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Biomedical subjects

M D Burke

Publications and source records attributed to M D Burke.

At least 19 recordsLinked to original sources
PubMed1979

Diabetes mellitus: test strategies for diagnosis and management.

Fasting plasma glucose determination is the test of choice for diagnosis of diabetes. Glucose tolerance testing should be reserved for patients with borderline fasting values or possible diabetic complications and those suspected of having gestational diabetes. Strict attention to patient variables is essential if glucose tolerance testing is to be of value. The diagnosis of diabetes should be reserved for those patients with symptoms and unequivocal hyperglycemia, those with fasting plasma glucose values of 140 mg/dl or more repeatedly, and those with glucose tolerance test values of 200 mg/dl or more at two hours and at least one other time.

Diabetes Mellitus↗
PubMed1978

Laboratory tests: basic concepts and realistic expectations.

Ordering and interpreting laboratory tests take familiarity with the concepts of normal limits, specificity, sensitivity, and prevalence. The relative importance of these test properties for clinical decisions is presented.

Clinical Laboratory Techniques↗
PubMed1978

Clinical enzymology. 1. Enzymes and isoenzymes: sample and patient variables.

Enzyme determinations are among the most commonly ordered laboratory tests and are valuable diagnostic aids. For the results to be useful, the sample must be processed and stored properly and patient variables, including age, sex, medication history, and exercise status, must be considered. Isoenzyme determinations are helpful in specific situations.

Adolescent↗
PubMed1978

Clinical enzymology 2. Test strategies and interpretation of results.

The greatest usefulness of enzyme determinations is in diagnosis and management of hepatic, cardiac, pancreatic, and skeletal muscle diseases. They occasionally are useful in patients with malignant or hematologic conditions. As a rule, enzyme determinations are sensitive enough for normal values to exclude disease but are too nonspecific for abnormal values to confirm disease. Exceptions to this rule are determination of the MB isoenzyme of creatine kinase, the flipped lactate dehydrogenase isoenzyme pattern, and calculation of the ratio of amylase clearance to creatinine clearance.

Acute Disease↗
PubMed1978

Hepatic function testing.

The clinical situation determines the choice of hepatic function tests. Alkaline phosphatase (ALP) and aspartate aminotransferase (GOT) tests serve to detect disease, and when used in combination with a gammaglutamyl transferase (GGTP) test, to exclude it. The combination of ALP, GOT, bilirubin, lactate dehydrogenase (LDH), albumin, globulin, and GGTP tests is useful for routine differential diagnosis. Prothrombin time indicates severity of disease. Interpretation is facilitated by attention to ALP or GOT predominance; the relationship of LDH, ALP, and bilirubin; and the ratio of GGTP to ALP. Abnormalities on routine tests frequently do no more than point out the need for more definitive procedures.

Alkaline Phosphatase↗
PubMed1978

Electrolyte studies. 1. Sodium and water.

Hyponatremia may be due to relative excess of water or to sodium (Na+) depletion or may be artifactual due to hyperlipemia or excess osmotically active solute in plasma. The cause can be determined from the history, hydration status, and results of simple ancillary tests, eg, osmolality determinations and estimations of urine Na+ concentration. Hypernatremia almost always means water lack. The cause can be determined by correlating clinical findings with urine osmolality test results.

Humans↗
PubMed1978

Electrolyte studies. 2. Potassium, chloride, and acid-base.

Hypokalemia plus elevated carbon dioxide (CO2) content usually indicates renal or gastrointestinal potassium (K+) loss. Hypokalemia plus decreased CO2 content usually means intestinal K+ loss. Hyperkalemia is common in metabolic acidosis and oliguric renal failure. With hemolysis or thrombocytosis, serum K+ concentration may be elevated while plasma concentration is normal. A CO2 value less than 18 mmole/liter suggests metabolic acidosis; a value greater than 30 mmole/liter suggests metabolic alkalosis.

Acid-Base Imbalance↗
PubMed1978

Blood gas measurements.

pH and blood gas measurements are used to detect and monitor ventilation, oxygenation, and acid-base disturbances. The blood sample must be drawn anaerobically and transported in ice water to the laboratory. Partial pressure of carbon dioxide in arterial blood (PaCO2) reflects alveolar ventilation; partial pressure of oxygen in arterial blood (PaO2) reflects oxygen loading. The alveolar-arterial PO2 gradient (PA-aO2) distinguishes hypoxemia due to hypoventilation from that due to inefficent pulmonary gas exchange. The demand status of the cardiovascular system and the hemoglobin value reflect oxygen delivery to tissues. The relationship among pH, PaCO2, and bicarbonate concentration, when interpreted in the light of clinical findings, specifies the type and duration of acid-base disturbance.

Acid-Base Imbalance↗