Episode 2-BLOOD tests Flashcards by Austin Shackelford

What does CBC stand for? Also, a CBC is actually a ___ of ___ that examines different parts of the blood.

Complete Blood Count……..panel of tests

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On the CBC test, what might be decreased with some medications, bone marrow failure, chemotherapy, and congenital marrow aplasia (marrow doesn’t develop normally)?

Decreased White Blood Cell Count

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What can cause increase in WBC count on the CBC test?

Infections, inflammation, cancer, leukemia

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What CBC test gives % of each of the 5 types of leukocytes? What is the 6th ‘special’ kind included?

WBC differential count…Band neutrophils (immature)

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What disease can be correlated/found with the CBC differential WBC count?

Acute/Chronic Lymphocytic Leukemia

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What part of the CBC is decreased with anemia?

RBC Count

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What part of the CBC is increased with fluid loss due to diarrhea, dehydration, burns..?

RBC Count

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What CBC panel measures the amount of oxygen-carrying protein in the blood and mirrors RBC count results?

Hemoglobin

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What CBC panel measures the percentage of RBCs in a given volume of whole blood and mirrors RBC count?

Hematocrit

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How much mass of the RBC is taken up by hemoglobin?

1/3 of the mass!

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RANDOM! What are 2 often causes of anemia?

lack of iron in the diet OR chronic blood loss

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Which CBC test is a measurement of the average size of RBCs?

Mean Corpuscular Volume (MCV)

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What CBC test is elevated when RBCs are larger than normal? What is this condition called? What is the cause??

Mean Corpuscular Volume is elevated. Its called a MACROCYTIC RBC and it is a Vitamin B12 deficiency! BOOM!

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When the CBC test _____ is decreased, RBCs are smaller than normal (_________) as is seen in ___________ or thalassemias.

MCV(mean corpuscular volume)…….MICROCYTIC……iron deficient anemia

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What is the CBC test that is a calculation of the average amount of oxygen-carrying hemoglobin inside a RBC?

Mean Corpuscular Hemoglobin (MCH)

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Macrocytic RBCs are large so tend to have a higher ______, while microcytic RBCs would have a lower value.

Mean Corpuscular Hemoglobin (MCH)

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What is the CBC test that is a calculation of the average concentration of hemoglobin inside a red cell?

Mean Corpuscular Hemoglobin Concentration (MCHC)

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Decreased MCHC values (_________) are seen in conditions where the hemoglobin is abnormally diluted inside the red cells, such as in iron deficiency anemia and in thalassemia.

hypoCHROMIA

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Increased MCHC values (__________) are seen in conditions where the hemoglobin is abnormally concentrated inside the red cells, such as in burn patients and hereditary spherocytosis, a relatively rare congenital disorder.

hyperCHROMIA

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What is the CBC test that is a calculation of the variation in the size of RBCs?

Red Cell Distribution Width(RDW)

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In some anemias, such as pernicious anemia, the amount of variation (_________) in RBC size (along with variation in shape – _________) causes an increase in the RDW (red cell distribution width).

ANI-SO-CYTO-SIS and POI-KILO-CYTO-SIS

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What is a normal reference range for the CBC test RDW (red cell distribution width?

11-15%

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TOSS UP! What is the CBC test that gives the number of platelets in a given volume of blood?..(Both increases and decreases can point to abnormal conditions of excess bleeding or clotting)

Platelet Count

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What is the condition where you don’t have enough platelets and therefore you have to chance for the blood not to clot and therefore bleed out?

Thrombo-cyto-penia

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What is the condition where you have too many platelets and therefore you are susceptible to clotting?

Thrombo-cyto-sis

What is the CBC test that is a machine-calculated measurement of the average size of platelets?

Mean Platelet Volume (MPV)

New platelets are ______, and an increased MPV occurs when increased numbers of platelets are being produced.

larger

WHAT does CMP stand for?

Comprehensive Metabolic Panel

How many individual blood tests are involved in the CMP (comprehensive metabolic panel)?

14!

