Diagnostic and Lab Tests

Question 1

Computed tomography (CT)

Answer 1

CT – uses series of x-ray beams analyzed by a computer to map brain structures by showing differences in tissue density. Can use contrast agent. One dimensional view. CT relatively safe. Some people have adverse reactions to contrast such as metallic taste in mouth, nausea, others may experience allergic reactions.
CT are not useful in screening for mental disorders. CT might be useful in ruling out brain lesions causing symptoms similar to a mental disorders
Educate clients – short test, (aprx 5 min. Lay still)

Question 2

Magnetic resonance imaging (MRI)

Answer 2

MRI – 3 dimensional view using a magnetic field. Interrupting the magnetic field in pulses yields information on tissue density worked up into a 3D picture of the brain. (cannot be used for all persons – ex metal plates, aneurysm clips, bone replacements)
Can help rule out a brain lesion as cause for symptoms but not able to diagnosis mental disorder
Used mainly for research to search for changes in brain structure in cases of mental disorders
No good evidence found yet linking brain structure and mental disorders
Educate clients – longer procedure 30+ minutes, loud, need to lay still during test

Question 3

Electroencephalography (EEG)

Answer 3

EEG- detects electrical activity in your brain using small, metal discs (electrodes) attached to your scalp.
Useful in dx seizure disorders.
Educate clients – electrodes are attached to scalp, will be exposed to bright lights (like strobe lights) can be uncomfortable.

Question 4

Electrocardiogram (ECG or EKG)

Answer 4

EKG records the electrical signals in your heart. It’s a common test used to detect heart problems and monitor the heart’s status in many situation.
Many medications will cause alterations in cardiac function which are monitored through EKG, Clozapine, Lithium
Educate clients – need to expose chest and lay still for a minute

Question 5

Drug screen (tox screen)

Answer 5

Drug screen will give + or negative results. Will not tell levels of substances using.
Ex Amphetamine may be positive but doesn’t mean the person is using meth amphetamine, could be using a prescription amphetamine such as Ritalin

Question 6

Uniralysis (UA)

Answer 6

UA- urinary tract infections, kidney disease and diabetes. involves checking the appearance, concentration and content of urine byproducts of normal and abnormal metabolism, cells, cellular fragments, and bacteria. … Some examples include glucose, protein, bilirubin, red blood cells, white blood cells, crystals, and bacteria

Question 7

Urine for culture and sensitivity (C+S)

Answer 7

C+S- urine culture is used to diagnose a urinary tract infection (UTI) and to identify the bacteria or yeast causing the infection. It may be done in conjunction with susceptibility testing to determine which antibiotics will inhibit the growth of the microbe causing the infection

Question 8

Hematology
CBC, CBC and diff

Answer 8

Complete Blood Cell Count (CBC or CBC and diff)
White Blood Cell (WBC)
Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils
Red Blood Cell (RBC)

CBC- Measure of WBC and RBC
CBC and diff – measures breakdown of types of WBC
anemia, infection and leukemia
Also monitor for Clozapine

Anemia can produce symptoms of depression

Question 9

Hematocrit

Answer 9

Hematocrit is a measure of how much space red blood cells take up in your blood. A high hematocrit level might mean you’re dehydrated. A low hematocrit level might mean you have anemia. Abnormal hematocrit levels also may be a sign of a blood or bone marrow disorder.

Question 10

Platelets

Answer 10

Platelets are blood cell fragments that help your blood clot. They stick together to seal cuts or breaks on blood vessel walls and stop bleeding.
Abnormal platelet levels may be a sign of a bleeding disorder (not enough clotting) or a thrombotic disorder (too much clotting)

Question 11

Prothrombin time (PT)

Answer 11

PT – how quickly blood clots. 11-12.5 sec is normal. Prothrombin is a protein produced by your liver. It is one of many factors in your blood that help it to clot appropriately. high levels liver disease and vit K deficiency (MONITER FOR CLIENTS ON HEPARIN)

Question 12

International normalized ratio (INR)

Answer 12

INR- monitor when a client is on warfarin, also high levels liver disease and vit K deficiency
When the INR is higher than the recommended range, it means that your blood clots more slowly than desired, and a lower INR means your blood clots more quickly than desired.
We want blood to clot more slowly in some circumstances ex: if DVT
D-Dimer – used to test to see if there is a DVT, unstable angina, myocardial infection (high levels)

Question 13

Hemoglobin glycosylated (HgbA1C)

Answer 13

HbgA1C- high levels hyperglycemia, uncontrolled diabetes, Low chronic blood loss, renal failure, sickle cell anemia.

Question 14

Ferritin

Answer 14

iron - anemia

Question 15

Alanine transaminase (ALT)

Answer 15

ALT is an enzyme found in the liver that helps your body metabolize protein. When the liver is damaged, ALT is released into the bloodstream and levels increase.

Question 16

Aspartate transaminase (AST)

Answer 16

AST is an enzyme that helps metabolize alanine, an amino acid. Like ALT, AST is normally present in blood at low levels. An increase in AST levels may indicate liver damage or disease or muscle damage.

