Ch. 17 Lab Values & Drug Monitoring Flashcards
1
Q
Corrected Calcium formula (when albumin is low)
A
Calcium (reported serum) + [(4.0-albumin) x 0.8]
2
Q
Drugs that increase calcium
A
Vitamin D
Thiazide diuretics
3
Q
Drugs that decrease calcium
A
Systemic steroids Long-term heparin Loop diuretics Bisphosphonates Cinacalcet Calcitonin Foscarnet Topiramate
4
Q
Calcium reference range
A
8.5-10.5 mg/dL
5
Q
Chloride reference range
A
95-106 mEq/L
6
Q
Magnesium reference range
A
1.3-2.1 mEq/L
7
Q
Phosphate reference range
A
2.3-4.7 mEq/L
8
Q
Potassium reference range
A
3.5-5 mEq/L
9
Q
Sodium reference range
A
135-145 mEq/L
10
Q
Bicarbonate reference range
A
24-30 mEq/L (venous)
22-26 mEq/L (arterial)
11
Q
Blood urea nitrogen reference range
A
7-20 mg/dL
12
Q
Serum creatinine reference range
A
0.6-1.3 mg/dL
13
Q
Anion Gap reference range
A
5-12 mEq/L
14
Q
White blood cells reference range
A
4k-11k cells/mm3
15
Q
Neutrophils reference range
A
45%-73%
16
Q
Bands reference range
A
3-5%
17
Q
ANC formula
A
WBC x [(% segs+ %bands)/100]
18
Q
Increased magnesium caused by:
A
Magnesium containing antacids
Laxatives with renal impairment
19
Q
Decreased magnesium caused by:
A
PPIs
Diuretics
Amphotericin
Echinocandins
20
Q
Increased phosphate caused by:
A
Renal failure
21
Q
Decreased phosphate caused by:
A
Phosphate binders
Oral calcium intake
22
Q
Increased potassium caused by:
A
ACE inhibitors ARBs Aldosterone receptor antagonists Tacrolimus Potassium supplements Drospirenone-containing oral contraceptives Canagliflozin
23
Q
Decreased potassium caused by:
A
Beta-2 agonists
Diuretics
Insulin
24
Q
Increased sodium caused by:
A
Hypertonic saline
25
Decreased sodium caused by:
Carbamazepine
Oxcarbenzapine
SSRIs
Diuretics
26
Increased bicarbonate caused by:
Loop diuretics
| Systemic steroids
27
Decreased bicarbonate caused by:
Topiramate
Zonisamide
Salicylate overdose
28
Increased SCr caused by:
```
Aminoglycosides
Amphotericin B
Cisplatin
Colistimethate
Cyclosporin
Loop diuretics
NSAIDs
Radiocontrast dye
Tacrolimus
Vancomycin
False increase due to SMZ/TMP or H2RAs
```
29
Decreased SCr caused by:
Low muscle mass, amputation, hemodilution
30
Increased WBCs caused by:
Systemic steroids
Colony stimulating factors
Epinephrine
Stress
31
Decreased WBCs caused by:
Clozapine
Chemotherapy that targets the bone marrow
Carbamazepine
Cephalosporins
Immunosuppressants (e.g. DMARDs, biologics)
Procainamide
Vancomycin
32
Band definition
Immature neutrophils released from the bone marrow to fight infection (called a left shift)
33
Increased Red Blood Cells (RBCs) caused by:
ESAs
Smoking
Polycythemia
34
Decreased RBCs caused by:
```
Chemotherapy that targets the bone marrow
Low production
Blood loss
Deficiency anemias (B12, folate)
Hemolytic anemia
Sickle cell anemia
```
35
Increase in Hgb/Hct caused by:
ESAs (Procrit, Aranesp, Epogen)
36
Decrease in Hgb/Hct caused by:
Anemias
37
Hgb reference ranges
Males: 13.5-18
Females: 12-16
38
Hct reference ranges
Males: 38-50%
Females: 36-46%
39
Mean Corpuscular Volume (MCV) reference range
80-100
40
Increased MCV caused by:
B12 or folate deficiency
41
Decreased MCV caused by:
Iron deficiency
42
Decreased Folic Acid (folate) caused by:
```
Phenytoin/fosphenytoin
Phenobarbital
Primidone
MTX
Sulfasalazine
SMZ/TMP
```
43
Decreased Vitamin B12 caused by:
PPIs
Metformin
Colchicine
Chloramphenicol
44
Coombs Test
Used to determine cause of hemolytic anemia (autoimmune vs. drug-induced)
45
Drug-Induced Positive Coombs Test
```
PCNs and cephalosporins (prolonged/high concentrations)
