LAB VALUES Flashcards
vital connection of blood to cells, tissues, and organs; maintains constant environment for cell activity
The circulatory system
Functions of the blood
Transportation of gases, nutrients, waste products, hormones
Defense against infection/ carry cells and antibodies
Regulate body temperature
Form blood clots (platelets) to prevent excess blood loss
Maintenance of body fluid (pH)
Plasma (55% of blood)
Liquid component of blood
Mixture of water, sugar, fat, proteins, salts
Helps maintain body’s fluid balance
RBC (erythrocytes)
Most abundant cell in blood; produced in bone marrow
Donut-shaped
120-day lifespan
Contains hemoglobin for O2 transport
3.9-5 female, 4.3-5.6 male
WBC (leukocytes)
About 1% of total blood
Main role is fighting infection (neutrophils and lymphocytes)
Platelets (thrombocytes)
Small fragments of cells
Assist with coagulation/blood clotting by sticking together
Destroyed by liver in 8 days
157-371 female, 135-317 male
thrombocytopenia..
Too few platlets
thrombocytosis..
Too many platlets
pH < 6.8
acidosis (more hydrogen ions)
pH > 7.8
alkalosis (less hydrogen ions)
Water pH
7.0 pH (equal amounts)
Human blood pH
7.34 to 7.44 (slightly alkaline)
Both acidosis and alkalosis can lead to ..
serious illness and eventual death unless a proper balance is restored.
Blood plasma has
chemical compounds called buffers to neutralize pH
RBC’s primary role
carry oxygen to cells and tissues
RBC’s formed in
bone marrow
Production of RBC’s
erythropoiesis (life span = 120 days)
Anemia is..
too few RBC’s or low hemoglobin
Oxygen is picked up by a protein in RBC called
Hemoglobin
Too many RBC’s (high Hgb)..
Polycythemia
RBC’s are destroyed by the..
liver, part of Hgb is converted to bilirubin, excreted as bile
When excessive amounts of Hgb are broken down or biliary excretion is decreased by liver disease or biliary obstruction
plasma bilirubin rises
Rise in plasma bilirubin results in
Jaundice
% of blood volume containing RBCs (normally about 45%, 35-44 female, 38-48 male)
Hematocrit
S/S of anemia
Weakness or fatigue
Lack of energy
Fainting
Paleness (pallor)
Shortness of breath
Fast or irregular heartbeat
Cold hands or feet
S/S of polycythemia
Disturbed vision
Dizziness
Headache
Flushing
Enlargedspleen
WBC’s (leukocytes) primary..
Defense against infection
WBC’s appear
Colorless, contain a nucleus, larger than RBC’s
WBC formation stimulated by bacteria
Leucopoiesis
ingest and destroy bacteria with the formation of pus (neutrophils, eosinophils, basophils)
Granulocytes
Lymphocytes and monocytes
Agranulocytes
Monocytes
phagocytosis
produced in bone marrow
Lymphocytes
formed in lymphatic tissue
delayed hypersensitivity reactions
help to calm irritation and inflammation
WBC’s 2 main sources
Red bone marrow (granulocytes)
Lymphatic tissue (lymphocytes)
Hepatic and biliary function tests
Bilirubin – excess amounts in blood
Cholesterol
Glucose
ALP
AST
ALT
PT
LDH
GGT
Liver enzyme elevation does not correlate with..
Extent of damage or prognosis
If (LFTS) liver count is elevated could indicate..
Fatty liver
Drug-induced
Hep A
Hep B
Hep C
Autoimmune hepatitis
inherited disorders
AST (aspartate aminotransferase) is found in
High energy cells released when cells are injured
AST is NOT elevated in..
Chronic liver disease
Increased AST alone can indicate..
Myocardial infarction
Highest elevations of AST are with..
Viral hepaptitis
AST is elevated in almost ALL..
Hepatocellular diseases
More specific for liver disease than AST..
ALT (alanine aminotransferase)
Rises higher than AST in..
Hepatitis
Numbers could indicate a..
Biliary obstruction
Elevated ______ and ______ with normal ______ rules out hepatic disease
AST
LDH
ALT
Elevated ALTs could indicate
Hepatitis
Cirrhosis
Tumors
Obstruction
Which lab value is most specific for hepatocellular damage
ALT
Higher AST indicates
Cirrhosis
Metastatic ca of liver
Higher ALT indicates
Acute hepatitis
nonmalignant hepatic obstruction
GGT (Gamma Glutamyl transpeptidase) is present in..
Hepatocytes and bile duct epithelium
Elevation of GGT indicates..
Hepatocellular disease
Post hepatic Biliary obstruction
GGT is elevated in disease that cause..
acute damage to liver or bile ducts
GGT elevation in patients with acute or chronic (most sensitive indicator)..
alcohol abuse
If GGT and ALP are elevated it indicates..
Biliary obstruction
If GGT and ALTs are elevated it indicates..
Hepatocellular disease
Cellular damage causes elevation of..
LDH
Conditions that cause elevation of LDH
Obstructive jaundice
Hemolysis
Myocardial infarction
Cancer (esp. lymphoma)
Bacterial or viral meningitis
Liver damage due to cirrhosis, chronic viral hepatitis
AFP (alpha-fetoprotein) is synthesized by
Fetal liver and yolk sac
Levels of AFP should _____ during first year of life
Decrease
AFP increases normally during
Pregnancy
If AFP is elevated, it could be a marker for..
