Lab Di 2 test 2 Flashcards
Cholelithiasis
- 90% of all gallbladder and duct disease
2. stones or calculi in gallbladder
Choledocholithiasis
- 1 in 10 have this (cholelithiasis already)
- gallstones in common bile duct
- gives obstruction to bile flow leading to jaundice and itching
cholecystitis
- acute or chronic inflammation of GB impacting cystic duct
- acute= middle age
- chronic = old
gallstone ileus
- are
2. gallstone into intestine causing blockage
billary cirrhosis
- ascending infection of bilary system
- leads to obstructive jaundice
- involves portal and periportal system
stone analysis
cholesterol
diagnosis
US
stone analysis
Bile Pigment Stones
diagnosis
HIDA scan: cystic duct obstruction
stone analysis
mixed
diagnosis
echography/xrays
Cardiovascular tests
categories
- MI-lab tests
- CAD/CHD
- primary and secondary HTN
- CHF
- DVT
MI Tests
current
- CK
- CKMB (CK2)
- Troponin
- Myoglobin (sometimes)
Mi Tests
classic
CPK CPK electro LDH LDH electro SGOT SGPT
Post MI lab tests levels
CK
earliest increase
3-6 hours
Post MI lab tests levels
CK
max level
24-36 hours
Post MI lab tests levels
CK
return to normal
3 days
Post MI lab tests levels
CK
amplitude X normal
7x
Post MI lab tests levels
troponin
earliest increase
3- 6 hours….slightly earlier than CK
Post MI lab tests levels
troponin
Max level
12-16 hours
Post MI lab tests levels
troponin
return to normal
4-9 days
Post MI lab tests levels
troponin
Amplitude X normal
Post MI lab tests levels
AST
earliest increase
6-8 hours
Post MI lab tests levels
AST
Max Level
24-48 hours
Post MI lab tests levels
AST
Return to normal
4-6 days
Post MI lab tests levels
AST
Amplitude X normal
5x
Post MI lab tests levels
LDH
Earliest increase
10-12 hours
Post MI lab tests levels
LDH
MAX level
48-72 hours
Post MI lab tests levels
LDH
Return to normal
10-12 hours
Post MI lab tests levels
LDH
Amplitude X normal
4x
CK indications
- MI
- Skeletal Muscle disease
- Neurologic disease
Troponin indications
- chest pain due to cardiac ischemia
- specific for cardiac muscle injury
- prediction of future cardiac problems
What distinguishes cardiac from skeletal forms of troponin?
ELISA pg 39
Troponin clinical implications
- differentiation btw cardiac and non-cardiac pain
- evaluation of unstable angina
- estimation of size of an MI
- Detection of reperfusion associated with coronary recanalization
- detection of periperative MI
Myoglobin indications
- early diagnosis of a MI
2. skeletal muscle injury of disease
Myoglobin elevation indicates
- MI
- skel mm inflammation (myositis)/ ischemia
- trauma
- mm dystrophy
- seizures
- rhabdomyolysis
CAD/CHD
screening
- Cholesterol
- Triglyceride
- HDL
- Lipoprotein electro
- Lipid ratio
Cholesterol
indications
- CHD and hyperlipidemia
2. part of a lipid profile
Cholesterol
clinical considerations
- Fasting
- diet
- alcohol
hypercholesteremia
- familial
- hyperlipidemia
- hypothyroidism
- DM uncontrolled
- MI
- stress
- atherosclerosis
- biliary sclerosis
Hypocholesteremia
- malnutrition
- malabsorption
- HYPERthyroidism
- pernicious anemia
- hemolytic anemia
- septicemia
- liver disease
increased mortality risk comes with cholesterol levels are greater than
160 mg/dl
Lipoproteins
HDL, LDL, VLDL
HDL ratio ideal
3:1
LDL=
total cholesterol - (HDL+triglyceride/5)
