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Flashcards in Lab Practical Deck (29)
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1

Critical Value

test results that fall significantly outside the normal range & may represent life-threatening values & require urgent medical intervention

2

reporting panic values

should be called within 30 minutes of verifying the test result

3

STAT

emergency testing only
test will be performed as rapidly as possible, generally 60 minutes or less from the time of receipt

4

TIMED

specimens which are require collection at a specific time (peak drug levels) are requested as 'timed study'
treated as STAT

5

ROUTINE

lab orders not specifically STAT or TIMED & will be processed with a routine priority
most are completed the same day

6

examples of timed draws

cardiac panel- every 4-6 hours
peaks & troughs of drugs

7

time for peak drug draw

1 hour after administration of drug

8

time for trough drug draw

30 minutes prior to administration of drug

9

BMP

glucose
calcium
electrolytes: Na, K, CO2, Cl
kidney tests: BUN, Creatinine

10

CMP

glucose
calcium
proteins: albumin & total protein
electrolytes: Na, K, CO2, Cl
kidney tests: BUN & Creatinine
Liver tests: ALP, ALT, AST, & bilirubin

11

Lipid panel

total cholesterol
HDL
LDL
Triglycerides

12

Liver panel

total bilirubin
AST
ALT
ALP
Albumin
Total protein
maybe: GGT, LDH, PT

13

other panels

cardiac - CK, CK-MB, troponin, BNP
nutrition
thyroid
hepatitis

14

Delta Checks

if a change in the value of an analyte exceeds an expected physiological range the result is flagged as a possible error

15

goal of a delta check

1. ID changes in patient condition
2. ID sample quality issues/patient misID

16

goal of a delta check

1. ID changes in patient condition
2. ID sample quality issues/patient misID

17

causes of discrepant results

pre-analytical: patient ID, specimen collection, post- collection
analytical : instrument, method
biological: rhythmic changes, lifespan, treatment

18

who investigates delta checks?

the lab to rule out any errors

19

steps to start investigation

1. repeat analysis
2. investigate pre-analytical issues
3. investigate analytical issues
4. consider changes in the patient

20

elevated potassium

almost always HEMOLYSIS

21

Myoglobin cardiac marker

more sensitive than CK-MB
rise within 1-4 hours
returns to baseline within 18-24 hours
not used often

22

CK-MB cardiac marker

rise within 4-6 hours
return to normal within 2-3 days

23

Troponin T

rise within 3 hours
peak by day 2
return to baseline after 7 days

24

Troponin I

rises 4-6 hours
peaks 12-18 hours
returns to baseline in 6 days

25

CKMB index

CK-MB(ng/ml)
--------------------- x 100
total CK activity

26

CM-MB is elevated & CKMB index >3

suggestive of MI

27

CK-MB is elevated & CKMB is

suggestive of skeletal muscle damage

28

hsCRP

indicator of risk of cardiovascular disease

29

BNP

b natriuretic peptide
major marker of congestive heart failure