Learning Lab Values and Drug Monitoring

Question 1

Leukocytosis

Answer 1

increase WBC

Question 2

Thrombocytosis

Answer 2

increase PLT

Question 3

Thrombocytopenia

Answer 3

decrease PLT

Question 4

Leukopenia

Answer 4

decrease WBC

Question 5

myelosuppresion

Answer 5

decrease in WBC, RBC, PLT (multiple blood cell lines)

Question 6

agranulocytosis

Answer 6

decrease in granulocytes (WBCs that secretory granules in the cytoplasm); includes decrease in neutrophils, basophils, eosinophils

Question 7

Ca levels***

Answer 7

Ca total: 8.5-10.5, ionized is 4.5-5.1. Calculate corrected Ca (only for total Ca, not ionized Ca) if albumin is low (normal albumin levels are 3.5-5)

Question 8

Drugs that increase Ca levels

Answer 8

vitamin D, thiazides

Question 9

Drugs that decrease Ca levels

Answer 9

systemic steroids, long-term heparin, cinacalcet (used to treat high levels of Ca), loop diuretics, bisphosphonates

Question 10

Drugs that lower Mg levels

Answer 10

PPIs, diuretics

Question 11

Increased phosphate levels = ?

Answer 11

renal failure

Question 12

Drugs that increase K levels***

Answer 12

3.5-5 is normal. RAAS drugs, canagliflozin, cyclosporine, tacrolimus, K supplements, bactrim, drosperinone-containing OCs

Question 13

Drugs that lower sodium

Answer 13

carbamazepine, oxcarbazepine, SSIs, diuretics

Question 14

Drugs that increase bicarb

Answer 14

loop diuretics, systemic steroids

Question 15

Drugs that decrease bicarb

Answer 15

topiramate

Question 16

Why we check bicarb

Answer 16

acid base status

Question 17

Increased BUN = ?

Answer 17

renal impairment, dehydration (BUN:Cr ratio > 20:1)

Question 18

Drugs that increase Scr***

Answer 18

drugs that impair renal function (AGs, amphotericin B, cisplatin, colistimethate, cyclosporine, loop diuretics, polymyxin, NSAIDs, radiocontrast dye, tacrolimus, vancomycin)

False increase d/t cobicistat, bactrim, H2RAs

Question 19

What causes decrease in Scr

Answer 19

low muscle mass, amputation, hemodilation

Question 20

Why do we check AG

Answer 20

high anion gap suggests metabolic acidosis

Question 21

WBC increase d/t

Answer 21

systemic steroids

Question 22

WBC decrease d/t

Answer 22

clozapine, chemo drugs, carbamazepine (not oxcarb), immunosuppressants

Question 23

eosinophil increase

Answer 23

parasitic infection

Question 24

basophil increase

Answer 24

hypersensitivity reaction

Question 25

lymphocyte increase

Answer 25

viral infections, lymphoma

Question 26

lymphocyte decrease

Answer 26

bone marrow suppression, HIV, systemic steroids

Question 27

MCV increase

Answer 27

macrocytic anemia- B12 def, folate def

Question 28

MCV decrease

Answer 28

microcytic anemia- iron def

Question 29

folic acid decrease d/t

Answer 29

phenytoin/fosphenytoin, phenobarbital, primidone, MTX, bactrim

Question 30

vit b12 decrease

Answer 30

PPIs, metformin

Question 31

Coombs Test positive = ? ****

Answer 31

drug-induced hemolysis caused by: [[penicillins, cephalosporins, (prolonged use/high concentrations), nitrofurantoin, sulfonamides]], [[dapsone, isoniazid, primaquine, quinidine, quinine, rifampin]], [[levadopa, methyldopa]], methylene blue, pegloticase, rasbiuricase

Question 32

G6PD

Answer 32

Deficiency caused by- fava beans, dapsone, methylene blue, nitrofurantoin, pegloticase, rasbiuricase, sulfonamides

Question 33

anti factor Xa

Answer 33

LMWH and UFH

Question 34

aPTT

Answer 34

UFH

Question 35

PLT decrease d/t

Answer 35

linezolid, VPA, heparin (HIT), LMWHs (enoxa, dalta, tinze), fondaparinux

Question 36

Albumin - highly protein bound drugs

Answer 36

warfarin, PHE, Ca

Question 37

Drugs that require Ca correction when albumin is low

Answer 37

alb < 3.5; PHE, VPA and calculate corrected Ca

Question 38

increased CK d/t

Answer 38

statins, tenofovir, raltegravir, dolutagrevir, daptomycin

Question 39

CK levels indicate

Answer 39

myositis, muscle damage, cardiac conditions

Question 40

C peptide

Answer 40

to distinguish t1dm vs t2dm, evaluates beta cell function. A C-peptide test is often used to help tell the difference between type 1 and type 2 diabetes. With type 1 diabetes, your pancreas makes little to no insulin, and little or no C-peptide. With type 2 diabetes, the body makes insulin, but doesn't use it well. T1 < ? and T2 0.5-2??? verify in book

Question 41

Uric acid increase d/t ***

Answer 41

diuretics, niacin, low dose ASA, pyrazinamide, cyclosporine, tacrolimus

Question 42

DILE can be caused by ? ***

Answer 42

many, but most likely: anti-TNF agents, hydralazine, isoniazid, MMI, methyldopa, minocycline, procainamide, PTU, quinidine, terbinafine