Intro terms and lab tests

Question 1

what term measures the validity of tests?

Answer 1

specificity

Question 2

what term is disease oriented and identifies those with the disease correctly?

Answer 2

sensitivity

Question 3

If a test is highly sensitive what does is minimize?

Answer 3

false negatives

SNOUT (Sensitive test with Negative results rules OUT disease)

Question 4

true positives/ true positives + false negatives =??

Answer 4

sensitivity

Question 5

What term is healthy oriented and correctly identifies those without disease?

Answer 5

specificity

Question 6

If specificity is high, what does it minimize?

Answer 6

false positives
(SPIN) Specific test with Positive result rules IN disease

Question 7

true negatives/ true negatives + false positives=??

Answer 7

specificity

Question 8

What is the normal range or reference range?

Answer 8

the test results from healthy patient population that distribute into a bell curve
central 95% is the tests normal range
*healthy individuals may fall outside the range and thats their own normal

Question 9

What test would be helpful in diagnosing UTI, kidney stones, malignancy and identifying systemic disease?

Answer 9

Urinalysis

Question 10

Physical exam part of urinalysis; what would these characteristics determine?
cloudy, foul smell, sweet smell, red color, yellow color, brown color

Answer 10

cloudy-bacteria, blood, crystals
foul smell-infection, sweet smell-ketones/diabetes
red-hematuria, kidney stones, UTI, bladder cancer
yellow-dehydration
brown-gomerulonephritis

Question 11

specific gravity of chemical part of urinalysis shows what

Answer 11

elevated with volume depletion

decreased with excessive fluid

Question 12

pH of urinalysis (4.6-8); if abnormal what does that indicate?

Answer 12

increased with vomiting, UTI, kidney disease

decreased with aspirin overdose, starvation, alcohol, high protein diet

Question 13

should protein be in the urine?

Answer 13

no– too large to pass through glomerulus, indicates glomerulonephritis, diabetes complication

Question 14

glucose in the urine indicates what?

Answer 14

uncontrolled diabetes, burns, pancreatitis, corticosteroid use, kushings disease

Question 15

ketones in the urine indicates what?

ketones are produced from the breakdown of fat

Answer 15

starvation, alcoholism, diabetic ketoacidosis

Question 16

bilirubin in the urine indicates what?

Answer 16

by-product of hemolysis

biliary obstruction and liver injury

Question 17

leukocyte esterase (detects enzymes released by WBCs) in the urine indicates what

Answer 17

UTI

Question 18

urobilinogen (bilirubin can interact with bacteria in the gut to produce it) in the urine is associated with what?

Answer 18

hemolysis and hepatocellular disease

Question 19

nitrites in the urine

only some bacteria convert nitrate to nitrite

Answer 19

infection

Question 20

upon microscopic exam of urinalysis what is the normal range under high power:
WBC
RBC

Answer 20

WBC: 0-5
RBC: 0-3

Question 21

red blood casts indicates what?

Answer 21

glomerulonephritis

Question 22

white blood casts indicates what?

Answer 22

pyelonephritis

Question 23

test that is sensitive for liver injury (in addition to aspartate aminotransferase/AST)

Answer 23

alanine aminotransferase (ALT)

Question 24

what liver profile test would be elevated with bile duct obstruction?

Answer 24

alkaline phosphatase

Question 25

what is elevated with liver injury or biliary obstruction and parallels alkaline phosphatase?

Answer 25

GGT (gamma glutamyl transpeptidase)

Question 26

what is unconjugated bilirubin elevated with and what is conjugated bilirubin elevated with?

Answer 26

unconjugated(bilirubin bound to albumin, not water soluble)-hemolysis conjugated (water soluable)- bile duct obstruction

Question 27

what plasma protein is a marker of liver function?

Answer 27

albumin

Question 28

what measures the time required for coagulation to occur, a measure of liver function and the coagulation proteins produced by the liver?

Answer 28

prothromin time

Question 29

what are indications for ordering coagulation studies

Answer 29

unexplained bleeding disorder/excessive bruising pregnancy loss patients on heparin or coumadin

Question 30

what coagulation study measures the extrinsic pathway and deals with INR in monitoring patients on coumadin?

