Lecture 3-6 - Lab Diagnostics Flashcards Preview

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Flashcards in Lecture 3-6 - Lab Diagnostics Deck (105):
1

What's the correct equation for determining positive predictive value?

TP/(TP+FP)

2

What percent of healthy individuals is equal to 1 standard deviation?

68%

3

Red blood cell counts & hemoglobin/hematocrit levels in people living in the Himalayan mountains are expected to be ____ than people living at sea level due to ____ oxygen levels.

Higher
Decreased

4

To be anemic, what do your hematocrit and hemoglobin levels have to be?

Low

5

If you order 20 tests on a healthy person, what's the chance that at least one will be outside the reference range?

Test #1 -> 0.95^1 = 0.95 = 5%
Test #5 -> 0.95^5 = 0.77 = 23%
Test #20 -> 0.95^20 = 0.35 = 65%

6

Testing glucose/HgA1c monitors for what?

Diabetes

7

What is the most important renal function test?

BUN/creatinine

8

What is the most important Liver test?

ALT

9

What is the most likely test to check heart levels?

Troponin

10

What is the fasting blood sugar level and random blood sugar level that you can automatically diagnose diabetes with?

Fasting DM = 126 mg/dL or higher
Random Blood sugar = any time it's greater than 200

11

What's the HgA1c that signifies the pt has diabetes?

>6.5%

12

What's the best liver test we have?

ALT

13

What test is most specific for the ductal cells of the liver?

ALP

14

When there is a loss of function of the liver, what loss of functions does the pt get?

-Bilirubin fails to be cleared
-Albumin is not synthesized (Na+ and albumin are huge blood pressure factors)
-Clotting factors (proteins) are not synthesized (if liver function drops, then clotting is reduced more too)

15

Identify the blood test that best supports liver failure

Rising bilirubin levels

16

Which tests are used to monitor damage to the liver as an early warning system? (To prevent it from failing)

ALT and AST

17

In normal adults, double the serum creatinine approximates how much GFR?

It approximates halving the GFR

18

What is the creatinine level in normal healthy adults?

1

19

If the creatinine levels are 2, then how much kidney function does the pt have?

50%

20

If the creatinine levels are 4, then how much kidney function does the pt have?

25% kidney function

21

If glomerular filtration rate is 30ml/min, how much percentage kidney function is this?

30%

22

If someone gets down to about a 30% GFR, which is about a serum creatinine of 3-4, then what do they need to do?

See a nephrologist

23

If someone gets down to about a 15% GFR, then what do they need to do?

Be put on dialysis or receive a transplant b/c they are going to die

24

Where is myoglobin primarily found?

All muscle tissue

25

CPK is the energy source primarily for what?

Muscle contraction

26

Troponin I/T is found where?

It is protein that is found in heart muscle only

27

Between myoglobin and troponin, which one usually reacts quicker?

Myoglobin

28

Between myoglobin and troponin, which one is more specific?

Troponin for the heart

29

What is the goal for total cholesterol?

<200 mg/dL

30

What is the goal for HDL-C (high-density lipoprotein cholesterol)?

>40 mg/dL

31

What is the goal for LDL-C (low-density lipoprotein cholesterol)?

<100 mg/dL

32

What does LDL promote?

Atherosclerosis

33

What is the goal for triglycerides?

<150 mg/dL

34

If you have a very high (>500 mg/dL) triglyceride value, what is it associated with?

Pancreatitis

35

What values of glucose show that the pt is pre-diabetic?

100-125

36

What 2 tests look for hepatocytes?

ALT and AST

37

What 3 tests are damage liver tests?

ALP
ALT
AST

38

What test is a function liver test?

Bilirubin

39

Which metabolic panel looks at liver function?

CMP = comprehensive metabolic panel

40

Which metabolic panel doesn't look at liver function?

BMP = basic metabolic panel

41

Identify the condition and/or organ system that is measured by a comprehensive metabolic panel (CMP), but not a basic metabolic panel (BMP).

Liver function

42

What function is not measure in either BMP (basic metabolic function) or CMP (comprehensive metabolic function)?

Cardiac function

43

Composes WBC count, RBC count, HGB/HCT, RBC indices (MCV, MCHC, RDW), and platelet count (PLT)

Complete blood count (CBC)

44

Composes WBC count, RBC count, HGB/HCT, RBC indices (MCV, MCHC, RDW), and platelet count (PLT)
WITH WBC TYPES (neutrophils, lymphs, monocytes, eosinophils, basophils)

CBC with Differential

45

If only one is low out of HGB and HCT, then is it anemia?

No

46

If both HGB and HCT are low, is it anemia?

Yes

47

What is the primary test to look at to see what type of anemia the pt has (volume of blood cells)?

MCV

48

What is the Erythrocytes sedimentation rate (ESR)?

How fast RBCs settle out in a tube (mm/hour)

49

What is the normal ESR (erythrocyte sedimentaion rate)?

0 - 20 mm plasma

50

What are the 2 tests that screen for inflammation?

ESR and CRP
(Erythrocytes sedimentation rate and C-reactive protein)

51

Is the erythrocyte sedimentation rate (ESR) a specific test for a certain disease?

It is not specific to certain diseases. You can't differentiate things from it. Therefore, it's only a good screening test.

52

Explain you a high ESR suggests inflammation

Liver gets excited and produces reactive substances because of interluken-6, which creates fibrinogens. These are sticky, and they stick to RBC membranes, making them precipitate out faster.

