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NPLEX > Labs and Imaging > Flashcards

Labs and Imaging Flashcards

1
Q

UA consists of

A
  • color and appearance
  • chemical findings
  • microscopic findings
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2
Q

SX that warrent UA

A

abdominal pain, back pain, frequent or painful urination, blood in your urine, or other urinary problems

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3
Q

what dose red or pink urine mean?

A
  • BPH
  • kidney stones
  • cysts
  • cancer
  • hard exercise
  • beets
  • blackberries
  • rhubabrb
  • rifampin
  • phenazopyridine
  • senna
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4
Q

Orange urine

A
  • Phenazopyridine
  • senna
  • rifampin
  • sulfasalazine (Azulfidine)
  • adriamycin
  • Vitamin A
  • Vitamin B12
  • dehydration
  • cholestasis
  • acute heaptitis
  • alcoholic liver disease
  • oral contraceptives
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5
Q

blue or green urine means

A
  • dyes
  • amitriptyline
  • cimetidine
  • triamterene
  • indomethacin
  • propofol
  • hypercalcemia
  • UTI by some bacteria
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6
Q

dark brown or cola-colored urine

A
  • fava beans
  • rhubarb
  • aloe
  • Chloroquine and primaquine
  • metronidazole
  • nitrofurantoin
  • senna
  • Methocarbamol
  • phenytoin
  • statins
  • UTI
  • exterme exercise
  • viral heaptitis
  • cirrhosis
  • dehydration
  • rhabdomyolysis
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7
Q

cloudy urine

A
  • kidney stones
  • UTI
  • dehydration
  • STI
  • diabetes
  • vaginitis
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8
Q

Urine dip stick includes

A
  • nitrite
  • leukocyte esterase
  • specific gravity
  • pH
  • protien
  • glucose
  • bilirubin
  • urobilinogen
  • ketones
  • blood
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9
Q

Nitrites indicate

A

normal: negative
abnormal: any shade of pink
* Cystitis
* E coli
* Klebsiella
* Proteus
* Enterobacter
* Cirtobacter

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10
Q

Leukocyte Esterase indicates

A

Bacterial infection
Trichomonas
Chlamydia
Balanitis
Urethritis
TB
Bladder tumors
Nephrolithiasis
Foregin bodies
Exercise
Glomerulonephritis

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11
Q

Specific Gravity indicates

A

Hyposthenuria (<1.010)
* Damage to kidney tubule cells (renal tubular necrosis)
* Diabetes insipidus
* Drinking too much fluid
* Kidney failure
* Low sodium level in the blood
* Severe kidney infection (pyelonephritis)

Hypersthenuria (>1.010)
* Adrenal glands do not produce enough hormones (Addison disease)
* Heart failure
* High sodium level in the blood
* Loss of body fluids (dehydration)
* Narrowing of the kidney artery (renal artery stenosis)
* Shock
* Sugar (glucose) in the urine
* Syndrome of inappropriate ADH secretion (SIADH)

Normal: 1.005 to 1.030

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12
Q

Bilirubin

A

Viral hepatitis (Hepatitis A-E)
Alcoholic liver disease (alcoholic steatosis, alcoholic hepatitis, cirrhosis)
Non-alcoholic steatohepatitis
Autoimmune hepatitis
Wilson disease
Hemochromatosis
Dubin-Johnson syndrome
Rotor syndrome
Primary biliary cirrhosis
Ischemic hepatitis
Sarcoidosis
Pregnancy
Drug-induced liver injury
Sepsis
Gallstones
Biliary stricture
Biliary atresia
Choledochal cyst
Cholangitis (bacterial, recurrent pyogenic, primary sclerosing, secondary sclerosing)
Cholangiocarcinoma
Intrahepatic malignancy
Extrahepatic malignancy (lymphoma, pancreatic cancer)
Chronic pancreatitis

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13
Q

Urobilinogen indicates

A

Hepatitis
Cirrhosis
Carcinoma
Hemolytic disorders

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14
Q

Bilirubin findings

A

Trace
Small
Moderate
Large

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15
Q

Urobilinogen findings

A

0.2 mg/dl
1 mg/dl
2 mg/dl
4 mg/dl
8 mg/dl

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16
Q

Protein results

A

trace 10 to 20 mg per dL
1+ (30 mg per dL),
2+ (100 mg per dL)
3+ (300 mg per dL)
4+ (1,000 mg per dL).

