Diagnostics (Pre/Post Midterm)

Question 1

Red Blood Cell Count
VIHA: 4.5 - 5.9 X 1012/L

Answer 1

Total # of RBC.

40% of blood volume. Produced in bone marrow. Life span =120 days.

Carries O2 from oxygen to tissues/lungs.

Low (Anemia): blood loss, bone marrow, lukemia, nutrient defin, c. inflamation.

Symptoms: fatigue, pallor, dizziness.

High (Polycythemia): COPD, Altitude, Severe dehydration.

Question 2

White Blood Cell Count
VIHA: 4 - 10.5

Answer 2

Body’s primary defense system.

Produced in bone marrow when there is an infection or inflammatory process. Life span = 13-20 days.

Destroyed in lymphatic system, excreted in feces.

Leukocytosis: Increase in # of WBC (during infection, inflammation, trauma)

Leukopenia: Decrease in # of WBC (increased risk of infection, viral infection, HIV/AIDS, Chemo

Symptoms: fever, exodus (usually related to area of infection)

Question 3

WBC: Neutrophil
*VIHA: 2 - 6

Answer 3

Most abundant. Present in bacterial Infection.

First responder: hallmark of acute infection.

Highly Motile

Question 4

WBC: Eosinophil
0.0 - 0.45

Answer 4

Make up 1 - 6 % of WBC

Combat paracites

Control mechanisms of allergy and asthma.

Question 5

WBC: Basophils
VIHA: 0.0 - 0.10

Answer 5

Least common WBC: Make up 0.01 - 0.03%

Stores histamine

Parasitic Infections & some allergic disorders

Question 6

WBC: Lymphocytes
VIHA: 1 - 4

Answer 6

2nd greatest in number. Include natural killer cells (NK cells), T-cells, B-cells.

Main type of cell found in lymph.

Primary in Viral infections

Question 7

WBC: Monocytes
VIHA: 0.10 - 0.80

Answer 7

Largest of all WBC. 2% - 10% of WBC.

Present in severe infections (Phagocytosis)

Question 8

HgB: Hemoglobin
*VIHA: 136 - 170 g/L

Answer 8

Iron containing protein found in RBCs. Enables bonding of O2.

Often used to check for anemia (not enough O2).

Question 9

Hct: Hematocrit
*VIHA: 0.40 - 0.52

Answer 9

Measure of the porportion of blood that is made up of RCB. Tested in congunction with HgB and RBC

Polycythemia = High Hct (COPD, dehydration, high altitude).

Anemia = Low Hct(blood loss, lukemia, nut. Defin, chronic inflammation, inadequate RBC production).

Question 10

Sodium: Na+
*VIHA: 135 - 145 mmol/L

Answer 10

Part of an electrolyte test.

Used to detect abnormal concentrations of Na+. Values do not vary quickly.

Hyponatremia: Low Na+ (CHF, decreased urinary excretion, no kidney reabsorption, diaretics, diarrhea/vomiting). Symptoms: nurologic & confusion.

Hypernatremia: High Na+ (dehydration, excessive sweathing, increase salt intake).

Question 11

Potassium: K+
*VIHA: 3.5 - 50 mmol/L

Answer 11

An electrolyte vital to metabolism and muscle function.
Regulates fluid, stimulates muscle contraction, maintains stable acid-base balance. K+ plays a role in the firing of the heart muscle.

Hyperkalemia - High K+ (too much via intake, renal failure, potassium sparring diuretics).

Hypokalemia - Low K+ (not enough via intake, GI losses, non-sparring diuretics) Symptoms: Arrythmias.

Question 12

Blood Urea Nitrogen (BUN)
VIHA: 3 - 7.5 mmol/L

Answer 12

Evaluation of kidney function, diagnose kidney disease, acute/chronic kidney function.

Urea is a waste product formed in the liver when protein is metabolized. Ordered when kidney problems are suspected.

BUN: Increase when kidneys cannot filter. S&S of disfunction: fatigue, lack of concentration, poor appetite, swelling/edema, hematuria, decrease in urinary output.

Question 13

Creatinine
*VIHA: 60 - 100 mmol/L

Answer 13

Evaluated together with Urea. Creatinine is a waste product of muscle from the breakdown of creatine. Test is used to assess kidney function.

Levels are elevated in renal failure (kidney).

Question 14

GFR: Glomerular Filtration Rate
*VIHA: > 60 ml/min

Answer 14

Used to screen and detect early kidney damage. Ordered to monitor those with known chronic kidney disease (CKD) or conditions like diabetes and hypertension.

Indicative of renal function. Also of dehydration.

Question 15

PT-INR: Prothrombin Time
*VIHA: 0.9 - 1.1 seconds

Answer 15

Used to detect and diagnose bleeding disorders or excessive blotting disorders.

INR is calculated from a PT result to monitor the effectiveness of an anticoagulant. Measures the seconds it takes for a clot to form.

Warfarin: Expect PT-INR to be 2.0 - 3.5 times longer. If >3.5 = bleeding (gums, nose bleeds, stool, urine). Antidote = Vitamin K.

Question 16

PTT: Partial Thromboplastin Time
*VIHA: 23 - 32 seconds

Answer 16

Used to evaluate coagulation factors.

