Chapter 4: Learning Lab Values & Drug Monitoring

Question 1

What can cause agranulocytosis

Answer 1

Clozapine, PTU, methimazole, procainamide, carbamazepine, Bactrim, and isoniazid

Question 2

What causes increased calcium levels

Answer 2

Calcium supplementation, Vitamin D, thiazide diuretics

Question 3

What causes decreased calcium levels

Answer 3

long-term heparin, loop diuretics, bisphosphonates, cinacalcet

Question 4

What causes decreased magnesium levels

Answer 4

PPIs, diuretics

Question 5

What causes increased phosphate levels

Answer 5

Renal failure

Question 6

What causes increased K levels

Answer 6

ACEi, ARBs, ARAs, aliskiren, canagliflozin, cyclosporine, tacrolimus, K supplements, SMX/TMP, drosperinone-containing contraceptives

Question 7

What causes decreased K levels

Answer 7

steroids, B-2 agonsts, diuretics, insulin

Question 8

What causes decreased Na levels

Answer 8

carbamazepine, oxcarbazepine, SSRIs, diuretics

Question 9

What causes decreased bicarbonate levels

Answer 9

Topiramate

Question 10

What causes increased BUN levels

Answer 10

Renal impairment and dehydration

Question 11

What causes increased SCr

Answer 11

Aminoglycosides, amphotericin B, cisplatin, colistimethane, cyclosporine, loop diuretics, polymyxin, NSAIDs, radiocontrast dye, tacrolimus, vancomycin

Question 12

Increased anion gap suggests:

Answer 12

metabolic acidosis

Question 13

What causes increased mean corpuscular volume (MCV)

Answer 13

B12 or folate deficiency

Question 14

What causes decreased mean corpuscular volume (MCV)

Answer 14

iron deficiency

Question 15

Folic acid is decreased due to

Answer 15

Phenytoin/phosphenytoin, phenobarbital, primidone, methotrexate, SMX/TMP

Question 16

Vitamin B12 is decreased due to

Answer 16

PPIs, metformin

Question 17

When is reticulocyte count decreased

Answer 17

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

Question 18

Coombs test is positive in

Answer 18

drug-induced hemolysis caused by PCNs and cephalosporins, dapsone, isoniazid, levodopa, methyldopa, methylene blue, nitrofurantoin, pegloticase, primaquine, quinidine, quinine, rasburicase, rifampin, and sulfonamides

Question 19

The RBC destruction with G6PD deficiency is triggered by:

Answer 19

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

Question 20

Anti-Xa peak should be obtained ___ hours after SC LMWH dose

Answer 20

4 hours

Question 21

What is Anti-Xa used to monitor

Answer 21

LMWH and UFH

Question 22

PT/INR is used to monitor

Answer 22

warfarin

Question 23

INR increases (without warfarin) due to

Answer 23

liver disease

Question 24

False increase in INR occurs from

Answer 24

daptomycin, oritavancin, telavancin

Question 25

aPTT or PTT is used to monitor

Answer 25

UFH and direct thrombin inhibitors

Question 26

False increase in aPTT occurs from

Answer 26

oritavancin and televancin

Question 27

Platelets decrease due to

Answer 27

Heparin, LMWHs, fondaparinux, linezolid, valproic acid

Question 28

Which drugs are impacted by low albumin

Answer 28

Warfarin, calcium and phenytoin

Question 29

Which drugs require correction for low albumin

Answer 29

calcium, phenytoin and valproic acid

Question 30

Amylase and lipase increase in pancreatitis, which can be caused by

Answer 30

didanosine, GLP-1 agonists, DPP-4 inhibitors, valproic acid, hypertriglyceridemia

Question 31

Creatine Kinase (CK or CPK) is increased due to

Answer 31

daptomycin, statins, tenofovir, raltegravir, dolutegravir

Question 32

What are the cardiac enzymes that are used in the diagnosis of MI

Answer 32

Troponin T, Troponin I, BNP and NT-proBNP

Question 33

BNP and NT-proBNP are markers of

Answer 33

Cardiac stress. Higher values indicate higher likelihood of HF

Question 34

Increased TSH (hypothyroidism) is due to

Answer 34

Tyrosine kinase inhibitors, lithium, carbamazepine

Question 35

Lactic acid can be increased due to

Answer 35

NRTIs and metformin

Question 36

Prolactin can increase due to

Answer 36

haloperidol, risperidone, and paliperidone

Question 37

Uric acid can be increased due to

Answer 37

diuretics, niacin, low doses of ASA, pyrazinamide, cyclosporine, tacrolimus, select pancreatic enzyme products, select chemotherapy (TLS)

Question 38

Causes of DILE

Answer 38

anti-TNF agents, hydralazine, isoniazid, methimazole, methyldopa, minocycline, procainamide, PTU, quinidine, terbinafine

Question 39

Which lab parameters are used to assess HIV and monitor treatment

Answer 39

CD4+ lymphocyte count and viral load

Question 40

What is the antibiody test used to screen for syphilis

Answer 40

RPR

Question 41

Those with TPMT deficiency may require lower doses of

Answer 41

azathiopurine and mercaptopurine

Question 42

Therapeutic drug level for vanco

Answer 42

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