Question 17

Alkaline phosphatase (ALP)

Answer 17

ALP is an enzyme in the liver, bile ducts and bone. Higher-than-normal levels of ALP may indicate liver damage or disease, such as a blocked bile duct, or certain bone diseases.

Question 18

Albumin and total protein

Answer 18

Albumin is one of several proteins made in the liver. Your body needs these proteins to fight infections and to perform other functions. Lower-than-normal levels of albumin and total protein might indicate liver damage or disease. (high levels can indicate dehydration). Low can indicate liver disease, also associated with burns.

Question 19

Bilirubin

Answer 19

Bilirubin is a substance produced during the normal breakdown of red blood cells. Bilirubin passes through the liver and is excreted in stool. Elevated levels of bilirubin (jaundice) might indicate liver damage or disease or certain types of anemia. High levels associated with prolonged fasting

Question 20

Gamma-glutamyltransferase (GGT)

Answer 20

GGT is an enzyme in the blood. Higher-than-normal levels may indicate liver or bile duct damage.

Question 21

L-lactate dehydrogenase (LD)

Answer 21

LD is an enzyme found in the liver. Elevated levels may indicate liver damage but can be elevated in many other disorders.

Question 22

Glucose (Fasting or Random)

Answer 22

fasting 8-12 hours prior to test

Question 23

Creatinine

Answer 23

may be signs of a kidney disease or disorder.

Question 24

Blood urea nitrogen (BUN)

Answer 24

may be signs of a kidney disease or disorder.

Question 25

Creatine kinase (CK/CPK)

Answer 25

also a muscle protein

Question 26

Myoglobin

Answer 26

is a protein that’s typically found in cardiac and skeletal muscle tissues. The only time - found in the bloodstream is when injury to a muscle has occurred
- CK and Myoglobin are used to diagnosis and rule of NMS

Question 27

Troponin

Answer 27

cardiac muscle damage, renal failure/damage
Troponin is a muscle protein that helps your muscles contract. When muscle or heart cells are injured, troponin leaks out, and its levels in your blood rise.
blood levels of troponin rise when you have a heart attack- often order troponin tests when patients have chest pain or other heart attack signs

Question 28

Cholesterol

Answer 28

typically asked to fast as well
High density – good
Low density - bad

Question 29

Lipid Profile

Answer 29

requests fast 8-12 hours before test
monitored for metabolic screening with antipsychotics

Question 30

Triglycerides

Answer 30

fat found in blood

Question 31

Electrolytes (lytes)

Answer 31

First 4 are top ordered. Usually what is meant if order reads lytes
Electrolytes are minerals that help maintain fluid levels and acid-base balance in the body. They include sodium, potassium, bicarbonate, and chloride.
Abnormal electrolyte levels may be a sign of dehydration, kidney disease, liver disease, heart failure, high blood pressure, or other disorders.

Sodium (Na+)
Potassium (K+)
Chloride (Cl−)
Bicarbonate (HCO3−) or CO2

Question 32

Mg Magnesium

Answer 32

is a vital mineral that participates in more than 300 biochemical reactions in your body including NT and hormonal activities - low magnesium levels contribute and worsen many psychiatric problems, including depression.

Question 33

Calcium

Answer 33

Calcium is a mineral - Low levels of calcium can produce symptoms of depression
Abnormal calcium levels in the blood may be a sign of kidney problems, bone disease, thyroid disease, cancer, malnutrition, or another disorder.
Also low levels of Zinc can be related to depression but this isn’t commonly tested for.

Question 34

Estrogen/Estradiol

Answer 34

There is a strong link between estradiol, mood and wellbeing. In fact, depression is correlated with sudden drops or fluctuations in estradiol, and long periods of sustained low levels of estrogen

Question 35

Vitamin B12

Answer 35

Vitamin B12 – high levels associated with types of leukemia, low levels associated with malabsorption. B12 deficiency can cause almost any psychiatric symptom-from anxiety, and panic to depression and hallucinations. This is because B12 deficiencies trigger symptoms in the nervous system and red blood cells.

Question 36

Vitamin D

Answer 36

Vitamin D – low levels of Vitamin D and calcium can produce symptoms of depression

Question 37

Thyroid stimulating hormone (TSH)
Thyroid hormones (T3 & T4)

Answer 37

TSH- Higher levels suggest hypothyroidism, or an underactive thyroid, while lower levels indicate hyperthyroidism, or an overactive thyroid. When TSH and thyroid hormones are out of balance, this can cause a range of issues relating to the muscles, breathing, body temperature,
thyroid gland to produce thyroxine (T4), and then triiodothyronine (T3)
TSH levels fluctuate if the production of T4 and T3 slows or accelerates: If T3 and T4 levels are high, less TSH is produced, and if T3 and T4 levels are low, more TSH is produced. Elevated TSH levels are often indicative of an underactive thyroid, a condition known as hypothyroidism. Conversely, low TSH levels may indicate too much T4 output in the blood which occurs when the thyroid gland is hyperactive, as with hyperthyroidism.