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CDM1 > Exam 1: Interpreting Clinical Lab Results > Flashcards

Exam 1: Interpreting Clinical Lab Results Flashcards

1
Q

What are vital signs (4+2)

A

Temperature, BP, HR, RR, O2 Sat, Pain

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2
Q

What is included in chem-7?

A

Na, Cl, BUN, K, HCO3, Cr, Glucose

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3
Q

What are some hematology tests?

A

WBC, platelets, Hgb, HCT

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4
Q

Temperature: reference range

A

97-100.3 F or 36.1-37.9 C

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5
Q

BP: Reference range

A

100-140 mmHg / 70-90 mmHg

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6
Q

HR: Reference range

A

60-100 bpm

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7
Q

RR: Reference range

A

14-18 breaths/min

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8
Q

O2 Sat: Reference range

A

92-100% on room air

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9
Q

Pain: Reference range

A

0-10

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10
Q

Sodium: Reference Range

A

135-146 mEq/L

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11
Q

Potassium: Reference Range

A

3.4-5.2 mEq/L

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12
Q

Chloride: Reference Range

A

98-110 mEq/L

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13
Q

Bicarbonate: Reference range

A

24-32 mEq/L

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14
Q

BUN: Reference range

A

7-23 mg/dL

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15
Q

Cr: Reference range

A

0.5-1.1 mg/dL

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16
Q

Glucose: Reference range

A

70-100 mg/dL

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17
Q

Calcium: reference range

A

8.4-10.4 mg/dL

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18
Q

Magnesium: Reference range

A

1.6-2.6 mg/dL

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19
Q

Phosphorus: Reference range

A

2.4-4.4 mg/dL

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20
Q

AST/ALT: Reference range

A

0-35 IU/L

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21
Q

Alkaline Phosphaase: Reference Range

A

30-120 U/L

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22
Q

Amylase: Reference Range

A

0-130 IU/L

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23
Q

Lipase: Reference range

A

0-160 IU/L

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24
Q

LDH: Reference range

A

50-150 U/L

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25
Q

Total Bilirubin: Reference range

A

0.1-1mg/dL

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26
Q

Direct Bilirubin: Reference range

A

0-0.2 mg/dL

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27
Q

Albumin: Reference Range

A

3.5-5 g/dL

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28
Q

INR: Reference Range

A

0.8-1.2

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29
Q

WBC: Reference Range

A

3.2-9.8 x10^3 cells/mm^3

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30
Q

Platelets: Reference Range

A

140-440 x10^3 /mL

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31
Q

Hgb: Reference range

A

14-18 g/dL for males

12-16 g/dL for females

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32
Q

HTC: Reference range

A

39-49% for males

33-43% for females

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33
Q

HR: What is considered bradycardia?

A

<60 bpm

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34
Q

HR: What is considered tachycardia?

A

> 100 bpm

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35
Q

Weight: ABW formula

A

Actual body weight: (wt in lbs) / 2.2 = wt in kg

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36
Q

Weight: IBW formula

A

Men: 50 + 2.3(# inches over 5ft)
Women: 45.5 + 2.3(# inches over 5ft)

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37
Q

Sodium: Where is it predominately found?

A

Extracellular fluid

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38
Q

Sodium: Why do sodium abnormalities usually occur?

A

Usually a result of changes in water homeostasis – volume overload (heart/liver failure) or volume depletion (vomiting/blood loss)

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39
Q

Sodium: HYPOnatremia: Na Loss examples

A

Excess sweating, N/V, medications (diuretics), shifting from extra to intracellular spaces

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40
Q

Sodium: HYPOnatremia: water gain examples

A

Increased intake, SIADH (syndrome of inappropriate ADH > increases water retention)

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41
Q

Sodium: HYPOnatremia: Symptoms

A

Fatigue, confusion, muscle weakness/spasms, and coma in serious cases

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42
Q

Sodium: HYPERnatremia: Causes

A

Secondary to intake of high Na containing products (ex. 0.9% NaCl, some antibiotics (oxacilin)

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43
Q

Sodium: HYPERnatremia: Symptoms

A

Asymptomatic but muscle spasms may occur

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44
Q

Potassium: Where is it found?

