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Medical Conditions 1 > Lab tests and values > Flashcards

Lab tests and values Flashcards

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USMLE® Step 1 flashcards
1
Q

What does a complete blood count look at mainly

A
  • RBCs
  • WBCs
  • Platelets
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2
Q

When looking at the RBCs in a CBC what are things that are looked and explain each?

A
  • hemoglobin: carries oxygen; if there is a lack of hemoglobin there is impaired oxygen transport which can cause shortness of breath , discoloring, fatigue etc.
  • Hematocrit: percentage of RBC in the blood; closely related to hemoglobin
  • ferritin: looks at iron levels
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3
Q

When looking at the WBCs in a CBC what are things that WBCs are responsible for and where are they made?

A
  • defense systems
  • when increased there is an active infection
  • production in bone marrow
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4
Q

When looking at the platelets in a CBC what are things that are considered/platelets are import for?

A
  • initiate clotting
  • local vasoconstriction
  • useful for tissue healing
  • increase/decrease can impair these functions
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5
Q

What are the tests included in Red cell indices

A
  • MCV
  • MCH
  • MCHC
  • RDW
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6
Q

MCV

A
  • defines the size of red blood cells
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7
Q

MCH

A
  • quantifies the amount of hemoglobin per red blood cell
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8
Q

MCHC

A
  • indicates the amount of hemoglobin per unit volume (correlates the hemoglobin content with the volume of the cell)
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9
Q

RDW

A
  • represents the coefficient of variation of the RBC volume distribution and is expressed as a percentage
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10
Q

what is anemia vs polycythemia

A
  • anemia: decreased RBC
  • polycythemia: increased RBC
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11
Q

causes of anemia

A
  • anemia (low iron)
  • hemorrhage
  • leukemia
  • cancer
  • pregnancy
  • overhydration
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12
Q

what are some causes of polycythemia

A
  • dehydration
  • congenital
  • smoking
  • high altitude
  • often occurs as an over compensation
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13
Q

Normal hemoglobin for
- males
- females

A
  • males: 14-17.4 g/dL
  • females: 12-16 g/dL
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14
Q

low hemoglobin levels

A
  • < 8 g/dL = transfusion
  • some facilities may use 10 g/dL
  • a physician may prescribe exercise at 6 g/dL
  • expect decreased exercise tolerance
  • possible orthostatic hypotension
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15
Q

Hematocrit
- what is it
- normal values
- what occurs if it is low

A
  • percentages of total volume of RBCs relative to the total volume of whole blood
  • males: 42%-52% and females 37-47%
  • if low include other signs and symptoms as part of clinical decision-making process
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16
Q

What is the normal range for WBC

A
  • 5-10x10 ^9/L
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17
Q

leukocytosis

A
  • increased WBC
  • > 11x10 ^9/L
  • consider infection, inflammation, necrosis
  • participation in PT based on clinical decisions
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18
Q

Leukopenia

A
  • decreased WBC
  • <4x10 ^ 9/L
  • exercise may be limited or contraindicated
  • possible reverse isolation
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19
Q

Neutropenia

A
  • neutrophils are low
  • neutropenic precautions (facility dependent)
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20
Q

Neutrophilia

A
  • most common cause of elevated WBC
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21
Q

Eosinophilia

A

parasitic infection
- or toxomytosis which is spread through feces of bats and other animals
- can also be elevated with with allergies

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22
Q

Basophilia

A
  • very uncommon
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23
Q

Monocytosis

A
  • end of acute infection or with chronic infections
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24
Q

Lymphocytosis

A
  • acute viral infections
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25
Q

Neutropenia causes and precautions

A
  • prolonged infection; splenomegaly; some medications
  • precautions
  • < 2,000 unable to fight infection adequately
  • < 500 (agranulocytosis) - risk of opportunistic infections (skin, mouth, pharynx, lungs)
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26
Q

lymphopenia (give a significant value)

