Medical Record Flashcards
(47 cards)
What can a basic metabolic panel detect?
- Kidney failure
- Diabetes related problems
- Respiratory distress
- Electrolyte imbalances
What are the main symptoms of electrolyte imbalances?
- Alter excitability of neurons, cardiac muscle, skeletal m
1. Weakness
2. Spasticity
3. Altered sensations
4. Cardiac arrhythmias
What causes hyponatremia?
- Excessive ingestion or infusion of water
- Excessive ADH
- Diseases that cause water retention: CHF, Cirrhosis, nephrotic syndrome, SIADH
What are causes of hypernatremia?
- Excessive water loss from body – sweating, diabetes insipidous, vomiting, diarrhea
- decreased ADH
Why would you look at potassium levels?
- Renal function
- Adrenal function
- Water balance
- Acid-base imbalances
What causes mental status changes, dizziness, weakness, myalgia, muscle twitches, nausea, vomiting, clammy skin, potential respiratory failure?
Hypokalemia
- loop diuretics can lead to this
- Any abnormalities in potassium levels should lead to consultation before treatment
What causes Numbness, tingling, flaccid paralysis, nausea, vomiting, diarrhea, anorexia?
Hyperkalemia
- Any abnormalities in potassium levels should lead to consultation before treatment
Bicarbonate and chloride move in [same/ opposite] directions into RBC. [Hyper-/ Hypo-] chloremia associated with hyperventilation.
opposite; Hyper
- chloride is involved with acid/base balance
- levels change with sodium and water
Evaluate kidney function in patients with renal failure; Differential diagnosis if kidney disease is suspected; Monitor kidney function secondary to certain drug
BUN (together with nitrogen)
What happens to BUN levels when there is decreased renal function, particularly renal blood flow?
BUN increases
- Other factors that can increase BUN: Increased protein catabolism, Increased protein dietary intake, GI bleeding
What can decrease BUN?
severe liver disease
Breakdown product of heme – yellow color in jaundice
Bilirubin
What can increase bilirubin levels?
- liver disease
- Bile duct occlusion
- Hemolytic anemia – excessive destruction of RBCs
Located in liver, heart, kidney and skeletal muscles; Increased in Liver disease and Myopathy
AST
Sensitive indicator of damage to liver cells; Primary means of detecting hepatitis
ALT
Mostly in heart and skeletal muscles - Used in differential diagnosis of chest pain; Elevated in injury to cancer cells
LDH
What is GGT elevated by?
Elevated by injury to liver cells
Related to bile ducts (Increased when they are blocked) Levels increased by: - Gall bladder disease - Liver disease - Bile duct disease - Chronic renal failure – secondary to increased bone turnover - Paget’s disease of bone - Hyperparathyroidism - Rheumatoid arthritis - Hepatocystic carcinoma
ALP
Alkaline phosphatase
What can decrease RBC count?
- Anemia
- Blood loss** most common
- Dietary deficiency of iron and specific vitamins
- Chemotherapy
- Other disorders
What can increase RBC count?
- Polycythemia
- Dehydration
- Pulmonary fibrosis
- High altitude
- Chronic heart disease
What lab results can you find for RBCs? other than count
- hematocrit- volume of whole blood is RBCs
- Hb levels- per volume of blood or per erythrocyte
- RBC shape - sickle cell, spherocytosis
- Reticulocytes - immature RBC
What WBCs are looked at during lab tests?
- Neutrophils – major WBC - phagocytotic (Neutropenia= Risk factor for infection, Neutrophilia = Usually indicates infection)
- Basophils – immune responses, particularly allergies
- Eosinophils – worm infections, allergies, and certain diseases
- Macrophages - phagocytotic
- Lymphocytes - B cells (antibodies), T cells, NK cells, decr. in AIDs
What are the measurements for hemostasis?
- PT - prothrombin time
- aPPT - activated partial thromboplastin time (used for low-molecular weight heparin)
- INR - PT results that do not vary between labs
What does a higher INR indicate?
increase risk of bleeding during surgery or after trauma
- Higher number INR = clotting time increases
- People on anticoagulants should have INR between 2 and 3