MIDTERMS MOD 5 Flashcards

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1
Q

PHYSIOLOGICAL VARIABLES (AADD,D/CV,DT,E,F,G,II,J,P,P,S,S,TNH)

A

AGE
ALTITUDE
DEHYDRATION
DIET
DIURNAL/CIRCADIAN VARIATIONS
DRUG THERAPY
EXERCISE
FEVER
GENDER
INTRAMUSCULAR INJECTION
JAUNDICE
POSITION
PREGNANCY
SMOKING
STRESS
TEMPERATURE and HUMIDITY

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2
Q

this refers to the resting metabolic state of the body
early in the morning after fasting for approximately 12 hours.

A

Basal state

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3
Q

this refers to values which patient results are compared to

A

Reference range

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4
Q

is ideal for establishing reference ranges on
inpatients because the effects of diet, exercise, and other
controllable factors on test results are minimized or eliminated.

A

Basal state

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5
Q

Basal state is influenced by a number of physiologic patient
variables which are ……

A

o Age
o Gender
o Conditions of the body that cannot be eliminated

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6
Q

Example of analytes affected by high altitude (both increase and decrease levels)

A

Increased levels
o RBC count
o Hemoglobin and Hematocrit levels
o Uric acid

Decreased levels
o Urinary creatinine
o Plasma renin

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7
Q

T or F

Analytes generally take weeks to adapt to high elevations/altitude; however, they adapt does not return to sea level within days.

A

F

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8
Q

a condition in which blood components that cannot easily leave the
bloodstream become concentrated in the smaller plasma volume.

A

hemoconcentration,

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9
Q

the decrease in body fluid

A

Dehydration

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10
Q

T or F

Dehydration may happen with persistent vomiting or diarrhea

A

T

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11
Q

Example of analytes that increase during dehydration

A

o RBC
o Enzyme
o Iron
o Calcium
o Sodium
o Coagulation factors (clotting factors)

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12
Q

these analyte levels may be elevated in patients on high-protein diets

A

ammonia, urea, uric acid

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13
Q

these analyte levels may be elevated in caffeine

A

Adrenocorticotropic Hormone (ADTH) , Cortisol

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14
Q

these analyte levels increase dramatically with the ingestion of carbohydrates or sugar-laden substances

A

Glucose (blood sugar)

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15
Q

Glucose (blood sugar) levels increase dramatically with the ingestion of carbohydrates or sugar-laden substances but return to normal within __________ if the patient has normal glucose metabolism.

A

2 hours

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16
Q

T or F

Eating carbohydrates can also increase insulin levels.

A

T

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17
Q

these analyte levels can decrease and electrolyte balance can be altered by drinking excessive amounts of water and other fluids (dilutional effect).

A

Hemoglobin

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18
Q

Fasting:
- Strictly no ingestion of food for approximately ________________

A

8-12 hours overnight

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19
Q

T or F

drinking of water is allowed for some fasting patients, patients who were advised not to drink water

A

T

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20
Q

(NPO: _________, meaning nothing by mouth)

A

“nil per os”

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21
Q

OVERFASTING:
fasting beyond _________

A

12 hours

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22
Q

T or F

patients who fasted beyond 12 hours will not be accepted for testing that requires fasting.

A

T

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23
Q

these analyte levels increase with the ingestion of foods such as butter or margarine, cheese, cream, and some enteral (tube feeding) preparations.

A

Lipid

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24
Q

Lipid is a term meaning ______

A

fat-soluble

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25
Q

Lipids do not dissolve in water and thus high levels of lipids are visible in serum or plasma,
causing it to appear milky (cloudy white) or turbid, and the specimen is described as being ____________

A

lipemic.

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26
Q

Lipemia can be present for up to _______ which is why accurate testing of _________ (a type of lipid) requires a __________ fast.

A

12 hours, triglycerides 12-hour

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27
Q

ingestion of large amounts of alcohol, which can also cause ________
(low blood sugar).

A

hypoglycemia

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28
Q

These analytes are increased by chronic consumption or recent ingestion of large amounts of alcohol,

A

Triglycerides, certain liver enzymes, and other liver function

29
Q

EFFECTS OF LONG-TERM STARVATION ( both Increased levels and Decreased levels )

A

Increased levels
- Creatinine
- Ketone
- Uric acid

Decreased levels
- Cholesterol
- Triglycerides
- Urea

30
Q

This means (happening daily)

A

diurnal

31
Q

This means (having a 24-hr cycle)

A

circadian

32
Q
A
33
Q

Factors that play a role in DIURNAL VARIATIONS:

A
  1. Posture
  2. Activity
  3. Eating
  4. Being awake or asleep
  5. Daylight and darkness
34
Q

These increase at night and decrease during daylight hours

A

Melatonin

35
Q

Drugs and the analytes they affect

Chemotherapy drugs - _______

A

Decreased
o WBC, platelets

36
Q

Drugs and the analytes they affect

Most drugs (that are toxic to liver)

Increase in …..
Decrease in……..

