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Flashcards in Lab values Deck (37):
1

Potassium

3.5-5 mEq/L

2

Bicarbonate

23 - 28 mEq/L

3

Chloride

96 - 106 mEq/L

4

Sodium

135 - 145 mEq/L

5

SCr (serum creatinine)

0.6 - 1.2 mg/dL

A rise in SCr almost always indicates worsening renal function

Cr is produced in the liver and a product of creatine metabolism in skeletal muscle

Affected by: age, muscle mass, sex, race, diet

6

BUN

10 - 20 mg/dL

The end product of protein metabolism (produced by the liver and excreted by the kidneys)

Elevated BUN causes:
- high protein diet
- GI bleeding (blood in gut converts to ammonia and urea nitrogen)
- Reduced renal blood flow (dehydration, blood loss)

Decreased BUN causes:
- malnutrition
- Severe liver damage

7

Glucose

70-110 mg/dL

8

TSH

0.5-5 mU/L

9

Troponin

0 - 0.5 ng/mL

10

Billirubin

0.3 - 1 mg/dL

11

Prealbumin

16 - 40 mg/dL

12

Albumin

3.5 - 5 g/dL

13

White Blood Cells

5000 - 10,000/mm3

14

ANC range & formula

1,500 - 8,000 cells/mm3
ANC = WBC x (Segs + Bands)
Predicts the body’s defense against infection

Neutropenia < 1,500 cells/mm3

Agranulocytosis < 500 cells/mm3
(AKA Absolute Neutropenia)

15

Platelets

150,000 - 450,000/uL (microliter, sub u for Greek symbol)

16

What is a “left shift”?

It is an increase in neutrophils and bands, and it indicates a response to inflammatory cytokines and production of large number of new bands to try to fight off infection.

17

What is “right shift”?

Increase in mature neutrophils, and signals an immunocompromised patient

18

MCV and purpose

Assess the size and content of RBC

75 - 100 fL

<75 Microcytic anemia (iron deficiency anemia)

>100 fL Macrocytic anemia (B12 or Folic Acid deficiency)

19

MCV and purpose

Assess the size and content of RBC

75 - 100 fL

<75 Microcytic anemia (iron deficiency anemia)

>100 fL Macrocytic anemia (B12 or Folic Acid deficiency)

20

What are drugs discussed in class that can induce thrombocytopenia?

- Aspirin (Bayer, Ecotrin)
- Warfarin (Coumadin)
- Ibuprofen (Motrin)
- Rivaroxaban (Xarelto)
- Apixaban (Eliquis)
- Clopidrogel (Plavix)
- Enoxaprin (Lovenox)

21

Name causes for thrombocytopenia

-Drug Induced
-Genetics
-Certain cancers and/or chemotherapy treatment

22

s/sx of thrombocytopenia

- Ecchymosis
- Petechiae
- Melena
- Mennorhagia
- Epistaxis
- Bleeding gums
- Prolonged bleeding from cuts

23

What is thrombocytopenia?

Low platelet count <150,000 uL (micro liters)

24

What is thrombocytosis?

aka Thrombocythemia

High Platelet count >800,000 uL

25

What are causes and risks of thrombocytosis?

Stress, infection, splenectomy, posthemorrhagic anemia

Increases risk of thrombosis

26

What is ESR?

Erythrocytes Sedimentation Rate (ESR) aka: Sed rate

Useful for monitoring the acticvity of inflammatory conditions (higher when disease is active and falls when the intensity of disease decreases)

27

BUN vs Cr

Similarities: both filtered by glomerulus

Differences: Urea is reabsorbed by tubules whereas creatine is minimally absorbed

28

BUN:Cr

Useful in determining dehydration and acute kidney injury.

>20:1 BUN reabsorption is increased, Dehydration is suspected

10:1 - 20:1 NORMAL range

<10:1 Renal damage causes reduced reabsorption of BUN

29

CrCl

Creatinine clearance provides a good approximation of GFR. The normal range is 90 - 140 mL/min

Two methods: Calculating CrCl (24 hr urine collection) or estimating it

Cutoffs:
Used for medications that are renally cleared

30

What is the Cockcroft-Gault Equation and what is its purpose?

It is used to estimate CrCl.

BUT FIRST, check IBW

ECrCl = (140-Age) x kg / 72 x SCr

Multiply final answer by 0.85 if female

31

What is the formula for IBW?

Female:
45.5 + (2.3 kg x “ over 5)

50 + (2.3 kg x “ over 5)

32

What is the formula for adj BW?

0.4 (ABC - IBW) + IBW

33

What are the limitations of the MDRD and CKD-Epi equations?

Both equations are not appropriate to be used in AKI

34

What are the limitations of the Cockcroft-Gault Equation?

- A stable kidney function is required
- Developed for adults only
- Not corrected for factors that affect SCr

35

Which patients are at risk of CKD?

DM, HTN, family history

36

What is the difference between AKI and CKD?

Increase in SCr by greater than or equal to 0.3 mg/dL within 48 hours
- Increase in SCr of 1.5 times or more than the patient’s baseline within the past week
- Urine volume <0.5 mL/kg/hour for >6 consecutive hours

37

Identify different stages of CKD

Units of GFR: mL/min/1.73 m2

Increased risk of developing kidney disease