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NAPLEX Prep > Lab Values and Drug Monitoring > Flashcards

Lab Values and Drug Monitoring Flashcards

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1
Q

Describe a CBC

A
  • Complete blood count
  • Analyzes WBCs, neutrophils, RBCs, and platelets
  • Includes hemoglobin and hematocrit
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2
Q

Average RBC and platelet lifespan

A

RBC (120 days)

Platelet (7-10 days)

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3
Q

Describe a BMP

A
  • Basic metabolic panel

- Includes electrolytes and glucose, acid/base, and renal function

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4
Q

Draw and label the fishbone for BMP and CBC

A

[see NAPLEX guide for picture]

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5
Q

Calcium and ionized calcium normal range

A

Calcium: 8.5-10.5 mg/dL
Ionized: 4.5-5.1 mg/dL

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6
Q

Common causes for calcium increases or decreases

A

Hyper: supplementation, Vitamin D, thiazide diuretics

Hypo: steroids, long-term heparin, loop diuretics, bisphosphonates, cinacalcet, calcitonin, foscarnet, topiramate

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7
Q

Chloride normal range

A

95-106 mEq/L

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8
Q

Magnesium normal range

A

1.3-2.1 mEq/L

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9
Q

Common causes for Mg decreases

A

PPI and diuretic use, amphotericin, foscarnet, echinocandins, diarrhea, chronic alcohol intake

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10
Q

Phosphate normal range

A

2.3-4.7 mg/dL

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11
Q

Common causes for phosphate increases or decreases

A

Increased in renal failure

Decreased d/t phosphate binders, foscarnet, oral calcium intake

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12
Q

Potassium normal range

A

3.5-5 mEq/L

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13
Q

Common causes for potassium increases or decreases

A

Increased due to ACEIs/ARBs, aldosterone receptor antagonists, aliskiren, NSAIDs, cyclosporine, tacarolimus, mycophenolate, drospirenone-containing oral contraceptives, bactrim, chronic heparin use, canagliflozin, pentamidine

Decreased due to steroids, beta-2 agonists, conivaptan, diuretics, insulin, mycophenolate

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14
Q

Sodium normal range

A

135-145 mEq/L

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15
Q

Common causes for sodium increases or decreases

A

Increased due to hypertonic saline

Decreased due to carbamazepine, oxcarbazepine, SSRIs, diuretics, desmopressin

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16
Q

Bicarbonate normal range

A

Venous: 24-30 mEq/L
Arterial: 22-26 mEq/L

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17
Q

Common causes for bicarbonate increases or decreases

A

Increased due to loop diuretics, systemic steroids

Decreased due to topiramate, zonisamide, salicylate overdose

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18
Q

BUN normal range

A

7-20 mg/dL

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19
Q

Common causes for BUN increases

A

Renal impairment and dehydration (used with SCr to determine fluid status and renal function)

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20
Q

Serum creatinine normal range

A

0.6-1.3 mg/dL

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21
Q

Common causes for SCr increases or decreases

A

Increased due to drugs that impair renal function, false increase due to Bactrim and H2RAs

Decreased due to low muscle mass, amputation, hemodilution

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22
Q

Anion gap normal range

A

5-12 mEq/L

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23
Q

WBC normal range

A

4,000-11,000 cells/mm^3

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24
Q

Common causes for WBC increases or decreases

A

Increased due to systemic steroids, colony stimulating factors, epinephrine, infection or inflammation

Decreased due to clozapine, chemotherapy targeting the bone marrow. carbamazepine, cephalosporins, immunosuppressants, procainamide, vancomycin

