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502 test 2 > Lab tests > Flashcards

Lab tests Flashcards

1
Q

What are normal WBC counts?

A

4-10,000 mm3

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2
Q

What would cause RBC count to be elevated?

A

Dehydration and bone marrow disorders (polycythemia Vera)

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3
Q

What conditions would cause a decrease in RBC counts?

A

Anemias, hemolysis and hemoglobinopathies

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4
Q

What are normal hematocrit ranges?

A

36-52%

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5
Q

What are normal RBC ranges?

A

3.5-5 million/mm3

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6
Q

What are normal hgb ranges?

A

12-17 grams %

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7
Q

What are the 5 different types of WBC?

A

Monocytes, eosinophils, basophils, lymphocytend neutrophils

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8
Q

What WBCs are elevated in bacterial infections?

A

Neutrophils

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9
Q

What WBCs are elevated in viral infections?

A

Lymphocytes

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10
Q

What are segmented neutrophils and what is normal range?

A
  • also known as segs or polys or PMNs (polymorphonuclears)
  • these are the most mature neutrophilic granulocytes present in circulating blood
  • 55-70%
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11
Q

What are the 4 different immature WBCs and when would you see them?

A

Band forms, metamyelocyte, myelocyte and blasts

** seen in severe infection and certain chronic and acute leukemias

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12
Q

When could you see an increase in WBCs?

A

Trauma, leukemias, infection, burns, inflammatory disease

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13
Q

When could you see a decrease in WBCs?

A

Viral infections, bone marrow disorders (aplastic anemia), lupus, autoimmune disease, vitamin b12 deficiency

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14
Q

What are normal lymphocyte ranges?

A

30-45%

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15
Q

What are normal monocytes ranges?

A

1-10%

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16
Q

What conditions can cause increase in hgb and hct?

A

Polycythemia Vera, dehydration, burns, high altitudes and smoking/COPD

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17
Q

What conditions can cause a decrease in hgb and hct?

A

Anemias ,bleeding, hemoglobinopathies, DIC and other bone marrow disorders

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18
Q

What conditions can cause an increase in platelets?

A

Myeloproliferative disorders
acute bleeding
post splenectomy

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19
Q

What conditions can cause a decrease in platelets?

A 
DIC
ITP
TTP
HIT
infection
ETOH
drug
bone marrow disorders
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20
Q

What are normal values for Fe (iron) and TIBC (total iron binding capacity) and ferritin ?

A

Fe: 150-175 mcg/dl
TIBC: 250-460 mcg/dl
Ferritin: males: 16-300 ng/ml
Females: 4-161 ng/ml

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21
Q

iron (Fe) values (Fe, TIBC and ferritin) are increased with the following conditions?

A

Hemochromatosis
Multiple transfusions
Lead poisoning
Hemolytic anemia

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22
Q

Iron (Fe) values are decreased with the following conditions

A 
Iron deficiency 
Nephrotic syndrome
Hypothyroidism 
Anemias of chronic diseases 
Chronic renal failure 
Infections
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23
Q

TIBC values are increased with:

A

Fe deficiency
Acute hepatitis
Pregnancy
Drugs (birth control pills)

24
Q

TIBC values are decreased with

A

Low protein states such as nephrotic syndrome
Anemia of chronic diseases
Hemochromatosis

25
Q

Ferritin values are increased with:

A

Hemochromatosis
Thalassemia
Multiple blood transfusions
Chronic inflammatory disorders

26
Q

Ferritin values are decreased with:

A

Fe deficiency anemia

27
Q

What is reticulocyte count? What are the normal values?

A

A reticulocyte count is a blood test that measures how fast red blood cells called reticulocyte are made by the bone marrow and released into the blood. Reticulocyte s are in the blood for about 2 days before developing into mature red blood cells.
Normal: 40-135,000 mcl

28
Q

Reticulocyte counts increased with:

A

Hemolytic anemia

Blood loss anemia

29
Q

Reticulocyte counts decreased with:

A 
Fe deficiency 
Aplastic anemia 
MDS
Pure red cell aplasia
Bone marrow suppression
30
Q

What is haptoglobin?

A

Synthesized by the liver and is a transporter of glycoproteins which serves as a carrier for free hemoglobin

31
Q

Haptoglobin decreased with:

A

HEMOLYTIC ANEMIAS such as transfusion reactions
TTP
Drugs (methyldopa)
Artificial heart valves

32
Q

What is the methylmalonic acid test?

A

This test is used to help diagnose early or mild vitamin B 12 deficiency
Normal value: 0-0.47 mcg/dl

33
Q

What is normal vitamin B 12 range? What conditions is Vitamin B 12 decreased in?

