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Test2 > Labs > Flashcards

Labs Flashcards

1
Q

Hematology

A

The lab dept concerned with identifying disease related to the blood; CBC, UA, ESRs, coag studies, fluid cell counts

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2
Q

CBC

A

Complete blood count; RBCs and indicies, WBC w/ or w/o diff, hemoglobin, hematocrit, platelets

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3
Q

RBC membrane

A

Elastic, lipid bilayer, cytoskeleton, membrane proteins

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4
Q

Hemoglobin structure

A

Iron, protoporphyrin, globin

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5
Q

Hemoglobin function

A

Carry oxygen (bind it and release it)

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6
Q

MCV

A

Mean corpuscular volume; estimates average size of red cell; classified as microcytic, nromocytic, or macrocytic

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7
Q

MCH

A

Mean corpuscular hemoglobin; How much hemoglobin is inside the RBC; used in combo w/ MCHC; classified as hypochromic or normochromic

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8
Q

MCHC

A

Mean corpuscular hemoglobin concentration; used in conjunction with MCH to determine amount of hemoglobin; classified as hypochromic or normochromic

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9
Q

RDW

A

RBC distribution width; amt of size variation;used to quantify the amount of anisocytosis; graded by severity 1+, 2+, 3+

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10
Q

Normchromia

A

RBC should lack a nucleus; should be consistent in size and shape; should be deformable and selectively permeable

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11
Q

What are possible causes to have an increased number of macrocytes (MCV > 100fL) in the blood?

A
  • B12/Folic acid deficiency
  • Accelerated erythropoiesis (spitting out of new RBCs)
  • liver disease
  • post-splenectomy
  • chemotherapy
  • hypothyroidism
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12
Q

What are some possible causes/pathology of too many microcytes (MCV < 80 fL) and/or hypochromic (MCHC < 33%) in the blood?

A

*Abnormal hemoglobin synthesis
*iron deficiency
*deficiency of heme synthesis (siderblastic anemia)
*deficiency of globin synthesis (thalassemia)
Chronic disease states

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13
Q

Piokilocytosis

A

Variation in shape

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14
Q

Presentation of target cells could be indicative of what?

A
  • Liver dysfunction
  • various anemias
  • Hgb-opathies
  • thalassemia
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15
Q

Presentation of spherocytes in the blood could be indicative of what?

A
  • hereditary
  • hemolytic anemia
  • age
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16
Q

Presentation of Stomatocytes in the blood could be indicative of what?

A

Cirrhosis

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17
Q

What are the 6 types of WBCs?

A
  • neutrophils
  • lymphocytes
  • monocytes
  • eosinophils
  • basophils
  • Band (young neutrophils)
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18
Q

Which WBC usually comprises 40-75% of the WBCs in normal blood?

A

Neutrophils

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19
Q

Which WBC usually comprises 30-40% of the WBCs in normal blood?

A

Lymphocytes

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20
Q

Which WBC usually comprises 2-8% of the WBCs in normal blood?

A

Monocytes

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21
Q

Which WBC usually comprises 1-4% of the WBCs in normal blood?

A

Eosinophils

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22
Q

Which WBC usually comprises 0.5-1% of the WBCs in normal blood?

A

Basophils

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23
Q

Which WBC usually comprises 0-3% of the WBCs in normal blood?

A

Band cells (young neutrophils)

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24
Q

What is the function of neutrophils?

A

Phagocytosis and killing of microorganisms

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25
Q

Someone who has an infection or has been using steroids could expect to have an elevated # of which WBCs?

A

Neutrophils

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26
Q

A decreased number of neutrophils could mean:

A
  • immune reaction
  • gram negative sepsis
  • drugs
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27
Q

What does it mean when someone has a left shift?

A

Means that the body is dumping out an increased number of band cell/immature neutrophils

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28
Q

What is the function of lymphocytes?

A
  • production of anti-bodies by B cells

* cytotoxic T cells and Helper T cells

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29
Q

If someone has an increase in lymphocytes, they may have:

A
  • viral infection
  • EBV
  • pertussis
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30
Q

If someone has a decrease in lymphocytes, they may have:

A
  • immuno-deficiency (HIV)
  • severe infection
  • long term corticosteroid use
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31
Q

Atypical lymphocytes could mean the person is positive for:

A

Infectious mononucleosis (EBV)

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32
Q

Function of monocytes

A

Circulating precursors to the phagocyte

Called macrophage in the tissues

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33
Q

Monocytes, in the tissue, are called

A

Macrophages

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34
Q

What is the function of eosinophils?

A

Kill antibody coated parasite via granule release

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35
Q

When are eosinophil levels increased?

