Test 1 Flashcards
(126 cards)
1
Q
Normal WBC count
A
4.5x10^3/uL
2
Q
Leukocytosis
A
Increased WBC count
Bacterial infections
Certain meds (corticosteroids)
smokers
3
Q
Leukopenia
A
decreased WBC count
viral/parasitic infections
radiation treatment for cancer
4
Q
Normal Neutrophils
A
50-70% of WBCs
Absolute = 1.8-7.8x10^3 /uL
5
Q
Neutrophilia
A
Leukocytosis
6
Q
Neutropenia
A
Leukopenia
severe =500/uL
moderate = 500-1000/uL
mild = 1000-1500
7
Q
Two forms of neutrophils
A
Band (less mature)
Segmented (segs)
8
Q
Normal Lymphocytes
A
about 20-40%
absolute count = 1.8-4.8x10^3/uL
9
Q
Lymphocytosis
A
Predominantly viral infections:
mono, cmv, HIV
10
Q
Lymphocytopenia
A
bacterial or fungal sepsis, post-op, chemo
11
Q
Normal Monocytes
A
2-8% of WBCs
absolute = 0-0.8x10^3 /uL
12
Q
Normal Eosinophils
A
0-7% of WBCs
absolute = 0-0.45x10^3 /uL
13
Q
Eosinopenia
A
Normal count can go down to 0
14
Q
Eosinophilia
A
mild = 500-1500
moderate=1500-5k
severe = >5k
Parasites! allergic disorders
15
Q
Normal Basophils
A
0-3% of WBCs
absolute = 0-0.2x10^3 /uL
16
Q
Platelets
A
150-450x10^3 /uL
17
Q
Thrombocytosis
A
Reactive (cytokine driven)
Autonomous (overproduction) - malignancy
18
Q
Thrombocytopenia
A
lab error? platelets can clump b/c of EDTA
Drug induced
Infection
19
Q
RBC count
A
Males = 4.6-6.0x10^3 /uL
Females =3.9-5.5x10^3 /uL
20
Q
Increased RBCs
A
cigarette smoking, dehydration, polycythemia
21
Q
Decreased RBCs
A
anemia, bleeding, hematopoetic failure, poor nutrition
22
Q
Hemoglobin
A
Males = 13.6-17.2 g/dL Females = 12-15 g/dL
23
Q
Increased Hemoglobin
A
Tobacco use and advanced COPD, alcohol abuse, dehydration
24
Q
Decreased Hemoglobin
A
Acute blood loss anemia, malnutrition, renal failure
25
Hematocrit
Males = 41-50%
Females 35-45%
% of whole blood that is made of RBCs
26
Reticulocyte count
0.5-1.5% of RBCs in adults and children
27
Increased Reticulocyte count
Hemolysis or hemolytic anemia, acute blood loss
28
Decreased Reticulocyte count
represents decrease in RBC production; vitamin def, bone marrow failure, decreased EPO (renal disease)
29
Hemoglobin A
two alpha and two beta chains
| =95-98%
30
Hemoglobin A2
two alpha and two delta chains
| =2-3.5%
31
Hemoglobin F
two alpha and two gamma chains; fetal
50-80% newborns
8% 6 mos
32
Alpha Thalassemia
hemoglobinopathy; impaired production of alpha chains, decreased HgA2
33
Beta Thalassemia
hemoglobinopathy; increased HgA2
34
Hemoglobin S
Sickle cell trait or disease
35
Universal donor
Blood type O
36
Universal recipient
Blood type AB
37
Serum Iron
60-150 mcg/dL
38
Increased iron
Beta thalassemia, alcoholic cirrhosis, high iron intake, hereditary hemochromatosis
39
Decreased Iron
iron deficiency anemia, chronic renal failure, inadequate absorption, increased loss, increased demand
40
Serum Ferritin
15-200 ng/mL
41
Increased Ferritin
hereditary hemochromatosis, hepatitis, cancer, alcoholism
| ACUTE PHASE REACTANT
42
Decreased Ferritin
Gold standard
| Iron deficiency anemia
43
Total Iron Binding Capacity (TIBC)
250-400 mcg/dL
| like stadium seating
44
Increased TIBC
iron deficiency anemia, pregnancy, viral hepatitis
45
Decreased TIBC
anemia of chronic disease, hemochromatosis
46
Transferrin Saturation
33% (=serum iron/TIBC)
47
Increased Transferrin Saturation
Megaolblastic anemia, iron overload states, hemochromatosis
48
Decreased Transferrin Saturation
Iron def anemia, chronic infection, malignancy
49
Albumin
50-60% of plasma proteins (most abundant)
| Synth in liver, functions as regulator of oncotic pressure
50
Increased albumin
dehydration
51
Decreased albumin
liver disease, malabsorption, abnormal loss
52
Prealbumin
A much better assessment of a patient's nutritional status because of shorter half-life and sensitivity to rapid changes.
