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PA 5260 - Clinical Science > Test 1 > Flashcards

Test 1 Flashcards

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1
Q

Normal WBC count

A

4.5x10^3/uL

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2
Q

Leukocytosis

A

Increased WBC count
Bacterial infections
Certain meds (corticosteroids)
smokers

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3
Q

Leukopenia

A

decreased WBC count
viral/parasitic infections
radiation treatment for cancer

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4
Q

Normal Neutrophils

A

50-70% of WBCs

Absolute = 1.8-7.8x10^3 /uL

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5
Q

Neutrophilia

A

Leukocytosis

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6
Q

Neutropenia

A

Leukopenia
severe =500/uL
moderate = 500-1000/uL
mild = 1000-1500

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7
Q

Two forms of neutrophils

A

Band (less mature)

Segmented (segs)

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8
Q

Normal Lymphocytes

A

about 20-40%

absolute count = 1.8-4.8x10^3/uL

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9
Q

Lymphocytosis

A

Predominantly viral infections:

mono, cmv, HIV

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10
Q

Lymphocytopenia

A

bacterial or fungal sepsis, post-op, chemo

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11
Q

Normal Monocytes

A

2-8% of WBCs

absolute = 0-0.8x10^3 /uL

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12
Q

Normal Eosinophils

A

0-7% of WBCs

absolute = 0-0.45x10^3 /uL

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13
Q

Eosinopenia

A

Normal count can go down to 0

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14
Q

Eosinophilia

A

mild = 500-1500
moderate=1500-5k
severe = >5k
Parasites! allergic disorders

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15
Q

Normal Basophils

A

0-3% of WBCs

absolute = 0-0.2x10^3 /uL

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16
Q

Platelets

A

150-450x10^3 /uL

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17
Q

Thrombocytosis

A

Reactive (cytokine driven)

Autonomous (overproduction) - malignancy

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18
Q

Thrombocytopenia

A

lab error? platelets can clump b/c of EDTA
Drug induced
Infection

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19
Q

RBC count

A

Males = 4.6-6.0x10^3 /uL

Females =3.9-5.5x10^3 /uL

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20
Q

Increased RBCs

A

cigarette smoking, dehydration, polycythemia

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21
Q

Decreased RBCs

A

anemia, bleeding, hematopoetic failure, poor nutrition

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22
Q

Hemoglobin

A 
Males = 13.6-17.2 g/dL
Females = 12-15 g/dL
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23
Q

Increased Hemoglobin

A

Tobacco use and advanced COPD, alcohol abuse, dehydration

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24
Q

Decreased Hemoglobin

A

Acute blood loss anemia, malnutrition, renal failure

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25
Q

Hematocrit

A

Males = 41-50%
Females 35-45%

% of whole blood that is made of RBCs

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26
Q

Reticulocyte count

A

0.5-1.5% of RBCs in adults and children

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27
Q

Increased Reticulocyte count

A

Hemolysis or hemolytic anemia, acute blood loss

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28
Q

Decreased Reticulocyte count

A

represents decrease in RBC production; vitamin def, bone marrow failure, decreased EPO (renal disease)

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29
Q

Hemoglobin A

A

two alpha and two beta chains

=95-98%

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30
Q

Hemoglobin A2

A

two alpha and two delta chains

=2-3.5%

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31
Q

Hemoglobin F

A

two alpha and two gamma chains; fetal
50-80% newborns
8% 6 mos

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32
Q

Alpha Thalassemia

A

hemoglobinopathy; impaired production of alpha chains, decreased HgA2

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33
Q

Beta Thalassemia

A

hemoglobinopathy; increased HgA2

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34
Q

Hemoglobin S

A

Sickle cell trait or disease

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35
Q

Universal donor

A

Blood type O

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36
Q

Universal recipient

A

Blood type AB

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37
Q

Serum Iron

A

60-150 mcg/dL

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38
Q

Increased iron

A

Beta thalassemia, alcoholic cirrhosis, high iron intake, hereditary hemochromatosis

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39
Q

Decreased Iron

A

iron deficiency anemia, chronic renal failure, inadequate absorption, increased loss, increased demand

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40
Q

Serum Ferritin

A

15-200 ng/mL

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41
Q

Increased Ferritin

A

hereditary hemochromatosis, hepatitis, cancer, alcoholism

ACUTE PHASE REACTANT

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42
Q

Decreased Ferritin

A

Gold standard

Iron deficiency anemia

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43
Q

Total Iron Binding Capacity (TIBC)

