Paulson - Lab Review

Question 1

6 meds that can cause hyperkalemia

Answer 1

K+ supplement

ACEI

ARB

bactrim

spironolactone

amiloride (diuretic)

Question 2

6 medical conditions that can cause hyperkalemia

Answer 2

CKD/AKI

hemolysis/bleeding

tumor lysis syndrome

metabolic acidosis

insulin deficiency

rhabdo (tissue breakdown)

Question 3

lab issue that can cause hyperkalemia

Answer 3

hemolyzed specimen

Question 4

2 medical conditions that can cause BUN:Cr > 30:1

Answer 4

GI bleed

prerenal AKI

Question 5

t/f: the higher the BUN:Cr ratio, the more likely an upper GI bleed

Answer 5

T!

Question 6

why does an upper GIB cause BUN:Cr ratio > 30:1

Answer 6

blood is absorbed as it passes thru small bowel → decreased renal perfusion

Question 7

4 causes of prerenal AKI

Answer 7

dehydration

decreased circulating volume

shock/hypotn

hemorrhage

Question 8

3 causes of decreased circulating volume

Answer 8

cirrhosis

CHF

nephrotic syndrome

Question 9

measure of the average size of the RBC

Answer 9

MCV

Question 10

ddx for elevated MCV (5)

Answer 10

macrocytic anemia → B12/folate deficiency

etoh

liver dz

myelodysplastic syndrome

hypothyroidism

meds

Question 11

6 common meds that cause elevated MCV

Answer 11

allopurinol

immunosuppressants

bactrim

H2 blockers

PPIs

metformin

Question 12

mc cause of low MCV

Answer 12

IDA

Question 13

besides IDA, 5 other causes of low MCV

Answer 13

thalassemia

lead poisoning

copper deficiency

zinc poisoning

GI bleed

colon ca

Question 14

2 main categories of increased total bilirubin

Answer 14

liver dz

hemolytic anemia

Question 15

6 lab tests that indicate hemolysis

Answer 15

haptoglobin

LDH

peripheral blood smear

reticulocytes

unconjugated bilirubin

urinalysis

Question 16

lab value that is decreased in hemolysis

Answer 16

haptoglobin → binds free hgb

Question 17

3 labs that are elevated/increased in hemolysis

Answer 17

LDH → released from lysed cells

reticulocytes → marrow response

unconjugated bilirubin → increased hgb breakdown

Question 18

peripheral blood smear finding of hemolysis

Answer 18

abnorma rbc

Question 19

urinalysis finding of hemolysis

Answer 19

free hgb and its metabolites

Question 20

7 signs of hemolysis related to liver dz

Answer 20

shock

early sepsis

hemodynamic instability

f/c

RUQ pain

hx prior biliary surgery

severe acute liver injury

Question 21

3 causes of elevated platelet count

Answer 21

reactive thrombocytosis

blood malignancies

familial thrombocytosis

Question 22

4 causes of reactive thrombocytosis

Answer 22

infxn

blood loss/anemia

non-infectious inflammation

post-splenectomy

Question 23

4 blood malignancies that cause reactive thrombocytosis

Answer 23

p. vera

CML

MDS

AML

Question 24

4 causes of hypomagnesemia

Answer 24

GI losses

meds

etoh

post transplant

Question 25

3 meds that cause hypomagnesemia

Answer 25

chronic PPI loop diuretics thiazide diuretics

Question 26

8 causes of elevated WBC

Answer 26

infxn inflammation neoplasms meds cigs stress/exercise obesity

Question 27

3 neoplasms that can cause elevated WBC

Answer 27

leukemia p. vera essential thrombocythemia

Question 28

3 meds that can cause elevated WBC

Answer 28

glucocorticoids catecholamines → epi lithium

Question 29

ALT predominant

Answer 29

drug-induced liver injury

Question 30

AST predominant

Answer 30

etoh-associated hepatitis

Question 31

ALP predominant

Answer 31

biliary obstruction or stone

Question 32

besides ALP, what other lab is elevated if liver/gallbladder obstruction

Answer 32

bilirubin

Question 33

would you see bilirubin elevation in fracture, osteomyelitis, or bone lesion

Answer 33

no

Question 34

6 causes of hypokalemia

Answer 34

diarrhea/sweat thiazide/loop diuretics hyperaldosteronism hypomagnesemia K+ driven into cells dialysis

Question 35

name 3 things that drive K+ into cells

Answer 35

insulin beta agonists (albuterol) alkalosis

Question 36

what causes elevated D-dimer (lots!)

Answer 36

DVT/PE DIC COVID19 severe infxn/sepsis surgery/trauma MI/CVA liver dz renal dz malignancy pregnancy