Exam 1 Flashcards
Serum gastrin test
used to diagnose Zollinger-Ellison syndrome (will be elevated)
Urea Breath Test
used to diagnose peptic ulcer disease
Elevated white blood cell count
supports diagnosis of IBS
Stool occult blood (guaiac)
supports diagnosis of IBS (positive result)
Erythrocyte sedimentation rate
supports diagnosis of IBS (increased) better test for chronic inflammation
C-reactive protein
supports diagnosis of IBS (increased)
Lactoferrin test
supports diagnosis of IBS and indicates inflammation in GI tract (positive result)
Lactose tolerance test
used to detect lactase deficiency (present if blood glucose does not increase by 30 mg/dL)
Alpha-1-antitrypsin (AAT)
used to diagnose protein-losing enteropathy
CEA and CA19-9
tumor markers used for colon cancer
SOB test
used to detect occult bleeding due to polyps
Susceptible to Hepatitis B infection
HBsAg negative
anti-HBc negative
anti-HBs negative
Acute infection to Hepatitis B
HBsAg positive
anti-HBc negative
anti-HBs negative
Recovery/immune from Hepatitis B infection
HBsAg negative
anti-HBc positive
anti-HBs positive
Immune (vaccination) to Hepatitis B
HBsAg negative
anti-HBc negative
anti-HBs positive
Chronically infected with Hepatitis B
HBsAg positive
anti-HBc positive
anti-HBs negative
Gilbert syndrome
reduction in the activity of UDP-glucuronosyltransferase due to insertion of two bases in the promoter region
increases indirect bilirubin
Crigler-najjar syndrome
defective UDP-glucuronosyltransferase mutations due to the exchange of amino acids that cause frameshift mutations or nonsense mutation
increases indirect bilirubin
Dubin Johnson syndrome
chronic and benign impaired biliary excretion of glucuronide and glutathione conjugates
increases direct bilirubin and GGT
Pre-hepatic
indirect > direct
ex. hemolytic anemia, CHF
Hepatic
direct > indirect
ALT/AST > ALP
ex. cirrhosis, Reye’s syndrome, hepatitis
Post-hepatic
direct > indirect
ALT/AST < ALP
ex. gallbladder stones, tumors
Hepatic panel can include:
bilirubin (total and direct)
total protein
albumin
ALT
AST
ALP
GGT
PTT
fibrinogen
ammonia
Coagulation tests in hepatic disease/failure (loss of hepatic function)
increased prothrombin time
decreased fibrinogen
Pre-analytical variables in ammonia analysis
EDTA or heparin anticoagulants
no hemolysis
must be placed on ice immediately after collection
centrifuge within 20 minutes of collection and separate plasma (freeze plasma to preserve ammonia in sample)
Reagent in Jaffe reaction (creatinine)
picric acid
Creatinine clearance formula
Ucreatinine x Uvolume/Pcreatinine x 1440 min
Stage 1 kidney disease
normal or increased GFR (GFR > 90)
Stage 2 kidney disease
mildly decreased GFR (GFR 60-89)
Stage 3 kidney disease
moderately decreased GFR (GFR 30-59)
Stage 4 kidney disease
severely decreased GFR (GFR 15-29)
Stage 5 kidney disease
end-stage kidney disease
GFR < 15
Decreases in uric acid (hypouricemia)
renal tubule not effectively reabsorbing uric acid
severe hepatocellular disease
Increases in uric acid (hyperuricemia)
excessive purine intake
increased DNA catabolism (malignancies, megaloblastic anemia, increased niacin intake)
drinking too much alcohol
renal insufficiency
Lesh Nyhan syndrome
gout
decreases in BUN levels
over-hydration/dilution
late pregnancy
decreased protein intake
severe liver disease
