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Clinical Lab > Pancreatic & GI tests & Renal Function Labs > Flashcards

Pancreatic & GI tests & Renal Function Labs Flashcards

1
Q

Is amylase specifically targeted to the pancreas?

A

No

It’s in the salivary glands and the pancreas

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2
Q

Amylase levels are seen in what conditions?

A 
acute pancreatitis
obstruction of a pancreatic duct
perforated stomach ulcers
acute appendicitis 
acute cholecystitis
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3
Q

How many hours after symptoms start will the amylase increase?

A

2-12 hours

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4
Q

Amylase serum levels will return to normal after how many days after the onset of symptoms?

A

3-4 days

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5
Q

When would you order an amylase lab?

A

When you are suspicious of pancreatitis, obstruction of a pancreatic duct, perforated stomach ulcers, acute appendicitis, or an acute cholecystitis

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6
Q

This is an enzyme that is found primarily in the pancreas.

A

Lipase

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7
Q

The role of lipase is?

A

to change fats to fatty acids

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8
Q

An increase in lipase will occur within how many hours after the onset of pancreatitis and will remain elevated for up to how many days?

A

24-36 hours

14 days

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9
Q

What conditions is an elevated lipase level associated with?

A

pancreatitis, pancreatic carcinoma, cholycystitis, renal disease, strangulated or impacted bowel, peritonitis

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10
Q

If lipase is elevated, we know that what organ is involved?

A

pancreas

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11
Q

Which bacteria is adapted to survive in the highly acidic gastric environment?

A

H. pylori

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12
Q

Is H. pylor gram-neg, gram-pos, or an anaerobe? What is the shape of it?

A

Gram-negative rod bacteria

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13
Q

H. pylori is associated to what infections of the gut?

A

chronic active gastritis, peptic ulcer disease, gastric CA, gastric lymphoma

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14
Q

When would you order H. pylori?

A

1) persistent dyspepsia (upset stomach or indigestion) for 2 weeks despite appropriate Abx therapy for tx of H.pylori infection 2) to assess the eradication of H. pylori

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15
Q

How can H. pylori be detected? What examination techniques are used? There are 4.

A

endoscopy
serum test
stool antigen test
Urea Breath test

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16
Q

Which test is the most common? What does it measure?

A

Serum test

Detects IgG antibody to H. pylori

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17
Q

This test uses chemical indicators on stool samples to detect the presence of blood not otherwise visible

A

Rapid Fecal Occult Blood Test (FOBT)

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18
Q

What are some indications for ordering this test (5)?

A 
Routine PE
Routine screening of asymptomatic individuals over 50 yo (Colon CA)
Anemia
Abdominal pain
suspected GI blood loss
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19
Q

How do you get a specimen to be used for a FOBT?

A

Digital Rectal Exam! (DRE)

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20
Q

When would you order a stool culture (4)?

A

1) Used a lot to help determine the cause of prolonged diarrhea. 2) for any person that may have been traveling outside of the country and experiences diarrhea 3) persons with abdominal pain and abdominal cramping with fever 4) patients with N/V and fever

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21
Q

What kind of bacteria would we worry about when ordering a stool culture?

A

Campylobacter species
Salmonella species
Shigella species
e-coli

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22
Q

Why is a stool culture helpful?

A

Helps determine what bacteria are causing the infection. It helps guide treatment: determines whether abx or medication is necessary to resolve the symptoms.

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23
Q

Are fecal leukocytes normally seen in stools in the absence of infection or other inflammatory processes?

A

No

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24
Q

Fecal leukocytes are commonly found in patients with?

A

Shigellosis
Salmonellosis
sometimes amebiasis
ulcerative colitis

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25
Q

Fecal leukocytes are commonly ordered in patients experiencing what symptoms?

A

Abdominal pain with fever
Diarrhea lasting longer than 3 days
Abdominal cramping
Bloody or mucousy stools

26
Q

Stool ova and Parasides is order to determine what?

