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S3 - Pathophysiology > Laboratory Tests And Values > Flashcards

Laboratory Tests And Values Flashcards

1
Q

PART 1

A

PART 1

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2
Q

What are the different types of tests for SARS-CoV-2?

A
  • Molecular test
  • Antigen test
  • Antibody test
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3
Q

The molecular test detects the virus’s _________ and diagnoses active coronavirus infection.

A

genetic material

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4
Q

The antigen test detects specific _______ found on the surface of the virus. This is also known as the rapid diagnostic test and diagnoses active coronavirus infection.

A

proteins

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5
Q

The antibody test tests for specific antibodies that are made by immune cells (__________) in response to a threat. These tests are also called ________ tests. They are _________ accurate but negative tests often need to be repeated to confirm findings using a ________ test.

A
  • lymphocytes
  • serological tests
  • highly
  • molecular
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6
Q

Lab values provide a PT with _________ information. These values are gleaned from taking a ________ (chart review).

A
  • supplemental

- history

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7
Q

Knowing lab values aids a PT in developing the best _____, utilizing the most appropriate ___________, and treating the patient _______.

A
  • POC
  • interventions
  • safely
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8
Q
  • Abnormal lab values represent _________ deviations that may require modification of PT treatment plan/intervention or even contraindicate PT intervention.
  • Abnormal lab values reflect disrupted ____________.
A
  • physiological

- homeostasis

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9
Q

What are reference values?

A

Comparative ranges or “normal values”

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10
Q

Normal reference range may vary across characteristics such as what?

A
  • Age
  • Gender
  • Location
  • Ethnicity
  • Culture
  • Economic
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11
Q

Reference ranges are established by testing large number of _________ individuals.

A

healthy

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12
Q

Reference ranges within __ standard deviations of the mean are typically considered normal.

A

2

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13
Q
  • Do all ill patients fall outside the reference range?

- Do all non-ill patients fall inside the reference range?

A
  • No

- No

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14
Q

What are the 3 uses for laboratory values?

A
  • Screening
  • Diagnosis
  • Monitoring
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15
Q
  • Is screening diagnostic?
  • It is used on __________ in an effort to ________ individuals who are at risk for certain diseases.
  • For those individuals identified at risk, ________ testing should be the next step.
A
  • No
  • populations, identify
  • diagnostic
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16
Q

PART 2

A

PART 2

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17
Q

-Some lab tests are sufficiently ________ and ________ allowing for diagnosis of pathology (cardiac enzymes), while others may only be a piece of the diagnostic puzzle (CRP).

A
  • sensitive

- specific

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18
Q

Some lab values are clear _______________ for receiving physical therapy, whereas others are suggestive that therapy provided should be less physiologically __________. (Hgb and HCT; platelets)

A
  • contraindications

- demanding

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19
Q
  • What are normal blood glucose levels?

- At what blood gluose levels should we avoid physical activity?

A
  • 70-99mg/dl (fasting)
  • <140mg/dl (2hrs after meal)

-Avoid physical activity if fasting glucose is >250mg/dl and ketosis is present, and use caution if glucose levels >300mg/dl and no ketosis is present.

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20
Q

Electrolytes are present in the human body, and the balance of the electrolytes in our bodies is essential for normal function of our cells and our organs. What are 4 common electrolytes that are measured?

A
  • Sodium
  • Potassium
  • Magnesium
  • Chloride
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21
Q
  • Sodium (Na+) is a critical determinant of __________.

- What is the normal adult value?

A
  • blood volume

- 135-145mEg/L

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22
Q
  • Elevated sodium plasma concentrations can suggest water __________.
  • Depressed sodium concentrations can suggest water __________.
A
  • loss

- retention

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23
Q

-Sodium (Na+) excretion at the level of the ______ is a critical determinant of blood volume.

A

kidney

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24
Q

What is an increase/decrease in sodium concentration called?

A
  • Increase= Hypernatremia

- Decrease= Hyponatremia

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25
Q

Hypernatremia can result from:

  • _________ fluid loss (sweating)
  • _________ gland dysfunction
  • Limited H2O intake (________ population)
  • Diuretics; ACE inhibitors, ARBs
  • ________ dietary intake
A
  • increased
  • adrenal
  • geriatric
  • excessive
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26
Q

Hyponatremia can result from:

  • _________ H2O intake (hypervolemia)
  • CHF, ________ failure, liver disease (hypervolemia)
  • Severe _______ and _________
  • ________ gland dysfunction
A
  • excessive
  • kidney
  • vomiting and diarrhea
  • adrenal
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27
Q
  • Potassium (K+) is particularly important for normal function of ________ cells.
  • What is the normal range of potassium?
A
  • excitable

- 3.5-5.5mEq/L

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28
Q

Potassium abnormalities can change the __________ and hence the excitability of excitable cells.

