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Unit 2 68 > Common Labs > Flashcards

Common Labs Flashcards

1
Q

digests starch and glucose

A

Amylase (AML)

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2
Q

salivary glands, lung tumors, ovarian cyst/tumors, pancreas produces

A

Amylase (AML)

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3
Q

Causes of elevated amylase levels

A

Pancreatitis (only 10% of the time! - usually WNL)
Chronic Renal Failure
Possible Perforated Peptic Ulcer
Macroamylasemia (rare, benign; serum vs urine)

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4
Q

Causes of low amylase levels

A 
usually insignificant, but 
Chronic pancreatitis
Pancreatic cancer
Liver disease
Toxemia pregnancy
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5
Q

Diagnostic findings of acute pancreatitis

A 
serum amylase (rises within 2 hours, peaks at 12 - 48 hours, normal 3 - 4 days)
serum lipase (*high levels up to 14 days!!*)
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6
Q

Why would a provider order an amylase lab? (uses)

A

Acute pancreatitis dx
Differential dx of Abdominal pain
Abdominal trauma/surgery = pancreatic injury
Perforation of peptic ulcer (r/o pancreatic damage which could cause chemical pancreatitis)

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7
Q

Produced by the liver and responsible for oncotic (pull) pressure

A

Albumin - the blood’s main protein

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8
Q

Cause of elevated albumin

A

dehydration!

most common

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9
Q

Hypoalbuminemia: causes of low albumin

A

*Malnutrition
*Liver disorder
Chronic diseases - hyperthyroidism, lupus, diabetes
Burns
Nephrotic Syndrome/Chronic Renal Failure
Hodgkin’s disease
Post Operative
Sepsis

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10
Q

Why would a provider order a albumin level?

A

Evaluate edema
Liver disease - jaundice
Suspcted malnutrition

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11
Q

______ is composed of 50% albumin

A

Total Protein

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12
Q

An elevation of total protein suggests:

A

Multiple Myeloma (will need to do immunologic typing)

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13
Q

Low total protein is caused from

A

Pregnancy
Cytotoxic Drugs
Dietary Deficiency

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14
Q

A provider orders a total protein for:

A

suspected hepatic disease (jaundice)
suspected protein deficiency
NP may also consider protein electrophoresis

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15
Q

Two enzymes located in hepatocytes and injury to the liver causes a release. Measurement of these enzymes reflects severity of hepatic injury

A

Aminotransferases:
Alanine (ALT)
Aspartate (AST)

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16
Q

Aminotransferase: ALT vs AST

A

ALT - L specific for the Liver
AST - increases after Cardiac or Skeletal muscle injury

An elevation of ALT and AST - hepatic problem, Alcholic, liver injury

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17
Q

An elevation of AST is caused by

A

Skeletal or Cardiac injury

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18
Q

A decrease in ALT and AST indicates

A

advanced cirrhosis or hepatitis

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19
Q

When should the NP request ALT and AST?

A

diagnosing/monitoring liver disease

screening tool for medications that cause liver damage

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20
Q

found in nearly all body tissues, produced by the liver and bones, and children’s levels is 2x - 4x that of adult due to growth

A

Alkaline Phosphatase (ALP)

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21
Q

An elevation of ALP (alkaline phosphatase) occurs when

A

Bile ducts are obstructed (conjugated or direct bilirubin increases too)
New bone formation
Paget’s disease (thickening & hypertrophy of long bones/deformity of flat bones - elderly)

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22
Q

Why would a NP select a ALP (alkaline phosphatase) lab?

A

To detect biliary obstructing hepatic lesions
Assessing Vitamin D tx to Rickets
Detect osteoblastic skeletal disease (Paget’s)

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23
Q

Acid phosphatase is a test to detect _______ and an elevation likely means _____

A

Prostate Cancer

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24
Q

Prostate-Specific Antigen (PSA) is produced by

A

normal, hyperplastic, and cancerous prostate tissue

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25
Q

An elevated prostate-specific antigen (PSA) may indicate

A 
benign prostatic hyperplasia
prostate cancer
doubles after prostate massage - need to wait 2 weeks
prostate biopsy (50 fold increase)
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26
Q

A prostate specific antigen lab value is used to:

A

detect prostate diseases (benign or cancer)
stage patient with cancer
confirm response to cancer