Tumors associated with various malignancies
AFP could be elevated with
Hepatocellular carcinoma (hepatoma)*
Germ cell tumors (testes** and ovaries)
Metastatic liver cancer*
Hepatoblastoma (childhood)*
High levels of AFP indicate _____
HCC (Nonseminomatous)
PT (Prothrombin time) is the time..
in seconds for plasma to coagulate or clot
PT is a clotting factor produced by the..
Liver
Vitamin ___ is needed to produce PT
K
Abnormal PT is often due to..
Liver disease (obstruction or parenchymas disease) or Warfarin (Coumadin) treatment
Other uses of PT
Determining cause of abnormal bleeding
Monitor warfarin usage
Screen for blood clotting factor deficiency
Screen for vitamin K deficiency
Monitor liver function
INR (international normalized ratio) evaluated for..
bleeding risk during/after invasive procedures
INR corrects variations of
PT due to different thromboplastin reagents
What values are monitored prior to an invasive procedure to ensure proper clotting will take place
PT, INR and platelets
Less than 1.5 is optimal for invasive procedures
1.5-2.0 is borderline
Total bilirubin =
Conjugated (direct) + unconjugated (indirect)
Increase of Unconjugated bilirubin indicates
Hepatocellular diseases and hemolytic anemias
Increased direct (conjugated) results from
Combines with plasma albumin and glucose
More specific to biliary disease and glucose
ALP increases with..
Obstructive jaundice
Choledocholithiasis
Pancreatic carcinoma
Cholangiocarcinoma
Mirizzi syndrome (impacted gallstone)
Choledochal cyst (Caroli’s Disease)
Gallbladder carcinoma
Bone growth and diseases
Pregnancy
Biliary cirrhosis
Acute hepatitis
Lab test for pancreatic function
Serum amylase
Serum lipase
Glucose tolerance test
Urinary amylase
Ketone bodies in urine: faulty metabolism
What causes a increase in amylase
Pancreatitis and salivary gland dysfunction
Renal disease
Lipase levels _____ amylase levels
Parallel
In acute pancreatitis and panc cancer lipase levels..
increase at same rate as amylase
Lipase persists _____
Longer (remains elevated)
Lipase can be evaluated in the..
Urine
Lab tests for Kidney function urine..
Urine pH
Specific Gravity
Hematuria (blood in urine)
Albuminuria (protein in urine)
Glucose (sugar in urine)
Red cell casts
White cells and white cell casts
Casts
Creatinine clearance
Uric acid
BUN and Creatine increase indicates
Renal function is abnormal
Specific gravity measures..
Kidney’s ability to concentrate urine
Hematuria (blood in urine) may indicate..
early renal disease or indicator of mass or stone
Albuminuria (protein in urine) indicates..
glomerular damage
benign and malignant neoplasms
Glucose in urine indicates..
Diabetes
renal tubule dysfunction
Red cell casts indicate..
bleeding into nephrons
renal trauma
calculi
pyelonephritis
Casts are formed as a result..
cellular debris, if in urine = tubular or glomerular issues, associated w/proteinuria and albuminuria, can have RBCs/WBCs in casts
White cells and white cell casts indicate
Inflammation
infection
tissue necrosis
Creatinine clearance determines..
glomerular filtration rate; ↓ indicates renal dysfunction, can be a muscle issue
Uric acid indicates..
gout, polycythemia, liver disease, renal disease
If GFR (glomerular filtration rate) is abnormal..
Patients CANNOT have CT/MRI contrast
White blood cell count, hemoglobin, and hematocrit is not specific to the..
Kidneys
Urea is..
produced by liver is a waste or byproduct of protein metabolism and should be excreted in urine.
Increased BUN indicates impaired..
Renal function ; directly proportional to renal function
A increase in BUN and creatinine due to decrease in GFR is..
Azotemia
Generalized blood tests..
White blood count: ↑ with bacterial infections
Platelets (thrombocytes): react to bleeding by clumping to form a blood clot, work with other coagulation factors in the body
Hemoglobin: occurs when there is extensive damage or destruction of RBC’s; can cause acute renal failure
Hematocrit: plasma/packed cell volume ratio, percentage of RBC’s
B-HCG is produced by..
trophoblastic cells (placenta)
B- hCG elevated along with AFP in conjunction with testicular mass usually indicated testicular cancer
Elevation in gestation trophoblastic disease (female pelvis)
Choriocarcinoma (female)
Elevation of PSA (prostate specific antigen) occurs with..
Prostate cancer
BPH (benign prostatic hypertrophy)
Prostatitis
Age
Prostate volume
PSA levels
<4 ng/mL = normal
4-10 ng/mL = benign/potential malignancy
>10 ng/mL = most likely cancer
PAP (Prostatic acid phosphatase) elevated in association with..
Prostate carcinoma
PAP used in conjunction with..
PSA
CEA (carcinoembryonic antigen) is a marker for
tumors (cancers)
not specific: It will increase with benign or malignant
CEA can be used to also evaluate
hepatitis, pancreatitis, colitis
Is a tumor marker for many..
malignancies, ie. Ovarian, breast, colorectal, pancreatic, lung
High TSH but decreased T3 and T4 indicates..
HYPOthyroidism
Low TSH and high T3 and T4 indicates
HYPERthyroidism
If calcium is too low PTH
increases
If calcium is too high PTH
decreases
Primary hyperparathyroidism (parathyroid adenoma)
↑ Serum parathyroid hormone (PTH)
↑ Serum calcium
Secondary hyperparathyroidism (parathyroid hyperplasia)
↑ Serum phosphates
↓ Serum calcium
