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Critical Care Paramedic > 1-6 Basic Lab Data > Flashcards

1-6 Basic Lab Data Flashcards

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1
Q

Specificity

A

A measure of how well a test detects a disease without yielding a false + result. The probability that a test will be negative in the absence of a disease.

How accurately the test identifies people who DO NOT have a disease.

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2
Q

What does a 100% specific test mean?

A

A 100% specific test only results in a positive result when the condition is present in the patient.

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3
Q

Sensitivity

A

A measure of how well a test detects a disease without yielding a false negative result. The probability that the test will be sensitive in the presence of a disease.

How accurately the test identifies people who DO have a disease.

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4
Q

What does a 100% sensitive test mean?

A

A 100% sensitive test reveals all patients with the tested-for condition. No test is 100% sensitive.

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5
Q

Normal pH range

A

7.35-7.45

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6
Q

Normal PaCO2 range

A

35-45

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7
Q

Normal HCO3 range

A

22-26

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8
Q

What are the main acid excreting organs?

A

Lungs and Kidneys

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9
Q

What is the peak increase of PCO2? And why?

A
  1. An end tital of 55 COULD be what the patient needs. If it gets over that, it becomes officially not good and we need to do something about it.
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10
Q

What is the primary imbalance in a respiratory acidosis and alkalosis

A

CO2

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11
Q

What is the primary imbalance in a metabolic acidosis or alkalosis

A

HCO3

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12
Q

Base excess range

A

-3 - +3

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13
Q

PaO2 Range

A

80-100 mmHg

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14
Q

SaO2 Range

A

90-100 %

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15
Q

What does the PaCO2 tell us?

A

ventilatory status

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16
Q

What is base excess/deficit?

A

The amount of base or acid required to titrate the pH of one liter of blood to normal pH. Used for METABOLIC acid/base disorders.

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17
Q

What does a negative base deficit mean? What does a positive base excess mean?

A

Negative base deficit: indicates the patient has a metabolic acidosis
Positive base excess: indicates the patient has a metabolic acidosis.

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18
Q

What happens when base excess goes above +3 or below -3?

A

The patient becomes more unstable. BE x 10 = the % failure of the pt’s current care.

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19
Q

Understand the difference between PaO2 and SaO2.

A

PaO2- the partial pressure of oxygen dissolved in the blood (if this value is less than 60, the pt WILL desat when the vent is disconnected)
SaO2- how much oxygen is bound to hemoglobin

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20
Q

For every 10 mmHg change in PCO2

A

the pH will change 0.08 in the opposite direction

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21
Q

For every 10 mEq change in HCO3

A

the pH will change 0.15 in the same direction

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22
Q

What causes a high O2 affinity?

A

LOW- O2, CO2, 2,3-DPG, temp
HIGH- pH

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23
Q

What does a CBC consist of?

A

WBC
WBC differential
RBC
Hgb
Hct
Platelet count

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24
Q

What does a left shift in neutrophils indicate and why?

A

A left shift is seen as an increase in the number of bands and is common in infections.
immature neutrophils = active infection (which produces a left shift)

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25
Q

A catecholamine dump is associated with an increase in what type of WBC?

A

Eosinophils

26
Q

What type of WBC causes pyrogenesis?

A

Monocytes

27
Q

What are the two types of lymphocytes, what response do they typically mitigate, and where do they mature?

A

B-type mature in the bone marrow, deal with bacterial.
T-type mature in the thymus and deal with tumors or viruses.

28
Q

What does the hematocrit measure?

A

the volume of RBCs found in 100 mL of blood and expressed as a percentage.

29
Q

Less than what platelet count is associated with risk of bleeding?

A

150,000

30
Q

Normal sodium range

A

135-145

31
Q

Where will the fluid go if there is elevated vs low Na

A

Low Na = fluid will move from the blood into the tissues.
High Na = fluid is drawn out of the tissues and moves into the blood. High risk of spontaneous head bleeds with this one.