A

Predominately an INTRAcellular cation (all but 2% is located within cells)

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45
Q

Potassium: Importance

A

Required for various enzymatic processes (Na/K ATPase, Krebs cycle)
Plays important role in sk. and sm. muscle contraction

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46
Q

Potassium: HYPOkalemia

A

Typically caused by fluid loss (bleeding, diarrhea, diuresis, vomiting)
Stool can contian 40-60mEq/L of K

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47
Q

Stool can contain ____ of K

A

40-60mEq/L

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48
Q

Potassium: HYPERkalemia

A

Typically caused by renal dysfunction (decreased clearance) – may be drug induced (ACEI/ARB, K-sparing diuretics)

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49
Q

Potassium: HYPO/HYPERkalemia s/sx

A

Muscle weakness - results from either LOW or HIGH levels of K
Dysrhythmias can be induced

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50
Q

Chloride: Where is it found?

A

Accounts for approximately 1/3 of all serum in EXTRAcellular fluid

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51
Q

___ accounts for approximately 1/3 of all serum in ___cellular fluid

A

Chloride, extracellular

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52
Q

Chloride: how is it filtered

A

Actively filtered via the kidneys (along with Na)

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53
Q

Chloride: Abnormalities causes

A

Reasons similar to those causing hypo+hypernatremia - diuretic use, vomiting

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54
Q

Chloride: HYPOchloremia s/sx

A

muscle excitability + tremors

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55
Q

Chloride: HYPERchloremia s/sx

A

weakness + lethargy

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56
Q

Bicarbonate: What does it measure

A

Levels of CO2 (Acid/base balance)

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57
Q

Bicarbonate: HYPObicarbonatremia

A

ACIDIC process

Metabolic, diabetic, ketoacidosis, or an overdose of ethylene, methanol, salicilates

58
Q

Bicarbonate: HYPERbicarbonatremia

A

ALKOLOTIC process or long term COPD (CO2 retention)

59
Q

BUN: Def

A

Waste product from production of ammonia by the liver

60
Q

BUN: How is it filtered?

A

Healthy kidneys can filter and remove urea via urine

61
Q

BUN: Low BUN

A

LIVER disease/damage, malnutrition

62
Q

BUN: High BUN

A

RENAL disease/damage, dehydration, or high protein intake

63
Q

SCr: Def

A

Chemical waste product produced primarily by muscle metabolism, filtered via kidneys, similarly to BUN

64
Q

SCr: Low Scr

A

Lack of nutrition/muscle mass

65
Q

SCr: High SCr

A

RENAL disease/damage, excess muscle mass

66
Q

What 2 Chem-7 lab results may indicate renal disease/damage?

A

High BUN and SCr – if kidney is not properly filtering out, high BUN/SCr = renal disease/damage

67
Q

Glu: Def

A

Source of energy for most cells

Carbohydrates to glucose (regulated by insulin and glucagon)

68
Q

Glu: LOW Glu: s/sx

A

Induce somnolence and coma

69
Q

Glu: HIGH Glu: s/sx

A

Indicate impairment –> diagnosis of DIABETES?

70
Q

Ca: Importance

A

Involved in muscle contraction and bone formation

71
Q

Ca: Storage

A

99% in skeleton and teeth

72
Q

Ca: How is it regulated

A

Vit D and parathyroid hormone

73
Q

Ca: Breakdown % of albumin bound, free, salt bound

A

40% albumin
45% free
15% salt

74
Q

Ca: HYPOcalcemia: causes

A

Poor Ca intake or vit D deficiency (~500mg of Ca removed from bones/day)
HYPOparathyroidism (part of feedback loop that regulates reabsorption of Ca from bones)

75
Q

Ca: HYPOCalcemia: s/sx

A

Paraesthesia
Tetany
QTc prolongation/arrhythmias

76
Q

Ca: HYPERcalcemia: Causes

A

Malignancy due to bone metastases
HYPERparathyroidism
Renal insufficiency

77
Q

Ca: HYPERcalcemia: s/sx

A

Bones, stones, groans, psychic moans

Lytic lesions
Urinary calculi
Malaise
N/V
Mental status changes (confusion and depression)
78
Q

