1 Flashcards
(61 cards)
1
Q
Microalbumin
A
Used to evaluate kidney damage
Indicates kidneys leaking protein
Common in diabetic patients and HTN
2
Q
Components of urinalysis
A
– specific gravity, glucose, blood, protein, nitrites, pH, ketones, leuk estrace
3
Q
Nitrites
A
produced as bacteria replicate in urinary tract. However negative nitrites do not rule out infection
4
Q
XRay
A
Evaluates solid structures
Does NOT evaluate soft structures such as tendons and ligaments
CT scan is advanced x-ray; mammogram
5
Q
MRI
A
Noninvasive diagnostic scanning. No radiation exposure
Metal implants, pins for reductions, pacemaker, aneurysm clips are disqualifying
Used for central nervous system, neck and back, bones and joints, heart, and breasts
Evaluates softer structures such as tendons and ligaments
6
Q
Pulmonary Function Tests
A
Evaluate lungs and pulmonary reserve
Evaluation response of bronchodilator therapy
Differentiate between restrictive and obstructive forms of COPD
7
Q
Chloride, blood
A
- Does not provide much information alone
- Can help identify acid-case imbalance and hydration when used in combination with other electrolytes
8
Q
Creatinine
A
- Diagnoses impaired renal function
- Used to estimate GFR
- Can become elevated with use of ACEI, aminoglycosides, certain chemotherapy agents, NSAIDs
9
Q
Creatinine clearance
A
- Used to measure GFR of kidney
- CrCl not affected if only 1 functioning kidney
- Decreases with age
10
Q
Estimated GFR
A
- Used to determine stage of kidney disease
- Utilizes creatinine, age, gender, and body size to calculate
- eGFR <60 for 3 months or more indicates chronic kidney disease
11
Q
Prostate-specific antigen (PSA)
A
-Screening method for prostate cancer
-PSA elevated in cancer, infection, BPH
– UTI and prostatitis can cause elevations for up to 6 weeks
- Secreted in ALL males
12
Q
Sodium, blood
A
- Monitor fluid and electrolytes
- Part of BMP/CMP
-Increased sodium due to:
increased sodium intake
Cushing syndrome
Excessive free water loss
-Decreased sodium due to:
Addisons, hypoaldosteronism. GI loss, excessive sweating, overhydration, burns, DI, renal insufficiency, diuretic
13
Q
BUN
A
-rough measurement of renal function and GFR
- Dietary protein can affect BUN
- Almost all renal diseases cause inadequate excretion of urea
- can be affected by hepatic function
14
Q
Uric Acid
A
- Diagnose gout and monitor treatment
- Gout is common metabolic disorder caused by chronic hyperuricemia
- Can be used to evaluate kidney stones
- Uric acid is excreted primarily by the kidney and a lesser amount by the intestinal tract
15
Q
Urodynamic Studies (Manometric)
A
- Used to identify problems with bladder function
- Includes urine flow studies, post-void residual, and cystometrogram
- Performed in combination with cystoscopy
16
Q
Chloride, urine
A
- electrolyte or acid-base imbalance
- 24 hour urine
17
Q
Substance abuse testing
A
- Metabolites of illegal drugs
- used for drug screens in pre-employment, narcotic agreements
18
Q
Toxicology
A
- Drugs of abuse, overdose, poisoning
- Often used in emergency department when clearing patient for psych delegate
19
Q
Osmolality
A
- Fluid and electrolyte imbalance
- Used to evaluate diabetes insipidus and SIADH
20
Q
Potassium, Urine
A
- Major cation of the cell
- Acid-base balance, electrolytes
- Renal and adrenal disease
21
Q
Sodium, Urine
A
- Evaluate fluid and electrolyte imbalances
- Monitor sodium therapy
- Volume depletion, acute renal failure, adrenal disturbances
22
Q
Uric Acid (urine)
A
-Useful for assessing uric acid metabolism in gout and renal calculi
23
Q
Urinalysis
A
- Kidney function and metabolic processes
- UTI – leuk estrace, nitrates
- Kidney stone – blood, proteinuria
- Diabetes - glucosuria
24
Q
Urine Stones
A
- Identify composition of kidney stones
- Calcium oxalate and calcium phosphate make up most stones
- Stones <5mm generally will pass; stones >7mm almost always require intervention to pass
25
Pyelography
- X-ray study that uses contrast material to visualize the kidneys, renal pelvis, ureters, and bladder
- Used to assess trauma on urinary system
26
KUB
