Diagnostic Studies

Front 1

What is the indication for Stool occult blood?

Back 1

Yearly screen >45y/o

Front 2

What is the indication for Serum potassium?

Back 2

Yearly in pts on diuretics or K supplements (incases of some cardiac arrythmias)

Front 3

What is the indication for Liver enzyme levels?

Back 3

Monitoring pt on hepatotoxic drugs, establish baseline values

Front 4

What is the indication for Serum amylase?

Back 4

Abdominal pain, suspect pancreatitis

Front 5

What is the indication for TSH?

Back 5

Suspicion of hypo/hyperthroidism, or thyroid dysfunction, >50yrs

Front 6

What is the indication for Chlamydia & gonorrhea?

Back 6

Sexually active pts w/multiple partners, to monitor for pelvic inflammatory dz

Front 7

What is the indication for Pap smear?

Back 7

Yearly for all women =/>18yrs, more often w/high-risk factors(dysplasia, HIV, herpes) Now checks for HPV, Chlamydia & gonorrhea, using DNA

Front 8

What is the indication for Urine culture?

Back 8

Pyuria (Pus in the urine; ↑ WBC in urine)

Front 9

What is the indication for Syphilis serum fluorescent treponemal antibody (FTA) test?

Back 9

Postive rapid plasma reagin (RPR) test result

Front 10

What is the indication for PPD?

Back 10

Easiest test to use for TB screening of individuals <35yrs or those w/hx of neg PPD, for persons in resident homes.

Front 11

What is the indication for fasting blood glucose (FBG)?

Back 11

Every 3yrs starting at 45yrs, monitor DM control

Front 12

What is the indication for UA?

Back 12

Sx or hx of recurrent urinary tract dz; pregnant women, men w/prostatic hypertrophy

Front 13

What is the indication for PT?

Back 13

Monitoring anticoagulant tx

Front 14

What is the indication for PSA?

Back 14

Screen men =/>50yrs for prostate CA yearly

Front 15

What is the indication for CXR?

Back 15

Monitor for lung lesions & infiltrates, CHF, anatomic deformities, postrauma, before surgery, f/u for + PPD, & monitor tx.

Front 16

What is the indication for Mammogram?

Back 16

Screen by 40yrs, then q 12-18mos (for 40-49), annually =/>50yrs, f/u for hx & tx of breast CA, routine screening when strong family hx of breast CA.

Front 17

What is the indication for Colon X-ray & proctosigmoidoscopy?

Back 17

Screen adults for colon CA beginning at 45yrs, f/u for presence of hemoglobin or guaiac + stools, polyps, diverticulosis

Front 18

What is the indication for CT scans?

Back 18

Before & p tx for cerain CAs, injuries, illness (suspected TIA, CVA, & diagnostic eval of certain S/Sx

Front 19

What is the indication for DNA testing of hair, blood, skin tissue, or semen samples?

Back 19

To gather postmertem evidence, in certain criminal cases, to establish identity & parentage.

Front 20

What tests should be ordered for a pt w/COPD?

Back 20

EKG to check hrt function & r/o hrt dz.
CXR to look for lung ▲s.
PFT & spirometry for lung volume & air flow.
Pulse ox to measure O2 in blood.
Exercise testing to determine if the O2 level drops during excerise.

Front 21

What tests would be ran for TB?

Back 21

PPD >10mm induration is +, CXR-active dx or reactivation,
AFB-acid fast bacilli on smear (from deep in lungs), Bronchoscopy w/biopsy, Thoracentesis of pleural fluid (WCB, pH, histologic eval & culture)

Front 22

What is aplastic anemia

Back 22

The marrow is suppresed (drugs, viruses , radiation or autoimmune processes), = less RBCs.

Front 23

What stimulates the production of red blood cells?

Back 23

Erythropoetin (secreted by the kidneys), erythropoetin production is stimulated by ↓ oxygenation of the blood.

Front 24

What does the O2 carrying capacity of the blood depend on?

Back 24

O2 supply, # of red blood cells, & health of the red blood cells (ability of RBC to function).

Front 25

What is megaloblastic anemia?

