interpretation fo lab data Flashcards
why INR is better monitoring tool?
Because the PT may vary according to the thromboplastin used to test the sample, INR is a better monitoring tool. INR is used to standardize the PT.INR is a ratio of the patient’s PT to that of International Reference Thromboplastin
high inr
low inr
and mangement
high inr: blood to thin, risk of bleeding, reduce the dose
low inr: blood to thick, risk of thrombosis, increase the dose
elevated inr management: antidote vitk, omit reuce the dose, give clotting factors
Factors that Interfere with INR
- vit k foods: increase clotting, low inr
- alcohol: decrease cloting, high inr
- vomit/ diarrhea: decrease cloting, high inr
4. drugs : cephalosporin, cimetidine aspirin, metronidazole, phenytoin
why creatinine is more sensitive than BUN
because kidney impairment is almost the only cause of elevated creatinine Excreted fully by the kidneys
crcl used in?
- for assessing kidney function in patients with renal impairment.
- monitor patients on nephrotoxic medications
- assess need for renal dose adjustment
Roles of fat in the body:
Carrier of some vitamins
Helps make hormones
Helps make cell membranes
Lubricates some body parts
Why HDL is good and LDL is bad?
LDL, on the other hand, is known as the “bad” cholesterol because it can build up in the arteries, forming plaque.
hDL (high-density lipoprotein) is known as the “good” cholesterol because it helps to remove LDL (low-density lipoprotein) cholesterol from the arteries and transport it back to the liver, where it is excreted from the body.
HbA1c
Random Blood sugar
Fasting Blood sugar
Glucose Tolerance Test
HbA1c: Average glucose control in the previous 3 month
Random Blood sugar: Non-fasting
Fasting Blood sugar: Nothing to eat or drink except H2O for at least 9-12 hrs
Glucose Tolerance Test: Starts fasting, then given glucose drink and measured over time
why Free Thyroxine more accurate thn total t4?
because Total T4 levels can be affected by conditions that alter the amount of thyroxine binding proteins.
Free T4 levels may be Increased or decreased by amiodarone, iodides, and lithium
drug that decrease conversion of T4 to T3
Corticosteroids and Propranolol
drugs that increase t3-t4 levels
Estrogen
Oral Contraceptives
t4: tomxifen, rolexifen
t3: levothyroxine
drugs which increas clearance of t4?
phenytoin
carbamezapein
phenobarbital
dopamine effect of tsh levels
dopamine agonists increase the tsh levels : dopamine, levadopa , glucocorticoids
dopamine antagnosit decrease tsh levels
falsely elevate AST
Erythromycin, levodopa, and tolbutamide may falsely elevate AST by interfering with the assay
drugs that increase
ggt
ast
alp
ggt: phenytoin, rifampin, phenobarbital, carbamezapen
ast: methyldopa and paracetmol
alt: hmgcoreductase enxyme, phenytoin, valproic acid
Buffering
refers to the ability of a solution to resist change in pH after the addition of a strong acid or base. The body’s principal buffer system is the carbonic acid/bicarbonate (H2CO3/ HCO3−) system.
anion gap formula
Anion gap = [Na+ - (Cl- + HCO3-)]
Alpha-fetoprotein (AFP)
May be raised in various cancers (liver, germ cell testicular cancers, bowel, stomach, lung, breast, lymphoma)
Non-cancerous conditions (e.g. chronic hepatitis, cirrhosis)
Carbohydrate antigen 125 (CA 125)
May be raised in many gynaecological conditions e.g. benign ovarian cysts, endometriosis, pregnancy & ovarian cancer.
Lactate dehydrogenase (LDH)
Levels can be raised for a variety of reasons where cellular destruction is present (e.g. lymphoma, pancreatitis, liver and kidney disease)
Carcinoembryonic antigen (CEA)
The preferred marker to monitor patients with colorectal cancer during treatment, but it is not useful for screening or diagnostic
Can also be raised in cancer of lung, breast, thyroid, pancreas, liver, stomach, ovary and bladder.
non-cancerous diseases and smoking might increase it
Prostate-specific antigen (PSA)
Specific tumour for prostate cancer & used for screening
level can also be raised in patients with BPH, elderly men and those with larger prostates.
*Microscopy
*Electron microscopy
*Culture & sensitivity
*Antigen detection (Serology)
*Molecular biology assays (Molecular diagnostics)
*Viral Load Tests
Microscopy: For direct detection of parasites & some fungi
Electron microscopy: Detection of viruses
Culture & sensitivity: For bacteria, Can be done for almost any body fluid or tissue
Antigen detection (Serology): e.g. HBsAg (hepatitis B surface antigen)
Molecular biology assays (Molecular diagnostics): Most commonly used is Polymerase Chain Reaction (PCR) to detect DNA / RNA of viruses and bacteria
Viral Load Tests:Measures the amount of virus in the sample.
Metabolic acidosis
Respiratory acidosis
Metabolic alkalosis
Respiratory alkalosis
metabolic acidosis: ↓ph,↓HCO3,↓PaCO2
Respiratory acidosis ph↓, ↑PaCO2, ↑HCO3−
Metabolic alkalosis:, ↑ph, ↑HCO3−, ↑PaCO2
Respiratory alkalosis ph↑, ↓PaCO2, ↓HCO3−
Normochromic Normocytic anemias:
Normochromic Macrocytic anemias:
Hypochromic Microcytic anemias:
Normochromic Normocytic anemias: Blood loss, Hemolytic anemia
Hypochromic Microcytic anemias: Iron deficiency
Normochromic Macrocytic anemias: Folic acid deficiency, Vitamin B12 deficiency
neutrophil
lymphocyte
monocyte
esonophil
basophil
neutrophil : bacterial / fungal infection, ra or ibd inflammation
lymphocyte: Bcell: bac/virus killing, Tcell: effected cell destuction
eosinophil killing of bac/fung , immune respone to parasite infection, allergic reaction
monocyte: phagocytosis of forign subs
basophil: histamine, hypersenstivity reaction
drugs that cause positive ANA
Procainamide, Isoniazid, Anticonvulsants
sign of hyperbilirubinemia
Jaundice is a classic sign of hyperbilirubinemia that usually occurs when total bilirubin exceeds 2 mg/dl. Other signs include scleral icterus and dark urine.
Drugs e.g. Antimalarials
function of
Na+
K+
cl-
mg+
ca+
po+
Na+: enzyme activity, acid base balance, osmotic regularity
K+: enzyme activity, osmotic regularity, cardiac and cns function and regulating muscle and nerve exitbility
cl-: k+ retention, transport of co2, cell osmolality, formation of hcl in git
mg+: enzyme activity, cardiac and neuromuscular function
ca+: bloog coagulation, endocrine, neuromuscular ( muscle contaction and nerve exitbility) Parathyroid, thyroid hormones & vitamin D influence Ca2+ values
po+ : formation of bones teeth, forming and stoing atp
normal VALUES
hb
wbc
platlete
inr
bun
hba1c
CRP
HB: males: 14-18
females: 12-16
wbc: 3200-11300 cell/mm
platlete: 150,000- 450,000
inr: 2-3
bun: 6-20mg/dl
hba1c: 4-5.6
crp: less thn 5mg/l
