Lab Values Flashcards
Lab values can be an indicator of…
change in health status
Pharmacist’s role with lab values:
- review labs for trends and abnormalities
- suggest med adjustments
- monitor therapy
What are some terms that indicate high values?
- hyper
- __cytosis
What are some terms that indicate low values?
- hypo
- ___ penia
What does a basic metabolic panel (BMP) measure?
- electrolytes
- acid-base balance
- kidney function
- blood sugar
What is a BMP also known as?
fishbone diagram
Normal range for Na+:
135-145 mEq/L
Normal range for K+:
3.5-5 mEq/L
Normal range for Cl-:
95-105 mEq/L
Normal range for HCO3-:
22-28 mEq/L
Normal range for BUN:
10-20 mg/dL
Normal range for sCr:
0.6-1.2 mg/dL
Normal range for glucose:
70-99 mg/dL
Normal range for Ca2+:
8.5-10.5 mg/dL
Sodium is the primary…
extracellular cation
Function of sodium:
balance fluids
Common causes of hypernatremia:
- fluid loss
- decreased fluid intake
- meds like corticosteroids, laxatives, IV fluids
Quick elevations in sodium leads to…
- coma
- seizure
- death
Treatment for hypernatremia:
- rehydration
- reduce sodium intake
Common causes of hyponatremia:
- excess body fluid
- meds like carbamazepine, thiazide and loop diuretics, and vasopressin
Sodium levels < 115 mEq/L leads to…
- confusion
- lethargy
- coma
- death
Potassium is the primary…
intracellular cation
Functions of potassium:
- nerve and muscle excitement
- acid base balance
High or low potassium levels can lead to…
cardiac arrest
Common causes of hyperkalemia:
- decreased potassium excretion (indicates renal failure)
- acidosis
- cell damage
- meds like ACE inhibitors, and ARBs
Treatments for hyperkalemia:
- sodium polystyrene
- sodium zirconium
Common causes of hypokalemia:
- increased loss via diarrhea or vomiting
- alkalosis
- meds like thiazide and loop diuretics and insulin
Chloride is the primary…
extracellular anion
Hyperchloremia or hypochloremia indicates issues with…
acid base balance
Functions of chloride:
- electrical neutrality
- water balance
- acid-base balance
Common causes of hyperchloremia:
- dehydration
- decreased loss or excretion via renal failure
- acid base disorders (respiratory alkalosis or metabolic acidosis)
Common causes of hypochloremia:
- increased fluid
- acid base disorders (respiratory acidosis or metabolic alkalosis)
- meds like bicarbs, loop diuretics, acid suppressants
General info on bicarbs:
- base that is renally regulated
- helps with acid base balance
Common causes of high levels of bicarb:
- hypoventilation
- vomiting
- gastric suctioning
Common causes of low levels of bicarb:
- hyperventilation
- renal failure
- diarrhea
Function of Blood Urea Nitrogen (BUN):
ratio assess renal function
- BUN:SCr is usually 20:1
Common causes of high levels of BUN:
- increased dietary protein intake
- prerenal if > 20:1
- intrinsic renal disease if between 10:1 and 20:1
Common causes of low levels of BUN:
- malnutrition
- liver disease
- SIADH
What is the function of serum creatinine (SCr)?
identify renal disorders
Common causes of high SCr:
- renal disorders
- increased protein intake/muscle mass
- rhabdomyolysis
Common causes of low SCr:
- decreased muscle mass
- malnutrition
Glucose is used to diagnose or monitor…
diabetes
Causes of hyperglycemia:
- diabetes
- high carb intake
- stress
- meds like steroids, dextrose IV fluids, and glucagon
Causes of hypoglycemia:
- fasting
- meds like insulin and sulfonylureas
What is the goal FBG for a patient with diabetes?
80-130 mg/dL
in the blood, calcium is 50% ____ and 50% ______
free and protein bound
Function of calcium:
- muscle contraction
- coagulation
- bone mineralization
Causes of hypercalcemia:
- hyperparathyroidism
- vitamin D elevation
- meds like thiazide diuretics and lithium
Causes of hypocalcemia:
- hypoparathyroidism
- renal failure
- meds like loop diuretics, calcitonin, and bisphophonates
Function of phosphorus:
- ATP
- macronutrient metabolism
Causes of hyperphosphatemia:
- renal failure
- hypoparathyroidism
- bone cancer
Causes of hypophosphatemia:
- hyperparathyroidism
- meds like phosphate binding antacids
Common causes of hypermagnesemia:
- renal failure
- meds that have magnesium for renal failure patients
Symptoms of hypermagnesemia:
- hypotension
- deep tendon reflex loss
- respiratory depression
Causes of hypomagnesemia:
- diarrhea
- vomiting
- malabsorption
- meds like diuretics
Symptoms of hypomagnesemia:
cardiac arrhythmias
Uric acid came from…
purine nucleic acid breakdown
Causes of hyperuricemia:
- increased purine production via nephrolithiasis or gout
- meds like thiazide diuretics and salicylates
Causes of hypouricemia;
- not important
- meds like allopurinol
Complete metabolic panel (CMP) provides…
more detailed picture of patient status
- 14 tests
- same as BMP, but with liver function and protein tests
What are the four liver function tests?
- alkaline phosphatase (ALP)
- alanine aminotransferase (ALT)
- aspartate aminotransferase (AST)
- total bilirubin
Alkaline phosphatase (ALP):
- found in liver, bones, and biliary tract
- becomes elevated in liver and bone disease
Alanine aminotransferase (ALT):
- mainly in liver
- elevated in liver disease or with HMG-CoA reductase inhibitors
Aspartate aminotransferase (AST):
elevated in organ disorders
Total bilirubin:
- product of hemoglobin breakdown
- high levels are caused by hemolytic disorders, hepatocellular disease
What are the three protein tests?
- total protein
- albumin
- pre-albumin
Protein tests are good for…
evaluating nutrition, liver, and kidney
Hyperproteinemia is caused by…
dehydration
Hypoproteinemia is caused by…
- malnutrition
- liver disease
- renal disease
Albumin is made in the ____ and used to recognize _____
liver, liver impairment
Pre-albumin is a faster indicator of…
change in nutrition status
Causes of leukocytosis:
- infection
- leukemia
- stress
- trauma
- meds like corticosteroids
Causes of leukopenia:
- aplastic anemia
- hypersplenism
- meds like chemotherapy and anticonvulsants
Neutrophils consists of…
segs and bands
Out of range neutrophils indicate…
- bacterial infections
- metabolic disorders
- stress
Out of range lymphocytes indicate…
- viral infections
- leukemia
Out of range eosinophils indicate:
- allergic disorders
- asthma
- parasitic infections
Out of range monocytes indicate…
- chronic infections
- leukemia or lymphoma
Out of range basophils indicate…
- hypersensitivity reactions
- inflammation
Function of hemoglobin:
carry oxygen in RBC
What is hematocrit?
% of blood volume made up of red blood cells
Causes of high levels of hemoglobin:
- severe dehydration
- intensive exercise
- smoking
- lung disorders
Causes of low hemoglobin:
- anemias
- blood loss
- hemolysis
- pregnancy
Where are platelets produced?
bone marrow
Causes of thrombocytosis:
- cancer
- splenectomy
- chronic inflammatory disorders
Causes of thrombocytopenia:
- aplastic anemia
- meds like chemo, heparin, and valproic acid
RBCs are produced in the…
bone marrow
Function of RBCs:
carry O2
Causes of erythrocytosis:
- high altitudes
- intensive exercise
Causes of erythropenia:
- anemias
- blood loss
- leukemia
