NBS General DIagnosis Flashcards
Posterior Pituitary - Decreased ADH (Vasopressin)
Diabetes insipidus (polydypsia, polyuria)
Adrenal Cortex - Decrease adrenocorticoids
Addison’s disease - BRONZE skin, weight loss, hypotension
Adrenal Cortex - Increase adrenocorticoids (ACTH)
Cushing’s - weight gain, HTN, buffalo hump, hirsutism, moon face
Cushings AKA
Hypercortisolism, hyperadrenocorticism
What hormones are increased in Cushings disease
Cortisol (sweet), Aldosterone (salty), Steroids (- cause hirsutism)
Increase Parathormone, MC is Primary
Post menopause female, Hypercalcemia, excessive bone resorption
Secondary increase parathormone – RENAL OSTEODYSTROPHY
Kidney disease causes feedback malfunction, chronic parathyroid function, Hypercalcemia, bone resorption, calcified vessels.
Decrease T3/T4 – Thyroid or ANT PIT
Myxedema - usually autoimmune (decrease t3,t4 and increase TSH
Cretinism
Hypothyroidism, Child, Congenital, Mental deficit, female (3:1)
Graves
Hyperthyroidism, MC autoimmune
Graves is associated with what condition?
DM
Pernicious anemia
Collagen disease
Vitamin D deficiency
Adult - osteomalacia
Child - Rickets
Hypophosphatemia AKA
Hypercalcemia
Cause of Hypercalcemia
- Hyperparathyroidism
- Bone ca (1&2)
- Hyperthyroidism (parafollicular cell increase osteoclast activity)
- Adsons, excessive fracture
- Diurectics, respiratory acidosis
Cuase of Hypocalcemia (Hyperphosphatemia)
- Hypovitaminosis D - Bone softening
- Hypoparathyroidism - Alkalosis, PANCREATITIS, diarrhea
Young RBC is called….
Reticulocyte
RBC life span
120 days
RBC component
MCV - size - 90
MCH - color - 30
MCHC - color - 30
Plateletes - Thrombocytes number
150,000 - 400,000
WBC number and life span
5k-10k
Life span is 15-30 days
WBC for chronic infection
Monocytes
WBC for allergies
Eosinophil
WBC for heavy metal/ polycythemia
Basophil
MC ca in children, age 3-5 progress rapidly, affects immature blood cell
Acute Lymphoblastic
AKA Acute myelogenous, Rapid cancer, affects myeloid WBC, MC leukemia in adults
Acute non lymphoblastic
Slow, uncommon adult form of Leukemia with PHILADELPHIA CHROMOSOME
Chronic Myelogenous
Macrocytic Normochromic Anemia; Problem, cause
Problem: RBC maturation, Reticulocytosis
Increase MCV
Cause: Poor uptake of B12, B9 deficiency - neural tube effect
Ferritin: Normal
Microcytic Hypochromic Anemia; Problem, cause
Problem: RBC loss
Decrease MCV, MCH
Cause; Iron deficiency, chronic hemorrhage (GI/bone disorder depletes iron stores)
Ferritin: Decrease
Which anemia is common in female during child bearing years?
Microcythic Hypochromic - Iron deficiency anemia
Hb disease, decrease MCH & MCV
Thalassemia (Mediteranian and European)
Sickle Cell
Ferritin: Normal
Thalassemia minor
Increase RBC
Hereditary
Thalassemia major aka
Cooley’s anemia
AVN of femoral head - crescent shaped associated with
Sickle cell
Urine: indicates inflammation, lesion, ulceration in lower tract
Dark red
Upper tract lesion
Smoky
Indicates stagnation of blood, fat & mucus, or weakness in the blood leading to such condition as anemia
White
Indicates disorder of liver or GB resulting in excess bile secretion.
Deposits of animal fats especially in the middle organs and possible inflammation
Yellow
Orange urine
B vitamins
Black urine
Ochronosis
End stage Malaria
Lead poisoning
URINANALYSIS: Specific gravity
Increase in DM
Decrease in Diabetes Insipidus
URINANALYSIS: Protein
Nephron disease Multiple Myeloma (BENCE JONES) and Muscular Dystrophy
URINANALYSIS: Glucose
Diabetes Melitus
Shock
URINANALYSIS: Ketone
DM
Starvation
URINANALYSIS: Blood
Trauma, infection, stone
Painless hematuria: Cancer
URINANALYSIS: Bilirubin
Indirect = bilirubin
Direct + bacteria = Urobilinogen
URINANALYSIS: PUS
Bladder, urethra usually
URINANALYSIS: Cast
Upper tract = descending = Strep
Lower tract = ascending = E.Coli, Chlamydia
URINANALYSIS: Schilling’s test
B12 24 hour urine test
IMMUNOGLOBULINS: IgG
Chronic, 85%
2nd to fight bacteria, fungi, toxins
Mom protects baby IN UTERO
IMMUNOGLOBULINS: IgA
5-10 %
Mucosal lining, GI, Lungs
Mom protects baby thru milk (Collustrum)
IMMUNOGLOBULINS: IgM
Acute, 5-10 %
1st to fight
IMMUNOGLOBULINS: IgE
Small amount
Hypersensitivity (allergies) - also Eosinophil, defense
IMMUNOGLOBULINS: IgD
Trace
STOOL: Clay color
Biliary obstruction
STOOL: Tarry color
Iron or blood
STOOL: Fat
Steatorrhea - GB or Pancreas Malabsorption
STOOL: Blood Frank
Lower GI
STOOL: Blood Occult
Upper GI (GUIAIAC)
STOOL: Culture
ID agent
LAB VALUES: ACPA (anti-citrulinate protein antibody)
RA - confirms and denotes severity
LAB VALUES: APA (Anti Parietal Antibody)
B12 deficiency (Pernicious Anemia)
LAB VALUES: Alpha Feto Protein
Neural Tube Defect (B9)
LAB VALUES: Acid Phosphatase
Prostate
LAB VALUES: Albumin/Globulin Ratio
Reversal in MM
Liver disease
TB
RA
LAB VALUES: Alkaline Phosphatase
Liver and Blastic bone
Alkaline phos is increase when body is making bone
LAB VALUES: Amylase/Lipase
Pancreatitis (head)
LAB VALUES: POLYARTHRALGIA: ANA (Antinuclear Antibody) – Collagen disease – Seropositive or negative?
