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CLIN PATH > Respi Block Exam > Flashcards

Respi Block Exam Flashcards

1
Q

You are planning to order the following tests on your patient: Uric Acid, Total & Direct Bilirubin, Creatinine, and Blood Urea Nitrogen. How would you instruct for the patient’s preparation before extraction?
• He should fast for 8hours before extraction.
• He must fill his bladder with liquids before extraction.
• He needs to rest overnight before extraction.
• Majority of the tests do not require him to fast.

A

He should fast for 8hours before extraction.

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2
Q 
Your follow-up patient is taking Amoxicillin 500mg tid, and Ascorbic Acid 500mg bid. Which of the following 
tests will NOT be affected? 
• Potassium 
• Glucose 
• Bilirubin 
• Creatinine
A

K

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3
Q 
You had a hard time looking for a good extraction site in a slim, fair-skinned lady, even with the help of a tourniquet, not until 3mins after. The prolonged tourniquet application may lead to the following EXCEPT: 
• Decrease in Glucose 
• Hemoconcentration 
• Increase in potassium 
• Gangrene of extremity
A

Gangrene of extremity

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4
Q 
Patients who has the habit of drinking coffee would LEAST LIKELY show the following blood chemical 
Interference: 
• decreased catecholamine levels 
• decreased bilirubin 
• elevated free fatty acids; 
• increased vanillylmandelic acid
A

decreased catecholamine levels

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5
Q 
In the following Demographics of an admitted patient, the following should be filled up only by the Attending Physician himself EXCEPT: 
• pertinent clinical history 
• patient’s name 
• clinical impression 
• physician’s signature 
• specification of specimen
A

patient’s name

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6
Q

You were able to withdraw only 1.5ml of blood which you placed in a 2.0ml tube with EDTA anticoagulant (Ethylenediaminetetraacetic acid). The Lab staff asks you to repeat the venipuncture because short draws or less than the required minimum volume of blood would cause the following effects:

  • excessive EDTA anticoagulant may affect RBC morphology
  • excessive EDTA anticoagulant may affect RBC morphology and excessive anticoagulant prolongs coagulation times
  • excessive anticoagulant will dilute the blood
  • excessive anticoagulant prolongs coagulation times
  • All
A

ALL

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7
Q 
Accessible veins in infants are usually reserved exclusively for 
• intravenous catheterization 
• All of the above 
• phlebotomy 
• parenteral therapy
A

parenteral therapy

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8
Q

Iatrogenic anemia of infants could most likely result from:

A

repeated venipuncture

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9
Q

Preferable sites for skin puncture in neonates & infants:

A

deep heel /big toe

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10
Q

Which parasite/s may be isolated and examined from the buffy coat layer of the blood?

  • All
  • Malaria
  • Leishmaniasis and Babesiosis
  • Babesiosis
  • Leishmaniasis
A

Leishmaniasis and Babesiosis

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11
Q

In a patient who was not properly instructed how to fast in preparation for a Lab exam, the following tests would most likely be inhibited EXCEPT:

  • total protein
  • amylase
  • lactate dehydrogenase
  • bilirubin
  • Urea
A

lactate dehydrogenase

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12
Q 
Venous blood is higher than the arterial blood in the following: 
• chloride 
• packed cell volume 
• oxygen 
• ammonia 
• pH
A

packed cell volume

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13
Q

The physician’s gloves should be properly disposed into this bin after using:

  • yellow
  • red
  • green
  • orange
  • black
A

yellow

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14
Q 
These antibiotics could affect blood chemical examinations EXCEPT: 
• Erythromycin 
• Penicillin G 
• Cephalosporins 
• Isoniazid 
• Cotrimoxazole
A

Cotrimoxazole

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15
Q

Variation in red cell shapes is called:

A

Poikilocytosis

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16
Q

This is NOT the correct Reference Value:

  • WBC 10,500 – 15,000 x 103/uL
  • Platelets = 150,000 – 450,000/cumm
  • Hematocrit males = 40-52%
  • Red blood cells males = 4.6 – 5.9 million/L
  • Hemoglobin females = 14 ± 2 g/dL
A

WBC 10,500 – 15,000 x 103/uL

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17
Q

Which of the following pathophysiologic processes will NOT result to Metabolic acidosis?
• increased loss of bicarbonate
• increased in what body perceives as stressors
• decreased renal excretion of acid
• increased production of nonvolatile acids

A

increased in what body perceives as stressors

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18
Q

The pO2 value in the peripheral tissues:

