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Phys Chem Test 1

FSC: Phys Chem Test 1

Reasons for biochemical tests determine a disease with a metabolic basis observe/monitor for biochemical changes that are caused by an ailment"
Biochemical Test Purpose Diagnosis: identifying disease Prognosis: likely course a treatment or disease might take Monitoring: monitor treatment for appropriateness Screening: mandatory a specific ages, during epidemic conditions and to determine subclinical ailments
Screening Tests TB Test, PKU (phenylketonuria) - infants prior to hospital release, scoliosis - school children
Serum straw colored fluid, obtained by letting blood stand and clot (no -anticoagulants added); does not have fibrinogen
Plasma yellow fluid on top, anticoagulant added to blood which is centrifuged; has fibrinogen
Serum vs. Plasma serum does not have fibrinogen or anti-coagulants, plasma has both
All extracted fluids must be accompanied by test order that has: Pt. name, sex, dob, date and time of sample collection, type of test to be done, possible diagnosis, MD name/number, medications pt. is taking, if inpatient: room number, unit
Biochemical Tests can be run for Glucose, CBC, BUN, creatinine clearance (blood and urine), total protein, lipid panel, vit c, minerals (iron, chloride, sodium)
Errors in Biochemical Analysis Pre-analytical Stage, Analytical Stage, Post-Analytical Stage
Pre-analytical Stage Errors sample collection affected - sample contamination, inappropriate chemical in collecting apparatus, sample transport issues
Analytical Stage Errors errors in procedure by technicians, machine failure produces incorrect results
Post-analytical Stage Errors calculating, and recording results errors - report the wrong results for the wrong patient
Interpretation of results There is a stable range of results for different genders/age groups/ethnicities
H2O percentages: male 60%
H2O percentages: female 55%
H2O percentages: infant 70%
Lean body mass H2O percentages 75-80
ICF vs. ECF 66% total body water ICF
Water in ECF 7-8% makes up plasma volume, rest is synovial fluid, peritoneal fluid ect.
Water Balance Amount of water intake should nearly equal amount of water lost
Sources of water intake pure water, fluids (soup, juices, milk, etc.), foods (high in H2O: fruits and vegetables)
H2O release by oxidative metabolism Glucose + O2 -> CO2 + H2O
Routes of H2O Output "Respiratory: release of H2O vapors Skin: sensitive and insensitive perspiration Renal: urine GI Tract: fecal matter, stool; (sick: vomiting/diarrhea) Eyes: tears"
Factors that influence H2O balance climate, disease/illness, cultural factors, availability of water or food, physical activity, medical treatment
Osmotic Concentration "aka osmolality -influence H2O movement into and of cell"
Osmotic Concentration contributing factors "mineral concentration: K in ICF; NA, CL, HCO3, MG in ECF other molecules: glucose, proteins (amino acids) outside of cell"
Oncotic Pressure the fluid pressure produced by protein levels
Obligatory Loss "1500mL/daily Skin - sweat - 500mL Lungs - gaseous H2O - 400mL GI - fecal H2O - 100mL (enzyme & saliva - reabsorbed) Kidney - urine - 500mL (min)"
Reasons for water excretion excretion of water soluble waste, to maintain proper ECF and ICF osmotic balance
Obligatory Sources "Oxidative metabolism - 400mL Dietary Intake - 1100mL"
Amount of urine is produced in 24 hours 1500-2000 mL
Dehydration: causes decreased intake-rare-fasting, air travel, extreme cold temp; Increased loss - GI dist, High temp, excessive sweating, post-op, hyperventilation, diuretics(natural, medications), low BG(sweating), high BG(dilute urine produced), increased ETOH intake, DKA
Dehydration: symptoms Thirst, Dryness of mouth/skin - decreased skin turgor, Oliguria(400-700mL), Hypotension, Tachycardia- heart muscle, Muscle weakness, cramps, dizziness, Weight loss Extreme - cerebral dehydration - cerebral vessels can tear - resulting in hemorrhage
Dehydration: Management increased oral intake, IV - 5
Gradual Rehydration 2/3 of H2O balance in 1 day, important in cerebra edema; rapid cerebral rehydration can result in brain vessel rupture
Ways by which body tries to correct dehydration "1. Hypothalamic thirst centers stimulated- feeling of thirst-pt. drinks fluid 2. ADH production (vasopressin) is increased- diuresis prevented-less urine excreted 3. Redistribution of H2O between ICF and ECF- H2O diffuses out -isotonic balance maintain
