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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
Black Urine
causes: alkaptonuria (metabolic dz)
26
Normal Specific Gravity (SG) of Urine
1.0003-1.035 in normal adult (differs in infants-2yrs)
27
High SG Implications
causes to know: dehydration
28
Low SG Implications
causes to know: diabetes insipidus
29
Normal Urine pH
4.6-8 (avg 6)
30
Acidic Urine (low pH) Clinical Implications
causes to know: uncontrolled DM (ketoacidosis)
31
Alkaline Urine (high pH) Clinical Implications
causes to know: UTI (some bacterial strains)
32
Hematuria
term for blood in the urine - false +: menstrual blood, concentrated urine, vigorous exercise - false -: vitamin C
33
Hematuria Clinical Implications
causes to know: lower uti nephrolithiasis urinary tract cancers renal cancers urinary catheter (trauma) anticoagulants strenuous exercise
34
Proteinuria Clinical Implications
term for increased protein in urine - largest indicator of renal (kidney) disease in any test
35
Glucosuria
increased glucose in the urine causes to know: - DM - large meal before test **positive glucose test requires evaluation for diabetes
36
Ketonuria
increased ketones in the urine causes to know: - DM (ketoacidosis) - starvation/fasting - (less important) but keto diet
37
False Positive for Urinary Ketones
dehydration can cause this
38
Urine Nitrites
#1 indicator of bacteria in urine as some bacteria converter nitrate into nitrite
39
Interfering Factors w/Urine Nitrite Readings
false positive: pyridium/AZO
40
Clinical Implications of Leukocyte Esterase in Urine
UTI!!
41
Interfering Factors w/Leukocyte Esterase Readings
false positive: - vaginal discharge - contamination false negative: - Pyridium/AZO
42
Urinary Bilirubin
Increased levels indicates LIVER problems
43
Urinary Urobilinogen
increased levels indicates LIVER disease
44
Urine Test Specimen Handling
TEST WITHIN ONE HOUR OR REFRIGERATE SPECIMEN
45
Urine Microscopy Analysis Components
- Bacteria - WBCs - RBCs - Casts (red cell, white cell, others) = kidney issues - crystals
46
Urine Microscopy WBC Implications
causes to know: uti stones cancer inflammation
47
Urine Microscopy RBC Implications
causes to know: UTI renal cancer bladder cancer kidney stones
48
Urine Microscopy Epithelial Cells In Sample
indicates contamination of sample w/skin cells
49
Urine Microscopy RBC Casts
indicates hemorrhage and is ALWAYS pathologic - ex: glomerulonephritis
50
Urine Microscopy WBC Casts
indicates pyelonephritis
51
Urine Microscopy - Crystals
all crystals are usually normal in urine (sometimes indicate kidney stones in large amounts) except Cystine crystals which are pathologic!!
52
Is pt taking AZO/Pyridium? Or Vitamin C?
URINE LABS MAY BE OFF!!!!
53
Basic Metabolic Panel (BMP) Components
1. Na+ 2. Cl- 3. HCO3- 4. K+ 5. BUN 6. Glucose 7. Ca2+ 8. Creatinine (CR)
54
Comprehensive Metabolic Panel (CMP) Components
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
BMP - Na+
primary cation in extracellular fluid - increased serum sodium: Hypernatremia (total water deficit) - decreased serum sodium: Hyponatremia (total water excess)
56
BMP - K+
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
BMP - Cl-
primary anion in extracellular fluid (besties w/Na+) - increased serum Cl-: hyperchloremia - decreased serum Cl-: hypochloremia
58
BMP - Bicarb
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
BMP - Blood Urea Nitrogen (BUN)
synthesized from protein metabolism
60
Increased BUN Implications
causes to know: - kidney insufficiency - urinary tract obstruction
61
Decreased BUN Implications
causes to know: - low protein diet
62
BMP - Creatinine
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
Low GFR
BAD, kidneys aren't filtering good - BMP is filtration rate of kidneys
64
BMP Report - Anion Gap
difference between serum cations and anions - anion gap = Na - (CL + bicarb)
65
BMP - Glucose
glucose is primary energy source for metabolism
66
Causes of Hyperglycemia (high glucose)