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17
Q

Protien causes

A

Minimal change disease
Idiopathic membranous glomerulonephritis
Focal segmental glomerulonephritis
Membranoproliferative glomerulonephritis
IgA nephropathy
DM
Collagen vascular disorders
Amyloidosis
Preeclampsia
Infection
Gastrointestinal and lung cancers
Lymphoma
Drugs
Hypertensive nephrosclerosis
Uric acid nephropathy
Acute hypersensitivity interstitial nephritis
Fanconi syndrome
Heavy metals
Sickle cell disease
Multiple myeloma
Myoglobinuria

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18
Q

Glucose cause

A

DM
Tubular damage

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19
Q

Ketones cause

A

DM

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20
Q

pH cause

A

High: Renal tubular acidosis
Low: DM or renal/bladder calculi

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21
Q

Blood cause

A

Renal calculi
Glomerulonephritis
Pyelonephritis

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22
Q

Hyaline cast

A

Conglomerations of protein indicating proteinuria

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23
Q

Hyaline cast cause

A

Acute:
Following strenuous exercise
Orthostatic proteinuria
Fever

Chronic:
Glomerulonephritis
Pyelonephritis
CHF
Chronic renal failure

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24
Q

RBC casts

A

Clump of RBC due to breakdown of glomerulus and stasis

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25
Q

RBC casts cause

A

Glomerulonephritis
SBE
Subacute bacterial endocarditis
Renal infarcts
Vasculitis
Sickle cell anemia
SLE
Malignant HTN
Goodpasture’s syndrome
PSGN

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26
Q

WBC casts cause

A

Acute pyelonephritis
Glomerulonephritis
Lupus nephritis

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27
Q

Renal tubular epithelial cell casts

A

Nephrosis
Amyloidosis
Heavy mental or other poisoning
Glomerulonephritis
Acute tubular necrosis
Pyelonephritis

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28
Q

Waxy or broad casts cause

A

Chronic renal failure

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29
Q

Crystals cause

A

Nephrolithiasis
Uric acid

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30
Q

Microalbumin cause

A

Moderate: Early detection of kidney disease

High: Kidney failure

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31
Q

24-h urine protein findings

A

N 150 mg/24 h
Proteinuria 150-500 mg/24h
>2000 mg/24 h
>3500 mg/24h

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32
Q

24-h urine protein cause

A

Glomerular
Nephrotic syndrome
Renal disease
HTN
Toxicity from heavy metals/ solvents
Preeclampsia/eclampsia

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33
Q

Fractional excretion of sodium findings

A

Increased sodium in urine = intrinsic kidney path
Normal sodium = prerenal cause
FENa > 2 damage to tubules
FENa < 1 decrease blood flow

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34
Q

Creatinine clearance findings

A

24-h urine collected and blood draw
M 90-139 ml/min
F 80-125 ml/min

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35
Q

Creatinine clearance cause

A

Tubular damage
Glomerulonephritis
Kidney failure

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36
Q

Albumin creatinine ratio findings

A

30-300 mg/day

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37
Q

Albumin creatinine ratio cause

A

Kidney damage in pt with DM

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38
Q

Uroflowmetry or “Uro Flow Test” findings

A

Measures voided volume, voiding time, average flow rate, max flow rate (Qmax) N urine volume >200ml over 15-30 sec
N peak flow: Male 20-25 ml/s, Female 20-30 ml/s

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39
Q

Uroflowmetry or “Uro Flow Test” cause

A

Decrease: Suggests bladder outlet obstruction (BOO) (most common in M), or weak detrusor muscle contraction
Increase: Suggests bladder spasticity
Intermittent flow: Straining to overcome resistance (sphincter tone)

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40
Q

Cytometry findings

A

Assesses bladder storage capacity, pressure as bladder fills, how full when urge triggered
Detrusor contractions before bladder fills to 150-250ml is abnormal

