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Health Assessment Exam 2 > Diagnostic Tests for Primary Care > Flashcards

Diagnostic Tests for Primary Care Flashcards

1
Q

Name the three plasma proteins

A

1) Albumin
2) Globulin
3) Fibrinogen

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2
Q

When we remove the fibrinogen from plasma we get what product?

A

Serum (albumin 2/3 + globulin 1/3)

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3
Q

What is the suffix that means …“of the clotting family”?

A

-ogen

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4
Q

What conditions increase the risk of clotting?

A

Obesity, venous stasis, hip and pelvic surgery, immobility, age, and excessively high estrogen levels

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5
Q

What are some of the causes of excess estrogen?

A

Age and smoking

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6
Q

Where are clotting factors produced? When?

A

Liver, at night

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7
Q

A venous clot is referred to as a what?

An arterial clot is referred to as a what?

A

Red clot

White clot

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8
Q

Clotting factors are highest at what time of day?

A

Early AM

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9
Q

Inflammation mediators are highest at what time of day?

A

AM

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10
Q

What is the action of ASA?

A

Inhibits platelet aggregation

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11
Q

What is the action of coumadin and heparin?

A

Inhibit clotting factors

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12
Q

What test determines nutritional status or the prognosis in liver disease?

A

Direct albumin

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13
Q

What are the functions of albumin?

A

1) It holds water in the vascular space

2) Binds drugs

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14
Q

What causes hypoalbuminemia?

A

1) Liver disease because of decreased synthesis of albumin (liver may be diseased or old)
2) Leaky kidneys

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15
Q

What is SAAG?

A

Serum ascities/albumin gradient

Albumin in the serum/albumin in the ascites

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16
Q

What SAAG ratio indicates portal HTN?

A

Greater than 1.1 (97% predictive)

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17
Q

What causes ascites other than portal HTN?

A

Nephrotic syndrome, infection (TB, fungal, CMV), pancreatic ascites, ovarian CA, peritoneal carcinomatosis

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18
Q

What protein is usually found in the urine?

A

Albumin (macroalbuminuria) 1+-4+

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19
Q

What levels of proteinuria go with the following diseases?
Nephritis?
Nephrosis?

A

1-2 +

3-4 +

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20
Q

What class of drugs are “prills”?

A

Ace inhibitors

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21
Q

Afferent means?

Efferent?

A

Toward the organ of interest

Away from the organ of interest (exit)

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22
Q

If there is microalbuminuria, what two diseases are suspect?

A

DM and HTN

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23
Q

What holds the afferent arteriole to the kidney open?

A

Prostaglandin (vasodilation)

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24
Q

What closes the efferent arteriole to the kidney?

A

Angiotensin II (vasoconstricts)

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25
Q

Hyperglycemia and HTN cause an increase in?

A

Prostaglandins and Angiotensin II

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26
Q

What increases by 1% each year after age 30?

A

Fibrinogen

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27
Q

What decreases by 1% each year after age 40?

A

Liver function

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28
Q

What drug gets knocked off protein binding sites easily and often?

A

Coumadin

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29
Q

When you add a new drug, when should you check the INR if the patient takes coumadin?

A

Within 72 hours

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30
Q

What does the alpha 1 globulin help to produce?

A

High density lipoprotein (HDL)

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31
Q

What are three functions of HDLs?

A

1) Clear excess cholesterol from the blood
2) Prevent LDL from oxidizing
3) Act as a potent anti-inflammatory

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32
Q

What is a good HDL level?

A

> 40 mg/dL

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33
Q

What helps to boost HDLs?

A

garlic, beans, omega-3, plant stanols, decreased trans fats and saturated fats, exercise, estrogen and ethanol

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34
Q

What drug boosts HDL the most?

A

Niaspan (up to 25%)

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35
Q

What drugs lower LDL cholestrol?

A

Statins

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36
Q

Which statin lowers LDL but also boosts HDL by 12%?

A

Crestor (rosuvastatin)

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37
Q

Beta globulins contribute to the making of?

A

Low density lipoprotein (LDL)

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38
Q

The higher the LDL, the greater the risk for?

A

Atherosclerosis

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39
Q

Which is better: small, dense LDL or large, loose LDL?

A

Large, loose LDL particles cannot deposit in the vessel walls as readily

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40
Q

What is the suggested level of LDL?

A

< 100 is acceptable

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41
Q

What are some risk factors for increased LDL?

A

Diet (high in sat fat or trans fat), smoking, high iron levels, lack of activity, abdominal fat

42
Q

When should you take your statin drug?

A

At night or before sleep

43
Q

What are triglycerides elevated by?

A

Sugars (high fructose corn syrup, alcohol, sugar)

44
Q

What is the ideal level of triglycerides?

A

< 150 mg/dL

45
Q

What is the recommended dose of fish oil?

A

1000 mg/day

46
Q

What two diseases should you expect to find with high triglycerides and a low HDL?

