interpretation fo lab data

Question 1

why INR is better monitoring tool?

Answer 1

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

Question 2

high inr
low inr
and mangement

Answer 2

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

Question 3

Factors that Interfere with INR

Answer 3

1. vit k foods: increase clotting, low inr
2. alcohol: decrease cloting, high inr
3. vomit/ diarrhea: decrease cloting, high inr
   4. drugs : cephalosporin, cimetidine aspirin, metronidazole, phenytoin

Question 4

why creatinine is more sensitive than BUN

Answer 4

because kidney impairment is almost the only cause of elevated creatinine Excreted fully by the kidneys

Question 5

crcl used in?

Answer 5

• for assessing kidney function in patients with renal impairment.
• monitor patients on nephrotoxic medications
• assess need for renal dose adjustment

Question 6

Roles of fat in the body:

Answer 6

Carrier of some vitamins
Helps make hormones
Helps make cell membranes
Lubricates some body parts

Question 7

Why HDL is good and LDL is bad?

Answer 7

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.

Question 8

HbA1c
Random Blood sugar
Fasting Blood sugar
Glucose Tolerance Test

Answer 8

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

Question 9

why Free Thyroxine more accurate thn total t4?

Answer 9

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

Question 10

drug that decrease conversion of T4 to T3

Answer 10

Corticosteroids and Propranolol

Question 11

drugs that increase t3-t4 levels

Answer 11

Estrogen
Oral Contraceptives

t4: tomxifen, rolexifen
t3: levothyroxine

Question 12

drugs which increas clearance of t4?

Answer 12

phenytoin
carbamezapein
phenobarbital

Question 13

dopamine effect of tsh levels

Answer 13

dopamine agonists increase the tsh levels : dopamine, levadopa , glucocorticoids
dopamine antagnosit decrease tsh levels

Question 14

falsely elevate AST

Answer 14

Erythromycin, levodopa, and tolbutamide may falsely elevate AST by interfering with the assay

Question 15

drugs that increase
ggt
ast
alp

Answer 15

ggt: phenytoin, rifampin, phenobarbital, carbamezapen
ast: methyldopa and paracetmol
alt: hmgcoreductase enxyme, phenytoin, valproic acid

Question 16

Buffering

Answer 16

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.

Question 17

anion gap formula

Answer 17

Anion gap = [Na+ - (Cl- + HCO3-)]

Question 18

Alpha-fetoprotein (AFP)

Answer 18

May be raised in various cancers (liver, germ cell testicular cancers, bowel, stomach, lung, breast, lymphoma)
Non-cancerous conditions (e.g. chronic hepatitis, cirrhosis)

Question 19

Carbohydrate antigen 125 (CA 125)

Answer 19

May be raised in many gynaecological conditions e.g. benign ovarian cysts, endometriosis, pregnancy & ovarian cancer.

Question 20

Lactate dehydrogenase (LDH)

Answer 20

Levels can be raised for a variety of reasons where cellular destruction is present (e.g. lymphoma, pancreatitis, liver and kidney disease)

Question 21

Carcinoembryonic antigen (CEA)

Answer 21

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

Question 22

Prostate-specific antigen (PSA)

Answer 22

Specific tumour for prostate cancer & used for screening
level can also be raised in patients with BPH, elderly men and those with larger prostates.

Question 23

*Microscopy
*Electron microscopy
*Culture & sensitivity
*Antigen detection (Serology)
*Molecular biology assays (Molecular diagnostics)
*Viral Load Tests

Answer 23

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.

Question 24

Metabolic acidosis
Respiratory acidosis
Metabolic alkalosis
Respiratory alkalosis

Answer 24

metabolic acidosis: ↓ph,↓HCO3,↓PaCO2

Respiratory acidosis ph↓, ↑PaCO2, ↑HCO3−

Metabolic alkalosis:, ↑ph, ↑HCO3−, ↑PaCO2

Respiratory alkalosis ph↑, ↓PaCO2, ↓HCO3−

Question 25

Normochromic Normocytic anemias:
Normochromic Macrocytic anemias:
Hypochromic Microcytic anemias:

Answer 25

Normochromic Normocytic anemias: Blood loss, Hemolytic anemia
Hypochromic Microcytic anemias: Iron deficiency
Normochromic Macrocytic anemias: Folic acid deficiency, Vitamin B12 deficiency

Question 26

neutrophil
lymphocyte
monocyte
esonophil
basophil

Answer 26

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

Question 27

drugs that cause positive ANA

Answer 27

Procainamide, Isoniazid, Anticonvulsants

Question 28

sign of hyperbilirubinemia

Answer 28

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

Question 29

function of
Na+
K+
cl-
mg+
ca+
po+

Answer 29

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

Question 30

normal VALUES
hb
wbc
platlete
inr
bun
hba1c
CRP

Answer 30

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