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Clinical DDx > Lab Findings > Flashcards

Lab Findings Flashcards

1
Q

abnormal pap

A

Trichomonas
HPV
Neoplasm

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2
Q

metabolic acidosis

A

Normal anion gap: Renal Tubular Acidosis, Diarrhea, Fistula, Hyperalimentation
Increased anion gap: Saliylate Rx, Sepsis, Ketoacidosis, Lactic acidosis, Methanol/Propylene Glycol

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3
Q

respiratory acidosis

A

CHF c Pulmonary Edema
Obesity-Hypoventilation
Neuromuscular disorders
COPD/Asthma, Pneumonia

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4
Q

adrenocortical insufficiency

A 
CORTICOSTEROID WITHDRAWAL
Infection: TB/Syphilis/HIV/Fungal
Mets: Lung, Breast, Colon
Adrenal abnormality including sepsis/thrombosis
ACTH-deficient: Pituitary disorder
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5
Q

primary hyperaldosteronism (low plasma renin)

A

Adrenal adenoma

Bilat adrenal hyperplasia

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6
Q

secondary hyperaldosteronism (high plasma renin)

A

Dehydration
CHF
Cirrhosis
Renal disease or renal artery stenosis

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7
Q

alkphos elevation

A

CHECK AST/ALT/GGT, THEN:
AST and/or ALT: Liver disease, Rx
GGT: Gallstones/GB disease
all wnl, think BONE: Paget, Osteomalacia, CA
all wnl, but not bone: Perf ulcer, Bowel infarct, Preg, Hyperparathyroidism

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8
Q

metabolic alkalosis (elevated HCO3 and PCO2)

A 
HypoK+
Diuretics
Vomiting
Cystic fibrosis
Posthypercapnia
Milk alkali syndrome
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9
Q

respiratory alkalosis (low HCO3 and PCO2)

A

NO HYPOXIA?: Hyperventilation/CO poisoning/Salicylate OD

HYPOXIC?: COPD/PE/Pneumonia, CHF

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10
Q

microcytic anemia

A 
Fe2+-deficient
Thalassemia
Sideroblastic anemia
Hgbpathy
Pb2+ poisoning
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11
Q

normocytic anemia

A

CRF
Hypothyroidism
Mixed micro/macro anemia

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12
Q

macrocytic anemia

A

RETICULOCYTES WNL: B12/Folate-deficient, EtOHic, Liver disease, Rxs like chemo/sulfonamides/phenytoin/ZDV
INC RET, INC BILI = HEMOLYSIS: G6PD, Hereditary ellipto/spherocytosis, Mechanical heart valve, SLE, Viral infec; Rxs like methyldopa/PCN/quinidine
INC RET, BILI WNL = ACUTE BLOOD LOSS

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13
Q

AST elevation

A 
Muscle disorder
Liver disease/toxicity
CHF/ARF
MI
Pancreatitis
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14
Q

elevated FSH/LH

A

Chemo/Rad
DEC ESTRADIOL: Turner, 46XO
DEC TESTOSTERONE: Klinefelter, 46XXY, Anorchism

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15
Q

low FSH/LH

A 
Hypothyroidism
Pituitary adenoma
DM
Chronic infec
ED/Malnutrition
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16
Q

glucosuria

A 
DM
Fanconi
Cystinosis
Wilson
Lowe syndrome
17
Q

hematuria

A

Hgb+, RBC-: Hgburia, Myoglobinuria

Hgb+, RBC+: UTI, Nephritis, Urolithiasis tumor

18
Q

hyperbilirubinemia

A

Rx-hepatitis, EtOH-cirrhosis
HepA-C, CMV, Mono, Exotic infec
Cholecystitis/lithiasis/angitis
Pancreatic CA/Hepatoma, Biliary cirrhosis
1o or Acquired hemolytic anemia
Inherited chronic liver disease (hemochromatosis, Dubin-Johnson, Gilbert, a1AT, autoimmune hep)

19
Q

hypercalcemia

A 
Hyperparathyroidism
Milk alkali syndrome (Rxs like thiazides/antacids/Li2+)
Hyperthyroidism
Sarcoidosis
Paget
Mets/PNP syndrome
20
Q

hypercholesterolemia

A 
Rxs like estrogen/steroids/thiazides/Bb
DM
Hypothyroidism
Nephrotic syndrome
Familial hyperchol
21
Q

hypergammaglobulinemia

A 
CHECK SPEP, THEN:
INC a1: Infec
INC a2: Liver disease, Nephrosis
INC b: Liver disease, Multiple myeloma
INC gamma: Liver disease, Multiple myeloma, Leukemia, Chronic infec, Collagen-Vasc disease, MGUS
22
Q

hyperglycemia

A 
Rxs like thiazides/estrogen/steroids
Pancreatitis
Cushing
CRF
Pheochromocytoma
DM or pre-DM if inc FBG
23
Q

hyperkalemia

A 
REPEAT TEST, THEN:
Rxs like ACEis/K+ supps/spironolactone/triamterene
RF
Hypergly
Acidosis
Addison
24
Q

hypernatremia with osmolality < 0.7

A

Central DI
Nephrogenic DI
CNS lesion

25
Q

hypernatremia with osmolality > 0.7

A

CHECK URINE Na+, THEN:
>20: DM, Cushing, 1o hyperaldosteronism, Interstit renal disease, High-prot diet, Rxs like diuretics
<10: Hypervent, Excess sweating, Infec diarrhea, Lactulose malabsorption