A

During parasitic infection and allergic reactions

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36
Q

Basophils are elevated during __________ and release ____________

A

Inflammation; histamine

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37
Q

What is the primary role of platelets?

A

Maintain vascular integrity

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38
Q

What is the essential function of platelets?

A

Blood clotting

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39
Q

What is the hemostatic function of platelets (thrombocytes)?

A

Primary phase in platelet aggregation

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40
Q

If you think someone has a blood clotting disorder, you would want to order a CBC to look at their _______ count.

A

Platelet

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41
Q

If you think someone has a blood disorder, you would order a CBC to look at their

A

RBC indicies

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42
Q

If you think someone is anemic, polycythemia, or they are hypoxic for no obvious reason, you could order a CBC to look at their ________ & _________

A

Hemoglobin and hematocrit

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43
Q

What are the two main functions of electrolytes?

A

Maintain a healthy water balance and stabilize pH

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44
Q

Renal regulation involves which 4 electrolytes?

A
  • sodium
  • potassium
  • carbon dioxide
  • choride
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45
Q

Which specific salts are the major determinants of extracellular osmolality?

A

Sodium

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46
Q

Which electrolyte is found primarily extracellular?

A

Sodium

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47
Q

Does aldosterone conserve or release sodium?

A

Conserves it;

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48
Q

What stimulates aldosterone to signal the kidneys to reabsorb sodium?

A

Low levels of sodium

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49
Q

Natriuretic hormone conserves or releases sodium?

A

Releases

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50
Q

What stimulates natriuretic hormone to tell the kidneys to excrete sodium?

A

Elevated levels of sodium

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51
Q

Antidiuretic hormone (ADH) releases or reabsorbs H20?

A

Reabsorbs

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52
Q

What hormone controls the reabsorption of water at the distal tubules, either diluting or concentrating the amount of sodium?

A

Antidiuretic hormone (ADH)

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53
Q

Hyponutremia triggers ___________ hormone to increase reabsorption of water and conserve sodium to increase the levels of sodium in the body

A

Aldosterone

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54
Q

Hypernutremia triggers ____________ hormone to decrease reabsorption of water, thus excreting more sodium in the urine to decrease the levels of sodium

A

Natriuretic

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55
Q

Who is the major cation within the cell?

A

Potassium

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56
Q

Which electrolyte maintains the cell membrane’s electrical potential, esp. neuromuscular tissue?

A

Potassium

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57
Q

Minor changes in what electrolyte can have significant consequences to cardiac function?

A

Potassium

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58
Q

Which electrolyte contributes to the metabolic portion of acid/base balance by having the kidneys exchange hydrogen ions to maintain pH?

A

Potassium

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59
Q

This hormone is stimulated by increased levels of potassium and said hormone then acts on the kidneys to excrete more potassium

A

Aldosterone

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60
Q

As _________ electrolyte is reabsorbed, _________ electrolyte is lost

A

Na+; K+

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61
Q

Alkalosis tends to increase or decrease levels of potassium?

A

Increase

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62
Q

Alkalosis causes potassium to shift into or out of the cell?

A

Into

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63
Q

Acidosis tends to increase or decrease potassium levels?

A

Decrease

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64
Q

Acidosis causes potassium to shift into or out of the cell?

A

Out of

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65
Q

Total CO2 is a measurement of:

A

*carbonic acid (H2C03)
*dissolved carbon dioxide
Serum bicarbonate (HCO3-)

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66
Q

What is the primary role of carbon dioxide?

A

Maintains a stable pH and acid/base balance

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67
Q

What is the secondary role of carbon dioxide?

A

Maintain electrical neutrality

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68
Q

C02 is excreted and reabsorbed by which organ?

69
Q

A person who is suffering from severe vomiting would have increased levels or decreased levels of CO2?

70
Q

A person in metabolic alkalosis will have increased levels or decreased levels of C02?

71
Q

A person with chronic diarrhea will have increased levels or decreased levels of C02?

72
Q

A person who chronically uses loop diuretics will have increased to decreased levels of C02?

73
Q

A person in renal failure will have increased or decreased levels of C02?

74
Q

A person in diabetic ketoacidosis will have increased or decreased levels of C02?

75
Q

A person who is literally starving will have increased or decreased levels of C02?

76
Q

Which electrolyte is the major extracellular anion?

77
Q

which electrolyte moves in and out of the cell with sodium and potassium, respectively?

78
Q

Chloride is reabsorbed/excreted in direct opposition to?

A

Bicarbonate to maintain acid/base balance

79
Q

What is the primary role of Chloride?

A

Maintain electrical neutrality and follows Na+ loss/excess to do this

80
Q

What major affect do Chloride have?