A

DMII or hypothyroidism

47
Q

What is a normal WBC count?

A

5000-10,000

48
Q

What ethnic groups have low WBCs?

A

AA and Native Americans

49
Q

Neutrophils make up what percentage of the total white count?

A

57-63%

50
Q

Neutrophils are the first line of defense in what type of invasion?

A

Bacterial

51
Q

Bands are what?

A

Immature neutrophils

52
Q

Lymphocytes make up what percentage of the WBC?

A

30%

53
Q

Lymphocytes are the first line of defense in what type of invasion?

A

Viral

54
Q

Monocytes turn into what type of cell in the tissue?

A

Macrophages

55
Q

What type of WBC will you see with parasites and allergies?

A

Eosinophils

56
Q

What is elevated in an allergic reaction and turn into mast cells in the tissue?

A

basophils

57
Q

All of the -phil cells, meaning “affinity for” are called?

A

Granulocytes

58
Q

Neutrophils are also called what?

A

Segs

59
Q

Where are neutrophils produced?

A

In the bone marrow

60
Q

How long do neutrophils live in the bloodstream?

A

5-6 hours

61
Q

Where do neutrophils migrate from the bloodstream?

A

Into the tissue

62
Q

When there are an increased number of bands, it is called a what?

A

Shift to the left

63
Q

What are some conditions where you see this shift?

A

GABHS, pyelonephritis, Acute appendicitis, bacterial meningitis

64
Q

What are some drugs that cause neutropenia?

A

Chemo, tagamet, zantac, tegretal, flagyl, gentamicin, imipenem, imuran

65
Q

what does prednisone do to your white count?

A

Increases it

66
Q

What is the mechanism for this?

A

Prednisone inhibits migration and degranulation. It releases neutrophils from the walls of vessels so numbers are greater

67
Q

What increases the migration of segs?

A

Fever

68
Q

CRP is a non-specific indicator for what?

A

Inflammation

69
Q

HS-CRP indicates a high risk of what?

A

Vascular inflammation and cardiac arrest

70
Q

What can reduce HS-CRP?

A

Exercise, loss of abdominal fat, statins, Actos, ASA, Omega-3, nuts, Mediterranean diet

71
Q

What measures the settling of RBCs in anticoagulated blood?

A

Sed Rate

72
Q

What are some of the names for monocytes in tissue?

A

Macrophage, Kuppfer, microglial, osteoclast, mesangial cells

73
Q

What is the response time for macrophages?

A

2-4 days

74
Q

What type of inflammation do monocytes work on?

A

Chronic

75
Q

What do you call it when macrophages surround a pathogen?

A

Granuloma

76
Q

Granulomatous diseases are chronic inflammatory diseases that often end in the suffix?

A

-osis

77
Q

Vitamin D is really not a vitamin but a what?

A

Hormone

78
Q

TNF alpha (a cytokine) can be helpful in what disease?

A

TB

79
Q

TNF alpha (a cytokine) can be harmful in what disease?

A

RA, Crohn’s, ankylosing spondylitis

80
Q

What are some of the TNF alpha inhibitors?

A

Remicade, Humira, Cimzia, Simponi

81
Q

The macrophage not only engulfs the pathogen but also does what?

A

Processes and presents it to the T4 cells

82
Q

What are some drugs that inhibit the immune system?

A

Methotrexate, plaquenil, prednisone, TNF alpha, cyclosporin A

83
Q

What cytokine increases the temperature set point?

A

IL -1

84
Q

IL-1 also causes serotonin release from the brain and duodenum causing what two symptoms?

A

nausea and vomiting

85
Q

Cells of the immune system are?

A

B cells (16%), T cells (70%) and NK cells (14%)

86
Q

T lymphocytes are the first responders to what?

A

Viral infections

87
Q

How many herpes viruses are there?

A

8

88
Q

B lymphocytes turn into what kind of cells?

A

Plasma cells

89
Q

How many days does it take to produce antibodies with an initial response? Memory response?

A

7-21, minutes to hours

90
Q

What do you call cancer of the plasma cell?

A

Multiple myeloma

91
Q

What are the five gamma globulins?

A

IgM, IgG, IgA, IgD, IgE

92
Q

What gammaglobulin is the first antibody formed to infection?

A

IgM

93
Q

What gammaglobulin is the second antibody formed to infection and lasts forever?

A

IgG

94
Q

What is the antibody of allergies?

A

IgE

95
Q

Erythropoietin is produced in the?

A

Kidneys

96
Q

Hypothyroidism causes anemia by?

A

A low metabolic rate

97
Q

Where do we get most of our iron?

A

Recycled old RBCs

98
Q

How much iron do we need in our diet?

A

1 mg daily

99
Q

How do we get iron deficient?

A

Bleeding

100
Q

Where is iron primarily absorbed?

A

Duodenum

101
Q

What are some reasons for poor iron absorption?

A

celiac disease, gastric bypass, lack of gastric acid

Health Assessment Exam 2 (13 decks)

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