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Block 4 - Psych > Clin Lab - Psych > Flashcards

Clin Lab - Psych Flashcards

(51 cards)

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1
Q

What is measured for alcohol use disorder?

A

serum alcohol level

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2
Q

What is the legal blood alcohol concentration (BAC)?

A

<80 mg/dL (17 mmol/L)

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3
Q

Does BAC correlate with symptoms? and why?

A

Not necessarily

  • Rate of metabolism of EtOH depends on other substances imbibed/consumed at similar time
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4
Q

What additional diagnostics seen w/ chronic alcohol use? and what is seen on each?

A
  • CBC – macrocytic anemia (MCV=119), thrombocytopenia, pancytopenia
  • CMP – elevated LFTs, hypoNa+, hypoK+, hypoglycemia
  • Imaging – occult injuries
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5
Q

Does a (+) drug screen mean the patient is currently using?

A

NO

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6
Q

What specimens can be used for a drug screen?

A

urine > blood

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7
Q

Is the screening test Qualitative or Quantitative?

A

Qualitative

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8
Q

NOTE

A
  • concentration is above a specific cut-off value
  • usually immunoassay
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9
Q

Describe confirmatory test for drug screens.

A
  • needed to measure exact concentration
  • Usually chromatography tests – more specific
  • Usually done at reference labs
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10
Q

NOTE

A

A panel does not measure all possible drugs

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11
Q

What may interfere opioid panel results?

A

fentanyl

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12
Q

Benzo panel detects metabolites of…

A

diazepam but not clonazepam or lorazepam

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13
Q

What other drugs or substances may interfere & cause false (+)s?

A
  • Naproxen & marijuana
  • Buproprion & amphetamines
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14
Q

NOTE

A
  • Concentration of urine will affect detection (dilute urine causes dilution of the drugs)
  • A (+) test doesn’t indicate dose or when it was taken
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15
Q

How long is a drug screen (+) for amphetamines/methamphetamine.

A
  • (+) test for 1-3 days after intake
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16
Q

What can cause an amphetamine/methamphetamine drug screen to have a false (+)?

A
  • OTC decongestants
  • Levodopa
  • Atenolol
  • Bupropion
  • Trazodone
  • Tricyclic antidepressants
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17
Q

Are false (-) commons when testing for amphetamines/methamphetamine?

A

YES

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18
Q

Describe drug screen testing for cocaine.

A
  • Detects metabolite as cocaine is quickly metabolized
  • (+) test for 1-3 days after intake
  • No significant false (+)s
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19
Q

How long will a drug screen be (+) for opioids.

A

(+) test for 1-7 days, depending on specific opioid

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20
Q

What can cause false (+) on an opioid drug screen?

A
  • poppy seeds
  • fluoroquinolones
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21
Q

Which synthetic opioids may not be detected on drug screen?

Study These Flashcards
A
  • fentanyl
  • methadone
  • buprenorphine
  • tramadol
22
Q

Describe drug screen testing for marijuana.

Study These Flashcards
A
  • Metabolite measured
  • (+) test for days to months
  • Synthetic cannabinoids – high rate of SEs, not detected on drug screen
23
Q

What can cause false (+) on a marijuana drug screen?

Study These Flashcards
A
  • hemp products
  • dronabinol
  • rarely naproxen, ibuprofen
24
Q

What are some other possible components on a drug screen?

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A
  • PCP
  • Ketamine
  • Benzos
  • LSD
25
What are the S/Sx of PCP ingestion?
- **nystagmus** - agitation - hallucinations
26
What will cause a false (+) on drug screen testing for PCP.
- tramadol - dextromethorphan - diphenhydramine
27
Describe drug screen testing for PCP.
- (+) test for days to weeks - No significant false (+)s - Not all benzos detected
28
Describe drug screen testing for LSD.
No significant false (+)s
29
Anorexia/bulimia often cause metabolic / electrolyte imbalances like...
- HypoK+ - HypoMg++ - HypoNa+ & hypoCl- - Metabolic alkalosis - Elevated BUN / creatinine
30
Depression Rule Out: What Thyroid dz testing is done?
TSH hypothyroid seen most (TSH
31
Depression Rule Out: What Adrenal dz testing is done?
- test based on symptoms --> hypercortisolism (24hr urine, midnight cortisol, low dose dexamethasone) --> hypocortisolism (AM cortisol)
32
Depression Rule Out: What Alcohol/drug abuse testing is done?
- UDS - alcohol level
33
Depression Rule Out: What neurodegenerative dz testing is done?
- Parkinson Dz - Alzheimer's Dz - Multiple sclerosis
34
Depression Rule Out: What will be elevated if B12 is low?
Methylmalonic acid & Homocysteine
35
Depression Rule Out: What testing is done for Vit D?
25 - hydroxyvitamin D
36
When should you do blood monitoring checks for Valproic acid?
at 2wks then every 3 months
37
When is Valproic acid used?
in Alz pts. who have been having behavioral issues
38
What two antiepileptic meds need blood monitoring?
- Lamotrigine - Carbamazepine
39
When should you do blood monitoring checks for other antiepileptics (lamotrigine/carbamazepine)?
- at 2 wks then every 3mos
40
When should you do blood monitoring checks for Lithium?
- weekly x4, then monthly x3, then every 3 months
41
What is so dangerous about lithium?
has a very narrow therapeutic window
42
What other meds need monitoring for SEs?
- Antipsychotics - Clozapine - Lithium - Valproic Acid - Carbamazepine - SSRIs/SNRIs - Ritalin
43
What tests are used to monitor SEs of Antipsychotics?
- lipid panel & fasting glucose - initially and at 3 months, then yearly
44
What tests are used to monitor SEs of Clozapine?
- weight gain - lipid panel - fasting glucose - CBC (wkly for 6mos, every 2wks for 6mos, then monthly)
45
What does clozapine treat & what can taking this medication cause?
- schizophrenia - profound neutropenia
46
What tests are used to monitor SEs of Lithium?
- thyroid function - CMP - CBC - EKG - UA (baseline & yearly)
47
What can lithium cause?
Nephrogenic Diabetes Insipidus
48
What tests are used to monitor SEs of Valproic acid?
- CBC - CMP - PT/PTT - EKG - UA (baseline & yearly)
49
What tests are used to monitor SEs of Carbamazepine?
- CBC - CMP - EKG - UA - Thyroid (baseline & yearly)
50
What tests are used to monitor SEs of SSRIs/SNRIs?
sodium & glucose
51
What tests are used to monitor SEs of Ritalin?
CBC

Block 4 - Psych (4 decks)

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