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Pharm 1 > Diagnostic Testing > Flashcards

Diagnostic Testing Flashcards

1
Q

Purpose of Diagnostic Tests

A
  1. Diagnose conditions
  2. Monitor for complications
  3. Track response to treatment
  4. Ultimate goal is to guide treatment decisions
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2
Q

Screening

A

-Diagnostic tests are sometimes done in order to screen for a condition
-Screening means the pt may have no manifestations of the disease but may have risk factors
-Sometimes diagnostic test is done because pt is showing signs and symptoms

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3
Q

For an abnormal result to occur…

A

-A physiological change has ALREADY TAKEN PLACE in the body

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4
Q

Screening for health conditions based on..

A

Who Wilson criteria for screening

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5
Q

Who Wilson criteria for Screening

A

-There should be a recognizable latent or early asymptomatic stage
-There should be an accepted treatment recognized for the disease
-*Treatment should be more effective if started early
-The condition should be an important health problem
-The natural history of the condition should be understood
-There should be a policy on who should be treated
-Diagnosis and treatment should be cost effective
-There should be a test that is easy to preform and interpret, is accurate, reliable, sensitive and specific

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6
Q

Blood testing

A

-Most common diagnostic tests are performed on blood
-Can collect different types of blood samples depending on what we are wanting to examine/measure

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7
Q

Blood makeup

A

-45% of blood is made up of cells (formed elements)
-RBCs, WBCs, Platelets

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8
Q

RBCs

A

-Erythrocytes
-Contain hemoglobin
-Responsible for transporting oxygen around the body

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9
Q

WBCs

A

-Leukocytes
-Responsible for fighting infections/play vital role in inflammatory response

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10
Q

Platelets

A

-Thrombocytes
-Play a vital role in early clotting

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11
Q

Liquid part of blood

A

-55%
-Called plasma
-Proteins (albumin, clotting factor, immunoglobulins
-Substances suspended in water (electrolytes, glucose, hormones, bilirubin)

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12
Q

Whole Blood Tests

A

-Used when we want to look at the formed elements in the blood
-There will be an anticoagulant in the tube to prevent the blood cells from clumping
- Called Complete blood count or CBC

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13
Q

Where are whole blood tests sent to

A

-Samples sent to HEMATOLOGY lab

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14
Q

Plasma/Serum Tests

A

-Used when blood is drawn to test electrolytes, hormones, and other substances suspended in plasma
-Tube will contain separator gel which separates plasma from the formed elements after centrifuging

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15
Q

Where are plasma/serum tests sent

A

-samples sent to BIOCHEMISTRY lab

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16
Q

Serum

A

-The blood clots prior to centrifuging so clotting factors are not in the serum
-Clotting factors removed

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17
Q

Plasma

A

-An anticoagulant in the tube prevents clotting so clotting does not occur
-thus plasma contains clotting factor

18
Q

Manitoba and plasma/serum

A

-Most labs in Manitoba test on plasma for majority of biochemistry testing
-however interchangeable
-Eg. Serum albumin and plasma albumin measure the same thing

19
Q

Nurses Draw Blood from

A

CVADs (central lines)

20
Q

DSM will reject specimens for analysis due to

A

-Labelling errors
-Unacceptable specimen quality

21
Q

Labelling Errors

A

-identifiers on the specimen label and order do not match
-Pts first and last name and PHIN are not on the test requisition and specimen label
-Name of ordering professional is not on the test requisition
-Location of patient is not on the test requisition

22
Q

Unacceptable specimen quality examples

A

-inappropriate transport
-inappropriate storage
-inappropriate container or specimen tubes
-inappropriate preservative
-hemolysis
-lipemia
-insufficient quantity for analysis

23
Q

Analyzing results steps

A
  1. Ensure the result is accurate
  2. Determine if the result is significant (hardest part)
24
Q

Tests can be inaccurate due to…

A

Interfering factors
-should confirm accuracy of a result BEFORE taking any action related to the result

25
Q

Most Common Reasons for an Inaccurate Result

A

-Diluted or quantity insufficient samples
-Improper timing
-Hemolysis

26
Q

What is Hemolysis ?

A

-The breaking of red blood cells during sample collection or handling and results in release of Intracellular contents into the plasma
-Eg shaking, dropping specimen

27
Q

Hemolysis can alter results in

A

-Potassium (falsely high), most common test affected by hemolysis, when RBC are broken, potassium is released into plasma = have to draw new sample before concluding whether pt is hyperkalemic or not
-PTT (falsely high)
-Troponin T (falsely low)

28
Q

Determining Significance Steps

A

-Look for cues in normal ranges
-Know the relevant treatment goals and lab result trends for that patient (determine if it’s okay for them to be out of range)
-Asking key questions (what is the pt’s baseline and recent trends? Does this result represent a potential serious time sensitive issue)

29
Q

Sodium normal range

A

135-145

30
Q

Sodium critical value

A

Less than 120 or over 160

31
Q

Potassium normal range

A

3.5-5.0mmol/L

32
Q

Potassium Critical Value

A

Less than 2.5, over 6.5

33
Q

Creatine Kinase Normal Range

A

52-175
-no critical value

34
Q

Why is potassium so critical

A

-important electrolyte in cardiac conduction and arrhythmia can happen whether it is high or low
-do not ignore a low potassium level just because pt is on med known to cause low potassium like some diuretics

35
Q

Creatine Kinase

A

-type of muscle enzyme
-in males normal range is more than 100units and elevations over 500units are considered mild
-only considered severe if Over 5000
-like this, some elevations are not causing serious health risks but are simply used to direct treatment

36
Q

Therapeutic/Target test Ranges

A

-In some cases the patient is receiving treatment in order to create an abnormal lab result
-Eg. Anticoagulants increasing INR (less likely to clot)

37
Q

INR Test

A

-International normalized ratio
-test used to measure clotting
-normal range 0.9-1.1
-we want patients INR to be 2-3x the normal range if taking anticoagulants
-abnormal but considered therapeutic

38
Q

PT, INR, PTT levels

A

-measure clotting such as prothrombin time, international normalized ratio or partial thromboplastin time
-will be elevated when the patient is begging anticoagulated with certain meds
-higher the value, slow coagulation time

39
Q

HGBA1c

A

Normal range: 4-6%
Target range: 7%
-tested in diabetics = average blood glucose

40
Q

Hgb Normal Range

A

-140-180g/L in males
-120-160g/L in females

41
Q

An acute drop in hemoglobin can be a sign of..

A

-a patient experiencing acute blood loss
-will assess patient for associated risk factors and signs and symptoms of bleeding before notifying the MD

42
Q

Hgb can be affected by

A

-how hydrated a patient is
-therefore Iv treatment can explain subtle variations

Pharm 1 (4 decks)

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