A

It affects water balance because H20 moves with Na+ and Cl-

81
Q

As Cl- moves into a cell, what moves out?

82
Q

As Cl- moves out of a cell, what moves in to help maintain acid/base balance?

83
Q

A basic metabolic panel (BMP) evaluates what organ(s) function(s)?

A

Kidney, bone, parathyroid, pancreas, liver

84
Q

End product of protein metabolism in the liver

85
Q

Combines with urea and free ammonia in liver

86
Q

BUN (blood urea nitrogen) indirectly measures:

A

Renal function
GFR
Liver function

87
Q

BUN levels are influenced by

A

Protein intake
Hydration status
GI Bleeds

88
Q

Which two components make up a renal function study?

A

BUN and creatinine

89
Q

Hyperuricemia is seen in:

A

Alcoholism
Leukemia
Metastatic cancer
DM

90
Q

Hypouricemia can be caused by:

A

Idiopathic
Chronic renal disease
Acidosis
Hypothyroidism

91
Q

1/2 of total calcium is bound mainly to?

92
Q

Calcium is necessary for:

A

Metabolic enzymatic pathway

93
Q

Calcium is vital to:

A

Muscle contraction

Cardiac and neural blood clotting

94
Q

Calcium levels can be used to evaluate:

A

Parathyroid function

Calcium metabolism

95
Q

Calcium levels are used to monitor:

A

Renal failure
Renal transplantation
Hyperparathyroidism
Various malignancies

96
Q

Complete Metabolic Panel consists of:

A
  • sodium
  • potassium
  • chloride
  • BUN
  • creatinine
  • glucose
  • calcium
  • aspartate aminotransferase
  • alk phos
  • protein
  • bilirubin
  • carbon dioxide
  • alanine aminotransferase
  • albumin
97
Q

Alkaline phosphates (ALP) is used to detect and monitor disease of:

A

Liver and Bone

98
Q

The most sensitive test in indication of a metastatic tumor of the liver

A

Intra-hepatic ALP

99
Q

An increase in extra-hepatic ALP is primarily indicative of:

A

New bone growth

100
Q

You may see an increase in extra-hepatic ALP with all of the following:

A 
Osteoblastic metastatic tumor
Paget’s disease
Healing Fx’s
RA
Hyperparathyroidism
101
Q

Bilirubin levels can be used to evaluate?

A

Liver function
Hemolytic anemia
Jaundice in newborns

102
Q

What happens to RBCs in the spleen?

A

Brokendown into heme and globin; heme is further catabolized into biliverdine

103
Q

In the spleen, biliverdin is converted to bilirubin. This is indirect/unconjugated or direct/conjugated bilirubin?

A

Indirect/unconjugated

104
Q

Where does bilirubin go from indirect/unconjugated to direct/conjugated?

A

In the liver

105
Q

What protein makes up roughly 60% of the total protein in the blood?

106
Q

What is the major effect of albumin within the blood?

A

To maintain colloidal osmotic pressure

107
Q

What is the function of albumin, other than to maintain osmotic pressure?

A

Transportation of hormones, vitamins, enzymes, and meds

108
Q

Where is albumin synthesized?

109
Q

Which protein levels can reflect liver function and nutritional status?

110
Q

Total serum protein is a combo of:

A

Albumin and globulins

111
Q

Who monitors liver and kidney functions?

112
Q

Where are globulins synthesized?

A

Liver and immune system

113
Q

What are some of the functions of globulins

A
  • helps determine chances of infection/multiple myeloma
  • fights infection
  • transports metal (iron)
114
Q

Aspartate aminotransferase (AST) enzyme is release and levels rise when

A

An injury or disease has caused cells to lyse, specifically heart muscle cells, liver cells, or skeletal muscle cells

115
Q

Alanine Aminotransferase (ALT) is an enzyme whose levels will rise when

A

There is a dysfunction in the liver

116
Q

Alanine aminotransferase is sensitive and specific to

A

Hepatocellular disease

117
Q

What cells secrete amylase?

A

Acinar cells

118
Q

If a patient comes in with acute abdominal pain, what enzyme should you evaluate?

119
Q

Increased levels in amylase could indicate:

A

Acute/chronic pancreatitis
GI disease
Acute cholecystokinin

120
Q

Lipase can be used to detect:

A

Acute pancreatitis
Renal insufficiency
Intestinal infarction or obstruction

121
Q

Which enzyme is more useful in the late diagnosis of acute pancreatitis, and why?

A

Lipase b/c it peaks later than amylase and remains elevated longer than amylase.

122
Q

Which enzyme is more useful in the early diagnosis of acute pancreatitis?

