Diagnostics

Question 1

Why would RBC count be low?

Answer 1

anemia (blood loss, problem with bone marrow)

Question 2

Why would RBC count be high?

Answer 2

• dehydration
• adaptation to high altitude
• adaptation to respiratory problems (COPD, smoker)

Question 3

When might WBCs be high?

Answer 3

• infection
• inflammation (response to tissue trauma)
• anxiety/stress
• leukemia

Question 4

When might WBCs be low?

Answer 4

• bone marrow problem

- immunodeficiency

Question 5

What are the different types of leukocytes and what might an elevation in each indicate?

Answer 5

• neutrophils - bacterial infection
• lymphocytes - viral infection
• monocytes - severe infetion, chronic infection
• eosinophils - parasite, allergy
• basophils - allergy, parasite

Question 6

What is a “shift to the left?”

Answer 6

• appearance of immature cells, particularly neutrophils, called band cells
• seen when production of cells is accelerated (they don’t have time to mature)
• indicative of severe infection

Question 7

What might a high hematocrit indicate?

Answer 7

• dehydration or fluid volume deficit

- anemia

Question 8

What might a high low hematocrit indicate?

Answer 8

• fluid volume excess

- polycythemia

Question 9

What might a high level of sodium indicate?

Answer 9

• dehydration
• excessive water loss (burns)
• excessive nutritional intake

Question 10

What might a low level of sodium indicate?

Answer 10

• fluid volume overload
• nutritional deficit
• side effect of a diuretic
• problem with kidneys

Question 11

What can happen in someone with hypernatremia?

Answer 11

• coma
• convulsions
• thirst
• agitation
• restlessness

Question 12

What might cause a high level of potassium?

Answer 12

• kidney disease

- potassium-sparing diuretics

Question 13

What might cause a low level of potassium?

Answer 13

• nutritional deficit
• non-potassium sparing diuretics
• alcoholism

Question 14

Why is hyperkalemia dangerous?

Answer 14

it can cause arrhythmias

Question 15

What is BUN?

Answer 15

• blood urea nitrogen

- urea is a byproduct of protein breakdown, it is normally filtered out by the kidneys

Question 16

What does BUN evaluate?

Answer 16

kidney function

Question 17

What might a high BUN indicate?

Answer 17

kidney problem

Question 18

What is creatinine?

Answer 18

waste product made by muscles, usually filtered out by kidneys

Question 19

What might a high level of creatinine mean?

Answer 19

kidney problem

Question 20

What is the GFR? What does it measure?

Answer 20

• glomerular filtration rate
• a measure of how much blood is being passed through the glomeruli each minute
• evaluates kidney function

Question 21

What does a low GFR indicate?

Answer 21

• kidney damage

- dehydration (less blood to kidney d/t low blood pressure)

Question 22

What is PT/INR and what does it measure?

Answer 22

• prothrombin time/international normalized ratio

- measures how long it takes blood to clot via the extrinsic and common pathway

Question 23

What is PTT and what does it measure?

Answer 23

• partial thromboplastin time

- measures how long it takes blood to clot via the intrinsic pathway

Question 24

When would you want INR to be elevated?

Answer 24

therapeutic level for warfarin/coumadin

Question 25

When would you want PTT to be elevated?

Answer 25

heparin therapy

Question 26

What is FOBT? What does it measure?

Answer 26

• fecal occult blood test

- detects unseen blood in stool

Question 27

When might a FOBT be positive?

Answer 27

• bleeding ulcer
• colon cancer
• inflammatory bowel disease
• hemorrhoids

Question 28

When might you use an X-ray (other than for orthopedics?)

Answer 28

• chest x-ray to visualize pneumonia

Question 29

What is an ultrasound?

Answer 29

• high frequency sound waves used to generate a live 2D image

Question 30

What is a CT?

Answer 30

• computerized tomography
• data from several x-rays
• generates 2D image “slices” of a 3D object

Question 31

What is a MRI?

Answer 31

• magnetic resonance imaging
• uses magnetic images to create image
• no radiation

Question 32

What is an angiogram?

Answer 32

• contrast medium and x-ray is used to look at vasculature

Question 33

What is an ECG?

Answer 33

• electrocardiogram

- measures electrical activity of the heart

Question 34

What is an echocardiogram?

Answer 34

• ultrasound of the heart

- used to visualize heart structure and function

Question 35

What is routine urinalysis?

Answer 35

• visual inspection and chemical testing (dipstick) of urine

Question 36

What is microscopic urinalysis?

Answer 36

• analysis of urine under microscopic

Question 37

What would urinalysis (routine and microscopic) tell you about?

Answer 37

• infection (UTI)
• kidney problems
• metabolic problems (diabetes)

Question 38

What is ALT? Why would you measure it and why would an elevation be significant?

Answer 38

• alanine aminotransferase
• liver enzyme
• released by liver when liver is damaged

Question 39

What is AST? Why would you measure it and why would an elevation be significant?

Answer 39

• aspartate aminotransferase
• liver enzyme
• released into blood when liver is damaged

Question 40

What is bilirubin? What is it’s significance? Why would you measure it?

Answer 40

• waste product of RBC breakdown, made by liver and excreted in bile
• increase indicates decrease in excretion (liver problem) or an increase in RBC breakdown

Question 41

What is albumin? What is it’s significance? Why would you measure it?

Answer 41

• plasma protein made by liver
• many drugs bind to it and are then inactivated (if albumin decreased, amount of available drug will increase)
• decrease can be from liver problem
• increase in albumin seen with dehydration