Decision making using Lab results

Question 1

_ is used to to screen for prostate cancer in men

Answer 1

Prostate Specific Antigen

Question 2

urine test used to detect presence of WBCs in urine

Answer 2

Leukocyte Esterase (associated with infections eg UTIs)

Question 3

tests to confirm DM

Answer 3

1) Fasting Plasma Glucose (>7mmol/l =126mg/dl)
2) HbA1C
3) Random Plasma Glucose
4) Oral Glucose Tolerance Test

Question 4

dysglycemia

Answer 4

abnormality in blood glucose levels

Question 5

reference range of HbA1C

Answer 5

good glycemic control = <5.6%
pre diabetic = 5.6 - 6.5 %
diabetes = >6.5%

Question 6

normal range of fasting plasma glucose

Answer 6

btwn 3.2 - 5.5 mmol/l

Question 7

Tools for decision making

Answer 7

1) reference interval
2) critical/alert value
3) diagnostic algorithm
4) diagnostic cut off value
5) Diagnostic criteria
6) Therapeutic Window Limit
7) Clinical Practice guideline

Question 8

normal range for K+

Answer 8

3.3 - 5.2 mmol/l

Question 9

analytes of interest for a patient with diarrhea & vomiting

Answer 9

Na+, K+, Cl- , HCO3-

Question 10

normal range for Random PG

Answer 10

<140mg/dl (7.8mmol/l)

140-199 - prediabetes
>200 - diabetes

Question 11

diagnoses of DM

Answer 11

fasting blood sugar > 7.0mmol/l on two separate occasions.

Question 12

where is gamma glutamyl transferase located

Answer 12

the cell membrane

Question 13

normal range for HbA1C

Answer 13

6.5 - 7.0 %

Question 14

what is the liquid combination used for oral glucose tolerance test

Answer 14

• mix 75g of glucose into 250/300ml of water
  (drink over 5 minutes)

Question 15

using OGTT, when in absolute DM declared

Answer 15

when px has a plasma glucose > 11.10mmol/l after 2hrs

Question 16

metabolic syndrome

Answer 16

clinical events that occur together, measure by either major/minor combination or both

Question 17

metabolic syndrome

Answer 17

clinical events that occur together, measure by either major/minor combination or both

Question 18

MAJOR criteria in metabolic syndrome

Answer 18

1) high blood pressure
2) glucose intolerance
3) low HDL cholesterol
4) high triglycerdemia
5) waist to hip ratio > 0.9

Question 19

MINOR criteria for metabolic syndrome

Answer 19

1) Polycystic ovarian syndrome
2) insulinemia
3) increased small dense LDL cholesterol
4) increased urinary sodium
5) increased fibrinogen
6) increased fibrinogen inhibition factor 1

Question 20

diagnostic criteria for metabolic syndrome

Answer 20

1) 3 major
2) 2 major + 1 minor
3) 1 major + 2 minor

Question 21

Friedewald Equation & its use

Answer 21

LDL-c = TC - (HDL-c) - TG/5 (mg/dl) // or TG/2.2 (mmol/l)

used to estimate LDL-c levels in the blood

Question 22

equation for VLDL-c

Answer 22

VLDL-c = TG/5

…LDL-c = TC - (HDL-c) - (VLDL-c)

Question 23

What are the Adult European Cholesterol Education guidelines for LDL-c levels

Answer 23

1) px with DM, LDL-c < 2.5mmol/l
2) HTN px < 3.0mmol/l
3) obesed px < 3.5mmol/l

*note Adult Treatment Plan

Question 24

ACEP guidelines for glucose level

Answer 24

fasting sample < 7.0mmol/l
random sample < 7.8mmol/l

Question 25

what are the critical values of serum potassium ?

Answer 25

lower end - 2.8mmol/l

upper end - 6.2mmol/l

Question 26

two components of dose-response relationship of drugs

Answer 26

1) dose-plasma concentration relationship
2) plasma concentration-response relationship

Question 27

what is therapeutic index?

Answer 27

LD50/ED50

LD50 = median lethal dose
ED50 = median effective dose