Quiz 1 Flashcards
1) Purpose of Lab Tests:
2) Do lab tests / values accurately reflect an individuals physiological status?
1) PURPOSE: Laboratory tests are used by Dr’s to screen patients, determine a diagnosis (identify or rule out a condition), or monitor a patient following a diagnosis of a disease. Or you can do tests to help determine who is at risk for a disease (i.e. those with high cholesterol could be treated/helped before other disease breaks out). Blood tests, urine tests, dna samples, etc.
2) REFLECT: Not always. They may fall in a normal range of values, but normal ranges vary based on age, gender, health status, etc. Margins of errors happen with test results, they are not always accurate.
And condition of individual may have changed from when the test was done to when you see them.
What is APACHE
How to remember
Acute Physiology and Chronic Health Evaluation
A system for prognosis development for critically ill patients (ICU patients).
A severity of disease classification system. Patients (older than 16) who are critically ill and admitted to ICU will get a score / value based on previous norms to predicts death rates, stay length in ICU based on certain values / scoring system
You can only do this procedure or give this medicine to ICU patients with certain scores
(Remember: APAHE helicopters bring very sick / injured patients to ICU)
Why is sodium so important in the body?
Increases in sodium leads to …
Decreases in sodium leads to …
Increases of sodium lead to increased _______
What is a Sodium Test?
Critical for fluid volume regulation in the body, and for muscle contraction, electrical conductivity of contractions, etc.
Increases in sodium leads to retention of water
Loss of sodium leads to loss of water
Thirst
A sodium test checks how much sodium is in the blood. Sodium is both an electrolyte and mineral. It helps keep the water (the amount of fluid inside and outside the body’s cells) and electrolyte balance of the body. Sodium (Na+) is also important in how nerves and muscles work. It also contributes to proper muscle contraction and nerve impulse conduction.
Potassium is important to body why?
Important for function of MUSCLE cells, heart cells, and nerve cells. Potassium works alongside sodium to maintain a normal blood pressure. Potassium is known as an electrolyte, and this helps to maintain a healthy balance of fluids in the body. It also helps to transmit electrical pulses to allow for proper nerve and muscle function.
Potassium is very important in the human body. Along with sodium, it regulates the water balance and the acid-base balance in the blood and tissues. … In the nerve cells, this sodium-potassium flux generates the electrical potential that aids the conduction of nerve impulses.
Potassium is crucial to heart function and plays a key role in skeletal and smooth muscle contraction, making it important for normal digestive and muscular function.
Why is calcium so important?
Critically Important for action potentials in muscles … and BONE strength. Plus it is an electrolyte so it works with Na+ and K+ to conduct charges in cells.
It helps rule in or rule out kidney or bone diesease (osteoporosis)
Calcium is responsible for neuronal excitability … hypercalcemia decreases the firing of neurons, resulting in muscle weakness and fatigue and tone
Calcium also plays an important role in muscle contraction, transmitting messages through the nerves, and the release of hormones. If people aren’t getting enough calcium in their diet, the body takes calcium from the bones to ensure normal cell function, which can lead to weakened bones.
Why is blood glucose so important
What is Insulin
Glucose, or commonly called sugar, is an important energy source that is needed by all the cells and organs of our bodies. Some examples are our muscles and our brain. Glucose or sugar comes from the food we eat.
Insulin is a hormone made by the pancreas that allows your body to use sugar (glucose) from carbohydrates in the food that you eat for energy or to store glucose for future use. Insulin helps keeps your blood sugar level from getting too high (hyperglycemia) or too low (hypoglycemia).
The cells in your body need sugar for energy. However, sugar cannot go into most of your cells directly. After you eat food and your blood sugar level rises, cells in your pancreas (known as beta cells) are signaled to release insulin into your bloodstream. Insulin then attaches to and signals cells to absorb sugar from the bloodstream. Insulin is often described as a “key,” which unlocks the cell to allow sugar to enter the cell and be used for energy.
If you have more sugar in your body than it needs, insulin helps store the sugar in your liver and releases it when your blood sugar level is low or if you need more sugar, such as in between meals or during physical activity. Therefore, insulin helps balance out blood sugar levels and keeps them in a normal range. As blood sugar levels rise, the pancreas secretes more insulin.