Positive
LAB VALUES: POLYARTHRALGIA: ANA (Antinuclear Antibody (5)
SLE (body wide) Scleroderma ( smooth muscle?) Sjogren (exocrine gland - dry eyes, mouth, etc) Polyarteritis Nodosa RA (synovium)
LAB VALUES: ASO titer (Anti Streptolysin O)
Strep Antibody
LAB VALUES: Bilirubin: Direct
Liver, GB, Head of pancreas
Conjugated = soluble = POST Hepatic Disorder
LAB VALUES: Bilirubin: Indirect
Liver, Spleen, Hemolytic Anemia, drugs, fever
Unconjugated = Insoluble = PRE Hepatic Disorder
LAB VALUES: BUN (Blood Urea Nitrogen)
Increase: Kidney
Decrease: Liver
LAB VALUES: Calcium
Increase: Hypercalcemia, Hyper-Parathyroid
Decrease: Hypocalcemia
LAB VALUES: CEA (Carcinogenic Embryonic Antigen)
Cancer
LAB VALUES: CPK (Creatine)
Muscle destruction
CK-MM = Muscle
CK- MB = Heart
CK-BB = Brain
LAB VALUES: CREATININe
Kidney function (MD increase Creatine CK-MM but decrease Creatinine)
LAB VALUES: CRP
Acute inflammation
Myocardial risk
LAB VALUES: ESR
Inflammation
ESR>80, patient 50 yo – Giant cell tumor, MM
LAB VALUES: Catecholamines
Adrenal Medulla (NE& epi) Dopamine
LAB VALUES: FTA/ABS (Specific)
SYPHILIS
LAB VALUES: Blood Glucose
80-120
DM
LAB VALUES: Glucose (CSF)
Decrease in bacterial infection
LAB VALUES: GGT
Liver Cirrhosis
LAB VALUES: GTT
DM
LAB VALUES: HCG
Increase: Twins, hydatiform mole, choricarcinoma
Decrease: Ectopic Pregnancy
LAB VALUES: POLYARTHRALGIA: HLA B27 seronegative or positive?
Seronegative
This group makes SYNDESMOPHYTE (bony growth originating inside a ligament)
LAB VALUES: POLYARTHRALGIA: HLA B27
UCRAP + Enteropathic arthropathy Ulcerative Colitis Crohn's Reiter's AS Psoriatic Entero
LAB VALUES: Cholesterol
HTN
LAB VALUES: Ketones
DM
LAB VALUES: LDH (Lactate Dehydrogenase)
Muscle & Liver disease
1= MI 2= always high 3,4,5=systemic
LAB VALUES: LE Prep
SLE
LAB VALUES: Mono Test
Paul Bunnell
Heterophile agglutination (Maybe EBV)
Mono - (Atypical Lymphocyte - Downey’s cell)
LAB VALUES: Protein
Increase: MM, MD
Decrease: Kidney
LAB VALUES: PSA (Prostate Specific Antigen)
Prostate (along with ACID phosphatase)
LAB VALUES: SGOT/AST (Serum Glutamate Oxyloacetic Transaminase)
Liver
Heart
LAB VALUES: SGPT/ALT (Serum Glutamate Pyruvic Transaminase)
Liver
LAB VALUES: T3/T4
Increase: Hyperthyroidism - Graves
Decrease: Hypo - Myxedema, Hashimoto
LAB VALUES: Uric Acid
Gout
Kidney
LAB VALUES: for AIDS
CD4, T Cells
ELISA is sensitive
Western Blot is specific
SPECIAL STUDIES: to identify agent
Stool, Sputum, Blood Culture
SPECIAL STUDIES: View regions
Arthroscopy
Endoscopy
SPECIAL STUDIES: Barium Study
GI Disorder
SPECIAL STUDIES: Ultrasound
Belly and Vessels
SPECIAL STUDIES: Pap smear
Uterus
SPECIAL STUDIES: Aspiration
Fluid
FAT Soluble Vitamis
ADEK
Antioxidants
ACES + Zinc
Cause of vitamin deficiency
Varies (usually d/t malnutrition)
Malabsorption
GLUTEN (protein) can cause
- Increases inflammation
- Irritates brain
- Dementia
- Depression
Post Viral Syndrome (4)
Guillian Barre
Ptyrasis Roseacea
Reye’s Syndrome
West Nile
All Can trigger Chronic Fatigue and Fibromyalgia
Micro&Path: Coccidiomycosis
San Joaqin Valley Fever
Spore dust
Micro&Path: Staph
Bone, joint, skin
Toxic shock
PID
Micro&Path: Strep
Skin
PID
Throat-kidney-heart
Micro&Path: Klebsiella
Friedlander’s pneumonia
Red currant jelly sputum
Micro&Path: Rotovirus Vs Rhinovirus
Rotovirus: childhood diarrhea
Rhinovirus: Common cold
Micro&Path: MUMPS
Parotid duct
Oophoritis (ovarian)
Orchitis (testicle)