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NAPLEX > "Must know" labs > Flashcards

"Must know" labs Flashcards

1
Q

Calcium (Ca)

A

total: 8.5-10.5 mg/dL
ionized: 4.5-5.1 mg/dL

  • calculate corrected Ca if albumin is low.
  • correction is NOT needed for ionized
  • incr w/ Ca supp, vit D, thiazide diuretics
  • decr. w/ long-term heparin, loop diuretics, bisphosphonates, cinacalcet, systemic steroids, calcitonin, foscarnet, topiramate
  • supplement Ca in pregnancy, osteoporosis
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2
Q

Magnesium (Mg)

A

1.3-2.1 mEq/L

  • incr. w/ Mg-containing antacids & laxatives w/ renal impairment
  • decr. w/ PPI, diuretics, amphotericin B, foscarnet, echinocandins, diarrhea, chronic alcohol intake
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3
Q

Phosphate (PO4)

A

2.3-4.7 mg/dL

  • incr. w/ renal failure
  • decr. w/ phosphate binders, foscarnet, PO Ca intake
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4
Q

Potassium (K)

A

3.5-5 mEq/L

  • incr. w/ ACEi, ARBs, aldosterone receptor antagonists, aliskiren, canagliflozin, cyclosporine, tacrolium, mycophenalate, K supp, bactrim, drospirenone containing PO contraceptives, chronic heparin kus, NSAIDs, pentamidine
  • decr. w/ beta-2 agonists, diuretics, insulin, steroids, conivaptan
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5
Q

Sodium (Na)

A

135-145 mEq/L

  • incr. w/ hypertonic saline, tolvaptan, conivaptan
  • decr. w/ carbamazepine, oxcarbazepine, SSRIs, diuretics, desmopressin
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6
Q

Bicarbonate (HCO3)

A

venous: 24-30 mEq/L
arterial: 22-26 mEq/L

  • assess acid-base status
  • incr. due to loop diuretics, systemic steroids
  • decr. due to topiramate, zonisamide, salicylate overdose
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7
Q

Blood Urea Nitrogen (BUN)

A

7-20 mg/dL

  • incr. w/ renal impairment and dehydration
  • used w/ SCr to assess fluid status and renal funct.
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8
Q

Serum Creatinine (SCr)

A

0.6-1.3 mg/dL

  • incr. w/ drugs that impair renal funct
  • decr. w/ low muscle mass, amputation, hemodilution
  • false incr. w. bactrim, H2RAs, cobicstat
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9
Q

Anion Gap

A

5-12 mEq/L

elevated = metabolic acidosis

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10
Q

White blood cells (WBC)

A

4K-11K cells/mm2

  • used to diagnose & monitor infection/inflammation
  • incr. as acute phase reactant, indicating a systemic reaction to inflammation or stress
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11
Q

neutrophils

A

45-73%

determine likelihood of infection and with acute WBC in absolute neutrophil count calculation

  • neutrophils = SEGmented neutrophils (“segs”)
  • immature neutrophils = bands
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12
Q

bands

A

3-5%

released from bone marrow to fight infection

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13
Q

eosinophils

A

0-5%

incr in drug allergy, asthma, inflammation, parasitic infection

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14
Q

basophils

A

0-1%

incr. in inflammation, hypersensitivity reaction, leukemia

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15
Q

lymphocytes

A

20-40%

incr. in viral infections, lymphoma
decr. in bone marrow suppression, HIV, or systemic steroids

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16
Q

Red Blood cells (RBC)

A

males: 4.5-5.5 x 10^6 cells/microL
females: 4.1-4.9 x 10^6

  • incr. w/ erythropoiesis-stimulating agents (ESAs), smoking and polycythemia
  • decr w/ chemo that targets bone marrow, low production, blood loss, deficiency anemias, hemolytic anemia, sickle cell anemia
17
Q

hemoglobin (Hgb, Hb)

A

males: 13.5-18 g/dL
females: 12-16 g/dL

  • Hgb carries O2 in RBCs
  • incr. w ESAs
  • decr. w anemias and bleed

Coombs Test and G6PD for drug-induced anemia

18
Q

mean corpuscular volume (MCV)

A

80-100 fL

  • incr. due to B12 or folate deficiency
  • decr. due to Fe deficiency
19
Q

folic acid (folate)

A

5-25 mcg/L

B12 and folate are ordered for further workup for macrocytic anemia
- decr. due to phenytoin/fosphenytoin, phenobarb, primidone, MTX, bactrim, sulfasalazine

supplement folate in women of childbearing age and alcoholism

20
Q

Vitamin B12

A

> 200 pg/mL

decr. due to PPIs, metformin, colchicine, chloramphenicol

21
Q

reticulocyte count

A

0.5-2.5%

measures reticulocytes being made in the bone marrow
- reticulocyte count incr. in blood loss and decr. in untreated anemia due to iron, folate or B12 deficiency & bone marrow suppression

22
Q

Coombs Test, direct (DAT)

A

negative

diagnose hemolytic anemia, when the cause of hemolysis is unclear

  • can be caused by penicillins/cephalosporins, dapsone, isoniazid, levodopa, methyldopa, methylene blue, nitrofurantoin, pegloticase, primaquine, quinidine, quinine, rasburicase, rifampin, sulfonamides

a (+) coombs test + likely drug cause: d/c drug

NAPLEX (13 decks)

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