Lab Medicine Flashcards
amylase
- greatly increased in EARLY phase of acute pancreatitis
- amylase is more sensitive than lipase but less accurate
- inflammation in pancreas and salivary glands may cause amylase to enter the blood
aspartate aminotransferase (AST)
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alanine aminotransferase (ALT)
-AST:ALT = 2:1 helps confirm alcohol etiology
alkaline phosphatase (ALP)
- where do these come from: liver and bone!
- liver disease, bone mets
- add GGT test helps det. hepatic (elevated) or bone (normal)
- causes: gi obstruction, liver dz, bone dz (pagets, rickets, osteomalacia)
biliruben-direct/indirect and total
- total: if elevated, fractionate for direct and indirect levels
- indirect=unconjugated (increase PRODUCTION; impaired biliruben uptake)
- direct=conjugated (liver dysfunction; biliary obstruction)
albumin
- synth. in liver
- influenced by nutrition, renal/hepatic function
- low levels consider chronic liver dz
- increase: dehydration, shock
- decrease: low hep. synth, increased losses
lactate dehydrogenase (LDH)
- when tissue dies LDH spills into blood
- very nonspecific
- ischemic bowel
gamma-glutamyl transferase (GGT)
-
total protein
- major proteins are albumin and globulin
- causes of increase: marked dehydration, drugs
- causes of decrease: chronic liver dz, inflamm bowel dz, diet, malabsorption, alcoholism, nephrotic syndrome
lipase
- damage to liver or pancreas
- more accurate than amylase/more specific
- elevated in pancreatitis (acute/chronic)
- elevation occurs later than amylase peak
urea breath test
- test of choice to confirm eradication of h. pylori after tx
- drink urea and blow into tube
gastrin
- hormone secreted that increases gastric acid production
- used to check gastrinoma (10x normal) =pathonomonic
- also increased in hypo/achlorhydria (most common)
- decreased: antrectomy with vagotomy, hypothyroidism
SAAG gradient
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H. pylori antibody serology
- rarely used
- we have less invasive
IgA endomysial antibody test
- test while on gluten rich diet
- highly specific test for celiac dz
IgA tTG antibody test
- test while on gluten rich diet
- highly specific and sensitive for celiac dz
- used when small bowel biopsy is neg
- false pos is rare
stool culture
-
quantitative fecal test
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Clostridium difficile toxin assay
-
fungal culture
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stool for ova and parasites
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stool for occult blood (hemoccult)
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fecal leukocyte/lactoferrin
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what test is used for screening for immunity for hep B
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whats the lab assessment for an alcoholic patient
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nasogastric tube
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esophageal manometry
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abdominal paracentesis
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esophagogastroduodenoscopy (EGD)
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sigmoidoscopy/colonoscopy
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