Back 25

Caused by a deficiency of B12 or folic acid, RBCs are large, fragile & short lived.

Front 26

What are ↓ hematocrit values a indicator of?

Back 26

Anemia, a hematocrit of ≤30 means that the pt is moderately to severely anemic.

Front 27

Explain how Folate & B12 deficiency effect the RBCs;

Back 27

If there is inadequate amts, the RBCs do not form properly & are released prematurely while they are still big this leads to macrocytic anemia.

Front 28

What is hematopoiesis?

Back 28

The formation of new blood elements.

Front 29

What is Iron Deficiency Anemia?

Back 29

Iron is necessary for hemoglobin production & function, w/loss of hemoglobin, cells become pale & small.

Front 30

Explain how pernicious anemia affects RBCs;

Back 30

Autoantibodies are produced against parietal cells, causing a ↓ in the production of intrinsic factor, which results in loss of B12 absorption.

Front 31

Explain how Intrinsic factor aids in the absorption of B12;

Back 31

It combines w/B12 protecting it from gastric digestion, & facilitates its transport across the intestinal mucosal membrane.

Front 32

Explain how a deficiency in transferin can lead to Iron deficiency anemia;

Back 32

Iron is transported in the blood by transferin (plasma protein) to ferritin to be stored. If there is a deficiency in transfein the iron cannot be transfered to ferritin to be stored.

Front 33

What causes a increase in Amylase levels & how long does it take for the levels to rise?

Back 33

Inflammation of the Pancreas or salivary glands.
2-6hrs after onset of pain.

Front 34

What causes a increase in Lipase levels?

Back 34

Damage to the pancreas, cholecytitis, severe renal dz, impacted bowel & peritonitis.

Front 35

How long does it take for Lipase levels to rise?

Back 35

24-36hrs after onset of illness (after the amylase levels start to return to normal) Remain elevated up to 14days.

Front 36

What causes Amonia (NH3) levels to rise?

Back 36

GI/Hepatic conditions, cirrhosis, acute hepatitis & GI hemorrage.

Front 37

What chronic dzs are Amonia (NH3) levels used to evaluate?

Back 37

Progress of severe liver dz & response to tx.

Front 38

Why would a Albumin level be low?

Back 38

Cirrhosis, hepatitis & liver dz.

Front 39

Why would a Globulin level be ↑?

Back 39

Liver dz & ETOH abuse

Front 40

Why would a Alkaline Phosphatase level be ↑?

Back 40

GI/Hepatic disorders; Obstructive jaundice, Liver CA, Hepatocellular cirrhosis, Biliary cirrhosis, Hepatitis, Cholestasis.

Front 41

What is cirrhosis?

Back 41

Chronic liver disease characterized pathologically by liver scarring with loss of normal hepatic architecture and areas of ineffective regeneration. There is a loss of functioning liver cells and increased resistance to blood flow through the liver.

Front 42

Why would bilirubin levels be ↑?

Back 42

Either excessive destrution of RBCs (hemolytic), or the liver is unable to excrete the bilirubin (obstruction).

Front 43

What dzs would cause ↑ bilirubin levels?

Back 43

Hepatitis, & cirrhosis (hepatocellular damage), Stones & Neoplasms (Obstructive), Hemolytic disorders.

Front 44

What test is used to detect Hep A?

Back 44

anti-HAV (HAV-ab) detects IgM antibodies w/in the 1st 2 wks of dz & remain present for up to 6mos.
IgG antibodies replace IgM antibodies & remain for life.

Front 45

What states of the dz can the anti-HAV detect?

Back 45

Previous exposure, noninfectivity, & immunity to hep A infection.

Front 46

What is Hep A virus?

Back 46

RNA virus, contracted through contaminated water or food, incubation period is 2-6 wks,acute stage lasts 2-12 wks, complete recovery takes wks-mos, doesn't produce a carrier state and doesn't cause chronic hepatitis.

Front 47

What does (HbsAg) hepatitis B surface antigen detect?

Back 47

Evidence of active HBV infection, Hep B surface antigen usually appears 4-6wks p infection. (seen 1st, may be + before clincal sx appear)

Front 48

What does hepatitis B core antibody (Anti-HBc) detect?

