T3- Basic Lab Principles Flashcards

1
Q

What determines diagnoses most of the time?

A

Clinician’s judgment 50% of the time, followed by radiologic studies 30%.

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2
Q

What is the purpose of diagnostic tests?

A

Establishing a diagnosis in a symptomatic patient.
Screening for disease in an ASYMPTOMATIC patient.
Assessing/monitoring disease condition with an established disease.
Monitor therapy.
Confirm the ABSENCE of a disease.

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3
Q

Why is inappropriate testing dangerous?

A

It can increase the time it takes to diagnose.
Financial cost
Physical/emotional distress
Liability to followup on any abnormal results
Misdiagnosis/red herrings
False negatives/positives.

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4
Q

What should we consider when ordering a test?

A

Time
Money
Sensitivity/specificity
Risk
Does it even affect how I will treat the patient?

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5
Q

What factors can affect lab results?

A

Age
Gender
Race
Medications
Pregnancy
Food ingestion
Posture
Timing

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6
Q

What is the definition of a reference range?

A

The set of values that 95% of the population falls under for that parameter.

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7
Q

What is a better point of reference?

A

Previous lab values, not reference values.

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8
Q

What are some examples of common laboratory tests we run?

A

CBC
BMP/CMP
LFT (liver function panel)
TFT (Thyroid function panel)
Renal panel
Anemia panel

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9
Q

Why do we need to be careful of just ordering panels?

A

We may get results we do not need that have no clinical significance.
The panel may not be the best test.

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10
Q

What is included in a CBC?

A

WBC
RBC
Hgb
Hematocrit
RBC indices
Platelets

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11
Q

What is the difference between a CBC with diff and without diff?

A

The differential part gives us the specific counts of each type of WBC, such as a neutrophil, eosinophil, lymphocyte, etc…

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12
Q

When do we order a CBC?

A

Infection
Hematologic diseases
Blood losses
General screening

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13
Q

When do we order a CBC with diff?

A

When we are concerned with possible etiologies involving abnormal WBCs.

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14
Q

What is included in a BMP?

A

Glucose
BUN
Creatinine
Sodium
Potassium
Chloride
Carbon dioxide/Bicarb
Calcium

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15
Q

What is the difference between a Chem-7 and a BMP?

A

It is a BMP without calcium

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16
Q

What extra things are included in a CMP?

A

BMP +
Serum albumin
Serum total protein
Alkaline phosphatase
Bilirubin
Aspartate aminotransferase (AST)
Alanine aminotransferase (ALT)

17
Q

What do we order BMPs for?

A

Hydration status
Renal function
Glucose screening
Electrolyte status
Anion gap
General screening

18
Q

What do we order a CMP for?

A

Nutritional status
LIVER function