A 
Normal: 180-400 pg/ml
Pernicious anemia 
Vegans
Irritable bowel syndrome 
Gastrectomy patients
** not a great test due to wide range of normal values
34
Q

What conditions is folic acid decreased with:

A

Malnutrition
Excessive uptake (pregnancy)
Hemolytic anemia
Acute leukemia

35
Q

What conditions decrease folic acid values

A

Methotrexate
Dilantin
ETOH effects folic acid synthesis

36
Q

What is direct Coombs test and when is it positive?

A

Detects antigen-antibody complexes on the RBC
An antibody is produced that coats the patients own cells
It is positive in hemolytic anemia

37
Q

What are the liver function tests?

A 
SGOT (AST)
SGPT ( ALT)
Bilirubin direct and indirect 
Alkaline phosphatase
Albumin
38
Q

What are normal values for AST and ALT?

A

AST: 5-40 IU/L
ALT: 5-35 IU/L

39
Q

When would you see an increase in AST/ALT??

A 
Hepatocellular damage
Fatty liver
Viral hepatitis 
ETOH hepatitis 
** AST/ALT ratio often greater than 2:1 in ETOH hepatitis
40
Q

What are normal values for direct and indirect bilirubin?

A 
Direct bilirubin (conjugated): 0.1-0.3 mg/dl 
Indirect bilirubin (unconjugated): 0.2-0.7 mg/dl
41
Q

What causes an increase in direct and indirect bilirubin?

A

Direct increases with: hepatocellular damage, obstructive jaundice, drug induced cholelithiasi and primary biliary cirrhosis

Indirect increases with: Gilbert syndrome, hepatocellular damage, hemolysis and primary biliary cirrhosis

42
Q

What are normal values for alkaline phosphatase and when is it increased?

A

Normal: 30-115 IU/L

Increases in hepatocellular jaundice and chronic biliary obstruction
Markedly increased in biliary cirrhosis and intrahepatic

43
Q

What are normal values of total protein and albumin? What causes a decrease in their values?

A

Total protein: 6-8.0 g/dl
Albumin: 3.4-4.7 g/dl

Both are decreased with hepatocellular jaundice and malnutrition

44
Q

What are normal sodium values?

A

135-145 men/l

45
Q

What causes an increase in sodium?

A

Hyperaldosteronism
Dehydration from vomiting/excess sweating
Inadequate water intake

46
Q

What abnormal test(s) are involved in the intrinsic and extrinsic clotting cascade?

A

PT (extrinsic) and PTT (intrinsic)

47
Q

The following factors are measured by the PTT.

A

12, 11, 9, 8, 10, 5, 2, 1

48
Q

True or false: The PT and PTT are both elevated in the condition of DIC?

A

True
Both the intrinsic and extrinsic pathway are involved during the consumptive process. All factors are being used up in the clotting process.

49
Q

The platelet count in DIC is usually

A

Low

50
Q 
The following condition is not associated with thrombocytopenia.
ITP
TTP
DIC
Polycythemia vera
A

Polycythemia vera

51
Q 
What abnormal finding on the peripheral blood smear might you expect on a patient with DIC?
Helmut cells
Thrombocytopenia
A and B
None of the above
A

A and B
** DIC often show decreased number of platelets and presence of large platelets and fragmented red cells (schistocytes/helmut cells).
PT and PTT are often prolonged.

52
Q

What is D-Dimer used to assess and what are normal values:

A 
normal: less than 500
represents fibrin degradation of a blood clot after fibrinolysis
Increased in : 
DVT
DIC
PE
malignancy
HIGH sensitivity LOW specificity
** a negative test rules out PE, DVT but a positive test does not confirm the diagnosis
53
Q

What are normal platelet values and what does it measure in blood?

A

normal: 150-400,000
formed by megakaryocytes in the bone marrow
adhere to vessel wall when damaged which begins the clotting process

54
Q

What are normal PTT (partial thromboplastin time) values and what does it look at in blood?

A

normal 26-34 seconds

evaluates INTRINSIC and common clotting pathways

55
Q

What conditions have an prolonged PTT time?

A

deficiency in specific coagulation factors (XII, XI, IX, VII, X, V, II and I
DIC
non specific inhibitor (lupus anticoagulant)
heparin, Coumadin and direct thrombin inhibitors

56
Q

what is PT/INR and what does it measure?

A

PT= prothrombin time
normal is 11-14 seconds
most sensitive to vitamin K dependent clotting factors 2, 7, 9, and 10
used to monitor Coumadin therapy

INR (international normalized ratio)
replaces the PT for better standardization in thromboplastin reagents worldwide
elevated in liver disease, Coumadin therapy, DIC, hereditary factor deficiencies in 10, 5, 7 and 1 and massive blood transfusions

57
Q

What can increase sodium values?

A

Adrenal insufficiency
Excess free H20
SIADH
Hyperg

502 test 2 (2 decks)

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