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UA > Test 2 > Flashcards

Test 2 Flashcards

1
Q

In the diabetes mellitus type 2 patient, which of the following lab values would be high?

A

Blood Acetone

*side note: as in a serum ketone test

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2
Q

If you had a patient with a concern of having contracted HIV from a new partner what studies would you order to alleviate their concerns?

A

Western blot & Elisa Study

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3
Q

If a 60 year old male presented to your office with a PSA (prostate specific antigen) of 12. What’s your initial diagnosis and what test would your perform next?

A

Prostate Cancer, Digital Rectal exam

*side note: as in benign prostatic hyperplasia or it could indicate prostatitis. MUST do a digital exam if PSA is high

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4
Q

A 19 year old female presents to your office with complaints of nausea. What would be the first test you would order for her?

A

hCG ( human chorionic gonadotropin)
*side note: hCG is produced by the placenta or malignant tumor. hCG is only found in urine during pregnancy (in normal situations) but can be found in male/female urine in testicular/ovarian cancers.

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5
Q

A pregnant female expresses concern for the wellbeing of her unborn child and disclosed to you, “ I didn’t know I was pregnant. I consumed alcohol and I didn’t take any prenatal vitamins.” What test would you order? If the test for this patient came back increased you would then suspect?

A

AFP (alpha-fetoprotein) test, neural tube defect
*side note: AFP is a substance made in the liver of an unborn baby (fetus). The amount of AFP in the blood of a pregnant woman can help see whether the baby may have such problems as spina bifida or down syndrome. Normal levels for non-prego = 0-40, normal for prego = 10-130. If AFP is high, it can also indicate multiple pregnancies, intrauterine death, and genetic disorders. Low AFP can indicate down syndrome.

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6
Q

A 42 year old patient presents with a red-orange urine. During you history you elicit that he had a sore throat two weeks prior for which he did not seek treatments. In order to confirm you suspicion you should order…

A

ASO test (antistreptolysin)
*side note: ASO is a blood test to measure antibodies against streptolysin O, a substance produced by group A Streptococcus bacteria.
Acceptable values, where there is no clinical suspicion of
Streptococcus infection are as follows:
- adults: less than 200 units
- children: less than 400 units

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7
Q

A patient presents with the following lab values on the CBC: WBC count is 19K with a differential that shows 86% neutrophils, 12% lymphocytes, 1% basophils. In this case you would suspect…

A

Bacterial infection
*side note: increased lymphocytes = viral infection. Increased monocytes can indicate TB, bacterial endocarditis, multiple myeloma, hepatitis, and typhoid. Increased eosinophils = allergic reaction/parasite. And increased basophils = CML (chronic myelocitic leukemia), Hodgkin’s, and ulcerative colitis.

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8
Q

A patient claims they have been swimming in the Chattahoochee with Dr. Amos on a date. The CBC shows WBC count of 32K, the differentials shows 60% neutrophils, 20% lymphocytes, 8% Monocytes, and 12% eosinophils, and normal basophils. In this case you have to question her judgement and whether or not she needs treatment for…

A

A parasite

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9
Q

If you suspected a patient had systemic lupus (SLE), how would you confirm your diagnosis?

A 
ANA test (Antinuclear Antibodies)
*side note: does not automatically confirm SLE, must also perform a double stranded DNA test
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10
Q

A patient presents with a WBC count of 29K. The differential is 50% Neutrophils, 45% lymphocytes, 5% others, you would suspect…

A

Viral infection

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11
Q

If a patients direct bilirubin was increased in the serum, it would indicate…

A

Biliary obstruction
*side note: in biliary obstruction, blood Alkaline Phosphatase (ALP) would be high as well as Gamma-glutamyl transferase (GGTP)

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12
Q

If a patient exhibits a higher than normal C reactive protein you would be able to determine the patient possibly has…

A

Acute non infectious inflammatory reaction
*side note: C-reactive protein is produced by the liver. The test is a non-specific/general test to test for inflammation of the tissues

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13
Q

What lab test would you order to check her liver function?

A

ALT/AST

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14
Q

A patient presents with polydipsia, polyphagia, and polyuria. What test would you order first because it is least expensive and the quickest to yield results?

A

UA

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15
Q

What would you suspect If a patient has glucose in the urine along with ketones?

A

Diabetes Mellitus

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16
Q

What test must you order next to confirm your suspicion?

A

GTT (Glucose tolerance test)

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17
Q

What glucose test is the best long term indicator for glucose in the blood stream?

A

Gylcosolated hemoglobin

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18
Q

If a patient has several periodical, unexplained, reoccurring, and residing neurological symptoms including loss of vision, which one test would you expect to yield a positive result?

A

HLA (Human leukocyte antigen)
*side note: proteins that help the body’s immune system tell the difference between own cells and foreign harmful substance. This test may be ordered if a patient complains of joint pain, stiffness, or swelling. HLA antigen testing is also used to match donated tissue in a person who is getting an organ transplant.

