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]

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2
Q

Drugs that increase calcium

A

Vitamin D

Thiazide diuretics

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3
Q

Drugs that decrease calcium

A
Systemic steroids
Long-term heparin
Loop diuretics
Bisphosphonates
Cinacalcet
Calcitonin
Foscarnet
Topiramate
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4
Q

Calcium reference range

A

8.5-10.5 mg/dL

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5
Q

Chloride reference range

A

95-106 mEq/L

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6
Q

Magnesium reference range

A

1.3-2.1 mEq/L

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7
Q

Phosphate reference range

A

2.3-4.7 mEq/L

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8
Q

Potassium reference range

A

3.5-5 mEq/L

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9
Q

Sodium reference range

A

135-145 mEq/L

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10
Q

Bicarbonate reference range

A

24-30 mEq/L (venous)

22-26 mEq/L (arterial)

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11
Q

Blood urea nitrogen reference range

A

7-20 mg/dL

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12
Q

Serum creatinine reference range

A

0.6-1.3 mg/dL

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13
Q

Anion Gap reference range

A

5-12 mEq/L

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14
Q

White blood cells reference range

A

4k-11k cells/mm3

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15
Q

Neutrophils reference range

A

45%-73%

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16
Q

Bands reference range

A

3-5%

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17
Q

ANC formula

A

WBC x [(% segs+ %bands)/100]

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18
Q

Increased magnesium caused by:

A

Magnesium containing antacids

Laxatives with renal impairment

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19
Q

Decreased magnesium caused by:

A

PPIs
Diuretics
Amphotericin
Echinocandins

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20
Q

Increased phosphate caused by:

A

Renal failure

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21
Q

Decreased phosphate caused by:

A

Phosphate binders

Oral calcium intake

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22
Q

Increased potassium caused by:

A
ACE inhibitors
ARBs
Aldosterone receptor antagonists
Tacrolimus
Potassium supplements
Drospirenone-containing oral contraceptives
Canagliflozin
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23
Q

Decreased potassium caused by:

A

Beta-2 agonists
Diuretics
Insulin

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24
Q

Increased sodium caused by:

A

Hypertonic saline

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25
Q

Decreased sodium caused by:

A

Carbamazepine
Oxcarbenzapine
SSRIs
Diuretics

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26
Q

Increased bicarbonate caused by:

A

Loop diuretics

Systemic steroids

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27
Q

Decreased bicarbonate caused by:

A

Topiramate
Zonisamide
Salicylate overdose

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28
Q

Increased SCr caused by:

A
Aminoglycosides
Amphotericin B
Cisplatin
Colistimethate
Cyclosporin
Loop diuretics
NSAIDs 
Radiocontrast dye
Tacrolimus
Vancomycin
False increase due to SMZ/TMP or H2RAs
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29
Q

Decreased SCr caused by:

A

Low muscle mass, amputation, hemodilution

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30
Q

Increased WBCs caused by:

A

Systemic steroids
Colony stimulating factors
Epinephrine
Stress

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31
Q

Decreased WBCs caused by:

A

Clozapine
Chemotherapy that targets the bone marrow
Carbamazepine
Cephalosporins
Immunosuppressants (e.g. DMARDs, biologics)
Procainamide
Vancomycin

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32
Q

Band definition

A

Immature neutrophils released from the bone marrow to fight infection (called a left shift)

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33
Q

Increased Red Blood Cells (RBCs) caused by:

A

ESAs
Smoking
Polycythemia

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34
Q

Decreased RBCs caused by:

A
Chemotherapy that targets the bone marrow
Low production
Blood loss
Deficiency anemias (B12, folate)
Hemolytic anemia
Sickle cell anemia
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35
Q

Increase in Hgb/Hct caused by:

A

ESAs (Procrit, Aranesp, Epogen)

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36
Q

Decrease in Hgb/Hct caused by:

A

Anemias

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37
Q

Hgb reference ranges

A

Males: 13.5-18
Females: 12-16

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38
Q

Hct reference ranges

A

Males: 38-50%
Females: 36-46%

39
Q

Mean Corpuscular Volume (MCV) reference range

A

80-100

40
Q

Increased MCV caused by:

A

B12 or folate deficiency

41
Q

Decreased MCV caused by:

A

Iron deficiency

42
Q

Decreased Folic Acid (folate) caused by:

A
Phenytoin/fosphenytoin
Phenobarbital
Primidone
MTX
Sulfasalazine
SMZ/TMP
43
Q

Decreased Vitamin B12 caused by:

A

PPIs
Metformin
Colchicine
Chloramphenicol

44
Q

Coombs Test

A

Used to determine cause of hemolytic anemia (autoimmune vs. drug-induced)

45
Q

Drug-Induced Positive Coombs Test

A
PCNs and cephalosporins (prolonged/high concentrations)
Isoniazid
Levodopa
Methyldopa
Nitrofurantoin
Quinidine
Quinine
Rifampin
Sulfonamides
46
Q