26
Q

hypertriglyceridemia

A 
REPEAT FASTING, THEN:
EtOHism
DM
RF
Hypothyroidism
Obesity
Familial hypertrigs
Rxs like estrogen/steroids/thiazides/Bb/tamoxifen/isotretinoin/nucleosideogs
27
Q

hypoalbuminemia

A 
Malabsorption d/t steatorrhea
Anorexia
Chronic liver disease
CHF
Nephrotic syndrome
Chronic infec
Extensive burns
Preg/OCPs
Protein-losing enteropathy
28
Q

hypocalcemia

A 
False positive (if SrCa2+ >8.5)
HypoMg2+
Hypoparathy OR pseudohypoparathy
Ricketts
VitD-deficient or weird metab
Check for hypoalbuminemia - see card for its ddx
29
Q

hypoglycemia

A 
Rxs like insulin/oral hypoglys/ethanol
Hypothy
Hypopituitarism
Liver disease
Addison
Insulinoma
Malabsorption
30
Q

hypokalemia

A

Rxs like diuretics/corticosteroids/AmphoB/gentamicin
Vomiting/diarrhea
Alkalosis
Renal tubular acidosis
Hyperaldosteronism/adrenal hyperplasia/Cushing
too much licorice….. facepalm

31
Q

hyponatremia

A

IF HYPERGLY: Spurious hypona+
IF HYPOVOL: Diuretics, burns, sweat, GI loss, CF
IF NORMOVOL: Hypothy, Addison, SIADH
IF HYPERVOL: CHF, RF, Nephrotic syndrome, Liver failure

32
Q

LDH elevation

A 
CHECK CBC AND ISOENZYMES, THEN:
LD1>LD2: AMI
INC LD2-4: CHF, PE
INC LD5: Musculoskeletal, or anemia of chronic disease
LD4/5 < 1.05: Liver disease
INC AMYLASE: Pancreatitis
INC TSH: Hypothy
DEC HAPTOGLOBIN: Hemolysis
33
Q

leukocytosis

A

INFECTION
Acute inflam like gout, RA, vasculitis, pancreatitis
Rxs like corticosteroids/epi
IF INC LYMPHOS BUT NO INFEC: Lymphocytic leukemia, Myeloid metaplasia

34
Q

leukopenia

A

Rxs like AEDs/chemo/ABX/antithy/procainamide/clozapine
EVERYTHING ELSE WNL: Viral syndrome, Idiopathic, or Benign chronic neutropenia
ABNORMAL LABS: HIV, SLE, Leukemia, Multiple myeloma, Myelodysplasia, Aplastic or Pernicious anemia

35
Q

polycythemia

A 
R-L shunt
Hemochromatosis
Tobacco abuse
IF HYPOXIC: COPD, Pulm HTN, Obst sleep apnea, Pickwickian
IF LOW EPO, INC Hgb: Polycythemia vera
INC EPO: RCC, Hepatocellular carcinoma
36
Q

proteinuria

A

TRANSIENT: Overexercise, dehydration, fever, cold exposure
<30 yo: Orthostatic proteinuria
INC BUN/CREAT: Renal artery stenosis, Glom disease, Polycystic KD, Diabetic nephropathy, acute tub necrosis, Rxs like salicylates/carbamazepine/aminoglycosides
IF KIDNEYS ARE FINE: CHF, Multiple myeloma, Waldenstrom macroglobulinemia

37
Q

pyuria

A

PYELONEPHRITIS/CYSTITIS
IF NEG URINE CULTURE: Appendicitis, PID, Pancreatitis, Renal disease/TB/nephritis, Vaginal contamination, Interstitial cystitis

38
Q

thrombocytopenia

A

Rxs like chemo/AEDs/thiazides/Au+/chloramphenicol
DVT/DIC/TTP
Splenomegaly d/t hypersplenism or leukemia
ITP
Collagen-Vasc disease
EtOHism
Hemolytic-Uremic syndrome

39
Q

uremia

A

CRF d/t DM, HTN, SLE, Glomerulonephritis, Amyloidosis
ARF d/t obstruction like BPH/CA, or if not:
ARF d/t Sepsis/Shock/CHF/Cirrhosis, Rhabdo, Collagen-Vasc, Renal artery stenosis/acute tub necrosis, or Rxs like ACEis/NSAIDs/contrast/Li2+/sulfonamides/aminoglycosides

Clinical DDx (3 decks)

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