A

Whether there are parasites present in the lower digestive tract, and so, to identify them

27
Q

What are the most common parasites detected?

A

Giardia
Entamoeba histolytica (causes amebiasis)
Cryptosporidium
It can also detect worms: roundworms, hookworms, tapeworms, flatworms, and flukes

28
Q

When would I order any of the 3 stool studies (5)?

A 
prolonged diarrhea
abdominal pain
abdominal cramping
N/V 
blood and mucus in the stool
29
Q

What organ is the sole site of urea formation?

A

Liver

30
Q

Urea is removed from the blood by which organ?

A

Kidneys

31
Q

The amount of urea is directly related to the amount of ______ in the patient’s diet, as well as the _____ ability to excrete urea.

A

protein

kidneys

32
Q

The BUN test measures what?

A

the glomeruli’s ability to filter and excrete urea, providing an estimate of renal function

33
Q

BUN is considered a ____ estimate? Why?

A

rough estimate because it’s neither specific or sensitive

34
Q

What could cause a falsely low BUN?

A

a low protein diet

35
Q

What could cause an elevated BUN level?

A

impaired glomerular/renail function

36
Q

Excessive amounts of urea in the blood is called?

A

Uremia

37
Q

Excessive amounts of nitrogen in the blood is called?

A

Azotemia

38
Q

An elevated Bun is uremia or azotemia?

A

Azotemia

39
Q

Creatinine is proportional to ____ ____ of the patient?

A

muscle mass

40
Q

Creatinine is filtered from the ____, and excreted by the ____?

A

blood

kidneys

41
Q

Creatinine levels reflect what?

A

glomerular filtration rate (GFR)

42
Q

Creatinine is utilized in several equations to calculate what?

A

estimated GFR

43
Q

Impaired renal function or urinary tract obstruction can lead to increased or decreased serum creatinine?

A

Increased serum creatinine

44
Q

What is more valuable: eGFR, GFR, creatinine?

A

eGFR

45
Q

Is eGFR on a CMP? Is it considered one of the 14 tests?

A

Yes

No

46
Q

eGFR helps detect what disease?

A

chronic kidney disease

47
Q

What 3 things can eGFR be used for?

A

screening purposes
diagnostic purposes
disease staging

48
Q

People with what 2 chronic conditions should their eGFR be screened?

A

DM Type II
HTN
*elderly should also be screened

49
Q

Screening for chronic kidney disease (CKD) usually utilizes what 2 things?

A

eGFR (in the blood/from serum creatinine) and urine protein

50
Q

eGFR does not usually detect CKD until it has reached what stage?

A

3

51
Q

eGFR alues above ____ are not reliable?

A

60

52
Q

At what stage or eGFR number do we refer a patient to a nephrologist?

A

stage 3

eGFR of 30

53
Q

Does eGFR increase as kidney function decreases?

A

No, it decreases

54
Q

What type of progression would an eGFR change of 10-20 in one year be?

A

Rapid progression

55
Q

What kind of change would constitute a slow progression of eGFR?

A

2-3 in one year

56
Q

This test compares the level of creatinine in the urine with the creatinine level in serum

A

Creatinine clearance

57
Q

How is the creatinine clearance test performed?

A

Urine is collected for 24 hours and blood is drawn at the time the urine is brought to the lab

58
Q

What tests have replaced the creatinine clearance test?

A

eGFR; urine dipsticks, urine ablumin creatinine ratio (UACR)

59
Q

What test is considered the gold standard for picking up kidney disease before the eGFR picks up on it?

A

Urine Albumin-to-Creatinine Ratio (UACR)

60
Q

When is urine collected for a UACR?

A

first morning void

61
Q

What test is recommended when the standard urine dipstick (tests for macroalbuminuria) returns positive (when screening a patient with DM or HTN)?

A

UACR

62
Q

When can a UACR also be ordered?

A

When the microalbumin-sensitive dipstick returns positive

Clinical Lab (4 decks)

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