Labs

Question 0

Renal function studies

Answer 0

BUN. 8-25

Creatinine 0.6-1.3

Question 1

ABG

Answer 1

pH.      7.35-7.45
PCO2  35-45
HCO3  22-27
Po2.    80-100
Sao2.   96-100

Question 2

Gastrointestinal studies

Answer 2

Cholesterol tot: 140-199
HDL.                  30-70
LDL.                   < 200
Protein                 6-8
Albumin.              3.4-5
Amylase.              25-151
Lipase.                 10-140
Ammonia.             10-80
ALT.                 10-40
AST.                 10-30
Bilirubin.          < 1.5

Question 3

Glucose

Answer 3

Hemoglobin A1C.  
4-5.9% non diabetic 
7% or lower good diabetic control
7-8% fail control
>8% poor control

Question 4

Erythrocyte studies

Answer 4

Hemoglobin 
F 12-15
M 14-16.5
Hematocrit 
F 35-47%
M 42-52%

Question 5

Coagulation studies

Answer 5

Platelets: 150,000-400,000
Below: thrombocytopenia
Above: polycythemia

Activated partial thromboplastin time aPTT 20-36 sec

Prothrombin time PT
9.5-11.8

INR:
2-3 for warfarin
3-4.5 for high dose warfarin

Question 6

Electrolyte values

Answer 6

K: 3.5-5
Na: 135-145
CL: 98-107
HCO3-: 22-29
Ca: 8.5-10.5 
Mg: 1.8-2.5
P: 2.5-4.5

Question 7

Cardiac Markers

Answer 7

Creatinine Kinase
MB 0-5%
MM 95-100%
BB 0% of CK

Question 8

Cardiac Markers

Troponin

Answer 8

Troponin 1 < 0.1-0.2

Myoglobin < 90 mcg

Question 9

Cardiac Markers

Natriuretic peptides

Answer 9

ANP 22-27
BNP <100
CNP not determined

Question 10

Hyponatremia

Answer 10

S/S
Weakness lethargy N/V confusion muscle cramps seizures
Tx:
restrict fluids IV isotonic solutions

Question 11

Hypernatremia

Answer 11

Thirst 
Hyperpyrexia (fever) 
Hallucinations
Lethargy 
Seizures
Tx: 
Restrict sodium
Increase water intake

Question 12

Hypokalemia

Answer 12

Fatigue NV
Muscle weakness 
Decreased GI motility 
Dysrhythmias 
Paresthesia 
Flat T waves on ECG

Question 13

Hyperkalemia

Answer 13

Muscle weakness 
Bradycardia
Dysrhythmias 
Flaccid paralysis 
Intestinal pain
Tall T Waves on ECG
Tx:
Admin. 50% glucose w/ insulin
Kayexalate 
Calcium gluconate
IV loop diuretics 
Renal dialysis

Question 14

Hypocalcemia: renal failure

Hypoparathyroidism pancreatitis alkalosis

Answer 14

Numbness tingling convulsion 
Positive Trousseau sign (swan hand)
Tetany (spasms) 
Tx: 
Admin. Calcium IV slowly

Question 15

Hypercalcemia: hyperparathyroidism

Malignant bone disease prolonged immobilization excess calcium supplementation

Answer 15

Muscle weakness constipation NV polyuria polydipsia neurosis dysrhythmias. 
Tx: 
Admin. Calcitonin 
avoid antacids 
Eliminate parenteral calcium

Question 16

Hypomagnesemia: 
Alcoholism 
Diabetic ketoacidosis 
Prolonged gastric suction
Diuretics

Answer 16

Neuromuscular irritability depression disorientation
Tx:
Admin. Mag IV
Foods high in mag.

Question 17

Hypermagnesemia: renal failure adrenal insufficiency excess replacement

Answer 17

Flushing hypotension drowsiness lethargy hypoactive reflexes depressed RR. Bradycardia
Tx: avoid mag antacids and laxatives restrict dietary intake.

Question 18

Hypophosphatemia: 
Alcohol w/d 
Diabetic ketoacidosis 
Resp. Alkalosis 
Refeeding syndrome

Answer 18

Paresthesias
Muscle wk/pain
Mental changes 
Cardiomyopathy resp. Failure 
Tx:
Correct underlying cause

Question 19

Hyperphosphatemia:
Renal failure
excess intake

Answer 19

Short term: tetany 
Long term: precipitation in non Osseous sites 
Tx: 
Admin. Aluminum hydroxide with meals 
Dialysis may be required.