Back 48

(appears shortly p the HbsAg is detectabele) Is the most reliable test to detect Hep B, IgM anti-HBc may remain present for life.

Front 49

What does Hepatitis B e Antigen (HBeAg) detect?

Back 49

Usually present for only 3-6wks, is one of the 1st indicators of ↑ viral replication & infectivity.

Front 50

What tests confirm chronic (life-long) infection of Hep C?

Back 50

Hep C anti-body, Hep C genotype (genetic marker of virus; 6 different ones) Hep C RNA quantitative (amt) or qualitative (+or-), Liver Panel.

Front 51

What would cause a ↑ BUN (blood urea nitrogen)?

Back 51

Impaired fenal function, Excessive protein intake, CHF, Na+ & H2O depletion, Shock, Hemorrhage into the GI tract, MI, Stress.

Front 52

What types on anemia cause a ↓ RBC count?

Back 52

Anemia associated w/cell production & destruction, blood loss, dietary insufficiency of iron & B12.

Front 53

What diseases cause RBC count to ↓?

Back 53

Hodkin's dz, Multiple myeloma, Leukemia, Lupus, Addison's dz, Rheumatic fever, Subacute fever, Subacute endocarditis.

Front 54

What diseases cause RBC count to ↑?

Back 54

Polycythemia vera, ↑ Bone marrow production, Renal dz, Extrarenal tumors, High altitude, Pulmonary dz, Cardiovascular dz, Tabacco/carboxyhemoglobin, Dehydration.

Front 55

What could be a cause of ↑ in platelets?

Back 55

Malignancy.
(Assess for bleeding due to abnormal platelet function)
Count ↑ in high altitudes, p strenuous excerise, & in winter.

Front 56

What could a ↓ in platelets indicate?

Back 56

Spontaneous bleeding, prolonged bleeding times, petchiae & ecchymosis. (Count ↓ before winter)

Front 57

What causes a ↓ in Specific Gravity results?

Back 57

(hyposthenuria)Diabetes insipidus (↑ urine volume), Glomerulonephritis & Phelonephritis (tubular damage affects the ability to concentrate urine), Severe renal damage (disturbs concentrating & diluting abilities)

Front 58

What causes a ↑ in Specific Gravity results?

Back 58

(hypersthenuria)DM, Nephrosis, Excessive H2O loss (dehydration, fever, vomiting, diarrhea), ↑ secretion of ADH, diuretic effects, CHF, Toxemia of pregnancy.

Front 59

A ↑ Specific Gravity is urine that is more dilute or concentrated?

Back 59

Concentrated

Front 60

A ↓ Specific Gravity is urine that is more dilute or concentrated?

Back 60

Diulte

Front 61

What does a normal CXR show?

Back 61

Normal-appearing & normally positioned chest, bony thorax (all bones, present, aligned, symmetrical & normally shaped), soft tissues, mediastinum, lungs, pleura, heart, & aoritc arch.

Front 62

Explain why urine becomes acidic?

Back 62

Amounts of Na+ & excess acid retained by the body ↑.

Front 63

Expalain why urine becomes alkaliotic?

Back 63

Contains bicarbonate-carbonic acid buffer, when there is an excess of base or alkali in the body.

Front 64

If a pt has acidotic urine what dzs should be considered?

Back 64

Metabolic acidosis, diabetic ketosis, diarrhea, starvation, uremia, UTIs caused by Escherichia coli, Respiratory acidosis (CO2 retention), Renal TB, Pyrexia.

Front 65

If a pt has alkalotic urine what dzs should be considered?

Back 65

UTIs caused by urea-splitting bacteris (Proteus & pseudomonas), Renal tubular acidosis, chronic renal failure, Metabolic acidosis (vomiting), Respriatory alkalosis involving hyperventilation ("blowing off" CO2), K depletion.

Front 66

What causes Impetigo?

Back 66

Strep, Staph or both.

Front 67

If a pt has a UTI what might the urine dip reveal?

Back 67

Leukocytes & Nitrates, it + send out for C&S.

Front 68

What does a Peak Flow Meter measure?

Back 68

FVC