Labs Flashcards
1
Q
Hematology
A
The lab dept concerned with identifying disease related to the blood; CBC, UA, ESRs, coag studies, fluid cell counts
2
Q
CBC
A
Complete blood count; RBCs and indicies, WBC w/ or w/o diff, hemoglobin, hematocrit, platelets
3
Q
RBC membrane
A
Elastic, lipid bilayer, cytoskeleton, membrane proteins
4
Q
Hemoglobin structure
A
Iron, protoporphyrin, globin
5
Q
Hemoglobin function
A
Carry oxygen (bind it and release it)
6
Q
MCV
A
Mean corpuscular volume; estimates average size of red cell; classified as microcytic, nromocytic, or macrocytic
7
Q
MCH
A
Mean corpuscular hemoglobin; How much hemoglobin is inside the RBC; used in combo w/ MCHC; classified as hypochromic or normochromic
8
Q
MCHC
A
Mean corpuscular hemoglobin concentration; used in conjunction with MCH to determine amount of hemoglobin; classified as hypochromic or normochromic
9
Q
RDW
A
RBC distribution width; amt of size variation;used to quantify the amount of anisocytosis; graded by severity 1+, 2+, 3+
10
Q
Normchromia
A
RBC should lack a nucleus; should be consistent in size and shape; should be deformable and selectively permeable
11
Q
What are possible causes to have an increased number of macrocytes (MCV > 100fL) in the blood?
A
- B12/Folic acid deficiency
- Accelerated erythropoiesis (spitting out of new RBCs)
- liver disease
- post-splenectomy
- chemotherapy
- hypothyroidism
12
Q
What are some possible causes/pathology of too many microcytes (MCV < 80 fL) and/or hypochromic (MCHC < 33%) in the blood?
A
*Abnormal hemoglobin synthesis
*iron deficiency
*deficiency of heme synthesis (siderblastic anemia)
*deficiency of globin synthesis (thalassemia)
Chronic disease states
13
Q
Piokilocytosis
A
Variation in shape
14
Q
Presentation of target cells could be indicative of what?
A
- Liver dysfunction
- various anemias
- Hgb-opathies
- thalassemia
15
Q
Presentation of spherocytes in the blood could be indicative of what?
A
- hereditary
- hemolytic anemia
- age
16
Q
Presentation of Stomatocytes in the blood could be indicative of what?
A
Cirrhosis
17
Q
What are the 6 types of WBCs?
A
- neutrophils
- lymphocytes
- monocytes
- eosinophils
- basophils
- Band (young neutrophils)
18
Q
Which WBC usually comprises 40-75% of the WBCs in normal blood?
A
Neutrophils
19
Q
Which WBC usually comprises 30-40% of the WBCs in normal blood?
A
Lymphocytes
20
Q
Which WBC usually comprises 2-8% of the WBCs in normal blood?
A
Monocytes
21
Q
Which WBC usually comprises 1-4% of the WBCs in normal blood?
A
Eosinophils
22
Q
Which WBC usually comprises 0.5-1% of the WBCs in normal blood?
A
Basophils
23
Q
Which WBC usually comprises 0-3% of the WBCs in normal blood?
A
Band cells (young neutrophils)
24
Q
What is the function of neutrophils?
A
Phagocytosis and killing of microorganisms
25
Someone who has an infection or has been using steroids could expect to have an elevated # of which WBCs?
Neutrophils
26
A decreased number of neutrophils could mean:
* immune reaction
* gram negative sepsis
* drugs
27
What does it mean when someone has a left shift?
Means that the body is dumping out an increased number of band cell/immature neutrophils
28
What is the function of lymphocytes?
* production of anti-bodies by B cells
| * cytotoxic T cells and Helper T cells
29
If someone has an increase in lymphocytes, they may have:
* viral infection
* EBV
* pertussis
30
If someone has a decrease in lymphocytes, they may have:
* immuno-deficiency (HIV)
* severe infection
* long term corticosteroid use
31
Atypical lymphocytes could mean the person is positive for:
Infectious mononucleosis (EBV)
32
Function of monocytes
Circulating precursors to the phagocyte
| Called macrophage in the tissues
33
Monocytes, in the tissue, are called
Macrophages
34
What is the function of eosinophils?
