Basic Lab Data Flashcards
Which organ is responsible for the production of the following enzymes?
How are these enzymes transported?
(ALT) - Alanine Transaminase
(AST) - Aspartate Transaminase
(ALP) - Alkaline Phosphatase
The liver is responsible for the creation of:
(ALT) - Alanine Transaminase
(AST) - Aspartate Transaminase
(ALP) - Alkaline Phosphatase
Albumin, a plasma protein made by the liver, is necessary for the transport of those enzymes
What are the major causes of acidosis?
Use MUDPILES:
M: Methanol U: Uremia D: DKA P: Paraldehyde I: Iron L: Lactic Acid E: Ethylene Glycol S: Salicylates (ASA products)
After analyzing your patient’s CBC, you note a significant WBC right shift. What is a right shift indicative of?
A right shift on the White Blood Cell count is indicative of a VIRAL infection.
How do the kidneys influence pH (per Hydrogen)?
The kidneys influence pH (per Hydrogen) by retaining or secreting bicarb (HCO3).
Which acid - base system reacts faster?
- Respiratory
- Metabolic
The Respiratory (lungs) system can change the acid - base factor significantly faster then the metabolic (kidneys) system.
What measures the effectiveness of coumadin-type anticoagulant medications?
Prothrombin time (PT) measures the effectiveness of coumadin-type anticoagulant medications (Warfarin).
What is a left shift?
What is a left shift indicative of?
A left shift is an increased number of neutrophil bands (immature) and is common with acute infections.
Left shift is primarily bacterial
What is the normal value range of Calcium (Ca++)?
9 - 11 mg/dL is the normal value range of Calcium (Ca++).
What is characterized by the following lab values?
Increase in pH
No Change PaCO2
Increase in HCO3
Uncompensated metabolic alkalosis is characterized by the following lab values:
Increase in pH
No Change PaCO2
Increase in HCO3
How is uncompensated metabolic alkalosis characterized?
Metabolic alkalosis is characterized as:
pH increased
PaCO2 no change
HCO3 increased
How long do elevated cTnI levels remain detectable at an elevated range, suggestive of myocardial specific injury?
Troponin (cTnI) levels stay elevated for approximately 5 - 10 days post infarction.
** this time can be extended for patients with renal injury due to the increased workload of the kidneys to get rid of the myoglobin **
Normal Range Value: < 0.05 ng/mL
______ is a crystalline product when the body breaks down purines (certain types of food).
Uric Acid
Standard Value Range: 2 - 8 mg/dL
If a patient has normal renal function, what is the normal time frame that the Creatine Phosphokinase (CPK) levels will return to baseline, subsequent to an Acute Myocardial Infarction (AMI)
3 - 4 days is the approximate time for the Creatine Phosphokinase (CPK) levels to return to baseline, subsequent to an Acute Myocardial Infarction (AMI), If a patient has normal renal function.
This WBC is predominately a viral killer?
The Lymphocyte White Blood Cell (WBC) is predominately a viral killer.
What is the normal Arterial Blood Gas (ABG) range for partial pressure of oxygen (PaO2)?
The normal Arterial Blood Gas (ABG) range for partial pressure of oxygen (PaO2) is:
35 - 45 mmHg
What is the International Normalized Ratio (INR)?
International Normalized Ratio (INR) is a standardized control used to compare the PT, regarding anticoagulant effectiveness of coumadin-type medications (Warfarin).
What is the normal value range of Creatinine (Cr) when examining the Basic Metabolic Panel (BMP)?
- 6 - 1.4 mg/dL (M):
- 6 - 1.1 mg/dL (F):
:is the normal value range of Creatinine (Cr) when examining the Basic Metabolic Panel (BMP)
What does the Partial Thromboplastin (PTT) measure?
Partial Thromboplastin (PTT) measures the effectiveness of heparin therapy.
A common problem of specimen collection associated with the breakdown of Red Blood Cells (RBC) and subsequent release of hemoglobin (Hgb) is known as:
- Hemoglobinuria
- Hematocrit
- Hemolysis
- Hemodialysis
- Hemolysis
A common problem of specimen collection associated with the breakdown of Red Blood Cells (RBC) and subsequent release of hemoglobin (Hgb) is known as Hemolysis.
You need to evaluate the functionality of your patient’s liver. Can this be done with a BMP
No, the Basic Metabolic Panel (BMP) does not assess liver functions.
The Comprehensive Metabolic Panel (CMP) is utilized to evaluate liver function.
What is occurring if the pH and the HCO3 are elevated?
Metabolic Alkalosis has occurred if the pH and the HCO3 are elevated.
_______ is an isoenzyme in the skeletal muscles, brain, and cardiac muscles. If this lab value is elevated, it could be indicative of myocardial insult.
Creatine Phosphokinase (CPK)
Normal Range Value: 5 - 35 mcg/dL
What is specificity?
Specificity is the probability that a test will be negative in the absence of a disease.
What is the normal average value for hemoglobin (Hgb)?
15 g/dL is the normal average value for hemoglobin (Hgb).
