Comprehensive metabolic panel

Comprehensive metabolic panel
Diagnostics
Computer screen report of a Comprehensive metabolic panel.
LOINC	24322-0, 24323-8

The comprehensive metabolic panel, or chemical screen, (CMP; CPT code 80053) is a panel of 14 blood tests which serves as an initial broad screening tool for physicians, nurse practitioners and physician assistants. Because it is often ordered as a routine part of an annual physical examination or check up, over time the CMP provides an important baseline of a patient's basic physiology. Any changes or abnormal results, and in particular combinations of abnormal results, thus provides important initial data for differential diagnosis, in which case more specialized tests may be indicated. In and of itself, however, the CMP provides an important gross check on the status of kidney function, liver function, and electrolyte and fluid balance.

In addition to being used at routine physicals of healthy patients, the CMP is routinely administered to monitor the status of a patient with a chronic disease, such as diabetes mellitus or hypertension.

Previous names for the panel of tests have been Chem 12, Chemistry panel, Chemistry screen, SMA 12, SMA 20 and SMAC (Sequential Multiple Analysis - Computer).^[1] The tests are performed on machines based on the AutoAnalyzer invented in 1957.

Testing

Pathophysiology sample values

BMP/ELECTROLYTES:
Na+=140	Cl−=100	BUN=20	/
			Glu=150
K+=4	CO2=22	PCr=1.0	\
ARTERIAL BLOOD GAS:
HCO3-=24	paCO2=40	paO2=95	pH=7.40
ALVEOLAR GAS:
	pACO2=36	pAO2=105	A-a g=10
OTHER:
Ca=9.5	Mg2+=2.0	PO4=1
CK=55	BE=−0.36	AG=16
SERUM OSMOLARITY/RENAL:
PMO = 300	PCO=295	POG=5	BUN:Cr=20
URINALYSIS:
UNa+=80	UCl−=100	UAG=5	FENa=0.95
UK+=25	USG=1.01	UCr=60	UO=800
PROTEIN/GI/LIVER FUNCTION TESTS:
LDH=100	TP=7.6	AST=25	TBIL=0.7
ALP=71	Alb=4.0	ALT=40	BC=0.5
		AST/ALT=0.6	BU=0.2
AF alb=3.0	SAAG=1.0		SOG=60
CSF:
CSF alb=30	CSF glu=60	CSF/S alb=7.5	CSF/S glu=0.4

Typically, the patient fasts for ten or twelve hours before the blood is drawn for the test. The following tests are then performed:^[1]

General tests

These tests help screen for a wide variety of problems. The glucose test in particular helps screen for diabetes mellitus and pre-diabetes. The calcium test can indicate or monitor bone diseases or diseases of the parathyroid gland or kidneys. Calcium salts, Lithium, Thiazide diuretics, Thyroxine, and vitamin D can all increase levels and may interfere with this test.^[2]

• Serum glucose
• Calcium

Protein tests

Tests of protein levels in the blood help screen for both kidney and liver disorders.

• Human serum albumin
• Serum total protein (TP)

Electrolytes

Electrolyte levels and the balance among them are tightly regulated by the body. Both individual values and ratios among the values are significant; abnormalities among either can indicate problems such as an electrolyte disturbance, acid-base imbalance, or kidney dysfunction.

• Sodium
• Potassium
• Carbon dioxide (CO₂)
• Chloride

Kidney function assessment

• Blood urea nitrogen (BUN)
• Creatinine

Liver function assessment

• Alkaline phosphatase (ALP)
• Alanine amino transferase (ALT or SGPT)
• Aspartate amino transferase (AST or SGOT)
• Bilirubin

References

1. ^ ^{a b} "Comprehensive Metabolic Panel". Lab Tests Online. 2005-10-31. http://www.labtestsonline.org/understanding/analytes/cmp/glance.html. Retrieved 2008-09-22. 
2. ^ http://www.nlm.nih.gov/medlineplus/ency/article/003477.htm

See also

• Reference ranges for common blood tests
• Basic metabolic panel
• Medical technologist

External links

• http://www.mgh.org/lab/CATALOG/TESTS/135.HTM — Reference range for each test in the CMP