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MSK clin Med > MSK Lab Medicine > Flashcards

MSK Lab Medicine Flashcards

1
Q

What is specificity

A

Ability to correctly identify those WITH disease

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2
Q

What is the true negative rate for a test that has 90% specificity

A

90%

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3
Q

What is sensitivity

A

Ability to correctly identify those WITHOUT disease

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4
Q

What is the positivity rate if the sensitivity is 90%

A

90%

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5
Q

What two results can you have with sensitivity

A

True positive and false negative

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6
Q

What results can you have with specificity

A

True negative
False positive

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7
Q

What is SPIN

A

Specificity

Specific Tests, when Positive, rule disease In

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8
Q

What is SNOUT

A

Sensitivity
Sensitive tests, when Negative, rule disease Out

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9
Q

What is accuracy

A

Measure of closeness to the true value (to correctly measure what we intend it to measure)

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10
Q

What is precision

A

Measure of reproducibility of the test

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11
Q

What is the reference range

A

Normal range of lab tests

Can be dependent on patient (age, gender,liver, or kidney function

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12
Q

What is the critical value

A

The panic value

Requires urgent intervention

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13
Q

What does stratum mean

A

immediately

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14
Q

How fast do STAT labs result

A

45-90 min

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15
Q

When is point of care testing used

A

Used for real time decision making

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16
Q

What does APR stand for

A

Acute Phase Reactants

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17
Q

What is more specific than ESR and CRP

A

procalcitonin

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18
Q

What metabolic dysfunction disorders may lead to elevated CRP

A

PCOS and diabetes

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19
Q

Which inflammatory marker test picks up RA

A

ESR more so than CRP

20
Q

What is a traditional CRP value

A

<1mg/dL or <10mg/L

21
Q

What CRP value is highly suggestive of bacterial infection

A

> 10mg/dl or 100mg/L

22
Q

What ESR level is highly suggestive of a bacterial infection

A

> 100mm/h

23
Q

Which inflammatory marker is easily impacted by pro-inflammatory states

A

ESR

24
Q

What does ESR measure

A

The speed at which the RBCs fall

25
Q

What may cause elevated ESR

A

malignancy
trauma
surgery
CKD
anemia
obesity
lab error

26
Q

What may lead to false low ESR level

A

CHF
Cachexia
lab error
leukocytosis

27
Q

What is procalcitonin used for

A

Guides antibiotic treatment and monitor bacteremia and sepsis

28
Q

What is the normal level for a PCT

A

.5ng/mL

29
Q

How quickly does PCT result

A

Rises in 3-4 hours and peaks in 6-24 hours

30
Q

What bacteria is seen with gram positive results

A

cocci (Staph and strep)

31
Q

What does Fluid analyses help show

A

Cause of fluid accumulation

32
Q

What is often the gold standard for diagnosing fluid accumulation

A

arthrocentesis

33
Q

When is a fluid analysis used

A

When etiology cannot be identified through non-invasive means

34
Q

What are the three common fluids analyzed

A

Plueral
CSF
Synovial

35
Q

What information is gathered from a fluid analysis

A

viscosity
cell counts/cytology
LDH
Gram stain/culture
situation specific tests

36
Q

What are contraindications for an arthrocentesis

A

Hemarthrosis
Overlying infection
Acute post-op
Inexperienced clinician
uncontrolled bleeding disorder

37
Q

What is a main complication from an arthrocentesis

A

Infection

38
Q

What is included with a native joint workup from an arthrocentesis

A

Gram stain/culture
Cell count/diff
AFB and fungal culture
Crystals
Glucose
+/- Lyme PCR

39
Q

What is the gold standard from testing for Lyme disease

A

Serologic testing

40
Q

What is a negative Lyme result going to be

A

<.8

41
Q

What is a positive Lyme result going to be

A

> 1.19

42
Q

What are the types of serologic testing

A

Enzyme immunoassay
western blot

43
Q

What shows positive intraoperative histology from a periprosthetic joint infection

A

Greater than 5 neutrophils per high power field (More than one slide)

44
Q

What is the gold standard for diagnosing crystal arthropathies

A

Crystal synovial fluid analysis (Arthrocentesis)

45
Q

What will be seen on imaging with crystal arthropathies

A

Chondrocalcinosis (Psuedogout)
Rat bite appearance

MSK clin Med (12 decks)

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