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Pathophysiology > Lab Values > Flashcards

Lab Values Flashcards

1
Q

List 3 different types of diagnostic tests

A
  1. Molecular test
  2. Antigen test
  3. Antibody test
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2
Q

What are molecular tests?

A

a type of diagnositc test that detect the genetic material of a virus

ex: RT-PCR test

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3
Q

what is an antigen test?

A

a diagnostic test that detects specific proteins found on the surface of the virus

also known as rapid diagnostic test

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4
Q

what is an antibody test?

A

also called serological test

a diagnostic test for antibodies that are made by the immune cells (lymphocytes) in response to a threat, such as a specific virus

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5
Q

T/F: reference values are not the same as normal values?

A

FALSE
interchangeable terms

*always compare pt values to the reference values determined at that lab

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6
Q

how are reference values established?

A
  1. test large numebrs of healthy individuals
    1. blood donors, med students, med techs, etc.
  2. results are evaluated statistically
  3. values with 2 SD of mean are typically considered normal
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7
Q

T/F: screening tests and diagnostic tests are the same thing

A

FALSE
screening tests are used to potentially ID individuals at risk

diagnostic tests confirm if those at risk individuals have the disease

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8
Q

avoid PT if fasting blood glucose levels are ______

A

>250 mg/dl

and if ketosis is present

use caution if glucose >300 mg/dl

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9
Q

what electrolyte is a critical determinant of blood volume?

A

Sodium

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10
Q

what is normal range for sodium levels in an adult?

A

135-145 mEq/L

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11
Q

elevated sodium levels can suggest _________

A

water loss or dehydration

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12
Q

depressed sodium concentrations can suggest ________

A

water retention

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13
Q

what is hypernatremia?

A

elevated sodium concentation

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14
Q

List some causes of hypernatremia

A
  1. increased fluid loss (sweating)
  2. adrenal gland dysfunction
    • increased aldosterone secretion favors Na retention
  3. limited water intake (geriatic pops)
  4. medications
    • diuretics, ACE inhibitors = favor water loss
    • ARBs = favor water retention
  5. Excessive dietary intake
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15
Q

what is hyponatremia?

A

decreased sodium concentration

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16
Q

List some causes of hyponatremia

A
  1. excessive water intake (hypervolemia)
  2. CHF, kidney failure, liver disease
  3. severe vomiting and diarrhea
  4. inadequate Na intake
  5. Diuretics = bulk flow of water
  6. adrenal gland dysfunction (addison’s disease)
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17
Q

what electrolyte is important for normal function of excitable cells?

A

Potassium (K)

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18
Q

what is the normal range for K+?

A

3.5 - 5.5 mEq/L

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19
Q

how can potassium abnormalities influence physiology?

A
  1. abnormalities can change the resting membrane potential and hence the excitability of excitable cells
  2. change in potassium levels provide insight into renal and adrenal function
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20
Q

what is hyperkalemia and how can it influence physiology?

A

it is high levels of K+

brings membrane potential closer to the threshold needed for the generation of an AP

results in arrhythmias

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21
Q

what is hypokalemia and how can it influence physiology?

A

low levels of K+

leads to hyperpolarization

makes the membrane more (-) and more difficult to stimualte

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22
Q

list some conditions that can result from hyperkalemia

A
  1. abnormal HR
  2. respiratory arrest
  3. neurologic consequences
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23
Q

list some conditions that can result from hypokalemia

A
  1. palpations
  2. fatigue, leg cramps, muscle weakness
  3. flaccid paralysis
  4. N&V
  5. constipation
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24
Q

List some causes of hyperkalemia

A
  1. kidney failure
  2. hypoaldosteronism/disease of adrenal gland
  3. dietary intake
  4. NSAIDs, ARBs, diuretics
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25
Q

List some causes of hypokalemia

A
  1. diarrhea
  2. N&V
  3. Diuretics
  4. Kidney dialysis
  5. low dietary intake
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26
Q

the s/s of hyperkalemia are MURDER, list them

A
  1. Muscle cramps
  2. Urine abormalities
  3. Respiratory distress
  4. Decreased cardiac contractility
  5. EKG changes
  6. Reflexes
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27
Q

What is the reference range for Ca2+?