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19
Q

If an otherwise normally healthy infant begins to exhibit mental retardation, what test would you order?

A

PKU (Phenylketonuria)
*side note: can’t break down phenylalanine. A strong “musty” or “mousy” odor to affected infants. If phenylalanine is not reduced in the diet early in life,
severe brain damage and mental retardation can occur
• Patients have paler skin and hair
• Blood tests detect this disease earlier than urine tests

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20
Q

If a patient has a low hematocrit what does that mean?

A

Decreased RBC’s

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21
Q

A 15 year old girl presents with a mass in the midline of the anterior neck. Your physical exam findings include a non tender diffuse mass. What lab test would you order to confirm your suspicious?

A

TSH (thyroid stimulating hormone)

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22
Q

True or false? Small amounts of protein are a normal finding in a urine sample in a person that has vigorously exercise

A

True

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23
Q

An increased MCV (Mean corpuscular volume) above 100 would be indicative of…

A

Macrocytes

*side note: MCV indicates the average size of red blood cells.

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24
Q

If you find nitrates in a urine sample you would most likely suspect? And the offending agent would most likely be…..

A

Normal findings, Nothing since it is a normal component of urine

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25
Q

If a patient presents with tender, shallow joints especially in the big toe; you would suspect? And what condition is described?

A

Low urine uric acid & high blood uric acid, Gout

*side note: normal = 250 to 750 milligrams per 24 hours

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26
Q

Gout is caused by…

A

Purine Metabolism Disorder

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27
Q

Alkaline phosphatase (ALP) levels would be elevated in…

A

Paget’s Disease
*side note: you can find high ALP in normal situations such as rapidly growing childern, pregnant women, and bone healing after fracture. Abnormally high ALP blood levels also found in: biliary tract obstruction (along with increased blood level of GGTP), osteoblastic bone tumors, osteomalacia (rickets), hepatitis, leukemia, lymphoma, and sarcoidosis

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28
Q

Eosinophils will be elevated in…

A

Trichinomis

*side note: this is a parasitic infection

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29
Q

If a patient has recurrent, chronic GI disorders, what screening test would you order to rule out ulcer?

A

H. Pylori test

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30
Q

A patient presents with a WBC count of 4300. This most likely means…

A

Normal Count

*side note: normal range is 4-10.5 thousan / cubic mm

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31
Q

A patient with a specific gravity of 1.015 and no ketone in the urine will need to screen for…

A

Nothing. This is normal.

32
Q

An African American male presents to your office with joint pain and fatigue. Which levels would you expect to be high, and what would be the most likely exam finding upon examination of the abdomen on this patient?

A

Hemoglobin, Dullness between T8-T10 on the right side of the abdomen upon percussion

33
Q

True or false? Rheumatoid factor tests are sensitive and specific?

A

False

34
Q

Rheumatoid arthritis is the only condition that will provide a positive result for rheumatoid factor?

A

False

35
Q

Which of the following blood tests would test the intrinsic clotting pathway?

A

PTT (Partial thromboplastin time)

*side note: Normal range: 30-50 seconds

36
Q

Blood urea nitrogen is found in the urine due to?

A

Breakdown of polypeptides

37
Q

Which of the following blood tests will test the extrinsic clotting pathway?

A

PT (Prothrombin Time)

*side note: 11 - 13.5 seconds

38
Q

What is the normal range for WBC count?

A

4-10.5 thousand/cubic mm

*side note: > 10.5 thousand = leukocytosis,

39
Q

Aka for immature neutrophils?

A

Band cells

40
Q

What are the normal values of WBC’s?

A 
Neutrophils = 40-65%
Lymphocytes = 20-35%
Monocytes = 2-10%
Eosinophils = 1-6%
Basophils = 0.5-1%
41
Q

Which of the WBC’s are polymorphonuclear?

A

Neutrophils (2-5 nuclei)
Eosinophils (2 nuclei)
Basophils (2 nuclei)
*side note: these are known as granulocytes. lymphocytes and monocytes are mononuclear and are known as agranulocytes

42
Q

What is the main function of monocytes?

A

Phagocytosis

*side note: monocytes are the most active of phagocytic cells

43
Q

What is the normal range for RBC count?

A

3.8-5.1 million/cubic mm

44
Q

What does anisocytosis mean in reference to RBC’s? Poikilocytosis?

A

Anisocytosis = different size cells (macrocytic or microcytic), Poikilocytosis = different shape cells

45
Q

What are some causes for macrocytic RBC’s?

A

Megaloblastic anemia, alcoholism, autoimmune hemolytic anemia, chronic liver disease

46
Q

What are some causes for microcytic RBC’s

A

Iron deficiency anemia, thalassemia, sickle cell anemia

*side note: the cells in sickle cell may be normocytic (50/50)

47
Q

What is the normal hematocrit (% of RBC’s in the blood) for men? Women?

