Lab tests Flashcards
Common lab investigations
tsh, cortisol, cbc, nakcl, glu, creatinine, bicarbonate
Tsh abnormal do
t3, t4
high white count =
infection, inflammation
platelets up
stressors
Low hemoglobin
anemia, tachycardia, shortness of breath
history of cancer
ca, mg, phosphate
Drug intox
T69 ,roh, acetaminophen (mucomyst), asa.
Problem with T69
recently, doesn’t tell you when
What’s included in T69
cannabis, benzo, cocaine, amphet, opioids
Stimulant intox
wbc high, high temp, pupils dilated, high hc, high lactate, chest pain, palpitations
Lactate
mismatch between oxygen you need vs how much is circulating sepsis, eschemic bowel, hypotensive, severe stress on the body.
Heroine
small pupils, comatose, breathing slowly
25 year old on the pill, 9 h flight, palpitations, shortness of breath
PE/ DVT
Suspicion of PE
gas, chest xray, ddimer
ddimer
sensitive, negative reassuring that they don’t have a blood clot, not specific so if + = chest xray
PERC rule
age over 50, heart rate above 100, sat under 95%, unilateral leg swelling, recent surgery/trauma, prior PE/DVT, hormone use, hemoptysis
EKG young woman
psvt
when to do Trop
for heart attack, family history, big smoker
Palpit, gittery rx
salbutamol, caffeine, synthroid too high, decongestants
severe episode of palipitations, sweating, anxiety, hta, sudden shots of epin, ne, dopamine, can look like a panic attack
pohechromocytoma
high creat
acute kidney injury, dehyrdrated
Why order lab in psychiatry
Side effects of Rx, physical cause underlying the sx
First presentation of psychosis labs
T69,cbc, nakcl tsh, mg, ph, ca, creat, hiv (encephalitis), vdrl (syphilis).
Atypical presentation, formerly not mentally ill, recent infection, low grade fever
herpes encephalitis (inflammation around lining of the brain)
Herpes encephalitis what to test
lumbar puncture, head ct, viral culture
Zyprexa:
HDL, CBC, prl, liver function tests, nakcl
Liver function tests include
ast, alp, bilt
high ast alt
hepatitis
high alcaline phosphatase
bilirubine problem, blockage
high creatinine and K
kidney failure
Urine analysis no symptoms
only when old, bad historians, psychotic, unresponsive
Urine culture
only when analysis is positive
New anxiety medical conditions old man
adrenal disease, dementia, polypharmacie, parkinson, ms, stroke, epilepsy, tutors, hypoglycaemia, cancer, hyper or hypocalcémie, liver and kidney failure, pheochromocytoma
arythmmia older person
mitrial fibrillation
what to do shortness of breath, chest pain
tropo, EKG, ddmimer, chest xray
CT head scan
tumor, stroke, bleed
Suspect bleed if
anticoagulants, recent head trauma
New seizure
head scan
bradycardia
Rx (bblocker + ca channel blocker).
Personality changes
= multi infarct dementia, brain tumor
cushings
high cortisol, anxiety
addisons
low cortisol
clozapine
Glu, HDL, CBC, (leukopenia, white blood cells, especially neutrophils= increased risk for sever infection), lft
elevated mean corpuscular volume
ROH
Val
risk of hepatotoxicity, leucopenia, thrombocytopenia, high ammonia level
Li
tremors, sudation, confusion, seizure, coma
MAOI
liver fn test, hepatotoxicity
tricyclic antidepressants
CBC, NAKCl, liver fn, ekg
neuroleptic malignant syndrome
CBC (high WBC), NAKCl, BUNm creatinine, ck (high)
Eating disorder
NaK (low purge, vo)Cl (low vo), Ph (low purge, hyperparathyroidism), Glu, TSH, ALT, AST, Prot, Albun, Bun, Cr, CBC, ECG, bicarb (high, purge low hyperventilate)
Renal
Bun, Cr
Low Mg
ROH
Dementia
CBC, NakCl, liver fn, BUn, Creat, thyr, b12, folate, vddl, urine, Ct, EEG
Hypoglycemia
anxiety
Hypocalcemia
anxiety