A

RMP

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29
Q

What is an increase/decrease in potassium concentration called?

A
  • Increase= Hyperkalemia

- Decrease= Hypokalemia

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30
Q

Does hyperkalemia result in the RMP being closer or further from the AP threshold? What does this result in?

A
  • Closer

- Arrhythmias

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31
Q

Hypokalemia leads to _____polarization and makes the RMP more negative and more ________ to stimulate.

A
  • hyperpolarization

- difficult

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32
Q

Potassium Deficit Mnemonic (A SIC WALT):

  • A=
  • S=
  • I=
  • C=
  • W=
  • A=
  • L=
  • T=
A
  • Alkalosis
  • Shallow Respirations
  • Irritability
  • Confusion, Drowsiness
  • Weakness, Fatigue
  • Arrhythmias
  • Lethargy
  • Thready Pulse
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33
Q

Potassium Excess Mnemonic (MURDER):

  • M=
  • U=
  • R=
  • D=
  • E=
  • R=
A
  • Muscle cramps
  • Urine abnormalities
  • Respiratory distress
  • Decreased cardiac contractility
  • EKG changes
  • Reflexes
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34
Q
  • Calcium (Ca+) is associated with primary ______parathyroidism.
  • What is the normal range of calcium?
A
  • hyperparathyroidism

- 2.1-2.6 mmol/L

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35
Q

What is an increase/decrease in calcium concentration called?

A
  • Increase= Hypercalcemia

- Decrease= Hypocalcemia

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36
Q

Hypocalcemia can result from ______ disease.

A

renal

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37
Q

What are the results of short term deficiencies of calcium?

A
  • numbness and tingling
  • muscle cramps and tetany
  • lethargy
  • convulsions
  • negative chronotropic and ionic effect
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38
Q

What are the long term effects of hypocalcemia?

A
  • Osteopenia

- Osteoporosis

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39
Q

Hypercalcemia is associated with primary _________________ caused by excessive release of parathyroid hormone from the parathyroid gland.

A

-hyperparathyroidism

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40
Q

What is an easy way to remember how hypercalcemia presents?

A

Stones, Bones, and Groans +Tachycardia

  • Stones- kidney stones
  • Bones- bone pain
  • Groans- abdominal pain, N/V
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41
Q

PART 3

A

PART 3

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42
Q

What are the normal FASTING plasma glucose levels for:

  • Adults
  • Adults >60
  • Children
  • Neonates
A
  • Adults= 70-100 mg/dl
  • Adults >60= 80-110 mg/dl
  • Children= 60-100 mg/dl
  • Neonates= 40-80 mg/dl
43
Q

What is the standard test for determining the test of diabetes?

A

Oral Glucose Tolerance Test

44
Q
  • A glucose value between 140 and 200 mg/dL 2 hours after drinking the glucose solution is called __________ ________ __________ (___).
  • This is associated with glucose resistance and is often called ___ diabetes or type __.
A
  • Impaired Glucose Tolerance (IGT)

- pre-diabetes or Type II

45
Q

Are people with IGT at risk of developing Type I diabetes?

A

Yes, over time

46
Q

A glucose value in excess of 200 mg/dL 2 hours after drinking the glucose solution is diagnostic of Type __ DM.

A

Type I

47
Q

Do insulin levels rise/fall as glucose does?

A

Yes, unless diabetic

48
Q

Is diabetes a condition of hyper or hypoglycemia?

A

Hyperglycemia

49
Q

Describe the Oral Glucose Tolerance Test.

A
  1. ) Patient is fasted
  2. ) Blood is sampled
  3. ) Patient consumes a high CHO drink
  4. ) Blood is sampled at 60 and 120 minutes
  5. ) Does the serum glucose levels increase and then return to normal levels
50
Q

_____________ is a test of long-term glyemic control.

A

Hemoglobin A1C

51
Q

What does the Hemoglobin A1C test specifically measure?

A

Measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated).

52
Q

List the A1C levels for:

  • Adult Normal
  • Good Glucose Control
  • Fair Glucose Control
  • Poor Glucose Control
A
  • Adult Normal= 4-6%
  • Good Glucose Control= 2.5-5.9%
  • Fair Glucose Control= 6-7%
  • Poor Glucose Control= greater than 7%
53
Q

Food consumption ________ blood glucose, whereas insulin and exercise _________ it.

A
  • increases

- decreases

54
Q

What level is considered HYPOglycemia?

A
  • <70 mg/dl
55
Q
  • What are some symptoms of hypoglycemia?

- Severe diabetic hypoglycemia leads to what?

A
  • headache, nervousness, irritability, decreased coordination, shaking, tachycardia, complaints of weakness
  • Coma
56
Q

What level is considered HYPERglycemia?

