Med Surg Focused Review

Question 1

RBC (Normal Range, Causes of Increased or Decreased Levels)

Answer 1

Females: 4.2 to 5.4 million/ul
Males: 4.7 to 6.1 million/ul
Elevated level: erythrocytosis, polycythemia vera, severe dehydration
Decreased level: anemia, hemorrhage, kidney disease

Question 2

WBC (Normal Range, Causes of Increased or Decreased Levels)

Answer 2

5,000 to 10,000/mm3
Elevated level: infection, inflammation.
Decreased level: immunosuppression, autoimmune disease

Question 3

MCV

Mean Corpuscular Volume

Answer 3

80 to 95 fl
Elevated level: macrocytic (large) rBcs, megaloblastic anemia.
Decreased level microcytic (small) rBcs, iron deficiency anemia

Question 4

MCH

Mean Corpuscular Hgb

Answer 4

27 to 31 pg/cell
Elevated/decreased level: same as above for mcV (Elevated level: macrocytic (large) rBcs, megaloblastic anemia.
Decreased level microcytic (small) rBcs, iron deficiency anemia)

Question 5

TIBC

Total iron-binding count

Answer 5

250 to 460 mcg/dl
Elevated level: iron deficiency anemia, polycythemia vera
Decreased level: malnutrition, cirrhosis, pernicious anemia

Question 6

IRON

Answer 6

Females: 60 to 160 mcg/dl
Males: 80 to 180 mcg/dl
Elevated level: hemochromatosis, iron excess, liver disorder, or lead toxicity.
Decreased level: iron deficiency anemia, chronic blood loss, inadequate dietary intake of iron.

Question 7

PLATELETS

Answer 7

150,000 to 400,000 mm3
Increased level: malignancy, polycythemia vera, rheumatoid arthritis.
Decreased level: enlarged spleen, hemorrhage, leukemia

Question 8

HGB

Answer 8

Females: 12 to 16 g/dl
Males: 14 to 18 g/dl
Elderly: levels slightly decreased
Elevated level: erythrocytosis, coPD, severe dehydration
Decreased level: anemia, hemorrhage, kidney disease

Question 9

HCT

Answer 9

Females: 37 to 47%
Males: 42 to 52%
Elderly: levels slightly decreased
Elevated /decreased level: same as above for Hgb

Question 10

APTT

Answer 10

30 to 40 seconds (1.5 to 2.5 times the control value if receiving heparin therapy)
Increased time: vitamin K deficiency, disseminated intravascular coagulation (Dic), liver disease, heparin administration
Decreased time: extensive cancer

Question 11

PT

Answer 11

11 to 12.5 seconds, 85 to 100%, or 1:1.1 client‑control ratio
Increased time: of clotting factors ii, V, Vii, or X, liver disease, warfarin therapy, disseminated intravascular coagulation
Decreased time: vitamin K excess, pulmonary embolus, thrombophlebitis

Question 12

INR

Answer 12

0.8 to 1.1 (desired goal of 2 to 3 on warfarin therapy) measures the mean of Pt to provide a universally recognized value.
Elevated level: warfarin therapy
Decreased level: cancer disorders

Question 13

D‑DIMER

Answer 13

less than 0.4 mcg/ml
Positive result: disseminated intravascular coagulation, malignancy
Negative result: can rule out pulmonary embolus or deep vein thrombosis

Question 14

FIBRINOGEN LEVELS

Answer 14

200 to 400 mg/dl
Elevated level: acute inflammation, acute infection, heart disease
Decreased levels: liver disease, advanced cancer, malnutrition

Question 15

FIBRIN DEGRADATION PRODUCTS

Answer 15

less than 10 mcg/ml
Elevated level: disseminated intravascular coagulation, massive trauma resulting in fibrinolysis
Decreased level: antic

Question 16

CBC

Answer 16

Includes RBC, WBC, MCV, MCH, Hgb, and Hct