Answer 30

PT (prothrombin time)

Question 31

what coagulation study measures the intrinsic pathway and is used to monitor heparin therapy?

Answer 31

aPTT (partial thromboplastin time)

Question 32

what do prolonged coagulation studies indicate?

Answer 32

patients on coumadin or heparin liver injury--cirrhosis vitamin K deficiency

Question 33

increased levels of amylase and lipase may be associated with what?

Answer 33

pancreatitis, biliary obstruction, pancreatic carcinoma

Question 34

is amylase or lipase more specific for pancreatic inflammation

Answer 34

lipase

Question 35

electrolyte tests measure what?

Answer 35

overall fluid status, acid/base status

Question 36

what electrolyte is the major extracellular cation, involved in blood and body fluid homeostasis, conduction of impulses and regulated by osmoreceptors in the hypothalamus?

Answer 36

Sodium

Question 37

dehydration, vomiting and diarrhea, and endocrine problems would cause sodium levels to increase or decrease?

Answer 37

increase (>145)

Question 38

overhydration and cushings disease would cause sodium levels to do what?

Answer 38

decrease (

Question 39

the major intracellular cation and involved in impulse conduction through membrane depolarization

Answer 39

potassium

Question 40

cell injury, kidney failure and addisons disease do what to potassium

Answer 40

elevate (>5) | *arrhythmia's

Question 41

malnutrition, vomiting and diarrhea, diuretics do what to potassium?

Answer 41

decrease (

Question 42

effect on chloride levels dehydration and overactive parathyroid glands: vomiting/ loss of gastric acid:

Answer 42

elevated (>107) | decrease (

Question 43

use of antacids and kidney disease does what to magnesium

Answer 43

elevate

Question 44

inadequate absorption and diuretics does what to magnesium

Answer 44

decrease

Question 45

calcium -half is protein bound, half is ionized only ionized is metabolically active important in what?

Answer 45

muscle contraction, cardiac function, nerve impulse, blood clotting

Question 46

hyperparathyroid, cancer, excessive vitamin D | -does what to calcium levels?

Answer 46

elevate

Question 47

hypoparathyroid, deficient protein, vitamin D deficiency | -does what to calcium levels?

Answer 47

decrease

Question 48

effect of insulin and glucagon on blood glucose

Answer 48

insulin--decrease | glucagon--increase

Question 49

what test measures the average blood glucose over the past 2-3 months

Answer 49

hemoglobin A1C (normal

Question 50

what does BUN measure

Answer 50

blood urea nitrogen | protein breakdown--waste is produced as urea in the liver--urea filtered by kidneys, excreted in urine

Question 51

impaired kidney function, decreased protein catabolism, dehydration --elevated or decreased BUN?

Answer 51

elevated

Question 52

liver failure, malnutrition, endocrine disorders | --elevated or decreased BUN

Answer 52

decreased

Question 53

production of ___ is constant and correlates with muscle mass, excreted by kidneys, assess renal function

Answer 53

creatinine

Question 54

what kidney test is more specific and sensitive than BUN in kidney disease

Answer 54

creatinine

Question 55

impaired renal function, large muscle mass-- decreased muscle mass, liver disease-- which is elevated creatinine and which is decreased

Answer 55

elevated creatinine--impaired renal function | decrease-- decrease muscle mass and liver disease

Question 56

levels of ___ are increased with: excessive cell breakdown of nucleonic acids(gout), destruction of cells (leukemia), inability to excrete ___ (renal failure)

Answer 56

uric acid

Question 57

whats the most sensitive test for screening thyroid disorders

Answer 57

TSH

Question 58

decreased TSH, increased T4 and T3 is what

Answer 58

hyperthyroidism

Question 59

elevated TSH, decreased T4 and T3 is what

Answer 59

hypothyroidism

Question 60

what is the gold standard for streptococcal pharyngitis

Answer 60

throat culture

Question 61

Misc labs: sedimentation rate-- screen for venous thrombosis-- increased with CHF--

Answer 61

marker of inflammation D dimer brain natriuretic peptide (BNP)