Hematology, Liver, GI Lab

Question 1

Agranular WBC

Answer 1

Monocytes

Lymphocytes

Question 2

Liver Function Tests

Answer 2

Albumin

Clotting Factor

Question 3

Anemia Lab Tests

Answer 3

Ferritin

Vit B12

Folic Acid

Question 4

Gamma-Glutamyl Transpeptidase
- What
- Where
- Meaning

Answer 4

Biliary excretory enzyme

Kidney, Spleen, Heart, Brain
- NOT bone or placenta

Concurrent rise with ALP indicate hepatobiliary disease

Rise in GGT = Alcohol abuse

Question 5

C-Reactive Protein

Answer 5

Rapid test for inflammation

Question 6

GI Lab Values

Answer 6

Digestive Enzymes
- Amylase
- Lipase

Indication of:
- Poor exocrine function of pancreas
- Blockage of ducts / gallbladder problem
- Inflammation / blockage of salivary gland
- Chronic kidney disease

Question 7

Neutrophils

Answer 7

Segmented
- Phagocytosis
- Release proteins to destroy foreign stuff

Band
- Small amount of Immature cells. Increases in proportion during infections

Question 8

Lactic Acid Dehydrogenase

Answer 8

Metabolic enzyme present in almost every tissue
- Elevated levels indicate cell damage

(Liver disease, lung disease, lymphoma)

Question 9

Liver Injury Tests

Answer 9

Aminotransferases (AST and ALT)

Question 10

Low Albumin

Answer 10

Chronic Liver Disease

Peripheral Edema and Ascites (Low Osmotic Pressure)

Question 11

Mean Corpuscular Hemoglobin Concentration

Answer 11

Average concentration of hemoglobin per volume of RBC
- Hypochromic, Normochromic, Hyperchromic

MCHC = Hgb / Hct

Question 12

Eosinophils

Answer 12

Allergic

Question 13

Lymphocyte

Answer 13

B-Cell
- Transform into plasma cells to produce antibodies

T-Cell
- Cell mediated immune response

Question 14

Reticulocyte Count

Answer 14

Amount of immature RBC

Reflects bone marrow production of RBC
- Good for diagnosis of anemia

Question 15

What is Cholestasis

Answer 15

Accumulation of substances that would normally be excreted by the liver into bile

Question 16

Aminotransferase

Answer 16

Assist with protein metabolism and metabolic processes in general

ALT - Specific for liver injury
AST - Other parts of the body (muscle injury)

Question 17

Red Blood Cell Indices

Answer 17

Information on Size and Hemoglobin content
- Calculated from RBC, Hemoglobin, Hematocrit

Question 18

Ferritin Lab Value

Answer 18

Stored Iron Complex
- How much iron stored in the body

Iron Deficiency = Microcytic Hypochromic Anemia

Question 19

Assessing ALP and GGT

Answer 19

High ALP + High GGT
- Hepatic Source

High ALP + Low GGT
- Non-Hepatic Source

Question 20

Alkaline Phosphatase
- What
- Where
- Meaning

Answer 20

Transporter that moves metabolites past cell membrane

Placenta, Bone, GI cells

Cholestasis enhances ALP as there is a blockage

Question 21

Cholestasis Identification Tests

Answer 21

Alkaline Phosphatase

Gamma-Glutamyl Transpeptidase

Question 22

Vit B12 Lab Value

Answer 22

Vit B12 Deficiency = Low Stomach Acid

Macrocytic Normochromic Anemia

Question 23

Complete Blood Count

Answer 23

Number of each type of Blood Cell
- Platelet
- RBC
- WBC

Question 24

Red Cell Distribution Width

Answer 24

Cell Size Distribution

Question 25

Complete Count With Differential

Answer 25

Number of each type of Blood Cell - Platelet - RBC - Different types of WBC

Question 26

Symptoms of Cholestasis

Answer 26

- Jaundice - Pruritus - Xanthomas - Malabsorption of Fat Soluble Vitamins - Anorexia

Question 27

Monocytes

Answer 27

Mature into macrophages Can also develop into foam cell if clearing lipids

Question 28

Mean Corpuscular Hemoglobin

Answer 28

Average weight of hemoglobin in RBC MCH = Hgb / RBC Count

Question 29

Bilirubin

Answer 29

Produced when Liver breaks down RBC High Bilirubin indicates jaundice

Question 30

When do we need dosage adjustments

Answer 30

Compromised liver function + drug with high first pass metabolism Compromised liver function + drug that requires activation by liver

Question 31

Low Clotting Factors

Answer 31

Excessive bleeding

Question 32

Folic Acid Lab Value

Answer 32

Involved in maturation of RBC Low Vit B12 is followed by low Folic Acid

Question 33

Basophils

Answer 33

Develop into mast cells Contains: - Heparin (Anticlotting) - Histamines (Promote allergic response) - Proteolytic Enzymes

Question 34

Non-Specific Markers Tests

Answer 34

Bilirubin Lactic Acid Dehydrogenase

Question 35

Granular WBC

Answer 35

Neutrophils Basophils Eosinophils

Question 36

What medication therapies require looking at Liver Lab Values

Answer 36

HIV medications Tuberculosis medications Rheumatoid Arthritis medications Statins Isotretinoin Or if patient is experiencing jaundice

Question 37

Erythrocyte Sedimentation Rate

Answer 37

Rate blood falls in a tube (Sedimentation Rate) - Should very slow Inflamed blood will fall faster (Higher sedimentation rate)

Question 38

Mean Corpuscular Volume

Answer 38

Average Size of RBC - Normocytic, Microcytic, Macrocytic MCV = Hct / RBC Count