Labs test 2

Question 1

LDL goals

Answer 1

• <100 for avg person

- <70 for high risk (DM, CAD, any strain on heart)

Question 2

HDL goals

Answer 2

• M >45

- F >55

Question 3

Trigs goals

Answer 3

• M <160

- F <135

Question 4

critical trigs level

Answer 4

> 400

Question 5

total chol goal

Answer 5

<200

Question 6

is CK-MB more or less sensitive and specific than troponins?

Answer 6

less

Question 7

what cardiac test is most specific for MI

Answer 7

troponin

Question 8

BNP level to r/o HF

Answer 8

<100

Question 9

BNP >400 means

Answer 9

HF

Question 10

FT3 is to test for what

Answer 10

hyperthyroidism

Question 11

primarily used as a tumor marker to evaluate the effectiveness of treatment for thyroid cancer and to monitor for recurrence.

Answer 11

thyroglobulin test

Question 12

Calcitonin is increased in

Answer 12

Medullary carcinoma of the thyroid

Question 13

GH: stimulation and suppression tests or random measurements preferred?

Answer 13

stimulation and suppression tests

Question 14

when is TRH ordered

Answer 14

when we need to evaluate the function of the pituitary gland.

Question 15

when to test HTN pts for aldosterone

Answer 15

Primarily used to screen hypertensive patients for possible Conn syndrome (adrenal adenoma producing excess aldosterone) for persistent or unresponsive HTN

Question 16

best collection method for catecholamines

Answer 16

24 hour urine specimen

Question 17

when to test for C-peptide

Answer 17

Used to differentiate endogenous insulin from exogenous insulin and production/administration
• Help tell when trying to differentiate type 1 diabetes and type 2 diabetes

Question 18

LFTs that measure synthetic function

Answer 18

• Albumin, Protein, globulin

* Don’t forget PT, PTT

Question 19

LFTs that measure inflammation

Answer 19

• Alanine Amino Transferase (ALT)
• Aspartate Amino Transferase (AST)
• Alkaline Phosphatase (ALP)
• Can also include
• Lactate Dehydroginase (LDH)
• Gamma Glutamyl Transferase (GGT)

Question 20

LFTs that measure biliary function/cleansing

Answer 20

• Bilirubin (total, direct, indirect)

* Don’t forget Ammonia

Question 21

is ALT or AST more specific to liver

Answer 21

ALT

Question 22

most sensitive marker of biliary obstructionff

Answer 22

GGT

Question 23

ALP: think ______

Answer 23

biliary tree

Question 24

AST/ALT >2

Answer 24

alcoholic hepatitis

Question 25

main elements of celiac panel

Answer 25

* Tissue Transglutaminase (tTG) Antibody, IgA * Gliadin Antibody, IgA * Total IgA

Question 26

C-reactive protein is sensitive for

Answer 26

inflammation

Question 27

ideal Protein/creatinine ratio

Answer 27

<0.2

Question 28

dipstick glucose critical value

Answer 28

4+ is a critical value (>1000mg/dL)

Question 29

normal renal threshold of glucose

Answer 29

180

Question 30

Unconjugated bilirubin gets excreted where

Answer 30

stool

Question 31

fatty cast means

Answer 31

nephrotic syndrome

Question 32

BUN and serum creatinine: which overestimates GFR

Answer 32

serum Cr

Question 33

Creatinine Clearance formula

Answer 33

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

Question 34

lab difference: past HBV vs HBV vax'ed

Answer 34

both have HBsAb antibody. past infx also has HBcAb (IgG)

Question 35

pCO2 range

Answer 35

35-45

Question 36

pH range

Answer 36

7.35-7.45

Question 37

bicarb range

Answer 37

22-26

Question 38

``` causes of ? • Chronic lung disease (BPD, COPD) • Neuromuscular disease • Extreme obesity • Chest wall deformity ```

Answer 38

acute resp acidosis

Question 39

when does CK-MB rise, peak, return to normal

Answer 39

t rises 3-6 hours after infarction, peak 12-24 return to normal in 12-48 hours

Question 40

Which typically stays elevated longer: troponin I or troponin T?

Answer 40

Troponin T (elevated 10-14 days compared to 7-10 days for I)

Question 41

What percentage of calcium is in the bones, what percentage circulates?

Answer 41

99% in bones, 1% in blood

Question 42

Of the circulating calcium, how much is free and how much is bound?

Answer 42

½ of the 1% circulating ca is free and ½ is bound (total free = 0.5%; total bound = 0.5%)

Question 43

corrected total Ca formula

Answer 43

0.8 (normal albumin (or 4) - measured albumin) + reported calcium

Question 44

What is worse for your heart - hyper or hypocalcemia?

Answer 44

hyper

Question 45

check what hormone in hyponatremia

Answer 45

ADH

Question 46

urine pH >7.5

Answer 46

proteus infx

Question 47

bence jones proteins in urinalysis

Answer 47

multiple myeloma

Question 48

BUN/Cr ratio in pre-renal failure and intra

Answer 48

Pre-renal failure: BUN/Cr ratio >20:1 | Intrinsic renal failure (BUN/Cr ratio <20:1)

Question 49

Cockcroft-Gault equation (for CrCl of serum)

Answer 49

[(140 - pt’s age)(wt in kg)] / (72 x serum creatinine)

Question 50

anion gap formula

Answer 50

Na - (Cl+HCO3)

Question 51

normal anion gap

Answer 51

12

Question 52

causes of high anion gaps

Answer 52

MUDPILES | Methanol, Uremia, DKA, Paraldehyde, Isopropyl alcohol, Lactic acidosis, Ethylene glycol & Ethanol, Salicylates