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68 Cards in this Set

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  • Back
What is the indication for Stool occult blood?
Yearly screen >45y/o
What is the indication for Serum potassium?
Yearly in pts on diuretics or K supplements (incases of some cardiac arrythmias)
What is the indication for Liver enzyme levels?
Monitoring pt on hepatotoxic drugs, establish baseline values
What is the indication for Serum amylase?
Abdominal pain, suspect pancreatitis
What is the indication for TSH?
Suspicion of hypo/hyperthroidism, or thyroid dysfunction, >50yrs
What is the indication for Chlamydia & gonorrhea?
Sexually active pts w/multiple partners, to monitor for pelvic inflammatory dz
What is the indication for Pap smear?
Yearly for all women =/>18yrs, more often w/high-risk factors(dysplasia, HIV, herpes) Now checks for HPV, Chlamydia & gonorrhea, using DNA
What is the indication for Urine culture?
Pyuria (Pus in the urine; ↑ WBC in urine)
What is the indication for Syphilis serum fluorescent treponemal antibody (FTA) test?
Postive rapid plasma reagin (RPR) test result
What is the indication for PPD?
Easiest test to use for TB screening of individuals <35yrs or those w/hx of neg PPD, for persons in resident homes.
What is the indication for fasting blood glucose (FBG)?
Every 3yrs starting at 45yrs, monitor DM control
What is the indication for UA?
Sx or hx of recurrent urinary tract dz; pregnant women, men w/prostatic hypertrophy
What is the indication for PT?
Monitoring anticoagulant tx
What is the indication for PSA?
Screen men =/>50yrs for prostate CA yearly
What is the indication for CXR?
Monitor for lung lesions & infiltrates, CHF, anatomic deformities, postrauma, before surgery, f/u for + PPD, & monitor tx.
What is the indication for Mammogram?
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.
What is the indication for Colon X-ray & proctosigmoidoscopy?
Screen adults for colon CA beginning at 45yrs, f/u for presence of hemoglobin or guaiac + stools, polyps, diverticulosis
What is the indication for CT scans?
Before & p tx for cerain CAs, injuries, illness (suspected TIA, CVA, & diagnostic eval of certain S/Sx
What is the indication for DNA testing of hair, blood, skin tissue, or semen samples?
To gather postmertem evidence, in certain criminal cases, to establish identity & parentage.
What tests should be ordered for a pt w/COPD?
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.
What tests would be ran for TB?
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)
What is aplastic anemia
The marrow is suppresed (drugs, viruses , radiation or autoimmune processes), = less RBCs.
What stimulates the production of red blood cells?
Erythropoetin (secreted by the kidneys), erythropoetin production is stimulated by ↓ oxygenation of the blood.
What does the O2 carrying capacity of the blood depend on?
O2 supply, # of red blood cells, & health of the red blood cells (ability of RBC to function).
What is megaloblastic anemia?
Caused by a deficiency of B12 or folic acid, RBCs are large, fragile & short lived.
What are ↓ hematocrit values a indicator of?
Anemia, a hematocrit of ≤30 means that the pt is moderately to severely anemic.
Explain how Folate & B12 deficiency effect the RBCs;
If there is inadequate amts, the RBCs do not form properly & are released prematurely while they are still big this leads to macrocytic anemia.
What is hematopoiesis?
The formation of new blood elements.
What is Iron Deficiency Anemia?
Iron is necessary for hemoglobin production & function, w/loss of hemoglobin, cells become pale & small.
Explain how pernicious anemia affects RBCs;
Autoantibodies are produced against parietal cells, causing a ↓ in the production of intrinsic factor, which results in loss of B12 absorption.
Explain how Intrinsic factor aids in the absorption of B12;
It combines w/B12 protecting it from gastric digestion, & facilitates its transport across the intestinal mucosal membrane.
Explain how a deficiency in transferin can lead to Iron deficiency anemia;
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.
What causes a increase in Amylase levels & how long does it take for the levels to rise?
Inflammation of the Pancreas or salivary glands.
2-6hrs after onset of pain.
What causes a increase in Lipase levels?
Damage to the pancreas, cholecytitis, severe renal dz, impacted bowel & peritonitis.
How long does it take for Lipase levels to rise?
24-36hrs after onset of illness (after the amylase levels start to return to normal) Remain elevated up to 14days.
What causes Amonia (NH3) levels to rise?
GI/Hepatic conditions, cirrhosis, acute hepatitis & GI hemorrage.
What chronic dzs are Amonia (NH3) levels used to evaluate?
