GI/GU/Renal Test

Question 1

What values are seen on liver lab test?

Answer 1

• Thrombopoietin (low)
• Coag factors (prolonged)
• Proteins (low)
• Cholesterol (high)
• Glucose (low)
• Urea (high ammonia level)

Question 2

What liver values come on a CMP?

Answer 2

• Total bilirubin
• AST
• ALT
• Alkaline phosphatase
• Albumin
• Total protein

Question 3

What liver values come on LFTs?

Answer 3

• Total bilirubin
• Direct / Conjugated bilirubin
• Indirect / Unconjugated bilirubin
• AST
• ALT
• Alk Phos
• Total protein
• Albumin
• Globulin

Question 4

List conditions/dz/ microorgs that can cause occult blood in the stool.

Answer 4

• GI bleed from ulcers, inflammation
• IBD
• GI cancers
• Hemorrhoids
• Diverticulosis/litis
• Infxs (shigella, campylobacter, salmonella, e. coli, Yersinia)

Question 5

Testing for H. pylori

Answer 5

CLO test (rapid biopsy)
Urea breath test

Question 6

Testing for C. diff

Answer 6

• antigen/toxin detection
• PCR/NAAT

Question 7

Testing for E. coli, Salmonella, Yersinia and Shigella

Answer 7

stool culture

Question 8

Testing for Rotavirus

Answer 8

stool antigen testing

Question 9

Testing for parasites

Answer 9

stool ova & parasites

Question 10

Testing for Enterobius vermicularis

Answer 10

“scotch tape” test

Question 11

What is the De Ritis ratio used for?

Answer 11

used to differentiate possible causes of hepatitis

Question 12

Tell us the different levels of the De Ritis ratio

Answer 12

> 2 –> alcoholic hepatitis
1 –> chronic cause (alcohol)
<1 –> acute cause (viral hep)

Question 13

Diagnostics & expected results of Hep A

Answer 13

• Hep A IgM: positive
• Hep A antigen in stool: positive

Question 14

Diagnostics & expected results of Hep B

Answer 14

Draw the Hep B chart
- the 5 phases
- HBsAg, Anti-HBc, IgM Anti-HBc, Anti-HBs

Question 15

Diagnostics & expected results of Hep C

Answer 15

• Hep C antibodies: positive
• Hep C RNA: positive

Question 16

Diagnostics & expected results of Autoimmune hepatitis

Answer 16

Anti-smooth muscle Ab: positive

Question 17

Diagnostics & expected results of alcoholic hepatitis

Answer 17

• De Ritis ratio >2
• GGT: positive

Question 18

Diagnostics & expected results of Non-alcoholic steatohepatitis

Answer 18

heterogenous appearance w/ fatty infiltrates on imaging
- NAFLD

Question 19

Causes of Metabolic Acidosis HAGMA (MUDPILERS)

Answer 19

• Methanol
• Uremia
• D.K.A*
• Paraldehyde
• Iron/Isoniazid
• Lactic acidosis*
• Ethanol/Ethylene glycol
• Renal failure/Rhabdo*
• Salicylates*

Question 20

Causes of Metabolic Acidosis NAGMA (HARDUPS)

Answer 20

• Hyperalimentation
• Acetazolamide
• Renal Tubular Acidosis
• Diarrhea*
• Ureteropelvic shunt
• Post-hypocapnia
• Spironolactone

Question 21

Causes of Acute Resp Acidosis (anything that causes hypoventilation)

Answer 21

• CNS depression
• airway obstruction
• Pulm edema
• Pneumonia
• Hemo/Pneumothorax
• Neuromuscular

Question 22

Causes of Metabolic Alkalosis (CLEVERPD)

Answer 22

• Contraction
• Licorice
• Endocrine (conn/Cushing/bartters)
• Vomiting*
• Excess alkali
• Refeeding
• Post-hypercapnia
• Piuretics

Question 23

Causes of Resp Alk (CHAMPSS)

Answer 23

• CNS dz
• Hypocapnia
• Anxiety*
• Mech. Ventilation
• Progesterone
• Salicylates*
• Sepsis*

Question 24

When would you see a high CO2?

Answer 24

Resp acidosis (more common)
OR
Metabolic alk

Question 25

When would you see a low CO2?

Answer 25

Resp alk
OR
metabolic acidosis *(more common)

Question 26

What is a normal PaO2?

Answer 26

80-100

Question 27

Base excess

Answer 27

> +2 = suggest metabolic alk

< -2 = suggest metabolic acidosis

Question 27

Explain A-a graident

Answer 27

determine the cause of Low PaCO2

• close = ventilation issue
• far apart = gas exchange issue