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Pathology > Lecture 3-6 - Lab Diagnostics > Flashcards

Lecture 3-6 - Lab Diagnostics Flashcards

1
Q

What’s the correct equation for determining positive predictive value?

A

TP/(TP+FP)

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2
Q

What percent of healthy individuals is equal to 1 standard deviation?

A

68%

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3
Q

Red blood cell counts & hemoglobin/hematocrit levels in people living in the Himalayan mountains are expected to be ____ than people living at sea level due to ____ oxygen levels.

A

Higher

Decreased

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4
Q

To be anemic, what do your hematocrit and hemoglobin levels have to be?

A

Low

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5
Q

If you order 20 tests on a healthy person, what’s the chance that at least one will be outside the reference range?

A

Test #1 -> 0.95^1 = 0.95 = 5%
Test #5 -> 0.95^5 = 0.77 = 23%
Test #20 -> 0.95^20 = 0.35 = 65%

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6
Q

Testing glucose/HgA1c monitors for what?

A

Diabetes

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7
Q

What is the most important renal function test?

A

BUN/creatinine

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8
Q

What is the most important Liver test?

A

ALT

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9
Q

What is the most likely test to check heart levels?

A

Troponin

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10
Q

What is the fasting blood sugar level and random blood sugar level that you can automatically diagnose diabetes with?

A

Fasting DM = 126 mg/dL or higher

Random Blood sugar = any time it’s greater than 200

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11
Q

What’s the HgA1c that signifies the pt has diabetes?

A

> 6.5%

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12
Q

What’s the best liver test we have?

A

ALT

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13
Q

What test is most specific for the ductal cells of the liver?

A

ALP

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14
Q

When there is a loss of function of the liver, what loss of functions does the pt get?

A
  • Bilirubin fails to be cleared
  • Albumin is not synthesized (Na+ and albumin are huge blood pressure factors)
  • Clotting factors (proteins) are not synthesized (if liver function drops, then clotting is reduced more too)
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15
Q

Identify the blood test that best supports liver failure

A

Rising bilirubin levels

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16
Q

Which tests are used to monitor damage to the liver as an early warning system? (To prevent it from failing)

A

ALT and AST

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17
Q

In normal adults, double the serum creatinine approximates how much GFR?

A

It approximates halving the GFR

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18
Q

What is the creatinine level in normal healthy adults?

A

1

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19
Q

If the creatinine levels are 2, then how much kidney function does the pt have?

A

50%

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20
Q

If the creatinine levels are 4, then how much kidney function does the pt have?

A

25% kidney function

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21
Q

If glomerular filtration rate is 30ml/min, how much percentage kidney function is this?

A

30%

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22
Q

If someone gets down to about a 30% GFR, which is about a serum creatinine of 3-4, then what do they need to do?

A

See a nephrologist

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23
Q

If someone gets down to about a 15% GFR, then what do they need to do?

A

Be put on dialysis or receive a transplant b/c they are going to die

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24
Q

Where is myoglobin primarily found?

A

All muscle tissue

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25
Q

CPK is the energy source primarily for what?

A

Muscle contraction

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26
Q

Troponin I/T is found where?

A

It is protein that is found in heart muscle only

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27
Q

Between myoglobin and troponin, which one usually reacts quicker?

A

Myoglobin

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28
Q

Between myoglobin and troponin, which one is more specific?

A

Troponin for the heart

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29
Q

What is the goal for total cholesterol?

A

<200 mg/dL

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30
Q

What is the goal for HDL-C (high-density lipoprotein cholesterol)?

A

> 40 mg/dL

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31
Q

What is the goal for LDL-C (low-density lipoprotein cholesterol)?

A

<100 mg/dL

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32
Q

What does LDL promote?

A

Atherosclerosis

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33
Q

What is the goal for triglycerides?

A

<150 mg/dL

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34
Q

If you have a very high (>500 mg/dL) triglyceride value, what is it associated with?

A

Pancreatitis

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35
Q

What values of glucose show that the pt is pre-diabetic?

A

100-125

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36
Q

What 2 tests look for hepatocytes?

A

ALT and AST

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37
Q

What 3 tests are damage liver tests?