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27
Q

This lab value is responsible for increasing triiodothyronine and thyoxine secretion

A

Thyroid-stimulating hormone - T3 and T4 scretion

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28
Q

An increase of thyroid stimulating hormone may indicate

A

Hypothyroidism - primary (TSH is working hard, why? failure of thyroid)
Thyroiditis
Inadequate hormone therapy (levothyroxine or Synthroid)

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29
Q

A decrease of thyroid stimulating hormone

A

Hyperthryoidism
Excess Levothyroxine intake
Pituitary failure - secondary (low or normal TSH)
Hypothalamic failure - tertiary (low or normal TSH)

30
Q

A patient that is considered euthyroid is a result of?

A

Thyroid stimulating hormone becomes normal

31
Q

A patient’s lab values present with elevated radioactive-iodine, T3 uptake, and total T4. The thyroid stimulating hormone level is low. What clinical syndrome may this patient have?

A

Thyrotoxicosis - this refers to an excess of circulating thyroid hormones. The thyroid gland senses you have enough = low TSH.

32
Q

A patient’s lab values presents with low radioactive iodine, T3 uptake, total and free T4. The thyroid stimulating hormone is elevated. What clinical syndrome is this?

A

Myxedema - a cause of untreated/poorly managed hypothyroidsim

33
Q

the product of protein metabolism

A

Blood Urea Nitrogen

34
Q

An elevation of blood urea nitrogen (BUN) is called? (medical term)

A

Azotemia

35
Q

Causes of elevated blood urea nitrogen (BUN) or azotemia (DR HUBCAP)

A

Decreased water intake (Dehydration)
Renal Insufficiency

Hyperthyroidism
decreased Urine flow (CHF)
Blood in GI tract
burns - increased protein Catabolism
inhibition of Anabolism by corticosteroid drugs
increased dietary intake of Protein
36
Q

Causes of decreased blood urea nitrogen (BUN)

NOLL

A

Nephrosis (possible)
Over-hydration
Liver failure or hepatitis
Late Pregnancy

37
Q

Why would a NP order a blood urea nitrogen level?

A

Assess renal function

Assess hydration

38
Q

The more muscle mass correlates with what serum laboratory product and is a better measurement of renal impairment (“specific” test for renal impairment)

A

serum Creatinine - specific for renal impairment

elevation = FALLING glomerular fitration rate

39
Q

Specificity versus Sensitivity of serum creatinine

A

Specificity - good, detects poor renal function by increasing

Sensitivity - not good, elderly (poor muscle mass) may have kidney damage without elevation. Overall, slow rise per day with moderately severe kidney damage

40
Q

An increase in serum creatinine can indicate:

A

Renal impairment
Athlete - nonpathological elevation due to increased muscle mass

(decreases are NOT significant)

41
Q

What laboratory value regulates and promotes neuromuscular activity, skeletal development, and blood coagulation?

A

Serum Calcium

child 10.6
adult 8.9 - 10.1

42
Q

What laboratory value is controlled by the parathyroid hormone (PTH), calcitonin, adrenal steroids, and is absorbed best with vitamin D

A

Serum Calcium

child 10.6
adult 8.9 - 10.1

43
Q

What are causes of elevated serum calcium?

D-MORPHIA

A

Diuretics (Hydrochlorothiazide slows/prevents Ca loss in urine)

Metastatic cancer
Overuse/excess ingestion of antacids
Renal disease (poor excretion)
Parathyroid tumor & Paget's disease
Hyperparathyroidism
Immobility, prolonged
Adrenal insufficiency
44
Q

A decrease in serum calcium is caused by

A

Cushing’s syndrome
Hypothyroidism
Malabsorption

45
Q

Why would a NP order a serum calcium

BAD AT

A

Blood clotting problems
Acid-base imbalance
Disorders - neuromuscular, skeletal, and endocrine

Arrhythmias
Tetany - muscle cramping

46
Q

Negative ion present in blood and stomach controlled by renal excretion; regulated by aldosterone secondarily to regulation of sodium

A

Chloride 95-105

47
Q

What is the primary cause of abnormal chloride levels?

