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Medical Conditions 1 > Lab tests and values > Flashcards

Lab tests and values Flashcards

1
Q

What does a complete blood count look at mainly

A
  • RBCs
  • WBCs
  • Platelets
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2
Q

When looking at the RBCs in a CBC what are things that are looked and explain each?

A
  • hemoglobin: carries oxygen; if there is a lack of hemoglobin there is impaired oxygen transport which can cause shortness of breath , discoloring, fatigue etc.
  • Hematocrit: percentage of RBC in the blood; closely related to hemoglobin
  • ferritin: looks at iron levels
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3
Q

When looking at the WBCs in a CBC what are things that WBCs are responsible for and where are they made?

A
  • defense systems
  • when increased there is an active infection
  • production in bone marrow
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4
Q

When looking at the platelets in a CBC what are things that are considered/platelets are import for?

A
  • initiate clotting
  • local vasoconstriction
  • useful for tissue healing
  • increase/decrease can impair these functions
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5
Q

What are the tests included in Red cell indices

A
  • MCV
  • MCH
  • MCHC
  • RDW
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6
Q

MCV

A
  • defines the size of red blood cells
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7
Q

MCH

A
  • quantifies the amount of hemoglobin per red blood cell
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8
Q

MCHC

A
  • indicates the amount of hemoglobin per unit volume (correlates the hemoglobin content with the volume of the cell)
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9
Q

RDW

A
  • represents the coefficient of variation of the RBC volume distribution and is expressed as a percentage
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10
Q

what is anemia vs polycythemia

A
  • anemia: decreased RBC
  • polycythemia: increased RBC
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11
Q

causes of anemia

A
  • anemia (low iron)
  • hemorrhage
  • leukemia
  • cancer
  • pregnancy
  • overhydration
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12
Q

what are some causes of polycythemia

A
  • dehydration
  • congenital
  • smoking
  • high altitude
  • often occurs as an over compensation
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13
Q

Normal hemoglobin for
- males
- females

A
  • males: 14-17.4 g/dL
  • females: 12-16 g/dL
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14
Q

low hemoglobin levels

A
  • < 8 g/dL = transfusion
  • some facilities may use 10 g/dL
  • a physician may prescribe exercise at 6 g/dL
  • expect decreased exercise tolerance
  • possible orthostatic hypotension
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15
Q

Hematocrit
- what is it
- normal values
- what occurs if it is low

A
  • percentages of total volume of RBCs relative to the total volume of whole blood
  • males: 42%-52% and females 37-47%
  • if low include other signs and symptoms as part of clinical decision-making process
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16
Q

What is the normal range for WBC

A
  • 5-10x10 ^9/L
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17
Q

leukocytosis

A
  • increased WBC
  • > 11x10 ^9/L
  • consider infection, inflammation, necrosis
  • participation in PT based on clinical decisions
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18
Q

Leukopenia

A
  • decreased WBC
  • <4x10 ^ 9/L
  • exercise may be limited or contraindicated
  • possible reverse isolation
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19
Q

Neutropenia

A
  • neutrophils are low
  • neutropenic precautions (facility dependent)
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20
Q

Neutrophilia

A
  • most common cause of elevated WBC
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21
Q

Eosinophilia

A

parasitic infection
- or toxomytosis which is spread through feces of bats and other animals
- can also be elevated with with allergies

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22
Q

Basophilia

A
  • very uncommon
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23
Q

Monocytosis

A
  • end of acute infection or with chronic infections
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24
Q

