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Advanced Clinical Skills > diagnostic lab interpretation > Flashcards

diagnostic lab interpretation Flashcards

1
Q

what are CBCs used for

A

evaluation of infection, anemia, bruising, petechiae, malignancy, over all immune status and many bothers

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2
Q

what tube is CBC collected in

A

Whole blood-lavender (EDTA) tube-invert tube 8-10 times after collection

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3
Q

when do we see an elevated WBC count

A

infection
steroid use
inflammation
smoking (mild)
allergies (mild)
pregnancy (mild)
Leukemia (very high)

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4
Q

when would a WBC count be decreased

A

Malignancy
immunocompromised
autoimmune disease
sepsis
mono

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5
Q

what is included in WBC differential

A

Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils
Bands

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6
Q

when are neutrophils increased

A

infections (bacterial/fungal)
trauma
stress
rheumatoid arthritis
myelocytic leukemia
gout

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7
Q

what is a ‘left shift’

A

bands - usually occur with acute and or severe infection
immature neutrophils “bands”

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8
Q

what is neutropenia and when is it seen

A

Low neutrophils
chemo/radiation
severe sepsis
aplastic anemia

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9
Q

what is the ANC

A

absolute neutrophil count (used to determine severity)
<15000 is neurtropenia
<500 is severe neutropenia

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10
Q

when are lymphocytes increased

A

chornic bacterial infetion
hepatitis
mono
lymphocytic leukemia
MM
Viral infection

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11
Q

when are lymphocytes decreased

A

HIV
Leukemia
Sepsis
Steroid
Chemo/radiation

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12
Q

when are monocytes increased

A

Leukemia
Viral infection (EBV)
chronic inflam dz
parasitic infection
tuberculosis

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13
Q

when are eosinophins increased

A

allergies (m/c)
addisons disease
parasitic infection

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14
Q

when are eosinophils decreased

A

alchohol intoxication
excessive cortisol production (cushings)

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15
Q

when are basophils increased

A

allergies
myeloproliferative dz
collagen vascular disease
varicella
s/p splenectomy

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16
Q

when are basophils decreased

A

acute infection
trauma
neoplasm

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17
Q

What is included with red cell components

A

red blood cell count (RBC)
Hemoglobin (Hb)
Hematocrit (Hct)
(reticulocyte count)
MCV
MCH
MCHC
RDW

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18
Q

who has higher RBC values

A

men

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19
Q

when would RBC be increased

A

conditioned athlete
higher altitudes
combat hypoxia from chronic disease
blood doping

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20
Q

when would a RBC be decreased

A

iron deficiency
blood loss
hemolysis
bone marrow suppression

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21
Q

what is hemoglobin

A

oxygen carrying portion of RBCs

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22
Q

what is hematocrit

A

percentage of RBCs in whole blood

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23
Q

when would H&H be low

A

hemorrhage, excess fluids, anemia

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24
Q

when would H&H be elevated

A

dehydration, polycythemia

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25
Q

what are reiculocytes

A

increased in response to decreased H&H / RBC
created in bone marrow
occur after hemorrhage, RBC loss
induced by erythropoietin

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26
Q

when would MCV be increased

A

flate or B12 deficiency
megaloblastic anemia
liver disease
hypothyroidism

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27
Q

when would MCV be decreased

A

iron deficiency
lead poisoning
thalassemia

28
Q

what is the MCV

A

size of the RBC
determines type of anemia

29
Q

What is the RDW

A

red cell distribution width
-estimate of uniformity of cell cells
-normal RDW in presence of anemia sugggests thalassemia

30
Q

when does RDW increase

A

foalte, B12 deficiency

31
Q

when would RDW be low

A

iron deficiency

32
Q

What is MCH

A

mean corpuscular hemoglobin
avg weight of hemoglobin

33
Q

what is MCH elevation a sign of

A

liver dx
hyperthyroid
cancer
alcohol
excessive estrogen medications
infectious complications

