excess sodium intake.

  Urine output decreases.

  Dry mucous membranes.
• What is the treatment for Hypernatraemia

  Oral water.

  IV 5% dextrose to increase blood sugar.
• What is the measurement in hyperkalaemia

  K > 4.9 mmol/l
• What are the cuases of hypokalaemia

  Vomiting.

  Diarrhoea.

  Diuretics.
• What are the clinical signs of hyponatraemia 


  Weakness.

  Cardiac arrhythmias.
• What is the treatment for hypernatraemia

  Oral or IV potassium
• What is the measurement for hypokalaemia

  K < 3.4
• What can hyperkalaemia cause

  cardiac arrest
• What is the cause of hyperkalaemia

  Renal failure.

  Adrenal failure.

  K released from damaged cells
• What is the treatment for hyperkalaemia

  Calcium gluconate.

  Insulin or glucose dialysis
• What is the measurement in acute renal failure

  No urine seen as < 400 ml/day.
• What causes ARF

  Lack of blood supply to kidneys.

  Kidney damage.

  Obstruction preventing urinary damage.
• What are the clinical signs of ARF

  Concentrated urine.

  Increase in serum urea and creatinine.

  Hyperkalaemia due to the low GFR.
• What is the treatment for ARF

  Dialysis
• What are the clinical signs in CRF

  Hyperkalaemia due to the low GFR.

  High serum urea and creatinine.
• what is the treatment for CRF

  Restriction of sodium and protein intake.

  Diuretics.

  Oral ion exchange resin which results in Potassium removal.

  Dialysis.

  Transplant.
• What is the measurement in hyponatraemia

  Na < 135
• What are the two types of hyponatraemia

  Water retention and sodium loss.
• What are the causes of hyponatraemia via sodium loss

  Vomiting.

  Diarrhoea.

  Lack of sodium intake.

  Lack of aldosterone.