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41
Q

Cytometry indications

A

neurogenic bladder, MS, spinal cord injury, diabetes, BPH

42
Q

Pressure Flow Study

A

Measures intravesical and detrusor muscle pressure required for voiding and flow rate (ml/s)
Normal voiding pressure not > 30cm of H2O pressure

43
Q

Pressure Flow Study cause

A

If bladder pressure is >50cm of H2O along with low urine flow: urethral overactivity (detrusor-sphincter dyssynergia) or urethral stricture or BOO (bladder outlet obstruction) may be cause

44
Q

Postvoid Residual Measurement findings

A

Measures amt of urine in bladder after micturition
PVR >100 ml is abnormal

45
Q

Urethral Pressure Profile finding

A

Measures intraluminal pressure along length of urethra (usu done in female-body pt)

46
Q

Urethral Pressure Profile cause

A

obstruction or incontinence
High pressure = Resistance
Low pressure = Compromised function

47
Q

Electromyography findings

A

In Females, it can assess pelvic floor or periurethral muscle activity for abnormal contraction or relaxation contributing to urinary obstruction or incontinence.
Can also check electrical activity in the bladder neck

48
Q

CBC with differential contains

A
  • RBCs
  • WBCs
  • platelets
  • hemoglobin
  • hematocrit
  • MCV
  • MCH
  • MCHC
  • RDW
49
Q

RBCs findings

A

increased
* polycythemia vera
* smoking
* dehydration
* cor pulmonale
* renal cell carcinoma
* hypoxia
* congential heart disease
* pulmonary fibrosis
* medication
normal
decreased
* anemia
* bleeding
* multiple myeloma
* leukemia
* malnutriton
* pregnancy
* hemolysis
* B12/6/9 deficency
* iron and copper
* overhydration
* medications

50
Q

Hemoglobin cause

A

decreased
* bone marrow defects
* renal disease
* cell destruction
* blood loss
* hemogloninopathies
* lead poisoning
* iron deficiency
* pregnancy
* over-hydration
increased
* polycythemia vera
* renal tumors
* COPD
* pulmonary fibrosis
* heart disease
* dehydration

51
Q

hypochromasia

A

increase in the red cells central pallor which occupies more than the normal third of the red cell diameter
found in: iron deficency and thalassaemia

52
Q

hematocrit

A

the volume of erythrocytes expressed as a precentage of the volume of whole blood

53
Q

hematocrit cause

A

increased
* erythrocytosis
* congenital heart disease
* polycythemia vera
* dehydration
* severe COPD
decreased
* anemia
* hemoglobinopathies
* hemolytic anemia
* hemorrhage
* nutrient deficiencies
* bone marrow failure
* prosthetic valves
* renal disease
* pregnancy
* blood cancers and malignancies

54
Q

hemoglobin interfering factors

A

very high WBC counts
severe lipidemia
RBC abnormalities
increased turbidity
increased bilirubin

55
Q

hematocrit interfering factors

A

RBC size
extremely high WBC counts
over and under hydration
pregnancy decreases due to hemoduilution
high altitudes increase due to hypoxia
post-hemorrhage values not reliable for several hours
drugs

56
Q

MCV (mean corpuscular volume)

A

average volume of RBCs how big they are
decreased MCV: microcytic RBCS <80
increased MCV: macrocyctic RBCs >100
normal: normocytic

57
Q

MCV interfering factors

A
  • high WBC
  • high platelets
  • agglutinated RBCs
  • RBC fragments
58
Q

mean corpuscular hemoglobin concentration (MCHC)

A

ratio of the average concentration of hemoglobin in a given volume of RBCs
normal MCHC: 32-36 normochromic
decreased <30 hypochromic

59
Q

normocytic, normochromic anemia

A

chronic illness
renal disease
acute blood loss
aplastic anemia
autoimmune hemolytic anemia

60
Q

microcytic, hypochromic anemia

A

iron deficiency
sideroblastic
lead poisoning
anemia of chronic disease (later stage)
thalassemia

61
Q

macrocytic, normochromic anemia

A

vitamin B12 or folate deficiency
pernicious anemia
side effects of chemotherapy
myelodysplastic syndrome
acute myelogenous leukemia