32
Q

Normal K+ value

A

3.5-5

33
Q

What should you suspect if you see a sine wave on the ekg?

A

“v-tach” at less than 120 is most likely hyperkalemia

34
Q

What is the relationship between K+ and pH?

A

Inverse.
acidic patient = k+ comes out of the cell
basic patient = potassium is pushed into the cell

35
Q

What is the threshold for treating hypoglycemia in neonates and infants/children

A

Neonates: < 40
Infants: < 60

36
Q

BUN is a metabolic by-product from the breakdown of what?

A

blood, muscle, protein

37
Q

Tell me about the sensitivity and specificity of BUN for kidney failure

A

high sensitivity and lower specificity

38
Q

Creatinine is a metabolic by-product from the breakdown of what?

A

protein

39
Q

Tell me about the sensitivity and specificity of creatinine for kidney failure

A

high specificity and lower sensitivity

40
Q

What is albumin and what does it do?

A

Albumin is a plasma protein made by the liver.
Water follows albumin, so it regulates osmotic pressure (fluid balance).

41
Q

Elevated liver enzymes indicate ______

A

liver damage/infection

42
Q

How is bilirubin created and what does a high level indicate?

A

bilirubin is created when RBCs are broken down and recycled. A high level can indicate hemolytic anemia, liver damage, blockage of the portal vein, or gallbladder disease.

43
Q

The liver converts ammonia to what?

A

urea

44
Q

What is the most common reason for elevated lactic acid levels?

A

Sepsis

45
Q

What does a high serum osmolarity mean?

What does a low serum osmolarity mean?

A

high means that the blood is very concentrated, so fluid will be shifting from the tissues and into the blood.

low means that the blood is very dilute and fluid will be shifting from the blood and into the tissues.

46
Q

Prothrombin time (PT) measures the efficacy of ______

A

coumadin-type anticoagulants

47
Q

Partial thromboplastin time (PTT) measures the efficacy of ______

A

intrinsic clotting factors, HEPARIN

48
Q

International normalized ratio (INR) compares ____

How do you interpret the value?

A

the patient : standardized control

If a person is not on coagulation therapy, the patient and control will be the same, resulting in an INR of 1.

49
Q

What should the INR be for a patient who is receiving warfarin therapy?

A

2-3

50
Q

What does a high vs normal D-dimer mean?

A

High = pt is making extra clots (DVTs, PEs)
Normal = pt is not making extra clots

51
Q

What is the most specific blood test for an acute MI

A

Cardiac-specific troponin (normal value 0.0 - < 0.50 mg/mL

52
Q

What is the hormone produced by the ventricles when they are stretched? What can it indicate?

A

B-type natriuretic peptide (BNP). High levels can indicate CHF (LV) or PE (RV).

53
Q

What is the order UMBC wants us to interpret ABGs?

A
  1. check the pH
  2. check the PaCO2
  3. check HCO3
  4. is it ROme or roME (resp or met)
  5. check PaO2
  6. check anion gap (when an acidosis)
54
Q

How well the test can RULE OUT a condition

A

specificity

55
Q

How well can the test FIND a condition

A

sensitivity

56
Q

Which system acid/base abnormality is associated with changes in the base excess?

A

Metabolic

57
Q

What are the conditions that can cause a left shift in the oxyhemoglobin dissociation curve?

A

INCREASED AFFINITY FOR 02
decreased temp
decreased 2,3-DPG
decreased PCO2
decreased PCO2
increased pH

58
Q

What are the conditions that can cause a right shift in the oxyhemoglobin dissociation curve?

A

DECREASED AFFINITY FOR 02
increased temp
increased 2,3-DPG
increased PCO2
increased PCO2
decreased pH

59
Q

Are platelets low or high in DIC?

A

low

60
Q
A

Critical Care Paramedic (20 decks)

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