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Questions and Answers
What is hypokalaemia primarily associated with?
What is hypokalaemia primarily associated with?
Which of the following is an important role of cholesterol?
Which of the following is an important role of cholesterol?
What is considered a concern with high levels of LDL cholesterol?
What is considered a concern with high levels of LDL cholesterol?
Which condition could lead to high levels of creatinine?
Which condition could lead to high levels of creatinine?
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What is the role of albumin in the body?
What is the role of albumin in the body?
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What is a common cause for high levels of LDL cholesterol?
What is a common cause for high levels of LDL cholesterol?
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What does a higher creatinine level indicate in relation to GFR?
What does a higher creatinine level indicate in relation to GFR?
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Which factor does NOT influence the reference range of biochemical results?
Which factor does NOT influence the reference range of biochemical results?
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Which of the following factors is not a cause of high LDL cholesterol?
Which of the following factors is not a cause of high LDL cholesterol?
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What could cause hypoalbuminaemia?
What could cause hypoalbuminaemia?
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Which condition is likely associated with hyperalbuminaemia?
Which condition is likely associated with hyperalbuminaemia?
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What is the main purpose of testing creatinine levels?
What is the main purpose of testing creatinine levels?
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Which of the following does not typically lead to hypokalaemia?
Which of the following does not typically lead to hypokalaemia?
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Which statement about bicarbonate is incorrect?
Which statement about bicarbonate is incorrect?
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Which condition would most likely lead to metabolic alkalosis?
Which condition would most likely lead to metabolic alkalosis?
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What is one of the treatments for high creatinine levels?
What is one of the treatments for high creatinine levels?
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What is the half-life of albumin, and what does it signify?
What is the half-life of albumin, and what does it signify?
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In what situation should biochemical information NOT be used?
In what situation should biochemical information NOT be used?
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Which of the following is NOT a cause of metabolic acidosis?
Which of the following is NOT a cause of metabolic acidosis?
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Why should cost vs benefit be considered in ordering tests?
Why should cost vs benefit be considered in ordering tests?
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What role does iron play in the body?
What role does iron play in the body?
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Which condition contributes to low iron levels?
Which condition contributes to low iron levels?
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What is transferrin's primary function?
What is transferrin's primary function?
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Which of the following is a sign of high iron levels in the body?
Which of the following is a sign of high iron levels in the body?
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Which statement about ferritin is true?
Which statement about ferritin is true?
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What treatment is usually recommended for anemia of chronic disease?
What treatment is usually recommended for anemia of chronic disease?
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Which of the following conditions can lead to poor absorption of iron?
Which of the following conditions can lead to poor absorption of iron?
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What happens to transferrin levels when the body is low on iron?
What happens to transferrin levels when the body is low on iron?
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What is the possible consequence of chronic blood loss related to iron levels?
What is the possible consequence of chronic blood loss related to iron levels?
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What might be a reason for high transferrin saturation levels?
What might be a reason for high transferrin saturation levels?
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What condition is indicated by high levels of evaporated alk phos in the blood?
What condition is indicated by high levels of evaporated alk phos in the blood?
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What is a potential consequence of hypomagnesemia?
What is a potential consequence of hypomagnesemia?
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Which factor can lead to neutropenia?
Which factor can lead to neutropenia?
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What condition is associated with elevated levels of phosphates in the blood?
What condition is associated with elevated levels of phosphates in the blood?
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What can cause thrombocytopenia?
What can cause thrombocytopenia?
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Increased levels of which enzyme typically indicate liver dysfunction?
Increased levels of which enzyme typically indicate liver dysfunction?
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What is the primary use of magnesium in the body?
What is the primary use of magnesium in the body?
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What is a common cause of hypermagnesemia?
What is a common cause of hypermagnesemia?
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Chronic depletion of phosphate can lead to which condition?
Chronic depletion of phosphate can lead to which condition?
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What is the most likely cause of leukocytosis?
What is the most likely cause of leukocytosis?
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Following which condition would you expect elevated alkaline phosphatase levels?
Following which condition would you expect elevated alkaline phosphatase levels?
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What role do neutrophils play in the immune system?
What role do neutrophils play in the immune system?
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Which of the following is a possible treatment for hypophosphatemia?
Which of the following is a possible treatment for hypophosphatemia?
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What is a potential effect of antibiotics on neutrophil levels?
What is a potential effect of antibiotics on neutrophil levels?
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What electrolyte assists with nerve function and muscle contraction?
What electrolyte assists with nerve function and muscle contraction?
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What condition can lead to high levels of potassium in the blood?
What condition can lead to high levels of potassium in the blood?
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Which of the following is a cause of hypokalaemia?
Which of the following is a cause of hypokalaemia?
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What typically causes hypernatremia?
What typically causes hypernatremia?
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Which of the following treatments is indicated for hyperkalaemia?
Which of the following treatments is indicated for hyperkalaemia?
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What is the normal range for potassium levels in mmol/L?
What is the normal range for potassium levels in mmol/L?
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What condition is caused by excessively low sodium levels?
What condition is caused by excessively low sodium levels?
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What is the primary method for treating hypokalaemia?
