ED Diagnostics Flashcards
Calcium, carbon dioxide, chloride, glucose, potassium, sodium, BUN, creatinine
Chem 7 or 8, electrolyte panel, BMP (call it whatever you want)
What is in a Chem 8 that isn’t in a chem 7?
CALCIUM!
Use this when you suspect an issue with the kidneys, electrolyte imbalance, acid/base imbalance, blood glucose issues, calcium level imbalance
BMP
Significant changes in these test results can indicate acute problems such as kidney failure, insulin shock or diabetic coma, respiratory distress, or heart rhythm changes
BMP
Approximately 90% of cases of _______ are caused by malignancy or hyperparathyroidism
Hypercalcemia
If you see HIGH CO2, think….
Acidosis or possible ketoacidosis
Low K+ and high glucose?
Ketoacidosis
If you see low glucose, think ?
Diabetic insulin overdose or sepsis
If you see an elevated BUN and creatinine, think ?
Renal failure
If you see an elevated BUN and normal creatinine, think ?
Diureased
Everything in BMP PLUS albumin, alk phase, AST, ALT, Tbili, and total protein
Comprehensive metabolic panel
AST, ALT, alk phos, and total bilirubin make up which test?
Liver function test (LFTs)
Albumin and total protein assess ?
Nutritional status
If you see low albumin, think ?
Malnutrition
If you see increased alk phos, think ?
Gallstones
If you see increased AST, ALT, think ?
Hepatits
If you see increased total bilirubin, think ?
Cirrhosis, hepatitis
RBC count, WBC count, Hematocrit, hemoglobin, platelet count
CBC with diff
If you see low RBC, hemoglobin and hematocrit, think ?
Blood loss
If you see high RBC, hemoglobin and hematocrit, think ?
Hemoconcentration due to dehydration
If you see low platelets, think ?
Acute infection, bleeding, DIC, HELLP syndrome
Hemolysis, elevated liver enzymes, low platelet count
HELLP syndrome
What does the differential WBC break down the white blood cell count into?
Neutrophils (40-80%), lymphocytes (20-40%), monocytes, eosinophils, basophils
High neutrophils think ?
Acute bacterial infection
Low neutrophils think ?
Severe widespread bacterial or viral infection
What is LEFT SHIFT?
Low neutrophils
High lymphocytes think?
A viral infection like mono, mumps, or measles
High eosinophils think ?
Acute allergic rxn
If you see VERY high eosinophils, think ?
Parasitic infection
If you see a urine glucose over 130 with ketones, what should you think?
Diabetes or DKA
If you see positive nitrites and leukocyte esterase on a UA, what should you think?
UTI
If you see UTI symptoms with negative nitrites or leukocyte esterase on UA, what should you think?
Interstitial cystitis
Measures HCG in blood, allows for dating of pg and evaluation of threatened pg, ectopic pg, or miscarriage
Serum quantitative beta HCG
Test for syphylis
RPR for syphilis antibodies
Test for gonorrhea
Nucleic acid amplification (NAA) urine test
When do you need to SWAB a patient who you think has gonorrhea?
If it could be vaginal, cervical, anal, or pharyngeal
Test for chlamydia
NAA urine test
Test for HSV
Blood sample
Test for HIV
RNA based HIV early detection blood sample test
How soon can the HIV test detect a new HIV infection post exposure?
9-11 days
Used to detect bacterial infection that has spread to the blood
Blood culture
Marker for cellular hypoxia
Lactate
When would you perform a peripheral venous lactate level test?
If you suspect sepsis or septic shock
pH, PaO2, PaCO2, HCO3, base excess
Arterial blood gas
ABG will show metabolic acidosis
DKA
ABG will show metabolic alkalosis
Vomiting
ABG will show hypoventilation due to pulmonary edema, Pneumonia, chronic obstructive pulmonary disease, respiratory depression from drugs
Respiratory acidosis
ABG will show hyperventilation due to PE, anxiety, pain, febrile illness
Respiratory alkalosis
Serum ketones and urine ketones present
DKA
Used to evaluate a patient for the presence of thrombosis, PE, and clot
D-Dimer
Measures fibrin componenet
D-Dimer
Are all D-Dimers indicative of PE?
NO NO NO NO NO NO NO NO NO NO NEVER NO BAD NO NO NO NEVER STOP NO BAD EVERYONE HATES YOU FOR ORDERING A D-DIMER
Secreted in response to volume overload/mycoardial stretch
BNP
Used clinically in the detection and management of congestive heart failure
BNP
Can you predict mortality with BNP?
Yes - Increase or persistent elevation in BNP levels despite treatment suggests progression of disease or resistance to treatment
Proteins essential to cardiac muscle contraction, which are complexed with actin and myosin filaments within cardiac myofibrils and are present within cardiac myocyte cytoplasm
Cardiac troponins
What is the Biomarker of choice for detection of myocardial injury?
Troponin
PT/INR measures what pathway of coagulation?
EXTRINSIC
Used to measure the effect of coumadin/warfarin
PT/INR
PTT test measures which pathway of coagulation?
INTRINSIC
The effect of heparin is measured using the ___ test
PTT
One more time… PTT = ?
Heparin
PT/INR = ?
Coumadin
Monospot test will detect mono between ___ and ___ weeks after the onset of the illness
2 and 6
Rapid strep tests for which group of strep?
Group A
Flu swab should be performed less than __ days after illness onset
4
Flu swab checks for what groups of flu?
A and B
Lipase and amylase reflect??
Pancreatic stress
Which test is more specific to the pancreas - lipase or amylase?
LIPASE
Best test for suspected kidney stone?
KUB
