Day 1 nephrology Flashcards
(17 cards)
clinical lab testing processing vs POC testing?
Qualitative test values and examples?
Quantitative test values and examples?
Semi qualitative tests?
Clinical lab is specimen obtained from patient then sent to lab. POC only disadvantage is possible to interpret results or perform test incorrectly. CLIA.
reported as positive or negative, pregnancy, culture, toxicology.
Reported as numeric value, Sodium, gluose, serum creatinine.
Reported as negative or varying degrees of positivity. Urine ketones, some bacterial cultures like sputum.
When are reference ranges used?
When do you expect a lab error?
Common causes of lab error?
numerical range for quantitative tests.
Result is not consistent with trends, confirmatory tests dont support, inconsistent with patients clinical status, large inaccuracy.
Processing or equipment errors, improper handling or collection, timing of tests, incorrect interpretation, drug interference.
4 types of drug laboratory interference?
What is the lab test tree?
BMP ranges?
methodological interference(urine discoloration by medications), drug induced end organ damage, direct pharmacologic effect, miscellaneous.
Na,Cl,BUN, GLUC on top then K,CO,SCr on bottom.
Sodium- 136-145 mEq/L. Chloride 96-106 mEq/L. Potassium 3.5-5 mEq/L. Bicarb is 21-27 mEq/L arterial and 24-30 mEq in vein. BUN 8-20 mEq/L. Serum Creatinine 0.5-1.2 mg/dL. Glucose(fasting) 70-99 mg/dL.
What is the CBC cross?
CBC ranges?
Hgb and Hct top and bottom. WBC, Plats on bottom.
WBC: 4.4-11.3. Hemoglobin: 14-17.5 male, 12.3-15.3 female. Hematocrit: Male 42-50%, Female 36-45%, Platelets: 140-440
Depressed WBC name? Increased WBC name?
WBC referential ranges?
What happens in left shift?
Leukopenia happens with increased age, Anemia, Viral infections, Medications. Leukocytosis- Bacterial infections, stress, Medications(corticosteroids).
Neutrophils(segs) 45-73%. Band neutrophils 3-5%. Eosinophils 0-4%. Basophils 0-1%. Monocytes 2-8%. Lymphocytes 20-40%.
shift from mature to immature.
ANC formula?
What causes depressed neutrophils(<1500)?
What causes elevated neutrophils(>12,000)?
WBC*(% segs + % bands)
Radiation, severe acute bacterial infections, Medications(chemo, captopril, cephalosporins, penicillins, vancomycin.)
Acute or chronic bacterial infections, trauma, MI, Lithium, G-CSFS, Corticosteroids.
What causes depressed lymphocytes(<1000)?
elevated lymphocytes(>4000)?
reference range for platelets?
HIV,radiation, corticosteroids, lymphoma, aplastic anemia.
infectious mononucleosis, viral infections, pertussis, tuberculosis, syphillis, lymphoma
140-440. Average lifespan is 8-12 days with 10% turnover.
What is thrombocytopenia and what causes it?
What is thrombocytosis?
What causes low hemoglobin? High hemoglobin?
<150,000. Increased risk for bleeding, advanced liver disease, leukemia, aplastic anemia, ITP, DIC,Medications.
> 440,000. increased risk for for hemmorhage and thrombosis. physical stress, splenectomy, trauma, severe iron deficiency anemia, polycythemia vera.
elderly, children, pregnant, bleeding, anemia. Living at higher altitudes, dehydration.
What is MCV?
What is MCH?
MCHC?
HCT/ RBC. Range is 80-96. Micro caused by iron deficiency anemia, thalassemia. Macro caused by Vitamin b12 and folic acid deficiency.
27.5-33.2 normal. decreased is iron deficiency increased is folate deficency.
Hgb/Hct. 33.4-35.5 normal. normo- normal and hemolytic anemia. hypochromic- iron deficiency anemia.
Indication of red cell size is what?
Reticulocyte count?
Hemolytic anemia?
RDW. 11.5-14.5 is normal. RDW increase is often an early sign of iron deficiency.
0.5-2.5% RBC. determine bone marrow function when RBC’s are low. if low it is caused by decreased production in bone marrow, cause by aplastic anemia, iron deficiency, vitamin b12 deficiency. High is caused by hemolytic anemia, sickle cell anemia, hemmorhage.
Hemolytic- premature destruction of RBC, caused by infection, autoimmune processes, and medication.
Aplastic anemia?
Macrocytic anemia?
Microcytic anemia?
bone marrow unable to produce RBC’s. Usually results in pancytopenia(decrease in WBC’s, RBC’s, and platelets).
insufficient number of RBC’s. cause by vitamin deficiencys or chronic alcohol intake.
small red blood cells, caused by iron deficiency, thalassemia.
Causes of abnormal urine color? Cloudy?
Red urine?
Green-blue urine color?
Brown or black urine?
clear is dilute urine, overhydration. Kidney damage, stones, UTI.
Daunorubicin, doxorubicin, phenazopyridine, rifampin, thioridazine, hematuria, dehydration
asparagus, amitriptyline, methalyene blue, triamterene. pseudomonas or proteus UTI.
fava beans, rhubarb, ferrous salts, methocarbamol, metronidazole, nitrofurantoin, senna, sulfonamides, severe hemmorhage, liver failure, renal failure, rhabdomyolsis.
Normal urine PH?
Specific gravity urine?
Urine protein?
- 5-8. Acidic–> systemic acidosis, diabetes, high fever, shock. Alkaline–> aged specimen, systemic alkalosis, chronic kidney disease, UTI.
- 010-1.025 normal. assess kidneys ability to concentrate urine. decreased specific gravity causes are excessive fluid intake, diabetes insispidus, kidney failure. increased is dehydration and SIADH.
zero to trace <150. 1 test is transient, more than 1 may indicate kidney disease or uncontrolled hypertension.
Urine glucose?
Ketones?
Nitrites?
normally negative, >180 may mean uncontrolled diabetes or kidney damage.
may be uncontrolled diabetes, starvation, low carb diets.
May show a UTI.
Leukocyte esterase?
WBC’s in urine?
RBC’s?
indicates pus in urine which indicates infection.
normally not there, if so there is infection.
Normally not there, after trauma, fever, coagulopathies, menstruation could cause.
If bacteria found in urine what do you do?
If you see epithelial cells?
Calcium oxalate? uric acid?
Culture with sensitivity.
Not clean catch, invalid.
calcium and phosphate crystals, high dietary calcium intake or parathyroid disorders. Gout.
Struvite in urine? Cystine?
Calcium reference range?
Phosphorus reference range?
by products of UTI. Autosomal recessive genetic defect in amino acid transporter in kidney.
- 5-10.8
- 6-4.5
