Interpretation of Labs Flashcards
What is the most important and first thing that must be done prior to performing lab testing?
Obtain patient consent
Patient comes in with sluggish, altered mental state. What test helps distinguish if they have hypoglycemia or stroke & should be done ASAP?
Glucose check
What is the reasoning behind administering glucose as IVPB (IV piggy back)?
Gives body time to process glucose (not all at once)
Difference between CBC & CBC w/ diff?
CBC w/ diff = CBC + absolute differential counts (WBC breakdown)
What is tested in a BMP (chem 7)?
kidney fx, electrolytes, acid-base fluid balance
What is tested in a CMP?
BMP + LFTs + Mg + PO4 + Ca
Conditions indicated w/ leukocytosis (neutrophil predominance)
Bacterial infection, inflammation, neoplastic issue
Conditions indicated w/ leukocytosis (lymphocyte predominance)
Viral (EBV) / Bacterial (pertussis) infection, lymphocytic leukemia (ALL, MLL)
Conditions indicated w/ leukocytosis (basophilia)
Allergic rxn, hypothyroidism, splenectomy, neoplastic issue
Conditions indicated w/ leukocytosis (monocytosis)
GI issues, sarcoidosis, B. marrow suppression
Conditions indicated w/ leukocytosis (eosinophilia)
Parasitic infections, allergic rxns, GI issues, cutaneous issues
Conditions indicated w/ leukopenia (neutropenia)
Overwhelming bacterial infection, AIDS, hypersplenism, cachexia, anaphylactic shock
Conditions indicated w/ leukopenia
lymphopenia
immunodeficiency, excess adrenocortical/corticosteroid (exogenous/endogenous), HIV, lymphatic obstruction, cancer, chemo drugs
Condition indicated by RBC MCV < 80
microcytic anemia (iron deficiency, spherocytosis, chronic diseases)
Conditions indicated by RBC MCV > 100
macrocytic anemia (megaloblastic folate/B12 deficiency, anti-retrovirals)
Conditions indicated RBC low Hct
acute bleed
plasma volume need 12-24 hrs to equilibrate
Thrombocytopenia-related conditions associated with the following values:
- 50K-70K:
- <10K-20K:
- 50K-70K = clinical evidence of bleeding
2. <10K-20K = major spontaneous bleeding
When should a blood transfusion be considered?
Thrombocytopenia such that:
- <70K-100K w/ acute bleed OR
- <10K asymptomatic
Conditions indicated w/ thrombocytosis
Reactive or myeloproliferative disorder
Conditions associated w/ low glucose hypoglycemia
Fasting, excess insulin/sulfonylurea drugs. hepatic/renal/adrenal insufficiency, insulinomas
3 scenarios where BUN increases
Azotemias (Pre-renal, renal, post-renal)
Pre-renal: BUN/Cr > 10, hypovolemia (i.e. dehydration, cirrhosis)
Post-renal: BUN/Cr»_space; 10, obstructive uropathy
Renal: BUN/Cr < 10, kidney not excreting urea
What 2 measurements together determine volume status?
BUN & creatinine
2 scenarios where BUN decreases
Urea synthesis (liver disease, malnutrition)
Dilutional state (SIADH, 3rd trimester preg)
What does creatinine measure?
What does it mean if it’s elevated compared patient’s baseline?
Kidney/renal fx
Loss of renal fx
Conditions indicated with abnml Na+
Neurologic issues (i.e. seizures, trauma)
Define hypovolemic vs euvolemic vs hypervolemic hyponatremia (low Na)
Hypovolemic: GI / renal loss
Euvolemic: SIADH
Hypervolemic: congestive heart failure, cirrhosis, CKI