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25
Neutrophils normal range
45-73%
26
Bands normal range
3-5% These are immature neutrophils, releases from marrow to fight infection (left shift)
27
Hemoglobin and hematocrit normal ranges
Hemoglobin: Men: 13.5-18 g/dL Women: 12-16 g/dL Hematocrit: Men: 38-50% Women: 36-46%
28
Mean corpuscular volume (MCV) normal range
80-100 fL
29
Common causes for MCV increases or decreases
Increased due to B12 or folate deficiency, alcoholism, chronic liver disease, hypothyroidism Decreased due to iron deficiency anemia, hemolytic anemia, lead poisoning, thalassemia
30
Common causes for folate decreases
Phenytoin/fosphenytoin, phenobarbital, primidone, methotrexate, sulfasalazine, bactrim
31
Common causes for B12 deficiency
PPIs, metformin, colchicine, chloramphenicol
32
Describe Antifactor Xa Activity
- Used to monitor LMWHs by obtaining peak anti-Xa 4 hours after dose - Monitoring recommended in pregnancy - Monitoring may be recommended in obesity, low body weight, pediatrics, elderly, or renal insufficiency
33
Prothrombin time/INR normal range
Prothrombin time: 10-13 seconds INR: <1.2 (for those not on warfarin)
34
Drugs that may falsely elevate prothrombin time/INR
Daptomycin, oritavancin, telavancin
35
Describe Activated Partial Thromboplastin Time (aPTT/PTT)
Used to monitor unfractionated heparin and direct thrombin inhibitors (e.g. argatroban)
36
aPTT/PTT normal range
22-38 seconds Treatment goal on heparin is 1.5-2.5x normal range
37
Platelets normal range
150,000-400,000/mm^3
38
Common causes for platelet deficiencies
Heparin, LMWHs, fondaparinux, glycoprotein IIb/IIIa receptor antagonists, linezolid, valproic acid, chemotherapy targeting the bone marrow
39
Albumin normal range
3.5-5 g/dL
40
Aspartate aminotransferase and alanine aminotransferase normal ranges
AST: 10-40 units/L ALT: 10-40 units/L
41
Bilirubin normal range
0.1-1.2 mg/dL
42
Amylase normal range
60-80 units/L
43
Lipase normal range
5-160 units/L
44
Creatinine kinase/creatinine phosphokinase normal range
Males: 55-170 IU/L Females: 30-135 IU/L
45
Common causes for CK increases
Daptomycin, quinupristin/dalfopristin, statins, fibrates, emtricitabine, tenofovir, tipranavir, raltegravir, dolutegravir, telbivudine Muscle damage, cardiac conditions
46
B-Type Natriuretic Peptide Normal Range
<100 pg/mL or ng/L
47
N-Terminal-ProBNP (NT-proBNP) Normal Range
Males: <61 pg/mL Females: 12-151 pg/mL
48
Total cholesterol normal range
<200 mg/dL
49
HDL normal range
<40 mg/dL = low | 60+ mg/dL = desirable
50
LDL normal range
70-189
51
TG normal range
<150 mg/dL
52
C-reactive protein (CRP) normal range
0-0.5 mg/dL
53
TSH and T4 normal ranges
TSH: 0.3-3 mIU/L | T4 (total thyroxine): 4.5-100.9 mcg/dL
54
Common causes for TSH increases or decreases
Increased or decreased due to amiodarone, interferons Increased (hypothyroidism) due to lithium, carbamazepine, oxcarbazepine
55
Common causes for uric acid increases
Diuretics, niacin, high doses of aspirin, pyrazinamide, cyclosporine, tacrolimus, ribacirin, some pancreatic enzyme products
56
Rheumatoid factor (RF) normal range
<40 IU/mL
57
Erythrocyte sedimentation rate (ESR) normal range
``` Males: = 20 mm/hr Females: = 30 mm/hr ```
58
Common drug-induced lupus erythematosus (DILE) offending agents
Anti-TNF agents, hydralazine, isoniazid, methimazole, methyldopa, minocycline, procainamide, propylthiouracil, quinidine, terbinafine
59
CD4+ T Lymphocyte Count Normal Range
800-1100 cells/mm^3
60
Arterial blood gas normal ranges
``` pH: 7.35-7.45 pCO2: 35-45 mmHg pO2: 80-100 mmHg HCO3: 22-26 mEq/L O2 Sat: >95% ```
61
Amikacin (traditional dosing) usual therapeutic range
Peak: 20-30 mcg/mL Trough: <5 mcg/mL
62
Carbamazepine usual therapeutic range
4-12 mcg/mL
63
Digoxin usual therapeutic range
0. 8-2 ng/mL (AFib) | 0. 5-0.9 ng/mL (HF)
64
Gentamicin (traditional dosing) usual therapeutic range
Peak: 5-12 mcg/mL Trough: <2 mcg/mL
65
Lithium usual therapeutic range
0.6-1.2 mEq/L (up to 1.5 for acute symptoms)
66
Enoxaparin usual therapeutic range
``` VTE treatment (daily): 1-2 anti-Xa units/mL VTE treatment (q12h): 0.6-1.2 anti-Xa units/mL Recurrent VTE prophylaxis in pregnancy: 0.2-0.6 anti-Xa units/mL ```
67
Phenobarbital/Primidone usual therapeutic range
20-40 mcg/mL
68
Phenytoin/fosphenytoin usual therapeutic range
10-20 mcg/mL
69
Free phenytoin usual therapeutic range
1-2.5 mcg/mL
70
Procainamide, NAPA, and combined usual therapeutic range
4-10 mcg/ml 15-25 mcg/mL 10-30 mcg/mL
71
Theophylline usual therapeutic range
5-15 mcg/mL | 5-10 mcg/mL (neonates)
72
Tobramycin (traditional dosing) usual therapeutic range
Peak: 5-10 mcg/mL Trough: <2 mcg/mL
73
Valproic acid usual therapeutic range
50-100 mcg/mL (up to 150 in some)
74
Vancomycin usual therapeutic range
Trough: 15-20 mcg/mL for most serious infections, 10-15 mcg/mL for other infections
75
Warfarin usual therapeutic range
2-3 or 2.5-3.5 in patients with mechanical mitral valves

NAPLEX Prep (3 decks)

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