A

40mmHg

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19
Q

Respiratory alkalosis is very commonly induced by the following EXCEPT:

  • liver failure
  • sepsis
  • CNS depression
  • aspirin intoxication
A

CNS depression

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20
Q

This is the ONLY condition that allows the Physician to do Arterial Blood Extraction:

  • Allen’s test return color of 5secs
  • Erythematous skin in sampling area
  • cannulation of the vessel anticipated
  • Inadequate collateral circulation
  • Coagulation defects
A

Allen’s test return color of 5secs

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21
Q

ph <7.4, hc03 >26, pc02 >45mmhg dx? This is the ONLY condition that allows the Physician to do Arterial Blood Extraction:

  • Allen’s test return color of 5secs
  • Erythematous skin in sampling area
  • cannulation of the vessel anticipated
  • Inadequate collateral circulation
  • Coagulation defects
A

Coagulation defects

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22
Q

The external intercostals contract during inspiration.

  • False
  • True
A

TRUE

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23
Q

FRC (Functional Reserve Capacity) is best characterized as:

  • The volume of gas present in the lungs after a patient takes a normal tidal volume
  • The volume of gas present in the lungs when patient has exhaled as much as she can
  • The volume of gas present in the lungs when the respiratory muscles are totally relaxed
  • The volume of gas a patient can inhale from the end-inspiratory point of tidal volume to total lung capacity
  • The maximal volume of gas a patient can exhale starting from the normal end-expiratory lung volume
A

The volume of gas present in the lungs after a patient takes a normal tidal volume

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24
Q

Preferable sites for skin puncture in neonates & infants:

A

deep heel /big toe

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25
Q

You were able to withdraw only 1.5ml of blood which you placed in a 2.0ml tube with EDTA anticoagulant. Ethylenediaminetetraacetic acid). The Lab staff asks you to repeat the venipuncture because short draws or less than the required minimum volume of blood would cause the following effects:

  • All
  • excessive anticoagulant will dilute the blood
  • excessive anticoagulant prolongs coagulation times
  • excessive EDTA anticoagulant may affect RBC morphology
  • excessive EDTA anticoagulant may affect RBC morphology and excessive anticoagulant prolongs
A

All

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26
Q

Anisocytosis

  • anisocytosis
  • polymorphisms
  • poikilocytosis
  • erythrocytosis
A

anisocytosis

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27
Q

Proteins on the extracytoplasmic face may associate with the membrane via:

A

glycosyl phosphatidyl inositol linked protein

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28
Q 
In a patient who was not properly instructed how to fast in preparation for a Lab exam, the following tests 
would most likely be inhibited EXCEPT: 
• Urea 
• lactate dehydrogenase 
• bilirubin 
• amylase 
• total protein
A

Amylase

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29
Q

After extracting blood from your patient, you handed the blood to the Laboratory. But The Med Tech on duty complained, because the hemolysed specimen you extracted could increase the following tests, EXCEPT:

  • Potassium
  • Lactate Dehydrogenase
  • Erythrocyte Sedimentation Rate
  • Sodium
A

Sodium

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30
Q

The lipid bilayer of the cell membrane is relatively impermeable to all EXCEPT the:

  • smallest and/or most hydrophilic molecules
  • largest and/or most hydrophobic molecules
  • smallest and/or most hydrophobic molecules
  • largest and/or most hydrophilic molecules
A

smallest and/or most hydrophobic molecules

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31
Q

Major cause of metabolic acidosis with normal anion gap in patient w/ renal failure

A

Diarrhea

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32
Q

Methylation of lysine residues in histones. Silincing

A

Histone Methylation

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33
Q

Lysine residues are acetylated by histone acetyl transferases (HAT). Acitivation

A

Histone acetylation

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34
Q

Cytosolic proteins destined for turnover, senescent proteins, or proteins that have become denatured due to extrinsic mechanical or chemical stresses can be tagged by multiplr ubiquitin molecule.

A

Proteasomal Degradation

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35
Q

Normal Values of RBC Count.

Male
Female

A

Male: 4.6-5.9 millions
Females: 4.2- 5.4

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36
Q

Factors of Polycythemia

A

High altitudes, physical training, smokers & polycythemia

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37
Q

What is anemia? The diagnosis of anemia.

A

Low blood count

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38
Q

Variation in cell sizes

A

Anisocytosis

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39
Q

Value of Hyperchromic, Normochromic, Hypochromic.