A

250-400 mcg/dL

like stadium seating

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44
Q

Increased TIBC

A

iron deficiency anemia, pregnancy, viral hepatitis

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45
Q

Decreased TIBC

A

anemia of chronic disease, hemochromatosis

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46
Q

Transferrin Saturation

A

33% (=serum iron/TIBC)

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47
Q

Increased Transferrin Saturation

A

Megaolblastic anemia, iron overload states, hemochromatosis

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48
Q

Decreased Transferrin Saturation

A

Iron def anemia, chronic infection, malignancy

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49
Q

Albumin

A

50-60% of plasma proteins (most abundant)

Synth in liver, functions as regulator of oncotic pressure

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50
Q

Increased albumin

A

dehydration

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51
Q

Decreased albumin

A

liver disease, malabsorption, abnormal loss

52
Q

Prealbumin

A

A much better assessment of a patient’s nutritional status because of shorter half-life and sensitivity to rapid changes.

53
Q

Increased Prealbumin

A

pregnancy, Hodgkin’s lymphoma

54
Q

Decreased Prealbumin

A

Renal/liver disease, malnutrition, Crohn’s disease, severe illness, inflammation or infection

55
Q

Alpha-1-Antitrypsin

A

Inhibits the action of many key enzymes released during inflammatory reactions in the lung

56
Q

Decreased Alpha-1-Antitrypsin

A

COPD before age 40
Prolonged jaundice
liver dysfunction

57
Q

Ceruloplasmin

A

Acute phase reactant!

Made in the liver, involved in copper transport w/in the body

58
Q

Increased Ceruloplasmin

A

Infection

59
Q

Decreased Ceruloplasmin

A

Wilson’s disease, liver failure or hepatitis

60
Q

Haptoglobin

A

Acute phase reactant! Produced in the liver and binds to free Hg when RBCs are destroyed

61
Q

Decreased Haptoglobin

A

Hemolytic anemia, transfusion reaction, artificial heart valves

62
Q

CH50

A

Total complement activity testing; decreased = decreased complement activity

63
Q

C3 and C4 testing. Decreased

A

Systemic Lupus Erythematosus

Bacterial infections

64
Q

C3 and C4 testing increased

A

Cancer

65
Q

IgA

A

found in secretions and along the mucosal epithelium; allows for clearance of pathogens by cilia or of toxins in the GI tract

66
Q

IgA deficiency

A

can be asymptomatic or cause frequent resp infections, inflammation of GI tract

67
Q

IgD

A

represents small % of immunoglobulins, exact function unknown

68
Q

IgE

A

Allergic reactions!

69
Q

IgG

A

Responsible for immunity to bacteria and other microorganisms. Lasts.

I already got Germs!

70
Q

IgM

A

Initial antibody secreted after an immune challenge

I get Meds

71
Q

CMP

A

Electrolyte function and abnormalities (Na, K, Chloride, CO2, anion gap, Ca)
Renal function (BUN, creatinine)
Liver function (bilirubin, alkaline phosphatase, AST, ALT)
Proteins (albumin, total protein)
Diabetes (glucose)

72
Q

BMP

A

4-5 electrolytes, 2 tests of kidney function, 1 test of glucose
Does not include liver function tests

73
Q

Hypernatremia

A

Unreplaced water loss; elderly patients with diminished thirst stimulation, patients given hypertonic saline solutions

74
Q

Hyponatremia

A

Inadequate Na in IV fluids, thiazide diuretics!, renal insufficiency

75
Q

Increased K+ cause

A

some drugs

76
Q

Decreased K+ cause

A

fluid and electrolyte loss

Diuretics

77
Q

Hyperglycemia

A

Diabetes, acute stress response, pancreatitis, diuretics, corticosteroids

78
Q

Hypoglycemia

A

Insulinoma, insulin overdose, starvation, hypothyroidism

79
Q

Increased BUN

A

High protein diets, GI bleed, dehydration, medication

80
Q

Decreased BUN

A

Liver disease/failure, overhydration, low protein diets

81
Q

Creatinine

A

Excreted entirely by the kidneys, not affected by liver like BUN is.