Kill antibody coated parasite via granule release
35
When are eosinophil levels increased?
During parasitic infection and allergic reactions
36
Basophils are elevated during __________ and release ____________
Inflammation; histamine
37
What is the primary role of platelets?
Maintain vascular integrity
38
What is the essential function of platelets?
Blood clotting
39
What is the hemostatic function of platelets (thrombocytes)?
Primary phase in platelet aggregation
40
If you think someone has a blood clotting disorder, you would want to order a CBC to look at their _______ count.
Platelet
41
If you think someone has a blood disorder, you would order a CBC to look at their
RBC indicies
42
If you think someone is anemic, polycythemia, or they are hypoxic for no obvious reason, you could order a CBC to look at their ________ & _________
Hemoglobin and hematocrit
43
What are the two main functions of electrolytes?
Maintain a healthy water balance and stabilize pH
44
Renal regulation involves which 4 electrolytes?
* sodium
* potassium
* carbon dioxide
* choride
45
Which specific salts are the major determinants of extracellular osmolality?
Sodium
46
Which electrolyte is found primarily extracellular?
Sodium
47
Does aldosterone conserve or release sodium?
Conserves it;
48
What stimulates aldosterone to signal the kidneys to reabsorb sodium?
Low levels of sodium
49
Natriuretic hormone conserves or releases sodium?
Releases
50
What stimulates natriuretic hormone to tell the kidneys to excrete sodium?
Elevated levels of sodium
51
Antidiuretic hormone (ADH) releases or reabsorbs H20?
Reabsorbs
52
What hormone controls the reabsorption of water at the distal tubules, either diluting or concentrating the amount of sodium?
Antidiuretic hormone (ADH)
53
Hyponutremia triggers ___________ hormone to increase reabsorption of water and conserve sodium to increase the levels of sodium in the body
Aldosterone
54
Hypernutremia triggers ____________ hormone to decrease reabsorption of water, thus excreting more sodium in the urine to decrease the levels of sodium
Natriuretic
55
Who is the major cation within the cell?
Potassium
56
Which electrolyte maintains the cell membrane’s electrical potential, esp. neuromuscular tissue?
Potassium
57
Minor changes in what electrolyte can have significant consequences to cardiac function?
Potassium
58
Which electrolyte contributes to the metabolic portion of acid/base balance by having the kidneys exchange hydrogen ions to maintain pH?
Potassium
59
This hormone is stimulated by increased levels of potassium and said hormone then acts on the kidneys to excrete more potassium
Aldosterone
60
As _________ electrolyte is reabsorbed, _________ electrolyte is lost
Na+; K+
61
Alkalosis tends to increase or decrease levels of potassium?
Increase
62
Alkalosis causes potassium to shift into or out of the cell?
Into
63
Acidosis tends to increase or decrease potassium levels?
Decrease
64
Acidosis causes potassium to shift into or out of the cell?
Out of
65
Total CO2 is a measurement of:
*carbonic acid (H2C03)
*dissolved carbon dioxide
Serum bicarbonate (HCO3-)
66
What is the primary role of carbon dioxide?
Maintains a stable pH and acid/base balance
67
What is the secondary role of carbon dioxide?
Maintain electrical neutrality
68
C02 is excreted and reabsorbed by which organ?
Kidneys
69
A person who is suffering from severe vomiting would have increased levels or decreased levels of CO2?
Increased
70
A person in metabolic alkalosis will have increased levels or decreased levels of C02?
Increased
71
A person with chronic diarrhea will have increased levels or decreased levels of C02?
Decreased
72
A person who chronically uses loop diuretics will have increased to decreased levels of C02?
Decreased
73
A person in renal failure will have increased or decreased levels of C02?
Decreased
74
A person in diabetic ketoacidosis will have increased or decreased levels of C02?
Decreased
75
A person who is literally starving will have increased or decreased levels of C02?
Decreased
76
Which electrolyte is the major extracellular anion?
Chloride
77
which electrolyte moves in and out of the cell with sodium and potassium, respectively?
Chloride
78
Chloride is reabsorbed/excreted in direct opposition to?
Bicarbonate to maintain acid/base balance
79
What is the primary role of Chloride?
Maintain electrical neutrality and follows Na+ loss/excess to do this
80
What major affect do Chloride have?