62
Q

Platelet count

A

thrombocytopenia: <150,000
thrombocytosis: > 400,000
thrombocythemia: > 1,000,000

63
Q

platelet count cause

A

thrombocytopenia
* hypersplenism
* hemorrhage
* leukemia
* myelofibrosis
* thrombotic thrombocytopenia purpura
* ITP
* aplastic anemia
* graves diasese
* pre-eclampsia
* DIC
* SLE
* pernicious anemia
* hemolytic anemia
* cancer chemotherapy
* severe infection
* drug reactions
thrombocytosis
* malignant disorders
* polycythemia vera
* acute infections
* sepsis
* post-splenectomy
* rheumatoid arthrtis
* iron deficiency
* primary thrombocytosis

64
Q

Platelet interfering factors

A

high altitude
strenous exercise
prior to menses
estrogen
drugs

65
Q

WBC findings

A

total WBC count
ER
low: less than 500 per mm
high: greater than 30,000

66
Q

WBC cause

A

leukocytosis
* infections
* leukemic neoplasia
* other malignancy
* trauma
* stress
* hemorrhage
* tissue necrosis
* inflammation
* dehydration
* thyroid storm
* post splenectomy
leukopenia
* drug toxicity
* bone marrow depression/failure
* severe infections
* dietary deficiencies
* marrow aplasia
* marrow infiltration
* autoimmune disease
* hypersplenism
* chemotherapy

67
Q

differential WBC count

A

normal
Neutrophil 60%
lymphocyte 30%
monocyte 6%
eosinophil 3%
basophil 0%n

68
Q

Neutrophils cause

A

neutrophillia
* acute infection
* trauma
* physical/emotional stress
* inflammatory disorders
* metabolic disorders
* myelocyctic leukemia
* cushing’s sundrome
neutropenia
* overwhelming bacterial infection
* viral infection
* aplastic anemia
* radiation therapy
* addisons disease
* chemotherapy
* dietary deficiency

69
Q

eosinophils cause

A

eosinophilia
* parasitic infections
* allergic reactions
* asthma, hay fever
* hodgkin’s disease
* eosinophil myaliga syndrome
* eczema
* leukemia
* autoimmune disease
* ovarian cancer
eosinopenia
* cushing syndrome
* endogenous or exogenous cortisol excess
* stress

70
Q

Basophils cause

A

basophilia
* myleoproliferative disease: polycythemia
* granulocytic leukemia
* chromci muelocytic leukemia
* hodgkin’s lumphoma
Basopenia
* acute phase infection
* hyperthyroidism
* stress reactions
* prolonged steroid therapy

71
Q

lymphocytes cause

A

lymphocytosis >4000
* viral infections: CMV, HIV
* pertussis, TB
* lymphocytic leukemia
* multipe myeloma
* infecitous mononucleosis/EBV
* infecitous hepatitis
* hypoadrenalism (addison’s disease)
Lymphopenia <1000
* myelocytic leukemia
* hodgkin’s disease
* sepsis
* immunodefiency diseases
* SLE
* adrenocorticosteroids and chemotherapy
* radaition

72
Q

monocytes cuase

A

monocytosis >500
* EBV
* TB
* subacute bacterial endocarditis
* syphilis
* chronic UC
* parasites (malaria)
* monocytic leukemia
moncytopenia <100
* prednisone
* HIV
* hairy cell leukemia
* aplastic anemia

73
Q

Mean platelet volume (MPV) cause

A

average volume of a population of platelets

74
Q

MPV cause

A

increased
* valvular heart disease
* ITP
* sepsis
* severe hemorrhage
* B12/folate def
* myelocytic leukemia
decreased
* aplastic anemia
* cancer chemotherapy
* wiskott-aldrich syndrome

75
Q

bleeding time cause

A

increased
* thrombasthenia
* bernard-soulier
* storage pool disease
* asprin
* platelet count <75,000
* von wilebrand disease
* uremia
* liver failure

76
Q

Prothrombin time

A

evalutates extrinsic system
Inceased
* deficency of VII, X, V, prothrombin, or fibrinogen
* vit K def
* liver disease
* warfarin
* DIC
* heparin