A
  1. 1 - 2.6 mmol/L
  2. 8 - 10 mg/dL
  3. 3 - 5.2 mEq/L
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28
Q

how would you expect Ca levels to look in an individual with hyperparathyroidism?

A

increased

increased PTH = increased osteoclast activity releasing Ca from bones and into circulation

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29
Q

What causes hypocalcemia and what are it’s short and long term effects?

A

can result from renal disease and certain meds (diuretics)

short term:

  • numbness and tingling
  • muscle cramps and tetany
  • lethargy
  • convulsions (neuromuscular instability)
  • negative chronotropic effect and ionic effect

long term:

  • osteopenia
  • OA
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30
Q

what causes hypercalcemia and what are it’s effects?

A

associated with hyperparathyroidism caused by excessive release of PTH

Effects:

  • kindey stones
  • bone pain
  • abdominal pain
  • tachycardia

Stone, bones, and groans

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31
Q

what are the normal fasting glucose levels in adults?

A

70 - 100 mg/dL

32
Q

what are the normal fasting glucose levels in elderly adults (<60)

A

80 - 110 mg/dl

33
Q

what are the normal fasting glucose levels in children and neonates?

A

children = 60 - 100 mg/dl

neonates = 40 - 80 mg/dl

34
Q

what is impaired glucose tolerance (IGT)?

A

a glucose value between 140-200 mg/dl 2 hours after drinking a glucose solution

associated with glucose resistance

increased risk for developing diabetes

35
Q

How is a glucose tolerance test performed?

A
  1. pt is fasted
  2. blood sampled
  3. pt consumes a high CHO drink
  4. blood is sampled 1-2 hrs later
    1. do serum glucose levels increase and then return to normal levels in a timely manner?
36
Q

what is hemoglobin A1c?

A

a test for long-term glycemic control

37
Q

what % are we looking out for when looking at Hemoglobin A1c?

A

7%

if it is above it means poor glucose control

6-7% is fair control

lower the better

38
Q

what blood glucose level is associated with hypoglycemia? what about hyperglycemia?

A

hypo = <70 mg/dl

hyper = >200 mg/dl

39
Q

a subject with a consistent blood glucose range between ______ and ______ is considered hyperglycemic

A

100 and 126 mg/dl

above 126 is considered to reflect diabetes

40
Q

what are the symptoms of chronic hyperglycemia?

A
  1. polyphagia (frequent hunger)
  2. polydipsia (frequent thirst)
  3. Polyuria
  4. Blurred vision
  5. fatigue
  6. weight loss
  7. poor wound healing
  8. cardiac dysrhythmias
41
Q

what is ketoacidosis?

A

develops when the use of glucose is severely limited resulting in increased break down of fats resulting in high levels of ketone bodies/ketosis

ketones lower blood pH

42
Q

What is the normal value for Creatinine in adults?

A
  1. 6 - 1.2 mg/dl (males)
  2. 5 - 1.1 mg/dl (females)
43
Q

how are normal creatinine levels maintained?

A

glomerular filtration at the kidneys

44
Q

what do elevated serum creatinine values mean?

A

suggest a decline in kidney’s capacity for excreting waste

45
Q

T/F: creatinine clearance rate decline with age

A

TRUE

46
Q

What are normal levels for blood urea nitrogen (BUN)?

A

6 - 20 mg/dl

47
Q

what is BUN a measure of?

A

measure the amount of urea nitrogen

this is a waste product of liver catabolism of amino acids present in serum

48
Q

what causes BUN levels to rise?

A

decreased renal function and decreased renal clearance

49
Q

Elevated BUN is associated with what?

A
  1. heart failure
  2. gastrointestinal bleeding
  3. hypovolemia
  4. kidney disease/failure
  5. shock
  6. urinary tract obstruction
50
Q

what is the normal range for bilirubin?

A

0.1 - 1.0 mg/dl

51
Q

what is bilrubin and what is it used to asses?

A

reddish-yellow substance formed when hemoglobin is broken down and then processed by the liver and excreted in bile

used to asses liver function

52
Q

how would liver disease/damage impact bilirubin?

