Module 5 Lab Data Flashcards
What is the purpose of a lab test
- Diagnose
- Treat
- Monitor
- prevent
- diseases
What lab tests do RT usually assess?
- ABGS
- Pulmonary secretions
- pleural fluid samples
- bronchoscopy samples
Critical value
Result that are VERY out of normal range and are potentially life threatening
What are the 4 test parameters that give info to make a diagnosis?
True positive
False positive
True negative
False negative
True Positive
The test is positive in a patient with disease
False Positive
Positive test occurs in a disease free patient
True Negative
Negative test in a disease free patient
False Negative
Negative test in a patient with disease
Sensitivity
Frequency of positive results in patients with disease
Specificity
Frequency of negative ntest results in patient without disease.
Total Body Weight Composition
Blood 8%
92% = other fluids and tissues
Composition of whole blood
Formed elements = 45%
Plasma = 55%
platelets <1%
Composition of whole blood:
Protein (7%)
Plasma –>Other solutes
Albumins (57%)
Globulins (38%)
Fibrinogen (4%)
Prothrombin (1%)
Composition of whole blood:
Other solutes (2%)
Plasma–>
What role does Albumin have with blood vessels?
ALbumin is a protein that keeps water inside the blood vessel.
Third spacing
Fluid is not staying in the vessel and they appear puffy
What is Hematology
Study of blood
2 branches of Hematology
Complete Blood Count (CBC) and Coagulation test
Complete Blood count (CBC)
Identifies normal and abnormal values of blood cells
Looking for everything and anything
What does a CBC test include?
RBC
WBC
Hemoglobin
Hematocrit
WBC differential
Platelet count
Coagulation tests
Screen for blood clotting abnormalities
What is a white blood cell differential count?
Breakdown of WBC and tells how much of each cell they have.
What is Hematocrit
Ratio of volume of RBC to total volume of blood
[percentage of blood made up of RBC]
- 41-50% = normal men
- 36-48% = normal women
what do Hematocrit levels indicate?
Can tell if a patient is dehydrated.
if the patient is dehydrated, it doesn’t affect their hemoglobin, but it affects their total blood volume and therefore the hematocrit % will be higher.
Thrombocytes
Platelets
Normal Values:
WBC Count
3.9-11.7 x10^3/uL
Normal Values:
Neutrophils & bands
2.0-8.0 x 10^9/L (40-75%)
Bands:
0-6%
Normal Values:
Lymphocytes
0.7-3.5 x 10^9/L (20-45%)
Normal Values:
Monocytes
0.0-1.0 x 10^9/L (2-10%)
Normal Values:
Eosinophils
0.0-0.7 x 10^9/L (0-6%)
Normal Values:
Basophils
0.0-0.2 x 10^9/L (0-1%)
List the leukocytes differentials in order of most abundant to least abundant.
-Neutrophils
-Lymphocytes
-Monocytes
-Eosinophils
-Basophils
What is the percentage breakdown for each element in Leukocytes?
Neutrophils (60-70%)
Lymphocytes (20-25%)
Monocytes (3 -8%)
Eosinophils (2-4)
Basophils (0.5 - 1%)
Which leukocytes have a difference between course and Egans percentage?
The two biggest: Neutrophils and lympocytes
Slides: Neutrophils (60-70%)
Lymphocytes (20-25%)
Egans: (40-75) and (20 - 45)
What could high WBC count indicate?
Could be an indication of infection
-i.e. Pneumonia
What are bands?
Baby neutrophils
What is the function of a white blood cell?
-Major component of immune system
-Protects against pathogenic microorganisms, foreign antigens
-Develop in bone marrow or lymphoid tissues
-Released into peripheral blood when mature
Abnormalities in the WBC count:
Neutrophilia/Neutropenia
- Increased neutrophils
- Decreased neutrophils
WBC Abnormalities:
Leukocytosis
Increased WBC
Cause: infection, inflammation, stress
Why is high WBC a problem when not controlled?
Unable to produce RBCS
WBC Abnormalities:
Leukopenia
Decreased WBC
Cause:
Drug toxicity
Bone marrow failure
Autoimmune reactions
Neutropenia
Sign of decreased bone marrow production
OR
Increased destruction of neutrophils in peripheral blood/tissue
Lymphocyte
Fight infection; promote immunity
Monocyte
Immediate and sustained response to inflammation/infection
engulfs stuff.
Eosinophil
immune system regulation
think allergic reactions
Basophils
immune system regulation
difference between Basophils and Eosinophils?
Basophils are largely circulating cells, but home to areas of allergic inflammation during the late phase response.
Eosinophils are resident to the GI tract, but also home to allergic inflammatory sites.
What shared function do Basophils and Eosinophils have?
Defense against parasites or allergic reactions, but also they play important roles in:
- Sntigen presentation
- Immune memory response
- and T helper 2 cell (Th2) differentiation.
Define Thrombus
Blood clot that forms inside a blood vessel
Blood clot definitions:
Embolus
if the thrombus dislodges and moves into circulation
Blood clots are concerning in
Acute myocardial infarction (AMI)
Acute Ischemic stroke (AIS)
Pulmonary embolism (PE)
Deep vein thrombosis (DVT)
What is D-Dimer
Measures protein fragment when clot dissolves
Thrombolytic Agents?
Prevent or “bust” existing clots
Clot buster?
If a clot is already formed, a clot buster is used.
tPA (stroke)
Streptokinase
Agents that slow platelet aggregation (preventative)?
ASA
Clopidogrel
What lab result helps diagnose pneumonia?
Sputum expectoration
Pleural effusion caused by Transudate and Exudate.
Factor for transudate?
Indicates a pressure differential that moves fluid from intravascular to extravascular space (only fluid, not protein
i.e CHF or chronic renal failure
Pleural effusion caused by Transudate and Exudate.
Factor for Exudate?
Usually caused by infection-inflammation makes vessel wall more permeable to fluid and protein
Infections: bacterial pneumonia, TB, Fungal, viral, pulmonary abscess (empyema), infarction, trauma, various cancers (especially breast), and pancreatitis
Bronchial washing
used to find infections.
salt solution is basically washed surface of airways
Bronchial washing
used to find infections.
salt solution is basically washed surface of airways
Basic chem 7 for tests?
electrolytes (Na+, K+, Cl-, Total CO2)
glucose level
renal-function tests
blood urea nitrogen (BUN)
creatinine
Sodium function
Controls osmotic pressure, water distribution, and extracellular fluid volume
- major osmotic ally active particle in the extracellular fluid
How is sodium balanced by the body?
The kidneys excrete excess via urine
- Aldosterone regulates sodium levels by increasing sodium reabsorption in exchange for potassium or hydrogen
Sodium normal values
Normal: 133-146 mmol/L
- Critical limits < 125 and >155mol
What are causes of excessive sodium (hyponatermia)
Increased body water (Na is diluted), renal loss, or extra renal loss.
- CHF, cirrhosis w/ascites, or excessive hypotonic IV fluid admin
- vomiting, diarrhea, sweating
- Enforced diuresis, drugs, DKA, renal damage, Hormonal abnormalities
What would cause Hypernatermia (increases plasma Na)
Excessive water loss (extra renal) via sweating or diarrhea
- inadequate water intake
- excessive Na retention (too much aldosterone or corticosteroids)