77
Q

International normalised ration (INR)

A

PT is expressed as a ratio of prothrombin clotting time for patient plasma divided by time for control plasma
INR 1 is normal
>1 clotting time is elevated

78
Q

activated partial thromboplastin time (aPTT)

A

evaluates intristic system
increased
* def in VIII, IX, XI, or XII

79
Q

thrombin time

A

measurement of the conversion of fibriongen to fibrin

80
Q

Factor assays

A

factor IX
factor VIII

81
Q

Direct Coomb test (Direct antiglobulin test)

A

used to detect antibodies that are stuck to the surface of red blood cells
abnormal:
* autimmune hemolytic anemia
* chronic lymphocytic leukemia
* erythroblastosis fetalis
* infectious mononucleosis
* mycoplasma infection
* syphilis
* SLE
* tranfusion reactions

82
Q

Indirect coombs test

A

looks for antibodies that are floating in the blood, to determine a reaction to blood transfusion
abnormal
* Erythroblastosis fetalis
* Incompatible blood match

83
Q

blood typing

A

measures the antigen and markers on the surface of RBCs
ABO
RH C or c, D or d, E or e
Kell K or k
Duffy Fya, Fyb, FY
kidd Jk, Jka, Jkb, Jkab

84
Q

erythrocyte sedimentation rate

A

sedimentation rate, non-spefic measurment of inflammation

85
Q

erythrocyte sedimentation rate cause

A
  • RA
  • psoriatic arthritis
  • gout
  • reactive arthritis
  • sarcoidosis
  • sjogren’s syndrome
  • calcium pyrophsophate depisition disease
  • urticaria
  • ankylosing spondylitis
  • juvenile RA
  • acute prostatitis
  • crohn’s disease
  • SIBO
  • UC
  • polymyalgia rheumatic
  • osteoarthritis
  • gastroenteritis
86
Q

Comprehensive metabolic panel contains

A
  • glucose
  • calcium
  • sodium
  • potassium
  • carbon dioxide
  • chloride
  • albumin
  • total protien
  • ALP
  • ALT
  • AST
  • bilirubin
  • BUN
  • creatinine
87
Q

glucose on CMP

A

increased
* daibetes
* hyperthyroidism
* pancreas disorders
* stress
decreased
* side effect of medications
* not eating enough
* more physically active
* liver disease
* kidney disease
* hypothyroidism
* alcohol use disorder
* Underactive adrenal or pituitary,

88
Q

calcium on CMP

A

total calcium: bound and free
increased
* hyperparathyroidism
* cancer of the bone
* paget’s disease
* too much Vit D
decreased
* malnutriton
* liver disease
* hypoparathyroidism
* Vit D, mag, calcium def
* pancreatitis
* kidney disease

89
Q

Sodium on CMP

A

increased hypernatermia
* dehydration
* gastroenteritis, vomiting, prolonged nasogastric drainage, burns, and excessive sweating
* intrinsic renal disease, post-obstructive diuresis, and with the use of osmotic or loop diuretics
* daibetes insipidus
* diabetic ketoacidosis
Hyponatermia
* diuretics
* kidney disease
* decreased sodium intake
* diuretics
* SIADH
* heart faliure
* stroke, hemorrhage, infection, trauma, and psychosis,
* ADH tumor
* drugs
* pneumonia
* hypothyroidism
* adrenal insufficency
* HIV

90
Q

potassium

A

Hyperkalemia
* kidney disease
* diet
* medications
* addisons
* burns or severe injuries
* diabetes
hypokalemia
* alcohol
* chronic kidney disease
* daibetic ketoacidsosis
* diarrhea
* diuretics
* laxatives
* excessive sweating
* folic acid def
* primary aldosteronism
* vommiting

91
Q

carbon dioxide

A

increased hypercapnia
* cushing’s syndrome
* kideny faliure
* COPD
* sleep apnea
* stroke
* hypothyroirism
* MS
* ALS
* muscular dystrophy
* spinal cord injuries
* flail chest
* ankylosing spondylitis
* tetanus
* botulism
* pulmonary embolism
* vascular disease
* dehydration
decreased
* addison disaese
* diabetic ketoacidosis
* shock
* kidney disorders