People with type 1 diabetes cannot make insulin because the beta cells in their pancreas are damaged or destroyed (from genetics). Therefore, these people will need insulin injections to allow their body to process glucose and avoid complications from hyperglycemia. People with Type II are overweight and taking too much sugar into their body, and pancreas can’t keep up with producing enough insulin.
Acidosis is less than what value
Alkalosis is more than what value
- 35
7. 45
Complete Blood Count (CBC) includes a count of what:
RBC's (erythrocytes) WBC's (leukocytes) Platelets Hemoglobin Hematocrit
A quick test to know count of RBC’s is a ________
And it is to test for _______
So a low ______ count is indicitive of _______
What carries O2 from blood to cells?
Blood being clotted is:
Hematocrit (Hct)
Anemia
Hct of Anemia
Hemoglobin
Hemostasis
RBC’s normally have what shape:
But if RBC’s become cresent shaped it is a sign of what disease:
Biconcave
Sickle Cell disease (can’t carry as much O2, and gets stuck in arteries causing clotting)
What is coagulation
When a liquid (blood) changes to a solid state
Do NOT memorize the normative values for every condition, those will be provided to you
Ok
REVEIW for tests by going through the “Reading Guides” and the POWER POINTS (which she does NOT go over in class)
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A decrease in the capacity of blood to carry oxygen is:
Anemia
Laboratory tests used to evaluate kidney function:
how to remember
BMP (Basic Metabolic Panel) is group of tests
Specific Tests:
- BUN (Blood urea nitrogen … nitrogen in blood from waste product or urea. Urea is made in liver and goes to urine. BUN tells you how well kidney is functioning. IF YOUR KIDNEYS ARE NOT FUNCTIONING WELL, BUN GOES UP
- Creatinine: If kidneys don’t function well …. ???
(Remember kidneys are for urine, and so UREA is the BUN test)
What is UREA?
IF YOUR KIDNEYS ARE NOT FUNCTIONING WELL, the BUN lab test will go UP or DOWN?
A colorless crystalline compound that is the main nitrogenous breakdown product of protein metabolism in mammals and is excreted in urine.
UP
Term for elevated level of WBC’s:
What does white mean in latin
Elevated (or more than) means what in latin
Leukocytosis
White = leuko Elevated = cytosis
Cells that play a key role in blood clotting
Platelets (or “thrombocytes”)
What does cytes mean in latin?
CELLS
Another name for platelets
Thrombocytes
Abnormal accumulation of fluid in the abdominal (peritoneal) cavity: (how to remember)
Procedure to remove fluid build-up in the abdomen:
Abnormal accumulation fluid in the thorax (lung/chest) cavity:
Procedure to remove fluid build-up in the thorax?
Ascites (fluid in “Asc” area)
Paracentesis (abdominal tap)
Pleural effusion
Thoracentesis
A patient with hypo or hyperkalemia must be carefully monitored for potential ____________ from irregular __________ levels.
(how to remember)
Cardiac Arrhythmia
Potassium levels
Kalemia = potassium
(glycemia is sugar, calcemia is calcium, and Kalemia is for K and Potassium is K)
What is a non-specific test for inflammatory disorders
how to remember
Erythrocyte Sedimentation Rate
ESR: rate at which the RBC’s settle out of unclotted blood plasma in one hour. An erythrocyte sedimentation rate measures how quickly red blood cells settle in a test tube. It can help detect inflammation in the body.
(OPPOSITE of inflame - RBC’s go down and settle in bottom of tube)
Which subtype of lymphocytes is vulnerable to being destroyed by HIV (human immunodeficiency virus)
T lymphocytes … which are subdivided into “helpers” and “suppressors” … and it is the HELPER T cells. CD4
A system established by the world health organization to standardize reporting of the results of blood coagulation tests:
INR = International Normalized Ratio
Percentage of whole blood occupied by RBC’s
Hematocrit (% of RBC’s in whole blood count)
A test for long-term glycemic control … and what does it do:
Hemaglobin A1c =(HbA1c)
Measures how much glucose in blood over a 90 day (weeks to months) time window / or how long a RBC lives.
