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84 Cards in this Set

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