Final Flashcards
FBG levels
70-99 normal
100-125 pre
126+ diabetes
GTT levels during time
30 min: X<200
1 hour: X<200
2 hour: <140
3 hour: 70-99
Levels for OGTT at two hours
Normal <140
Pre: 140-199
Diabetes 200+
A1C levels
< 5.7 normal
- 7-6.4: pre
- 5+ diabetes
Charcot joint MC due to what
DM
DKA/diabetic coma
Shortage of insulin
Hyperglycemia
Deep heavy breathing
Hypoglycemia considered under what
70mg/dl
MC in diabetic patient
What are the two types of hypoglycemia not related to diabetes and their numbers
Postprandial (reactive) within 4 hours of eating below 70mg/dl
Fasting hypoglycemia (post absorptive) usually related to underlying disease and when under 50mg/dl -excess insulin or carb deprivation
What is whipples triad
S/s of hypoglycemia
Low plasma glucose level
Relief of s/s with increased glucose levels
RBC casts/WBC casts
Red: glomerulonephritis
Etiologies of vascular calcification
HPT or DM
What gives feces the brown color
Stercobilinin
Clay (gray white), tan feces
Biliary obstruction
Red feces
Lower GI blood
Black and tarry feces
Upper GI bleeding ex: ulcers
Green feces
Green leafy veggies and antibiotics and crohns
White feces
Pancreatitis or pancreatic cancer
Pasty feces noted with
Increased fats from gallbladder disease
Greasy/buttery feces is noted with
Cystic fibrosis
Pus and feces
Found in ulcerative colitis and chronic dysentery abscesses and fistulas
Fasts and feces found in
Malabsorption syndromes, pancreases, liver, biliary disease
What is the universal blood donor
O-
What is universal receiver of blood
AB+
Higher the title number of an organism then the more ____
Virulent
Syphilis caused by what organism
Spirochete treponema
Syphilis stages
Primar: 3-4 weeks after infection recognized by chanre (painless)
-darkfield exam
Secondary: systemic; fever, rash, CNS
The latent periods
Tertiary: 3-10 years post infection = soft granulomatous lesions GUMMAS
Testing for syphilus
Non treponema tests (screening) (VDRL, RPR) then treponemal tests (confirmatory) ( TPI/MHA-TP, FTA-abs)
6 D’s of Charcot joint
Distention Density Debri Dislocation Disorganization Destruction
Protocol for Lyme disease
Sensitive ELIZA and then specific western blot
ASOT
Rapid antigen detection for streptococcal pharyngitis that is at glomerulonephritis, rheumatic fever, endocarditis or scarlet fever stage
Aka mono spot test
Heterophile Ab screening test
Approximately 2 weeks after onset, IgM react with warm RBC
1:56 or greater= mono
Rubella aka
German measles
Devastating to first trimester fetus
CRS (congenital rubella syndrome)
S/s fever, lymphadenopathy and maculopapular rash!!!
ELISA: determine mother immunity. POSITIVE IS GOOD.
AIDS and CD4+ t Cell counts
<200 = AIDS.
Viral load HIV
Amount of HIV in blood and how rapidly HIV is progressing
CD4 count
How well the immune system is functioning
HIV testing
- Immunoassays detecting HIV1/2 and then differentiating
3. Nuclei acid amplification testing
+ ANA detects what
Detects collagen and autoimmune disorders
SLE, scleroderma, mixed connective tissue disease, sjogrens, RA
What does RA affect and lab work associated with it
MCP, PIP and wrists
Abnormal IgG antibodies
RF and what antibody being detected
IgM
Levels required for Rheumatoid diagnosis
RF found at tiger greater than 1:80
Diagnosis of RA 4+ of the following things
Morning stiffness 6wk+ Pain on joint motion 6wk+ Swelling of one joint 6wk+ Swelling of another joint 6wk+ Bilateral symmetrical joint swelling Subcutaneous nodules Xray changes (RAT BITE)
What labs should be ordered for RA
RF with SED rate
If anemia: CBC
AS
C. Inflammatory disorder affecting young males primarily C. LBP in males Pannus destroys joint 15-35 Limited chest expansion Iritis/conjunctivitis Enthesopathy (bone formation at tendon insertion) (fluffy looking) \+HLAB27, + ESR (-RA, ANA)
Other reasons for sacroilitis
+ HLAB27
AS, enteropathic, psoriatic, reactive arthritis
- HLAB27
Infection, gout, DJD, HPT, trauma, pregnancy, DISH, OCI
What seronegative arthropathies usually have symmetrical and bilateral AS?
