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Part 2 Exam > Labs > Flashcards

Labs Flashcards

1
Q

What labs do you need for the kidney?

A

GFR, BUN, Creatinine, Electrolytes, magnesium, protein/albumin and globulins, PH and PCO2

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2
Q

Na

A

primary determinant of extracellular fluid volume

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3
Q

K

A

important for function of excitable cells such as nerves, muscles, and heart

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4
Q

Cl

A

important for fluid balance and acid base status

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5
Q

Protein/albumin and globulins - kidney

A
  • detects nutritional status

- severe infection, dehydration, renal disease

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6
Q

Magnesium - kidney

A

regulated by kidneys

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7
Q

PH and PCO2 -kidney

A

move together

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8
Q

Metabolic alkalosis

A

pH>7.45
CO3>30
Cause: vomiting, diarrhea, dehydration

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9
Q

Metabolic acidosis

A

pH<7.35
CO3<24
cause: increased acid production, decreased renal acid secretion

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10
Q

Labs you need for bone

A

calcium, phosphate and alkaline phosphate, magnesium, vitamin D

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11
Q

Phosphate (PO4) and alkaline phosphate

A

necessary for bone formation, acid base balance, storage and transfer of energy

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12
Q

Magnesium - bone

A

concentrated in bone and muscles

-regulated by kidneys

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13
Q

What labs are needed for the pancreas?

A

glucose, amylase, lipase

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14
Q

Glucose - pancreas

A

measures blood glucose

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15
Q

Lipase

A

used to detect acute pancreatitis

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16
Q

What labs are needed for the liver?

A

glucose, alkaline phosphate, total bilirubin, ammonia (NH3), protein/albumin and globulins, AST, ALT, lipid panel

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17
Q

Total bilirubin

A
  • processed by the liver

- elevated bilirubin could indicate cirrhosis, hepatitis, jaundice

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18
Q

Ammonia (NH3)

A
  • evaluates liver function and metabolism
  • the liver converts ammonia from blood to urea
  • if the liver is damage, then increased ammonia levels are noted
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19
Q

Protein/albumin and globulins

A
  • detects nutritional status
  • increased causes: hepatitis
  • decreased causes: liver disease
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20
Q

AST

A

found in liver, cardiac muscle, kidney, brain and lungs

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21
Q

ALT

A

primarily found in the liver but also in muscle

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22
Q

Both AST and ALT

A
  • are indicators of liver disease

- sensitive to hepatic inflammation and necrosis

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23
Q

What labs are needed for the parathyroid?

A

calcium

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24
Q

Parathyroid - low calcium

A

can cause hypoparathyroidism

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25
Q

What labs are needed for the thyroid?

A

TSH, T3 and T4 levels

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26
Q

Low TSH, high T3 and T4

A

hyperthyroidism

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27
Q

High TSH, low T3 and T4

A

hypothyroidism

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28
Q

What labs are needed for the prostate?

A

PSA

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29
Q

What labs are needed for the lungs?

A

pH and PCO2

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30
Q

pH and PCO2 - lungs

A

move opposite

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31
Q

Respiratory alkalosis

A

pH > 7.45
CO2 < 35
Cause: COPD, CHF, Pain

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32
Q

Respiratory acidosis

A

pH < 7.35
CO2 >45
Cause: ALS, asthma, COPD

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33
Q

What labs are needed for GU?

A

UA

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34
Q

UA

A

should be clear yellow

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35
Q

Red Blood Cell - lifespan

A

120 days

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36
Q

Hemoglobin

A
  • measurement based on spectrometric absorbance
  • assesses anemia, blood loss, and bone marrow suppression
  • function: carry oxygen, bind and release
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37
Q

Hematocrit

A
  • assesses blood loss and fluid balance
  • also called PCV, is a ratio
  • 3:1 ratio
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38
Q

MCV

A
  • mean corpuscular volume

- estimates average size of red cell

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39
Q

MCH

A

mean corpuscular hemoglobin

40
Q

RDW

A
  • RBC distribution width

- amount of size variation, used to quantitate the amount of anisocytosis

41
Q

Platelets

A

Clotting

-thrombocytopenia or thrombocytosis

42
Q

Thrombocytopenia

A

low platelet count

43
Q

Thrombocytosis

A

high platelet count

44
Q

White Blood Cells

A

neutrophils, lymphocytes, momocytes, eosinophils, basophils

45
Q

Neutrophils

40 to 75%

A
  • phagocytosis and killing microorganisms
  • elevated = infections, steroid use
  • left shift
46
Q

Lymphocytes

30 to 40%

A
  • production of antibodies (B-cells)
  • cytotoxic and helper function (T-cells)
  • viral infections, EBV, pertussis, immune-deficiency (HIV), corticosteroids, severe infection
47
Q

Monocytes

2 to 8%

A
  • part of the innate immune system
  • circulating precursor to the phagocyte
  • called a macrophage in the tissues
  • replenishing resent macrophages under normal states
  • move quickly in response to inflammation signals
48
Q

Eosinophils

1 to 4%

A
  • kills antibody - coated parasites via granola release
  • increased during parasitic infection and allergic reactions >4%
  • reaction to foods, allergens or acid reflux, can inflame or injure the esophageal tissue
49
Q

Basophils

0.5 to 1%

A
  • AKA: mast cells
  • very rarely seen <1%
  • elevated during inflammation (HSN)
  • play a role in both parasitic infections and allergies
50
Q

What is bilirubin?