Elevated number of neutrophils is called:
Low amount of neutrophiles is called:
Neutrophilia
Neutropenia
Suffex for decrease / lack / deficiency
Suffex for increase
penia
philia / cytosis (remember cytosis means elevated)
Often ordered along with a PT (Prothrombin Time) test to investigate unexplained _____________
aPTT …. (Activated Partial Thrombin Time)
bleeding or clotting
Standardized Measures to evaluate or develop a prognosis for critically ill patients
APACHE
Acute Physiology and Chronic Health Evaluation
Test to measure the kidney’s ability to concentrate urine
(how to remember)
Test of urea levels in urine
Specific Gravity
(Remember: have to concentrate to get my urine DOWN … gravity)
BUN
What test measures urine concentration
specific gravity
Immature RBC’s are called:
how to remember
reticulocytes
Immatures ones will be rediculed … reticul
It is reasonable to expect that a patient with severe renal impairment will have:
elevated creatinine and elevated blood urea nitrogen levels
A system to develop the prognosis for critically ill patients is termed:
APACHE
The surgical puncture of the abdominal cavity to remove fluid is termed:
paracentesis (abdominal tap)
Which of the following tests allows for laboratory-to-laboratory comparison of bleeding time?
INR: international normalized ratio
This type of white blood cell produces antibodies, fights tumor cells, and responds to viral infection.
B-lymphocytes
A basic metabolic panel (BMP) includes tests for all of the basic lab tests, EXCEPT:
liver function (that is in CMP)
The CMP is an expanded version of the basic metabolic panel (BMP), which does not include LIVER tests. A CMP (or BMP) can be ordered as part of a routine physical examination, or may be used to monitor a patient with a chronic disease, such as diabetes mellitus or hypertension.
A decrease in the capacity of the blood to carry oxygen is termed:
Anemia
A complete blood count (CBC) includes a measure of all of the following cells:
What one’s are NOT included in a CBC:
RBC’s
WBC’s
Platelets
White blood cell differential (to see how many are neutrophils vs. basophils vs. lymphocytes, etc.)
What are several (5) limitations of lab testing:
1) Range of values for a given test is known as the reference range or expected value (or normal range). How well the reference range depicts homeostasis may vary with age, sex, weight, outside environmental factors, fluid status, etc.
2) The less prevalent the disease, the less data we have, so the less precise we can be in making accurate predictions/diagnosis. Or, the less prevalent the disease, the less accurate lab tests / normative values are.
3) Human error in person taking test.
4) Lab tests get contaminated, or testing materials are broken or unavailable.
5) People’s tolerance to non-homeostasis conditions is totally different.
What is a Type 1 Error
What is a Type 2 Error
Type 1: False positive … saying you have condition when you don’t
Type 2: False negative … saying you do NOT have condition when you actually do.
1) What is a BMP? And … What specific tests are included in a BMP?
2) What health conditions can be monitored with values from a BMP?
1) BMP = basic metabolic panel. Most basic lab tests. 8 specific tests for electrolyte level, acid-base balance, blood sugar, kidney status, ion (K, Ca, Na) levels, urine sample, glucose, O2/CO2. There are normative values for each of these tests based on age and sex, and consequences of abnormal values.
2) Health conditions monitored from these tests: Kidney failure, insulin shock, diabetes, respiratory distress, cardiac issues, acid/base balance, kidney status, diabetes, death.
1) What is a glycosylated hemoglobin (HbA1c) test?
2) How does a HbA1c differ from a fasting plasma glucose test?
1) Test to determine long-term blood sugar levels (and ability to maintain steady blood sugar). It measures amount of blood sugar on/in RBC’s over 120 days … which tells you how much glucose is available in blood stream / or blood sugar levels over a 120 day period.
2) HbA1c test is looking at RBC counts over 3 month weeks and months, Whereas Fasting Plasma Glucose test just measures blood over last 8 hours. So, you can fast for 8 hours to get blood sugar levels back to normal (instead of doing a test right after they ate ice cream). fasting blood sugar test, measures blood sugar levels and is used to diagnose diabetes. … If you don’t have diabetes, your body reacts by producing insulin, which prevents hyperglycemia (high blood sugar). If you have diabetes, you aren’t producing insulin to break down sugars.
