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PA Patient Diagnostics > Real Exam 1 > Flashcards

Real Exam 1 Flashcards

1
Q

What is sensitivity?

A

High sensitivity means that the test will likely find all positives
Will provide some false positives
Screening

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2
Q

What is specificity?

A

Will find all negatives
Will provide some false negatives
Confirms

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3
Q

Why is patient preparation and education important before diagnostic testing?

A

Patient may need to prepare for test by fasting or some other manner
One test may be more expensive which would factor into the patient’s decision

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4
Q

What are the different types of urine specimens?

A

First morning - typically most concentrated
Random
Timed - looking for something that is excreted at a certain point throughout the day
Double voided - have person urinate into toilet and then collect next urination
Culture and sensitivity - try to grow bacteria in urine and then test to see if it is sensitive to antibiotics

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5
Q

What are some reasons that a urine specimen may be rejected by the lab?

A 
Mislabeling
Contamination
Improper storage
Not enough urine
Improper collection
Missing requisition
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6
Q

Why would a urine specimen be obtained?

A

Diagnose renal or urinary tract diseases
Monitor for renal or urinary disease
Detect metabolic or systemic disease

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7
Q

Why is urine preferred over blood?

A

Easily performed
Cheap
ID UTIs
24 hour urine is good reflection of homeostasis

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8
Q

What are the different urine collection methods?

A 
Routine
Midstream and clean-catch
Twenty four hour
Catheterization
Suprapubic aspiration
Pediatric
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9
Q

What is a suprapubic aspiration for urine collection?

A

Needle is inserted through the skin above the pubic bone and urine is directly withdrawn from bladder
Done when there is extensive trauma to the urethra, making it impossible to pass catheter through

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10
Q

What is a urine reagent strip?

A

Patient urinates onto a piece of paper

Done when cheap and fast results are desired

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11
Q

What information can be obtained from a urine reagent strip?

A 
Glucose
Albumin
Hemoglobin
Bile concentrations
pH
Specific gravity
Protein
Ketone bodies
Nitrates
Leukocyte esterase
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12
Q

What results would be seen on a urinalysis for a patient with a UTI?

A

Leukocyte esterase

Nitrites

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13
Q

What results would be seen on a urinalysis for a patient with diabetes?

A

High levels of glucose
Sweet smelling urine
Presence of ketones

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14
Q

What results would be seen on a urinalysis for a patient with kidney disease?

A

Casts
Waxy casts = chronic kidney disease
RBC = trauma or tumor

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15
Q

What results of a urinalysis would be seen for a patient with kidney stones?

A

Bilirubin

Crystals

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16
Q

What results would be seen on a urinalysis for a patient with liver disease?

A

Musty odor

Uroblinogen

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17
Q

What can cause urine to be cloudy?

A 
WBC
RBC
Bacteria
Sperm
Mucous
Food
Medication
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18
Q

What does alkaline urine signify?

A

Bacteria
UTI
Citrus fruits
Vegetables

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19
Q

What does acidic urine signify?

A

Metabolic acidosis
Starvation
Dehydration
Meats/cranberries

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20
Q

What does elevated protein levels in urine signify?

A

Kidney damage

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21
Q

When is a urine culture ordered?

A

Infection is suspected
Collected through clean catch
Tells what organisms are present

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22
Q

What is the significance of a Bence-Jones protein test?

A

Presence of Bence-Jones proteins signifies multiple myeloma

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23
Q

What does specific gravity of urine signify?

A

Hydration level

High specific gravity means dehydration

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24
Q

What does the presence of leukocyte esterase in urine signify?

A

UTI or gonorrhea

Leukocyte esterase is released by WBCs

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25
Q

What does the presence of nitrites in urine signify?

A

Bacteria
Nitrates are converted into nitrites by bacteria
Indicates E. coli, klebsiella, pseudomonas, proteus, and staphylococcus

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26
Q

What does the presence of ketones in urine signify?

A

Poorly controlled diabetes
Alcoholism
High protein diet
Ketones are a end product of fatty acid breakdown

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27
Q

What does the presence of bilirubin in urine signify?

A

Stones

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28
Q

What does the presence of crystals in urine signify?

A

Kidney stones
Parathyroid disease
Malabsorption

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29
Q

Why is bence-jones protein tested for in urine and not blood?

A

It is cleared from the blood very quickly

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30
Q

What is toxicology testing?

A

Done during an overdose to determine what the overdose cause was

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31
Q

What is substance abuse testing?

A

Done to monitor if any drug use has been occurring

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32
Q

What does a microalbumin test measure?

A

Levels of albumin

Indicates renal disease

33
Q

What populations need to have a microalbumin test?

A

Diabetics over the age of 12

Diabetics are susceptible to renal disease

34
Q

What populations would have a positive PPD test at 5 MM?

A

HIV patients
Patients with close recent contact with TB patient
Patients with CXR consistent with old TB

35
Q

What populations would have a positive PPD test at 10 MM?

A

Immigrants
IV drug abusers
Medical workers

36
Q

What is a positive PPD test for the general population?

A

Greater than 15 MM

37
Q

What is a urea breath test used to diagnose?