Isoniazid
Levodopa
Methyldopa
Nitrofurantoin
Quinidine
Quinine
Rifampin
Sulfonamides
```
46
G6PD triggers
```
Fava beans
Chloroquine
Dapsone
Methylene blue
Nitrofurantoin
Primaquine
Probenacid
Quinidine
Quinine
Rasburicase
Sulfonamide
```
47
Anti Xa Activity monitors:
| Is increased by:
Monitors LMWHs
| Increased due to heparin, LMWHs and fondaparinux
48
PT/INR false increase caused by:
Daptomycin, oritavacin, televancin
49
aPTT or PTT monitors:
| False increase caused by:
Monitors UFH and direct thrombin inhibitors (argatroban)
| False increased caused by oritavancin, televancin
50
Albumin reference range
3.5-5
51
Platelet reference range
150-450
52
Drugs that decrease platelets
heparin, LMWHs, fondapariunx, valproic acid
53
Drugs affected by decreased albumin
Warfarin
Phenytoin
Valproic acid
Calcium
54
Abnormal LFT value
2-5x ULN
55
Pancreatitis is measured by:
Amylase and Lipase
56
Increased risk of pancreatitis is caused by:
Didanosine
GLP-1 agonists
VPA
Hypertriglyceridemia
57
CK/CPK can be increased due to
Daptomycin
Statins
Tenofovir
Dolu/Raltegravir
58
Abnormal values for BNP/NT-proBNP indicate
MI
or
if present with sxs of HF, can be indicative of HF
59
Total Cholesterol reference range
<200
60
HDL reference range
<40 low
| >60 desirable
61
LDL reference range
70-189
62
Trigylceride reference range
<150
63
CRP elevation and ESR are indicative of
Inflammation
64
Fasting plasma glucose abnormal ranges
>126: DM
| 100-125: Pre-DM
65
Hgb A1C reference range
<7%
66
Preprandial glucose reference range
80-130
67
Post-prandial glucose reference range
<180
68
TSH can be increased/decreased by
Increased/decreased by: amiodarone, interferons
| Increased (hypothyroidism) due to lithium, CBZ/OCBZ
69
Uric Acid can be increased by
```
Diuretics
Niacin
High doses of ASA
Pyrazinamide
Cyclosporine/tacro
```
70
Drug-Induced Lupus Erythematosus (DILE) can be caused by:
```
Anti-TNF agents
Hydralazine
Isoniazid
Methimazole
Methyldopa
Procainamide
Propylthiouracil
Quinidine
Terbinafine
```
71
pCO2 reference range
35-45
72
HCO3 reference range
22-26
73
pH reference range
7.35-7.45
74
Cosyntropin Stimulation Test is used for
Testing adrenal suppression
75
Lactic acid is increased by
NRTIs, metformin, alcohol, cyanide
76
Elevated Procalcitonin is indicative of
Systemic bacterial infections or severe local infections
77
Rapid Plasma Reagin (RPR) is used to test for
Syphilis
78
Increased AST > Increased ALT, Increased GGT can indicate
Alcoholic hepatitis
79
Increased Alk phos/Tbili/GGT with normal or slightly elevated AST/ALT can indicate
Cholestasis (biliary)
80
Increased BUN/SCr/K/PO4/PTH with Decreased Hgb/Hct/Ca can indicate
Chronic Kidney Disease
81
Increased WBC/Neutrophils/Bands (and possibly increased lactate/ESR/CRP/procalcitonin) can indicate
Infection (bacterial)
82
Increased or normal WBC without increased neutrophils and/or bands can indicate
Infection (viral)
83
Increased eosinophils can indicate
Infection (parasitic)
84
Increased ESR/CRP/ANA can indicate
Autoimmune disorder
85
Increase lactic acid/AG and present metabolic acidosis can indicate
Lactic acidosis
86
Carbamazepine therapeutic drug level:
4-12
87
Digoxin therapeutic drug level:
0. 8-2 (Afib)
| 0. 5-0.9 (CHF)
88
Phenobarb./Primidone therapeutic drug level:
20-40
89
Fos/Phenytoin therapeutic drug level:
10-20
90
Procainamide therapeutic drug level:
4-10
91
Theophylline therapeutic drug level:
5-15
| 5-10 (neonates)
92
VPA therapeutic drug level:
50-100
93
Lithium therapeutic drug level:
0.6-1.2