When running a CMP, typically, the patient fasts for _______ before the blood is drawn for the test.

10-12 hours

What 14 panel blood test measures all of these!? Sodium, Potassium, Calcium, Chloride, Carbon Dioxide, Glucose,Albumin Total Protein,Total Bilirubin, Alkaline Phosphatase (ALP), Aspartate Aminotransferase(AST),Alanine Aminotransferase (ALT),Blood Urea Nitrogen (BUN)!!

CMP (comprehensive metabolic panel)!

Measuring glucose in the blood (CMP) determines if a patient is _______ or ________.

hyperglycemic......or.......hypoglycemic

Fasting hyperglycemia is associated with _____ OR ______.

Type 1 or Type 2 D.Mellitus

What are the four bodily needs for SODIUM?

1.Plasma Volume 2.Nerve Impulses 2.Muscle Contractions (HEART) 4.GLUCOSE absorption in S.I.

What are the two types of SODIUM imbalances?

HyperNatremia and HypoNatremia

What are the 3 bodily needs of Potassium?

1.Nerve Impulses 2.Muscle contraction (HEART) 3.Acid/Base Balance

What are the two types of Potassium imbalance?

HyperKalemia and HypoKalemia

What protein does Calcium need for transport in the blood?

Albumin

BOOM: what are the SIX, yes 6, bodily needs of Calcium?

1.Muscle Contraction 2.Cardiac Function 3.Enzyme Activation 4.Exocytosis of NeuroTransmitters 5.BLOOD CLOTTING 6.Bone/TOOTH architecture

What are two types of Calcium imbalances?

HyperCalcemia and HypoCalcemia

What are the 2 (psh) bodily needs of Chlorine?

1. Acid/Base Balance 2. GABA (inhibitory!) & Glycine Action

Albumin is synthesized by the ______.

Liver!

What two organs does the Albumin count check the status of?

1. Liver and 2.Kidneys

What are the 4 functions of Albumin?

1. Oncotic Pressure 2.Transportation(a BUNCH of shit) 3.Calcium binding/transport 4. BUFFER

_________ is a waste product made in skeletal muscle and filtered by the ______.

Creatinine.....kidneys

High [Creatinine] in blood indicates?

Kidney failure (inability to filter OUT the creatinine)

_____ _____ ______ is a measure of the amount of urea in the blood.

Blood urea nitrogen

Urea is a waste product made in the liver from ______ _____ ________.

amino acid metabolism

______ is often ordered with ______ when kidney problems are suspected.

BUN (Blood Urea Nitrogen)....Creatinine

What do ALT, AST and ALP stand for? BRING IT BACK METABOLISM!!!

1.ALT=-A-L-anine amino-T-ransferase 2. AST=A-S-partate amino-T-ransferase 3.ALP=-A-L-kaline P-hosphatase

What does a HIGH level of ALT,AST,and ALP in the blood indicate?

LIVER DAMAGE (like Troponin is an indicator for Heart damage)

Out of ALT, AST, and ALP which ones are involved in amino acid catabolism?

ALT (alanine aminotransferase) and AST(aspartate aminotransferase)

Where are the two places ALP (alkaline phosphatase) is found?

Bile ducts and Bone

Which enzyme can be backed up like a SEWER and seep from the backed up BILE DUCTS and into the blood?

ALP-alkaline phosphatase

What is Bilirubin a waste product of? Is it hydrophilic or hydrophobic?

Biliruben is a wast product of Hemoglobin metabolism. It is hydroPHOBIC

How long do RBCs live?

90-120 days

What are the 3 tissues responsible for removing RBCs from the circulation? ONCE these three tissues produce bilirubin where is the final place for bilirubin?

1.Liver 2.Spleen (L+S=90%) 3.Bone Marrow(10%)....They all extract the billirubin, but it ALL ends up at the liver eventually

What are we checking in the CMP when looking at CO2?

Lung Status... are we expelling CO2 efficiently?

What are the four items we look for in a Lipid Panel/Cholesterol test?