A

H. Pylori infections

38
Q

What information does an arterial blood gas give?

A

Blood pH
Acid-base balance
Respiratory/ventilation function
Metabolic function

39
Q

Under what circumstances would an ABG be ordered?

A 
Respiratory distress
Cardiac disease
Ventilated patients
Surgery
ICU patients
Monitor electrolyte therapy
40
Q

What is normal blood pH?

A

7.35 to 7.45

41
Q

What are the components of an ABG?

A 
PO2
PCO2
HCO3
pH
O2 saturation
O2 content
Base excess
42
Q

What does PCO2 of blood determine?

A

Adequacy of ventilation by lungs
Respiratory compound of acid-base abnormality
As PCO2 rises then pH decreases

43
Q

What is HCO3 regulated by?

A

Regulated by kidneys

Metabolic component of acid-base determination

44
Q

What does PO2 of blood determine?

A

Evaluates lung’s ability to oxygenate blood

45
Q

What does O2 saturation of blood determine?

A

Indicates percentage of hemoglobin saturated with oxygen

46
Q

What does O2 content of blood determine?

A

Represents actual amount of oxygen in blood

47
Q

What is respiratory alkalosis?

A

High pH caused by low levels of pCO2

48
Q

What is respiratory acidosis?

A

Low pH caused by high levels of CO2

49
Q

What is metabolic alkalosis?

A

High pH caused by high levels of HCO3

50
Q

What is metabolic acidosis?

A

Low pH caused by low levels of HCO3

51
Q

What are the components of a BMP?

A 
Sodium
Potassium
Chloride
Bicarb
Calcium
BUN
Creatinine
Glucose
52
Q

What is the normal range of sodium?

A

136 - 145

53
Q

What are the causes of hypernatremia?

A

High sodium diet
Low sodium excretion
Increased free body water loss (burns or excessive sweating)

54
Q

What are the causes of hyponatremia?

A

Decreased sodium intake
Increased sodium loss
Increased free body water (hyperglycemia, CHF, and ascites)

55
Q

What is the normal range of potassium?

A

3.5 - 5.0 mEq/L

56
Q

What are the causes of hyperkalemia?

A

Nausea
Vomiting
Intestinal colic
Diarrhea

57
Q

What are the causes of hypokalemia?

A 
Weakness
Paralysis
Hypoeflexia
Ileus
Dysrhythmias
58
Q

What is the function of screening calcium levels?

A

Screen and diagnose conditions of bones, heart, nerves, kidneys, and teeth

59
Q

What are the causes of hyperchloremia?

A

Dehydration
Metabolic acidosis
Respiratory alkalosis
Kidney disease

60
Q

What are the causes of hypochloremia?

A 
Overhydration
CHF
Vomiting
Diarrhea
GI suctioning
Diuretic therapy
61
Q

What is a serum calcium level?

A

Measure of all the calcium in the blood

62
Q

What is an ionized calcium level?

A

Measure of free calcium in the blood

63
Q

What are the causes of hypercalcemia?

A 
Excessive vitamin D intake
Hyperthyroidism
High calcium intake
Cancer
TB
64
Q

What are the causes of hypocalcemia?

A 
Hypothyroidism
Low calcium intake
Low vitamin D intake
Malnutrition
Low albumin levels
Alcoholism
65
Q

What is the normal level of glucose?

A

Fasting - 70-99 mg/dL

Random - less than 200 mg/dL

66
Q

When/how can glucose be diagnosed?

A

HbA1c greater than 6.5%
Fasting glucose greater than 126
2 hour glucose greater than 200 during OGTT
Random glucose greater than 200 in patients with symptoms

67
Q

What is HbA1c?

A

Average measure of glucose over the past three months

68
Q

What are causes of hyperglycemia?

A

Cushing’s syndrome
Pancreatitis
Pancreatic cancer

69
Q

What are causes of hypoglycemia?

A

Excessive exercise
Lack of food intake
Kidney failure
Stomach surgery

70
Q

What is BUN?

A

Chief end product of protein metabolism
Produced in the liver from ammonia
Used to determine kidney function

71
Q

What parts of an ABG can be used to tell kidney function?

A

BUN
Creatinine
Creatinine clearance

72
Q

What is creatinine?

A

Waste product produced by muscles breaking down creatine

Excreted entirely by kidneys

73
Q

What is creatinine clearance?

A

Measures the creatinine concentrations in both the blood and the urine
Allows kidney filtration ability to be calculated

74
Q

What is in a CMP that is not in a BMP?

A 
ALT
AST
ALP
Bilirubin
Albumin
Total protein
75
Q

What liver enzyme test is the most specific to the liver?

A

ALT

Specific to liver dysfunction

76
Q

Elevated AST levels most commonly indicate dysfunction of what two organ systems?

A

Liver

Heart

77
Q

What is the function of a 5 prime nucleotidase test?

A

Supports diagnosis of hepatobiliary obstructive disease

Confirms that ALP is liver vs other tissue

78
Q

What is total bilirubin?

A

Shows levels of both indirect and direct bilirubin

PA Patient Diagnostics (5 decks)

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