A

ALP
ALT
AST

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38
Q

What test is a function liver test?

A

Bilirubin

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39
Q

Which metabolic panel looks at liver function?

A

CMP = comprehensive metabolic panel

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40
Q

Which metabolic panel doesn’t look at liver function?

A

BMP = basic metabolic panel

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41
Q

Identify the condition and/or organ system that is measured by a comprehensive metabolic panel (CMP), but not a basic metabolic panel (BMP).

A

Liver function

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42
Q

What function is not measure in either BMP (basic metabolic function) or CMP (comprehensive metabolic function)?

A

Cardiac function

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43
Q

Composes WBC count, RBC count, HGB/HCT, RBC indices (MCV, MCHC, RDW), and platelet count (PLT)

A

Complete blood count (CBC)

44
Q

Composes WBC count, RBC count, HGB/HCT, RBC indices (MCV, MCHC, RDW), and platelet count (PLT)
WITH WBC TYPES (neutrophils, lymphs, monocytes, eosinophils, basophils)

A

CBC with Differential

45
Q

If only one is low out of HGB and HCT, then is it anemia?

A

No

46
Q

If both HGB and HCT are low, is it anemia?

A

Yes

47
Q

What is the primary test to look at to see what type of anemia the pt has (volume of blood cells)?

A

MCV

48
Q

What is the Erythrocytes sedimentation rate (ESR)?

A

How fast RBCs settle out in a tube (mm/hour)

49
Q

What is the normal ESR (erythrocyte sedimentaion rate)?

A

0 - 20 mm plasma

50
Q

What are the 2 tests that screen for inflammation?

A

ESR and CRP

Erythrocytes sedimentation rate and C-reactive protein

51
Q

Is the erythrocyte sedimentation rate (ESR) a specific test for a certain disease?

A

It is not specific to certain diseases. You can’t differentiate things from it. Therefore, it’s only a good screening test.

52
Q

Explain you a high ESR suggests inflammation

A

Liver gets excited and produces reactive substances because of interluken-6, which creates fibrinogens. These are sticky, and they stick to RBC membranes, making them precipitate out faster.

53
Q

How many factors are there in forming a clot?

A

13

54
Q

Which coagulation pathway uses naked collagen?

A

The contact factor pathway (intrinsic pathway)

55
Q

Which coagulation pathway uses exploded tissues (tissue factor III)?

A

Tissue factor pathway (extrinsic pathway)

56
Q

What are the 4 vitamin K-dependent factors?

A

II, VII, IX, X

57
Q

Which vitamin K-dependent factor is the most important (ultra-dependent on vitamin K)?

A

VII

58
Q

Where are vitamin K-dependent factors produced?

A

In our gut

59
Q

The contact factor pathway is responsible for making which factor?

A

IX

60
Q

The tissue factor pathway is responsible for making which factor?

A

VII

61
Q

Which factors does heparin target?

A

X and II

62
Q

Which factors does warfarin (Coumadin) target?

A

VII BIG TIME!!!

63
Q

Vitamin K antagonist

A

Coumadin (warfarin)

64
Q

What factors does Coumadin (warfarin) hit?

A

II, VII, IX, X

65
Q

What is coumadin (warfarin) monitored with?

A

PT/INR (prothrombin time) - tissue factor pathway

66
Q

Why is VII affected so much by Coumadin (warfarin)?

A

It has a very short half life

67
Q

Antithrombin activator

A

Heparin

68
Q

A patient has hemophilia, which is the most common serious bleeding disorder in the world. What does it have an absence of? What test do you use for this?

A
  • Factor VIII (8)

- Use PTTT

69
Q

What is PT/INR used to monitor?

A

Warfarin/Coumadin therapy, and liver function

70
Q

Most common serious bleeding disorder

A

Hemophilia

71
Q

What do you divide to find INR (international normalization ration)?

A

INR = Pt’s time to clot/normal time to clot

72
Q

What is the common target PT/INR range for DVT prophylaxis (deep vein thrombosis)?

A

2.0 to 3.0

73
Q

What is the common target PT/INR range for a mechanical heart valve?

A

2.5 to 3.5

74
Q

What composes neutrophils?

