LAB TESTS AND VALUES HIGH YIELD

Question 1

why do we obtain tests?

Answer 1

rule out or confirm diagnosis
screening
provide baseline
monitoring therapy
monitoring homestatic functions

Question 2

common reasons to obtain tests?

Answer 2

infection
suspicions of systemic diseases
monitor disease progression
pre-operative testing

Question 3

considerations for ordering tests?

Answer 3

benefit of information obtained
cost/insurance
location of test
amount of time to obtain results
risk to patients

Question 4

what are the types of tests?

Answer 4

culture swabs
specimen
aspirate fluid
blood sample

Question 5

general interpretation of results?

Answer 5

normal

abnormal

Question 6

direct shift indicates?

Answer 6

pathological, disease state

Question 7

indirect shift indicates?

Answer 7

non-pathological

• metabolic
• medications
• non pathological factors

Question 8

interpretation of values are dependent on?

Answer 8

sex
age
race
time of day
error

Question 9

sources of error?

Answer 9

sample contamination
sample handling
amount of sample
lab error
performance of test

Question 10

how reliable is lab testing?

Answer 10

must meet stringent standards of statistical reliability

Question 11

what are the cornerstones of reliability? what can happen in the test performances as a result?

Answer 11

accuracy and precision

sensitivity and specificity

false negative, false positive

Question 12

what are the office tests?

Answer 12

random glucose finger stick
KOH/fungal culture
woods light examination
biopsies
culture swab

Question 13

name this stain:

highly sensitive (few false negative tests) but rarely organism specific

dry or formalin

Answer 13

PAS

periodic acid-schiff reaction

Question 14

name this stain:

in tandem with PAS, highest sensitivity, but not organism specific.

dry or formalin

Answer 14

gomori ntethenamine silver, silver based stain

Question 15

name this stain:

adds specificity and screens for pigmented lesions within nail matrix

dry or formalin

Answer 15

fontana masson stain, silver based

Question 16

name this stain:

augments the superior sensitivity of PAS/GMS by providing high specificity (organism ID) for targeted patient therapy

dry only

Answer 16

molecular genetic testing (PCR Assay)

Question 17

how do we properly assess lesions?

Answer 17

ABCDE

asymmetry
border
color
diameter
evolving

Question 18

what culture swabs are used as specimens for testing?

Answer 18

gram stain

culture and sensitivity

Question 19

what are the common laboratory tests?

Answer 19

hematogic
urinalysis
renal function
coagulation
liver fxn
chemistries
-electrolytes 
-metabolites
-hormones
-enzymes
other
-ESR/CRP

Question 20

what are the common panel tests?

Answer 20

CBC w or w/o differential
basic metabolic panel (BMP)
comprehensive metabolic panel (CMP)
urinanalysis (UA)

Question 21

what are the hematologic tests?

Answer 21

blood composition
RBC
WBC
granulocytes
agranulocytes
platelets 
CBC w and w/o differential 
hemoglobin (Hgb)
hematocrit (Hct)
mean corpuscular volume (MCV)
macrocytic anemia 
microcytic anemia
mean corpuscular hemoglobin (MCH)
mean corpuscular hemoglobin concentration (MCHC)
red blood cell distribution width (RDW)
neutrophils
eosinophils
basophils
lymphocytes
monocytes
erythrocyte sedimentation rate (ESR)
CRP
Hemoglobin A1c

Question 22

WBCs consist of?

Answer 22

granulocytes

agranulocytes

Question 23

what are the granulocytes?

Answer 23

neutrophils
eosinophils
basophils

Question 24

what are the agranulocytes?

Answer 24

lymphocytes

monocytes

Question 25

what does the complete blood count consist of?

Answer 25

``` RBC WBC platelet Hgb Hct MCV MCH MCHC RDW ```

Question 26

what is the increased production of RBC called? - decreased destruction - increased demands

Answer 26

polycythemia

Question 27

what is the effect of decreased production of RBC called?

Answer 27

increased destruction blood loss deficiencies in production

Question 28

increased WBC is called?

Answer 28

leukocytosis bacterial infection foreign substance

Question 29

decreased WBC is called?

Answer 29

leukopenia viral infection bone marrow deficiency

Question 30

increased platelet count?

Answer 30

thrombocytosis

Question 31

decreased platelet count?

Answer 31

thrombocytopenia

Question 32

what is this hematologic test? oxygen carrying compound contained in RBC index of oxygen carrying capacity male: 18-27 g/dl female: 12-16 g/dl evaluates anemias

Answer 32

hemoglobin (Hgb)

Question 33

what are the chemistry tests?

Answer 33

``` basic metabolic panel (BMP) creatinine creatinine clearance Blood urea nitrogen comprehensive metabolic panel alanine aminotransferase (ALT) aspartate amino transferase (AST) bilirubin ```

Question 34

what are the two types of clotting pathways?

Answer 34

extrinsic | intrinsic

Question 35

prothrombin time (PT) partial thromboplastin time (PTT) International normalized ration (INR) these are measures of?

Answer 35

blood coagulation

Question 36

what are the contents of urinalysis?

Answer 36

``` appearance pH specific gravity protein ketones glucose microscopic exam ```

Question 37

synovial fluid analysis uses what kind of test?

Answer 37

arthrocentesis

Question 38

what is the most valuable test in rheumatology?

Answer 38

arthrocentesis

Question 39

this is indicated for all undiagnosed arthritis?

Answer 39

synovial fluid analysis