A

Increase in AST, ALP, LDH

Decrease in Clotting factors (production is affected)

37
Q

Drugs and the analytes they affect

Oral contraceptives

Increase in …..
Decrease in……..

A

Increase in Erythrocyte sedimentation rate (ESR)

Decrease in Vitamin B12

38
Q

Drugs and the analytes they affect

Steroids and diuretics
Increase in …..

A

Increase in Amylase, lipase

39
Q

Drugs and the analytes they affect

Thiazide diuretics
Increase in …..
Decrease in……..

A

Increase in Calcium, glucose
Decrease in Sodium & potassium

40
Q

Drugs that interfere with BLOOD TESTS should be stopped or avoided
________ hours prior to obtaining blood samples for testing.

A

4 to 24

41
Q

Drugs that interfere with the URINE TESTS should be avoided for __________ hours prior to the urine sample collection.

A

48 to 72

42
Q

Reminder: review exercise, position, and intramuscular

A
43
Q

Fever also increases ______ and may disrupt its normal diurnal variation.

A

cortisol

44
Q

Fever-induced hypoglycemia increases ______ levels, followed by a rise in __________ levels.

A

insulin…glucagon

45
Q

T or F

RBC, hemoglobin and hematocrit values – higher among females than in males

A

F

46
Q

Yellow pigment of skin

A

Jaundice (icterus)

47
Q

The term ________ means relating to or marked by jaundice and is used to describe serum, plasma, or urine specimens that have an abnormal deep yellow to yellow-brown color due to high bilirubin levels.

A

Icterus

48
Q

T or F

Jaundice can interfere in reagent-strip analyses on urine.

A

T

49
Q

In Standing position

  • RBC count may increase approximately ________ in a standing position.
A

15 minutes

50
Q

WHY does potassium ion levels significantly increase within 30 minutes of standing

A

Because of the release of intracellular potassium from muscle.

51
Q

T or F

During pregnancy, body fluids normally increase, and may have a diluting effect on the RBCs, leading to a higher RBC count.

A

F

Lower RBC count not Higher

52
Q

Patients who smoke prior to specimen collection may increase:

A
  • Cholesterol
  • Growth hormone
  • Cortisol
  • Triglycerides
  • Glucose
  • WBC count
53
Q

Chronic smoking increases:

A
  • RBC count
  • Hemoglobin levels
54
Q

Generally, smoking can:

A
  • Decrease immunoglobulins IgA, IgG, IgM
  • Increase immunoglobulin IgE
55
Q

T or F

in Crying infants an Increased WBC count may be observed

A

T

56
Q

Generally, STRESS may affect analyte values
Increased in _____
Decreased in ________

A

Increased in ACTH, Catecholamines, Cortisol
Decreased in Iron

57
Q

T or F

Acute heat exposure causes interstitial fluid to move into the blood vessels, decreasing plasma volume and influencing its composition.

A

F

increasing plasma volume

58
Q

This factor may influence the composition of body fluids.

A

TEMPERATURE and HUMIDITY

59
Q

causes interstitial fluid to move into the blood vessels, increasing
plasma volume and influencing its composition.

A

TEMPERATURE and HUMIDITY

60
Q

Some patients’ veins feel hard and cord-like and lack resiliency because they are
occluded or obstructed. These veins may be ________________________ or _______________________ from the effects of inflammation, disease, or chemotherapy drugs.

A

sclerosed (hardened) ; thrombosed (clotted)

61
Q

Patient’s with possible damaged veins:

A
  1. regular blood donors
  2. persons with chronic illnesses (cancer)
  3. illegal IV drug users
62
Q

_________ is swelling caused by the abnormal accumulation of fluid in the tissues.

A

Edema

63
Q

A ___________ is a swelling or mass of blood (often clotted) that can be caused by blood leaking from a blood vessel during or following venipuncture.

A

hematoma

64
Q

Reasons why specimens collected from bruised (with hematoma) areas are avoided:

A
  1. The site is painful
  2. The site may be contaminated with hemolyzed blood from outside the vein
    (NOTE: never use hemolyzed blood sample for testing as it would lead to erroneous results)
  3. Obstruction of blood flow may occur as the effects of the clotting process may also lead to inaccurate test results.
65
Q

_____________patients often present challenge to the phlebotomist. Veins on obese patients may be deep and difficult to find. Proper tourniquet selection and application is the first step to a successful venipuncture.

A

Obese

66
Q

________(obstruction or stoppage of normal lymph flow).

A

lymphostasis

67
Q

Impaired lymph flow makes the arm susceptible to swelling, called, ____________, and to infection.

A

lymphedema

68
Q
A