8/18/2019 47372042 Ultimate Podiatry Review Manual 8 (Dragged) 2 Copy

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LABSCHEMISTRY PANEL /BASIC METABOLIC PROFILE 

BMP

SODIUM (Na+) 

Normal Range = 135-145 mEq/LSodium is the predominant extracellular cation. Levels of sodium generally

reflect the hydration state of the patient.

 Increased in: Dehydration, polyuria, hyperaldosteronism, steroids, oralcontraceptives, inadequate water intake.

 Decreased in: CHF, vomiting, diarrhea, sweating, nephropathy, adrenal

insufficiency, thiazides, diuretics, ACE inhibitors, antidepressants,antipsychotics.

POTASSIUM (K+)

Normal Range = 3.5-5.0 mEq/L

Potassium is the primary intracellular cation and is the electrical balance to

sodium. Potassium imbalance causes disruption in the function of neurons

and muscles, and the symptoms of DKA are a result of the hypokalemia it

produces. Potassium movement also accompanies glucose, and in the kidneys

potassium is excreted at the expense of sodium. Potassium levels in the bloodare affected chiefly by pH; acidosis is accompanied by hyperkalemia, and

alkalosis causes hypokalemia. The action of catecholamines on beta receptorshas a secondary effect of reducing blood potassium.

 Increased in: Hemolysis, tissue damage, acidosis, renal failure, addison’s

disease, exercise, potassium-sparing diuretics, NSAIDs, !-blockers, ACE

inhibitors, and TMX.

 Decreased in: Prolonged vomiting/diarrhea, hyperaldosteronism, cushing’s

syndrome, osmotic diuresis, trauma, subarachnoid hemorrhage, adrenergicdrugs, diuretics.

CHLORIDE (Cl-)

Normal Range = 98-107 mEq/L

Chloride is a secondary player in the maintenance of acid/base balance and is

a placeholder in the anion gap. Retention causes acidosis, loss alkalosis. Increased in: Massive diarrhea, nephrotic syndrome, renal failure, diabetes

insipidus, hyperparathyroidism, acetazolamide, androgens, salicylates.

 Decreased in: Vomiting, diarrhea, GI suction, DKA, respiratory acidosis,excessive sweating, acute intermittent porphyria, adrenal insufficiency,

laxative use, corticosteroids, diuretics.

BICARBONATE (HCO3-)

Normal Range = 22-28 mEq/L

Bicarbonate is the main component of the body’s buffer system and is thecentral player in regulation of blood pH. Bicarbonate levels are regulated by

the kidneys.

 Increased in: metabolic alkalosis, compensated respiratory acidosis, volumecontraction, mineralocorticoid excess, diuretics.

 Decreased in: Metabolic acidosis, compensated respiratory alkalosis,

fanconi’s synd, volume overload, acetazolamide.

BLOOD UREA NITROGEN (BUN)

Normal Range = 8-20 mg/dLBUN is the end product of protein metabolism, and is directly related to the

amount of protein ingested. It is a relative indicator of kidney function.

 Increased in: Renal failure, urinary tract obstruction, degydration, shock,burns, CHF, GI bleed, nephrotoxic drugs.

 Decreased in: Hepatic failure, nephritic syndrome, cachexia.

CREATININE (Creat)

Normal Range = 0.6-1.2 mg/dL

Creatinine is a normal product of the breakdown of muscle tissue, and isproduced at a constant rate. As such, it is an absolute indicator of kidney

function, and the ratio of BUN to Creat in the blood can give clues to the

etiology of a kidney problem. Increase in BUN and Creat is termed azotemia.

10:1 ratio is pre-renal azotemia, caused by insufficient renal blood flow. A

less than 10:1 ratio is renal azotemia, which is indicative of renal failure.

 Increased in: Renal failure, urinary tract obstruction, nephrotoxic drugs,hypothyroidism.

 Decreased in: Reduced muscle mass.

GLUCOSE (Glu)

Normal Range = 60-110 mg/dLGlucose is closely regulated so as to provide energy to all cells in the body

without allowing any spillover into the urine. The excess of glucose seen in

DM is the underlying cause for all complications of that disease. Increased in: DM, cushing’s syndrome, chronic pancreatitis, corticosteroids,

phenytoin, estrogens, thiazides.

 Decreased in: Insulinoma, adrenocortical insufficiency, hypopituitarism, liverdisease, malignancy, insulin, ethanol, propanolol, solfonylureas, tolbutamide.

CALCIUM (Ca2+)

Normal Range = 8.5-10.5 mg/dL

Calcium is important in bone mineralization as well as a clotting cofactor. Itis regulated by calcitonin and parathyroid hormone, and binds to albumin inserum.

 Increased in: Hyperparathyroidism, vitamin D excess, multiple myeloma,

paget’s disease, sarcoidosis, vitamin A intoxification, addison’s disease,antacids, thiazides, lithium

 Decreased in: Hypoparathyroidism, vitamin D deficiency, renal insufficiency

magnesium/phosphorus deficiency, massive transfusion, hypoalbuminemia.

ANION GAP 

Normal Range = (Na+K) - (Cl+HCO3)