PARAthyroid
calcium
parathyroid are 4 peas
sized glands around the
thyroid. they can get
damaged from surgery
and radiation treatments
carried out on the thyroid
xxx
text here
koilonychia
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hemolytic anemia
the destruction of RBC is at a faster
rate than their creation leading to
deficit. several types of hemolytic
anemia. Malaria is hemolytic
RBCs are made in the marrow of
bones.
SIDEROBLASTIC AMENIA is the
erythoblasts in the bone marrow have
rings of iron atoms at the periphery,
unable to use the iron in hemeglobin
production, leaving cells stuck in a
state of not being able to further
mature. this condition is assiciated
with lead exposure, alcoholism, vit B6
def, some medications
TIBC Total IRON Binding Capacity
xxx CBC panel, complete blood count
count of: red blood cells, white blood cells, platelets (fragments that clot the blood when needed)
hematocrit, = volume of the blood sample that the red blood cells take up space. compared to
normal, high % can indicate dehydration, low anemia
hemoglobin = amount of hemoglobin the rbc are carrying
a CBC with differential will quantify the different white blood cells present in the sample.
expressed as grams per deciliter (g/dL)
MCV measures size of RBC. Microcytosis (MCV < 80 fL) Macrocytosis (MCV > 96 fL)
27-31 MCH measures avg amnt of hemoglobin per RBC
hematocrit is %
HISTAMINE Each receptor type has distinct locations
and functions. H1 receptors’ role in
maintaining alertness and reaction time is
crucial for daily functioning.
H2 receptors, primarily located in
stomach cells, play a critical role in
releasing acid. However, in the brain, they
also modulate neurotransmitter release,
influencing overall brain activity.
H3 receptors, acting as autoreceptors,
modulate the release of neurotransmitters
such as dopamine and serotonin in the
central nervous system. This modulation
maintains balance and prevents
overexcitability in the brain.
The role of H4 receptors in the nervous
system is less defined but is important for
immune responses. These receptors are
H4 receptors accept mainly found on immune cells, indicating
their potential role in neuroinflammatory
histamine from processes. The diverse functions of these
EOSINOPHILs. receptors highlight the complexity and
importance of histaminergic signaling in
H4 activates the brain.
dendrites, mast cells,
moncytes, T cells
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red blood cell = erythrocyte
rbc lives 120 days BMP basic metobolic panel screening of blood
white blood cell = leukocyte electrolytes present
platelet = thrombocyte glucose numbers
kidney filtering function such as BUN bld urea nitrogen
too many cells, over the norm not enough cells, under the norm
xxx macrocytosis/ large cell size include
microcytosis/ small cell size include B12 & folate defic (megaloblastic) &
iron defic & thalassemia (hereditary) alcoholic liver disease
most anemias & blood disorders
occur with “normal” sized blood cells
a Px can be anemic with a low blood
cell count but func
ANEMIA
shorthand differential
CMP
comprehensive MP
common clinical abrev
for CBC & BMP (basic metabolic
panel)
with normal ranges
BMP basic MP
HCO3
BLOOD PRESSURE GUIDELINES
ACC american college of cardiology's
numbers for blood pressure, 2017
normal 120 80
elevated 130 80
stage 1 hyper 131-9 sys OR 81-9 dia
stage 2 hyper 140 sys OR 90 dia
hyper crisis 180 sys OR 120 dia
cholesterol panel
HDL 60 or more
LDL 100 or less
BLOOD SUGAR TESTING
HbA1c, hemoglobin A1c, or A1c expressed as %
there is a type of hemoglobin that can allow for glucose to attach but only if blood sugar is
consistently high. A1c should be low in a healthy person.