What is the primary method for treating hypokalaemia?
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Which of the following medications is commonly associated with high triglyceride levels?
Which of the following medications is commonly associated with high triglyceride levels?
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What causes a breakdown of red blood cells that can lead to hyperkalaemia?
What causes a breakdown of red blood cells that can lead to hyperkalaemia?
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What is a common cause of uraemia?
What is a common cause of uraemia?
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What can result from severe blood loss?
What can result from severe blood loss?
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Which of the following conditions is linked to high triglyceride levels?
Which of the following conditions is linked to high triglyceride levels?
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Which factor is NOT a cause of hypokalaemia?
Which factor is NOT a cause of hypokalaemia?
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Study Notes
Biochemistry Explained
- Biochemistry tests are important for tailoring treatment plans.
- However, they should not be used in isolation and should be considered alongside the whole clinical picture.
- Biochemistry results guide treatment and dietary recommendations.
- Do not use this information alone to diagnose any medical condition.
- Consult a medical professional for diagnosis and treatment.
- Medication and supplementation should be considered alongside biochemistry results.
- Tests can only be requested through a medical officer.
- Consider cost vs. benefit, especially when considering expensive tests.
Reference Ranges
- Reference ranges for biochemistry tests vary depending on the facility, lab conducting the test, age, and gender of the individual.
Albumin
- Albumin is a protein produced by the liver.
- It helps keep fluids in the blood and transports vitamins, enzymes, and hormones.
- Hypoalbuminaemia (low albumin) indicates inflammation, infection, surgery, liver disease, renal disease, diabetes, or malnutrition.
- Hyperalbuminaemia (high albumin) can be caused by dehydration, a high protein diet, or certain medications.
- Treat the underlying condition, an infusion is not a long-term solution.
- The half-life of albumin is around 21 days, so levels reflect chronic changes rather than acute changes.
- Factors other than diet, such as hydration and exercise, can affect albumin levels.
Bicarbonate
- Bicarbonate is a byproduct of metabolism.
- It travels through the blood to the lungs and is exhaled as CO2.
- It is excreted and reabsorbed by the kidneys to regulate pH (acid-base balance).
- Values are altered with liver, respiratory, and renal disease.
- Metabolic acidosis (low bicarbonate) can be caused by diarrhea, renal disease, liver failure.
- Metabolic alkalosis (high bicarbonate) can be caused by vomiting, laxatives, dehydration, or eating disorders.
- Treat the underlying condition.
Cholesterol
- Cholesterol is a structural component of cell membranes, essential for hormone production and bile synthesis.
- High cholesterol increases the risk of heart disease and stroke.
- High LDL cholesterol is a concern and can be caused by poor dietary choices, lack of exercise, genetics, obesity, smoking, age, and diabetes.
- Low HDL cholesterol is a concern and can be caused by obesity, refined carbohydrates, low exercise, and certain medications.
Creatinine
- Creatinine is a waste product produced by muscles.
- It is filtered by the kidneys and excreted in urine.
- Creatinine levels are used to evaluate kidney function alongside urine protein levels.
- High creatinine levels can be caused by acute or chronic renal failure, infection, diabetes, hypertension, heart disease, urinary tract issues, and drug toxicity.
- Treat the underlying condition, dialysis may be required.
Iron
- Iron is involved in oxygen transport in the blood, oxygen storage in muscles, immune function, and is a component of enzymes used for energy production.
- Serum iron refers to iron in the liquid part of the blood.
- Ferritin is a protein that stores iron in the liver and bone marrow, providing a measure of stored iron.
- Transferrin is the main iron transport protein, produced relative to the body's needs.
- Transferrin saturation reflects how much iron the transferrin can hold.
- Low iron can be due to inadequate dietary intake, acute or chronic infections, poor absorption, or blood loss.
- High iron can be caused by hemochromatosis and requires treatment like chelation or blood removal.
- Treatment for iron deficiency depends on the cause, including dietary manipulation, medication, transfusion, or treating the underlying problem.
- Epo medication is usually prescribed for anemia of chronic disease.
Anemia
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Iron deficiency Anemia usually occurs under conditions of low iron in the blood.
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Anemia of chronic disease can also have low iron levels in the blood, but the low iron levels are also associated with inflammation and decreased iron absorption.
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Iron deficiency anemia can be treated through diet and with supplemental iron.
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Anemia of chronic disease might require iron transfusions, and if the hemoglobin is low, blood transfusions may be required as well.
Liver Function Tests (LFTs)
- Elevated ALT can be caused by viral hepatitis, alcohol use, medications, liver cancer, liver disease, heart failure, obesity, and sepsis.
- Elevated AST can be elevated due to chronic liver disease and can be higher than ALT in alcoholic liver disease.
- AST levels can remain elevated for months, even after the cause of the elevation has been resolved.
- Normal or slightly elevated AST levels can indicate excessive parenteral nutrition, biliary tract infection, or long-term nil per gut (parenteral nutrition used).
- Low levels of AST can indicate hyperparathyroidism, blood transfusion, zinc deficiency, or severe PEM (Protein Energy Malnutrition).
