Lab Bootcamp Flashcards
normal BUN
7-20 mg/dL
normal CO2
20-29 mmol/L
normal Cr
0.8-1.2 mg/dL
normal glucose
70-100 mg/dL
normal serum chloride
101-111 mmol/L
normal serum K+
3.5-5.1 mg/dL
normal serum Na+
136-144 mEq/L
panic values for sodium
<120 mEq/L or >160 mEq/L
normal Na+ range
135-145 mEq/L
s/sx of hyper/hyponatremia
weakness, brain swelling/shrinkage, lethargy, seizures
common causes of hyponatremia
diarrhea
vomiting
CKD
CHF
diuretics
SIADH
Addison’s disease
SCC of lung
Pancreatitis
SSRI
Cirrhosis
symptoms of hyponatremia
weakness, confusion, coma, lethargy
panic values K+
< 2.5 or >6.5 mEq/L
causes of hypokalemia
Elevated WBC
Decreased intake (anorexia, starvation)
GI loss (diarrhea, vomiting, laxative abuse)
skin loss (exercise, burns)
renal loss (malignant HTN, renal tumor, Cushings syndrome, diuresis, antibiotic use, dialysis, Sjogrens)
Redistribution (tx of DKA, metabolic alkalosis)
hypokalemia s/sx
muscle weakness
ileus
hyporeflexia
flat T waves
prominent U waves
causes of hyperkalemia
metabolic acidosis
tissue trauma
ACE-I/ARBs
NSAIDs
Addisons
Rhabdomyolysis
CKD/AKI
Decreased urine excretion (ESRD, ACE, spironolactone)
panic values chloride
<80 or >115 mEq/L
functions of chloride
works in acid base balance
major ECF anion
follows sodium to maintain electrical balance
when bicarb drops in metabolic acidosis –> Cl rises
hyperchloremia s/sx
lethargy
Kussmal respirations
weakness
hypochloremia s/sx
excitability of muscle fibers
hypotension
shallow breathing
tetany
causes of hypochloremia
vomiting
gastric suctioning
burns
over hydration
SIADH
Chronic respiratory acidosis
DKA
CKD
normal Bicarb levels
23-30 mEq/L
panic value bicarb
<6 mEq/L
causes of decreased bicarb levels
diarrhea
starvation
DKA
shock
dehydration
causes of increased bicarb
vomiting
gastric suctioning
aldosteronism
COPD
metabolic alkalosis
compensated respiratory acidosis
Panic value Cr
> 4 mg/dL
what is creatinine
protein by-product of muscle breakdown
causes of increased Cr
acute and chronic renal failure
decreased renal blood flow
dehydration
cefoxitin
muscle damage (rhabdo)
causes of decreased Cr
muscle wasting diseases (myasthenia graves, muscular dystrophy)
aging
malnutrition
amputation
lower in women 2/2 decreased muscle mass
potential complications of reduced GFR
anemia
blood pressure increased
calcium absorption decreases
dyslipidemia
HF
volume overload
hyperkalemia
hyperparathyroidism
hyperphosphatemia
LV hypertrophy
metabolic acidosis
normal eGFR
> 60 mL/min
medications to be adjusted in CKD
antimicrobials (sulfa, PCN)
CV agents (digoxin)
analgesics (methadone, Demerol)
insulin
drugs to avoid in CKD
tetracyclines
nitrofurantoin
spironolactone
ASA
lithium
NSAIDs
mag containing medications
normal BUN
10-20 mg/dL
panic value BUN
> 100 mg/dL
what is BUN
urea formed in liver from ammonia which is end product of protein metabolism; excreted by kidney
causes of increased BUN
AKI/CKD
CHF
dehydration
GI bleed
acute MI
urinary tract obstruction
starvation
causes of decreased BUN
liver failure
malnutrition
malabsorption syndromes
SIADH
what does BUN:Cr ratio >20 suggest
dehydration
GI bleed suggested by BUN:Cr ratio of what value
> 30 mg/dL
glucose panic values
<50 or >400 mg/dL
causes of increased glucose
infection
uncontrolled DM
bushings
stress
pancreatitis
corticosteroid therapy
thiazide diuretics
causes of decreased glucose
insulin overdose
pancreatic cancer
addison’s
hypothyroidism
liver damage
malnutrition
sepsis
normal urine pH
4.6-8.0
normal RBC urine
<3 high power field
acute presentations when you should consider UA
abdominal pain
