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Foundations of Medicine PA S1 > Everything Red in Lab Medicine & Lab Tests > Flashcards

Everything Red in Lab Medicine & Lab Tests Flashcards

1
Q

Reference Range

A

range of values within a population of people who do NOT have a given disease (ranges from lab to lab)
- upper and lower limits
- “normal range”

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2
Q

Desirable Range

A

a range set for a pt based on their prognosis and the goal for their labs based on their individual conditions and unique situation
- associates lab results w/clinical outcomes

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3
Q

Therapeutic Range

A

the range of concentrations in which a drug is effective on bodily tissues and does its job
- low therapeutic range means that there isn’t a high conc. of drug before it can be toxic

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4
Q

Threshold

A

in some lab tests, the presence of a disease is associated with falling above a specific value (threshold)

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5
Q

Sensitivity

A

focuses on the population of individuals who have the disease
- a test will be sensitive if it is capable of correctly identifying everyone with the disease
- has a low diagnostic threshold though: due to this, there will likely be a handful of false positives

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6
Q

Specificity

A

focuses on population of individuals without the disease
- a test will be specific if it is capable of correctly identifying everyone without the disease
- has a high diagnostic threshold though: due to this, there will be more false negatives
- all healthy people will have normal result but some sick people will also come out negative even though they are sick

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7
Q

Troponin Test for MI

A

an example of a highly sensitive test as it will detect everyone actively having a heart attack but it will also find people who are not (false positives)

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8
Q

Positive Predictive Value

A

focuses on people with a + test result and then looks at how many of those results ACTUALLY have that condition/disease

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9
Q

Negative Predictive Value

A

focuses on people with a - test result and then looks at how many of those results ACTUALLY have that condition/disease

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10
Q

Prevalence

A

the number of people in a population that have a given condition/disease
- usually represented as a %
- 48% of Americans have HTN

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11
Q

Incidence

A

the number of new cases of a given disease/condition in a given time period
- usually in 1 year
- ex: # of new HIV cases in a year

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12
Q

Pre-Analytic Phase

A

where the order for a lab is placed and followed through with specimen collection and then being sent to lab
- where most errors occur!!

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13
Q

If you ordered…

A

CBC: $51
Lipid Panel: $68
Urinalysis: $92
Hgb A1c: $61
TSH: $108
HIV test: $92
TOTAL w/o insurance: $472

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14
Q

Normal Urine Colors

A

Straw color (hydrated, low specific gravity)
Amber color (dehydrated, high specific gravity)

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15
Q

Colorless Urine

A

causes to know:
- large fluid intake
- untreated DM
- diabetes insipidus

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16
Q

Urinalysis Components

A

color
specific gravity
pH
heme/blood
albumin/protein
urinary glucose
ketones
nitrite
leukocyte esterase
bilirubin
urobilinogen

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17
Q

Bright Yellow (neon) Urine

A

cause: vitamin B intake

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18
Q

Orange Urine

A

causes to know:
medications (pyridium/AZO)

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19
Q

Brownish/Greenish Yellow Urine

A

bilirubin

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20
Q

Reddish/Dark Brown Urine

A

causes to know:
blood (RBCs)
hemoglobin
myoglobin

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21
Q

Milky Color Urine

A

causes:
fat, pus or WBCs

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22
Q

Purple Urine

A

causes:
porphyria, purple urine bag syndrome

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23
Q

Green Urine

A

causes:
meds, food dyes

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24
Q

Brown-Black Urine

A

causes:
hemoglobin, lysol poisoning, melanin

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25
Q

Black Urine

A

causes:
alkaptonuria (metabolic dz)

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26
Q

Normal Specific Gravity (SG) of Urine

A

1.0003-1.035 in normal adult (differs in infants-2yrs)

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27
Q

High SG Implications

A

causes to know:
dehydration

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28
Q

Low SG Implications

A

causes to know:
diabetes insipidus

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29
Q

Normal Urine pH

A

4.6-8 (avg 6)

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30
Q

Acidic Urine (low pH) Clinical Implications

A

causes to know:
uncontrolled DM (ketoacidosis)

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31
Q

Alkaline Urine (high pH) Clinical Implications

A

causes to know:
UTI (some bacterial strains)

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32
Q

Hematuria

A

term for blood in the urine
- false +: menstrual blood, concentrated urine, vigorous exercise
- false -: vitamin C

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33
Q

Hematuria Clinical Implications

A

causes to know:
lower uti
nephrolithiasis
urinary tract cancers
renal cancers
urinary catheter (trauma)
anticoagulants
strenuous exercise

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34
Q

Proteinuria Clinical Implications

A

term for increased protein in urine
- largest indicator of renal (kidney) disease in any test

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35
Q

Glucosuria

A

increased glucose in the urine
causes to know:
- DM
- large meal before test
**positive glucose test requires evaluation for diabetes

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36
Q

Ketonuria

A

increased ketones in the urine
causes to know:
- DM (ketoacidosis)
- starvation/fasting
- (less important) but keto diet

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37
Q

False Positive for Urinary Ketones

A

dehydration can cause this

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38
Q

Urine Nitrites

A

1 indicator of bacteria in urine as some bacteria converter nitrate into nitrite

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39
Q

Interfering Factors w/Urine Nitrite Readings

A

false positive: pyridium/AZO

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40
Q

Clinical Implications of Leukocyte Esterase in Urine

A

UTI!!

