PE - Clinical Lab Studies

Question 0

Mean corpuscular hemoglobin

Answer 0

Average amount of Hb in each RBC

Question 1

Erythrocytosis types

Answer 1

(erythrocytosis = high RBC count)

1. polycythemia vera (more RBC’s than normal range)
2. relative polycythemia (water lost from circulatory system, but RBC count still ok; i.e relative)
3. factitious polycythemia (blood doping, epo)
   * *patients will present with swelling (except possibly not with relative polycythemia)

Question 2

Description or values that help refine diagnosis when dealing with RBC’s and amount of Hb

Answer 2

• microcytic (iron deficiency anemia)
• normocytic (sickle cell anemia)
• macrocytic (pernicious anemia)

Question 3

Terms for low and high WBC count and what these might indicate

Answer 3

Low = leukopenia (hypovalemia - which is dehydration - , early leukemia, drugs, radiation, blood dyscrasias)
High = leukocytosis (infection, allergies, necrosis, exercise, pregnancy, stress, drugs, leukemia)

Question 4

Erythrocyte sedimentation rate (ESR)

Answer 4

-0-20 mm/hr
-indicates presence and intensity of an inflammatory process
Increased in:
-many, but not all, infections (bacterial infections, acute hepatitis, mono)
-acute myocardial infarction but not with angina
-rheumatoid arthritis but not degenerative
-cancer (tissue necrosis)

Question 5

Differential white blood cells included in complete blood cell count (CBC)

Answer 5

neutrophils (if these are abnormal/immature, there may be something going on)
lymphocytes
monocytes
eosinophils
basophils

Question 6

One disease that differential WBC count can tell you about

Answer 6

Leukemia
*don’t need to know the different types, just know that there are different types and they vary in their aggressiveness, treatments, and prognosis

Question 7

Deficiencies in neutrophils, lymphocytes, and eosinophils and what they are associated with

Answer 7

Neutrophilic leukocytosis - bacterial infections, inflammatory disorders, drug reactions, leukemia
Lymphocytosis - bacterial infections, viral infections, leukemia
Eosinophilic leukocytosis - allergic reactions

Question 8

*Platelet count range

Answer 8

150,000-350,000 /cu mm

**make sure you know the minimum

Question 9

Thrombocytopenia is seen in:

Answer 9

Cancer therapy
Radiation therapy
Blood loss

Question 10

*Fasting blood glucose

Answer 10

70-100 mg/dL

- gives you information about a specific point in time

Question 11

*Fasting blood glucose in hyperglycemic patients (diabetes mellitus)

Answer 11

> 126 mg/dL

Question 12

Conditions under which a person would be hypoglycemic (low FBG)

Answer 12

• factitious conditions
• exogenous insulin
• oral hypoglycemic drugs

Question 13

*Increased cholesterol (hyperlipidemia) number

Answer 13

above 240 mg/dL

-increased risk of ischemic heart disease, cerebrovascular accidents, peripheral vascular disease

Question 14

LDL and HDL normal and abnormal ranges

Answer 14

LDL
normal: <130 mg/dL
increased: >160 mg/dL
HDL
normal: >60 mg/dL
low: <35 mg/dL

Question 15

Renal Function Tests

Answer 15

• BUN (blood urea nitrogen)

- Creatinine

Question 16

Liver function tests

Answer 16

ALT (alanine aminotransferase)
ASP (aspartate aminotransferase) – increased ALT or ASP may = viral hepatitis, alcoholic hepatitis, toxic hepatitis
Bilirubin - increased levels may = jaundice

Question 17

*What is the test for prothrombin time and in what instances is it used?

Answer 17

-test is the International Standard Ratio (INR)
-it tells you about the blood coagulation
-may be increased for patients on Coumadin (an anticoagulant, could bleed heavily during tx) or pt.’s with hepatitis
Normal Prothrombin Time = 11-15 seconds
Normal INR = 0.8-1.2
Increased INR = >2.5

Question 18

Activated partial thromboplastin time (aPTT)

Answer 18

Increased in:

• hemophilia
• heparin treatment for patients on kidney dialysis
• normal range: 25-35 seconds

Question 19

*Platelet count ranges

Answer 19

Normal: 150,000-450,000 /cu mm (*make sure you know the minimum)
Bleeding problems: <50,000 /cu mm

Question 20

Normal ejection fraction

Answer 20

> 50% (50-60)
decreased in:
-heart failure
-cardiac valvulopathy (aortic stenosis, aortic insufficiency)