A

Hyperchromic: >31pg/cell
Normochromic: 27-31pg/cell
Hypochromic: <27pg/cell

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40
Q

MCH decreases inversely proportional as size of central pallor

A

1/3

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41
Q

Factors of increase ESR (Erythrocyte Sedimentation Rate).

  • Hematocrit
  • Blood viscosity
  • Conc. Of fibrinogen
  • Size of RBC
  • WBC Count
A
  • high Htc
  • low blood viscosity
  • high conc of fibrinogen
  • Mycrocytic RBC
  • Extreme elevation of WBC count.
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42
Q

Normal Hb count.

Female
Male

A

Female: 14.0 +_ 2.0 g/dL
Male: 16.0 +_2.0 g/dL

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43
Q

Find the Hb Count.

Hb: 14.5 g/dL
Htc: 45mL/dL

A

32.2 g/dL packed cells

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44
Q

Factors of low ESR.

A
  • high Htc
  • change in RBC shape
  • high albumin conc
45
Q

Normal value of WBC.

A

Adult: 4500-10,500/mm3 or 4.5 -10.5 × 10 3 /uL

46
Q

High count in WBC.

A 
Neutrophils- 62
Lymphocytes- 30
Monocytes- 5
Eosinophil- 2.5
Basophils- 0.75
47
Q

Granulocytes cells.

A

Neutrophils
Basophils
Eosinophils

48
Q

Characteristics of Neutrophils

A
  • Intravasation
  • Extravasation
  • Paracellular Diapedesis
  • Transcellular Diapedesis
49
Q

Low platelet count

A

Thrombocytopenia

50
Q

Normal value of Platelets

A

150,000- 400, 000 cells/mm3

51
Q

Clothing factor of platelets

A

Alpha granules

52
Q

Severe thrombocytopenia

A

<50,000

53
Q

Diurnal Variation.

  • Iron
  • corticosteroirs
  • phosphates
  • neutrophils
A
  • Iron- AM
  • corticosteroirs- AM
  • phosphates- AM
  • neutrophils- PM
54
Q

Effects of these drugs.

  • Isoniazid
  • Ascorbic
  • Caffiene
A

• Isoniazid- increase NH3
- increase transferase

• Ascorbic - low bilirubin

               - high creatine (Blood & Urine)
               - high glucose
               - high transferase
               - high urates

• Caffiene - low bilirubin
- high vanillylmandelic acid (B&U)

55
Q

Effects of Drugs.

  • Calcium
  • Oxalates
  • Glucose
  • Cephalosporin
A

• Calcium- high K

• Oxalates - low acid phosphate
- low lactate dehydrogenase

• Glucose - high creatinine
- high urate

• Cephalosporin- high creatinine
- high glucose (U)

56
Q

Functions of Electrolytes.

A
  • maintenance of osmotic pressure & hydration (Na)
  • Buffering function (HCO3)
  • Activators in enzyme reactions (Mg)
  • Normal neuromuscular-excitability (Ca)
  • Redox reaction (electron transport) (Fe)
57
Q

The difference between the sums of the conc of the principal cations and the principal anions

A

Anion Gap

58
Q

Calculate Anion Gap formula.

A

AG= (Na + K) - (Cl + HCO3-)

Normal Value: 10-18mmol/L

59
Q

Decrease anion gap results to.

A

Multiple myeloma
Protein error
Instrument error

60
Q

Function as water pull

A

Na

61
Q

Abundant cation in the ECF

A

Na

62
Q

Decrease in K uptake

A

Hypokalemia

63
Q

Used to determined primarily to screen for cystic fibrosis.

A

Chloride/ Sweat Chloride

64
Q

Causes of Spuriously High K

A
  1. High platelet count
  2. Prolonged application of tourniquet
  3. Increase muscular activity
  4. Hemolyzed specimen
  5. Contamination with EDTA
65
Q

Determines the ECF vol.

A

Na

66
Q

Renal threshold for Na

A

110-130mmol/L

67
Q

Promotes natriuretisis and relaxation of vascular smooth muscle (vasodilation)

A

Atrial natriuretic factor

68
Q

Normal value of Na in ECF

A

135-145 mmol/L

69
Q

Normal Value of Na in ICF

A

4-10mmol/L

70
Q

Major ICF cation

A

K

71
Q

Seen in excessive sweating, diarrhea, renal loss, diabeted in sipidus

A

Hypernatremia

72
Q

Increase urinary losses of K occurs in:

A
  • abnormally increase aldosterone
  • Androgenital syndrome
  • renal tubular acidosis
  • Fanconi syndrome
  • uses of diureticd
  • carbonic anhydrase inhibitors
73
Q

Anticoagulants tends to increase….

