Lab Final Flashcards
ESR: Reference Ranges
-Reference Range: Males <40 (1-15mm/hour)/Women <40 (1-20mm/hour)
-Reference Range >40: Males (Age/2) & Female (Age +10/2)
ESR >100 requires:
Immediate further testing, labs, imaging
Fecal Occult: How to perform
- 2 drops in Box A & B: wait 30 seconds= Blue is (+)
- 2 Drops below on +++ strip: Wait 30s = Blue (++) is confirmatory
Fecal Occult screens for:
-Colorectal cancer
-Ulcerative conditions of the GI tract
-Monitoring IDA/Recovery from surgery
UA: Color
-Milky: pus, bacteria, fat
-Red/smoky brown: Blood
-Yellow foam: Bile
-Pigments: Never normal
-White foam: Albumin
-Coca-cola colored: AGN-Streptococcal infection
UA: Turbidity
-Normal: Clear
-Abnormal: Blood, myoglobin, WBCs, mucous, bilirubin, bacteria
UA: Odor
-NL: aromatic
-Abnormal:
1. Ammoniacal: Bacterial decomposition of urine (urine retention)
2. Fruity (sweet): Ketone bodies (DM)
3. Stale Water: Advanced kidney disease
4. Foul: Bacteriuria (UTI)
UA: Specific Gravity
-NL: 1.003-1.030
-Low: Excessive Hydration (Diabetes Insipidus)
-High: Dehydration (Diabetes Mellitus), Fever-could also cause this
-Fixed @ 1.010: Advanced kidney failure
UA: pH
-NL: 4.5-8.0
-Low: Acidosis, fevers, high protein diets
-High: Alkalosis, cystitis
UA: Proteinuria
-Mostly indicative of renal disease
-Strip is sensitive to albumin
-Trace proteinuria: NOT clinically significant
Functional vs. Organic Proteinuria
-Functional proteinuria: Not associated with easily demonstratable systemic or renal damage
-Orthostatic proteinuria: MCC; Large amount of protein excreted in urine (standing) but normal sitting
-Organic Proteinuria
-Prerenal: Fever, hypertension
-Renal: Glomerulonephritis, Pyelonephritis
-Postrenal: Cystitis, urethritis, prostatitis
UA: Glycosuria
-Normal renal threshold: 180 mg/dL
-Glycosuria w/o hyperglycemia: Pregnancy
-Glycosuria w/ hyperglycemia: Diabetes Mellitus (MCC)
UA: Ketonuria
-Causes: Diabetes mellitus (type I), Starvation, Severe hydration, Kids
UA: Blood
-Hematuria: Bleeding as a result of trauma or irritation; Ie. Kidney stone-Nephrolithiasis
-Hemoglobinuria: Lysis of RBCs in urinary tract, intravascular hemolysis, or transfusion
UA: Leukocyte Esterase
-Prescence of WBCs (Inflammation): Pyuria
UA: Nitrite
-Bacteria: Gram negative
-Reductase: Nitrate->nitrite (E. Coli)
-4 hour incubation
UA: Bilirubin
-Causes: Biliary tract obstruction (cholelithiasis), Liver disease
-Unconjugated bilirubin (not soluble)
UA: Urobilinogen
-Similar significance to bilirubin
-Small amount: NL
-False +: Warm urine
Hematocrit
-Reference Range: Women (37-47%)/Men (40-54%)
-Hb x 3 = Hct
Hemoglobin
-Reference Range: Women (14.0g/dL +/-2)/Men (16.0/dL +/- 2)
-Anemia: Women (<11g/dL)/Men (<13g/dL)
-Limitations: Tourniquet on too long (>1 min), Dehydration
Monospot
-Heterophile antibody test: Rapid, inexpensive less sensitive & less specific
-CBC: Leukocytosis, Lymphocytosis (>50%), Reactive lympocytes (>10%), Thrombocytopenia
-Management: Avoid strenuous exertion-contact sports, heavy lifting, NO side posture
Neutrophil
-Elevation (Neutrophilia): Physiologic: Stress (Exposure to cold, pregnancy, drugs), Pathologic: Acute bacterial infection, general inflammation
-Decreases: Neutropenia (Viral Infections)
Lymphocyte
-Elevations: Lymphocytosis (Viral Infections)
-Decreases: Lymphocytopenia (Bacterial Infections)
Monocyte
-Elevation: Good sign; Recovery from infection
Eosinophil
-Elevation: Allergy (6-10%)/Parasite (25-30%), Malignancies
Basophil
-Elevation: Hypersensitivity reaction, myxedema, myeloproliferative conditions (CML, PCV, BAD until proven otherwise
Causes for RBCs on a microscopic exam
-Causes: AGN, Nephrolithiasis, GU malignancy, Benign prostatic hyperplasia, cystitis, pyelonephritis
-0-2/HPF
RBC Casts are associated w/:
AGN
WBCs on microscopic exam are caused by:
-Causes: Pyelonephritis, Renal TB, Cystitis
WBC Cast is associated with:
Acute pyelonephritis
Epithelial cells indicate:
Contamination
Lipid casts are associated with
Advanced kidney disease
Pseudocasts indicate
Fibre/Dust
Crystals typically have no significance
True
