Lab Findings Flashcards
abnormal pap
Trichomonas
HPV
Neoplasm
metabolic acidosis
Normal anion gap: Renal Tubular Acidosis, Diarrhea, Fistula, Hyperalimentation
Increased anion gap: Saliylate Rx, Sepsis, Ketoacidosis, Lactic acidosis, Methanol/Propylene Glycol
respiratory acidosis
CHF c Pulmonary Edema
Obesity-Hypoventilation
Neuromuscular disorders
COPD/Asthma, Pneumonia
adrenocortical insufficiency
CORTICOSTEROID WITHDRAWAL Infection: TB/Syphilis/HIV/Fungal Mets: Lung, Breast, Colon Adrenal abnormality including sepsis/thrombosis ACTH-deficient: Pituitary disorder
primary hyperaldosteronism (low plasma renin)
Adrenal adenoma
Bilat adrenal hyperplasia
secondary hyperaldosteronism (high plasma renin)
Dehydration
CHF
Cirrhosis
Renal disease or renal artery stenosis
alkphos elevation
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
metabolic alkalosis (elevated HCO3 and PCO2)
HypoK+ Diuretics Vomiting Cystic fibrosis Posthypercapnia Milk alkali syndrome
respiratory alkalosis (low HCO3 and PCO2)
NO HYPOXIA?: Hyperventilation/CO poisoning/Salicylate OD
HYPOXIC?: COPD/PE/Pneumonia, CHF
microcytic anemia
Fe2+-deficient Thalassemia Sideroblastic anemia Hgbpathy Pb2+ poisoning
normocytic anemia
CRF
Hypothyroidism
Mixed micro/macro anemia
macrocytic anemia
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
AST elevation
Muscle disorder Liver disease/toxicity CHF/ARF MI Pancreatitis
elevated FSH/LH
Chemo/Rad
DEC ESTRADIOL: Turner, 46XO
DEC TESTOSTERONE: Klinefelter, 46XXY, Anorchism
low FSH/LH
Hypothyroidism Pituitary adenoma DM Chronic infec ED/Malnutrition
glucosuria
DM Fanconi Cystinosis Wilson Lowe syndrome
hematuria
Hgb+, RBC-: Hgburia, Myoglobinuria
Hgb+, RBC+: UTI, Nephritis, Urolithiasis tumor
hyperbilirubinemia
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)
hypercalcemia
Hyperparathyroidism Milk alkali syndrome (Rxs like thiazides/antacids/Li2+) Hyperthyroidism Sarcoidosis Paget Mets/PNP syndrome
hypercholesterolemia
Rxs like estrogen/steroids/thiazides/Bb DM Hypothyroidism Nephrotic syndrome Familial hyperchol
hypergammaglobulinemia
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
hyperglycemia
Rxs like thiazides/estrogen/steroids Pancreatitis Cushing CRF Pheochromocytoma DM or pre-DM if inc FBG
hyperkalemia
REPEAT TEST, THEN: Rxs like ACEis/K+ supps/spironolactone/triamterene RF Hypergly Acidosis Addison
hypernatremia with osmolality < 0.7
Central DI
Nephrogenic DI
CNS lesion
hypernatremia with osmolality > 0.7
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
hypertriglyceridemia
REPEAT FASTING, THEN: EtOHism DM RF Hypothyroidism Obesity Familial hypertrigs Rxs like estrogen/steroids/thiazides/Bb/tamoxifen/isotretinoin/nucleosideogs
hypoalbuminemia
Malabsorption d/t steatorrhea Anorexia Chronic liver disease CHF Nephrotic syndrome Chronic infec Extensive burns Preg/OCPs Protein-losing enteropathy
hypocalcemia
False positive (if SrCa2+ >8.5) HypoMg2+ Hypoparathy OR pseudohypoparathy Ricketts VitD-deficient or weird metab Check for hypoalbuminemia - see card for its ddx
hypoglycemia
Rxs like insulin/oral hypoglys/ethanol Hypothy Hypopituitarism Liver disease Addison Insulinoma Malabsorption
hypokalemia
Rxs like diuretics/corticosteroids/AmphoB/gentamicin
Vomiting/diarrhea
Alkalosis
Renal tubular acidosis
Hyperaldosteronism/adrenal hyperplasia/Cushing
too much licorice….. facepalm
hyponatremia
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
LDH elevation
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
leukocytosis
INFECTION
Acute inflam like gout, RA, vasculitis, pancreatitis
Rxs like corticosteroids/epi
IF INC LYMPHOS BUT NO INFEC: Lymphocytic leukemia, Myeloid metaplasia
leukopenia
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
polycythemia
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
proteinuria
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
pyuria
PYELONEPHRITIS/CYSTITIS
IF NEG URINE CULTURE: Appendicitis, PID, Pancreatitis, Renal disease/TB/nephritis, Vaginal contamination, Interstitial cystitis
thrombocytopenia
Rxs like chemo/AEDs/thiazides/Au+/chloramphenicol
DVT/DIC/TTP
Splenomegaly d/t hypersplenism or leukemia
ITP
Collagen-Vasc disease
EtOHism
Hemolytic-Uremic syndrome
uremia
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