1) What is a comprehensive metabolic panel (CMP)?
2) How does it differ from a BMP?
3) What is main test from CMP not in BMP:
(how to remember)
1) All the BMP tests, but with other tests to determine LIVER and other functions. So it tests to see how the LIVER is doing.
2) LIVER. The CMP is an expanded version of the basic metabolic panel (BMP), which does not include LIVER tests.
3) Bilirubin Test: Bilirubin is a fluid made by liver found in the bile; do bilirubin test in CMP to assess liver function
(remember: Billy and Rubin are lobes of the liver)
1) What is a complete blood count (CBC)? What cell types are included/counted?
1) A lab test to measure count of:
i. RBC’s
ii. WBC’s
iii. Platelets
iv. Hemoglobin (oxygen carrying protein)
v. Hematocrit (% of RBC’s)
What are a few tests for RBC’s:
1) Hematocrit: % of RBC’s compared to total blood (should be about 44%). Remember Anemia is low RBC’s count.
2) Hemoglobin: Hb is a protein in RBC’s to carry O2 to cells, and carry’s CO2 from cells back to lungs. If you have a low hemoglobin count, means you have a low RBC count, which means anemia (may need a transfusion).
3) RBC Shape Test: RBC’s should be biconcave. If they are not, you can get sickle cell disease which is RBC’s shape changed, which means they can’t get through vessels as well, so you don’t get as much O2 to cells/tissues.
4) Reticulocyte Count: Reticulocytes are immature RBC’s. If you have a lot, means marrow is producing a lot more RBC’s which means you are losing RBC’s somewhere.
5) Iron Test: Iron is required for synthesis of Hb. So if you lack iron, you lack Hb, so you lack RBC’s ability to carry O2 to tissues.
6) Vitamin B12, Folic Acid
Decreased WBC count = ____________. This results from __________
Increased WBC count = _________. This results from ____________
Most of the WBC’s are __________, so a decreased number of these is _________, and increased amount is _________.
leukopenia … CANCER or chemotherapy
leukocytosis … INFECTION
neutrophils … neutropenia … neutrophilia
Tests for WBC’s:
how to remember
1) Neutrophils: Neutropenia (see above) means you are at increased risk of infection, or have cancer, or went through chemo recently. Neutrophilia (see above) suggests a presence of infection or body is fighting an infection. These are the MOST NUMEROUS WBC’s.
2) Basophils: This count tells you about HISTAMINE levels to fight allergies
3) Eosinophils: This count tells you about fighting PARASITIC WORMS
4) Monocytes: Go to injury/infection to eat / PHAGOCITIZE
5) Lymphocytes: Most numerous agranual. B Lymphocytes for ANITBODIES, and T lymphocytes (helpers and suppressors) for immune purposes, and NK or natural killer cells.
(Remember: Because Nobody Enjoys More Lymphocytes)
Coagulability means:
Platelets are for:
Hemostasis = (How to remember)
Anticoagulation =
Uncle Les was on a blood thinner, why?
Why did they take Uncle Les off blood thinner during surgery?
CLOTTING
Clotting
Stopping blood flow (blood (hemo) stay)
Bleed excessively. SO anticoagulants are medications to stop blood clots (good for some patients, but can then bleed excessively). Blood thinner
Uncle Les has had blood clots in the past, leading to MI, stroke, thrombosis, etc. So they put him on blood thinners so he wouldn’t clot.
But for surgery, you don’t want to be on a blood thinner :)
There are coagulability tests, and what would they measure / test?
***** What are some Coagulability tests:
Platelet count … to measure whether excessive bleeding or thrombosis (clotting) will be more likely to occur.
1) CBC (Complete Blood Count): Tells you levels of platelets
2) PT: Prothrombin Time … and aPTT: Activated Partial Thromboplastin time …. These are tests to measure the time it takes for a blood clot to form after certain chemicals are added. If it takes longer, some or more clotting factors are absent/low
3) INR: International normalized ratio (see notes above about INR’s). INR is one of the coagulation tests used to evaluate hemostasis.
What serum hormones are tested that may affect a patient’s physical therapy management?