A

< 200 indicates HIV –> AIDS

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27
Q

Platelets: Normal ranges

A
  • 140-400 k/uL
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28
Q

Thrombocytosis

A
  • elevated platelets
  • > 450 k/uL
  • can be elevated with acute infection
  • asymptomatic until >1,000,000
  • > 600,000 may be related to myeloproliferation disorders (bone marrow)
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29
Q

Thrombocytopenia

A
  • <150
  • risk of bleeds
  • <20 k/uL team approach to determine need for transfusion prior to mobility
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30
Q

Basic Metabolic Panel (BMP): purpose

A
  • tests electrolyte levels, acid-base balance, blood sugar, and kidney status
31
Q

What electrolyte levels does the BMP look at

A
  • Na
  • K
  • Cl
  • CA
32
Q

Sodium

A
  • extracellular cation (Na+)
  • important for fluid balance, acid-base balance, serum osmolarity
  • important at neuromuscular junction
33
Q

Hyponatremia: causes

A
  • inadequate Na+ intake
  • excessive water intake (dilutes)
  • diuretics
  • renal failure
34
Q

Hyponatremia: effects

A
  • confusion
  • mental status changes
  • weakness
  • hypotension
35
Q

Hypernatremia: causes

A
  • diet
  • dehydration
  • excessive sweating (losses water)
  • thermal burns
  • ADH insufficiency
36
Q

Hypernatremia: effects

A
  • muscle weakness
  • restlessness
  • extreme thirst
  • confusion
  • lethargy
  • irritability
  • seizures
  • unconsciousness
37
Q

Potassium: overview

A
  • major intracellular cation
  • maintains hydration, osmotic pressure
  • important for skeletal and heart muscle contraction
  • Na-K pump
38
Q

Hyperkalemia: causes

A
  • excessive intake
  • long term heparin use
  • adrenal gland insufficiency
  • impaired kidney function
  • crush injuries
  • burns
39
Q

hyperkalemia: effects

A
  • ECG changes
  • nausea
  • diarrhea
40
Q

Hypokalemia: causes

A
  • loop diuretics
41
Q

hypokalemia: effects

A
  • cardiac arrhythmia
  • dyshythmia
42
Q

Chloride

A
  • extracellular anion
  • electrical neutrality of extracellular fluid
  • Cl levels being off are mostly caused by a metabolic issue
43
Q

Hypochloremia: causes

A
  • over hydration
  • Addison’s disease
  • heart failure/lung disease
  • metabolic alkalosis
44
Q

Hyperchloremia: causes

A
  • hyperventilation
  • dehydration
  • kidney dysfunction
  • metabolic acidosis
45
Q

Calcium

A
  • mineral
  • strong bones and health teeth
  • important for neuromuscular activity (relaxation and contraction)
  • neural transmission
  • plays a role in blood clotting
46
Q

Hypocalcemia: causes

A
  • hypoparathyroidism (PTH, calcitonin)
  • inadequate Ca++, vitamin D intake (need Vitamin D needed for Ca absorption)
  • rickets, tetany
47
Q

hypocalcemia: effects

A
  • dry skin, course hair, and nails that easily break
  • muscle cramps, spasms, or stiffness
  • tingling in the lips, tongue, fingers and feet
  • arrhythmia
48
Q

Hypercalcemia: causes

A
  • hyperparathyroidism
  • tumors
  • osteoporosis
  • immobility
  • excess Ca or Vitamin D
  • paget’s disease
49
Q

Hypercalcemia: effects

A
  • constipation
  • Nausea and vomiting
  • abdominal pain
  • loss of appetite
  • more frequent urination
  • increased thirst
  • confusion
50
Q

Kidney functions tests

A
  • BUN (Blood Urea Nitrogen)
  • creatinine
51
Q

BUN

A
  • waste product of protein metabolism
  • related to protein intake
52
Q

What causes an increase in BUN

A
  • increased protein intake
  • dehydration
  • starvation
  • catabolism
  • burns
  • GI bleed
53
Q