A 
Men = 45%
Women = 40%
48
Q

Each gram of hemoglobin binds _____ ml of O2.

A

1.34

49
Q

What is the normal range of hemoglobin in the blood?

A

11.6-15.2 g/dl

50
Q

Fetal hemoglobin (HbF) greek letters?

A

α2γ2

51
Q

Adult hemoglobin (HbA) greek letters?

A

α2β2

52
Q

Primitive (embryo) hemoglobin (HbP) greek letters?

A

α2ɛ2

53
Q

Decreased levels of hemoglobin is typically found in what condition?

A

Iron deficiency anemia

*side note: also found in hemolytic anemia, sickle cell, and renal failure.

54
Q

Mean corpuscle volume (MCV) indicates…

A

The average size of a red blood cell

55
Q

Normal range MCV?

A

80-99 femtoliters (fL)

*side note: MCV > 99 = macrocytes

56
Q

Mean corpuscle hemoglobin (MCH) indicates…

A

The average mass of hemoglobin per RBC.

57
Q

Normal range MCH?

A

27-31 picograms

*side note: this indicates normochromic. MCH > 31 = hyperchromic.

58
Q

Methemoglobin (MetHb) normal range?

A

1-2 %
*side note: 10-20% will present with skin discoloration (bluish), 20-30% headache/anxiety, 30-50% fatigue/dizziness/tachycardia/confusion, 50-70% coma/arrythmia, > 70% death. You acquire MetHb by CO poisoning.

59
Q

Erythrocyte Sedimentation Rate (ESR) indicates…

A

The rate at which RBC’s sediment (fall) in a period of one hour.
*side note: this is a non-specific test for inflammation in the body. The further the RBC’s sediment (fall) in the test tube, the more inflammation there is.

60
Q

ESR normal range for males? Females?

A 
Males = 1-13 mm/hr
Females = 1-20 mm/hr
61
Q

Total iron body capacity indicates…

A

The body’s ability to bind iron with transferrin

62
Q

What is the normal range for ACT (activating clotting time)?

A

94-120 seconds

63
Q

BJ (Bence Jones) proteins are normally found in patients with…

A

Multiple Myeloma
*side note: found in 50-80% of patients with MM. You may also find BJ proteins in patients with Waldenström’s macroglobulinemia, end-stage of renal failure, and amyloidosis

64
Q

What are the 4 common symptoms for multiple myeloma? (hint: CRAB)

A 
C = Calcium (elevated)
R = Renal failure
A = Anemia 
B = Bone lesions (lytic)
65
Q

Schilling’s test is used to determine…

A

B12 amount

*side note: this is a UA not a blood test

66
Q

What is the normal urine creatinine range in a 24 hour sample for men under 40? Women under 40?

A

Men = 107-139 mL/min
Women = 87-107 mL/min
*side note: Creatinine clearance values normally go down as you get older (normal values go down by 6.5 mL/min for every 10 years past the age of 20).

67
Q

Acid phosphatase is an enzyme that is found primarily in the…

A

Pancreas

*side note: the pancreas has 100x more acid phosphatase than any other body tissue

68
Q

Increased serum levels of acid phosphatase is indicative of…

A

Prostate cancer that has metastasized to the bone

*side note: a bunch of other shit too but prostate cancer is the one you need to know.

69
Q

What’s the aka for aspartate aminotransferase (AST)?

A

Serum Glutamic Oxaloacetic Transaminase (SGOT)
*side note AST aka SGOT are normally low in the blood. You find high levels 6-10 hours after injury to the liver, cardiac/skeletal muscle, kidney, pancreas, brain, and RBC’s.

70
Q

True or false? Lactate acid dehydrogenase (LDH) is seldom found in the body.

A

False
*side note: LDH is present in almost all tissues in the body. LDH helps produce energy and exists in 5 isoenzyme forms. LDH usually becomes elevated in response to cell damage.

71
Q

Blood troponin levels are usually elevated following…

A

A heart attack.

*side note: cardiac troponin is usually too low to detect.

72
Q

Where can you find CPK-1, CPK-2, and CPK-3?

A

CPK-1 = brain and lungs
CPK-2 = heart
CPK-3 = skeletal muscle
*side note: CPK-1 is aka CPK-BB, CPK-2 is aka CPK-MB, and CPK-3 is aka CPK MM.

73
Q

What is the normal range of blood albumins?

A

3.5-5.0 g/dl

74
Q

What is the normal range for a fasting blood glucose test?

A

70-100 mg/dl
*side note: most of the time blood glucose will be under 125 mg/dl (not fasting). If blood glucose is
125 = hyperglycemia. If blood glucose is 100-125 mg/dl after fasting = pre-diabetic and > 126mg/dl = diabetes mellitus

75
Q

Why would a lipase test normally be administered?

A

To test for disease of the pancreas, most often acute pancreatitis.

76
Q

What is the optimal LDL/HDL ration?

A

3.5 : 1

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