53
Increased Prealbumin
pregnancy, Hodgkin's lymphoma
54
Decreased Prealbumin
Renal/liver disease, malnutrition, Crohn's disease, severe illness, inflammation or infection
55
Alpha-1-Antitrypsin
Inhibits the action of many key enzymes released during inflammatory reactions in the lung
56
Decreased Alpha-1-Antitrypsin
COPD before age 40
Prolonged jaundice
liver dysfunction
57
Ceruloplasmin
Acute phase reactant!
| Made in the liver, involved in copper transport w/in the body
58
Increased Ceruloplasmin
Infection
59
Decreased Ceruloplasmin
Wilson's disease, liver failure or hepatitis
60
Haptoglobin
Acute phase reactant! Produced in the liver and binds to free Hg when RBCs are destroyed
61
Decreased Haptoglobin
Hemolytic anemia, transfusion reaction, artificial heart valves
62
CH50
Total complement activity testing; decreased = decreased complement activity
63
C3 and C4 testing. Decreased
Systemic Lupus Erythematosus
| Bacterial infections
64
C3 and C4 testing increased
Cancer
65
IgA
found in secretions and along the mucosal epithelium; allows for clearance of pathogens by cilia or of toxins in the GI tract
66
IgA deficiency
can be asymptomatic or cause frequent resp infections, inflammation of GI tract
67
IgD
represents small % of immunoglobulins, exact function unknown
68
IgE
Allergic reactions!
69
IgG
Responsible for immunity to bacteria and other microorganisms. Lasts.
I already got Germs!
70
IgM
Initial antibody secreted after an immune challenge
I get Meds
71
CMP
Electrolyte function and abnormalities (Na, K, Chloride, CO2, anion gap, Ca)
Renal function (BUN, creatinine)
Liver function (bilirubin, alkaline phosphatase, AST, ALT)
Proteins (albumin, total protein)
Diabetes (glucose)
72
BMP
4-5 electrolytes, 2 tests of kidney function, 1 test of glucose
Does not include liver function tests
73
Hypernatremia
Unreplaced water loss; elderly patients with diminished thirst stimulation, patients given hypertonic saline solutions
74
Hyponatremia
Inadequate Na in IV fluids, thiazide diuretics!, renal insufficiency
75
Increased K+ cause
some drugs
76
Decreased K+ cause
fluid and electrolyte loss
| Diuretics
77
Hyperglycemia
Diabetes, acute stress response, pancreatitis, diuretics, corticosteroids
78
Hypoglycemia
Insulinoma, insulin overdose, starvation, hypothyroidism
79
Increased BUN
High protein diets, GI bleed, dehydration, medication
80
Decreased BUN
Liver disease/failure, overhydration, low protein diets
81
Creatinine
Excreted entirely by the kidneys, not affected by liver like BUN is.
