Test 1 Introduction to Lab Monitoring

Question 1

potential factors that can affect laboratory samples

Answer 1

• improper handling or collection
• inadequate specimen
• technical errors
• fault or outdated reagents
• food substances
• medications
• diagnostic or therapeutic procedures

Question 2

components of basic metabolic panel (BMP) or “Chem-8”

Answer 2

• Sodium
• Potassium
• Chloride
• Bicarbonate (Abbreviated CO2)
• Blood urea nitrogen (BUN)L
• Creatinine: decreased in children and elderly compared to adults
• Glucose
• Calcium

Question 3

components of CBC

Answer 3

\+ RBC
- Hbg
- Hematocrit
- Platelets (Plts) or thrombocytes
\+ WBCs
- Neutrophils
- Lymphocytes
- Monocytes
- Eosinophils
- Basophils

Question 4

components of complete metabolic panel (CMP) or “Chem-14”

Answer 4

\+ Part one: Chemistry values from “Chem-8”: sodium, potassium, chloride, bicarbonate, blood urea nitrogen, creatinine, calcium
\+ Part two: Liver function tests (LFTs)
- Aspartate aminotransferase 
- Alanine aminotransferase
- Alkaline phosphatase 
- Total bilirubin
- Total protein
- Albumin

Question 5

Formula for corrected calcium

Answer 5

Corrected Ca2+ (mg/dL) = Measured Ca2+ + [(4-Albumin) x 0.8]

Question 6

Formula for anion gap

Answer 6

[Na+] – [Cl-] – [Bicarbonate CO2 from serum blood]

Question 7

Recognize hepatic failure when given a patient’s labs

Answer 7

Increase in: 
- indirect bilirubin 
- PT 
- INR
Decrease in: 
- albumin

Question 8

Recognize renal failure when given a patient’s labs

Answer 8

• increased BUN (azotemia)
• high Cr (low GFR)
• proteinuria

Question 9

How can you tell a patient has an infection by looking at their inflammatory markers on their labs?

Answer 9

• ESR (generic range: 0-30 mm/hr) increases with infection
• CRP (Normal range: 0.0-8.0 mg/L) increased wit infection / inflammation [Low: < 1.0 mg/L | Average: 1.0-3.0 mg/L | High: > 3.0 mg/L]

Question 10

Factors that may influence BMP lab values

Answer 10

• hyperglycemia -> hyponatremia
• increased fluid loss -> hypernatremia
• diarrhea, vomiting -> hypokalemia
• loop and thiazide diuretics -> hypokalemia
• metabolic acidosis -> hyperkalemia
• ACEI, ARB, K supplements, K sparing diuretics -> hyperkalemia
• Cl changes with respect to Na
• age, gender, and muscle mass affects Cr
• carbs intake affect glucose

Question 11

Factors that may influence CMP lab values

Answer 11

• heart / liver injury -> increase aspartate aminotransferase
• liver injury -> increase alanine aminotransferase
• obstructive liver disease, bone fractures, bone growth, and bone metastases -> increased alk phos
• hepatocellular injury, biliary obstruction, or hemolysis -> increased total bilirubin
• liver failure, bleeding loss, burn -> decreased albumin

Question 12

Factors that may influence CBC lab values

Answer 12

• infection -> increased WBC

- immunocompromised state -> decreased WBC

Question 13

Factors that may influence UA lab values

Answer 13

• infection -> alkaline pH, increased WBC
• dehydration -> increased specific gravity
• fluid overload -> decreased specific gravity
• renal injury -> proteinuria
• insulin deficiency, decreased carb intake -> increased ketones
• nephrolithiasis, increased vaginal blood -> presence of RBC

Question 14

Factors that may influence inflammatory markers in lab values

Answer 14

• infection, neoplasms, pregnancy -> increased ESR
• inflammation, infection, or acute myocardial infarction/cardiovascular disease -> increased CRP
• PCT secreted by thyroid, lung, and intestine in response to inflammation