92
Q

chloride

A

increased
* addison disease
* carbonic anhydrase inhibitors
* diarrhea
* ethylene glycol poisoning
* ketoacidosis
* kidney disease
* lactic acidosis
* methanol poisoning
* renal tubular acidosis
* salicylate toxicity
* ureteral diversion
* cancer
* hypoglycemia
* alcohol
* seziures
decreased
* bartter syndrome
* burns
* congestive heart failure
* cushing syndrome
* dehydration
* excessive sweating
* hyperaldosteronism
* COPD
* asthma
* pulmonary fibrosis
* scoliosis
* drugs
* sleep apnea
* SIADH
* vomiting

93
Q

albumin

A

increased
* dehydration
* diarrhea
decreased
* infection
* sepesis
* surgery
* IBD
* kidney disease
* cirrhosis
* fatty liver disease
* liver cancer
* hepatitis A, B, or C
* malnutrition
* hypothyroidism

94
Q

total protien

A

increased
* multpile meyeloma
* waldenstrom disease
* HIV
* hepatitis B or C
decreased
* kidney
* liver
* malnutriton
* celiac disease
* crohn’s disease

95
Q

ALP

A

increased
* cholestasis of pregnancy
* cirrhosis of liver
* hepatitis
* biliary atresia
* biliary stricture
* cholangiocarcinoma and pancreatic head adenocarcinoma
* mononucleosis
* bone metastasis
* paget’s disease of the bone
* osteogenic sarcoma
* fractures that are healing
* hyperparathyroidism
* hyperthyroidism
* osteomalacia
* Vit D def
* celiac disease
decreased
* malnutrition
* zinc def
* mag def
* hypothyroidism
* hypophosphatasia
* Wilson disease.

96
Q

ALT

A

increased
* Alcohol-induced liver injury.
* Fatty liver disease
* Hepatitis
* Cirrhosis
* Taking medications that are toxic to your liver.
* Liver tumor or liver cancer.
* Liver ischemia
* Hemochromatosis
* Mononucleosis
decreased
* B6 def
* chronic kidney disease

97
Q

AST

A

increased
* Alcohol-induced liver injury.
* Hepatitis
* Cirrhosis
* Taking medications that are toxic to your liver.
* Liver tumor or liver cancer.
* liver ischemia
* Heart attack
* Mononucleosis
* Muscle disease.
* Pancreatitis.
* burns
* seizures
* surgerys including heart
* intense exercise
decreased
* Vit B6 def
* chronic kidney disease

98
Q

in CMP bilirubin

A

increased
* erythroblastosis fetalis
* hemolytic anemia
* sickle cell disease
* premature birth
* mononucleosis
* wilson disease
* Crigler-Najjar syndrome
*
* Transfusion reaction
* cirrhosis
* hepatitis
* gilbert disease
* biliary stricture
* cancer of pancrease or gallbladder
* gallstones
decreased

99
Q

BUN

A

increased
* dehydration
* burns
* medications
* urinary tract obstruction
* congestive heart failure
* recent heart attack
* Gastrointestinal bleeding
* Shock
* high protein diet
* kidney disease
decreased
* malnutrtion
* lack of protien
* liver disease
* overhydration

100
Q

creatinine on CMP

A

increased
* obstruction of urinary tract
* kidney damage, faliure, infection, or reduced blood flow
* eclampsia
* preeclampsia
decreaased
* malnutriton
* muscular dystrophy
* liver disease
* low protien diet

101
Q

total serum testosterone

A

decreased
* klinefelter syndrome
* testicle injuries
cancer treatments, such as chemotherapy and radiation
stress
AIDS
alcohol use disorder
kidney disease
cirrhosis of the liver
pituitary gland conditions
autoimmune disease
infection
obesity
metabolic syndrome
using certain medications
increased
* tumor
* steroid use
* congenital adrenal hyperplasia
* PCOS
* ovarian cancer
* disorder of pitutary gland

102
Q

FSH

A

NPLEX (28 decks)

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