If A1c greater than 6.5%, diagnosed as DIABETIC. tested every 3 months as this parameter
does not change quickly
regular blood sugar testing; when expressed as mg/dL it’s a large number, expressed as
mmol/L small numbers
Fasting of 8 hours, how your body handles an empty stomach.
mg/dL: 70-100 ml/dL normal | 100> <125 prediabetic | >126 DIABETIC
mmol/L: 3.9-5.5 normal | 5.6-6.9 prediabetic | >7.0 DIABETIC
random blood sugar test: 90-140 mg/dL is normal OR 7.8 mmol/L
Oral Glucose Tolerance Test OGTT: will be a fasting
blood draw followed by a sugary drink and 5 blood
draws over the next 2 hours to see how body handles
meals. the results to the side indicate a peak in BS
1 hr after sugar drink then slow decrease after that
shorthand
homocystiene is an amino acid
that the body limits so that it
does not damage arterial walls.
folic acid/ B9 breaks down
homocystiene. B12 converts
homocystiene into methione.
therefore a person needs folic
old blood cells @ 120 days, are broken down in the Spleen. the globin in the hemaglobin is broken
into constituent amino acids to be used again. the iron in the heme molecule is removed and sent
acid & B12
back into iron stores to be used as needed. what's left is a green molecule an enzyme in the spleen
acts upon turning it into yellow bilirubin which is released into the bloodstream where albumin
protiens attach to it and escort it to liver cells. the liver cells modify the bilirubin into conjugated
bilirubin, a substance that is fit to travel throught he bile ducts as a component of bile. it gets
squirted into the duodenum during digestion and makes its way into the small intestine where it is
further modified by bacteria that live there. it is changed from conjugated bilirubin into
urobilinogen. some of this urobilinogen is returned to circulate in the blood to be picked up by
tissues that want to use it. the rest becomes stercobilin which is brown in color. this brownness is
what is given normal feces their brown color. this is why grayish, or clay colored, or light colored
feces indicate a problem with the liver, it means something went wrong in the reb blood cell
recycling process
Liver tests of the CMP
Alkaline phosphatase (ALP). It's an enzyme made in your liver, bones, kidneys, and digestive system. Abnormal levels of ALP
may be a sign of health conditions, such as liver disease, bone disorders, and chronic kidney disease.
Alanine aminotransferase (ALT). It's a protein made mostly in the liver. Damaged liver cells release ALT into your blood. High
levels in your blood may be a sign of liver injury or disease. You may have high ALT levels in your blood before you have any
symptoms, so an ALT test can give your doctor a way of catching some liver diseases early.
Aspartate aminotransferase (AST). This protein is made mostly in your liver, but also in some muscles and other organs. Your
doctor may use this test to help diagnose or monitor liver damage or disease.
Total protein. It refers to the total amount of protein in your blood, which includes albumin and globulin. Globulins are
proteins that help fight infections and carry nutrients in your body. Some globulins are made in the liver and others are made
by the immune system. Low total protein levels can be a sign of a serious health problem.
Albumin. It's made in your liver and is the main protein in your blood and carries hormones, vitamins, and enzymes
throughout your body. Low levels may be a sign of liver or kidney disease or another medical condition. High levels may be a
sign of dehydration.
Bilirubin. It's a yellow byproduct when the Spleen breaks down old red blood cells - 120 days. Your liver usually filters most of
the bilirubin out of your blood. If your liver is damaged, bilirubin can leak out. If you have too much bilirubin in your blood,
you may get jaundice, when your skin and eyes turn yellow. This test can help your doctor check on how well your liver is
working.
Calcium is one of the most important minerals in your body. You need the right amount of calcium in your blood for your
nerves, muscles, and heart to work well. Low levels of calcium may be a sign of bone disease, thyroid disease, parathyroid
disorders, kidney disease, or other conditions.
Total Protien is made up of Albumin + Globulin. Subtract Albumin # from Total Protien for Globulin #. Low protien in the blood
indicates a problem. Albumin predominant but both albumin & globulin transport molecules including hormones
ALP or ALK PHOS or alkaline phosphatase is an enzyme. abnormal volume in blood indicates a problem with LIVER, KIDNEY,
or BONES, High AlkPhos indicates LV or bones. Other liver test results like ALT AST or bilirubin need to be off as well,
otherwise it must be the bones. AlkPhos can indicate small fractures healing.