A

the body responding to a shift in CO2 (carbon dioxide, increase = chloride decrease, CO2 decrease = chloride increase)

48
Q

Causes of increased chloride levels

MD CANE

A

Metabolic Acidosis - body blowing off CO2
Dehydration from diarrhea

Cardiac disease
Anemia
Nephritis
Eclampsia

49
Q

Hypochloremia is caused by

A 
Diabetes
GI loss - vomiting or gastric suction
Thiazide Diuretic
Fever
Pneumonia
CHF - dilutional hypochloremia
50
Q

An intracellular cation that maintains electrical conduction within the cardiac and skeletal muscles.

A

Potassium 3.5 - 5.3

51
Q

Hyperkalemia causes include

A 
DKA
Burns or crushing injuries
Renal disorders
Abnormal intake
Medications
Myocardial infarction (MI)
or your specimen hemolyzed
52
Q

What will the EKG show in a patient with hyperkalemia?

A

prolonged PR interval
wide QRS complex
ST-segment depression
tall, tented T-waves

53
Q

What are causes of hypokalemia?

REM

A

Renal disorders
Excess licorice ingestion (aldosterone-like effect)
Medications

54
Q

What will the EKG show in a patient with hypokalemia?

A

ST-segment depression
flattened T wave
U wave elevation

severe - ventricular fibrillation, respiratory paralysis, and cardiac arrest

55
Q

Why would a NP want to know serum potassium levels?

CARD

A

Complaints of weakness, muscle cramps, or parathesias
Arrhythmias - can detect orgin
Renal function
Diuretics (thiazide or loop)

56
Q

Maintains osmotic (pull) pressure of extracellular fluid, promotes neuromuscular function, and maintains acid-base balance

A

Sodium

57
Q

Hypernatremia causes are

A

Aldosteronism
Inadequate water intake or Insensible loss (fever, sweat)
Excess intake

(dehydration, kidney dysfunction, diuretics, diarrhea)

58
Q

Hyponatremia causes

A

Heart failure
Cirrhosis
Nephrotic Syndrome
(all three have elevated body water, but low circulating volume = ADH stimulation and water retention = sodium dilution

Diarrhea, Vomiting
Diuretics

59
Q

Why would a NP monitor sodium levels

A

Disease monitoring: heart failure, liver disease, chronic renal failure
Edematous patient
Fluid and Electrolyte evaluation
Acid-base balance evaluation
Neuromuscular function evaluation
Lithium medication - can cause diabetes insipidus

60
Q

What lab value is affected by red blood cells degradation and attaches to blood albumin

A

Bilirubin

61
Q

How is bilirubin excreted? When bilirubin is above ___ jaundice is visible

A

bile - stool will have a PALE color when bile duct is obstructed
> 3

62
Q

An increase in unconjugated or indirect bilirubin indicates

A

hepatic damage
hemolytic disease of newborn
sickle cell crisis

63
Q

An increase in direct or conjugated bilirubin results from

A

obstruction

possible hepatic damage

64
Q

Why would the NP order bilirubin levels?

A

Liver function evaluation
Biliary obstruction assessment
Hemolytic anemia assessment and diagnosis
Jaundice monitoring
Aids in differential diagnosis of jaundice
Phototherapy or transfusion needs - > 18 = exchange, possible brain damage

65
Q

First line defense against bacteria & inflammation

50% - 70% total WBC

A

Neutrophils

66
Q

Increase in chronic or viral infection or in leukemia

25-35% of total WBC

A

Lymphocytes

67
Q

Secondline of defense
Stronger & longer lived than neutrophils
Respond to viral infections & chronic bacterial infections and inflammation
2 - 6% total WBC

A

Monocytes

68
Q

Elevated in Allergies, parasite infections, and drug reactions
0-3% of WBC

A

Eosinophils

69
Q

Similar to neutrophils. Play a role in preventing blood clotting, are elevated in allergic reactions and in hypothyroidism
1-3% of total WBC

A

Basophil

70
Q

Immature or early stage neutrophils. These are elevated when the body is first launching a response to a bacterial or viral infection and are a sign of acute infection
0-5% of total WBC

A

Immature granulocytes (Bands)

71
Q

Acute infection with an increase in bands.

Up in some leukemia & pernicious anemia

A

shift to left

72
Q

An increase in mature neutrophils. Seen in diseases of liver

A

shift to right

Unit 2 68 (32 decks)

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