Bilateral: AS/enteropathic
Asymmetrical: psoriatic, Reiters
Dagger sign
AS
Shinny corner sign/rhomanus lesion
AS
What does BUN measure and end product of what
Amount of urea nitrogen in the blood and is an end product of protein metabolism
Metabolism function of the liver and excretory function of the kidneys
Azotemia
Elevated blood levels of BUN
Metabolic function of liver and excretory of kidney
Increased BUN
Renal disease
High protein diet
Decrease BUN
Liver disease
Overhydration
What may elevate creatinine
Renal disorders
Glomerulonephritis, pyelonephritis, tubular necrosis, reduced renal blood flow and obstruction
What are the kidney function tests
BUN and creatinine
What may uric acid be elevated with
Gout Renal disease Mets MM Alcoholism Leukemia’s
Gout of the big toe aka
Podagra
Proteins decrease with what
Liver and kidney disease
Malabsorption
Proteins increase with?
MM
Dehydration
C infections
Malignancies
Albumin is a measure of
Liver function
Albumin increase?
Dehydration
Albumin decrease?
Liver disease
Malnutrition
Over hydration
Inflammatory disease
Albumin and globulin levels in collagen diseases
Albumin decreased and globulin increased
Lab specifics of lytic mets
Increased Ca++
ALP normal or increased
Normocytic normochromic anemia
Lab specifics of blastic mets
Ca++ normal or decreased
ALP increased
Normocytic hypochromic anemia
ALP increased in
Blastic mets Pagets Bone disease Healing fractures HPT
Decreased ALP
Hypothyroidism
Pernucious anemia
3 etiologies for chondrocalcinosis
Cartilage degeneration Crystal deposition (CPPD/gout) Cation disease (hemochromatosis/Hyperparathyroidism/Wilson’s)
PAP
Prostate acid phosphatase
Elevated when prostate CA has metastasized beyond prostate
Also elevated in MM and benign prostatic hypertrophy
PSA
More sensitive and specific than PAP
PSA levels
4-10ng/mL are suspicious
10+ ng/ml = high probability of CA
LDH
Lymphoma
AFP
Liver cancer
GGTP
Liver and biliary tract
Most sensitive tes for alcohol induced liver disease
Elevated GGTP and ALP implies?
Hepatobiliary disease a
AST
Heart disease and (liver)
What is included in an electrolyte profile
Na (major extracellular)
K (major intracellular)
Cl
Bicarbonate
Calcium
Neurotransmission and muscle contraction
99% in bone
Phosphorus
80-85% in bone
Calcium levels can evaluate
Parathyroid function
Increased/decreased Ca
Increased:
HPT/HPPT, muscle weakness, MM
Decreased: HoPPT, alcoholics, vitamin D deficiency, tetany
MC cause of hypercalcemia
Primary hyperparathyroidism
S/s of hypercalcemia
Constipation Nausea Loss of appetite Extreme thirst Tired Weak
Hyperparathyroidism
Produces osteoclastic hormone 1-adenoma 2-C. Renal disease 3- Osteodystophy
Primary HPT
Increased parathromone
Increased Ca++
Hypophosphatemia
Secondary HPT
C. Renal disease
Decreased Ca+, hyper phosphatemia
Tertiary HPT
Dialysis patients
High PTH, and calcium)
Xray of HPT
Osteopenia Subperiosteal reabsorption Distal tuft reabsportion Acro-ostolysis Brown tumors Loss of cortical definition Vascular Ca++ SI joint erosions/AC joint
Most definitive radiographic sign of HPT
Subperiosteal resorption
Hyper phosphatemia
Renal failure
HoPPT, excess vitamins D, bone mets
MM
Hypophosphatemia with?
HPT
Decreased intestine absorption increased renal excretion
Increased magnesium
Dehydration
Renal insufficieny
DM
Decreased MG seen with
Malabsorption Alcohol Cirrhosis Tetany Muscle weakness Cardiac arrhythmia
One eyed pedicle
Lytic mets
Osteoblastoma
ABC
Congential
Amylase
Pancreatitis
Lipase
Acute pancreatitis
Creating phosphokinase (CPK)
Cardiac muscle
High cholesterol and low
High associated with hyper lipids is
Low: liver disease/malnutrition
What is the most sensitive and specific test for myocardial damage
Cardiac troponin
