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84 Cards in this Set
- Front
- Back
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Urinanalysis
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never routine
dx. renal dz. dx. urinary tract dz. monitor renal/urinary dz. dx. metabolic dz. tagged c something |
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Reasons for blood test
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establish dx
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Blood Fasting Collections
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8hr
12hr |
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Large Sensitivity
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- test rule out dz.
Sn N out |
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Large Specificity
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+ test can rule in dz.
Sp P in |
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ESR
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inflammation (ESR will drop before inflammation is out)
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Hb
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O2 carrying component
1/3 of cells volume RBC x 3 = Hb |
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RBC's
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indirect measure of Hb
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HCT
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% of red cell mass
indirect estimate of RBC's in blood volume Hb x 3 = HCT |
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MCV
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size
HCT x 10/RBC = MCV |
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MCH
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quantity of Hb in average cell
Hb x 10/RBC = MCH |
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MCHC
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color
concentration of Hb in average cell Hb x 100/HCT = MCHC |
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RBC Distribution Width (RDW)
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never goes down
increase c factor deficiency EN c thalassemia minor EN c chronic dz. increase c IDA |
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anemia
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decrease Hb conc.
decrease RBC count |
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Pathogenesis of Anemia
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Factor Deficiency
Production Deficit Depletion |
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Factor Deficiency Anemia
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change in size (MCV)and color (MCHC)
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Microcytosis
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decrease MCV
decrease MCHC m/c cause IDA |
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Macrocytosis
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deficit in B12/folic acid
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megaloblastic anemia
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m/c b12 deficit (hypersegmented neutrophils)
folic acid deficiency |
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schilling test
stage 1 stage 2 |
differentiate between B12/intrinsic factor
stage 1 - c out intrinsic factor (abnormal lack of intrinsic factor) stage 2 - c intrinsic factor (malabsorption abnormal stage 1 & 2) |
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production deficit anemia
2 causes |
normocytic/normochromic
hypoplastic bone marrow systemic dz. |
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Hb %
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HbA - 98
HbF - <2 HbA1 - 98 HbA2 - 1-2 |
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Sickle Cell
trait (minor) |
8%
HbS - 20-40 HbA1 - 60-80 HbA2 - 2-3 HbF - 2 |
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Sickle Cell
disease |
1%
HbS - >80 HbA1 - 0 HbA2 - 2-3 HbF - 2 |
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Thalassemia
Minor (trait) |
HbA1 - 50-85
HbA2 - 4-6 HbF - 1-3 RBC EN RDW EN MCV decreased MCHC decreased |
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Thalassemai
Major (dz.) |
HbA1 - 5-20
HbA2 - 2-3 HbF - >65 microcytosis, hypochromic c target cells (sideroblasts) |
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Normocytic Normochromic Anemia
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IDA
Chronic Illness Acute Blood Loss Aplastic Anemia Acquired Hemolytic Anemia |
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Microcytic Hypochromic
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decrease MCV
decrease MCHC IDA Thalassemia Lead Poisoning |
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Microcytic Normochromic
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decreased MCV
renal dz. |
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Macrocytic Normochromic
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increase MCV
B12 or folate chemotherapy |
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increase MCV
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B12 deficiency
folic acid deficiency alcoholism chronic liver dz. |
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decrease MCV
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IDA
thalassemia anemia of chronic dz. |
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increase MCH
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macrocytic anemia
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decrease MCH
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microcytic anemia
hypochromic anemia |
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increase MCHC
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spherocytosis
intravascular hemolysis cold agglutinins |
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decrease MCHC
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IDA
thalassemia |
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increase RDW
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IDA
B12 or folate hemoglobinopathies (sickle cell) hemolytic anemia posthemorrhagic anemia |
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WBC elevation
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INFLAMMATION
infection neoplasia immunosuppression |
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Leukocytosis
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WBC increase
inflammation bacterial infx |
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Leukopenia
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WBC decrease
viral infx. bone marrow decrease |
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Neutrophils (PMN)
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50-70%
fx. by phagocytosis bacterial infx. any inflammation |
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lymphocytes
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20-40%
agranulocyte increase c viral dz. decrease # of granulocytes |
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monocytes
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0-8%
increase c SBE disseminated TB typhoid some lymphomas |
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eosinophils
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0-3%
histamine rx. increase c allergic response ex. allergy, parasite |
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basophils
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0-1%
increase c myeloproliferative even if increase of 3% not good |
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white count EN/PMN increase
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inflammation
bacterial infx. |
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leukopenia/lymphocytosis
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viral infx
immunity exception is mononucleosis |
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Infectious Mononucleosis
ratio of lymphocyte to WBC cout |
.35 is mononucleosis 100% of the time
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Acute Leukemia
total white count predominant cell prognosis bone marrow |
high but low (40,00-50,000)
immature cell 5yr = 0% 1yr = 10% 25%+ immature cells |
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Chronic Leukemia
total white count predominant cell prognosis |
125,000-150,000
mature 5yr = 60% |
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Acute Lymphocytic Leukemia
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children
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Acute Myelogenous Leukemia
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elderly
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Chronic Lymphocytic Leukemia
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elderly (>50yrs)
male 2:1 |
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Chronic Myelogenous Leukemia
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20-50 yrs
20% of all leukemias associated c Ph chromosome |
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Polycythemia (3 types)
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increase in blood cell mass
vera - all cell increase relative - dehydration secondary - hypoxia |
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dark red urine
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kidney bleeding
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bright red urine
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lower urinary bleeding
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dark yellow
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urobilinogen or bilirubin
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green
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pseudomonas
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colorless
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glycosuria
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cloudy
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pus
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sweet smell
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ketones
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foul smell
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UTI
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stool smell
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enterovesical fistula
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burnt sugar
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maple sugar
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musty urine smell
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phenylketonuria
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urine ph
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5.5 - 8.0
reflection of body normalization |
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increase urine ph
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alkalemia
UTI crystal ending in -ate vomitting renal tubular acidosis |
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decrease urine ph
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acidemia
diabetes mellitus starvation COPD respiratory acidosis uric acid crystals |
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protein in urine
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should be 0
other than - is abnormal |
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increase protein in urine
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nephrotic syndrome
glomerulonephritis malignant hypertension amyloidosis preeclampsia CHF orthostatic proteinuria |
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specific gravity
range increase decrease |
concentrating ability of kidney
range (1.010- 1.040) increase - dehydration decrease - less concentrating ability |
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increase specific gravity
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dehydration
pituitary tumor decrease renal blood flow glycosuria proteinuria fever excess sweating vomitting diarrhea |
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decrease specific gravity
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overhydration
diabetes insipidus renal failure diuresis |
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glucose in urine
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should be 0
if + renal threshold is reached may be present if passing a stone |
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Nitrite in urine
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+ when UTI
- due to inactivation |
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WBC esterase
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usually -
enzyme liberated when WBC broken down + possible UTI |
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Ketones in urine
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product of fat metabolism
+ starvation diabetes alcoholism weight reduction hyperthyroid fasting increase protein diet |
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bilirubin in urine
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sample is brown
+ gall stones liver metastasis extrahepatic duct obstruction |
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SI
TIBC |
serum iron
total iron binding capacity |
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decrease SI
decrease TIBC |
chronic dz
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decrease SI
increase TIBC |
chronic IDA
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increase SI
decrease TIBC |
hemachromatosis
iron therapy overload |
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increase SI
increase TIBC |
oral contraceptives
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