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*Part IV Boards > Physical Diagnosis 3 > Flashcards

Physical Diagnosis 3 Flashcards

1
Q

Acid Phosphatase (PAP)

A

enzyme is present minimally in many tissues but 100 times higher in the prostate than any other tissue. it is also found in seminal fluid. it is released into the blood stream in metastatic carcinoma of the prostate, when the capsule breaks

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2
Q

increased acid phosphatase

A

prostatic carcinoma**
any carcinoma metastasis to bone
hyperparathyroidism

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3
Q

prostate specific antigen (PSA)

A

enzyme which is localized in normal prostatic epithelial cells and prostatic carcinoma cells. 80% of men with prostatic carcinoma have a significant increase in PSA
best prognostic indicator for monitoring reoccurance of cancer and best to detect effectiveness of therapy

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4
Q

PSA and acid phosphatase

A

increases early detection of prostatic cancer

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5
Q

what is the most reliable test for prostate cancer?

A

digital rectal exam

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6
Q

A/G ratio

A

represents serum albumin level divided by the serum globulin level; approximately 2:1
reversed in multiple myeloma

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7
Q

Alkaline phosphatase

A

enzyme found in many tissues, especially bone and liver. it is termed alkaline because this enzyme functions best at a pH of 9, and is associated with liver and osteoblastic activity. children normally have an alkaline phosphatase value 5 times that of your average healthy adult

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8
Q

alkaline phosphatase is increased in

A

osteoblastic lesions (broken bone, liver), hepatic disease, hyperparathyroidism

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9
Q

amylase

A

pancreatic enzyme that splits starch. high values often indicate pancreatitis. most common cause of pancreatitis are alcoholism and cholelithiasis

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10
Q

amylase is increased in

A

acute pancreatitis

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11
Q

ANA (FANA)

A

fluorescent antinuclear antibody test is used to demonstrate the presence of antibodies that lead to the production of the LE cell. there are two ANA that are significant in SLE (anti-DNA and anti-DNP

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12
Q

anti-DNP

A

usually present in patients with various collagen diseases

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13
Q

anti-DNA

A

strong evidence for the presence of SLE

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14
Q

ANA (FANA) results

A

positive doesn’t definitely indicate SLE

a negative definitely rules it out

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15
Q

ASO titre

A

one of a group of serologic procedures that demonstrates that the patient has reacted to an infection by group A streptococci. It measures the amount of antibodies present

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16
Q

ASO titre increase in

A

acute glomerulonephritis

rheumatic fever

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17
Q

BUN

A

chief end product of amino acid metabolism, formed by the liver. it is excreted in urine and comprises of about 1/2 of urinary solids

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18
Q

BUN increased in..

decreased..

A

increased in renal disease

decreased in hepatic disease

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19
Q

calcium (serum)

A

calcium, as well as phosphorus, are stored in the bone and are constantly exchanged with blood and tissue fluids: vitamin D and parathromone influence this process. vitamin D is needed to intestinal absorption of calcium. parathromone increases the rate of bone destruction with mobilization of calcium and phosphorus from bone. 99% of the calcium in the body is found int eh bones and teeth. the ionized form of calcium functions in the activation of enzymes in the blood clotting, in muscle contraction and in the transmission of nerve impulses. a decreased serum level causes tetany

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20
Q

increased calcium in

decreased in..

A

hyperparathyroidism, bone metastasis

hypoparathyroidism, acute pancreatitis, renal failure

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21
Q

CPK

A

present almost exclusively in skeletal muscle, heart muscle, and in brain tissue. it enters the circulation quickly after atrophy or necrosis of the cells. it is one of the most valuable tests to indicate the occurrence of an MI
CK-MB (heart attack), CK-BB (stroke), CK-MM (muscular dystrophy)

22
Q

creatinine

A

end product of the normal metabolism of phosphocreatine usitilized for muscle energy. it is a nitrogenous compound secreted in the urine. this level does not vary with diet, so it is a very valuable indicator of kidney function

23
Q

increased creatinine in

decreased in

A

increased in renal disease

decreased in muscular dystrophies

24
Q

CRP

A

not normally present in a patient’s blood. it appears in the presence of inflammation and is an earlier indicator of inflammation than an ESR. it is best used to evaluate the course and severity of tissue necrosis

25
Q

CRP present in..