What causes a decrease in BUN

A
  • pregnancy
  • over hydration
  • liver disease
54
Q

Creatinine

A
  • waste production of muscle metabolism
  • usually increased in renal disease
  • not related to protein intake
55
Q

What causes increase in creatinine

A
  • Muscle degeneration
  • Rhabdomyolysis
  • Steroid use
56
Q

What causes decrease creatinine

A
  • decrease muscle mass
  • muscular dystrophy
  • myasthenia gravis
  • starvation
57
Q

BUN/Creatinine Ratio

A
  • assessment of liver and kidney
  • increased with dehydration, glomerulonephritis, burns
  • Decreased with liver disease, muscle injury, renal dialysis, malnutrition
58
Q

BUN/Creatinine Ratio
and PT implications

A
  • changes may impair exercise tolerance
  • include with other signs and symptoms to make a clinical decision
  • dialysis
  • > 20 signifies volume depletion
59
Q

Glucose tests

A
  • Fasting blood sugar
  • 2 hour postprandial blood sugar (after eating)
  • oral glucose tolerance test
  • HbA1c
60
Q

Fasting blood sugar level for diabetic

A
  • > 126 dx for diabetes
61
Q

2 hour postprandial blood sugar (after eating)

A
  • > 200 dx for diabetes
62
Q

oral glucose tolerance test

A
  • fixed amount of glucose consumption that is measured at fixed intervals
  • should return to normal within 2 hours
63
Q

HbA1c

A
  • blood sugar concentration over period of many days
  • Normal <5.7%
  • prediabetes (metabolism syndrome): 5.7-6.4%
  • Diabetes >6.5
  • determines fraction of hemoglobin containing bound glucose
  • reflect average over weeks or months
  • A1c > 7% usually requires oral hypoglycemic agents
64
Q

Glucose: normal and other important levels

A
  • normal 70-100 mg/dL
  • <100 mg/dL considered unsafe for exercise and must consume simple sugar
  • < 60 mg/dL may lead to diabetic shock
  • > 300 mg/dL may lead to ketoacidosis (glucose will broken down into ketones)
65
Q

Hypoglycemia symptoms

A
  • activation of sympathetic nervous system
  • diaphoresis
  • tachycardia
  • increased RR
  • hypotension
  • visual changes
  • seizures
  • unresponsiveness
66
Q

Hyperglycemia symptoms

A
  • related to dehydration and acidosis
  • lethargy
  • acetone breath
  • dehyrdation
  • polyuria
  • thirst
  • confusion
  • nausea
  • vomiting
  • kussmaul breathing
67
Q

Bicarbonate: acid-base balance

A
  • produced in the reaction between CO2 and water
  • low indicates metabolic acidosis
68
Q

Respiratory acidosis

A
  • pH < 7.35
  • P CO2 >45 mmHg
69
Q

Respiratory alkalosis

A
  • pH > 7.5
  • Pa CO2 < 35 mmHg
70
Q

Metabolism Acidosis

A
  • pH < 7.35
  • HCO3 < 22 mm/L
71
Q

Metabolic alkalosis

A
  • pH>7.5
  • Pa CO2 > 26 mmL
72
Q

what does a comprehensive metabolic panel look at that a basic metabolic panel does not

A
  • BMP + liver test and functions + ammonia
  • bilirubin
  • total protein
  • albumin
  • serum Enzymes
  • Ammonia
73
Q

Inflammatory markers: 3 most common test

A
  • C-reactive protein
  • erythrocyte Sedimentation rate (sed rate)
  • plasma viscosity
  • indicate some type of inflammation but not specific
74
Q

Nonspecific tests of inflammation look at what conditions

A
  • inflammatory bowel disease
  • certain types of arthritis such as rheumatoid
  • autoimmune disease such as SLE
  • polymyalgia rheumatica
  • temporal arteritis
  • suspected infections
  • cancer
  • infection

Medical Conditions 1 (16 decks)

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