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cdm > Labs Review > Flashcards

Labs Review Flashcards

1
Q

BMP shows K+ of 5.6

Whats your differential? (Meds, Conditions, Lab issues)

A 
Meds: 
Bactrim
ACEI
K+ supplement
ARB
NSAIDs
Digoxin
BB
Amloride
Succinylcholine
spironolactone
"BAK AND BASS"
Medical conditions:
Metabolic acidosis
Rhabdo
Tumor lysis syndrome
Hemolytic anemia
Insulin deficiency
CKD/AKI
"MR THICk"

Lab issues: hemolyzed specimen

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2
Q

You see a patient with a BUN of 49 and a Cr of 1.5

What 2 things are on your differential?

A

GIB
Because blood is absorbed as it passes through the small bowel and patients may have decreased renal perfusion. The higher the BUN:Cr ratio, the more likely an upper GIB

PRERENAL AKI
Dehydration, ↓ effective circulating volume (cirrhosis, CHF, nephrotic syndrome), shock/hypotension, hemorrhage

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3
Q

Patient has an MCV of 105.

What is on your DDx?

A 
conditions:
Myelodysplastic syndrome
Hypothyroidism
Alcohol
Liver dz 
Vit B12 or folate deficiency
“My HALV”
Meds: LOTS!:
Immunosuppressants, 
Metformin
PPIs
H2 blockers, 
Allopurinol,
Bactrim,

“IM PHAB”

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4
Q

If you see a high MCV, what is the 1st thing you should do?

A

Check B12 and folate

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5
Q

MCV is 76, what is at the top of your DDx?

What else?

A 
GI bleed (colon CA)
IDA!!!!
Lead poisoning, 
Copper deficiency
Thalassemia, 
Zinc poisoning,

“Gee, I Love Cooking That Zucchini”

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6
Q

You see an ↑ total Bili

What are 2 main categories you are thinking of?

A

Liver Dz & Hemolytic Anemia

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7
Q

Causes of a Platelet count of 700k

A

Familial thrombocytosis
Reactive thrombocytosis
CML
MDS (myelodysplastic syndrome)

Blood malignancies
Blood loss/anemia
Post-splenectomy

Polycythemia vera
AML
Infection
Non-infectious inflammation

“FRCM Big Bad Plt PAIN”

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8
Q

Characterisitc findings in CML

A

“The CLM (chronic myelogenous leukemia) CAB (chronic, accelerated, blast crisis stages) is FULL (abd fullness) in PHILADELPHIA (chromosome), and the driver is FATIGUED”
Abd fullness, Fatigue. See Philadelphia chromosome.
**CBC with leukocytosis→Bone marrow biopsy.
PCR- BCR*ABL gene

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9
Q

Characteristic findings in AML

A

Fatigue, pallor, weakness, gingival bleeding, ecchymosis, epistaxis, anemia, thrombocytopenia

> 20% blasts

Auer Rods (Myeloid origin)

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10
Q

T/F? Platelets are an acute phase reactant

A

True

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11
Q

T/F: You should order a BMP for r/o hemolytic anemia

A

False

Need LFTs

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12
Q

T/F: There is a hemolysis panel order set

A

False
Need to order:
UA &
Each individual lab (CMP, Haptoglobin, LDH, Peripheral blood smear, Reticulocyte count, Unconjugated bilirubin)

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13
Q

Haptoglobin in Hemolysis

A

↓

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14
Q

LDH in Hemolysis

A

↑

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15
Q

Peripheral blood smear in hemolysis

A

Abnormal RBCs

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16
Q

Reticulocyte count in Hemolysis

A

↑

17
Q

Unconjugated bilirubin in Hemolysis

A

↑

18
Q

UA findings in Hemolysis

A

Urobilinogen

(+) for blood

19
Q

Causes of Mag of 1.2 (Conditions, Meds, etc)

A

Conditions:
GI losses
Diarrhea>vomiting
“Gee, I Lost my mag when I was having diarrhea”

Meds:
Transplant pt (post)
Diuretics (loop & thiazide)
Alcohol use disorder.
PPI usage (Chronic) 
(impairs absorption by intestinal epithelial cells)
"TDAP"
20
Q

Labs of Polycythemia Vera.

Tx?

A

↑ PLTs
↑ H&H
↑ WBCs

Therapeutic phlebotomy, Give ASA

21
Q

What 4 conditions require PPI’s indefinitely?

A
  • H. Pylori
  • Hospitalized folks
  • Barretts esophagus
  • GIB

“Pylori was Hospitalized with a Bad GIB”

22
Q

Bad S/E of PPIs

A
  • C-diff (via ∆pH of GI tract)
  • Osteoporosis (↑ Fx risk)
  • CKD

“PP out of your COC”

23
Q

T/F: Your pt returns for f/u post-hospital DC and is on PPI’s, so you must keep them on PPI’s

A

False

if not being actively treated for GIB or Barretts, etc, pt may go off PPI’s

24
Q

WBC of 13.2 DDx

A
  • Leukemia
  • Essential thrombocythemia
  • P. vera
  • Acute or chronic inflammation
  • Infection
  • Neoplasms
    “Le PAIN”

Medications:
- GCs, catecholamines (epi), lithium
“Go Call Liz”

Smoking
Obesity
Stress/exercise
“say SOS”

25
Q

T/F? If a pt is on Lithium, they should stop and be on more modern Rx

A

False
if pt is doing well on Lithium-leave them be.
Dont change their life

26
Q

T/F? Smoking creates a state of chronic inflammation

A

True

27
Q

LFTs:

AST Predominant

A

Alcohol associated Hepatitis

“A Scotch Above”

28
Q

LFTs:

ALP predominant

A
  • Biliary obstruction
  • Bone
    “wheres my Bili Baby??”
29
Q

How to Determine the cause of ALP elevation?

A

Check Bilirubin

30
Q

LFTs:

ALP predominant, Bili elevated

A

liver/gallbladder obstruction

“A Block”

31
Q

LFTs:

ALP predominant, Bili not elevated

A
  • Fracture,
  • Osteomyelitis,
  • Bone lesion,
    “Full On Bone issue”
32
Q

LFTs:

ALT predominant

A

Drug-induced liver injury

“A Little Toke”

33
Q

K+ of 2.4 causes

A 
Conditions:
- GI losses, mostly diarrhea
- Significant sweat loss
- Dialysis
"GiSD"
Rx:
- Hyperaldosteronism
- Diuretics (Thiazide & Loop) 
- Hypomagnesemia
"Hy-Di-Ho"
Things that drive K+ into cells:
- Beta agonists (eg albuterol)
- Alkalosis
- Insulin
"BAI"
34
Q

COMMON causes of ↑ D-Dimer

A 
DVT/PE
DIC
COVID-19
Severe infection-sepsis
Surgery/trauma
MI/CVA
Liver disease
Renal disease
Malignancy
Pregnancy

cdm (16 decks)

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