Thyroid hormone (TH): needed for normal growth and and metabolism and development (without = hypothyroidism)
Parathyroid Hormone (PTH): regulates calcium metabolism.
TSH
Cortisol
ACTH
ADH
What is a urinalysis:
Why is it taken?
What does color of urine tell you?
What is specific gravity?
An analysis of the urine.
A urine sample is obtained to know the HEALTH of the KIDNEY. Urine’s color, odor and cloudiness tell you a lot. Urine is 95% water, and 5% solids … and it is the end product of the metabolic process in the body. Mainly it is water, urea, and sodium chloride. So many nutrients or protiens or sugar is distributed through blood, and filtered through kidney. If kidney is not working, and thus water % goes down and other counts go up, kidney is not filtering properly to get those nutrients and electrolytes back into the blood stream to the cells.
Color of urine tells you a lot. The more yellow, means less water. More RBC’s makes urine more RED. Color can be altered by medications and foods / drinks consumed. Dark brown urine may be liver disease
Specific Gravity: This is a measure of the concentration of solutes in urine. Specific gravity increases with MORE solutes. Higher amounts mean dehydration.
Describe 2 microbiologic studies commonly encountered by physical therapists.
Microbiologic studies are normally NOT done by PT’s, but there are 2 that help know potential causes of infection.
Gram stains: Identify bacteria by placing a colored dye and cells infected (gram-positive) will appear certain color.
Wound Cultures: Test to detect bacteria in blood, throat, urine, skin, wound, stool, CSF, etc. Samples of the tissue are obtained to test for bacteria present. GROW the culture to know what bacteria is causing the infection.
Skin legions:
What is peritoneal fluid?
How is it obtained for testing?
Peritoneal fluid is a liquid made in the abdominal cavity which lubricates the surface of tissue that lines the abdominal wall and pelvic cavity. It covers most of the organs in the abdomen.
Through an abdominal tap (paracentesis): Fluid collected from peritoneal space in abdomen. The peritoneal cavity is a potential space between the parietal peritoneum, which lines the abdominal wall, and the visceral peritoneum, which envelopes the abdominal organs.
Hypo =
Hyper =
Low
High
What are keytones?
how to remember
Keytones are byproducts of the body breaking down fat for energy that occurs when carbohydrate intake is low. If sugar is low, body looks for other source for energy -
and turns to excess fat. When we fast or are starving, the body naturally pulls from fat reserves if it is low on glucose to create energy. Fat gets released into bloodstream and broken down in liver to be used as fuel.
But in a person with diabetes who isn’t producing insulin, fat keeps getting released at high levels and circulating through body’s system and the liver produces keytones, which decrease blood pH
(remember: the key to getting tone is fasting … so body turns to eating your fat).
What is White Blood Cell Differential:
A white blood cell (WBC) count measures the number of white blood cells in your blood, and a WBC differential determines the percentage of each type of white blood cell present in your blood. So gets a count / % of neutrophils, basophils, lymphocytes, etc.
Explain types of Lymphocytes (lymphs):
B lymphocytes (B cells): T lymphocytes (T cells): Natural killer (NK) cells:
T-cells recognize and kill virus-infected cells directly (helpers and suppressors). Some help B-cells to make antibodies, which circulate and bind to antigens.
B lymphocytes (B cells) are ANTIBODY-producing cells that are essential for acquired, antigen-specific immune responses. Plasma cells are fully differentiated B-cells that produce antibodies, immune proteins that target and destroy bacteria, viruses and other “non-self” foreign antigens.
T lymphocytes (T cells) finish maturing in the thymus and consist of a few different types. Some T cells help the body distinguish between “self” and “non-self” antigens. Others initiate and control the extent of an immune response, boosting it as needed and then slowing it as the condition resolves. Other types of T cells directly attack and neutralize virus-infected or cancerous cells. Helper and suppressor.
Natural killer cells (NK cells) directly attack and kill abnormal cells such as cancer cells or those infected with a virus.
What are the electrolytes in your body?
What is their purpose?
Sodium (Na), Potassium (K), Calcium (Ca)
One of the 3 main electrolytes/ions in the body (Na+, K+, Ca+). They help conduct electrical impulses in body, muscle contractions, acid-base balance, bone strength, etc.