A
  • > 200 mg/dl
57
Q

What causes hyperglycemia?

A

Insufficient insulin in the body or the body is unable to use insulin properly.

58
Q

A subject with a consistent range between ___ and ____ mg/dl is considered hyperglycemic, while above ___ mg/dl is generally held to reflect diabetes.

A
  • 100 and 126

- 126

59
Q

What are some symptoms of chronic hyperglycemia (diabetes)?

A
  • Polyphagia (hunger)
  • Polydipsia (thirst)
  • Polyuria (increased urine production)
  • Blurry vision
  • Fatigue
  • Weight loss
  • Poor wound healing
  • Cardiac dysrhythmias
60
Q

Individuals who have poorly controlled hyperglycemia can develop ketoacidosis, what is this?

A

Develops when the use of glucose is limited severely resulting in increased breakdown of fats resulting in high levels of KETONE BODIES which lowers the pH of blood.

61
Q

How will ketoacidosis present?

A

Fruity smell of breath

62
Q

If a patient is hyperglycemic, what 3 things do they need?

A
  • Hydration
  • Insulin
  • Electrolytes
63
Q

What do we give someone who is hypoglycemic?

A

SNICKERS

64
Q

What are some comorbidities associated with hyperglycemia (diabetes) / A1C levels above 7%?

A
  • loss of vision secondary to retinal damage
  • decline in renal function secondary to reduce effectiveness of glomeruli in damaged kidney
  • cardiac syndrome (arrhythmias)
  • peripheral neuropathy
65
Q

Difference between Type I and Type II diabetes?

A
  • Type I- reduced availability of insulin

- Type II- insulin ineffectiveness

66
Q

What percent of american teenagers are obese and failed to meet exercise guidelines?

A

40%`

67
Q

PART 4

A

PART 4

68
Q

Creatine is released from ___________ in constant amounts and is excreted by the _______ in constant amounts. Therefore blood and serum creatine levels should exist in a constant ratio if the ________ are functioning normally.

A
  • striated muscle
  • kidneys
  • kidneys
69
Q

As the kidneys fail we will see an _________ in serum creatinine.

A

-increase, suggesting a decline in the kidney’s capability to excrete wastes.

70
Q
  • Creatinine clearance changes with age, _________ state and medical conditions.
  • Serum creatine levels are larger in males or females?
A
  • physiological

- males (.6-1.2)

71
Q
  • What is a Blood Urea Nitrogen (BUN) test?

- What are normal urea nitrogen levels?

A
  • Measure of urea nitrogen, which is a waste product of liver catabolism of amino acids.
  • Normal= 6-20 mg/dL
72
Q

BUN levels rise with ___________ renal function and renal clearance.

A

decreased

73
Q

Elevated BUN levels are associated with:

  • ______ failure (not being cleared)
  • __________ bleeding
  • Hypovolemia (dehydration) (not being cleared)
  • ________ disease/failure (not being cleared)
  • Shock (not being cleared)
  • _________ tract obstruction (being cleared but backs up into the blood)
A
  • heart
  • GI
  • Kidney
  • Urinary
74
Q
  • Bilirubin is also used to assess _____ function.

- What is normal bilirubin levels?

A
  • liver

- 0.1-1 mg/dL

75
Q

What is bilirubin?

A

A reddish-yellow substance formed when hemoglobin is broken down, the resulting bilirubin is further processed by the liver then excreted in the bile.
(retention of iron)

76
Q

Normally RBC ______ = RBC __________.

A

production = destruction

77
Q

Bilirubin is one of the by-products of the ____ molecule found in the RBCs. Liver damage/disease _______ the amount of bilirubin that it modifies and removes from the blood resulting in ___________ of bilirubin in the blood.

A
  • heme
  • reduces
  • accumulation
78
Q

Bilirubin ______ products from the liver enter the biliary tract and onto the small intestine and are responsible for the color of feces.

A

degredation

79
Q

Blood accumulation of bilirubin can lead to what?

A

Jaundice, yellow discoloration of the skin.

80
Q

Why is jaundice associated with bruising?

A

Bruising bringing blood to interstitial space, causing discoloration (yellowing).

81
Q

What are 3 main causes of elevated serum bilirubin?

A
  • Cirrhosis (scarring of the liver)
  • Increased RBC destruction
  • Anatomic obstruction
82
Q

What 3 things can cause cirrhosis?

A
  • Hepatitis
  • Alcohol liver disease
  • Liver tumors
83
Q

Increased RBC destruction causes an increase in bilirubin which can not be effectively dealt with. What are 3 things that cause RBC destruction?

A
  • Sickle Cell Anemia
  • Hemolytic anemia
  • Transfusion reaction
84
Q

Anatomical obstruction limits movement of bilirubin to the ___________. What are 2 examples of anatomical obstruction leading to increased bilirubin?