Magnesium
- Magnesium plays a crucial role in over 300 biochemical reactions in the body.
- Normal Magnesium levels are between 0.75-1.1mmol/L.
- Hypomagnesemia (low magnesium) can result from increased renal losses, dietary inadequacy, alcoholism, diarrhoea, medications (diuretics, proton pump inhibitors, antibiotics), acute pancreatitis, gastric bypass, refeeding, and treatment involves supplementation.
- Hypermagnesemia (high magnesium) is uncommon but can occur in individuals with renal impairment who consume excessive magnesium supplements (oral or IV).
Neutrophils
- Neutrophils are white blood cells that are important for the immune response to infection and inflammation.
- Neutropenia (low neutrophils) can be caused by cancer, severe infection, medications (chemotherapy, radiotherapy), autoimmune disorders, aplastic anaemia, or granulocyte colony-stimulating factor (G-CSF).
- Leukocytosis (high neutrophils) can be caused by medications, stress, burns, pregnancy, splenectomy, smoking, obesity, cancers (leukemia).
Phosphate
- Phosphate is an electrolyte that plays a vital role in energy production, nerve function, bone strength, and tooth formation.
- Normal phosphate levels are between 0.75-1.5mmol/L
- Hypophosphatemia (low phosphate) can result from malnutrition, alcoholism, severe burns, diarrhoea, diabetic ketoacidosis, medications (diuretics, antacids, corticosteroids), and refeeding.
- Critical low phosphate can lead to osteomalacia, neuromuscular disturbances like encephalopathy, respiratory depression, seizures, and coma.
- Hyperphosphatemia (high phosphate) can occur due to renal disease, hypocalcaemia, uncontrolled diabetes, dietary phosphate restriction, phosphate binders, and can be secondary to blood loss, trauma, surgery, malignancy, or viral infections.
Platelets
- Platelets (thrombocytes) are colourless blood cells that help form blood clots to stop or slow bleeding and play a role in wound healing.
- Thrombocytopenia (low platelets) can be caused by leukemia and other cancers, certain types of anaemia, viral infections (hepatitis C, HIV), chemotherapy, and radiation therapy.
- Thrombocytosis (high platelets) can be secondary to blood loss from trauma, surgery, malignancy, viral infections, and even smoking.
Phosphate
- Low phosphate levels can be caused by heavy alcohol consumption and certain medications like heparin, quinine, and anticonvulsants.
- Phosphate retention is not common and is usually seen in people with severe blood loss, such as those who have undergone major surgery or trauma.
Potassium
- Potassium is an electrolyte that assists with nerve function, muscle contraction, regulates heartbeat, and the movement of nutrients in and waste products out of cells.
- Low potassium levels (hypokalemia) can be caused by vomiting, diarrhea, excessive sweating, antibiotic therapy, hypomagnesemia, poor dietary intake, refeeding, and certain medical conditions.
- High potassium levels (hyperkalemia) can be caused by impaired renal function, dehydration, medications, type 1 diabetes, destruction of red blood cells due to tissue injury, and medical conditions like Addison's disease.
- High potassium levels can also be caused by constipation.
- Hypokalemia or recurrent need for potassium repletion may be linked to underlying magnesium deficiency.
- Hyperkalemia can be treated by potassium restriction or medication.
Sodium
- Sodium is an electrolyte that helps maintain fluid balance in cells and plays a key role in normal nerve and muscle function.
- Low sodium levels (hyponatremia) can be caused by overhydration, diarrhea, vomiting, excessive hydration, medical conditions like hypothyroidism, certain medications like diuretics, and SIADH (syndrome of inappropriate secretion of antidiuretic hormone).
- High sodium levels (hypernatremia) can be caused by dehydration, vomiting, renal disease, poorly controlled diabetes, diabetes insipidus, certain medications, and recreational drugs.
- Hyponatremia is treated by fluid restriction or IV therapy.
- Hypernatremia is treated with IV therapy.
Triglycerides
- Triglycerides are a type of fat found in blood that is stored in fat cells and released for energy following hormonal response.
- High triglyceride levels can be caused by medications, parental nutrition, obesity, poorly managed diabetes, excessive alcohol intake, genetic predisposition, liver disease, and renal disease.
Urea
- Urea is a byproduct of ammonia breakdown that occurs in the liver where it is filtered and excreted in urine.
- Low urea levels can be caused by low protein intake, severe liver disease, and severe malnutrition.
- High urea levels (uraemia) can be caused by breakdown of lean tissues, excessive protein administration, dehydration, impaired kidney function, especially in individuals with chronic heart failure due to poor blood perfusion of the kidneys.
- Dialysis may be required for individuals with renal failure.
White Blood Cells
- Low white blood cell count can indicate low immunocompetence, often secondary to chemotherapy or radiotherapy.
- High white blood cell count can indicate upregulated immunocompetence, often associated with infection or inflammation, leukaemia, trauma, or stress.
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Description
Explore the essential concepts of biochemistry and its pivotal role in healthcare. This quiz covers topics such as biochemistry tests, reference ranges, and the significance of proteins like albumin in clinical settings. Understand how to interpret results and the importance of professional consultation.