A

Amylase b/c it peaks sooner than lipase

123
Q

Total cholesterol is the most accurate predictor of the risk of:

A

Coronary artery disease

124
Q

Which organ metabolizes ingested cholesterol?

125
Q

Subnormal levels of cholesterol could indicate:

A

Severe liver disease or malnutrition

126
Q

Positional changes affect the results of what?

A

Total cholesterol

127
Q

Lipoproteins transport _______, ______, and _______ through the blood system

A

Cholesterols, triglycerides, other soluble fats

128
Q

Lipoproteins levels are influenced by:

A

Genetics
Diet
Lifestyle
Medications

129
Q

LDL carries cholesterol from ______ to ________

A

Liver, cells

130
Q

High levels of LDL could be indicative of:

A

CAD

Peripheral vascular disease

131
Q

Low levels of LDL could be indicative of:

A

Cardio-protective mechanism

132
Q

HDL is produced where?

133
Q

What is the purpose of HDL?

A

Remove cholesterol from the tissue and vascular endothelium

134
Q

What is HDL’s goal?

A

Remove lipids from endothelium and protect against heart disease

135
Q

High levels of HDL could be indicative of:

A

Cardio-protective mechanism

136
Q

Low levels of HDL could be indicative of:

A

Risk of CAD

137
Q

Who is in charge of carrying triglycerides?

138
Q

Glycerol + fatty acid = ?

A

Triglycerides

139
Q

Which organ forms triglycerides?

140
Q

How are triglycerides transported?

A

Mainly by VLDL; LDL to a lesser extent

141
Q

What is the main purpose of triglycerides?

A

Storage for energy

142
Q

What are the essential functions that are controlled by the thyroid?

A

Regulation of energy metabolism
BMR
Promotion of protein synthesis and growth

143
Q

Prostate specific antigen is found where?

A

Prostatic lumen

144
Q

PSA is used to monitor treatment for:

A

BPH
Infection
Cancer

145
Q

Hemoglobin A1C is primarily used to:

A

Diagnose and monitor diabetes treatment

146
Q

What test is used to determine the cause of metabolic acidosis?

147
Q

Anion gap is the difference between

A

Cations and anions in the extracellular fluid

148
Q

An increased anion gap could signify:

A
  • renal failure
  • renal tubular acidosis
  • lactic acid
  • diabetic ketoacidosis
  • Alcoholic ketoacidosis
  • Starvation
  • GI loss
  • hypoaldosteronism
149
Q

Decreased anion gap could signify:

A
  • multiple myeloma
  • excess alkali ingestion
  • chronic vomiting/suction
  • hyperaldosteronism
150
Q

Arterial blood gasses are used to monitor:

A
  • patients on ventilators
  • nonventilator patients
  • preoperative baseline parameters
  • regulate electrolyte therapy
151
Q

What are the 4 acids found in blood?

A

Carbonic acid (H2CO3)
Dietary acids
Lactic acid
Ketoacidosis

152
Q

An increase in H+ in the blood = _________in pH, which means the blood is _________?

A

Decrease; acidic

153
Q

An decrease in H+ in the blood = ___________ in pH, which means the blood is ____________.

A

Increase; alkaline

154
Q

UA is a non-invasive study for patient’s with:

A 
Abdominal pain
Back pain
Dysuria
Hematuria
Urinary frequency
Urinary leakage
Fever of unknown origin (FUO)
155
Q

If the urine is cloudy, could mean the presence of:

A

Pus
WBCs
RBCs
Bacteria

156
Q

If the urine is dark red, it could indicate

A

Bleeding from the kidney

157
Q

If the urine is bright red, it could indicate:

A

Bleeding from the lower urinary tract

158
Q

If the urine is dark yellow, it could indicate the presence of

159
Q

If the urine is green, it could indicate the presence of:

A

Pseudomonas infection

160
Q

What medication can make the urine orange?

161
Q

What medication can make the urine brown?

A

Nitrofurantoin

162
Q

What medication can make the urine bright yellow/orange?

163
Q

Strong, sweet smell of acetone in urine could indicate:

A

Diabetic ketoacidosis

164
Q

Foul odor to urine could indicate:

165
Q

Fecal odor to urine could indicate

A

Enterovesicle fistula

166
Q

Acidic urine could indicate possible:

A

Metabolic/resp. Acidosis
Starvation
Dehydration
High protein diet

167
Q

Alkaline urine could indicate the possibility of:

A

UTI
Bacteria
Diet high in citrus fruits/veggies
Some medications (streptomycin, neomycin)

168
Q

Increase in bilirubin in the urine could indicate:

A

Obstruction of the bile duct (i.e. gallstone)

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