Labs test 2 Flashcards
LDL goals
- <100 for avg person
- <70 for high risk (DM, CAD, any strain on heart)
HDL goals
- M >45
- F >55
Trigs goals
- M <160
- F <135
critical trigs level
> 400
total chol goal
<200
is CK-MB more or less sensitive and specific than troponins?
less
what cardiac test is most specific for MI
troponin
BNP level to r/o HF
<100
BNP >400 means
HF
FT3 is to test for what
hyperthyroidism
primarily used as a tumor marker to evaluate the effectiveness of treatment for thyroid cancer and to monitor for recurrence.
thyroglobulin test
Calcitonin is increased in
Medullary carcinoma of the thyroid
GH: stimulation and suppression tests or random measurements preferred?
stimulation and suppression tests
when is TRH ordered
when we need to evaluate the function of the pituitary gland.
when to test HTN pts for aldosterone
Primarily used to screen hypertensive patients for possible Conn syndrome (adrenal adenoma producing excess aldosterone) for persistent or unresponsive HTN
best collection method for catecholamines
24 hour urine specimen
when to test for C-peptide
Used to differentiate endogenous insulin from exogenous insulin and production/administration
• Help tell when trying to differentiate type 1 diabetes and type 2 diabetes
LFTs that measure synthetic function
- Albumin, Protein, globulin
* Don’t forget PT, PTT
LFTs that measure inflammation
- Alanine Amino Transferase (ALT)
- Aspartate Amino Transferase (AST)
- Alkaline Phosphatase (ALP)
- Can also include
- Lactate Dehydroginase (LDH)
- Gamma Glutamyl Transferase (GGT)
LFTs that measure biliary function/cleansing
- Bilirubin (total, direct, indirect)
* Don’t forget Ammonia
is ALT or AST more specific to liver
ALT
most sensitive marker of biliary obstructionff
GGT
ALP: think ______
biliary tree
AST/ALT >2
alcoholic hepatitis
main elements of celiac panel
- Tissue Transglutaminase (tTG) Antibody, IgA
- Gliadin Antibody, IgA
- Total IgA
C-reactive protein is sensitive for
inflammation
ideal Protein/creatinine ratio
<0.2
dipstick glucose critical value
4+ is a critical value (>1000mg/dL)
normal renal threshold of glucose
180
Unconjugated bilirubin gets excreted where
stool
fatty cast means
nephrotic syndrome
BUN and serum creatinine: which overestimates GFR
serum Cr
Creatinine Clearance formula
UV/P
• U = mg per dL of creatinine excreted in the urine over 24 hours
• V = volume of urine in mL per minute
• P = serum creatinine in mg per dL
lab difference: past HBV vs HBV vax’ed
both have HBsAb antibody. past infx also has HBcAb (IgG)
pCO2 range
35-45
pH range
7.35-7.45
bicarb range
22-26
causes of ? • Chronic lung disease (BPD, COPD) • Neuromuscular disease • Extreme obesity • Chest wall deformity
acute resp acidosis
when does CK-MB rise, peak, return to normal
t rises 3-6 hours after infarction, peak 12-24 return to normal in 12-48 hours
Which typically stays elevated longer: troponin I or troponin T?
Troponin T (elevated 10-14 days compared to 7-10 days for I)
What percentage of calcium is in the bones, what percentage circulates?
99% in bones, 1% in blood
Of the circulating calcium, how much is free and how much is bound?
½ of the 1% circulating ca is free and ½ is bound (total free = 0.5%; total bound = 0.5%)
corrected total Ca formula
0.8 (normal albumin (or 4) - measured albumin) + reported calcium
What is worse for your heart - hyper or hypocalcemia?
hyper
check what hormone in hyponatremia
ADH
urine pH >7.5
proteus infx
bence jones proteins in urinalysis
multiple myeloma
BUN/Cr ratio in pre-renal failure and intra
Pre-renal failure: BUN/Cr ratio >20:1
Intrinsic renal failure (BUN/Cr ratio <20:1)
Cockcroft-Gault equation (for CrCl of serum)
[(140 - pt’s age)(wt in kg)] / (72 x serum creatinine)
anion gap formula
Na - (Cl+HCO3)
normal anion gap
12
causes of high anion gaps
MUDPILES
Methanol, Uremia, DKA, Paraldehyde, Isopropyl alcohol, Lactic acidosis, Ethylene glycol & Ethanol, Salicylates
