Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

1. NAPLEX Prep > Chapter 4-Lab Values and Drug Monitoring > Flashcards

Chapter 4-Lab Values and Drug Monitoring Flashcards

1
Q

Point of care testing

A

Provides rapid results at the site of patient care. There are many POC tests, including tests for cardiac enzymes, A1C, INR, and dvarious infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Complete Blood Count

A

Analyzes WBCs, RBCs, and PLTs
Hg and Hct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

CBC with differential

A

the types of neutrophils are analyzed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Basic Metabolic Panel

A

Includes 7-8 tests that analyze electrolytes, glucose, renal function, and acid/base (with HCO2 or bicarbonate) status. Some labs calculate and report an anion gap along with the BMP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Comprehensive Metabolic Panel (CMP)

A

Includes the tests of the BMP plus albumin, ALT, AST, total bilirubin, and total protein.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

> ——<

A

…………..Hgb
WBC>———–<PLT
Hct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

—-|——|—–<

A

Na |Cl |BUN
————————<Glucose
K |HCO3|SCr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Leukocytosis

A

Increased WBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Polycythemia

A

Increased RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Thrombocytosis

A

Increased platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Leukopenia

A

Decreased WBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Anemia

A

Decreased RBC or Hgb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Thrombocytopenia

A

Decreased platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Myelosuppression

A

Decreased WBCs, RBCs, and platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Agranulocytosis

A

Decreased granulocytes (WBCs that have secretory granules in the cytoplasm). Includes decreased neutrophils, basophils, and eosinophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Drug causes of agranulocytosis

A

Clozapine, propylthiouracil, methimazole, procainamide, carbamazepine, sulfamethoxazole/trimethoprim, isoniazid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Granulocytes

A

Neutrophils, basophils, eosinophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

TJC requires that accredited facilities create and follow a protocol to

A

identify and report critical values to the responsible healthcare provider, who has an established timeframe to manage the result.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Calculate corrected calcium when

A

albumin is low.
Correction is not needed for ionized calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Increased calcium is due to

A

Calcium supplementation, vitamin D, thiazide diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Decreased calcium is due to

A

Long-term heparin, loop diuretics, bisphosphonates, cinacalcet, systemic steroids, calcitonin, foscarnet, topiramate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When should you supplement calcium?

A

Pregnancy, osteoporosis/osteopenia and with certain drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Increased Mg is due to

A

Magnesium-containing antacids and laxatives (higher risk with renal impairment)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Decreased Mg is due to

A

PPIs, diuretics, amphotericin B, foscarnet, echinocandins, diarrhea, chronic alcohol intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Phosphate is increased by

A

CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Phosphate is decreased by

A

phosphate binders, foscarnet, oral calcium intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Potassium is increased by

A

ACE inhibitors, ARBs, aldosterone receptor antagonists, aliskiren, canagliflozen, cyclosporine, tacrolimus, mycophenolate, potassium supplements, sulfamethoxazole/trimethoprim, drospirenone containing oral contraceptives, chronic heparin use, NSAIDs, pentamidine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Potassium is decreased by

A

beta 2 agonists, diuretics, insulin, steroids, conivaptan, mycophenolate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Sodium is increased by

A

hypertonic saline, tolvaptan. conivaptan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Sodium is decreased by

A

carbamazepine, oxcarbazepine, SSRIs, diuretics, desmopressin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Bicarbonate is increased by

A

loop diuretics, systemic steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Bicarbonate is decreased by

A

topiramate, zonisamide, salicylate overdose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

BUN increased in

A

renal impairment and dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

BUN is used with

A

SCr to assess fluid status and renal function (BUN:SCr)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

SCr is increased by

A

aminoglycosides, amphotericin B, cisplatin, colistimethate, cyclosporine, loop diuretics, polymyxin, NSAIDs, radiocontrast dye, tacrolimus, vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

SCr can be falsely increased by

A

Sulfamethoxazole/trimethoprin, H2RAs, cobicistat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

SCr is lowered by

A

low muscle mass, amputation, hemodilution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

An increased anion gap suggests

A

metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are WBCs used to diagnose?

