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Clin Med Final Material- Semester 2 > Lab correlation and Review: Schoenwald > Flashcards

Lab correlation and Review: Schoenwald Flashcards

1
Q

Abnormal labs are usually not called to the provider

But CRITICAL lab values are:

A

called to the provider or their nursing staff

–Critical labs are those values that are potentially life threatening to a patient

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2
Q

Critical Lab Values: Hematology

  • WBC: ____
  • HCT: ____
  • differential >___% Bands, immature cells present
A
  • WBC <2.0 or >35.0 x 10³
  • HCT <14% or >60%
  • > 30% bands, immature cells present
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3
Q

Critical Lab Values: Hematology

  • Platelets _______
  • INR >____
A
  • Platelets <20,000 or >1,000,000

- >4.0

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4
Q

Critical Lab values:
Serum glucose: < ____or >___ mg/dl

  • Serum potassium ____ mEq/L
  • Serum Sodium ______
A
  • <40 or >500 mg/dl
  • <2.5 or >6.5 mEq/L
  • <120 or >160
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5
Q

Critical Lab values:
Arterial blood gases

  • pO2 < _____ mmHg
  • pH ____
  • pCO2 ___
A

pO2 <40 mm Hg

pH <7.2 or >7.6

pCO2 <20 or >70 mm Hg

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6
Q

Critical Lab Values:

-Microbiology

A
  • Positive blood culture
  • Gram stains on CSF and body fluids
  • Positive strep screens
  • Positive influenza
  • Positive COVID 19 test
  • Positive C diff testing (+/-)
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7
Q

Microbiology report interpretation:

-what makes it unique?

A

Report interpretation different than general lab reports

Note: the status of the report

  • it might say final, Or preliminary (which means the status might change)
  • gram stain result: will be available right away
  • the culture result takes longer

-antimicrobial susceptibility report: they test the bug (organism) against different ABX (if an ABX doesn’t work it will be Resistant ®, if it shows the abx works (ie Susceptible= S)

-

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8
Q

If MIC is greater than a number, this means

A

the bug (organism) is resistant to the antibiotic

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9
Q

Pregnancy tests:

-urine test?

A
  • Measure serum/urine human chorianic gonadotropin (HCG)
  • HCG secreted by placental trophoblast after fertilization
  • HCG present as soon as 3-10 days after conception
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10
Q

Pregnancy test: HCG rises rapidly within _______

A

-rapidly rises in the first few weeks of pregnancy, serum levels generally higher than urine

  • After 30 days, HCG about the same level in either urine or serum
  • Qualitative and Quantitative tests available
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11
Q

Quantatitive HCG:

  • measures _____
  • used as a tool to assess ______
A
  • *beta subunit

- gestational age

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12
Q

Quantitative HCG is elevated in (what conditions?)

A
  • **ectopic pregnancy but generally not quite as high as normal pregnancy
  • Also used as a tumor marker-germ cell tumors (choriocarcinoma and embryonal cell cancers)
    (note: may be ordered for males in the setting of tumors)
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13
Q

Gestation:
<1 week–> HCG=
-at 4 weeks?

A
  • 5-50

- 1000-30,000

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14
Q

Limitations of pregnancy testing

A
  • Test performed too early after conception
  • Urine tests need concentrated urine to be reliable
  • False positive results from some medications (anticonvulsants, antiparkinsonian, tranquilizers)
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15
Q

Liver Disease:

  • list Diminished factors
  • ____ is elevated in the setting of liver disease
A

INR can be elevated in liver disease (since INR is dependent on vit K dependent factors (2,7,9.10)

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16
Q

DIC (disseminated intravascular Coagulation) and Fibrinolysis:
-diminished factors?

A

1, 5, 8

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17
Q

Congenital deficiency’s:

-diminished factors?

A

all of them

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18
Q

Heparin:

diminished factors?

A

Factor 2

19
Q

Warfarin:

diminished factors?

A

2,7, 9, 10, 11

20
Q

Autoimmune disease:

diminished factors?

A

8

21
Q

Vit K deficiency:

-diminished factors?

A

2,7,9,10, 11

22
Q

PT (protime)

  • normal range?
  • critical range?
A

normal 11-12.5 seconds,

>20 seconds is critical

23
Q

INR critical level=

A

> 4

24
Q

PT (protime):

  • measures which pathways?
  • used for _____ monitoring
A
  • **Measures extrinsic and common pathways (Factors II,V,VII and X)
  • Warfarin monitoring
25
Q

PT:

-elevated in ______

A

liver disease due to lack of Vitamin K dependent factors (II,VII,IX, and X)

26
Q

INR=

-normal level

A

=international normalized ratio

-Normal <1.1 -no anticoagulation

27
Q

INR:

-therapeutic range?

A

2.0-3.0 (general- may vary slightly by clinician preference and disease process)

28
Q

PTT:

  • normal?
  • Therapeutic ?
A
  • Normal 30-40 seconds,

- Therapeutic 1.5 x normal control)

29
Q

PTT:

  • measures which pathways?
  • Monitor for _____ therapy
A

intrinsic and common pathways of coag cascade

-Monitor for heparin therapy(Heparin inactivates prothrombin(Factor II)

30
Q

T/F: PTT can be used to monitor LMW heparin

A

FALSE. DOES NOT monitor low molecular weight heparin therapy (Lovenox)

31
Q

LMWH activates antithrombin and has indirect inhibition of Factor ___

A

XA

32
Q

_______ can be utilized for monitoring LMWH

A

Factor XA assay

33
Q

PTT:

measures which factors?

A

Factor II, V,VIII,IX,X,XI, and XII

34
Q

PT= _____ pathway

A

**extrinsic

35
Q

PTT= _____ pathway

A

intrinsic

PTT= partial thromboplastin time

36
Q

D-dimer:

-normal?

A

normal varies**

37
Q

D-dimer:

-describe

A

=Protein fragment present as blood clots dissolve

=Fibrin degradation product

38
Q

Ultrasensitive D-dimer test is also known as _______

A

quantitative

39
Q

D-dimer is elevated in DVT and ___

A

PE

40
Q

D-dimer has a High ______ predictive value for DVT and PE

A

**negative

41
Q

D-dimer is also utilized in _____ panel

A

**DIC panel

42
Q

Fibrinolysis (summary?)

A

Thrombin–> Fibrinogen to Soluble fibrin—> Crosslinked fibrin—> crosslinked fibrin DP’s and D-dimer**

43
Q

Common Risk Factors For Clotting(also Reasons for elevated _______

-list reasons

A

**d-dimer)

  • Major surgery or trauma
  • Hospitalization or living in a nursing home
  • Prolonged immobility—this can include long trips by plane, car, etc. or prolonged bed rest
  • Use of birth control or hormone replacement therapy
  • Broken bone, cast
  • **Pregnancy or recent childbirth
  • **Antiphospholipid syndrome
  • Certain cancers
  • Inherited clotting disorder such as **factor V Leiden mutation
  • hx of prior venous thromboembolism (VTE)
  • Obesity
  • Smoking

Clin Med Final Material- Semester 2 (22 decks)

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