A

rheumatoid arthritis, malignancy, infections

26
Q

ESR

A

refers to the amount of RBCs that fall to the bottom of a test tube in one hour. inflammation and necrosis of the tissue causes RBCs to aggregate and become heavier. the heavier the cell, the faster it falls. the cells are made heavier by proteins produced by the body in inflammatory states

27
Q

ESR increased in

A

multiple myeloma
temporal arteritis
collagen diseases

28
Q

glucose (blood)

A

blood sugar is formed from carbohydrates and stored in the liver as glycogen. slight elevations are said to be of questionable significance. this test is done in the fasting state is diagnostic of diabetes mellitus if 2 consecutive fasting blood sugar tests are over 140 mg%

29
Q

glucose (CSF)

A

CSF glucose is usually 60% of blood glucose. blood glucose is drawn 1 hour prior to a spinal tap. changes in blood sugar are seen in the CSF 1-3 hours later

30
Q

glucose (CSF) decreased in

A

meningitis

31
Q

increased protein, normal glucose in CSF

A

viral meningitis

32
Q

meningitis s/s

A 
stiff neck (nuchal rigidity)
Kernig/Brudzinski
photophobia
worst headache of life
fever (bacterial=high)
33
Q

GGT

A

enzyme found mainly in liver, kidney, spleen, prostate. enzyme is normally higher in males because of large amounts found in the prostate. test is used to determine liver cell dysfunction and alcohol induced liver disease

34
Q

GGT is more sensitive in detecting

A

obstructive jaundice, cholangitis, cholecystitis

35
Q

glycosylated hemoglobin (hemoglobin A1C)

A

test of RBCs that reveals the body’s ability to utilize glucose over a period of 2-3 months. it is used only to evaluate the efficiency of insulin when controlling the blood sugar level

36
Q

HLA B27*

A

indicates PEAR

37
Q

HDL cholesterol

A

lipoprotein thought to play a role in removing LDLs from the arteries.
women usually have higher levels than men

38
Q

high HDL indicates..

low HDL…

A

high: low risk of coronary heart disease
low: indicates high risk

39
Q

there is a correlation between low HDL levels and..

A

obesity and diabetes mellitus

40
Q

what can increase the levels of HDL?

A

physical exercise

41
Q

I-131 uptake

A

thyroid scan procedure is used to determine ability of the thyroid to hold iodine
iodine is radioactive is treated the same way regular iodine is treated

42
Q

I-131 uptake increased in..

decreased in..

A

increased in: hyperthyroidism

decreased in: hypothyroidism

43
Q

immunoelectrophoresis

A

blood test used to measure levels of immunoglobulin and registers monoclonal spikes.
increase in monoclonal indicates a neoplastic process
bence jones proteins in the urine further indicates monoconal spike
IgG is elevated in multiple myeloma

44
Q

LDH

A

enzyme found in tissues of kidney, heart, pancreas, skeletal muscle, spleen, brain, lungs
associated with necrosis and active in Kreb’s cycle of the liver and muscle.

45
Q

when one has an LDH level 3 times normal, that indicates

A

MI

46
Q

lipase

A

enzyme involved in changing fats to fatty acids and glycerol. pancreas is the main source of this enzyme

47
Q

increased lipase indicates..

A

acute pancreatitis

48
Q

lipids

A

used by the body for energy. precursors to steroid hormones and bile acids. total lipids are cholesterol, triglycerides, phospholipids which all circulate as lipoprotein

49
Q

cholesterol

A

fat-soluble steroid alcohol needed to make bile acids, cell membranes, and sex hormones
major risk for coronary heart disease

50
Q

cholesterol is increased in..

decreased in..

A

increased: diabetes mellitus, atherosclerotic tendencies
decreased: cirrhosis

*Part IV Boards (14 decks)

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