A

Plasma vol

74
Q

Normal Value of K in Serum Samples

A

3.8-5.0mmol/L

75
Q

Primary organ responsible for co trolling ECF K

A

Kidney

76
Q

Minor regulator of K homeostasis

A

Gut

77
Q

Major EC anion

A

Chloride

78
Q

Normal Serum Chloride Conc

A

98-108mmol/L

79
Q

High blood Cl

A

Hyperchloremia

80
Q

Occurs in all types of metabolic acidosis, diarrhea, profused sweating, increase gastric juice secretion, salt-losinh nephritis

A

Hypochloremia

81
Q

Abundant cation in the body

A

Ca

82
Q

Function of Ca

A
  • Structural
  • Neuromuscular
  • Enzymatic
  • Signaling
83
Q

Normal Range of H+

A

4.5×10 -3 M —– 3.5 ×10 -3 M

84
Q

<7.4 pH
>45 PCO2
>26mEq/L HCO3-

A

Respi Acidosis -> Renal Compensation

85
Q

Contradictions of Aaterial Blood Extraction

A
  • Coagulation defectd
  • Circulatory comprise in the extrimity
  • Inadequate collateral circulation
  • Infection in sampling area
  • When cannulation of that vessel is anticipated
86
Q

Complication of Arterial Blood Extraction

A
  1. Nerve Injury
  2. Ischemic changes hand & wrist
  3. Occult bleeding
87
Q

Major Causes of Metabolic Alkalosis

A
  • Loss of H+ (e.g. vomit)
  • Renal H+ loss (e.g. hypercalcemia)
  • Shift of H+ into IC space (Hypokalemia)
  • Alkalotic agents (HCO3 excess)
  • Contraction Alkalosis (laxative abuse, loss of H2O)
88
Q

PaCO3 is high above the upper limit of the reference rangr eith normal or near normal pH seco dary to renal compensation and an increase serum HCO3- levels

A

Chronic Respiratory Acidosis

89
Q

May be secondary to COPD

A

Chronic Respi Acidosis

90
Q

PaCO3 is increase with an accompanying acidemia

A

Acute Respi Acidosis

91
Q

Results from CNS disease or drug-induced respi depression

A

Acute Respi Acidosis

92
Q

Marked by decrease level of CO2 in the blood due to breathing excessively

A

Respi Alkalosis

93
Q

Low PaCo3

High pH

A

Acutr Respi Alkalosis

94
Q

Low PaCO3

normal/near pH

A

Chronic Respi Alkalosis

95
Q

Caused by anxiety, fever, overbreathing, pregnancy, tumor, sever anemia, overdose of certain drugs, liver disease

A

Respiratory Alkalosis

96
Q

Ordered when there is O/CO2 or pH imbalance

A

ABG TEST

97
Q

Parameters of Arterial and Venous Blood

Cl
HCO3
pCO2
pO2
pH
A 
Arterial
• Cl- high
• HCO3- low
• pCO2- low
• pO2- increase
•pH- less acidic
Venous Blood
Cl- low
• HCO3- high
• pCO2- high
• pO2- low
•pH- more acidic
98
Q

AGB is drawn from the

A

Radial artery

99
Q

Test to confirm collateral circulation

A

Allen Test

100
Q

Cells are randomly dumped together. Can be abnormal.

A

Agglutination

101
Q

Cells are arranged in stack of coins

A

Rouleaux

102
Q

Tetany is caused by a decreased level of this electrolytes

A

Ca

103
Q

Increase level of this electrolytes can paralyze the heart

A

K

104
Q

A deficiency of these ions could lead to the development of anemia.

  • Fe • Cobalt
  • Zn • Nickel
  • Copper • Except Nickel
  • All • Except Cu
A

All

105
Q

Regulates the blood level of phosphate

A

PTH
Vit D

Or include Calcitonin

106
Q

What is the probable cause of for the ascitis of a Pt with a Serum-Ascitis Albumin Gradient or Gap (SAAG) of 1.56g/dL?

A

Right-sided heart failure

107
Q

A 25 y.o female Pt has the ff test result: TIBC 275 ug/dL; serum iron 55ug/dL. Interpret the % transferrin saturation for her age and gender.

A

Normal.

% Sat= Serum/ TIBC × 100

= 55/ 275 ×100
= 20 %

Normal= 20% - 50%

108
Q

Ceruplasmin is carrier of protein of which electrolytes?

A

Copper

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