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41
Q

Interfering Factors w/Leukocyte Esterase Readings

A

false positive:
- vaginal discharge
- contamination
false negative:
- Pyridium/AZO

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42
Q

Urinary Bilirubin

A

Increased levels indicates LIVER problems

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43
Q

Urinary Urobilinogen

A

increased levels indicates LIVER disease

44
Q

Urine Test Specimen Handling

A

TEST WITHIN ONE HOUR OR REFRIGERATE SPECIMEN

45
Q

Urine Microscopy Analysis Components

A
  • Bacteria
  • WBCs
  • RBCs
  • Casts (red cell, white cell, others) = kidney issues
  • crystals
46
Q

Urine Microscopy WBC Implications

A

causes to know:
uti
stones
cancer
inflammation

47
Q

Urine Microscopy RBC Implications

A

causes to know:
UTI
renal cancer
bladder cancer
kidney stones

48
Q

Urine Microscopy Epithelial Cells In Sample

A

indicates contamination of sample w/skin cells

49
Q

Urine Microscopy RBC Casts

A

indicates hemorrhage and is ALWAYS pathologic
- ex: glomerulonephritis

50
Q

Urine Microscopy WBC Casts

A

indicates pyelonephritis

51
Q

Urine Microscopy - Crystals

A

all crystals are usually normal in urine (sometimes indicate kidney stones in large amounts) except Cystine crystals which are pathologic!!

52
Q

Is pt taking AZO/Pyridium? Or Vitamin C?

A

URINE LABS MAY BE OFF!!!!

53
Q

Basic Metabolic Panel (BMP) Components

A
  1. Na+
  2. Cl-
  3. HCO3-
  4. K+
  5. BUN
  6. Glucose
  7. Ca2+
  8. Creatinine (CR)
54
Q

Comprehensive Metabolic Panel (CMP) Components

A
  1. All components of BMP (Na, Cl, Bicarb, BUN, glucose, Ca, K, CR)
  2. AST
  3. ALT
  4. Alk phos.
  5. Albumin
  6. Bilirubin
  7. Total Protein
55
Q

BMP - Na+

A

primary cation in extracellular fluid
- increased serum sodium: Hypernatremia (total water deficit)
- decreased serum sodium: Hyponatremia (total water excess)

56
Q

BMP - K+

A

primary cation of intracellular fluid
**changes in K+ conc. can affect: nerves, heart, muscle (think AP)
- increased serum K+: hyperkalemia
- decreased serum K+: hypokalemia

57
Q

BMP - Cl-

A

primary anion in extracellular fluid (besties w/Na+)
- increased serum Cl-: hyperchloremia
- decreased serum Cl-: hypochloremia

58
Q

BMP - Bicarb

A

ion formed in the kidneys that acts as a buffer when H+ is produced by metabolism of acids
- increased bicarb: alkalosis
- decreased bicarb: acidosis

59
Q

BMP - Blood Urea Nitrogen (BUN)

A

synthesized from protein metabolism

60
Q

Increased BUN Implications

A

causes to know:
- kidney insufficiency
- urinary tract obstruction

61
Q

Decreased BUN Implications

A

causes to know:
- low protein diet

62
Q

BMP - Creatinine

A

muscles metabolis creatine and lead to creatinine production
- more muscle mass = more creatinine
- range differs between men and women
- elevated creatinine = decreased renal function

63
Q

Low GFR

A

BAD, kidneys aren’t filtering good
- BMP is filtration rate of kidneys

64
Q

BMP Report - Anion Gap

A

difference between serum cations and anions
- anion gap = Na - (CL + bicarb)

65
Q

BMP - Glucose

A

glucose is primary energy source for metabolism

66
Q

Causes of Hyperglycemia (high glucose)

A

causes to know:
- diabetes
- severe infection
- steroids

67
Q

Causes of Hypoglycema (low glucose)

A

endocrine disorders, metabolic disorders

68
Q

BMP - Ca2+

A

sad ion that isn’t included in fish chart

69
Q

Hypercalcemia

A

increased serum calcium
causes to know: heart problems, hyperparathyroidism, too much vitamin D