It affects water balance because H20 moves with Na+ and Cl-
81
As Cl- moves into a cell, what moves out?
HC03-
82
As Cl- moves out of a cell, what moves in to help maintain acid/base balance?
HC03-
83
A basic metabolic panel (BMP) evaluates what organ(s) function(s)?
Kidney, bone, parathyroid, pancreas, liver
84
End product of protein metabolism in the liver
Urea
85
Combines with urea and free ammonia in liver
Nitrogen
86
BUN (blood urea nitrogen) indirectly measures:
Renal function
GFR
Liver function
87
BUN levels are influenced by
Protein intake
Hydration status
GI Bleeds
88
Which two components make up a renal function study?
BUN and creatinine
89
Hyperuricemia is seen in:
Alcoholism
Leukemia
Metastatic cancer
DM
90
Hypouricemia can be caused by:
Idiopathic
Chronic renal disease
Acidosis
Hypothyroidism
91
1/2 of total calcium is bound mainly to?
Albumin
92
Calcium is necessary for:
Metabolic enzymatic pathway
93
Calcium is vital to:
Muscle contraction
| Cardiac and neural blood clotting
94
Calcium levels can be used to evaluate:
Parathyroid function
| Calcium metabolism
95
Calcium levels are used to monitor:
Renal failure
Renal transplantation
Hyperparathyroidism
Various malignancies
96
Complete Metabolic Panel consists of:
* sodium
* potassium
* chloride
* BUN
* creatinine
* glucose
* calcium
* aspartate aminotransferase
* alk phos
* protein
* bilirubin
* carbon dioxide
* alanine aminotransferase
* albumin
97
Alkaline phosphates (ALP) is used to detect and monitor disease of:
Liver and Bone
98
The most sensitive test in indication of a metastatic tumor of the liver
Intra-hepatic ALP
99
An increase in extra-hepatic ALP is primarily indicative of:
New bone growth
100
You may see an increase in extra-hepatic ALP with all of the following:
```
Osteoblastic metastatic tumor
Paget’s disease
Healing Fx’s
RA
Hyperparathyroidism
```
101
Bilirubin levels can be used to evaluate?
Liver function
Hemolytic anemia
Jaundice in newborns
102
What happens to RBCs in the spleen?
Brokendown into heme and globin; heme is further catabolized into biliverdine
103
In the spleen, biliverdin is converted to bilirubin. This is indirect/unconjugated or direct/conjugated bilirubin?
Indirect/unconjugated
104
Where does bilirubin go from indirect/unconjugated to direct/conjugated?
In the liver
105
What protein makes up roughly 60% of the total protein in the blood?
Albumin
106
What is the major effect of albumin within the blood?
To maintain colloidal osmotic pressure
107
What is the function of albumin, other than to maintain osmotic pressure?
Transportation of hormones, vitamins, enzymes, and meds
108
Where is albumin synthesized?
Liver
109
Which protein levels can reflect liver function and nutritional status?
Albumin
110
Total serum protein is a combo of:
Albumin and globulins
111
Who monitors liver and kidney functions?
Proteins
112
Where are globulins synthesized?
Liver and immune system
113
What are some of the functions of globulins
* helps determine chances of infection/multiple myeloma
* fights infection
* transports metal (iron)
114
Aspartate aminotransferase (AST) enzyme is release and levels rise when
An injury or disease has caused cells to lyse, specifically heart muscle cells, liver cells, or skeletal muscle cells
115
Alanine Aminotransferase (ALT) is an enzyme whose levels will rise when
There is a dysfunction in the liver
116
Alanine aminotransferase is sensitive and specific to
Hepatocellular disease
117
What cells secrete amylase?
Acinar cells
118
If a patient comes in with acute abdominal pain, what enzyme should you evaluate?
Amylase
119
Increased levels in amylase could indicate:
Acute/chronic pancreatitis
GI disease
Acute cholecystokinin
120
Lipase can be used to detect:
Acute pancreatitis
Renal insufficiency
Intestinal infarction or obstruction
121
Which enzyme is more useful in the late diagnosis of acute pancreatitis, and why?
Lipase b/c it peaks later than amylase and remains elevated longer than amylase.
122
Which enzyme is more useful in the early diagnosis of acute pancreatitis?