Lymphocytosis

A
  • acute viral infections
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25
Neutropenia causes and precautions
- prolonged infection; splenomegaly; some medications - precautions - < 2,000 unable to fight infection adequately - < 500 (agranulocytosis) - risk of opportunistic infections (skin, mouth, pharynx, lungs)
26
lymphopenia (give a significant value)
< 200 indicates HIV –> AIDS
27
Platelets: Normal ranges
- 140-400 k/uL
28
Thrombocytosis
- elevated platelets - >450 k/uL - can be elevated with acute infection - asymptomatic until >1,000,000 - >600,000 may be related to myeloproliferation disorders (bone marrow)
29
Thrombocytopenia
- <150 - risk of bleeds - <20 k/uL team approach to determine need for transfusion prior to mobility
30
Basic Metabolic Panel (BMP): purpose
- tests electrolyte levels, acid-base balance, blood sugar, and kidney status
31
What electrolyte levels does the BMP look at
- Na - K - Cl - CA
32
Sodium
- extracellular cation (Na+) - important for fluid balance, acid-base balance, serum osmolarity - important at neuromuscular junction
33
Hyponatremia: causes
- inadequate Na+ intake - excessive water intake (dilutes) - diuretics - renal failure
34
Hyponatremia: effects
- confusion - mental status changes - weakness - hypotension
35
Hypernatremia: causes
- diet - dehydration - excessive sweating (losses water) - thermal burns - ADH insufficiency
36
Hypernatremia: effects
- muscle weakness - restlessness - extreme thirst - confusion - lethargy - irritability - seizures - unconsciousness
37
Potassium: overview
- major intracellular cation - maintains hydration, osmotic pressure - important for skeletal and heart muscle contraction - Na-K pump
38
Hyperkalemia: causes
- excessive intake - long term heparin use - adrenal gland insufficiency - impaired kidney function - crush injuries - burns
39
hyperkalemia: effects
- ECG changes - nausea - diarrhea
40
Hypokalemia: causes
- loop diuretics
41
hypokalemia: effects
- cardiac arrhythmia - dyshythmia
42
Chloride
- extracellular anion - electrical neutrality of extracellular fluid - Cl levels being off are mostly caused by a metabolic issue
43
Hypochloremia: causes
- over hydration - Addison's disease - heart failure/lung disease - metabolic alkalosis
44
Hyperchloremia: causes
- hyperventilation - dehydration - kidney dysfunction - metabolic acidosis
45
Calcium
- mineral - strong bones and health teeth - important for neuromuscular activity (relaxation and contraction) - neural transmission - plays a role in blood clotting
46
Hypocalcemia: causes
- hypoparathyroidism (PTH, calcitonin) - inadequate Ca++, vitamin D intake (need Vitamin D needed for Ca absorption) - rickets, tetany
47
hypocalcemia: effects
- dry skin, course hair, and nails that easily break - muscle cramps, spasms, or stiffness - tingling in the lips, tongue, fingers and feet - arrhythmia
48
Hypercalcemia: causes
- hyperparathyroidism - tumors - osteoporosis - immobility - excess Ca or Vitamin D - paget's disease
49
Hypercalcemia: effects
- constipation - Nausea and vomiting - abdominal pain - loss of appetite - more frequent urination - increased thirst - confusion
50
Kidney functions tests
- BUN (Blood Urea Nitrogen) - creatinine
51
BUN
- waste product of protein metabolism - related to protein intake
52
What causes an increase in BUN
- increased protein intake - dehydration - starvation - catabolism - burns - GI bleed
53
What causes a decrease in BUN
- pregnancy - over hydration - liver disease
54
Creatinine
- waste production of muscle metabolism - usually increased in renal disease - not related to protein intake
55
What causes increase in creatinine
- Muscle degeneration - Rhabdomyolysis - Steroid use
56
What causes decrease creatinine
- decrease muscle mass - muscular dystrophy - myasthenia gravis - starvation
57
BUN/Creatinine Ratio
- assessment of liver and kidney - increased with dehydration, glomerulonephritis, burns - Decreased with liver disease, muscle injury, renal dialysis, malnutrition
58
BUN/Creatinine Ratio and PT implications
- changes may impair exercise tolerance - include with other signs and symptoms to make a clinical decision - dialysis - >20 signifies volume depletion
59
Glucose tests
- Fasting blood sugar - 2 hour postprandial blood sugar (after eating) - oral glucose tolerance test - HbA1c
60
Fasting blood sugar level for diabetic
- >126 dx for diabetes
61
2 hour postprandial blood sugar (after eating)
- > 200 dx for diabetes
62
oral glucose tolerance test
- fixed amount of glucose consumption that is measured at fixed intervals - should return to normal within 2 hours
63
HbA1c
- blood sugar concentration over period of many days - Normal <5.7% - prediabetes (metabolism syndrome): 5.7-6.4% - Diabetes >6.5 - determines fraction of hemoglobin containing bound glucose - reflect average over weeks or months - A1c > 7% usually requires oral hypoglycemic agents
64
Glucose: normal and other important levels
- normal 70-100 mg/dL - <100 mg/dL considered unsafe for exercise and must consume simple sugar - < 60 mg/dL may lead to diabetic shock - >300 mg/dL may lead to ketoacidosis (glucose will broken down into ketones)
65
Hypoglycemia symptoms
- activation of sympathetic nervous system - diaphoresis - tachycardia - increased RR - hypotension - visual changes - seizures - unresponsiveness
66
Hyperglycemia symptoms
- related to dehydration and acidosis - lethargy - acetone breath - dehyrdation - polyuria - thirst - confusion - nausea - vomiting - kussmaul breathing
67
Bicarbonate: acid-base balance
- produced in the reaction between CO2 and water - low indicates metabolic acidosis
68
Respiratory acidosis
- pH < 7.35 - P CO2 >45 mmHg
69
Respiratory alkalosis
- pH > 7.5 - Pa CO2 < 35 mmHg
70
Metabolism Acidosis
- pH < 7.35 - HCO3 < 22 mm/L
71
Metabolic alkalosis
- pH>7.5 - Pa CO2 > 26 mmL
72
what does a comprehensive metabolic panel look at that a basic metabolic panel does not
- BMP + liver test and functions + ammonia - bilirubin - total protein - albumin - serum Enzymes - Ammonia
73
Inflammatory markers: 3 most common test
- C-reactive protein - erythrocyte Sedimentation rate (sed rate) - plasma viscosity - indicate some type of inflammation but not specific
74
Nonspecific tests of inflammation look at what conditions
- inflammatory bowel disease - certain types of arthritis such as rheumatoid - autoimmune disease such as SLE - polymyalgia rheumatica - temporal arteritis - suspected infections - cancer - infection

Medical Conditions 1 (16 decks)

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