70
Q

Hypocalcemia

A

decreased serum calcium
causes to know: muscle contractions, seizures, hyperparathyroidism, vitamin D deficiency

71
Q

Hemoglobin A1c Test

A

POCT that tells avg blood sugar level in past 6-12 weeks
- anything about 6.5% indicates DM
- not accurate during pregnancy

72
Q

Serum Amylase Test

A

tests for amylase (pancreatic enzyme)
increased causes: pancreatitis
decreased causes: pancreas insufficiency

73
Q

Serum Lipase Test

A

test for lipase (pancreatic enzyme)
increased causes: pancreatitis

74
Q

Serum Aspartate Aminotransferase (AST)

A

liver enzyme (but also in heart, muscle, kidney)
- increased causes: LIVER!! (sometimes MI too)

75
Q

Serum Alanine Aminotransferase (ALT)

A

primarily in liver (Small amounts elsewhere but not really)
- released when liver is injured
- increase = INJURED LIVER

76
Q

Serum ALkaline Phosphatase

A

liver enzyme but in many other cell types
- increased causes: liver problems
- decreased causes: osteoporosis

77
Q

Serum Bilirubin

A

comes from breakdown of RBCs

78
Q

Serum Gamma-Glutamyl Transferase (GGT)

A

liver enzyme (also found in kidney, prostate, and spleen)
- therefore, higher conc. men
- increased levels = liver problems

79
Q

Complete Blood Count (CBC) Components

A

includes:
- WBCs
- RBCs
- Platelets
- Hemoglobin
- Hematocrit

80
Q

CBC w/Differential

A

includes everything in normal CBC + counts on each individual WBC type

81
Q

5 Types of WBCs

A

Eosinophils
Basophils
Lymphocytes
Neutrophils
Monocytes

82
Q

Leukocytosis

A

term for general increase in WBCs
- associated with acute infections!!

83
Q

Leukopenia

A

term for general decrease in WBCs
- associated with:
viral infections
BAD infections like sepsis!

84
Q

Neutrophils

A

most numerous WBC and the primary defense against microbial invasions

85
Q

Neutrophilia Implications

A

pathological causes to know:
- bacterial infection
- inflammation
non-pathological causes to know:
- steroids

86
Q

Neutropenia

A

causes to know:
- overwhelming bacterial infection (sepsis)
- viral infections

87
Q

Lymphocytes

A

migrate to areas of inflammation and come from bone marrow as acting members of immune response
3 types:
1. T Cells
2. B Cells
3. Natural Killer Cells (NK)

88
Q

Lymphocytosis

A

causes to know:
- mononucleosis (viral infection)

89
Q

Lymphopenia

A

causes to know:
- chemo/radiation
- AIDS/HIV

90
Q

Eosinophils

A

type of WBC that fights inflammation from allergic rxns, asthma, and parasitic infection (wheezes, sneezes and weird diseases!)
- chemicals in granules are toxic to invaders

91
Q

Eosinophilia

A

increased eosinophils in blood
causes to know: asthma (wheezes), allergies (sneezes), and parasitic infections (weird diseases)

92
Q

Eosinopenia

A

decreased eosinophils in blood

93
Q

Basophils

A

type of WBC that works w/immune system, specifically w/inflammation from allergies
- granules produce histamine and other substances

94
Q

Basophilia

A

increase in Basophils in blood
causes:
allergies (seasonal, food, drug)

95
Q

Basopenia

A

decrease in basophil in blood (uncommon)

96
Q

Monocytes

A

type of WBC that resides in blood and destroys germs and eliminates infected cells
- second line of defense
- big nuclei

97
Q

Monocytosis

A

increased monocytes in blood
causes: infection (and recovery)

98
Q

Monocytopenia

A

decrease in monocytes in the blood

99
Q

Red Blood Cells (RBCs)

A
  • no nuclei
  • carry oxygen and CO2 to tissues and to lungs
  • lifespan 120 days
100
Q

Erythrocytosis

A

increase in RBCs in blood
causes: polycythemia vera (blood CA)

101
Q

Erythrocytopenia

A

decrease in RBCs in blood
causes: anemia

102
Q

Hemoglobin (Hgb)

A

initial test for anemia
- differs between men and women

103
Q

Hematocrit

A

% of RBCs within entire blood

104
Q

Hct & Hgb Math

A

Hct = Hgb x 3

105
Q

Platelets

A

smallest of formed cellular elements
- responsible for blood clotting, vasoconstriction, vasodilation, etc.

106
Q

Thrombocytosis

A

hight platelets in blood
causes:
cancers (leukemia)
acute infection

107
Q

Thrombocytopenia

A

low platelets in blood
causes:
some infections
liver cirrhosis/disease

Foundations of Medicine PA S1 (13 decks)

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