Progress of severe liver dz & response to tx.
Why would a Albumin level be low?
Cirrhosis, hepatitis & liver dz.
Why would a Globulin level be ↑?
Liver dz & ETOH abuse
Why would a Alkaline Phosphatase level be ↑?
GI/Hepatic disorders; Obstructive jaundice, Liver CA, Hepatocellular cirrhosis, Biliary cirrhosis, Hepatitis, Cholestasis.
What is cirrhosis?
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.
Why would bilirubin levels be ↑?
Either excessive destrution of RBCs (hemolytic), or the liver is unable to excrete the bilirubin (obstruction).
What dzs would cause ↑ bilirubin levels?
Hepatitis, & cirrhosis (hepatocellular damage), Stones & Neoplasms (Obstructive), Hemolytic disorders.
What test is used to detect Hep A?
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.
What states of the dz can the anti-HAV detect?
Previous exposure, noninfectivity, & immunity to hep A infection.
What is Hep A virus?
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.
What does (HbsAg) hepatitis B surface antigen detect?
Evidence of active HBV infection, Hep B surface antigen usually appears 4-6wks p infection. (seen 1st, may be + before clincal sx appear)
What does hepatitis B core antibody (Anti-HBc) detect?
(appears shortly p the HbsAg is detectabele) Is the most reliable test to detect Hep B, IgM anti-HBc may remain present for life.
What does Hepatitis B e Antigen (HBeAg) detect?
Usually present for only 3-6wks, is one of the 1st indicators of ↑ viral replication & infectivity.
What tests confirm chronic (life-long) infection of Hep C?
Hep C anti-body, Hep C genotype (genetic marker of virus; 6 different ones) Hep C RNA quantitative (amt) or qualitative (+or-), Liver Panel.
What would cause a ↑ BUN (blood urea nitrogen)?
Impaired fenal function, Excessive protein intake, CHF, Na+ & H2O depletion, Shock, Hemorrhage into the GI tract, MI, Stress.
What types on anemia cause a ↓ RBC count?
Anemia associated w/cell production & destruction, blood loss, dietary insufficiency of iron & B12.
What diseases cause RBC count to ↓?
Hodkin's dz, Multiple myeloma, Leukemia, Lupus, Addison's dz, Rheumatic fever, Subacute fever, Subacute endocarditis.
What diseases cause RBC count to ↑?
Polycythemia vera, ↑ Bone marrow production, Renal dz, Extrarenal tumors, High altitude, Pulmonary dz, Cardiovascular dz, Tabacco/carboxyhemoglobin, Dehydration.
What could be a cause of ↑ in platelets?
(Assess for bleeding due to abnormal platelet function)
Count ↑ in high altitudes, p strenuous excerise, & in winter.
What could a ↓ in platelets indicate?
Spontaneous bleeding, prolonged bleeding times, petchiae & ecchymosis. (Count ↓ before winter)
What causes a ↓ in Specific Gravity results?
(hyposthenuria)Diabetes insipidus (↑ urine volume), Glomerulonephritis & Phelonephritis (tubular damage affects the ability to concentrate urine), Severe renal damage (disturbs concentrating & diluting abilities)
What causes a ↑ in Specific Gravity results?
(hypersthenuria)DM, Nephrosis, Excessive H2O loss (dehydration, fever, vomiting, diarrhea), ↑ secretion of ADH, diuretic effects, CHF, Toxemia of pregnancy.
A ↑ Specific Gravity is urine that is more dilute or concentrated?
A ↓ Specific Gravity is urine that is more dilute or concentrated?
What does a normal CXR show?
Normal-appearing & normally positioned chest, bony thorax (all bones, present, aligned, symmetrical & normally shaped), soft tissues, mediastinum, lungs, pleura, heart, & aoritc arch.
Explain why urine becomes acidic?
Amounts of Na+ & excess acid retained by the body ↑.
Expalain why urine becomes alkaliotic?
Contains bicarbonate-carbonic acid buffer, when there is an excess of base or alkali in the body.
If a pt has acidotic urine what dzs should be considered?
Metabolic acidosis, diabetic ketosis, diarrhea, starvation, uremia, UTIs caused by Escherichia coli, Respiratory acidosis (CO2 retention), Renal TB, Pyrexia.
If a pt has alkalotic urine what dzs should be considered?
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.
What causes Impetigo?
Strep, Staph or both.
If a pt has a UTI what might the urine dip reveal?
Leukocytes & Nitrates, it + send out for C&S.
What does a Peak Flow Meter measure?