What is creatine … what is it used for in body?
Source of limited quick energy for metabolism in phosphagen system.
It basically is a Waste product of muscle metabolism
GO THROUGH POWER POINT 1 and learn/review all those itesm
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Activated Partial Thromboplastin Time (aPTT)
Anemia
Basophils
Bilirubin
Blood urea nitrogen (BUN)
Complete blood count (CBC)
Creatinine
Cytosis
Eosinophils
Erythrocyte Sedimentation Rate (ESR)
Hematocrit
Hemoglobin (Hb)
Hemoglobin A1c (HbA1c)
Hypo-
Hyper-
International normalized ratio (INR)
Ketones
Leukocytes
Lymphocytes
Helper T cells
Suppressor T cells
Β-lymphocytes
Monocytes
Neutrophils
Occult blood
Paracentesis
Penia
Philia
Platelets
Prothrombin time (PT)
Red blood cells (RBCs)
Reticulocyte
Specific gravity
Thrombocytes
Urinalysis
White blood cells (WBCs)
White blood cell differential (Diff)
aPTT: activated partial thromboplastin time (one of the coagulation studies that evaluates hemostasis)
Anemia: decrease in the capacity of blood to carry oxygen because RBC count is low; identified via CBC test
Basophils: type of leukocyte; active in immune response (mostly allergies) from histamines
Bilirubin: fluid made by liver found in the bile; do bilirubin test in CMP to assess liver function
BUN: level that evaluates kidney failure; usually a test to measure the amount of urea nitrogen in the blood
CBC: actual number of blood elements in relation to volume; DOES NOT test cell function; identifies: infection, anemia, arthritis, certain cancers
Creatine: test included in BMP; waste product of muscle metabolism; rise in creatinine = decline in kidney’s capacity for excreting waste
Cytosis: elevation
Eosinophils: type of leukocyte; elevated in the presence of worm infestation or allergies
ESR: rate at which the RBC’s settle out of unclotted blood plasma in one hour. An erythrocyte sedimentation rate measures how quickly red blood cells settle in a test tube. It can help detect inflammation in the body.
Hematocrit: % of whole blood occupied by RBCs
Hemoglobin (Hb): oxygen carrying capacity of RBCs by protien carrying molecule
HbA1c: glycosylated hemoglobin; determines the fraction of Hb containing bound glucose and reflects the average blood glucose concentration over a number of weeks to months
Hypo: less amount of something
Hyper: greater amount of something
INR: one of the coagulation tests used to evaluate hemostasis
Keytones: represent failure to obtain sufficient glucose metabolism; one of the measurements when a routine urinalysis is done
Leukocytes: WBC; monocytes, neutrophils, basophils, lymphocytes, eosinophils
Lymphocytes: type of leukocyte
Helper T Cells: type of lymphocyte; middle man in the adaptive immune system
Suppressor T Cells: type of lymphocyte; close down the immune system after invading organisms are destroyed
B-Lymphocytes: types of lymphocyte; produce antibodies against antigens
Monocytes: type of leukocyte; are the phagocyte of the immune system
Neutrophils: type of leukocyte; represent the majority of WBC
Occult Blood: blood that is found in the feces that is not visibly apparent. HIDDEN blood
Paracentesis: procedure to remove fluid build-up in abdomen
Penia: too little of something
Philia: too much of something
Platelets: component of blood that help it to be able to clot
PT: coagulation study done to evaluate hemostasis
RBC’s: carry oxygen from the lungs to the tissues
Reticulocyte: Immature bone marrow production of RBCs
Specific Gravity: measurement in urinalysis; measures the kidney’s ability to concentrate urine and depends on the state of hydration
Thrombocytes: platelets; help to clot blood to stop bleeding
Urinalysis: the analysis of urine; three main components: water, urea, sodium chloride
WBC’s: leukocytes; fight infection and react against foreign bodies or tissue
WBC Diff: peripheral blood smear; WBC count of the total number of WBC
Is Abdominal tap same as Paracentesis?
Yes, it is a procedure to remove excess fluid from the abdominal cavity.
