Baseline laboratory test evaluate disease progression

Normal range is typically prefered over reference range

Values outside normal range must require clinical intervention

In pre-analytical variations Albumin is better than pre-albumin

B- agonist can reduce serum potassium

Thiazides reduces serum uric acid

Vancomycin test should applied after first dose

Ptt measured after 6 hours after start

Mole is influenced by added weight of salt or ester formulation

Mole is technically and pharmacologically and meaningful than the gram

An increase in serum sodium concentration could reflect hypervolemia

Natiuretic hormone increases excretion of water

Dilutional hyponatremia occurs when ECF expands with equivalent increase in sodium

Sodium depletion hyponatremia cause by mineralocorticoid activity

Hypernatremia caused by hyperaldosteronism

Primary defense against hypotonicity is thirst and subsequent fluid intake

Potassium is the most abundant EC cation

Kidney have high ability to conserve potassium

Osmotically inactive solutes cause dilutional hyponatremia

Excessive cellular breakudown causes hyperkalemia

Dissolved co2 represents small component of total co2

In absense of metabolic alkalosis, hypercholremia is seldom

If potassium is incroporated, AG would be 5 to 12

Elevated anion gab may indicate metabolic acidosis

High protein intake affects BUN as renal factor

Ratio of SCR to BUN should be 15:1

Scr is slightly higher in muscular subject

Doubling of SCR will corresponds to 50% reduction in GFR

Jellife method have greatest accuracy in patient with scr values less than 1.5

Increases in serum cystatin C levels tend to occur earlier than increase in SCR

Cystatin C is being evaluated as potential predictor of cardiovascular disease.

Every 1% reduction in the elevated A1c reduce the risk of microvascular disease by 14%

A1c value should be greatly exceeding 8 in controlled patients with diabetes

Hyperglycemia may be worsened by medication as HMGCOA reductases

Patient can lose 25-30% of total body calcium with change in conc of ca+² in the plasma

Hypocalcemia is caused by decrased absorption of vitamin D

Malignancy usually causes hypocalcemia

Toxemia (pre-eclampsia) in pregnancy associated with hypermagnesmia

Magnesium helps in de-phosphrylation of ATP

Hypomagnesemia prolong PT intervals

Mineralocorticoid activity causes hypo-kalemia

Severe hypophosphatemia caused by using antacids

Dysfunction of leukocytes caused by severe hypophosphatemia

Albumin normal conc is 3.6-5 g/dl or 36-50 mg/dl

Hepatic disease associated with decrease in albumin and pre-albumin

Pre-albumin contributes 80% of serum colloid osmotic pressure

Decrease in immunoglobulin levels could indicate rheumatoid arthritis

Uric acid Normal conc is 3-8 mg/dl or 179-476 mmol/l

Because globulin not manufactured solely by liver, the ratio of albumin to globulin isn't changed with liver disease

In medication history, the practitioner must confirm diagnosis using disease-specific questions in the third situation

Medication history interview enables pharmacist to conduct postliminary medication counselling

Patient selection should be taken for all patient

Patients with polypharmacy may benefit more compared to others in patient selection

In self-preparation step, disease specific questions should be asked

Medication interview can be easy as most interviews will be conducted at the patient's bedside

Pharmacist shouldn't exchange information with other health care professional

Close-ended question reveal knowledge concerning medication use

Exhaustive interview need to be avoided in the interview

Pharmacist should respect patient's right to decline an interview

ward round is a visit made by medical practitioner to hospital outpatients

one ward round is conducted everyday although two is not common

in certain cases as psychiatric patients, ward rounds is done elsewhere away from the patient bedside

clinical ward rounds ensure safe, effective and economic use of drug

clinical ward rounds increase the length of hospital stay

clinical pharmacist should attend clinical meetings whenever possible

from goals of the clinical pharmacist's participation in clinical rounds is to investigate usual drug orders or doses

clinical pharmacists participate in patient discharge planning compared to doctors in teaching hospitals

medical practitioners in teaching hospital have more opportunities to keep themselves up to date with new developments in therapeutics

pharmacist in non teaching hospital have opportunities to promote evidence-based pharmacotherapeutics and quality and safe use of medicine by continuous medical education

pharmacist develop on appreciation of how the patients's own wishes and their social, cultural and educational circumstances that may influence therapeutic chances

ward round participation strengthens the inter-professional relationship among various health professionals

in pre-ward round, relevant information updated be junior nurse

in ward round, junior nurse updates on current status and preform clinical safety checks

in ward rounds, junior nurse are encouraged to present findings

in post-ward round, patients or carers may follow through in depth discussion

clinical review of selected patients occurs in pre-ward rounds

health care professional must work collectively to coordinate and enhance the value of good patient care