Intro To Basic Lab & Testing Flashcards
What test would you order if you suspected Anemia?
CBC- specifically to look at Hgb/HCT (decreased in all anemias)
Normal Hgb/HCT?
1:3 (Middle of the fish bone)
What test would you order if you suspected a Bleeding Disorder?
CBC- to look at platelets (R. Wedge of fishbone)
Low Platelets?
Thrombocytopenia
High Platelets?
Throbscytosis
What test would you order if you suspected an Infection?
CBC (WBC’s- L. wedge of fishbone)
sedimentation rate
C-reactive protein
urinalysis
What test would you order if you suspected Allergies?
CBC (looking for eosinophils)
What test would you order if you suspected Diabetes?
Blood glucose,
hemoglobin A1C,
lipid profile,
urinalysis
What test would you order if you suspected Pancreatic Disease?
Blood glucose
amylase
lipase
urinalysis
What test would you order if you suspected Liver Disease?
Blood glucose,
liver profile studies (AST, ALT)
What test would you order if you suspected Kidney Disease?
Serum chemistries, renal profile, urinalysis
What test would you order if you suspected Hypo or Hyper thyroid?
-TSH:
Thyroid Panel
Urinalysis
What test would you order if you suspected Cardiac Disease?
Serum chemistry, cardiac enzymes (CK-MB, troponin)
-Released after cardiac ischemia (3-6 hours)
Lipid profile
What is a Left Shift?
predominance of immature neutrophils (bands or stabs) with only one or two nuclear lobes separated by a thick chromatin band.
When you have more than 20% bands are seen or when the total neutrophil count is greater than 80%.
May indicate Bacterial Infection, toxemia, hemorrhage
Normal Neutrophil (PMN) % ?
60%
What is a right shift?
predominance of mature neutrophils with four nuclear lobes.
Liver disease, megaloblastic anemia, iron def. disease, more chronic problems
Normal % of Lymphocytes ?
30%
Increased Lymphocyte % can be indicative of?
virtually any viral disease,
acute and chronic lymphocytic leukemias,
immune disorders
Monocytes: involved in? % volume of leukocytes? Shape of nucleus? Increased % can be indicative of?
5% volume of leukocytes, Turn into macrophages kidney shaped nucleus Increased: Bacterial and protozoal Infections, Infectious Mono, Hodgin’s disease, Ulcerative Colitis, Regional enteritis
Eiosinophils: involved in? % volume of leukocytes? Shape of nucleus? Increased % can be indicative of?
average 2 % of leukocyte volume; involved primarily with parasitic infections and inflammatory reactions. have a bi-lobed nucleus, Increased; “NAACP” Neoplasm, Allergy, Addison’s disease, Collagen Vascular Disease, Parasites
Basophils: involved in % volume of leukocytes? Shape of nucleus? Increased % can be indicative of?
average .4% of leukocyte volume,
involved primarily in the release of histamine for inflammatory responses
have a bi or tri-lobed nucleus,
Increased:
Myeloproliferative disorders particulary Chronic myeloid leukemia.
What is the BUN:Creatinine ratio in pre-renal disease?
20:1, BUN reabsorption increased, dehydration suspected
What is the BUN:Creatinine ratio in intrarenal disease?
What is the BUN:Creatinine ratio in post-renal disease?
10-20:1; normal, can also be postrenal disease, BUN reabsorption within normal limits.
What are the electrolytes in Serum Chemistries?
Sodium, Chloride, Bicarbonate, Potassium
Affected by volume changes (fluid imbalances) in the body
Affects the acidity and alkalinity of the blood
Essential for proper activity of nerve and muscle cells (including cardiac function)
Glucose normal range
70-100
Hyperglycemia causes?
Diabetes mellitus, Cushing’s syndrome, acromegaly, inc. epinephrine, acute pancreatitis, ACTH administration.
Hypoglycemia causes?
Pancreatic Disorders, extrapancreatic tumors, hepatic disease, endocrine disorders, exogenous insulin or oral hypoglycemic agent admin, malnutrition, sepsis
Pancreatic enzymes are?
Amylase
Lipase
Inflammatory Markers?
Sedimentation Rate
C-Reactive Protein
BUN?
Blood Urea Nitrogen
Normal 5-20 mgs/dl
CR
Serum Creatinine
Normal 0.4-1.2 mgs/dl
AST?
Aspartate aminotransferase
Up to 40 units /lt
ALT?
Alanine Aminotransferase
Up to 40 units/lt
AST:ALT ratio variation in alcoholic liver disease?
Alcoholic Hepatitis AST>ALT
AST:ALT ratio variation in a liver infection?
Viral Hepatitis : ALT >AST
Thyroid Stimulating Hormone (TSH)
Normal: 0.4-6µU/Ml
secreted by the pituitary, controls the secretion of thyroxine (T4) from the thyroid gland. T4 is then converted into T3 in the gut, liver, kidneys
One case of elevated TSH?
Hypothyroidism
Alkaline Urine Causes?
infections (such as Proteus), systemic alkalosis, renal tubular acidosis
Glucose in Urine?
Positive in DM, especially when the serum glucose exceeds 200mg/dL, pancreatitis, other endocrine disorders, metabolic disturbances
Dark yellow to green, red to black Urine?
Bile or bilirubin
Erythrocytes, hemoglobin, myoblobin, food coloring, beets, cascara, iron, macrodantin/pyridium
Foamy Urine?
Proteinuria, bile salts
Cloudy Urine?
precipitates of urates, phosphates or sulfates; Pyuria, blood, mucus, biliribin
Increased Specific Gravity (urine concentration)
Increased in volume depletion, fasting, dehydration, CHF,, DM, Nephrosis
Decreased Specific Gravity (urine concentration)
Decreased in infection, compulsive water drinking, Diabetes Insipidus, Glomerulonephritis
Blood in Urine causes?
Positive in stones, tumors (benign or malignant), coagulopathy, infection, menses (contamination)
Causes of Urine Keytones?
Positive in starvation/fasting, diabetic acidosis, high fat diet, vomiting, diarrhea, hyperthyroidism, pregnancy
Causes of Urine Protein?
Positive in Kidney disease, pregnancy, fever, heavy exercise
Causes of Urine Nitrates?
bacteria in urine will convert urinary nitrate to nitrite, results in an infection in the urine
Causes of Leukocyte esterase >5/HPF WBCs in Urine?
When combined with the nitrite test, it has a predictive value for UTI of 74% if both tests are positive.
