GI, NG tube, foley catheter, sutures, Phlebotomy

Question 1

What color tube do you use for thyroid function tests?

Answer 1

Gold

Question 2

What color tube do you use for CBC?

Answer 2

Lavender

Question 3

What color tube do you use for type & cross blood units?

Answer 3

purple/pink

Question 4

What color tube do you use for STAT Chemistries?

Answer 4

green/light green

Question 5

What color tube do you use for routine chemistries?

Answer 5

Gold/yellow or red

Question 6

What color tube do you use for ESR?

Answer 6

Lavender

Question 7

What color tube do you use for CRP?

Answer 7

Red or Gold

Question 8

What color tube do you use for HIV?

Answer 8

Purple

Question 9

What color tube do you use for Vitamin Levels?

Answer 9

Yellow/gold

Question 10

Risk factors for DM:

Answer 10

• age > 44
• BMI >24
• First degree FHx
• Physical Inactivity
• HTN
• Vascular disease
• Ethnicity

Question 11

In venous samples glucose can drop by how much if the tourniquet is left on for 6 minutes?

Answer 11

25 mg/dL

Question 12

Explain what a FPG test is

Answer 12

person who has not eaten in the past 10-14 hours

Question 13

Blood glucose chart

Answer 13

Question 14

Clotting factors made in the liver

Answer 14

2, 5, 7, 10

Question 15

A1C & blood glucose chart

Answer 15

Question 16

When to assess glycemic status (A1C or other glycemic measures)

Answer 16

• two times a year in pts who are meeting tx goals
• at least quarterly and PRN in pts whose therapy has changed and/or who are not meeting glycemic goals

Question 17

What are the incretins?

Answer 17

GLP-1 and GIP, released from gut within minutes of eating

GLP-1 still active in type II DM, but GIP is not

Question 18

Alk Phos Normal levels

Answer 18

35-115 U/L

Question 19

AST Normal Levels

Answer 19

15-43 U/L

Question 20

ALT Normal Levels

Answer 20

6-63 U/L

Question 21

GGT normal levels

Answer 21

8-60 U/L

Question 22

Albumin serum normal levels

Answer 22

40-60 G/L

UCDavis values: 3.4-4.8 g/dL

10-15 grams synthesized in the liver/day

Question 23

Lactate

Answer 23

60% hepatic clearance

• in liver disease → results in lactic acidosis
• important component in septic shock
• threshold in shock > 2 mmol/L

Question 24

What is the preferred test for pancreatitis?

Answer 24

Lipase

Question 25

What does the hypothalamus do?

Answer 25

HEAL * **H**omeostatic mechanisms that control hunger, thirst and sexual desire * **E**ndocrine control (via the pituitary) * **A**utonomic nervous system control * **L**imbic system (emotion, sleep cycle)

Question 26

Does the posterior pituitary make hormones?

Answer 26

no, it only stores them ADH & Oxytocin

Question 27

What are the basic guidelines for ordering Thyroid Function Tests?

Answer 27

Question 28

When calcium levels are high, what happens to PTH?

Answer 28

PTH production is decreased \*\*Calcium & PTH have an inverse relationship\*\*

Question 29

Name the adrenal hormones from the cortex and the medulla

Answer 29

* _Cortex_: * Cortisol * Aldosterone * Sex hormones -→ small amount * _Medulla_: * Catecholamines: epi, norepi, dopamine

Question 30

Evaluation for Cushing's Syndrome

Answer 30

Question 31

Hypothyroidism: causes and s/sxs

Answer 31

* _Causes_: * Primary: Hashimoto's = most common in the world and associated with thyroid antibodies * iatrogenic (post-surgical) * Iodine deficiency * drug induced: lithium, amiodarone, interferon * _S/sxs_: * fatigue, weight gain, cold intolerance, dry skin & hair, and muscle cramps

Question 32

Hyperthyroidism causes & s/sxs

Answer 32

* _Causes_: * **graves** = MC; autoimmune etiology * toxic adenoma * iodine induced * thyroid storm: accelerated hyperthyroidism uncommon but serious (10-75% mortality rate) * _S/sxs_: * anxiety, heat intolerance, weight loss, tremors, palpitations, exophthalmos (bulging eyes)

Question 33

Evaluating Hyperthyroidism

Answer 33

Question 34

Typical diameter of small intestine and large intestine

Answer 34

small intestine: 5cm large intestine: 8-10 cm

Question 35

What is included in a coag panel?

Answer 35

clotting factors: 2,5 7, 10 PT INR

Question 36

Total serum bilirubin normal values

Answer 36

0.3-1.3mg/dL * elevation of **indirect/unconjugated:** \> 85% of total * product of hgb breakdown from RBS * not water soluble * converted by liver to direct/conjugated * elevation of **direct/conjugated:** \> 50% * water soluble

Question 37

INR

Answer 37

not always reliable to gauge bleeding risk b/c it is only used to assess the extrinsic pathway * INR of 1 = patient's PT is normal * INR \> 1 = clotting time is elevated * INR \> 5 or 5.5 = unacceptable high risk of bleeding * INR of 0.9-1.3 = normal range * INR of 2.0-3.0 = normal range for a pt on warfarin * INR target is higher in patients with a mechanical heart valve

Question 38

AST vs ALT

Answer 38

* _AST_: * indicates hepatocellular damage → **immediate/acute response** * found mainly in the liver but also the heart, RBCs, muscle and pancreas * less specific * elevated indicates: * **EtOH abuse,** post-exercise, thyroid * normal value: 15-43 U/L * _ALT_: * hepatocellular injury marker after 24-48 hours but higher levels → **delayed onset** * more specific to liver especially when elevated \> 500 * valuable in chronic liver disease monitoring for overall liver health and mortality * Elevation indicates: * hepatitis, autoimmune, hemochromatosis, medications, toxins, Wilson disease * Normal value: 6-63 U/L