Diagnostics and Laboratory Testing Flashcards

1
Q

Diagnostic efficacy

A

does the test correctly identify abnormalities?

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2
Q

Diagnostic effectiveness

A

does the test change your diagnosis?

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3
Q

therapeutic efficacy

A

does the test change your management?

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4
Q

therapeutic effectiveness

A

does the test change the patient’s outcome?

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5
Q

sensitivity

A

true positive rate
how accurate is it to give the result I’m suspecting
want 90% sensitivity

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6
Q

specificity

A

true negative rate
tells you the patient doesn’t have it/they have a negative result
want 90% specificity

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7
Q

an asymptomatic patient with abnormal results

A

does not equal significant disease

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8
Q

likelihood ratio

A

describes the proportion of accurate and inaccurate positive test results
LR = sensitivity / (1-specificity) or TP rate/ FP rate

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9
Q

likelihood ratios greater than 10 provide ___

A

considerable confidence

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10
Q

tests part of the CBC

A

RBC, red blood cell indices (MCV, MCH, MCHC, RBC distribution width), WBC, platelet count

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11
Q

RBC normal values (males and females)

A

males: 4.7 -6.1 x 10^6 / uL
females: 4.2 - 5.4 x 10^6/uL

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12
Q

Hemoglobin normal values (males and females) and critical values

A

males: 14 - 18 g/dL
females: 12 - 16 g/dL
critical values: <5 or >20

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13
Q

Hematocrit normal values (males and females) and critical values

A

males: 42 - 52%
females: 37 - 47%
critical values: <15% or > 60%

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14
Q

MCV normal value

A

80 - 90 fL

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15
Q

MCH normal value

A

27 - 31 pg

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16
Q

MCHC normale value

A

32 - 36 g/dL (32% - 36%)

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17
Q

RBC distribution width normal value

A

11 - 14.5%

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18
Q

WBC normal value and critical values

A

5 - 10 x 10^9/ L

critical: <2.5 or >30

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19
Q

Neutrophils normal value

A

55-70%

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20
Q

Lymphocytes normal value

A

20-40%

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21
Q

Monocytes normal value

A

2-8%

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22
Q

Eosinophils normal value

A

1-4%

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23
Q

Basophils normal value

24
Q

Platelet count normal values and critical values

A

150 -400 x 10^9/L

critical: <40 or >1000

25
thrombocytopenia numeric value
<100 x 10^9/L
26
thrombocytosis numeric value
>400 x 10^9/L
27
thrombocythemia numberic value
>1000 x 10^9 /L
28
if less than _____ , hesitate to put in epidural/spinal in due to risk of _____
100,000 | hematoma that could compress the cord
29
when are coagulation studies indicated?
patients taking anticoagulants, liver disease, coagulation disorder, and malnutrition
30
are coagulation studies predictive of perioperative bleeding?
no
31
which clotting factor is not made in the liver?
Von Willebrand Factor
32
what tests are considered coagulation tests?
activated clotting time, bleeding time, platelet count, PT, aPTT, INR, Ecarin clotting time
33
PT normal value
12 - 14 seconds
34
aPTT normal value
25 -32 seconds
35
Which test evaluates EXTRINSIC factor function?
PT and INR
36
Which test evaluates INTRINSIC factor function?
aPTT
37
INR normal value
0.8 - 1.1
38
Which coagulation study is the most accurate?
INR
39
ACT normal value
80 -150 seconds
40
Bleeding time normal value
3 - 7 minutes
41
Which patients/disease processes should you consider getting serum chemistry?
hepatic or renal disease, malnutrition, malabsorption, ETOH abuse, gastric bypass, anasarca
42
What tests are included in the serum chemistry?
sodium, potassium, carbon dioxide, calcium, chloride, glucose
43
Na+ normal values
135 - 145 mEq/L
44
K+ normal values
3.5 - 5.0 mEq/L
45
CO2 normal values
23 - 29 mEq/L
46
Ca++ normal values
8.5 - 10.5 mg/dL
47
Cl- normal values
96 - 106 mmol/L
48
Glucose normal values
fasting: 70 - 99 mg/dL | postprandial at 2 hours: <140 mg/dL
49
What other patients/disease processes might you consider checking renal function tests on?
diabetics, hypertension, family history, elderly, taking diuretics, when radiographic dye will be used
50
What tests are included in renal function tests?
BUN, creatinine, eGFR
51
BUN normal values
5 - 25 mg/dL
52
creatinine normal values
0.6 - 1.2 mg/dL
53
which test is the most accurate reflection of renal function?
creatinine clearance | it is a reflection of GFR
54
pregnancy testing may be valuable in ____
pediatric patients having menses, poor historians, irregular periods, undergoing infertility treatment
55
what is the most frequently ordered preoperative test?
ekg
56
MET desirable score
>4 (ability to climb two flights of stairs) | key to determining need for preop cardiac testing