Class 5 - Labs and Imaging

Question 1

What is the types of diagnosis that can be a significant finding in a Complete Blood Count (CBC) with Differential?

Answer 1

High WBC - Leukocytosis (infection)
Low Hgb - Anemia
Low Hct - Anemia
Low Platelets - Thrombocytopenia (prone to bleeding)

Differential metrics on test can indicate an infection.

Question 2

For the Basic Metabolic Panel (BMP), what are the significant findings that can be found?

Answer 2

High Sodium (Hypernatremia) or Low Sodium (Hyponatremia) - dehydration

High Potassium - Hyperkalemia (Poor kidney function)

High Blood Urea Nitrogen (BUN) and/or Creatinine (Creat) - Renal insufficiency or renal failure

High Bicarbonate (HC03) - posiible respiratory disease
Low Bicarbonate - Hyperventilation

High Chloride (Cl) - dehydration

Question 3

For the Comprehensive Metabolic Panel (CMP), what are the significant findings that can be found?

Answer 3

In conjunction with the BMP….

Total Protein (T Prot) Low - Hemorrhage, liver disease, kidney disease

Low Albumin (Alb) - Liver or kidney problem

Liver Function Tests (LFTs) consist of tests to determine liver damage

Question 4

For the Cardia Order Set, what will be ordered for every patient complaining of chest pain?

Answer 4

Troponin (Trop)
EKG
CXR
CBC
BMP

Question 5

What is the significance of a D-Dimer?

Answer 5

Since it is a protein that is excreted by clots of blood, it is ordered the physician is considering Pulmonary Embolism as a DDx.

If the D-Dimer is negative, a PE can be excluded from the DDx.

If the D-Dimer is positive it does not necessarily mean there is a PE. It means we must order a CTA Chest or VQ scan to rule out PE.

Question 6

What type of respiratory lab is used to help dx CHF?

Answer 6

B-type Natriuretic Peptide (BNP)

Question 7

What do the labs measuring Arterial Blood Gas (ABG) and Venous Blood Gas (VBG) help diagnose?

Answer 7

ABG

Low pH - Acidosis
Low pO2 - Hypoxia
High/Low HCO3 - Metabolic Problem
High/Low pCO2 - Respiratory Problem

VBG

Low pH - Acidosis
High pH - Alkalosis

Question 8

For Ultrasounds & Sonograms, what are the potential findings these tests can find?

Answer 8

Ultrasound Doppler Lower extremities - DVT

Abdominal Ultrasound of RUQ - Cholelithiasis, Cholecystitis, Bile sludge, gallbladder wall thickening, bile duct obstruction

Ultrasound Obstetrics/Transvaginal - Intrauterine Pregnancy (IUP), ectopic pregnancy, ovarian cyst, ovarian torsion

US Scotum - Testicular torsion, testicular mass.

Question 9

Lots of CT Scans….

What potential findings can be found using “CT w/o IV Contrast”?

Answer 9

CT Head - Large Hemorrhagic or Ischemic CVA

CT C-Spine/T-Spine/L-Spine - Cervical, Thoracic, Lumbar spine fracture or subluxation (partial dislocation)

CT Chest - PNA, PTX, Pleural effusion, rib fracture.

CT Abd/Pel - Kidney Stones, Pyelonephritis