Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
68 Cards in this Set
- Front
- 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?
|
Malignancy.
(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?
|
Concentrated
|
|
A ↓ Specific Gravity is urine that is more dilute or concentrated?
|
Diulte
|
|
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?
|
FVC
|