Lab Values and Drug Monitoring - Quiz 1 Flashcards
What are the components of a fishbone diagram?
WBC, Hgb, Hct, Plt
Na, Cl, BUN, Glucose, K, HCO3, sCr
What is the difference between cytosis and penia?
Cytosis: excessive
Penia: deficiency
When is corrcted Ca used?
When albumin is low
Ca levels?
8.5-10.5
Ionized: 4.5-5.1
Mg levels?
1.3-2.1
What increases calcium levels?
- Calcium
- Vit D
- Thiazides
What decreases Ca levels?
- Long term heparin
- Loops
- Bisphosphonates
- Cinacalcet
What decreases Mg?
- PPI
- Diuretics
- Amp B
PO4 levels?
2.3-4.7
What increases phosphate levels?
CKD
K levels?
3.5-5
What increases potassium levels?
- ACEIs
- ARBS
- aldosterone receptor antagonists
- aliskirin
- SGLT2I (canagliflozin)
- Immunosuppressants (Cyclosporine, tacrolimus)
- Potassium
- Bactrim
- Drospirenone COC
What decreases potassium levels?
- beta 2 agonist
- diuretics
- insulin
- SPS
Na levels?
135-145
What increases sodium levels?
- hypertonic saline
- tolvaptan
What decreases Na levels?
- Carbamazepine
- Oxcarbazepine
- SSRIs
- Diuretics
What decreases bicarb?
Topiramate
When would you see an elevation in BUN (>20)?
Renal impairment and dehydration
BUN levels?
7-20
sCr levels?
0.6-1.3
Drugs that increase sCr?
- Aminoglycosides
- Amp B
- Cisplatin
- Colistimethate
- Cyclosporine
- Loops
- Polymixin
- NSAIDs
- Contrast dye
- Tacrolimus
- Vancomycin
Glucose levels
70-100
Anion gap levels?
5-12
What does anion gap monitor?
Increased gap indicates metabolic acidosis
What increases WBC?
Systemic steroids
What decrease WBC?
- Clozapine
- Chemo
- Carbamazepine
- Immunosuppressants
What are bands?
Immature neutrophils that fight infection (causing a left shift)
What increases eosinophils?
Asthma, inflammation, parasites
What increases basophils?
Hypersensitivity reactions
What increases lymphocytes?q
- Viral infection
- Lymphoma
What decreases lymphocytes?
- Bone marrow suppression
- HIV
- systemic steroids
What increase RBC counts?
ESAs
What decreases RBC counts?
- Chemo
- Deficiency anemias
- Hemolytic anemia
- Sickle cell anemia
What does Hgb monitor?
Decrease in Hgb -> anemia
What are normal Hgb values?
Males: 13.5-18
Females: 12-16
What is MCV for?
80-100
Increased: macrocytic (B12 or folate def)
Decreased: microcytic (iron def)
Normal iron levels?
65-150
What decreases folate levels
- Phenytoin
- Phenobarbital
- Primidone
- Methotrextate
What decreases B12?
- PPI
- Metformin
What is the Coombs test for?
Used to diagnose hemolytic anemia
What causes a positive Coombs test?
- Penicillin and cephalosporins
- Isoniazid
- L-Dopa
- Methyldopa
- Quinidine
- Quinine
- Rifampin
- Sulfonamides
What agents can cause hemolytic anemia in patietns with G6PD?
- Fava beans
- Dapsone
- Methylene blue
- Nitrofurantoin
- Pegloticase
- Primaquine
- Rasburicase
- Quinidine
- Quinine
- Sulfonamides
What does anti-Xa monitor?
LMWH and UFH
What is normal INR and what does it monitor?
<1.2 (not on warfarin)
Monitors warfarin: Increased -> bleeding risk and liver failure (if not on warfarin)
Low warfarin -> clotting risk
What agents causes a false increase in INR?
- Daptomycin
- Oritavancin
- Televancin
What does aPTT moniotr?
UFH
Lifespan of plts?
7-10 days
What decreases plt count?
- Heparin
- LMWH
- Fondaparinux
- Linezolid
- Valproate
What causes decreased albumin?
- Cirrhosis
- Malnutrition
What enzymes are released from injured hepatocytes?
- AST
- ALT
What is used to monitor for hepatic enceph?
Ammonia
What are the components of LFTs?
- Albumin
- AST
- ALT
- Tbili
- Alk Phos
What are the agents that monitor for pancreatitis?
- Amylase
- Lipase
What is used to asssess for muscle inflammation?
CPK (CK
What are the cardac enzyme and what doe they assess?
- Troponin T
- Troponin I
Used for MI diagnosis - BNP
- NT-proBNP
Markers of cardiac stress (HF)
LDL levels?
<100
Desirable HDL levels?
≥60
What are the components of a lipid panel?
- LDL
- HDL
- TG
- TC
What is CRP used for?
Marker of inflammation
What is tht
FGP indications?
Diabetes: ≥126
Prediabetes: 100-125
Fasting is ≥8hrs
Ideal A1C?
<7% (over 3 months, delayed)
What is C-peptide?
Used to differentiate T1D from T2D
T1D will have little to none
TSH levels?
0.3-3
What is used to assess for gout?
Urate
What increases TSH?
Hypothyroidism, TKI, lithium, carbamazepine
What decreases TSH?
Hyperthyroidism
Drugs that can cause lupus?
- Anti-TNF
- Hydralazine
- Isoniazid
- Methimazole
- Methyldopa
- Miinocycline
- Procainamide
- PTU
- Qinidine
- Terbinafie
What are the CD4 levels that classifies a patient as immunocompromised?
<200
What is used to diagnose HIV?
- CD4 ount
- Viral load
pH levels?
7.35-7.45
What is used for prostate cancer and BPH?
PSA levels (≥4 is positive)
What is used to indicate pregnancy?
hCG
What is used to indicate ovulation?
LH
What increases Lactic acid?
- NRTIs
- Metformin
What is used to test for Tb?
PPD or TST
What is used to diagnose syphillis?
RPR or VDRL
What outcomes can TPMT def lead to? What drgus shol be adjusted?
Myelosuppression
Azathioprine, mercaptopurine
Carbamazepine lvels?
4-12 mcg/mL
Digoxin levels?
0.8-2 ng/mL (AF)
0.5-0.9 ng/mL (HF)
Gentamicin levels?
Peak: 5-10mcg/mL
Trough: <2mcg/mL
Lithium levels?
0.6-1.2 mEq/L
Phenytoin levels?
1-2 mcg/mL
Theophylline levels
5-15 mcg/mL
Vancomycin levels?
AUC: 400-600
Severe infection: 15-20 mcg/mL
Other infection: 10-15 mcg/mL
Warafarin levels
INR 2-3