G6PD triggers

A
Fava beans
Chloroquine
Dapsone
Methylene blue
Nitrofurantoin
Primaquine
Probenacid
Quinidine
Quinine
Rasburicase 
Sulfonamide
47
Q

Anti Xa Activity monitors:

Is increased by:

A

Monitors LMWHs

Increased due to heparin, LMWHs and fondaparinux

48
Q

PT/INR false increase caused by:

A

Daptomycin, oritavacin, televancin

49
Q

aPTT or PTT monitors:

False increase caused by:

A

Monitors UFH and direct thrombin inhibitors (argatroban)

False increased caused by oritavancin, televancin

50
Q

Albumin reference range

A

3.5-5

51
Q

Platelet reference range

A

150-450

52
Q

Drugs that decrease platelets

A

heparin, LMWHs, fondapariunx, valproic acid

53
Q

Drugs affected by decreased albumin

A

Warfarin
Phenytoin
Valproic acid
Calcium

54
Q

Abnormal LFT value

A

2-5x ULN

55
Q

Pancreatitis is measured by:

A

Amylase and Lipase

56
Q

Increased risk of pancreatitis is caused by:

A

Didanosine
GLP-1 agonists
VPA
Hypertriglyceridemia

57
Q

CK/CPK can be increased due to

A

Daptomycin
Statins
Tenofovir
Dolu/Raltegravir

58
Q

Abnormal values for BNP/NT-proBNP indicate

A

MI
or
if present with sxs of HF, can be indicative of HF

59
Q

Total Cholesterol reference range

A

<200

60
Q

HDL reference range

A

<40 low

>60 desirable

61
Q

LDL reference range

A

70-189

62
Q

Trigylceride reference range

A

<150

63
Q

CRP elevation and ESR are indicative of

A

Inflammation

64
Q

Fasting plasma glucose abnormal ranges

A

> 126: DM

100-125: Pre-DM

65
Q

Hgb A1C reference range

A

<7%

66
Q

Preprandial glucose reference range

A

80-130

67
Q

Post-prandial glucose reference range

A

<180

68
Q

TSH can be increased/decreased by

A

Increased/decreased by: amiodarone, interferons

Increased (hypothyroidism) due to lithium, CBZ/OCBZ

69
Q

Uric Acid can be increased by

A
Diuretics
Niacin
High doses of ASA
Pyrazinamide
Cyclosporine/tacro
70
Q

Drug-Induced Lupus Erythematosus (DILE) can be caused by:

A
Anti-TNF agents
Hydralazine 
Isoniazid
Methimazole
Methyldopa
Procainamide
Propylthiouracil
Quinidine
Terbinafine
71
Q

pCO2 reference range

A

35-45

72
Q

HCO3 reference range

A

22-26

73
Q

pH reference range

A

7.35-7.45

74
Q

Cosyntropin Stimulation Test is used for

A

Testing adrenal suppression

75
Q

Lactic acid is increased by

A

NRTIs, metformin, alcohol, cyanide

76
Q

Elevated Procalcitonin is indicative of

A

Systemic bacterial infections or severe local infections

77
Q

Rapid Plasma Reagin (RPR) is used to test for

A

Syphilis

78
Q

Increased AST > Increased ALT, Increased GGT can indicate

A

Alcoholic hepatitis

79
Q

Increased Alk phos/Tbili/GGT with normal or slightly elevated AST/ALT can indicate

A

Cholestasis (biliary)

80
Q

Increased BUN/SCr/K/PO4/PTH with Decreased Hgb/Hct/Ca can indicate

A

Chronic Kidney Disease

81
Q

Increased WBC/Neutrophils/Bands (and possibly increased lactate/ESR/CRP/procalcitonin) can indicate

A

Infection (bacterial)

82
Q

Increased or normal WBC without increased neutrophils and/or bands can indicate

A

Infection (viral)

83
Q

Increased eosinophils can indicate

A

Infection (parasitic)

84
Q

Increased ESR/CRP/ANA can indicate

A

Autoimmune disorder

85
Q

Increase lactic acid/AG and present metabolic acidosis can indicate

A

Lactic acidosis

86
Q

Carbamazepine therapeutic drug level:

A

4-12

87
Q

Digoxin therapeutic drug level:

A
  1. 8-2 (Afib)

0. 5-0.9 (CHF)

88
Q

Phenobarb./Primidone therapeutic drug level:

A

20-40

89
Q

Fos/Phenytoin therapeutic drug level:

A

10-20

90
Q

Procainamide therapeutic drug level:

A

4-10

91
Q

Theophylline therapeutic drug level:

A

5-15

5-10 (neonates)

92
Q

VPA therapeutic drug level:

A

50-100

93
Q

Lithium therapeutic drug level:

A

0.6-1.2