A

Segs, bands, and milos

PMNs and Segs

75
Q

What test determines anemia?

A

MCV

76
Q

Certain infections can be WBC indicators. If you have elevated WBC’s, what does neutrophilia suggest?

A

Bacterial source

77
Q

Certain infections can be WBC indicators. If you have elevated WBC’s, what does lymphocytosis suggest?

A

Viral source

78
Q

Certain infections can be WBC indicators. If you have elevated WBC’s, what does eosinophilia suggest?

A

Allergies or worms

79
Q

With leukemia, does the patient have high or low WBC count?

A

Either

80
Q

What is the HGB x 3 rule?

A

Give HGB, multiply by 3, and get hematocrit (HCT)

Hematocrit/3 = hemoglobin

81
Q

What is the level of RBCs in a patient with polycythemia vera?

A

High RBC count

82
Q

Neoplastic proliferation of RBCs causing increased RBC, HGB, and HCT

A

Polycythemia vera

83
Q

What are the criteria for HGB in women with anemia?

A

Less than 12 g/dL

84
Q

What are the criteria for HGB in men with anemia?

A

Less than 13.5 g/dL

85
Q

What is the criteria of HGB in anemia when you think about transfusing?

A

Less than 10 g/dL

86
Q

What is the criteria of HGB in anemia when you have to transfuse? What is the HCT level?

A

7 g/dL

HCT = 21

87
Q

Characteristics of microcytic anemia

A

MCV < 80

Iron-Deficiency anemia

88
Q

Characteristics of normocytic anemia

A

MCV 80-100
Recent blood loss
Anemia of chromic disease
Renal failure

89
Q

Characteristics of macrocyctic anemia

A

MCV>110
Vitamin B12 deficiency
Folic acid deficiency

90
Q

What’s the most common type of anemia?

A

Microcytic anemia (MCV<80)

  • iron-deficiency anemia
  • thalassemia
91
Q

Other term for microcytic anemia?

A

Megaloblastic anemia

92
Q

Recall the most common screening tests for syphilis

A
  • RPR (rapid plasma reagin)

- Venereal Disease Research Lab (VDRL)

93
Q

Explain why RPR and VDRL must be followed

with either a FTA-ABS or MHA-TP when testing for syphillis

A

RPR and VDRL are sensitive for syphillis, but they are not specific for it, therefore they are only screening tests.
FTA-ABS and MHA-TP can confirm that the disease is or is not syphillis after the screening test marks it a possibility for being syphillis.

94
Q

Interpret a urinalysis to determine if the patient has a urinary tract infection

A
  • Leukocyte esterase
  • blood
  • nitrite
  • protein
95
Q

Interpret a urinalysis to determine if the patient has uncontrolled
diabetes

A

-glucose

96
Q

Which diagnostic test is least valuable for visualizing soft tissues?

A

X-ray (radiography)

97
Q

What does ANA (antinuclear antibody test) look for?

A

Connective tissue diseases

98
Q

What are the two most common autoimmune conditions that are observed with ANA (antinuclear antibody test)?

A
  • Systemic lupus erythematosus (SLE) - 95%

- Scleroderma - 60-90%

99
Q

If a patient that has lupus tests positive for ANA (antinuclear antibody test), what 2 tests do you have to run to confirm it?

A
  • anti-double-stranded DNA

- anti-Sm

100
Q

Which diagnostic test penetrates soft tissues easily and dense tissues less easily?

A

X-ray (radiography)

101
Q

Which diagnostic test can image more soft tissue structures difficult to see on traditional x-ray, and is more sensitive than traditional x-ray (multiple angle x-ray)?

A

CT-scan (computer tomography)

102
Q

Which diagnostic test is used to image areas where soft tissues meet (ex: spinal cord)?

A

MRI (magnetic resonance imaging)

103
Q

Which diagnostic test uses sound waves to produce the image in a variety of tissues?

A

Ultrasound

104
Q

Which diagnostic test uses radioactive material to produce an image?

A

Nuclear scans

105
Q

Which diagnostic test uses magnetic fields/radio waves to produce images?

A

MRI (magnetic resonance imaging)

Pathology (4 decks)

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