Electrolyte substance whose solution conduct electricity
Ionic substances separate into "positive ions - cations negative ions - anions"
Positive Ions Cations - potassium (K+), sodium (Na+)
Negative Ions Anions - Chloride (Cl-), Bicarbonate (HCO3-), Potassium Sulfate (SO4 2-), HPO4-
ECF Ions Sodium, chloride, Bicarbonate
Hyponatremia: causes More often due to excessive sodium lost the decreased intake; burns, excessive sweating, increased physical exercise, V/D, overfunction of hormonal function
US Sodium Intake/output Intake: 100-200mmol/L , Output: <100mmol/L
Hyponatremia: symptoms thirst, dryness of skin, loss of skin tone, weight loss, muscular weakness/cramping, altered cardiac function
Hyponatremia: Treatment "Treat underlying cause: DM, hormonal malfunctions, renal causes Saline IV- observe while administering"
Hypernatremia: Causes increased sodium intake
Hypernatremia: Symptoms thirst (because H2O follows salt), water retention, high b/p, hypertension, dyspnea, abnormal EKG - can lead to cardiac arrest
Potassium: Role neuromuscular control, maintains ICF osmolality
Hyperkalemia: Causes protein malnutrition, vomiting, excessive sweating (excretes sodium in sweat - kidney reabsorbs sodium and excretes potassium)
Hypokalemia: Treatment oral supplements, IV- monitor closely, rapid absorption can cause alterations in heart function
Hydrogen Ion Concentration results form respiration and metabolism influence the pH of the body
Normal pH range 7.35-7.45
Buffer combination of a weak acid and its salt or a weak base and its salt that resists the pH change
Buffer system: H2CO3 /HCO3- (carbonic acid/bicarbonate ion)
Buffer system: H3PO4 /PO4-3 (phosphoric acid/phosphate ion)
pH scale decides acidity/alkalinity in a system
Acidic pH 0
Neutral pH 7
Alkaline pH 14
Respiratory acidosis/alkalosis causes hypo or hyperventilation
Metabolic acidosis/alkalosis causes dealing with oxidative products of metabolism
Process of alkalosis/acidosis more H+ = acidosis, more HCO3- = alkalosis normal: hydrogen ion produced = ion excreted by lungs/kidneys, imbalance results in alkalosis or acidosis
Body chemistry equations CO2+ HCO3 = H2CO3 = H+ +HCO3-
Metabolic Acidosis: Defined increased H+ production and decreased H+ excretion
Metabolic Acidosis: Causes - Excessive H+ acidic food in diets, increased: ketoacidosis (DM, starvation, ETOH), lactoacidosis (exercise + dehydration), drugs (salicylates, diuretics), sulfur containing amino acids (via parenteral admin, lysine, arginine, histidine or cysteinie), diarrhea
Metabolic Acidosis: Causes - Decreased H+ excretion renal failure, increased sensation of pancreatic juices and enterokinal (small intestine) secretions that produce alkalinity
Metabolic Acidosis: Management rehydration, treat underlying cause, medications: insulin therapy for DM, chelates to remove salicylates; extreme conditions: HCO3- supplements given under careful monitoring
Respiratory Acidosis: Defined CO2 is being retained and it converts to H2CO3 = H+ and HCO3-
Respiratory Acidosis: Causes Hypoxia, anxiety, fear, trauma to brain/diaphragm, infection (pulmonary edema ie bronchitis, asthma, COPD), drug intoxication, lack of neuromuscular control
Respiratory Acidosis: Management air passages need to be dilated; medications: inhalers (vasodilators), antibiotic therapy; Extreme cases- ventilators (O2 support)
Metabolic Alkalosis: Causes removal of H+ (GI disturbances - V/D/Gastric aspirations, congenital chloride loosing diarrhea), hormonal disturbances (promote diuresis), increased intake of some drugs (over dependence on antacids)
Metabolic Alkalosis: Management correction of gastro disturbances; potassium therapy - monitor closely
Respiratory Alkalosis: Defined excess CO2 is being exhaled
Respiratory Alkalosis: Causes hyperventilation due to anxiety, fear, excitement; severe anemia, high altitude, excessive exercise, cerebral trauma
Respiratory Alkalosis: Management Breath into paper bag, rebreathe exhaled CO2
Hypokalemia: Symptoms muscle aches/weakness/cramping, dizziness, generalized apathy Extended Deficiency: EKG changes, cardiac malfunction
Created by: kallenpoole



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