34
Q

what is a decreased MCH typically associated with

A

anemias

35
Q

What is MCHC

A

Mean corpuscular hemoglobin concentration
concentration of hemoglobin per erythrocyte

36
Q

when would platelets be elevated

A

splenecotmy
chronic leukemias
iron deficiency anemia
malignancy

37
Q

when are platelet levels decreased

A

Drug indcued (heparin)
ETOH abuse
aplastic anemia
leukemia

38
Q

what is a BMP

A

basic metabolic panel
used to rule in/out many metabolic concerns
looks at electrolytes and renal function

39
Q

What is normal BUN
what is the BUN

A

8-18 mg/dL
level of renal function as well as liver function
-elevated in acute and chronic renal failure

40
Q

what is the normal creatinine and what does it measure

A

0.6 - 1.2 mg/dL (1)*
indicator of Kidney function - increases with poor renal function both acutely and crhonically

41
Q

when will creatinine levels increase

A

GI bleeding
High protein diets
strenuous exercise
dehydration
REnal failure
urinary stasis
shock
surgery
diabetic neuropathy

42
Q

when will creatinine decrease

A

pregnancy
starvation
wasting disease
corticosteroids
low protein intake
dialysis

43
Q

What is the normal GFR

A

> 90 mL / min/1.73m2

44
Q

what is the normal BUN:creatinine ratio

what are abnormal ratios

A

10:1

20:1 suggests pre-renal azotemia
ATN ratio usually 10-15:1

45
Q

what does the BUN:creatinin ratio help determine

A

cause of renal failure
cannot be used to difinitively distinguish between the two

46
Q

What is the normal sodium level

A

135-145 mEq/L
important in function of nerves and muscles

47
Q

What is normal Potassium levels

A

3.5 - 5.0 mmol/L

48
Q

what are low potassium levels due to

A

losses, starvation, urine loss and medications
if significantly low, needs emergent IV replacement

49
Q

when are high potassiums usually seen

A

usually d/t medications
if significantly high - need chelation

50
Q

What is the normla Chloride level

A

97 - 107 mEq/L
essential in oxygen exchange

51
Q

what occurs when chloride levels change

A

alter repsitatory function
also indicator of hydration status

52
Q

What are normal CO2 levels

A

23- 29 mEq/L
essential indicator of oxygen exhange in the body
useful in determining blood pH

53
Q

What is normal albumin levels

A

3.5 g / dL
main protein in blood
allows for oncotoci pressures

54
Q

when would albumin be high and low

A

high: dehydration
Low: liver disease, malabsoprtion, malnutrition, nephrotic syndrome, pregnnacy

55
Q

when is total bilirubin elevated

A

common bile duct obstruction
hemolysis

56
Q

what is another name for LFTs

A

transaminases
AST and ALT

57
Q

when are LFTs elevated

A

cirrhosis
hepatitis
liver cancer

58
Q

what portion of the LFTs are more speific to the liver

A

ALT

AST found in numeous parts of the body

59
Q

when would ALK be elevated

A

biliary obstruction
cirrhosis
hepatitis
destructive bone disease
recent MI
(kids)

60
Q

when would ALk be lower

A

anemia
hypothyroidism

61
Q

what evaluates coagulation factors in extrinsic and common fathways

A

PT/INR

62
Q

what are common reasons for LD/LDH elevation

A

exercise
infection
heart attack/failure
liver disease
anemia

63
Q

what does the anion gap determine

A

the magnitude of electrolyte imbalance
paricularly useful in poisioning

64
Q

are lipid labs fasting or non-fasting

A

fasting
must be at least 8 hours prior but 12 hours better

65
Q

What is Hs-CRP

A

used to adjunct to lipids to evaluate CV risk status

66
Q

what is BNP used for

A

to detect, support and evaluate HF
levels decrease if pt are taking ACEi, BB, and/or diuretics

Advanced Clinical Skills (2 decks)

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