1.LDL/LDL-c 2.HDL/HDL-c 3.Triglycerides 4.Total Cholesterol

In general, cholesterol tests are done to help assess a patient’s risk of _____ _____ ______ or risk of vascular disease in other parts of the body (e.g., carotid-->stroke)..

coronary artery disease

What are the two main sources of cholesterol?

1.Endogenous-Liver 2.Exogenous-Diet`

METABOLISM!! What is the building block of Cholesterol? What is the KEY ENZYME?

Building Block: Acetyl-CoA....KEY ENZYME:HMG-CoA Reductase (remember me?!?!)

Which one is the "bad" cholesterol?

LDL-c

The potential problem is that high LDL has been associated with the accumulation of _____ _____ (______) in the arteries (_________), which reduces blood flow.

fatty deposits (plaques)......(atherosclerosis)

Which is the "good" cholesterol?

HDL-c

When the liver receives the cholesterol, it typically excretes it in the _____.

bile

What is the awesome analogy for HDL-c because it has room to pick up cholesterol and bring it back to the liver?

"deflated beach ball" analogy!

What is very HIGH LDL-c?

>190mg/dL

Can you have too high of HDL-c? What IS a high level?

No! the higher the better! A high level is >60mg/dL...some people get up to 100 though!

Elevated _________ have also been shown to be associated with plaque formation and cardiovascular disease, although the relationship is less strong when compared LDL-C.

Triglycerides

The normal range for serum triglycerides is ________; a level above this range is referred to as __________.

35-160 mg/dL.....hypertriglyceridemia

The _____ ______ _____ is an easy, inexpensive, non-specific test that has been used for many years to help detect conditions associated with acute and chronic inflammation, including infections, cancers, and autoimmune diseases.

Erythrocyte Sedimentation Rate (ESR)

______ _______ ______ is said to be non-specific because increased results do not determine exactly where the inflammation is in the body or what is causing it, and also because it can be affected by other conditions besides inflammation.

Erythrocyte Sedimentation Rate (ESR)

Why does the inflammatory blood drop to the bottom during an ESR?

Because of heavy ROULEAUX formations

Bottom line: The more RBCs that fall to the bottom of the tube in one hour, the _____ the ESR.

Higher

What type of tube is used for a ESR? What is a NORMAL distance for RBCs to fall in 1 hour of an ESR?

West-Er-Gren...Normal: 10-20mm/hr

What are the 4 inflammatory conditions associated with an Elevated ESR?

1.Temporal Arteritis (CRAZY picture) 2.Poly-my-alga Rheumatica (shoulder/pelvic stiffness) 3. Rheumatoid Arthritis 4.SLE-(systemic lupus ery-them-a-to-sus)

____ is a useful blood test that can be used to not only diagnose diabetes mellitus but also to track the management of diabetes mellitus.

A1C

The hemoglobin A1C test is most indicative of average blood glucose levels over the last ______.

3-4months (90-120 days... life of a RBC!)

About what % of hemoglobin is NORMALLY glycylated? So whats the diagnosis threshold again? (going back to endo)

4-6% >6.5%

_____ _____ _____ is a protein produced in the liver and secreted into the blood and is considered a "marker" for inflammation, meaning its presence indicates a heightened state of inflammation in the body.

C-Reactive Protein (CRP)

In fact, ______ seems to be at least as predictive of cardiac risk as cholesterol levels.

C-Reactive Protein (CRP)

Whats a High CRP?

>3mg/L

__________ is a chronic bacterial infection of the tissues that support the teeth. *If you get this wrong, I will shoot you.

Periodontal Disease

Periodontal disease is more severe and prevalent in patients with ________.

type 1 and type 2 diabetes mellitus

There appears to be an association between periodontal disease and _________ ________ ________.

atherosclerotic cardiovascular disease

As a Dentist: What 4 tests should I order if I see periodontal disease and suspect more systemic diseases could be present?

1. Lipid Panel (for atherosclerosis) 2.Fasting Blood Glucose (DM) 3.A1C(DM) 4. CRP (Cardiac Risk)