Ca: Ionized calcium only changes with changes in ____

A

Vit D or parathyroid hormones

79
Q

Ca: Ionized Ca: Ref Ranges Children/Adults

A

Children: 4.4-6 mg/dL
Adults: 4.4-5.3 mg/dL

80
Q

Corrected calcium calculation equation

A

Observed serum Ca + 0.8(4 - serum Alb)

81
Q

Phosphate: Where is it found

A

Major INTRAcellular anion

82
Q

Phosphate: Importance

A 
Important role in: 
Bone mineralization
Storage and transfer of energy
Muscle contraction
Metabolism of glu and lipids
Maintenance of acid/base balance
83
Q

Phosphate: HYPOphosphatemia: Levels

A

Moderate: 1-2.5mg/dL
Severe: <1mg/dL

84
Q

Phosphate: HYPOphosphatemia: Causes

A

Inadequate dietary intake
Hyperparathyroidism (increased excretion)
DKA (diabetic ketoacidosis)

85
Q

Phosphate: HYPOphosphatemia: s/sx

A

Muscle weakness/dysfunction and mental status changes

86
Q

Phosphate: HYPERphosphatemia: Causes

A

Common cause: renal failure

87
Q

Calcium-Phosphate Product > 55 in CKD then ____

A

precipitation occurs and lytic lesions form

88
Q

Magnesium: Where is it found?

A

2nd most abundant INTRAcellular cation

89
Q

Magnesium: Importance

A

Required for utilization of ATP for energy

Important for regulating energy, protein synthesis, neuromuscular transmission, CV tone

90
Q

Magnesium: Storage

A

Bone and muscle tissues

91
Q

Magnesium: HYPOmagnesemia: Causes

A

Vomiting, diarrhea, diuretics

92
Q

Magnesium: HYPOmagnesemia: Often coincides with ___

A

HYPOkalemia

93
Q

Magnesium: HYPOmagnesemia: s/sx

A

N/V, EKG changes

94
Q

Magnesium: HYPERmagnesemia: causes

A

Excessive Mg intake or renal failure

95
Q

Magnesium: HYPERmagnesemia: s/sx

A

Sedation, N/V, decreased reflexes, EKG changes

96
Q

Cockcroft-Gault Formula: CrCl equation

A

CrCl = (140-age)(IBW) / (72*SCr) * 0.85(if female)

97
Q

T/F: Cockcroft -Gault equation is the only validated method of renal fxn for drug dosing

A

True

98
Q

Cockcroft-Gault equation: Issues

A
  • unstable kidney fxn (change in Scr by >50% in 24hours): CrCl over estimated
  • Elderly (> 65): some institutions will round Scr to 1 if <1
99
Q

AST/ALT: What are they?

A

Enzymes found within liver that aid in metabolism of proteins and AA

100
Q

Increase in AST/ALT indicates ____

A 
hepatocellular injury (hepatitis or cirrhosis)
can see increase AST in other types of cell injury (post MI) but ALT is more specific for liver

Drug induced: statins, TZDs, EtOH

101
Q

Which drugs can increase AST/ALT

A

Statins, TZDs, and EtOH

102
Q

ALP: What is it?

A

Enzyme that aids in producing proteins within body

103
Q

ALP: Where is it located and secreted?

A

Located in liver and bone

Secreted in bile

104
Q

Increases in ALP indicates ___

A

obstruction (liver/biliary) or bone disease/breakdown (Paget’s disease)

105
Q

Someone with Paget’s disease may see an increase of ___ (enzyme)

A

ALP

106
Q

LDH: What is it?

A

LD is necessary for citric acid cycle to produce NADH and pyruvate – becomes energy

107
Q

LDH: Where is it located?

A

Present in most tissues (making it non-specific for liver)

108
Q

Increases in LDH may indicate ____

A

Some type of liver dysfunction

Almost always increases post MI within 10-12 hours

109
Q

___ almost always increases post MI within 10-12 hours

A

LDH

110
Q

Bilirubin: What is it?

