Lab Values Flashcards by Gretchen Hackett

What 3 things need to be on a lab order?

Name
Diagnosis
Time (Stat, Fasting v. Not, ect.)

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What lab value is taken at 8AM?

Cortisol

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What needs to be considered in collection of sample?

Needle gauge (20)
Correct tubes based on color (different things in tubes like anti-coags, ect.)
Temperature
Light sensitive sample

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What are the 4 types of blood tests?

Cellular components
Chemistry components
Qualitative (are you preggers)
Quantitative (shit, how far along)

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What is in the buffy coat?

Leukocytes and platelets

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What is the liquid component in which blood cells are suspended?

Plasma (55% total volume)

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What is plasma mostly made of?

Water

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That is eq. for plasma?

Plasma = Whole blood - (RBC + WBC + Platelets)

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What is serum?

Plasma minus fibrinogen and other clotting factors

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Equation for serum?

Whole blood - (RBC + WBC + Platelets + Fibrinogen + Prothrombin

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When do you order a test?

Only if it assist in diagnosing

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What are 2 things considered in test results?

Reference range: Alk phos is higher in kids, lipids in m/w
Certain states… like fasting

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What are the 4 panels discussed?

Electrolyte
CMP
BMP
HFP

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Where is most of K?

Intracellular

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What fluctiaions will show symptoms and be clinically significant?

0.2-0.3

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What can commonly make K goofy?

Diet, meds, or traumatic draw (release K when damage cells poking the damn needle around)

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What do BUN/Creatinine measure?

Kidney function (both filtered by glomerulus)

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What is reabsorbed by the tubules and can be regulated?

UREA

-Creatine reabsorption remains the same

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If BUN:Cr is over 20?

Pre-renal due to decreased blood flow to kidney

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If BUN:CR of less than 10:1?

Post-renal: Obstruction

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Where is it best to get CO2 and what does it measure?

Acid-base from arterial blood

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What should fasting glucose be?

60-100

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What can increase glucose?

Stress, meds (prednisone)

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When do you use the formula to correct Ca?

WHen albumin is under 4

-1/2 Ca is free and 1/2 is protein bound

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What is formula for corrected Ca?

0.8 (normal albumin-patient albumin) + serum Ca

Where is albumin synthesized?

Liver

With chronic illness how does albumin and globulin change?

Albumin decreases | Globulin increases

Where is alkaline phosphatase found (enzyme)?

Liver, placenta, bone

What do you use to see what organ is making extra alk phos?

GGTP (gamma-glutamyl transpeptidase) -If this is high, then probs liver, if not then bone -And obviously if preggers, placenta

If total bilirubin is high, what do you need?

Indirect and direct

What can increase conjugated or direct bilirubin?

Alcohol, gallstones, obstructive problem, liver problem

What can increase unconjugated bilirubin?

Neonatal

What measures the amount of glucose attached to RBCs by chromatography and is a measure of average glucose over previous 90 days?

Hemoglobin A1C

What is a normal A1C? What do we want A1C in diabetics?

under 6.5, under 7

What are some lipids measured?

Total cholesterol (under 200), HDL (higher better), Cholesterol/HDL, LDL, Triglycerides (under 150) -LDL, ect. really depends on other co-morbid conditions going on

What is used to see if someone is having a heart attack?

Troponin I/T- involved in contraction, cardiac sensitive

Myoglobin, sensitivity and specificty compared to CPK, when does it rise?

Mre specific and less sensitive than CPK | rises QUICKLY

What are the 3 isoenzymes of CPK?

MM, MB, BB

If you are screening for thyroid issue, what do you order?

TSH

High TSH?

Underactive thyroid

Low TSH?

Overactive thryoid

Where is TSH made and what can it differentiate?

Pituitary, primary v. secondary hypothyroidism

What is a better test than total T4 because you can rule out abnormality in binding globulins are part of the abn?

Free T4

Low Free T4?

True underactive thyroid

High free T4?

True overactive thyroid

When do you use total T3?

Suspected hyperthyroidism | -Highly metabolically active but it varies

What is ordered to monitor hyperthyroidism?

Free T3

What types of drugs do we monitory?

Narrow therapeutic window 1. Digoxin 2. Phenytoin 3. Lithium 4. Vancomycin

When are tumor markers used?

TO follow patients previously diagnosed to see their progress... they aren't suepr specific

AFP?

Hepatoma, germ cell, neoplasms

CEA?

Colon, breast, others

CA125?

Ovarian

PSA?

Prostate

What are the calculated values in a CBC?

MCV, MCH, MCHC, RDW

What does a CBC with diff include?

Number of different white cells

When are neutrophils elevated?

Bacterial infections

What do neutrophils do?

Digest bacteria

What are bands?

Immatrue neutrophils

What does it mean if you see left shift or bandemia?

Trying to make neutrophils to fight infection or a myeloproliferative disorder

High eosiniphils?

Allergies or parasite

Lymphocytes up or down?

VIRAL

RBC?

Number ciruculating in peripheral blood - 90-120 day survival

HGB?

O2 carrying capacity of blood (heme and globulin)

HCT?

% volume made by RBC

MCV?

Hct/RBC

MCH?

Mean corpuscular hemoglobin

MCHC?

(MCH concentration)- Concentration

RDW?

Average size of RBC

Anisocytosis?

SIZE difference

Poikilocytosis?

SHAPE difference

Macrocytosis?

BIG

Microcytosis?

SMAL

Hypochromic?

PALE

Hyperchromic?

DARK

WHat is number 1 cause anemia in young women?

Iron deficiency

Ferritin?

Binds iron for storage

Folate?

B vitamin needed for RBC to function

B12?

Neede to metabolize folic acid (Injections for supplement)

TIBC?

Protein available to bind free iron

Transferrin saturation?

(Serum iron * 100%)/ TIBC

Retic count?

Immature RBC- MEasure of erythropoeitc activity of BM

3 Coags?

PTT, PT, INR

PTT

Intrinsic- Heparin

Extrinsic- Common

INR?

Warfarin

What's + on dipstick of someone with UTI?

Leuks, Nitires, Blood

If you are healthy with no other issues how many organisms for a + urine culutre?

100,000

With a + test and sensitivites?

3-8 antibiotics and given MICs

What can you culture?

ANYTHING- Culture based on what you think is causing issue

What does stool culture look for?

Bacteria

What does O & P look look for?

Identify actual parasite or egg

When do you see leukocytes in poop?

Bacterial infection

What causes nasty smelly mucoidy diarrhea and pseudomembranous colitis?

C. Diff

What can cause contaigous diarrhea of inhants and small children?

Rotavirus antigen

What looks for malabsorption?

Fecal fat