82
Increased Creatinine
Disorders of renal function, urinary tract obstruction, rhabdo, gigantism
83
Decreased Creatinine
Debilitation, decreased muscle mass
84
Unconjugated (indirect) bilirubin
70-85% of total bilirubin
85
Indirect hyperbilirubinemia
Hepatocellular dysfunction, disease process that increases RBC destruction, medications
86
Conjugated (Direct) bilirubin
15-30% of total bilirubin
87
Direct hyperbilirubinemia
Obstructive; gallstones, obstruction of extrahepatic ducts by tumor, liver metastases
88
Direct hyperbilirubinemia
Obstructive; gallstones, obstruction of extrahepatic ducts by tumor, liver metastases
89
Hyperproteinemia causes
dehydration, malignancy, infection
90
Hypoproteinemia causes
Hepatic failure or disease, malnutrition, malabsorption, renal failure or disease
91
High Alkaline Phosphatase (ALP) levels
Cirrhosis, liver tumors
cancers that metastasize to the bone
Primary cancer of the bone
92
High Alkaline Phosphatase (ALP) levels
Cirrhosis, liver tumors
cancers that metastasize to the bone
Primary cancer of the bone
93
ALP
functions in growth and development of bones, teeth and other tissues
Present in Kupffer cells in liver and biliary tract
94
AST
aspartate aminotransferase
| evaluation of patient liver status
95
Increased AST
cell inflammation, injury and death
| liver diseases, tumors, mono
96
ALT
alanine aminotransferase - in jaundiced patients, elevation of ALT points to liver as source
97
Increased ALT
hepatotoxic drugs, cirrhosis, hepatitis
>3x normal is significant!
98
AST:ALT ratio >1
alcoholic cirrhosis>2
| metastatic tumor of the liver
99
AST:ALT ratio
acute/viral hepatitis, mononucleosis
100
BUN:creatinine ratio
normal 10:1 - 20:1
101
Pre-renal azotemia
>20:1
| results from abnormalities in systemic circulation that decrease blood flow to the kidneys
102
Intra-renal azotemia
103
Azotemia
Increase in nitrogen-containing compounds in the blood
104
Post-renal azotemia
early >20:1
| late
105
Creatinine Clearance - men
0.7-1.3 mg/dL
106
Creatinine Clearance - women
0.6-1.1 mg/dL
107
CKD stages based on GFR
```
Stage 1 >90
Stage 2 = 60-89
Stage 3 = 30-59
Stage 4 = 15-29
Stage 5
```
108
Mean plasma glucose
(35.6xHgbA1C) - 77.3
109
HgbA1C values
diagnosis of diabetes >6.5%
| poor control diabetes >8%
110
C-peptide in Diabetes
Type 1 = low
| Type 2 = normal or high
111
In evaluation of abdominal pain
Amylase and lipase test to screen for pancreatitis. Lipase rises later and sticks around longer than amylase.
112
Normal Uric Acid Levels
4.0-8.5 mg/dL
gout > 6.8 mg/dL
113
Natriuretic peptides
function to inhibit the reabsorption of Na in the renal tubule so that Na excretion in the urine increases
114
Types of natriuretic peptides
ANP = synth in atrial cardiomyocytes
BNP = initially identified in the brain
(^ released when ventricles stretch)
C-type = nervous system and endothelium
115
BNP
B/c strong correlation to L ventricular pressure, can be used to diagnose CHF fairly accurately.
Ischemia causes release of BNP in myocardial infarction
116
Time of onset & duration of cardiac enzymes
myoglobin: 3 hrs; early marker
CK-MB: 3-6 hrs, not elev. in all patients until 12 hrs, returns to baseline in 36-48hr
TROPONIN: 2-3 hrs, stays for 7-14 days
LDH: within 24-48 hrs, peak 2-3 days, normal in 5-10 days
117
Flipped LDH
LDH-2 is most abundant usually, except in MI when LDH-1 becomes more abundant.
118
Reason for ordering D-dimer
Intravascular clotting; DVT, PE
119
Total Cholesterol normal
120
Triglycerides
normal 500 mg/dL
121
HDL
Men desired > 60 mg/dL
at risk 60 mg/dL
at risk
122
LDL
ideal for those at risk = 70-100 mg/dL
near ideal = 100-130
borderline = 130-159
high > 160 mg/dL
123
BNP normal
500 probable CHF
124
Total Creatine Kinase
normal = 50-200 u/L
125
Troponin I and T
troponin I
126
D-dimer
normal
