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Laboratory Medicine > Block 1 > Flashcards

Block 1 Flashcards

1
Q

Two types of pathology

A

Anatomic; Clinical

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2
Q

Three subjects needed to interpret labs

A

Population prevalence; Disease incidence; Test characteristics

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3
Q

5 reasons to order a lab test

A

Order; Routine check up; Pre-op; Monitoring; Diagnostics

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4
Q

Usual values found in a population

A

Reference Range

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5
Q

Optimal health or minimal risk of related complications and disease

A

Optimal Range

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6
Q

Specific to lab based on equipment and methods

A

Reference Range

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7
Q

Range that varies with age, sex, race, diet, drugs, stress and population

A

Reference Range

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8
Q

Assay imprecision or Test error variability

A

Analytical Variability

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9
Q

Natural biological fluctuation or lifestyle variation

A

Intra-individual variability

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10
Q

General Chemistry Test

A

Comprehensive Metabolic Panel (CMP)

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11
Q

CMP gives info on (7):

A

Na; Cl; BUN; K; HCO3; Cr; Glu

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12
Q

5 main electrolytes

A

Na; Cl; Mg; Ca; K

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13
Q

Amount of tests annually

A

6.8 billion

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14
Q

Increases by how much %

A

7% annually

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15
Q

5 major liver functions

A
  1. Synthesis and secretion of proteins
  2. Storage of energy (glycogen)
  3. Metabolizes drugs and toxins
  4. Transformation and clearance
  5. Aids digestion through Biliary System
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16
Q

5 Liver Tests

A

Globulin; AST; ALT; Bilirubin; Albumin

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17
Q

Globulin contains

A

100s of serum proteins, including carrier enzymes, complement immunoglobulins

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18
Q

Increase or decrease in Globulin should be evaluated by

A

Serum Electrophoresis

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19
Q

Asparate Aminotransferase (AST) found in

A

Liver tissues

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20
Q

AST detects

A

Liver damage

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21
Q

Alanine aminotransferase (ALT) founf

A

in cytosol of liver

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22
Q

ALT detects

A

Liver damage

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23
Q

Which is more specific, ALT or AST

A

ALT

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24
Q

Increased levels of ALT or AST can be caused by

A

Viral Hep, Fatty Liver, Toxins due to medications, Strenuous exercise

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25
Q

Bilirubin formed from

A

Old Blood Cells

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26
Q

Bilirubin is conjugated where

A

In the liver

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27
Q

Bilirubin is conjugated in the liver with

A

glucuronic acid

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28
Q

The role of glucuronic acid with bilirubin is

A

to make is soluble

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29
Q

In the intestine glucuronic acid is removed by bacteria forming

A

Urobilinogen

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30
Q

A portion of the urobilinogen participates in what cycle?

A

enterohepatic

31
Q

Indirect testing for bilirubin indicates

A

pre-hepatic

32
Q

Direct testing for bilirubin indicates

A

post-hepatic

33
Q

Increase in indirect bilirubin can be caused by

A
  1. increased production
  2. impaired conjugation function
  3. impaired hepatic intake of bilirubin
34
Q

Diseases known to cause increase in indirect bilirubin

A
  1. Hemolysis
  2. Kernicterus
  3. Grigler-Najjar
  4. Gilberts
35
Q

Increase in direct bilirubin can be caused by

A
  1. elevated conjugated bilirubin levels
  2. hepatobiliary obstructon
  3. reduced secretion of conjugated bilirubin into bile or into intestines
36
Q

Diseases that can cause increase in direct bilirubin

A

Hepatitis; Dubin- Johnson syndrome

37
Q

Albumin is synthesized

A

in the liver

38
Q

Albumin with globulins make up

A

total protein in serum

39
Q

synthesized in what amount

A

150-250 mg/kg/ day

40
Q

a 70kg man makes how much albumin a day

A

10-18g

41
Q

Main agent of intravascular osmotic pressure

A

Albumin

42
Q

Albumin transports

A

bilirubin, hormones, metats, vitamins and drugs

43
Q

Increased level of albumin caused by

A

acute dehydration

44
Q

Decreased levels of albumin caused by

A

depressed synthesis or increased losses

45
Q

Diseases that can cause a DECREASE in synthesis of albumin

A

End stage liver disease, intestinal malabsorption syndromes, protein malnutrition

46
Q

Protein malnutrition and decreased synthesis of albumin can lead to what syndrome

A

Kwashiorkor “rice diet”

47
Q

Disease that can cause a LOSS in albumin

A

Nephrotic syndrome, severe burns

48
Q

Extra storage for albumin is found in

A

skin

49
Q

Kidney Functions

A

waste, erythropoein, renin, vit D synthesis

50
Q

Kidney processes how many liters of blood a day

A

200L

51
Q

Erythropoetin stimulates

A

red blood cell production in bone marrow

52
Q

Renin is used in

A

Regulation of blood pressure

53
Q

Kidney Tests

A

Urinalysis, Creatine, Blood Urea Nitrate (BUN)

54
Q

BUN tests for

A

breakdown of proteins

55
Q

Creatine tests for

A

breakdown of creatin in muscles

56
Q

Rate of elimination of creatine is proportional to

A

glumural filtration

57
Q

Physical, chemical and microscopic exam of urine

A

Urinalysis

58
Q

Heart tests

A

Lipid panel, Brain (B-type) Natriuretic protein, troponins

59
Q

Lipid panel tests for

A

cholesterol, triglycerides, HDL, Choles/HDL ratio, LDL calculated

60
Q

Lipid panel shows risk of

A

heart disease

61
Q

Urinalysis catergories

A

Urobilinogen, glucose, ketone, bilirubin, protein, nitrite, leukocyte, blood, ph, SG stick, sediment

62
Q

Increase in nitrite and leukocytes in urinalysis can indicate

A

urinary infection

63
Q

BNP secreted in heart due to

A

excessive stretching of heart muscle

64
Q

BNP differentiates between

A

congested heart failure and other causes of dysphea

65
Q

Troponin is released when

A

heart muscle is damaged

66
Q

Most specific when looking for heart infraction

A

Troponin I

67
Q

Lab test for brain

A

cerebrospinal fluid analysis

68
Q

Lab test for lungs

A

Ph, Co2 levels, O2 levels and lung size

69
Q

Thyroid function lab test

A

TSH levels

70
Q

Parathyroid hormone (PTH) levels can indicate

A

issues with bone marrow or Ca2

71
Q

Most common test inappropriately ordered

A

estrogen

72
Q

Endocrine tests

A

TSH, FSH, LH, PTH, Estrogen, Testerone

73
Q

Osler’s rule

A

all abnormalities into one dx

Laboratory Medicine (1 decks)

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