Heparin = will increase the PTT time. Typically between 34 - 80 seconds.

Question 17

Fecal Occult Blood Test: FBOT
VIHA: Negative

Answer 17

Blood in fecal matter should be negative.

Main use is as a screen for early colon cancer.

Question 18

X-Ray

Answer 18

Diagnostic Imaging which is produced when electrons absorb some of a structures intensity as they pass though an object at the speed of light. Dense areas are white (Bone), and air filled areas are black. Bones, which are made of calcium and have a high atomic number absorbs x-rays efficiently. The lungs and trapped gas also show up clearly. Useful in the detection of skeletal system as some soft tisse. Particularily pneumona, lung cancer, pulmonary edema, bowel obstruction, gallstones, and kidney stones.

Question 19

Ultrasound

Answer 19

An imaging technique that uses high frequency sound waves to acquire real time images. Useful for viewing abdominal contents, pelvis, muscles, pregnancies, vessels, the heart and other soft tissue structures.

Question 20

Routine Urinalysis

Answer 20

A urine test which is performed to measure and test for a wide variety of substances and cells.

Question 21

Microscopic Urinalysis

Answer 21

Can be ordered at the same time as a routine urinalysis, or perhaps as a follow-up if abnormal findings were present in the routine analysis. The microscopic analysis is looking at cells, crystals, bacteria, and counting them as an observed number which are measured as few +, moderate++, or many+++.

Question 22

Procalcitonin

Answer 22

A test to evaluate the risk of an ill person developing a systemic bacterial infection, or sepsis.

Question 23

Troponin (Inc. High Sensitivity)

Answer 23

There are different Troponin tests: I, T, and High Sensitivity

Troponin I and T are proteins found in heart muscle and are released into the blood when there is damage to the heart.

High Sensitivity Troponin tests detects the same protein that the standard test does, just at much lower rates. It may help detect heart injury and actue coronary syndrome earlier than the standard test.

Ordered when a person has a suspected heart attack.

Question 24

ECG

Answer 24

Electrocardiogram. The ECG measures the electrical activity of the heart. It can also provide information on the areas of the heart that are damaged. Useful to help diagnose a myocardial infarction, pulmonary embolism, mumurs, dysrhythmias, and monitoring the effects of a heart medication.

Question 25

Echocardiogram

Answer 25

An echocardiogram is a type of ultrasound test. There are many different types, but the Transthoracic Echocardiogram (TTE) is the standard one completed. It is a non-invasive, highly accurate and quick assessment of the overall health of the heart.

Question 26

Angiogram

Answer 26

An angiogram is a test that allows x-ray visualization of the coronary arteries and vessels that suppy the blood to the heart. This occurs following the injection of a contrast medium that has been released into the coronary arteries from a catheter which has been inserted into a blood vessel.

Question 27

Stress Test

Answer 27

Also known as a Stress Echocardiogram. It is an ultrasounds image of the heart to assess the heart wall motion in response to physical stress. First, an “at rest” image is taken, then the images of the heart are taken “at stress”. However, this test does not image the coronary arteries directly. Helps to detect cardiomyopathies,

Ischemia of one or more coronary arteries could cause wall motion abnormalities, potentially indicating coronary artery disease (CAD).

Question 28

Ejection Fraction

Answer 28

Ejection fraction is the fraction of outbound blood pumped from the heart with each heartbeat. It is commonly measured by echocardiogram and demonstrated a measure of a person’s cardiac function.

Ejection fraction is an important determinant in systolic heart failure (ventricular). CAD, congenital heart disease, valvular heart disease. Unlike heart rate, which can be low or high in a healthy person, a low ejection fraction is always associated with disease.

Question 29

Natriuretic Peptides

Answer 29

Natriuretic peptides refer to a peptide which induces natriuresis, which is the discharge of sodium through urine. They are particularly important in the control of blood pressure. There are two main peptides of particular importance for N232. Brain Natriuretic peptides, and Atrial natriuretic peptides.

Question 30

Brain natriuretic peptides

Answer 30

BNP is an amino acid peptide secreted by the ventricle of the heart in response to excessive stretching of the heart muscle cells (Cardiomyocytes). The net effect of BNP is a decrease in blood pressure due to a decrease in systemic vascular resistance, and thus afterload. Also have a result in decreased cardiac output due to reduction in blood volume following natriuresis and diuresis.

Normal levels rules out acute heart failure in an emergency setting. Can be used for screening and prognosis of heart failure. Typically increased levels in patients with left ventricular dysfunction.

Question 31

Atrial Natriuretic Peptide

Answer 31

ANP is a powerful vasodilator, and protein secreted by the heart muscle cells. It is released by muscle cells in the atria in response to high blood pressure. ANP acts to reduce water, sodium, and adipose loads on the circulatory system, reducing blood pressure

Question 32

D-Dimer

Answer 32

D-dimer tests are used to help rule out the presence of an inappropriate blood clot (thrombus). Some of the conditions that the D-dimer test is used to help rule out include:
Deep vein thrombosis (DVT)
Pulmonary embolism (PE)
Stroke

It is a quick, non-invasive way to help rule out abnormal or excess clotting.