A

it is an orange-yellow pigment formed in the liver by the breakdown of hemoglobin and excreted in bile

51
Q

Used to evaluate bilirubin

A
  • liver function
  • hemolytic anemia
  • jaundice in newborns
52
Q

Bilirubin - total

A

sum of 70-85% indirect (unconjugated) and direct (conjugated)

53
Q

Total bilirubin process - spleen

A
  • RBC breakdown into heme and globin

- Heme: catabolized to form Biliverdin in the spleen

54
Q

Total bilirubin proces - converted

A
  • biliverdin is converted to bilirubin

- this is indirect (unconjuated) bilirubin

55
Q

Where is unconjugated bilirubin converted?

A

spleen

56
Q

Total bilirubin proces - liver

A
  • indirect bilirubin is conjugated with glucuronide

- becoming direct (conjugated) bilirubin

57
Q

Where is direct (conjugated) bilirubin converted?

A

liver

58
Q

Conjugated

A

bilirubin travels from liver to small intestine

59
Q

Unconjugated

A

bilirubin is bound to albumin in the blood

60
Q

Total Cholesterol

A
  • most accurate predictor of the risk of Coronary Heart Disease
  • liver metabolizes ingested cholesterol
  • positional changes can affect results (its in hospital are expected to have lower level of TC than outpatients)
61
Q

LDL

“Bad Cholesterol”

A
  • LDL carry cholesterol from liver to cells
  • High levels = > risk CAD/Peripheral Vascular Disease
  • Low levels = cardio-protective
62
Q

HDL

“Good Cholesterol”

A
  • unsaturated fats
  • mainly in liver, used to remove cholesterol from tissue and vascular endothelium
  • high levels = cardio-protective
  • low levels = >risk of CAD
63
Q

Triglycerides

A
  • type of fat (lipid) found in the blood and stored in fat cells
  • risk for atherosclerosis
  • formed in the liver
  • transported by LDL and VLDL
  • acts as a storage for energy
64
Q

Total Cholesterol/HDL Ratio

A
  • predictor of heart disease risk

- calculated by total cholesterol/HDL

65
Q

VLDL

A
  • very low density lipoprotein

- predominant carrier of triglycerides

66
Q

Urine Analysis

A

monitors chronic renal disease and some metabolic disease

67
Q

Yellow color measures

A

hydration and dehydration

68
Q

Cloudy color urine

A

pus, WBC’s, RBC’s, or bacteria

69
Q

Dark red urine

A

bleeding with kidney (hematuria)

70
Q

Bright red urine

A

bleeding from the lower urinary tract (hematuria)

71
Q

Dark yellow urine

A

could indicate presence of bilirubin

72
Q

Green urine

A

pseudomonas infection

73
Q

Food that can affect urine color

A

beet, blackberries, rhubarb - pink or red

74
Q

Mediations that can affect urine color

A

Pyridium - organe
Nitrofurantoin - brown
Rifampin - yellow orange

75
Q

Odor

A
  • strong sweet smell of acetone = diabetic ketoacidosis
  • foul order = urinary tract infection
  • fecal order = enterovesicle fistula
76
Q

pH - acidic

A

possible metabolic/respiratory acidosis, starvation, dehydration, high protein die
<6.5

77
Q

pH - alkaline

A

UTI, bacteria, high diet in citrus fruits/veggies, some medications
>7.0

78
Q

Specific Gravity

A
  • AKA weight of particles in urine
  • measures the concentration of chemical particles (wastes and electrolytes) in urine
  • high = concentrated urine (dehydration )
  • low = diluted urine (chronic renal disease)
  • good indicator of kidneys ability to concentrate urine and hydration
79
Q

Proteinuria

A

usually measure albumin

80
Q

Proteinuria - indicator

A
  • glomerular damage

- basement membrane

81
Q

Proteinuria - possible dx

A
  • nephrotic syndrome
  • DM complications
  • High BP
  • UTI
82
Q

Proteinuria - persistence

A
  • requires further workup

- 24 hour urine or electrophoresis

83
Q

Leukocyte Esterase (WBC)

A

positive = UTI, need for C&S

84
Q

Nitrites

A

positive = UTI, need for C&S

85
Q

Ketones

A

positive = poorly controlled diabetic or hyperglycemia from massive fatty acid catabolism

86
Q

Aldosterone

A
  • conserves Na+
  • stimulated by >levels increases renal excretion of K+
  • opposite of Na+ regulation
  • aldosterone hormone
87
Q

Aldosterone hormone

A

stimulated by low levels of Na+ causing kidneys to reabsorb Na+ thus increasing Na+

88
Q

Hyponatremia

A
  • triggers aldosterone
  • increases reabsorption
  • sonservation of Na+
  • Na+ level increases
89
Q

Hypernatremia

A
  • triggers natriuretic
  • decrease reabsorption
  • excretion of Na+
  • Na+ level decrease
90
Q

Aldosterone blockers cause

A
  • modest diuresis of natruesis

- inhibits potassium and hydrogen ion secretion

91
Q

Vitamin D

A

indicator of risk for osteoporosis

92
Q

Glucose - liver

A

criteria for diagnosing DM

93
Q

Normchromia

A

normal RBCs that lack a nucleus and organelles

94
Q

Hyperchromia

A
  • MCHC <36% RBC with decreased surface to volume ratio
  • seen in hemolysis and burn
  • spherocytes
95
Q

Spherocytes

A

cells with no central pallor

96
Q

Macrocytes

MCV>100 fL

A
  • macrocytic anemia

- macrocytes seen in acute blood los, polychromasia is usually present

97
Q

Hypochromia

A

central area of pallor, literally means low color, many times this is seen in IDA often referred to a microcytic/hypochromic anemia

Part 2 Exam (7 decks)

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