A

Used to diagnose/monitor infection and inflammation. Can increase as an acute phase reaction, indicating a systemic reaction to inflammation or stress (surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

WBCs are increased by

A

systemic steroids, colony stimulating factors, epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

WBCs are decreased by

A

Clozapine, chemotherapy that targets bone marrow, carbamazepine, cephalosporins, immunosuppressants (DMARDs, biologics), procainamide, vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Neutrophils and bands are used

A

with clinical s/sx to assess the likelihood of acute infection. WBCs are used in the absolute neutrophils count calculation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Neutrophils are also called

A

Polymorphonuclear cells (PMNs or polys) or segmented neutrophils (segs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

bands

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Eosinophils increase in

A

drug allergy, asthma, inflammation, parasitic infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Basophils increase in

A

Inflammation, hypersensitivity reactions, leukemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Lymphocytes increase in

A

viral infections, lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Lymphocytes decrease in

A

bone marrow suppression, HIV, or due to systemic steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Monocytes increase in

A

chronic infections, inflammation, stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

RBCs lifespan

A

120 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

RBCs increase due to

A

ESAs, smoking, and polycythemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

RBCs decrease due to

A

Chemotherapy that targets the bone marrow, low production, blood loss, deficiency anemias, hemolytic anemias, sickle cell anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Hemoglobin is

A

The iron-containing protein that carries oxygen in RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Hgb/Hct increases due to

A

ESAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Hgb/Hct decreased in

A

anemias and bleeding
See Coombs test and G6PD for drug-induced anemias

56
Q

Mean Corpuscular Volume (MCV)

A

Reflects the size and average volume of RBCs

57
Q

MCV increases

A

Macrocytic anemia due to B12 or folate deficiency

58
Q

MCV decreases

A

Microcytic anemia due to iron deficiency

59
Q

Folic acid decreases by

A

phenytoin/fosphenytoin, phenobarbital, primidone, methotrexate, sulfamethoazole/trimethoprim, sulfasalazine

60
Q

Supplement folic acid in

A

Women of childbearing age and alcoholism

61
Q

Vitamin B12 decreases by

A

PPIs, metformin, colchicine, chloramphenicol

62
Q

Reticulocyte count

A

Measures the amount of reticulocytes (immature red blood cells) being made by the bone marrow

63
Q

Reticulocyte count is increased in

A

Blood loss

64
Q

Reticulocyte count is decreased in

A

untreated anemia, due to iron, folate, or B12 deficiency, and with bone marrow suppression

65
Q

Coombs test, direct

A

Used in the diagnosis of hemolytic anemia when the cause is unclear

66
Q

Drugs that can cause hemolytic anemia

A

penicillins and cephalosporins, dapsone, isoniazid, levodopa, methyldopa, methylene blue, nitrofurantoin, pegloticase, primaquine, quinidine, quinine, rasburicase, rifampin, and sulfonamides

67
Q

G6PD

A

Used to determine if hemolytic anemia is due to G6PD deficiency

68
Q

RBC destruction with G6PD deficiency is triggered by

A

Stress, foods (fava beans)
Drugs- dapsone, methylene blue, nitrofurantoin, pegloticase, primaquine, rasburicase, sulfonamides

69
Q

Therapeutic doses of LMWH anti Xa level

A

Obtain a peak anti-Xa level 4 hours after a SC LMWH dose: 1-2 IU/ml

70
Q

Unfractionated heparin anti Xa level

A

Obtain 6 hours after IV infusion starts and every 6 hours until therapeutic: 0.3-0.7 IU/mL

71
Q

Anti-Xa

A

Used to monitor low molecular weight heparins and unfractionated heparin. Monitoring for LMWH is recommended in preganancy and may be used in obesity, low body weight, pediatrics, elderly, renal insufficiency