back pain
painful or frequent urination
blood in the urine
chronic conditions to monitor UA
HTN
CKD
DM
Liver disease
UA protein level indicating proteinuria
> 150 mg/day
what does leukocyte esterase + UA indicate
presence of whole or lysed WBC in urine
what does nitrates in UA indicate
urinary nitrates reduced to nitrites by bacteria (gram - rods in sufficient number)
UA dipstick findings suggestive of UTI
increased specific gravity
more alkaline pH
presence of nitrites
presence of bacteria
presence of leukocyte esterase
blood and protein urine testes
normal WBC count
4.0-10.5
normal RBC count
4-5.8
polycythemia / erythrocytosis
increased RBC
anemia
decreased RBC
leukopenia
decreased WBC
neutrophilia
increased neutrophil
basophilia
increased basophils
thrombocytosis
increased platelets
thrombocytopenia
decreased platelets
normal hemoglobin female vs male
F: 14 + or - 2 g/dL
M: 16 + or - 2 g/dL
normal hematocrit female and male
F: 37-47%
M: 40-54%
normal MCV
80-90 fL
what is MCV; what does it tell us
mean corpuscular volume
reports cell size - how big or small
what is MCH and what does it tell us
mean corpuscular hemoglobin
reports average weight of individual red cell
causes of increased RBC
polycythemia
neonates
hypoxia
renal tumors
causes of decreased RBC
bone marrow failure
hemolysis/hemorrhage
EPO deficiency
leukemia
pregnancy
causes of decreased hgb
overhydration
iron/nutritional deficiencies
anemia
CKD
drug induced
hemorrhage
causes of increased hemoglobin
dehydration
high altitude
heavy smoker/COPD
congenital heart disease
polycythemia
causes of increased MCV
macrocytic anemia - folate deficiency, B12 deficiency
chemotherapy
causes of decreased MCV
microcytic anemia- thalassemia, iron deficiency
lead toxicity
what is RDW on CBC
red cell distribution - tells us about differences in sizes of the red cells
elevated in iron deficiency anemia and sickle cell
anisocytosis
variable size of RBCs (high RDW)
5 white cells on CBC w diff
neutrophils
lymphocytes
basophils
monocytes
eosinophils
neutrophil function and normal range
phagocytosis
5-10,000 per microliter
lymphocyte functions
immune response
antibodies
recognize and kill pathogens
stör information for future immune responses
monocyte function
phagocytosis
participation in immunologic responses
eosinophil function
respond to allergies and parasitic infections
normal eosinophil range
1-4%
normal monocyte range
1-10%
basophil function
function similar to mast cells in allergic responses
interpretations of increased neutrophils
acute bacterial infection
infammatory
toxic
hemorrhage or hemolysis
DKA
hematologic malignancies
interpretations of deceased neutrophils
viral infection
overwhelming bacterial infection (body shuts down after a while in sepsis)
bone marrow failure
exposure to radiation
aplastic anemia
drug-induced
interpretations of increased lymphocytes
acute viral infection
chronic infections
hematologic malignancies
connective tissue disorders
hyperthyroidism
splenomegaly
interpretations of decreased monocytes
aplastic anemias
interpretation of decreased eosinophils
aplastic anemia
interpretations of increased monocytes
viral infection
hematologic malignancies
lipid storage disease
interpretation of increased eosinphils
allergies/dermatological
parasitic
blood dycrasias
pernicious anemia
average platelet lifespan
5-9 days
normal range platelets
150,000 to 350,000 per mL of blood
thrombocytosis
increased platelets
thrombocytopenia
decreased platelets
what does retic count tell us
tells us if erythropoiesis is effective
reticulocytes = immature RBCs