53

How many factors are there in forming a clot?

13

54

Which coagulation pathway uses naked collagen?

The contact factor pathway (intrinsic pathway)

55

Which coagulation pathway uses exploded tissues (tissue factor III)?

Tissue factor pathway (extrinsic pathway)

56

What are the 4 vitamin K-dependent factors?

II, VII, IX, X

57

Which vitamin K-dependent factor is the most important (ultra-dependent on vitamin K)?

VII

58

Where are vitamin K-dependent factors produced?

In our gut

59

The contact factor pathway is responsible for making which factor?

IX

60

The tissue factor pathway is responsible for making which factor?

VII

61

Which factors does heparin target?

X and II

62

Which factors does warfarin (Coumadin) target?

VII BIG TIME!!!

63

Vitamin K antagonist

Coumadin (warfarin)

64

What factors does Coumadin (warfarin) hit?

II, VII, IX, X

65

What is coumadin (warfarin) monitored with?

PT/INR (prothrombin time) - tissue factor pathway

66

Why is VII affected so much by Coumadin (warfarin)?

It has a very short half life

67

Antithrombin activator

Heparin

68

A patient has hemophilia, which is the most common serious bleeding disorder in the world. What does it have an absence of? What test do you use for this?

-Factor VIII (8)
-Use PTTT

69

What is PT/INR used to monitor?

Warfarin/Coumadin therapy, and liver function

70

Most common serious bleeding disorder

Hemophilia

71

What do you divide to find INR (international normalization ration)?

INR = Pt's time to clot/normal time to clot

72

What is the common target PT/INR range for DVT prophylaxis (deep vein thrombosis)?

2.0 to 3.0

73

What is the common target PT/INR range for a mechanical heart valve?

2.5 to 3.5

74

What composes neutrophils?

Segs, bands, and milos
(PMNs and Segs)

75

What test determines anemia?

MCV

76

Certain infections can be WBC indicators. If you have elevated WBC's, what does neutrophilia suggest?

Bacterial source

77

Certain infections can be WBC indicators. If you have elevated WBC's, what does lymphocytosis suggest?

Viral source

78

Certain infections can be WBC indicators. If you have elevated WBC's, what does eosinophilia suggest?

Allergies or worms

79

With leukemia, does the patient have high or low WBC count?

Either

80

What is the HGB x 3 rule?

Give HGB, multiply by 3, and get hematocrit (HCT)
(Hematocrit/3 = hemoglobin)

81

What is the level of RBCs in a patient with polycythemia vera?

High RBC count

82

Neoplastic proliferation of RBCs causing increased RBC, HGB, and HCT

Polycythemia vera

83

What are the criteria for HGB in women with anemia?

Less than 12 g/dL

84

What are the criteria for HGB in men with anemia?

Less than 13.5 g/dL

85

What is the criteria of HGB in anemia when you think about transfusing?

Less than 10 g/dL

86

What is the criteria of HGB in anemia when you have to transfuse? What is the HCT level?

7 g/dL
HCT = 21

87

Characteristics of microcytic anemia

MCV < 80
Iron-Deficiency anemia

88

Characteristics of normocytic anemia

MCV 80-100
Recent blood loss
Anemia of chromic disease
Renal failure

89

Characteristics of macrocyctic anemia

MCV>110
Vitamin B12 deficiency
Folic acid deficiency

90

What's the most common type of anemia?

Microcytic anemia (MCV<80)
-iron-deficiency anemia
-thalassemia

91

Other term for microcytic anemia?

Megaloblastic anemia

92

Recall the most common screening tests for syphilis

-RPR (rapid plasma reagin)
-Venereal Disease Research Lab (VDRL)

93

Explain why RPR and VDRL must be followed
with either a FTA-ABS or MHA-TP when testing for syphillis

RPR and VDRL are sensitive for syphillis, but they are not specific for it, therefore they are only screening tests.
FTA-ABS and MHA-TP can confirm that the disease is or is not syphillis after the screening test marks it a possibility for being syphillis.

94

Interpret a urinalysis to determine if the patient has a urinary tract infection

-Leukocyte esterase
-blood
-nitrite
-protein

95

Interpret a urinalysis to determine if the patient has uncontrolled
diabetes

-glucose

96

Which diagnostic test is least valuable for visualizing soft tissues?

X-ray (radiography)

97

What does ANA (antinuclear antibody test) look for?

Connective tissue diseases

98

What are the two most common autoimmune conditions that are observed with ANA (antinuclear antibody test)?

-Systemic lupus erythematosus (SLE) - 95%
-Scleroderma - 60-90%

99

If a patient that has lupus tests positive for ANA (antinuclear antibody test), what 2 tests do you have to run to confirm it?

-anti-double-stranded DNA
-anti-Sm

100

Which diagnostic test penetrates soft tissues easily and dense tissues less easily?

X-ray (radiography)

101

Which diagnostic test can image more soft tissue structures difficult to see on traditional x-ray, and is more sensitive than traditional x-ray (multiple angle x-ray)?

CT-scan (computer tomography)

102

Which diagnostic test is used to image areas where soft tissues meet (ex: spinal cord)?

MRI (magnetic resonance imaging)

103

Which diagnostic test uses sound waves to produce the image in a variety of tissues?

Ultrasound

104

Which diagnostic test uses radioactive material to produce an image?

Nuclear scans

105

Which diagnostic test uses magnetic fields/radio waves to produce images?

MRI (magnetic resonance imaging)