72
Q

PT/INR

A

Used to monitor warfarin

73
Q

INR increases (without warfarin)

A

Due to liver disease

74
Q

False increases in INR

A

daptomycin, oritavancin, telavancin

75
Q

aPTT or PTT

A

Used to monitor UFH and direct thrombin inhibitors (argatroban)

76
Q

False increases in aPTT or PTT

A

Oritavancin, telavancin

77
Q

UFH when to obtain PTT/PTT

A

obtain 6 hours after IV infusion starts and every 6 hours until therapeutic

78
Q

Platelets have an average lifespan of

A

7-10 days

79
Q

Spotaneous bleeding can occur when platelets are

A

<20,000 cells/mm^3

80
Q

PLTs decrease bt

A

heparin, LMWH, fondaparinux, glycoprotein IIb/IIIa receptor antagonists, linezolid, valproic acid, chemotherapy that targets bone marrow

81
Q

Albumin decreases due to

A

Cirrhosis and malnutrition

82
Q

What drugs are impacted by low albumin

A

Highly protein bound drugs
Warfarin, calcium, phenytoin

83
Q

What drugs need correction for low albumin?

A

Phenytoin, valproic acid, and calcium

84
Q

Bilirubin

A

Used along with other liver tests to determine causes of liver damage and detect bile duct blockage

85
Q

Ammonia increases due to

A

Valproic acid, topiramate

86
Q

Ammonia decreases due to

A

Lactulose

87
Q

Amylase/Lipase

A

Pancreatic enzymes
Increase in pancreatitis, which can be caused by didanosine, stavudine, GLP-1 agonist, DPP4inhibitors, valproic acid, hypertriglyceridemia

88
Q

CK or CPK

A

Use to assess muscle inflammation (myositis) or more serious muscle damage and to diagnose cardiac conditions

89
Q

CK or CPK increases due to

A

Daptomycin, quinipristin/dalfopristin, statins, fibrates, emtricitabine, tenovir, tipranavir, raltegravir, dolutegravir

90
Q

Markers of cardiac stress

A

BNP and NT-proBNP.
They are not HF or heart disease specific, but higher values indicate a higher likleihood of HF when consistent with HF symptoms

91
Q

Myoglobin

A

Marker of muscle injury

92
Q

How long should fasting occur before lipid blood draw?

A

9-12 hours before

93
Q

LDL goal

A

<100 mg/dL

94
Q

HDL goal

A

> /= 60 is goal
<40 is low

95
Q

CRP

A

Indicates inflammation which could be due to many conditions (infection, trauma, malignancy).
Higher levels indicate increased risk.
High sensitivity CRP is more sensitive for CVD

96
Q

Ankle brachial index

A

Measures the ratio of BP in the lower legs to the BP in the arms. Used to assess the severity of peripheral artery disease. An ABI <1 indicated some degree of PAD.

97
Q

Fasting begins how long before FPG draw?

A

> /= 8 hours

98
Q

What FPG is positive for diabetes?

A

> /= 126 mg/dL

99
Q

What FPG is positive for prediabetes

A

100-125mg/dL

100
Q

Hemoglobin A1C is based on

A

The attachment of glucose to hemoglobin.
Increased glucose= increased BG attached to Hgb= Increased A1C

101
Q

Normal estimated average glucose

A

<154 mg/dL

102
Q

An eAG of 126 corresponds to an A1C of

A

6%

103
Q

Preprandial blood glucose goal

A

80-130 mg/dL

104
Q

Postprandial blood glucose goal

A

<180mg/dL

105
Q

C-Peptide

A

Insulin breakdown product used to evaluate beta cell function (distinguishes type 1 and 2 diabetes).
Decreased or absent in type 1 diabetes

