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Lab Values & Drug Monitoring Flashcards

1
Q

Point of Care (POC) Testing:

A
  • cuts out the whole sending samples to a lab and then having to send back one’s results
  • get the test done right then and there and act on them
  • it always an individual to perform a test at patient’s bedside
  • ex: fingerstick, INR,
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2
Q

Home testing kits:

A
  • many include testing for like illegal substances
  • fecal occult blood test
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3
Q

(CBC) Complete Blood Count: includes

one way to order labs

A

WBC-
Hgb-
Hct-
PLT-

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4
Q

Calcium, total

Calcium, ionized

What is the normal reference range for _____?

If this is elevated, could mean ________?

If this is decreased, could mean ________?

Which drugs increase this lab value?

Which dugs decrease this lab value?

A

8.5-10.5 mg/dL

4.5-5.1 mg/dL

Calculate corrected calcium if albumin is low
Correction is not needed for ionized calcium

Increased due to calcium supplementation, (Vitamin D, thiazide diuretics)

Decreased due to (long term heparin* loop diuretics, bisphosphonates cinacalcet*), systemic steroids, calcitonin, foscarnet, topiramate.

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5
Q

(Mg) Magnesium

What is the normal reference range for _____?

If this is elevated, could mean ________?

If this is decreased, could mean ________?

Which drugs increase this lab value?

Which dugs decrease this lab value?

A

1.3-2.1 mEq/L

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6
Q

What is the normal reference range for _____?

If this is elevated, could mean ________?

If this is decreased, could mean ________?

Which drugs increase this lab value?

Which dugs decrease this lab value?

A
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7
Q

What is the normal reference range for _____?

If this is elevated, could mean ________?

If this is decreased, could mean ________?

Which drugs increase this lab value?

Which dugs decrease this lab value?

A
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8
Q

What is the normal reference range for _____?

If this is elevated, could mean ________?

If this is decreased, could mean ________?

Which drugs increase this lab value?

Which dugs decrease this lab value?

A
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9
Q

What is the normal reference range for _____?

If this is elevated, could mean ________?

If this is decreased, could mean ________?

Which drugs increase this lab value?

Which dugs decrease this lab value?

A
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10
Q

WBC

What is the normal reference range for _____?

If this is elevated, could mean ________?

If this is decreased, could mean ________?

Which drugs increase this lab value?

Which dugs decrease this lab value?

A
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11
Q

Hgb

What is the normal reference range for _____?

If this is elevated, could mean ________?

If this is decreased, could mean ________?

Which drugs increase this lab value?

Which dugs decrease this lab value?

A
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12
Q

Hct

What is the normal reference range for _____?

If this is elevated, could mean ________?

If this is decreased, could mean ________?

Which drugs increase this lab value?

Which dugs decrease this lab value?

A
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13
Q

Plt

What is the normal reference range for _____?

If this is elevated, could mean ________?

If this is decreased, could mean ________?

Which drugs increase this lab value?

Which dugs decrease this lab value?

A
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14
Q

(BMP) Basic Metabolic Panel: includes

one way to order labs

A

Na-
Cl-
BUN-
K-
HCO3- bicarbonate
SCr-
Glucose-

Sometimes there is an 8th parameter added on which would be the Anion Gap

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15
Q

Na

What is the normal reference range for _____?

If this is elevated, could mean ________?

If this is decreased, could mean ________?

Which drugs increase this lab value?

Which dugs decrease this lab value?

A
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16
Q

Cl

What is the normal reference range for _____?

If this is elevated, could mean ________?

If this is decreased, could mean ________?

Which drugs increase this lab value?

Which dugs decrease this lab value?

A
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17
Q

BUN

What is the normal reference range for _____?

If this is elevated, could mean ________?

If this is decreased, could mean ________?

Which drugs increase this lab value?

Which dugs decrease this lab value?

A
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18
Q

K

What is the normal reference range for _____?

If this is elevated, could mean ________?

If this is decreased, could mean ________?

Which drugs increase this lab value?

Which dugs decrease this lab value?

A
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19
Q

HCO3 (bicarbonate)

What is the normal reference range for _____?

If this is elevated, could mean ________?

If this is decreased, could mean ________?

Which drugs increase this lab value?

Which dugs decrease this lab value?

A
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20
Q

SCr

What is the normal reference range for _____?

If this is elevated, could mean ________?

If this is decreased, could mean ________?

Which drugs increase this lab value?

Which dugs decrease this lab value?

A
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21
Q

Glucose

What is the normal reference range for _____?

If this is elevated, could mean ________?

If this is decreased, could mean ________?

Which drugs increase this lab value?

Which dugs decrease this lab value?

A
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22
Q

How do you calculate Anion Gap

A
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23
Q
A
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24
Q

Can also order a Comprehensive Metabolic Panel (CMP): includes

A

everything in a BMP + liver function tests (LFTs)

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25
Our bone marrow makes different blood cell lines which include:
-WBCs -RBCs -Platelets
26
Neutrophils, Basophils, & Eosinophils collectively are referred to as _____
Granulocytes
27
High WBCs is called a ______________
Leukocytosis
28
Low WBCs is called a ___________
Leukopenia
29
High RBCs is called a __________
Polycythemia
30
Low RBCs is called a ________ can also be a low hemoglobin.
Anemia
31
High Platelets is called __________
Thrombocytosis
32
Low Platelets is called ___________
Thrombocytopenia
33
Changes in multiple cell lines, at the same time. Is called ____________
Agranulocytosis
34
When we see agranulocytosis, which can definently be due to many different drugs like antibiotics, and we are seeing reductions in __________________
(Neutrophils, Basophils, & Eosinophils) "the granulocytes"
35
WBCs can also be called _________
Leukocytes
36
RBCs can also be called _________
Erythrocytes
37
a reticulocyte is _____________
an immature RBC
38
When we order a lab value, a lot of times what we are looking at is a _________. we take this and compare it to the __________
number reference range
39
40
What is the normal reference range for _____? If this is elevated, could mean ________? Which drugs increase this lab value? Which dugs decrease this lab value?
41
When the WBC is elevated, it generally tells us an infection may be present. However, we need more information to be sure that. So, we can order a WBC Differential, which is a ______________. This includes:
differential of our WBCs with all the different components of them broken down for us. Neutrophils Bands Eosinophils Basophils Lymphocytes Monocytes
42
Understanding when one of each of the components is elevated and what that means will be helpful. Neutrophils Bands Eosinophils Basophils Lymphocytes Monocytes
Neutrophils -if elevated, indicative an infection is present. Bands (immature neutrophils) - if elevated "left shit" released early and are indicative an infection is present.
43
Neutrophils & Bands are used together to calculate a ________
(ANC) Absolute Neutrophil Count
44
How do you calculate ANC?
45
A RBC Differential includes: sometimes a RBC Differential is also called a _________
-RBC -Hgb -Hct "RBC Indices"
46
When Hgb & Hct are low, essentially means patient has ______. So then we have to figure out the cause of this by getting a RBC differential and seeing those values for _____
anemia - MCV (Mean Corpuscular Volume) - MCHC - RDW
47
(MCV) Mean Corpuscular Volume, tells you ______
the size of the cells
48
When the MCV is low, it means:
the cells are small (microcytic) commonly caused by iron deficiency
49
When MCV is large, it means:
the cells are large (macrocytic) commonly caused by B12 and Folate deficiency
50
Hct = Hgb x 3
Knowing the Hemoglobin (Hgb) value & just multiplying by 3 will give you the hematocrit (Hct).
51
Different tests used for different types of anemia -Coombs Test -G6PD Deficiency
52
A Coombs Test: -used when hemolytic anemia is suspected ---the RBCs are destroyed faster than the bone marrow can produce them - Indicates whether ____________ - Used to differentiate __________
patient is making antibodies against RBCs autoimmune vs drug induced hemolysis
53
If Test is + for Coombs test, then drug that may be causing problem should _____
be discontinued.
54
Examples of drugs that can be + on a Coombs test:
55
G6PD Deficiency -used when hemolytic anemia is suspected ---the RBCs are destroyed faster than the bone marrow can produce them -the RBCs are _________
missing G6PD enzyme
56
Anticoagulation labs
57
Liver Function Tests & GI
AST ALT albumin
58
AST What is the normal reference range for _____? If this is elevated, could mean ________? If this is decreased, could mean ________? Which drugs increase this lab value? Which dugs decrease this lab value?
59
ALT What is the normal reference range for _____? If this is elevated, could mean ________? If this is decreased, could mean ________? Which drugs increase this lab value? Which dugs decrease this lab value?
60
albumin What is the normal reference range for _____? If this is elevated, could mean ________? If this is decreased, could mean ________? Which drugs increase this lab value? Which dugs decrease this lab value?
61
Cardiovascular labs/biomarkers
CPK troponins BMP
62
Acid-Base --Arterial Blood Gas (ABGs) pg54
63
-hCG (human corionic gonadotropin): this test we do to ___________
determine if a patient is pregnant or not
64
if hCG is +, then the patient is ________
pregnant ***may be hidden on exam, carefully look over lab values
65
-Cosyntropin stimulation test, is a test for
adrenal suppression
66
Drugs that could cause Lactoacidosis:
67
-Lactic acid What is the normal reference range for _____? If this is elevated, could mean ________? Which drugs increase this lab value? Which dugs decrease this lab value?
68
-Procalcitonin What is the normal reference range for _____? If this is elevated, could mean ________? Which drugs increase this lab value? Which dugs decrease this lab value?
69
-PPD or Mantoux Test: This is how me test for ___________
tuberculosis
70
-(RPR) Rapid Plasma Reagine: is a test we use for __________
diagnosing syphilis So, a + RPR means syphilis present
71
(ESR) Erythrocyte Sedimentation What is the normal reference range for _____? If this is elevated, could mean ________? Which drugs increase this lab value? Which dugs decrease this lab value?
72
(CPR) C-Reactive Protein What is the normal reference range for _____? If this is elevated, could mean ________? Which drugs increase this lab value? Which dugs decrease this lab value?
73
(RF) Rheumatoid Factor What is the normal reference range for _____? If this is elevated, could mean ________? Which drugs increase this lab value? Which dugs decrease this lab value?
74
(ANA) Anti-Nuclear Antibody What is the normal reference range for _____? If this is elevated, could mean ________? Which drugs increase this lab value? Which dugs decrease this lab value?
75
Labs that may be taken when someone has an autoimmune disorder/condition include: _____________
ESR CRP RF ANA
76
What is the normal reference range for _____? If this is elevated, could mean ________? If this is decreased, could mean ________? Which drugs increase this lab value? Which dugs decrease this lab value?
77
78
Therapeutic Drug Monitoring:
79
carbamazepine
Therapeutic range:
80
digoxin
81
gentamicin (traditional dosing)
82
Lithium
83
Phenytoin/Fosphenytoin Free Phenytoin
84
Procainamide NAPA(procainamide active metabolite) Combined
85
Theophylline
86
Tobramycin (traditional dosing)
87
Valproic acid
88
Vancomycin
89
Warfarin
90
The prophylactic drugs are used to lower (UA) Uric acid levels, with a goal UA level of______________
less than 6mg/dL
91

Basic Science Concepts (7 decks)

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