- 1 view abdominal xray
- Abdominal pain or trauma
- Identify pathologic conditions
- Calculi, obstruction, masses, or ruptured viscus
27
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Antidiuretic hormone (ADH)
SIADH v DI
```
Also called arginine vasopressin
Made by hypothalamus and stored in pituitary gland
Acts to maintain blood pressure, blood volume and tissue water content by controlling the amount of water and hence the concentration of urine excreted by the kidney
Regulates the amount of water in blood
• SIADH ||| High levels of ADH – retain water ||| low serum sodium, low osmo; high urine osmo
• DI ||| low levels of ADH ||| release water ||| high serum sodium, high osmo; low urine osmo
28
Antithyroglobulin antibody
Sign of thyroid gland damage
| Measured if thyroiditis is suspected
29
Antithyroid peroxidase antibody
Suggests that the cause of thyroid disease is an autoimmune disorder, such as Hashimoto's disease or Graves' disease
30
Anion gap
Measurement of the difference or gap between the negatively charged (chloride and bicarbonate) and positively charged electrolytes (sodium and potassium)
Performed as part of CMP
Higher number indicates more acid
>12 in severe DKA
• Increased with acidic; decreased with alkalitic
31
Calcitonin
Produced in parafollicular cells of thyroid gland
Opposes parathyroid hormone
Works to regulate calcium and phosphate
• Decreases serum calcium when high –inhibits reabsorption and increases calcium renal excretion
• suspected medullary carcinoma of the thyroid.
32
Calcium
Measures amount of calcium circulating in the blood
Used to monitor bone diseases and calcium regulating disorders
Elevated levels seen in parathyroid disorders, malignancy
valuate parathyroid function and calcium metabolism
33
Cortisol
Steroid hormone that regulates a wide range of processes throughout the body, including metabolism and the immune response
Increases your heart rate, elevates your blood pressure and boosts energy supplies
Released by adrenal glands
Helps control stress
Loss of regulation can lead to disorders of cortisol excess, such as Cushing Syndrome, or cortical insufficiency, such as Addison Disease
hyperfunctioning or hypofunctioning adrenal glands.
34
C-Peptide
Byproduct of insulin formation in the pancreas
Determines if you are Type I or Type II diabetic
Shows how well your body makes insulin
High level means you are insulin resistant
Low level is not enough insulin being produced
evaluate diabetic patients and to identify patients who secretly self-administer insulin. C-peptide is also helpful in monitoring patients with insulinomas
35
Dexamethasone suppression
Measures whether adrenocorticotrophic hormone (ACTH) secretion by the pituitary can be suppressed
Determines if cortisol is affected by taking a dose of dexamethasone
Checks for Cushings Syndrome
Normal result would be decreased level of cortisol in the blood
36
Diabetes mellitus autoantibody panel
Checks for antibodies produced in response to insulin and other chemicals related to insulin
Used to differentiate between Type I and Type II diabetes
Among the antibodies tested for are:
Islet cell cytoplasmic autoantibodies (ICA)
Glutamic acid decarboxylase autoantibodies (GADA)
Insulinoma-associated-2 autoantibodies (IA-2A)
Insulin autoantibodies (IAA)
Will not be present in Type II diabetes
37
glucose, blood
Measures amount of glucose in blood
| Main source of energy
38
Glucose, postprandial
Determines the amount of glucose in plasma after a meal
Indicator of glycemic control and risk of complications from diabetes
• The 2-hour PPG test is a measurement of the amount of glucose in the patient’s blood 2 hours after a meal is ingested (postprandial). It is used to diagnose diabetes mellitus (DM).
39
Glucose tolerance
Checks how well the body processes glucose
Can help detect type II diabetes or pre-diabetes
Used in pregnancy to screen for gestational diabetes
Compares blood sugar before and after drinking a sugary drink
• This test is used to assist in the diagnosis of diabetes mellitus (DM). It is also used in the evaluation of patients with hypoglycemia.
