Metabolic Panel

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1. BUN serves as a index of function of both liver and kidney, and is used clinically as a rough measurement of renal function.
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2. Your patient has an abnormal sodium test result. He is agitated and restless, with hyperreflexia. Is this hyponatremia or hypernatremia?
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3. In your patient with abnormal sodium levels due to hyperaldosteronism, what other electrolyte problem are they likely to have?

Explanation

Aldosterone increases potassium excretion

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4. Creatinine is a measure of ______ function, and decreases with age (less muscle mass).
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5. Your patient has secondary hypertension due to hyperaldosteronism. Would you expect to find hypernatremia or hyponatremia in this patient?

Explanation

Aldosterone causes sodium retention

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6. Your patient has an arrhythmia. In a general sense, which electrolyte is likely the problem?
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7. Your patient has an abnormal sodium test result. She is very lethargic and confused. Is this hyponatremia or hypernatremia?
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8. Abnormalities in sodium level usually are reflecting a true sodium abnormality.

Explanation

Abnormal levels usually reflect a variation in serum water volume rather than sodium content.

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9. What is the most common cause of electrolyte imbalance?
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10. This is NOT an indication for a metabolic panel.
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11. Your CHF patient has abnormal sodium test results. Would you expect this to be hyponatremia or hypernatremia?
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12. BUN is ________ in kidney injury and ________ in hepatic failure.
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13. Your patient is nervous and excitable. You observe tetany and find a prolonged QT interval. Is this hypocalcemia or hypercalcemia?
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14. These are part of the Basic Metabolic Panel.

Explanation

Basic:
sodium, potassium, chloride, carbon dioxide, BUN, creatinine, glucose, calcium
Complete:
all basic + AST, ALT, alkaline phosphatase, total bilirubin, total protein, albumin

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15. BUN:Creatine ration is usually ___.

Explanation

If greater than 20:1 consider pre-renal causes of azotemia (high BUN) such as dehydration or GI bleed.

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16. If you order a serum calcium (instead of a free calcium), what else do you need to order along with it?

Explanation

Half of calcium is bound to albumin. If albumin is low, then calcium level will also be low.
(You can run an equation to get a corrected calcium using a "normal" albumin of 4)

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17. Your patient is somnolent and has a shortened QT interval. Is this hypocalcemia or hypercalcemia?
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18. If you are unable to correct for low potassium, what should you check?
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19. Carbon dioxide level is a reflection of the body's pH. What would you expect to see in chronic diarrhea?
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20. Carbon dioxide level is a reflection of the body's pH. What would you expect to see in severe vomiting?
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21. These can be causes of hyperkalemia (check all that apply):

Explanation

Bumetanide is a loop diuretic - would be more likely to cause LOSS of potassium, hypokalemia

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22. All of these can be causes of LOW blood glucose except:

Explanation

thiazides can cause hyperglycemia

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23. If your patient is hypercalcemic, what other electrolyte should you check in order to help determine the cause of the hypercalcemia?

Explanation

If chloride is high, then the cause of the hypercalcemia is primary hyperparathyroidism.
If chloride is normal, then the cause of the hypercalcemia is malignancy.

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24. Which drugs can increase serum glucose? Check all that apply.
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BUN serves as a index of function of both liver and kidney, and is...
Your patient has an abnormal sodium test result. He is agitated and...
In your patient with abnormal sodium levels due to hyperaldosteronism,...
Creatinine is a measure of ______ function, and decreases with age...
Your patient has secondary hypertension due to hyperaldosteronism....
Your patient has an arrhythmia. In a general sense, which electrolyte...
Your patient has an abnormal sodium test result. She is very lethargic...
Abnormalities in sodium level usually are reflecting a true sodium...
What is the most common cause of electrolyte imbalance?
This is NOT an indication for a metabolic panel.
Your CHF patient has abnormal sodium test results. Would you expect...
BUN is ________ in kidney injury and ________ in hepatic failure.
Your patient is nervous and excitable. You observe tetany and find a...
These are part of the Basic Metabolic Panel.
BUN:Creatine ration is usually ___.
If you order a serum calcium (instead of a free calcium), what else do...
Your patient is somnolent and has a shortened QT interval. Is this...
If you are unable to correct for low potassium, what should you check?
Carbon dioxide level is a reflection of the body's pH. What would...
Carbon dioxide level is a reflection of the body's pH. What would...
These can be causes of hyperkalemia (check all that apply):
All of these can be causes of LOW blood glucose except:
If your patient is hypercalcemic, what other electrolyte should you...
Which drugs can increase serum glucose? Check all that apply.
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