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.
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
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
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
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
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
7
Q
Accessible veins in infants are usually reserved exclusively for • intravenous catheterization • All of the above • phlebotomy • parenteral therapy
A
parenteral therapy
8
Q
Iatrogenic anemia of infants could most likely result from:
A
repeated venipuncture
9
Q
Preferable sites for skin puncture in neonates & infants:
A
deep heel /big toe
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
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
12
Q
Venous blood is higher than the arterial blood in the following: • chloride • packed cell volume • oxygen • ammonia • pH
A
packed cell volume
13
Q
The physician’s gloves should be properly disposed into this bin after using:
- yellow
- red
- green
- orange
- black
A
yellow
14
Q
These antibiotics could affect blood chemical examinations EXCEPT: • Erythromycin • Penicillin G • Cephalosporins • Isoniazid • Cotrimoxazole
A
Cotrimoxazole
15
Q
Variation in red cell shapes is called:
A
Poikilocytosis
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
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
18
Q
The pO2 value in the peripheral tissues:
A
40mmHg
19
Q
Respiratory alkalosis is very commonly induced by the following EXCEPT:
- liver failure
- sepsis
- CNS depression
- aspirin intoxication
A
CNS depression
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
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
22
Q
The external intercostals contract during inspiration.
- False
- True
A
TRUE
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
24
Q
Preferable sites for skin puncture in neonates & infants:
A
deep heel /big toe
25
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
All
26
Anisocytosis
* anisocytosis
* polymorphisms
* poikilocytosis
* erythrocytosis
anisocytosis
27
Proteins on the extracytoplasmic face may associate with the membrane via:
glycosyl phosphatidyl inositol linked protein
28
```
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
```
Amylase
29
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
Sodium
30
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
smallest and/or most hydrophobic molecules
31
Major cause of metabolic acidosis with normal anion gap in patient w/ renal failure
Diarrhea
32
Methylation of lysine residues in histones. Silincing
Histone Methylation
33
Lysine residues are acetylated by histone acetyl transferases (HAT). Acitivation
Histone acetylation
34
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.
Proteasomal Degradation
35
Normal Values of RBC Count.
Male
Female
Male: 4.6-5.9 millions
Females: 4.2- 5.4
36
Factors of Polycythemia
High altitudes, physical training, smokers & polycythemia
37
What is anemia? The diagnosis of anemia.
Low blood count
38
Variation in cell sizes
Anisocytosis
39
Value of Hyperchromic, Normochromic, Hypochromic.
Hyperchromic: >31pg/cell
Normochromic: 27-31pg/cell
Hypochromic: <27pg/cell
40
MCH decreases inversely proportional as size of central pallor
1/3
41
Factors of increase ESR (Erythrocyte Sedimentation Rate).
* Hematocrit
* Blood viscosity
* Conc. Of fibrinogen
* Size of RBC
* WBC Count
* high Htc
* low blood viscosity
* high conc of fibrinogen
* Mycrocytic RBC
* Extreme elevation of WBC count.
42
Normal Hb count.
Female
Male
Female: 14.0 +_ 2.0 g/dL
Male: 16.0 +_2.0 g/dL
43
Find the Hb Count.
Hb: 14.5 g/dL
Htc: 45mL/dL
32.2 g/dL packed cells
44
Factors of low ESR.
* high Htc
* change in RBC shape
* high albumin conc
45
Normal value of WBC.
Adult: 4500-10,500/mm3 or 4.5 -10.5 × 10 3 /uL
46
High count in WBC.
```
Neutrophils- 62
Lymphocytes- 30
Monocytes- 5
Eosinophil- 2.5
Basophils- 0.75
```
47
Granulocytes cells.
Neutrophils
Basophils
Eosinophils
48
Characteristics of Neutrophils
* Intravasation
* Extravasation
* Paracellular Diapedesis
* Transcellular Diapedesis
49
Low platelet count
Thrombocytopenia
50
Normal value of Platelets
150,000- 400, 000 cells/mm3
51
Clothing factor of platelets
Alpha granules
52
Severe thrombocytopenia
<50,000
53
Diurnal Variation.
* Iron
* corticosteroirs
* phosphates
* neutrophils
* Iron- AM
* corticosteroirs- AM
* phosphates- AM
* neutrophils- PM
54
Effects of these drugs.
* Isoniazid
* Ascorbic
* Caffiene
• 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
Effects of Drugs.
* Calcium
* Oxalates
* Glucose
* Cephalosporin
• Calcium- high K
• Oxalates - low acid phosphate
- low lactate dehydrogenase
• Glucose - high creatinine
- high urate
• Cephalosporin- high creatinine
- high glucose (U)
56
Functions of Electrolytes.