Low AlkPhos can be interpreted as zinc or nutritional deficiency
HEPATITIS SYMPTOMS
JAUNDICE
1) hemolytic - blood jaundice,
wide spread destruction of RBC
2) hepatocellular - damage to
liver
3) blockage of bile duct
GYNECOMASTIA
xxx
defic of B12 can lead to
megaloblastic anemia,
enlarged RBCs that do not
have all the cell
recommended for all women child baring age parts/functionality and die
recommended 10 x more, previous spina fifida before 120 days
birth
a subset of megaloblastic
anemia, is pernicious
anemia. autoimmune the
cells in the stomach lining
that make intrinsic factor
are targeted by immune
system leading to B12
deficiency
xxx
xxx
Vitamin B Mnemonic
NO 4 8 10 11
Thiamine 1
(1 2 3) (5 6 7) 9
12
Riboflavin 2
Niacin 3
Pantothenic acid 5
Pyridoxine 6
Biotin 7
Folate 9
Cobalamin 12
niacin B3
deficiency
excess
xxx 2 blood tests for presence of
INFLAMMATION. will not indicate where or
what tissues aretext here just the
inflammed
presence of.
ESR (erythrocyte sedimentation rate) if red
blood cells sink to the bottom of the test
tube in greater numbers within an hour than
the normal number, it is said to indicate
inflammation bc “the blood cells must be
clumping together causing them to be
heavier and fall”
CRP (c-reactive protien) the higher the
number the higher the amount of c-reactive
protien made by the liver released into the
blood stream. this is said to happen when
there is inflammation but could be
anywhere in the body
c reactive
protien
10 - 100
can
indicate
RA
inflamation and autoimmune testing
ANA Antinuclear Antibody test - nuclear in the name of this test means nucleus of your own body cells. it detects when blood
contains antibodies against the nuclii of its own cells - autoimmune indicator but non specific, just the presence of autoimmune
anti-dsDNA - specific marker for SLE indicates the body has made antibodies against its own ds double stranded DNA
ESR & CRP - non specific inflammation indicators
anti-histone antibody test - detects a response by the body to drug induced lupus like symptoms. the person will also get a
positive ANA result. anti-histone will clarify it is drug induced reaction
ANA = autoimmune general
SMITH = less common SLE antibody
indicates drug induced lupus
common SLE antibody
osteo OA versus rheumatoid RA
OA x ray shows
narrowing of joint
space between the
bones and bone
spurs, bony growths
filling in the joint
space to compensate
ARTHRITIS
drug treatments RA OA
DMARD for RA
RA
both RA OA
OA usually knee
specific for RA - anti-CCP
x ray of normal, OA, OA is about the in RA the damage is
& RA knee wearing away of coming from inflamation.
cartliage between inflammation in the joint
2 bones space erodes bone
DEXA
bone mineral density scan
GENETIC EXCESS COPPER / EXCESS IRON
2 GENETIC CAUSES FOR ANEMIA
sideroblastic anemia
immature RBCs
Anemia is a very common problem overall. A reticulocyte count can help differentiate between anemia
caused by low red blood cell production and anemia due to increased destruction of red blood cells.
“If a patient is anemic and the reticulocyte count is high, this suggests that the anemia is due to
peripheral blood loss (bleeding) or destruction (hemolysis) and that the bone marrow is responding to the
anemia as it should”
“If the patient is anemic and the reticulocyte count is in the normal range or low, this indicates that the
anemia is due to decreased RBC production or under-functioning bone marrow,” A low reticulocyte count
could be a sign of bone marrow failure, which could be related to certain types of cancer or other causes.
ERYTHROPOIETIN
A protein containing sialic acid that enhances erythropoiesis by stimulating formation of
proerythroblasts and release of reticulocytes from bone marrow; it is formed by the kidney
and liver, and possibly by other
tissues, and can be detected in
human plasma and urine.
athletic performance enhancement
diagnosing
Gout vs Pseudogout
components of CBC