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NAPLEX Prep > Lab Values and Drug Monitoring > Flashcards

Lab Values and Drug Monitoring Flashcards

1
Q

Describe a CBC

A
  • Complete blood count
  • Analyzes WBCs, neutrophils, RBCs, and platelets
  • Includes hemoglobin and hematocrit
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2
Q

Average RBC and platelet lifespan

A

RBC (120 days)

Platelet (7-10 days)

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3
Q

Describe a BMP

A
  • Basic metabolic panel

- Includes electrolytes and glucose, acid/base, and renal function

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4
Q

Draw and label the fishbone for BMP and CBC

A

[see NAPLEX guide for picture]

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5
Q

Calcium and ionized calcium normal range

A

Calcium: 8.5-10.5 mg/dL
Ionized: 4.5-5.1 mg/dL

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6
Q

Common causes for calcium increases or decreases

A

Hyper: supplementation, Vitamin D, thiazide diuretics

Hypo: steroids, long-term heparin, loop diuretics, bisphosphonates, cinacalcet, calcitonin, foscarnet, topiramate

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7
Q

Chloride normal range

A

95-106 mEq/L

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8
Q

Magnesium normal range

A

1.3-2.1 mEq/L

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9
Q

Common causes for Mg decreases

A

PPI and diuretic use, amphotericin, foscarnet, echinocandins, diarrhea, chronic alcohol intake

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10
Q

Phosphate normal range

A

2.3-4.7 mg/dL

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11
Q

Common causes for phosphate increases or decreases

A

Increased in renal failure

Decreased d/t phosphate binders, foscarnet, oral calcium intake

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12
Q

Potassium normal range

A

3.5-5 mEq/L

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13
Q

Common causes for potassium increases or decreases

A

Increased due to ACEIs/ARBs, aldosterone receptor antagonists, aliskiren, NSAIDs, cyclosporine, tacarolimus, mycophenolate, drospirenone-containing oral contraceptives, bactrim, chronic heparin use, canagliflozin, pentamidine

Decreased due to steroids, beta-2 agonists, conivaptan, diuretics, insulin, mycophenolate

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14
Q

Sodium normal range

A

135-145 mEq/L

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15
Q

Common causes for sodium increases or decreases

A

Increased due to hypertonic saline

Decreased due to carbamazepine, oxcarbazepine, SSRIs, diuretics, desmopressin

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16
Q

Bicarbonate normal range

A

Venous: 24-30 mEq/L
Arterial: 22-26 mEq/L

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17
Q

Common causes for bicarbonate increases or decreases

A

Increased due to loop diuretics, systemic steroids

Decreased due to topiramate, zonisamide, salicylate overdose

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18
Q

BUN normal range

A

7-20 mg/dL

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19
Q

Common causes for BUN increases

A

Renal impairment and dehydration (used with SCr to determine fluid status and renal function)

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20
Q

Serum creatinine normal range

A

0.6-1.3 mg/dL

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21
Q

Common causes for SCr increases or decreases

A

Increased due to drugs that impair renal function, false increase due to Bactrim and H2RAs

Decreased due to low muscle mass, amputation, hemodilution

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22
Q

Anion gap normal range

A

5-12 mEq/L

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23
Q

WBC normal range

A

4,000-11,000 cells/mm^3

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24
Q

Common causes for WBC increases or decreases

A

Increased due to systemic steroids, colony stimulating factors, epinephrine, infection or inflammation

Decreased due to clozapine, chemotherapy targeting the bone marrow. carbamazepine, cephalosporins, immunosuppressants, procainamide, vancomycin

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25
Q

Neutrophils normal range

A

45-73%

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26
Q

Bands normal range

A

3-5%

These are immature neutrophils, releases from marrow to fight infection (left shift)

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27
Q

Hemoglobin and hematocrit normal ranges

A

Hemoglobin:
Men: 13.5-18 g/dL
Women: 12-16 g/dL

Hematocrit:
Men: 38-50%
Women: 36-46%

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28
Q

Mean corpuscular volume (MCV) normal range

A

80-100 fL

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29
Q

Common causes for MCV increases or decreases

A

Increased due to B12 or folate deficiency, alcoholism, chronic liver disease, hypothyroidism

Decreased due to iron deficiency anemia, hemolytic anemia, lead poisoning, thalassemia

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30
Q

Common causes for folate decreases

A

Phenytoin/fosphenytoin, phenobarbital, primidone, methotrexate, sulfasalazine, bactrim

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31
Q

Common causes for B12 deficiency

A

PPIs, metformin, colchicine, chloramphenicol

32
Q

Describe Antifactor Xa Activity

A
  • Used to monitor LMWHs by obtaining peak anti-Xa 4 hours after dose
  • Monitoring recommended in pregnancy
  • Monitoring may be recommended in obesity, low body weight, pediatrics, elderly, or renal insufficiency
33
Q

Prothrombin time/INR normal range

A

Prothrombin time: 10-13 seconds

INR: <1.2 (for those not on warfarin)

34
Q

Drugs that may falsely elevate prothrombin time/INR

A

Daptomycin, oritavancin, telavancin

35
Q

Describe Activated Partial Thromboplastin Time (aPTT/PTT)

A

Used to monitor unfractionated heparin and direct thrombin inhibitors (e.g. argatroban)