106
Q

Increased TSH=

A

Hypothyroidism

107
Q

Decreased TSH=

A

Hyperthyroidism

108
Q

TSH can be increased or decreased by

A

Amiodarone, interferons

109
Q

TSH can be increased (hypothyroidism) due to

A

Tyrosine kinase inhibitors, lithium, carbamazepine

110
Q

Uric acid increases due to

A

diuretics, niacin, low doses of aspirin, pyrazinamide, cyclosporine, tacrolimus, select pancreatic products, select chemotherapy (due to tumor lysis syndrome)

111
Q

Nonspecific tests used in autoimmune disorders, inflammation, infections

A

CRP, Rheumatoid factor, erythrocyte sedimentation rate (ESR), antinuclear antibodies (ANA), antihistamine antibodies

112
Q

Drug-induced lupus erythematosus (DILE)

A

Can be caused by many drugs. More likely with anti-TNF agents, hydralazine, isoniazid, methimazole, methyldopa, minocycline, procainamide, propylthiouracil, quinidine, terbinafine.
Causative agent must be D/Cd

113
Q

CD4T immunocompromised state

A

<200 cells/mm^3

114
Q

Arterial blood gas

A

Must be drawn from an artery
pH, pCO2, pO2, HCO3, O2 sat

115
Q

Human Chorionic Gonadotropin (hCG)

A

Positive result indicates pregnancy

116
Q

Luteinizing Hormone (LH)

A

Rises mid/cycle, causes egg release from the ovaries (ovulation)

117
Q

Lactic acidosis indicates

A

Anaerobic metabolism, which occurs in long-distance running and in certain medical conditions (sepsis)

118
Q

Lactic acid is increased by

A

NRTIs, metformin, alcohol, cyanide

119
Q

Prolactin increased by

A

Haloperidol, risperidone, paliperidone, methyldopa

120
Q

Prolactin decreased by

A

Bromocriptine

121
Q

Rapid plasma reagin (RPR) or Venereal diseases research laboratory (VDLR)

A

Used to screen for syphilis

122
Q

Thiopurine methyltransferase (TPMT)

A

Those with genetic deficiency of TPMT are at increased risk for myelosuppression and may require lower doses of azathioprine and mercaptopurine

123
Q

Decreased vitamin increases risk of

A

Osteoporosis, osteomalacia (rickets), CVD, diabetes, hypertension, infectious diseases, and other diseases

124
Q

Carbamazepine normal therapeutic range

A

4-12 mcg/mL

125
Q

Digoxin normal therapeutic range

A

0.8-2 ng/mL (AF)
0.5-0.9 ng/mL (HF)

126
Q

Gentamicin (traditional dosing) normal therapeutic range

A

Peak: 5-10 mcg/mL
Trough: <2 mcg/mL

127
Q

Lithium normal therapeutic range

A

0.6-1.2 mEq/L

128
Q

Phenytoin/Fosphenytoin normal therapeutic range

A

10-20 mcg/mL.
If albumin is low calculate corrected calcium

129
Q

Free phenytoin normal therapeutic range

A

1-2.5mcg/mL

130
Q

Procainamide normal therapeutic range

A

4-10 mcg/mL

131
Q

NAPA normal therapeutic range

A

15-25 mcg/ml

132
Q

Procainamide + NAPA combined normal therapeutic range

A

10-30 mcg/ml

133
Q

Theophylline normal therapeutic range

A

5-15mcg/mL

134
Q

Tobramycin normal therapeutic range

A

Peak: 5-10 mcg/ml
Trough <2 mcg/ml

135
Q

Valproic acid normal therapeutic range

A

50-100 mcg/ml (up to 150 in some patients)

136
Q

Vancomycin normal therapeutic range

A

Trough: 15-20 mcg/mL for most serious infections (pneumonia, endocarditis, osteomyelitis, meningitis, bacteremia)
Trough: 10-15 mcg/ml for others

137
Q

Warfarin normal therapeutic range

A

Goal INR 2-3 for most conditions, use higher range (2.5-3.5) for high-risk conditions, such as mechanical mitral valves

1. NAPLEX Prep (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions