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Basic Science Concepts > Lab Values & Drug Monitoring > Flashcards

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
Q

Our bone marrow makes different blood cell lines which include:

A

-WBCs

-RBCs

-Platelets

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26
Q

Neutrophils, Basophils, & Eosinophils collectively are referred to as _____

A

Granulocytes

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27
Q

High WBCs is called a ______________

A

Leukocytosis

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28
Q

Low WBCs is called a ___________

A

Leukopenia

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29
Q

High RBCs is called a __________

A

Polycythemia

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30
Q

Low RBCs is called a ________
can also be a low hemoglobin.

A

Anemia

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31
Q

High Platelets is called __________

A

Thrombocytosis

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32
Q

Low Platelets is called ___________

A

Thrombocytopenia

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33
Q

Changes in multiple cell lines, at the same time. Is called ____________

A

Agranulocytosis

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34
Q

When we see agranulocytosis, which can definently be due to many different drugs like antibiotics, and we are seeing reductions in __________________

A

(Neutrophils, Basophils, & Eosinophils) “the granulocytes”

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35
Q

WBCs can also be called _________

A

Leukocytes

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36
Q

RBCs can also be called _________

A

Erythrocytes

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37
Q

a reticulocyte is _____________

A

an immature RBC

38
Q

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 __________

A

number

reference range

39
Q
A
40
Q

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?

A
41
Q

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:

A

differential of our WBCs with all the different components of them broken down for us.

Neutrophils
Bands
Eosinophils
Basophils
Lymphocytes
Monocytes

42
Q

Understanding when one of each of the components is elevated and what that means will be helpful.

Neutrophils
Bands
Eosinophils
Basophils
Lymphocytes
Monocytes

A

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
Q

Neutrophils & Bands are used together to calculate a ________

A

(ANC) Absolute Neutrophil Count

44
Q

How do you calculate ANC?

A
45
Q

A RBC Differential includes:

sometimes a RBC Differential is also called a _________

A

-RBC
-Hgb
-Hct

“RBC Indices”

46
Q

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 _____

A

anemia

  • MCV (Mean Corpuscular Volume)
  • MCHC
  • RDW
47
Q

(MCV) Mean Corpuscular Volume, tells you ______

A

the size of the cells

48
Q

When the MCV is low, it means:

A

the cells are small (microcytic)

commonly caused by iron deficiency

49
Q

When MCV is large, it means:

A

the cells are large (macrocytic)

commonly caused by B12 and Folate deficiency

50
Q

Hct = Hgb x 3

A

Knowing the Hemoglobin (Hgb) value & just multiplying by 3 will give you the hematocrit (Hct).

51
Q

Different tests used for different types of anemia

-Coombs Test
-G6PD Deficiency

A
52
Q

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 __________
A

patient is making antibodies against RBCs

autoimmune vs drug induced hemolysis

53
Q

If Test is + for Coombs test, then drug that may be causing problem should _____

A

be discontinued.

54
Q

Examples of drugs that can be + on a Coombs test:

A
55
Q

G6PD Deficiency
-used when hemolytic anemia is suspected
—the RBCs are destroyed faster than the bone marrow can produce them

-the RBCs are _________

A

missing G6PD enzyme

56
Q

Anticoagulation labs

A
57
Q

Liver Function Tests & GI

A

AST
ALT
albumin

58
Q

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?

A
59
Q

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?

A
60
Q

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?

A
61
Q

Cardiovascular labs/biomarkers

A

CPK
troponins
BMP

62
Q

Acid-Base
–Arterial Blood Gas (ABGs) pg54

A
63
Q

-hCG (human corionic gonadotropin): this test we do to ___________

A

determine if a patient is pregnant or not

64
Q

if hCG is +, then the patient is ________

A

pregnant

***may be hidden on exam, carefully look over lab values

65
Q

-Cosyntropin stimulation test, is a test for

A

adrenal suppression

66
Q

Drugs that could cause Lactoacidosis:

A
67
Q

-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?

A
68
Q

-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?

A
69
Q

-PPD or Mantoux Test: This is how me test for ___________

A

tuberculosis

70
Q

-(RPR) Rapid Plasma Reagine: is a test we use for __________

A

diagnosing syphilis

So, a + RPR means syphilis present

71
Q

(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?

A
72
Q

(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?

A
73
Q

(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?

A
74
Q

(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?

A
75
Q

Labs that may be taken when someone has an autoimmune disorder/condition include: _____________

A

ESR
CRP
RF
ANA

76
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
77
Q
A
78
Q

Therapeutic Drug Monitoring:

A
79
Q

carbamazepine

A

Therapeutic range:

80
Q

digoxin

A
81
Q

gentamicin (traditional dosing)

A
82
Q

Lithium

A
83
Q

Phenytoin/Fosphenytoin

Free Phenytoin

A
84
Q

Procainamide

NAPA(procainamide active metabolite)

Combined

A
85
Q

Theophylline

A
86
Q

Tobramycin (traditional dosing)

A
87
Q

Valproic acid

A
88
Q

Vancomycin

A
89
Q

Warfarin

A
90
Q

The prophylactic drugs are used to lower (UA) Uric acid levels, with a goal UA level of______________

A

less than 6mg/dL

91
Q
A

Basic Science Concepts (7 decks)

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