36
Q

aPTT/PTT normal range

A

22-38 seconds

Treatment goal on heparin is 1.5-2.5x normal range

37
Q

Platelets normal range

A

150,000-400,000/mm^3

38
Q

Common causes for platelet deficiencies

A

Heparin, LMWHs, fondaparinux, glycoprotein IIb/IIIa receptor antagonists, linezolid, valproic acid, chemotherapy targeting the bone marrow

39
Q

Albumin normal range

A

3.5-5 g/dL

40
Q

Aspartate aminotransferase and alanine aminotransferase normal ranges

A

AST: 10-40 units/L
ALT: 10-40 units/L

41
Q

Bilirubin normal range

A

0.1-1.2 mg/dL

42
Q

Amylase normal range

A

60-80 units/L

43
Q

Lipase normal range

A

5-160 units/L

44
Q

Creatinine kinase/creatinine phosphokinase normal range

A

Males: 55-170 IU/L
Females: 30-135 IU/L

45
Q

Common causes for CK increases

A

Daptomycin, quinupristin/dalfopristin, statins, fibrates, emtricitabine, tenofovir, tipranavir, raltegravir, dolutegravir, telbivudine

Muscle damage, cardiac conditions

46
Q

B-Type Natriuretic Peptide Normal Range

A

<100 pg/mL or ng/L

47
Q

N-Terminal-ProBNP (NT-proBNP) Normal Range

A

Males: <61 pg/mL
Females: 12-151 pg/mL

48
Q

Total cholesterol normal range

A

<200 mg/dL

49
Q

HDL normal range

A

<40 mg/dL = low

60+ mg/dL = desirable

50
Q

LDL normal range

A

70-189

51
Q

TG normal range

A

<150 mg/dL

52
Q

C-reactive protein (CRP) normal range

A

0-0.5 mg/dL

53
Q

TSH and T4 normal ranges

A

TSH: 0.3-3 mIU/L

T4 (total thyroxine): 4.5-100.9 mcg/dL

54
Q

Common causes for TSH increases or decreases

A

Increased or decreased due to amiodarone, interferons

Increased (hypothyroidism) due to lithium, carbamazepine, oxcarbazepine

55
Q

Common causes for uric acid increases

A

Diuretics, niacin, high doses of aspirin, pyrazinamide, cyclosporine, tacrolimus, ribacirin, some pancreatic enzyme products

56
Q

Rheumatoid factor (RF) normal range

A

<40 IU/mL

57
Q

Erythrocyte sedimentation rate (ESR) normal range

A 
Males: = 20 mm/hr
Females: = 30 mm/hr
58
Q

Common drug-induced lupus erythematosus (DILE) offending agents

A

Anti-TNF agents, hydralazine, isoniazid, methimazole, methyldopa, minocycline, procainamide, propylthiouracil, quinidine, terbinafine

59
Q

CD4+ T Lymphocyte Count Normal Range

A

800-1100 cells/mm^3

60
Q

Arterial blood gas normal ranges

A 
pH: 7.35-7.45
pCO2: 35-45 mmHg
pO2: 80-100 mmHg
HCO3: 22-26 mEq/L
O2 Sat: >95%
61
Q

Amikacin (traditional dosing) usual therapeutic range

A

Peak: 20-30 mcg/mL
Trough: <5 mcg/mL

62
Q

Carbamazepine usual therapeutic range

A

4-12 mcg/mL

63
Q

Digoxin usual therapeutic range

A
  1. 8-2 ng/mL (AFib)

0. 5-0.9 ng/mL (HF)

64
Q

Gentamicin (traditional dosing) usual therapeutic range

A

Peak: 5-12 mcg/mL
Trough: <2 mcg/mL

65
Q

Lithium usual therapeutic range

A

0.6-1.2 mEq/L (up to 1.5 for acute symptoms)

66
Q

Enoxaparin usual therapeutic range

A 
VTE treatment (daily): 1-2 anti-Xa units/mL
VTE treatment (q12h): 0.6-1.2 anti-Xa units/mL
Recurrent VTE prophylaxis in pregnancy: 0.2-0.6 anti-Xa units/mL
67
Q

Phenobarbital/Primidone usual therapeutic range

A

20-40 mcg/mL

68
Q

Phenytoin/fosphenytoin usual therapeutic range

A

10-20 mcg/mL

69
Q

Free phenytoin usual therapeutic range

A

1-2.5 mcg/mL

70
Q

Procainamide, NAPA, and combined usual therapeutic range

A

4-10 mcg/ml
15-25 mcg/mL
10-30 mcg/mL

71
Q

Theophylline usual therapeutic range

A

5-15 mcg/mL

5-10 mcg/mL (neonates)

72
Q

Tobramycin (traditional dosing) usual therapeutic range

A

Peak: 5-10 mcg/mL
Trough: <2 mcg/mL

73
Q

Valproic acid usual therapeutic range

A

50-100 mcg/mL (up to 150 in some)

74
Q

Vancomycin usual therapeutic range

A

Trough: 15-20 mcg/mL for most serious infections, 10-15 mcg/mL for other infections

75
Q

Warfarin usual therapeutic range

A

2-3 or 2.5-3.5 in patients with mechanical mitral valves

NAPLEX Prep (3 decks)

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