Amylase b/c it peaks sooner than lipase
123
Total cholesterol is the most accurate predictor of the risk of:
Coronary artery disease
124
Which organ metabolizes ingested cholesterol?
Liver
125
Subnormal levels of cholesterol could indicate:
Severe liver disease or malnutrition
126
Positional changes affect the results of what?
Total cholesterol
127
Lipoproteins transport _______, ______, and _______ through the blood system
Cholesterols, triglycerides, other soluble fats
128
Lipoproteins levels are influenced by:
Genetics
Diet
Lifestyle
Medications
129
LDL carries cholesterol from ______ to ________
Liver, cells
130
High levels of LDL could be indicative of:
CAD
| Peripheral vascular disease
131
Low levels of LDL could be indicative of:
Cardio-protective mechanism
132
HDL is produced where?
Liver
133
What is the purpose of HDL?
Remove cholesterol from the tissue and vascular endothelium
134
What is HDL’s goal?
Remove lipids from endothelium and protect against heart disease
135
High levels of HDL could be indicative of:
Cardio-protective mechanism
136
Low levels of HDL could be indicative of:
Risk of CAD
137
Who is in charge of carrying triglycerides?
VLDL
138
Glycerol + fatty acid = ?
Triglycerides
139
Which organ forms triglycerides?
Liver
140
How are triglycerides transported?
Mainly by VLDL; LDL to a lesser extent
141
What is the main purpose of triglycerides?
Storage for energy
142
What are the essential functions that are controlled by the thyroid?
Regulation of energy metabolism
BMR
Promotion of protein synthesis and growth
143
Prostate specific antigen is found where?
Prostatic lumen
144
PSA is used to monitor treatment for:
BPH
Infection
Cancer
145
Hemoglobin A1C is primarily used to:
Diagnose and monitor diabetes treatment
146
What test is used to determine the cause of metabolic acidosis?
Anion gap
147
Anion gap is the difference between
Cations and anions in the extracellular fluid
148
An increased anion gap could signify:
* renal failure
* renal tubular acidosis
* lactic acid
* diabetic ketoacidosis
* Alcoholic ketoacidosis
* Starvation
* GI loss
* hypoaldosteronism
149
Decreased anion gap could signify:
* multiple myeloma
* excess alkali ingestion
* chronic vomiting/suction
* hyperaldosteronism
150
Arterial blood gasses are used to monitor:
* patients on ventilators
* nonventilator patients
* preoperative baseline parameters
* regulate electrolyte therapy
151
What are the 4 acids found in blood?
Carbonic acid (H2CO3)
Dietary acids
Lactic acid
Ketoacidosis
152
An increase in H+ in the blood = _________in pH, which means the blood is _________?
Decrease; acidic
153
An decrease in H+ in the blood = ___________ in pH, which means the blood is ____________.
Increase; alkaline
154
UA is a non-invasive study for patient’s with:
```
Abdominal pain
Back pain
Dysuria
Hematuria
Urinary frequency
Urinary leakage
Fever of unknown origin (FUO)
```
155
If the urine is cloudy, could mean the presence of:
Pus
WBCs
RBCs
Bacteria
156
If the urine is dark red, it could indicate
Bleeding from the kidney
157
If the urine is bright red, it could indicate:
Bleeding from the lower urinary tract
158
If the urine is dark yellow, it could indicate the presence of
Bilirubin
159
If the urine is green, it could indicate the presence of:
Pseudomonas infection
160
What medication can make the urine orange?
Pyridium
161
What medication can make the urine brown?
Nitrofurantoin
162
What medication can make the urine bright yellow/orange?
Rifampin
163
Strong, sweet smell of acetone in urine could indicate:
Diabetic ketoacidosis
164
Foul odor to urine could indicate:
UTI
165
Fecal odor to urine could indicate
Enterovesicle fistula
166
Acidic urine could indicate possible:
Metabolic/resp. Acidosis
Starvation
Dehydration
High protein diet
167
Alkaline urine could indicate the possibility of:
UTI
Bacteria
Diet high in citrus fruits/veggies
Some medications (streptomycin, neomycin)
168
Increase in bilirubin in the urine could indicate:
Obstruction of the bile duct (i.e. gallstone)