40
Glycosylated hemoglobin
Monitors long term control of diabetes
| Shows average blood sugar over the previous 2-3 months
41
Insulin assay
Measures amount of insulin in blood
Ordered with glucose and c-peptide
Identify causes of hypoglycemia
42
Osmolality
Measures the amount of chemicals dissolved in serum
Chemicals that affect serum osmolality include sodium, chloride, bicarbonate, proteins, and sugar (glucose)
Osmolality increases with dehydration and decreases with overhydration
43
Parathyroid Hormone (PTH)
Assist in evaluation of hypercalcemia or hypocalcemia
Monitored in patients with chronic renal failure
Only hormone secreted in response to hypocalcemia
Measure serum calcium simultaneously
• PTH is measured to assist in the evaluation of hypercalcemia or hypocalcemia. It is routinely monitored in patients with chronic renal failure (CRF).
44
Phosphate, phosphorus
Assist in interpretation of parathyroid and calcium abnormalities
Determined by calcium metabolism, PTH, renal excretion, and decreased intestinal absorption
45
Sodium
Evaluates and monitors fluid and electrolyte balance and therapy
Included in BMP/CMP
Symptoms of hyponatremia may start at 125 mEq
Affected by sodium intake, GI pathology, diuretics, renal insufficiency, excessive oral water intake
46
Testosterone
Evaluate ambiguous sex characteristics, precocious puberty, virilizing syndromes in female, and infertility and impotency in male
Vary by stage of maturity
Affected by certain medications and alcohol
47
Thyroglobulin
Tumor marker for well-differentiated thyroid cancer
| Deceased in less well-differentiated cancers
48
Thyroid-stimulating hormone (TSH)
Used to diagnose primary hypothyroidism and differentiate from secondary or tertiary hypothyroidism
Monitor exogenous thyroid therapy
Elevated TSH --> HYPOthyroid
Decreased TSH --> HYPERthyroid
49
Thyroxine, total and free
Determine thyroid function
Ordered in combination with TSH
• T4 and TSH are used to monitor thyroid replacement and suppressive therapy.
50
Triiodothyronine, (T3)
Evaluates thyroid function
Used to diagnose hyperthyroidism
Monitors replacement and suppressive therapy
51
Parathyroid scan
Used to locate parathyroid glands prior to surgery
| Indicates cause of hyperparathyroidism
52
Thyroid scanning / hot or cold
Nodules classified as hot or cold
Hot nodule is “functioning” nodule. Benign adenoma or localized goiter
Cold nodule is “nonfunctioning.” Cyst, carcinoma, nonfunctioning adenoma, lymphoma, thyroiditis
Preceded by uptake scan
53
Thyroid ultrasonography
Indicate if thyroid nodule is fluid-filled cyst or a solid tumor
Monitor medical treatment or observe a thyroid nodule or enlargement
54
Cortisol, urine
Used in patient with suspected adrenal gland dysfunction
Utilizes 24 hour urine collection
Can be affected by medication
55
Glucose, urine
```
Reflects glucose elevation in blood
Part of routine UA
Screening tool for DM
Can occur in diseases that affect renal tubule or in genetic defects of metabolism
Elevated in SGLT2 therapy
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56
Microalbumin
Indicator of renal damage
Related to duration of diabetes and degree of glycemic control
Earliest indicator of nephropathy. Can identify diabetic nephropathy 5 years earlier than protein urine tests
57
VMA, HVA, and catecholamines
24 hour urine test
Screening test for catecholamine producing tumors
Neuroblastoma, pheochromocytoma, and other rare adrenal/neural crest tumors
58
Fasting Plasma Glucose (FPG)
8 Hour fast
| ≥ 125 mg/dL = high glucose
59
Random Plasma Glucose
≥ 200 mg/dL = high
| Randomly timed; less accurate
60
2-hour oral glucose tolerance test
more costly and inconvenient than fasting plasma glucose or Hgb A1c, and not commonly used for diagnosis,
≥ 200 = high
61
parathyroid scan
Used to locate parathyroid glands prior to surgery
Indicated a single focus of increased nuclear activity in the mediastinum which would more accurately direct parathyroid surgery.
