Clinical Chemistry Made Easy

✍ Scribed by Jeremy Hughes, J. Ashley Jefferson

• Publisher: Churchill Livingstone
• Year: 2008
• Tongue: English
• Leaves: 215
• Category: Library

✦ Table of Contents

Front Cover
Clinical Chemistry Made Easy
Copyright Page
Foreword
Preface
CHAPTER 1. Sodium and water balance
Introduction
Distribution
Control of sodium balance
Control of water balance
When should I check sodium level?
What do I do with the result?
Hyponatraemia (serum Na <135 mmol/L)
Hypernatraemia (serum Na >145 mmol/L)
Assessment of polyuria
CHAPTER 2. Disorders of potassium balance
Distribution
Potassium excretion
When should I check potassium level?
Patients with cardiac disease
Figure 2.2 Renal excretion of potassium. Potassium secretion is controlled in thecortical collecting duct (CCD). Sodium reabsorption in this segment produces anegative voltage gradient, promoting K secretion under the actions of aldosterone.Aldo-R, aldosterone receptor.
Patients receiving drugs that may affect serumpotassium level
Patients with diabetes mellitus
Patients with major fluid and electrolyte fluxes
Patients with renal impairment
Patients with weakness of unknown aetiology
What do I do with the result?
Hypokalaemia (<3.5 mmol/L)
Symptoms and signs
Differential diagnosis
Artefactual
Low potassium intake
Shift of potassium into the intracellular compartment
Gastrointestinal losses
Figure 2.3 Differential diagnosis of hypokalaemia. Aldo, aldosterone;BAH, bilateral adrenal hyperplasia; ECV, extracellular fluid volume;hypoMg, hypomagnesaemia.
Renal losses
Special situations
Heart disease
Liver failure
Management
Assessment
Emergency treatment
Non-urgent treatment
Hyperkalaemia
Symptoms and signs
Figure 2.4 ECG changes of hyperkalaemia.
Special situations
Differential diagnosis (Fig. 2.5)
The most common causes of hyperkalaemia are
Figure 2.5 Differential diagnosis of hyperkalaemia. ACEI, angiotensinconvertingenzyme inhibitors; ARB, angiotensin II receptor blockers;NSAIDs, non-steroidal anti-inflammatory drugs.
CHAPTER 3. Assessment of renal function and urinary protein excretion
Introduction
Assessment of renal function
Assessment of proteinuria
Differential diagnosis of renal failure
Management
CHAPTER 4. Metabolic acid–base disorders
Introduction
Acid–base homeostasis
Buffers
Respiratory control of pH
Renal regulation of pH
When should I check acid–base balance?
Seven steps to the clinical assessment of acid–base status
Metabolic acidosis
Lactic acidosis
Ketoacidosis
Renal failure
Poisoning
Hyperchloraemic metabolic acidosis
Gastrointestinal HCO3¯ Loss
Renal tubular acidosis
Metabolic alkalosis
CHAPTER 5. Arterial blood gas analysis
Normal values
Respiratory physiology
Respiratory function
Assessment of oxygenation
Assessment of ventilation
Respiratory failure
Treatment of hypoxaemia
Respiratory acid–base disorders
Respiratory acidosis
Respiratory alkalosis
CHAPTER 6. Calcium, phosphate and magnesium metabolism
Calcium homeostasis
Phosphate homeostasis
Magnesium homeostasis
CHAPTER 7. Liver function tests
Introduction
Anatomy and physiology
When should I consider checking a patient’s liver function?
Assessment of hepatic synthetic function
Clinical assessment
CHAPTER 8. Lipid disorders
Introduction
Hyperlipidaemia and atherosclerosis
CHAPTER 9. Markers of cardiac and muscle injury and disease
Introduction
Creatine kinase
Cardiac troponins
Other markers of myocardial injury
Additional tests in acute myocardial infarction
Disorders of skeletal muscle
CHAPTER 10. Immunological investigations
Introduction
Autoantibodies
Erythrocyte sedimentation rate (ESR)
C-reactive protein (CRP)
Immunoglobulins and light chains
Complement
When should I consider performing immunological tests?
What do I do with the result?
INDEX