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Block 4 - Psych > Clin Lab - Psych > Flashcards

Clin Lab - Psych Flashcards

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1
Q

What is measured for alcohol use disorder?

A

serum alcohol level

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2
Q

What is the legal blood alcohol concentration (BAC)?

A

<80 mg/dL (17 mmol/L)

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3
Q

Does BAC correlate with symptoms? and why?

A

Not necessarily

  • Rate of metabolism of EtOH depends on other substances imbibed/consumed at similar time
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4
Q

What additional diagnostics seen w/ chronic alcohol use? and what is seen on each?

A
  • CBC – macrocytic anemia (MCV=119), thrombocytopenia, pancytopenia
  • CMP – elevated LFTs, hypoNa+, hypoK+, hypoglycemia
  • Imaging – occult injuries
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5
Q

Does a (+) drug screen mean the patient is currently using?

A

NO

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6
Q

What specimens can be used for a drug screen?

A

urine > blood

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7
Q

Is the screening test Qualitative or Quantitative?

A

Qualitative

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8
Q

NOTE

A
  • concentration is above a specific cut-off value
  • usually immunoassay
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9
Q

Describe confirmatory test for drug screens.

A
  • needed to measure exact concentration
  • Usually chromatography tests – more specific
  • Usually done at reference labs
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10
Q

NOTE

A

A panel does not measure all possible drugs

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11
Q

What may interfere opioid panel results?

A

fentanyl

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12
Q

Benzo panel detects metabolites of…

A

diazepam but not clonazepam or lorazepam

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13
Q

What other drugs or substances may interfere & cause false (+)s?

A
  • Naproxen & marijuana
  • Buproprion & amphetamines
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14
Q

NOTE

A
  • Concentration of urine will affect detection (dilute urine causes dilution of the drugs)
  • A (+) test doesn’t indicate dose or when it was taken
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15
Q

How long is a drug screen (+) for amphetamines/methamphetamine.

A
  • (+) test for 1-3 days after intake
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16
Q

What can cause an amphetamine/methamphetamine drug screen to have a false (+)?

A
  • OTC decongestants
  • Levodopa
  • Atenolol
  • Bupropion
  • Trazodone
  • Tricyclic antidepressants
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17
Q

Are false (-) commons when testing for amphetamines/methamphetamine?

A

YES

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18
Q

Describe drug screen testing for cocaine.

A
  • Detects metabolite as cocaine is quickly metabolized
  • (+) test for 1-3 days after intake
  • No significant false (+)s
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19
Q

How long will a drug screen be (+) for opioids.

A

(+) test for 1-7 days, depending on specific opioid

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20
Q

What can cause false (+) on an opioid drug screen?

A
  • poppy seeds
  • fluoroquinolones
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21
Q

Which synthetic opioids may not be detected on drug screen?

A
  • fentanyl
  • methadone
  • buprenorphine
  • tramadol
22
Q

Describe drug screen testing for marijuana.

A
  • Metabolite measured
  • (+) test for days to months
  • Synthetic cannabinoids – high rate of SEs, not detected on drug screen
23
Q

What can cause false (+) on a marijuana drug screen?

A
  • hemp products
  • dronabinol
  • rarely naproxen, ibuprofen
24
Q

What are some other possible components on a drug screen?

A
  • PCP
  • Ketamine
  • Benzos
  • LSD
25
Q

What are the S/Sx of PCP ingestion?

A
  • nystagmus
  • agitation
  • hallucinations
26
Q

What will cause a false (+) on drug screen testing for PCP.

A
  • tramadol
  • dextromethorphan
  • diphenhydramine
27
Q

Describe drug screen testing for PCP.

A
  • (+) test for days to weeks
  • No significant false (+)s
  • Not all benzos detected
28
Q

Describe drug screen testing for LSD.

A

No significant false (+)s

29
Q

Anorexia/bulimia often cause metabolic / electrolyte imbalances like…

A
  • HypoK+
  • HypoMg++
  • HypoNa+ & hypoCl-
  • Metabolic alkalosis
  • Elevated BUN / creatinine
30
Q

Depression Rule Out: What Thyroid dz testing is done?

A

TSH
hypothyroid seen most (TSH

31
Q

Depression Rule Out: What Adrenal dz testing is done?

A
  • test based on symptoms
    –> hypercortisolism (24hr urine, midnight cortisol, low dose dexamethasone)
    –> hypocortisolism (AM cortisol)
32
Q

Depression Rule Out: What Alcohol/drug abuse testing is done?

A
  • UDS
  • alcohol level
33
Q

Depression Rule Out: What neurodegenerative dz testing is done?

A
  • Parkinson Dz
  • Alzheimer’s Dz
  • Multiple sclerosis
34
Q

Depression Rule Out: What will be elevated if B12 is low?

A

Methylmalonic acid & Homocysteine

35
Q

Depression Rule Out: What testing is done for Vit D?

A

25 - hydroxyvitamin D

36
Q

When should you do blood monitoring checks for Valproic acid?

A

at 2wks then every 3 months

37
Q

When is Valproic acid used?

A

in Alz pts. who have been having behavioral issues

38
Q

What two antiepileptic meds need blood monitoring?

A
  • Lamotrigine
  • Carbamazepine
39
Q

When should you do blood monitoring checks for other antiepileptics (lamotrigine/carbamazepine)?

A
  • at 2 wks then every 3mos
40
Q

When should you do blood monitoring checks for Lithium?

A
  • weekly x4, then monthly x3, then every 3 months
41
Q

What is so dangerous about lithium?

A

has a very narrow therapeutic window

42
Q

What other meds need monitoring for SEs?

A
  • Antipsychotics
  • Clozapine
  • Lithium
  • Valproic Acid
  • Carbamazepine
  • SSRIs/SNRIs
  • Ritalin
43
Q

What tests are used to monitor SEs of Antipsychotics?

A
  • lipid panel & fasting glucose
  • initially and at 3 months, then yearly
44
Q

What tests are used to monitor SEs of Clozapine?

A
  • weight gain
  • lipid panel
  • fasting glucose
  • CBC

(wkly for 6mos, every 2wks for 6mos, then monthly)

45
Q

What does clozapine treat & what can taking this medication cause?

A
  • schizophrenia
  • profound neutropenia
46
Q

What tests are used to monitor SEs of Lithium?

A
  • thyroid function
  • CMP
  • CBC
  • EKG
  • UA (baseline & yearly)
47
Q

What can lithium cause?

A

Nephrogenic Diabetes Insipidus

48
Q

What tests are used to monitor SEs of Valproic acid?

A
  • CBC
  • CMP
  • PT/PTT
  • EKG
  • UA (baseline & yearly)
49
Q

What tests are used to monitor SEs of Carbamazepine?

A
  • CBC
  • CMP
  • EKG
  • UA
  • Thyroid (baseline & yearly)
50
Q

What tests are used to monitor SEs of SSRIs/SNRIs?

A

sodium & glucose

51
Q

What tests are used to monitor SEs of Ritalin?

A

CBC

Block 4 - Psych (4 decks)

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