A

it would reduce the amount of bilirubin that is modified in the liver and removed from the blood = bilirubin accumulates in the blood = jaundice

53
Q

List some causes of elevated bilirubin

A
  1. Increased RBC desctruction = increased bilirubin which can not be effectively dealt with
    1. sickle cell anemia
    2. hemolytic anemia
    3. transfusion reaction
  2. anatomic obstruction
    1. limits movement of bilirubin to the small intestine
    2. biliary strictures
    3. gall stones
54
Q

what is the normal reference value for albumin?

A

3.5 - 5.5 g/dl

55
Q

what is albumin?

A

a protein synthesized in the liver

transports many small charged molecules in the blood

it makes up 2/3 of blood proteins and is important in maintaining oncotic pressure

56
Q

what can cause lower-than normal levels of albumin?

A

liver disease (can’t synthesize it)

malnutrition (lack raw materials)

57
Q

List conditions that are assocaited with low serum levels of albumin

A

ascites (abdominal edema)

burns = high vascular permeability (loss from blood)

glomerulonephritis (kidney disease)

malnutrition

malabsorption syndroms (crohn disesae, celiac disease, or Whipple disease)

58
Q

what can glomerulonephritis lead to?

A

albuminuria = too much albumin in urine

shouldnt be there normally as it is normally too big to enter the tubules from the blood

59
Q

List other markers of Liver function

A

Liver panel which will include:

  • AST (aspartate aminotrasferase)
  • ALT (alanine aminotrasferase)
  • LDH (lactate dehydrogenase)
  • GGT (gamma-glutamyl transpeptidase)

*these tell us about the activity of these enzymes not their concentrations

60
Q

Increased RBC can be a result/indicative of what?

A
  1. polycythemia vera
  2. dehydration
  3. severe dirrhea
  4. poisoning
  5. pulmonary fibrosis
  6. high altitude
  7. chronic heart disease
61
Q

decreased RBC can be a result of/indicative of what?

A
  1. anemia
  2. blood loss
  3. Hodgkin’s disease
  4. multiple myeloma
  5. leukemia
  6. SLE
  7. rheumatic fever
  8. endocarditis
62
Q

what are the reference values for RBC for men/women?

A

male = 4.5 - 5.3 x 106/mm3

female = 4.1 - 5.1 x 106/mm3

63
Q

what are the reference values for hemoglobin?

A

male = 13-18 g/dl

female = 12-16 g/dl

64
Q

what is the reference value for hematocrit?

A

male = 37-49%

female = 36-46%

65
Q

T/F: A WBC count is only for neutrophils?

A

False

while it generally represents the number of neutrophils it is for all WBCs

66
Q

what value represents the body’s ability to fight infection?

A

Absolute neutrophil count (ANC)

an estimation of the number of neutrophils in the blood

67
Q

list the tests of coagulation

A 
Prothrombin time (PT)
activated partial thromboplastin time (aPPT)
68
Q

what are test of coagulation for?

A

used to determine coagulability either diagnostically or to monitor anticoagulant therapy of heparin or warfarin

run pre-surgery and when anti-coagulant therapy is given

PT = 12-15 sec

aPTT = 30-40 sec

69
Q

what is the international normalized ration (INR)?

A

developed to reduce variability in results between labs

it is a standarized method of determinig clotting time and hence bleeding risk

70
Q

INR = ______/_______

A

prothrombin test/prothrombin control

ratio of the pt’s to a normal control’s prothrombin time

71
Q

INR can be prolonged (larger) in:

A
  1. presence of anticoagulants
  2. liver dysfunction
  3. Vitamin K deficiency
  4. coagulation factors deficiency
72
Q

what is the specific gravity of urine?

A

a ratio of the density of a substance (urine)/ density of a reference substance (water)

reflects the concentration of excreted molecules in the urine

73
Q

what is the normal reference value for the specific gravity of urine in adults?

A

1.005 - 1.030

74
Q

what is the normal pH of urine (during a urinalysis)?

A

4.6 - 8.0

75
Q

a higher urine pH is indicative of what?

A

can be caused by severe vomiting

a kidney disease

some urinary tract infections

asthma

76
Q

what may cause a low urine pH?

A

severe lung disease (emphysema)

uncontrolled diabetes

aspirin overdose

severe diarrhea

dehydration

starvation

alcohol or drinking antifreeze

Pathophysiology (18 decks)

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