* maintenance of osmotic pressure & hydration (Na)
* Buffering function (HCO3)
* Activators in enzyme reactions (Mg)
* Normal neuromuscular-excitability (Ca)
* Redox reaction (electron transport) (Fe)
57
The difference between the sums of the conc of the principal cations and the principal anions
Anion Gap
58
Calculate Anion Gap formula.
AG= (Na + K) - (Cl + HCO3-)
| Normal Value: 10-18mmol/L
59
Decrease anion gap results to.
Multiple myeloma
Protein error
Instrument error
60
Function as water pull
Na
61
Abundant cation in the ECF
Na
62
Decrease in K uptake
Hypokalemia
63
Used to determined primarily to screen for cystic fibrosis.
Chloride/ Sweat Chloride
64
Causes of Spuriously High K
1. High platelet count
2. Prolonged application of tourniquet
3. Increase muscular activity
4. Hemolyzed specimen
5. Contamination with EDTA
65
Determines the ECF vol.
Na
66
Renal threshold for Na
110-130mmol/L
67
Promotes natriuretisis and relaxation of vascular smooth muscle (vasodilation)
Atrial natriuretic factor
68
Normal value of Na in ECF
135-145 mmol/L
69
Normal Value of Na in ICF
4-10mmol/L
70
Major ICF cation
K
71
Seen in excessive sweating, diarrhea, renal loss, diabeted in sipidus
Hypernatremia
72
Increase urinary losses of K occurs in:
* abnormally increase aldosterone
* Androgenital syndrome
* renal tubular acidosis
* Fanconi syndrome
* uses of diureticd
* carbonic anhydrase inhibitors
73
Anticoagulants tends to increase....
Plasma vol
74
Normal Value of K in Serum Samples
3.8-5.0mmol/L
75
Primary organ responsible for co trolling ECF K
Kidney
76
Minor regulator of K homeostasis
Gut
77
Major EC anion
Chloride
78
Normal Serum Chloride Conc
98-108mmol/L
79
High blood Cl
Hyperchloremia
80
Occurs in all types of metabolic acidosis, diarrhea, profused sweating, increase gastric juice secretion, salt-losinh nephritis
Hypochloremia
81
Abundant cation in the body
Ca
82
Function of Ca
* Structural
* Neuromuscular
* Enzymatic
* Signaling
83
Normal Range of H+
4.5×10 -3 M ----- 3.5 ×10 -3 M
84
<7.4 pH
>45 PCO2
>26mEq/L HCO3-
Respi Acidosis -> Renal Compensation
85
Contradictions of Aaterial Blood Extraction
* Coagulation defectd
* Circulatory comprise in the extrimity
* Inadequate collateral circulation
* Infection in sampling area
* When cannulation of that vessel is anticipated
86
Complication of Arterial Blood Extraction
1. Nerve Injury
2. Ischemic changes hand & wrist
3. Occult bleeding
87
Major Causes of Metabolic Alkalosis
* 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
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
Chronic Respiratory Acidosis
89
May be secondary to COPD
Chronic Respi Acidosis
90
PaCO3 is increase with an accompanying acidemia
Acute Respi Acidosis
91
Results from CNS disease or drug-induced respi depression
Acute Respi Acidosis
92
Marked by decrease level of CO2 in the blood due to breathing excessively
Respi Alkalosis
93
Low PaCo3
| High pH
Acutr Respi Alkalosis
94
Low PaCO3
| normal/near pH
Chronic Respi Alkalosis
95
Caused by anxiety, fever, overbreathing, pregnancy, tumor, sever anemia, overdose of certain drugs, liver disease
Respiratory Alkalosis
96
Ordered when there is O/CO2 or pH imbalance
ABG TEST
97
Parameters of Arterial and Venous Blood
```
Cl
HCO3
pCO2
pO2
pH
```
```
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
AGB is drawn from the
Radial artery
99
Test to confirm collateral circulation
Allen Test
100
Cells are randomly dumped together. Can be abnormal.
Agglutination
101
Cells are arranged in stack of coins
Rouleaux
102
Tetany is caused by a decreased level of this electrolytes
Ca
103
Increase level of this electrolytes can paralyze the heart
K
104
A deficiency of these ions could lead to the development of anemia.
* Fe • Cobalt
* Zn • Nickel
* Copper • Except Nickel
* All • Except Cu
All
105
Regulates the blood level of phosphate
PTH
Vit D
Or include Calcitonin
106
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?
Right-sided heart failure
107
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.
Normal.
% Sat= Serum/ TIBC × 100
= 55/ 275 ×100
= 20 %
Normal= 20% - 50%
108
Ceruplasmin is carrier of protein of which electrolytes?
Copper