causes to know: - diabetes - severe infection - steroids
67
Causes of Hypoglycema (low glucose)
endocrine disorders, metabolic disorders
68
BMP - Ca2+
sad ion that isn't included in fish chart
69
Hypercalcemia
increased serum calcium causes to know: heart problems, hyperparathyroidism, too much vitamin D
70
Hypocalcemia
decreased serum calcium causes to know: muscle contractions, seizures, hyperparathyroidism, vitamin D deficiency
71
Hemoglobin A1c Test
POCT that tells avg blood sugar level in past 6-12 weeks - anything about 6.5% indicates DM - not accurate during pregnancy
72
Serum Amylase Test
tests for amylase (pancreatic enzyme) increased causes: pancreatitis decreased causes: pancreas insufficiency
73
Serum Lipase Test
test for lipase (pancreatic enzyme) increased causes: pancreatitis
74
Serum Aspartate Aminotransferase (AST)
liver enzyme (but also in heart, muscle, kidney) - increased causes: LIVER!! (sometimes MI too)
75
Serum Alanine Aminotransferase (ALT)
primarily in liver (Small amounts elsewhere but not really) - released when liver is injured - increase = INJURED LIVER
76
Serum ALkaline Phosphatase
liver enzyme but in many other cell types - increased causes: liver problems - decreased causes: osteoporosis
77
Serum Bilirubin
comes from breakdown of RBCs
78
Serum Gamma-Glutamyl Transferase (GGT)
liver enzyme (also found in kidney, prostate, and spleen) - therefore, higher conc. men - increased levels = liver problems
79
Complete Blood Count (CBC) Components
includes: - WBCs - RBCs - Platelets - Hemoglobin - Hematocrit
80
CBC w/Differential
includes everything in normal CBC + counts on each individual WBC type
81
5 Types of WBCs
Eosinophils Basophils Lymphocytes Neutrophils Monocytes
82
Leukocytosis
term for general increase in WBCs - associated with acute infections!!
83
Leukopenia
term for general decrease in WBCs - associated with: viral infections BAD infections like sepsis!
84
Neutrophils
most numerous WBC and the primary defense against microbial invasions
85
Neutrophilia Implications
pathological causes to know: - bacterial infection - inflammation non-pathological causes to know: - steroids
86
Neutropenia
causes to know: - overwhelming bacterial infection (sepsis) - viral infections
87
Lymphocytes
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
Lymphocytosis
causes to know: - mononucleosis (viral infection)
89
Lymphopenia
causes to know: - chemo/radiation - AIDS/HIV
90
Eosinophils
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
Eosinophilia
increased eosinophils in blood causes to know: asthma (wheezes), allergies (sneezes), and parasitic infections (weird diseases)
92
Eosinopenia
decreased eosinophils in blood
93
Basophils
type of WBC that works w/immune system, specifically w/inflammation from allergies - granules produce histamine and other substances
94
Basophilia
increase in Basophils in blood causes: allergies (seasonal, food, drug)
95
Basopenia
decrease in basophil in blood (uncommon)
96
Monocytes
type of WBC that resides in blood and destroys germs and eliminates infected cells - second line of defense - big nuclei
97
Monocytosis
increased monocytes in blood causes: infection (and recovery)
98
Monocytopenia
decrease in monocytes in the blood
99
Red Blood Cells (RBCs)
- no nuclei - carry oxygen and CO2 to tissues and to lungs - lifespan 120 days
100
Erythrocytosis
increase in RBCs in blood causes: polycythemia vera (blood CA)
101
Erythrocytopenia
decrease in RBCs in blood causes: anemia
102
Hemoglobin (Hgb)
initial test for anemia - differs between men and women
103
Hematocrit
% of RBCs within entire blood
104
Hct & Hgb Math
Hct = Hgb x 3
105
Platelets
smallest of formed cellular elements - responsible for blood clotting, vasoconstriction, vasodilation, etc.
106
Thrombocytosis
hight platelets in blood causes: cancers (leukemia) acute infection
107
Thrombocytopenia
low platelets in blood causes: some infections liver cirrhosis/disease

Foundations of Medicine PA S1 (13 decks)

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