Lab and Ancillary Procedures Flashcards
___ is always asked
thyroid function
neurological conditions that can have psych symptoms
- cerebrovascular accident
- epilepsy
- neoplasms
- dementia
tests: ct/mri
endocrine conditions that can have psych symptoms
- hypothyroidism
- hyperthyroidism
metabolic or systemic conditions that can have psych symptoms
- fluid and electrolyte imbalance
- encephalopathies
toxic conditions that can have psych symptoms
- intoxication
- always rule out substance abuse!
nutritional conditions that can have psych symptoms
- vit b12 deficiency (pernicious anemia)
infections that can have psych symptoms
aids and neurosyphilis (ask sexual history!)
autoimmune conditions that can have psych symptoms
- sle
- nmda receptor encephalitis
neoplastic conditions that can have psych symptoms
pancreatic carcinoma
basic screening tests
- cbc: anemia, platelet levels
- renal fn: urinalysis, creatinine, bun
- liver fn: alp, ast, ggt
- thyroid fn
- electrolytes
- glucose
- lipid profile
- ecg
___ are contraindicated if bleeding is likely
ssri
significance of electrolytes
- ssri = hyponatermia
- antipsychotics = hypokalemia
significance of glucose testing
- baseline for side effects
- hypoglycemia
- 2nd gen antipsychotics = metabolic problems
significance of ecg
- cardiotoxicity from medications
- anxiety vs mi
neuroendocrine tests
- thyroid
- prolactin
- catecholamines
lithium can lead to ___
hypothyroidism
___ can elevate prolactin levels
second gen antipsychotics (dopamine receptor antagonists)
- prolactin is inhibited by dopamine
- presentation: amenorrhea, galactorrhea, gynecomastia
significance of catecholamine testing
- low serotonin metabolite 5-hiaa is associated with violence
- high ne and e = ptsd
kidney and liver function tests
- bun and creatinine
- important for pts on lithium
blood tests for std
- vdrl (syphilis)
- cns-vdrl: neurosyphilis
- fta-abs: antibodies for t pallidum
- hiv test
tests for benzodiazepines
- liver function
- urine drug screen (addiction)
tests for antipsychotics
- cbc: clozapine can cause for agranulocytosis
- weekly cbc and then every 2 weeks for first 6 mos
- liver/kidney fn
- ecg
tests for tcas
- cardiotoxic: ecg
tests for mao-i
- baseline bp
- can cause serotonin syndrome
tests for carbamazepine
- anticonvulsant, mood stabilizer
- pre-treatment cbc with plt
- liver fn for hepatotoxicity
tests for valproate
- liver fn (hepatotoxicity)
tests for lithium
- gold standard for bipolar disorder!
- baseline cbc, electrolytes, ecg, tft, renal fn
- fbs
- pregnancy test!!
- sodium depletion = toxic lithium levels
- therapeutic range: 0.6-1.2 mEq/L
- toxic levels: >2.0 mEq/L
when to do lumbar puncture
- sudden onset of psych symptoms
- fever + neuro symptoms = meningitis
time detectable of drugs in urine
- amphetamine 48h
- barbituates 24hrs - 3 wks
- benzodiazepine 3d
- cannabis 3d to 4wks
- cocaine 6-8 hrs
- opioids 36-72 hrs