82
Q

Increased Creatinine

A

Disorders of renal function, urinary tract obstruction, rhabdo, gigantism

83
Q

Decreased Creatinine

A

Debilitation, decreased muscle mass

84
Q

Unconjugated (indirect) bilirubin

A

70-85% of total bilirubin

85
Q

Indirect hyperbilirubinemia

A

Hepatocellular dysfunction, disease process that increases RBC destruction, medications

86
Q

Conjugated (Direct) bilirubin

A

15-30% of total bilirubin

87
Q

Direct hyperbilirubinemia

A

Obstructive; gallstones, obstruction of extrahepatic ducts by tumor, liver metastases

88
Q

Direct hyperbilirubinemia

A

Obstructive; gallstones, obstruction of extrahepatic ducts by tumor, liver metastases

89
Q

Hyperproteinemia causes

A

dehydration, malignancy, infection

90
Q

Hypoproteinemia causes

A

Hepatic failure or disease, malnutrition, malabsorption, renal failure or disease

91
Q

High Alkaline Phosphatase (ALP) levels

A

Cirrhosis, liver tumors
cancers that metastasize to the bone
Primary cancer of the bone

92
Q

High Alkaline Phosphatase (ALP) levels

A

Cirrhosis, liver tumors
cancers that metastasize to the bone
Primary cancer of the bone

93
Q

ALP

A

functions in growth and development of bones, teeth and other tissues
Present in Kupffer cells in liver and biliary tract

94
Q

AST

A

aspartate aminotransferase

evaluation of patient liver status

95
Q

Increased AST

A

cell inflammation, injury and death

liver diseases, tumors, mono

96
Q

ALT

A

alanine aminotransferase - in jaundiced patients, elevation of ALT points to liver as source

97
Q

Increased ALT

A

hepatotoxic drugs, cirrhosis, hepatitis

> 3x normal is significant!

98
Q

AST:ALT ratio >1

A

alcoholic cirrhosis>2

metastatic tumor of the liver

99
Q

AST:ALT ratio

A

acute/viral hepatitis, mononucleosis

100
Q

BUN:creatinine ratio

A

normal 10:1 - 20:1

101
Q

Pre-renal azotemia

A

> 20:1

results from abnormalities in systemic circulation that decrease blood flow to the kidneys

102
Q

Intra-renal azotemia

A
103
Q

Azotemia

A

Increase in nitrogen-containing compounds in the blood

104
Q

Post-renal azotemia

A

early >20:1

late

105
Q

Creatinine Clearance - men

A

0.7-1.3 mg/dL

106
Q

Creatinine Clearance - women

A

0.6-1.1 mg/dL

107
Q

CKD stages based on GFR

A 
Stage 1 >90
Stage 2 = 60-89
Stage 3 = 30-59
Stage 4 = 15-29
Stage 5
108
Q

Mean plasma glucose

A

(35.6xHgbA1C) - 77.3

109
Q

HgbA1C values

A

diagnosis of diabetes >6.5%

poor control diabetes >8%

110
Q

C-peptide in Diabetes

A

Type 1 = low

Type 2 = normal or high

111
Q

In evaluation of abdominal pain

A

Amylase and lipase test to screen for pancreatitis. Lipase rises later and sticks around longer than amylase.

112
Q

Normal Uric Acid Levels

A

4.0-8.5 mg/dL

gout > 6.8 mg/dL

113
Q

Natriuretic peptides

A

function to inhibit the reabsorption of Na in the renal tubule so that Na excretion in the urine increases

114
Q

Types of natriuretic peptides

A

ANP = synth in atrial cardiomyocytes
BNP = initially identified in the brain
(^ released when ventricles stretch)
C-type = nervous system and endothelium

115
Q

BNP

A

B/c strong correlation to L ventricular pressure, can be used to diagnose CHF fairly accurately.
Ischemia causes release of BNP in myocardial infarction

116
Q

Time of onset & duration of cardiac enzymes

A

myoglobin: 3 hrs; early marker
CK-MB: 3-6 hrs, not elev. in all patients until 12 hrs, returns to baseline in 36-48hr
TROPONIN: 2-3 hrs, stays for 7-14 days
LDH: within 24-48 hrs, peak 2-3 days, normal in 5-10 days

117
Q

Flipped LDH

A

LDH-2 is most abundant usually, except in MI when LDH-1 becomes more abundant.

118
Q

Reason for ordering D-dimer

A

Intravascular clotting; DVT, PE

119
Q

Total Cholesterol normal

A
120
Q

Triglycerides

A

normal 500 mg/dL

121
Q

HDL

A

Men desired > 60 mg/dL
at risk 60 mg/dL
at risk

122
Q

LDL

A

ideal for those at risk = 70-100 mg/dL
near ideal = 100-130
borderline = 130-159
high > 160 mg/dL

123
Q

BNP normal

A

500 probable CHF

124
Q

Total Creatine Kinase

A

normal = 50-200 u/L

125
Q

Troponin I and T

A

troponin I

126
Q

D-dimer

A

normal

PA 5260 - Clinical Science (2 decks)

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