Male: 14 - 18 g/dL
Female: 12 - 16 g/dL
_____ is defined as an elevation of HCO3- above the normal value.
Metabolic Alkalosis is defined as an elevation of HCO3- (bicarb) above the normal value.
For every _____ mEq of bicarbonate (HCO3), the pH will change _____ in the same direction.
For every 10 mEq of bicarbonate (HCO3), the pH will change 0.15 in the same direction.
How do the lungs regulate acidity in the body?
The lungs regulate acidity in the body by increasing or decreasing the amount of CO2 present.
What does a Base Excess (BE) of > -10 mmol/L indicate?
> -10 mmol/L indicates severe shock
What are the main purposes of lab data analysis?
The main purposes of lab data analysis is:
- Establish baseline data
- Observe trends and changes over time
What is the normal Arterial Blood Gas (ABG) range for serum bicarbonate (HCO3)?
The normal Arterial Blood Gas (ABG) range for serum bicarbonate (HCO3) is:
22 - 26 mEq/L
Which lab value is significant in the determination of dehydration or over-hydration?
Serum Osmolality is significant in the determination of dehydration or over-hydration.
Normal Range Value: 282 - 295 mOsm
What is an acceptable International Normalized Ratio (INR) in persons receiving coumadin-type medications (Warfarin)?
International Normalized Ratio (INR) should be 2-3 in persons receiving coumadin-type medications (Warfarin).
What is released into the blood stream subsequent to a muscle injury?
Myoglobin is released into the blood stream subsequent to a muscle injury.
An elevated myoglobin level may be suggestive of cardiac muscle injury
Myoglobin is NOT sensitive
Normal Value Range: 9 - 12 mcg/mL
What labs can be analyzed via a BMP?
Basic Metabolic Panel:
Sodium (Na+): 135 - 145 mEq/L Potassium (K+): 3.5 - 5 mEq/L Chloride (Cl-): 96 - 106 mEq/L Calcium (Ca++): 9 - 11 mg/dL Glucose (Glu): 60 - 89 mg/dL BUN: 7 - 21 mg/dL Creatinine (Cr): 0.9 mg/dL (M/F average) Bicarbonate (HCO3): 22 - 26 mEq/L (serum)
** Bicarb is usually assessed via ABG **
What is considered a normal anion gap?
8 - 16 mEq/L is considered a normal anion gap.
[Na+ + K+] - [Cl- + HCO3-] = Anion Gap (AG)
What is the “Rule of Three” to determine a certain value via the Complete Blood Count (CBC)?
The “Rule of Three” to determine a certain value via the Complete Blood Count (CBC) is:
RBC x 3 = Hemoglobin (Hgb)
Hgb x 3 = Hematocrit (Hct)
(ex: RBC 5 x 3 = Hgb 15; Hgb 15 x 3 = Hct 45)
What is the time frame you would expect to see a rise in Creatine Phosphokinase (CPK) subsequent to an Acute Myocardial Infarction (AMI)?
Within 4 - 6 hours is the time frame you would expect to see a rise in Creatine Phosphokinase (CPK) subsequent to an Acute Myocardial Infarction (AMI).
How does the body off gas carbonic acid (H2CO3)?
The body off gases carbonic acid (H2CO3) by combining the H+ ion with deoxygenated hemoglobin (Hgb) which is called isohydric buffering and released from the lungs to form exhaled CO2.
What does a positive Base Excess (BE) indicate?
A positive Base Excess (BE) indicates the patient has metabolic alkalosis.
______ measures the degradation products of cross-linked fibrin created during fibrinolysis.
D-dimer Assey measures the degradation products of cross-linked fibrin created during fibrinolysis.
Normal Range Value: < 0.5 - 1 mcg/mL
< 500 - 1000 mcg/L
What is an elevated CPK suggestive of?
Creatine Phosphokinase (CPK) is suggestive of:
Myocardial injury: CPK-MB
Renal Failure
Tongue Injury
Normal Range Values: 5 - 35 mcg/dL
What does a negative Base Excess (BE) indicate?
A negative Base Excess (BE) indicates the patient has metabolic acidosis.
What is the formula to determine a patient’s anion gap (AG)?
[Na+ + K+] - [Cl- + HCO3-] = AG
[Sodium + Potassium] - [Chloride + Bicarb] = AG
Creatinine (Cr) aids in the diagnosis of _______.
Creatinine (Cr) aids in the diagnosis of renal dysfunction.
What is the proper sequence for interpreting Arterial Blood Gases (ABGs)?
The proper sequence for interpreting Arterial Blood Gases (ABGs) is:
- pH
- PaCO2
- HCO3
- PaO2
- Assess the anion gap (AG)
What is the normal value range of Creatine Phosphokinase (CPK)?
5 - 35 mcg/mL is the normal value range of Creatine Phosphokinase (CPK).
What is a normal value for prothrombin time (PT)?
11.2 - 13.2 seconds is a normal value for prothrombin time (PT).
______ is defined as a reduction of HCO3 below normal.
Metabolic acidosis is defined as a reduction of HCO3 below normal.
What does the Blood Urea Nitrogen (BUN) panel evaluate?
The Blood Urea Nitrogen (BUN) panel evaluates renal function and hydration status.