A

Metabolic byproduct of the lysis of erythrocytes by reticuloendothelial system

111
Q

Bilirubin: HYPERbilirubinemia

A

Prehepatic - hemolysis
Hepatic - defective removal of bilirubin from blood or conjugation
Posthepatic or cholestatic - obstruction

If total bilirubin > 2mg/dL - jaundice can develop

112
Q

Albumin: What is it

A

Most abundant protein in body

Synthesized in liver –> marker of true hepatic function

113
Q

Albumin: 3 Major functions

A
  1. controlling oncotic pressure in plasma
  2. transporting AA synthesized in liver to other tissues
  3. transporting poorly soluble ligands
114
Q

Amylase+Lipase: What are they?

A

Enzymes secreted by pancreas to breakdown carbs, proteins, and fats

115
Q

___ increases after onset of acute pancreatitis in most patients

A

Amylase and lipase

116
Q

INR: What is it

A

Measures clotting tendency or coagulation properties of blood

117
Q

INR is prolonged in those ___

A

receiving warfarin and those with liver damage

118
Q

Erythrocytes: Produced in ___

A

Bone marrow

119
Q

Erythrocytes: Released into ___ and circulate for ___H

A

Released into peripheral blood

Circulate for 120 days (60 days for those w CKD)

120
Q

What is the difference between Hgb and HCT?

A

Hgb: O2 carrying compound in RBCs
HCT: % of RBC in volume of whole blood

121
Q

Platelets: What are they

A

Maintain integrity of blood vessels, play key role in hemostasis + blood clotting

122
Q

Platelets: lifespan

A

8-12 ays

123
Q

Leukocytes (WBC): Neutrophils: % of total WBC

A

~60%

124
Q

Leukocytes (WBC): Neutrophils: Increases in ___

A

infections, tissue destruction, inflammatory disease, stress, steroids

125
Q

Leukocytes (WBC): Neutrophils: Decreases in ___

A

Cancer, post-chemotherapy, side effects of drugs

126
Q

Absolute Neutrophil count equation

A

ANC = (WBC)(% neutrophils)

127
Q

What is neutropenia?

A

ANC < 500/mm^3 –> increased risk of infection

128
Q

Leukocytes (WBC): Bands: % of WBC

A

~5%

129
Q

Leukocytes (WBC): Bands: What are they?

A

Immature neutrophils

130
Q

Leukocytes (WBC): Bands: Increase in ___

A

response to acute infection (left shift = bands > 5%)

131
Q

Leukocytes (WBC): Lymphocytes: % of WBC

A

~30%

132
Q

Leukocytes (WBC): Lymphocytes: What do they do?

A

Recognize foreign substances and initiate immune response

133
Q

Leukocytes (WBC): Lymphocytes: 2 types

A

T-lymphocytes: cell mediated immunity

B-lymphocytes: antibody mediated immunity

134
Q

Leukocytes (WBC): Monocytes: % of WBC

A

~7%

135
Q

Leukocytes (WBC): Monocytes: Where are they formed

A

In bone marrow, migrate to tissue and mature into macrophages

136
Q

Leukocytes (WBC): Monocytes: Increase in ___

A

Subacute bacterial endocarditis, malaria, tuberculosis, recovery phase from infections, initial recovery from chemotherapy

137
Q

Leukocytes (WBC): Eosinophils: % of WBC

A

~3%

138
Q

Leukocytes (WBC): Eosinophils: What are they

A

Surface receptor of IgG and IgE

139
Q

Leukocytes (WBC): Eosinophils: What do they do?

A

Involved in hypersensitivity response or allergic disorder

140
Q

Leukocytes (WBC): Basophils: % of WBC

A

~<1%

141
Q

Leukocytes (WBC): Basophils: What do they doinfla

A

Probably involved in immediate hypersensitivity reactions and delayed allergic reactions

142
Q

Leukocytes (WBC): Basophils: May increased due to ___

A

Inflammation and leukemia

CDM1 (19 decks)

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