A

-small intestine

  • biliary structures
  • gall stones
85
Q
  • Albumin is a protein synthesized in the ______ and plays an important role in what?
  • What are normal albumin levels?
A
  • liver, plays an important role in keeping fluid in blood from leaking out into the tissues (defines oncotic pressure)
  • 3.5-5.5g/dl
86
Q
  • Albumin constitutes __/__’s of blood proteins.
  • Lower-than-normal levels of serum albumin may be caused by _____ disease (inability to synthesize normal amounts) and ___________ (lack of raw materials).
A
  • 2/3
  • liver
  • malnutrition
87
Q

Conditions associated with “low” serum levels of albumin include:

  • _______ (abdominal edema)
  • _______:high vascular permeability (loss from blood).
  • ______________ (kidney disease)
  • ___________ syndromes (Crohn, celiac, or whipple disease)
  • ____________
A
  • ascites
  • burn
  • glomerulonephritis
  • malabsorption
  • malnutrition
88
Q

In regards to glomerulonephritis:
-Normally albumin ______ filtered by the kidney-albumin is too big a molecule to enter the tubules
Kidney disease allows albumin to enter the kidney tubules and hence to be _________

Albuminuria-too _____ albumin in urine
Microalbuminuria: Modest increase, associated with increased risk for developing _________

A
  • isn’t
  • excreted
  • much
  • diabetes
89
Q
  • What are 4 other markers (enzymes) of liver function?

- Should we see activity of these enzymes in the blood?

A
  • AST and ALT (Aspartate/Alanine Aminotransferase), LDH (Lactate dehydrogenase), GGT (Gamma-glutamyl transpeptidase)
  • No, if we see activity it means there is tissue damage allowing leakage of these enzymes from the liver into circulation.
90
Q

What diagram should we remember in regards to Complete Blood Cell Count (CBC)?

A

\ /
\ Hbg /
W \ /
B |—————————| Plt
C / \
/ HCT \
/ \

91
Q

RBC normal numbers for males and females?

A

Male: 4.5-5.3 X 10⁶/mm³
Female: 4.1-5.1 X 10⁶/mm³

92
Q

Hemoglobin (Hb) normal levels for males and females?

A

Male: 13-18 g/dl
Female: 12-16 g/dl

93
Q

Hematocrit (Hct) normal levels for males and females?

A

Male: 37-49%
Female: 36-46%

94
Q
  • Is a WBC count a measure of all leukocytes or just neutrophils?
  • What is the primary implication related to the presence of an infection?
A
  • All leukocytes

- Elevated leukocyte count

95
Q

_________ is a risk factor for developing an infection.

A

Neutropenia

96
Q
  • What is an ANC?
  • This reflects the body’s ability to do what?
  • What is the most common cause of decreased ANC?
  • What ANC reflects a drastic increase in infection risk?
A
  • Absolute neutrophil count (estimate)
  • Fight infection
  • Chemotherapy
  • ANC <500/mm³
97
Q
  • Platelets initiate the ______ sequence to plug damaged blood vessels. As platelet count decreases, bleeding risk ____________.
  • What is normal platelet count?
A
  • clotting
  • increases

-150,000-450,000 cells/mm³

98
Q

What are 2 tests used to test coagulation and what are their normal time ranges?

A
  • prothrombin time (PT) = 12-15s

- activated partial thromboplastin time (aPTT) = 30-40s

99
Q
  • _________ is a standardized method of determining clotting time and hence bleeding risk.
  • INR = (_________ test / _________ control)
A
  • International normalized ratio

- prothrombin, prothrombin

100
Q

INR can be prolonged in:

  • Presence of ______________
  • ______ dysfunction
  • Vitamin __ deficiency
  • _________ factors deficiency
A
  • anticoagulants
  • liver
  • K
  • coagulation
101
Q

______ urine has less color, increased color suggests __________ urine.

A
  • dilute

- concentrated

102
Q

Specific gravity urinalysis reflects the concentration of _______ molecules in the urine. The more molecules that get _____________, the greater the specific gravity and hence is a measure of _______ function.

A
  • excreted
  • excreted
  • kidney
103
Q
  • What is the normal pH value of a urinalysis?
  • What can cause a high pH (alkaline)?
  • What can cause a lows pH (acidic)?
A
  • 4.6-8
  • A higher pH (alkaline) can be caused by severe vomiting, a kidney disease, some urinary tract infections, and asthma.
  • A low (acidic) pH may be caused by severe lung disease (emphysema), uncontrolled diabetes, aspirin overdose, severe diarrhea, dehydration, starvation, alcohol or drinking antifreeze

S3 - Pathophysiology (14 decks)

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