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73 Cards in this Set
- Front
- Back
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LAB VALUES
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LAB VALUES
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What is a normal WBC?
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5000 - 10,000
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What are indications of an elevated WBC?
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infections, tissue necrosis, crush injuries, acute MI, inflammation disorders, myeloproliferative disorders (leukemia) CA, surgery, stress, DKA, meds (epi, cortocosteroids), eclampsia, uremia, collegen vascular disorders
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What are indications of decreased WBC?
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leukopenia if <4000. Overwhelming infection, sepsis, viral infections, HIV-AIDS, immunosupression, bone marrow suppression, anemias (aplastic, pernicious) meds (chemo, abx)
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What is the function of neutrophils?
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Most common PMN, produced in 7-14 days, and is phagocytosis killing bacterial microorganisms
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What is a "shift to the left" mean?
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Early immature forms of neutrophils (BANDS) enter circulation due to significantly stimulated production - maybe infection, etc.
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What are some indications of elevated neutrophils?
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Acute infection, inflammatory disorder, tissue destruction, hematologic disorders, meds (epi, corticosteroids, histamines, lithium) DKA, uremia, thyroid storm, hypoxia, eclampsia
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What are some indications of decreased neutrophils?
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AKA neutropenia. overwhelming infection, sepsis, viral, anemia, chemo, liver pathology (alcoholism)
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What are some indications of increased bands?
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bands are immature forms of segmented neutrophils. >5% = shift to left. Sepsis, infectious process, inflmmation, immediate post op, necrosis, metabolic acidosis, hypoxia, acute hemorrhage, trauma
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What is the % and absolute value for the following Differential counts:
Neutrophils Lymphocytes Monocytes Eosinophils Basophils |
Neutrophils: 55-70% 2500-8000
Lymphocytes: 20-40% 1000-4000 Monocytes: 2-8% 100-700 Eosinophils: 1-4% 50-500 Basophils: 0.5-1.0% 25-100 |
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What is the function of Lymphocytes?
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fight chronic bacterial infection and acute viral infections
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Name the 2 types of lymphocytes?
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T cells (mature in thymus) and B cells (mature in bone marrow)
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What is the function of T-cells?
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Fight cellular type immune reactions
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What is the function of B-cells?
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Involved in humoral immunity (antibody production)
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What are some indications of increased lymphocytes?
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viral infection (mono, hepatits, flu, MMR, CMV, herpes, TB, chronic lymphocytic leukemia
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What are some indications for reduced lymphocytes?
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Cushings, corticosteroid intake, chemo, radiation, epi, immunosupression, SLE, CA, renal failure, alcoholism, post op, sarcoid, zinc deficiency
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What is the purpose of monocytes?
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remove necrotic debris & microorganisms from blood thru phagocytosis. Produce interferon (body's endogenous immunostimulant
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What is the purpose of eosinophils? What are indications of increased eosinophils?
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respond to allergic disorders and parasitic diseases, fungal infections, collagen vascular disorders
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What is the purpose of basophils? What are indications of increased basophils?
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Respond to allergic, parasitic, fungal, collagen disorders. Leukemia, hodgkins, myeloproliferative disorders, chronic allergic reactions, urticaria, sarcoid, drug/food hypersinsitivity
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What is an elevated neutrophil count called and name some causes?
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Neutrophilia. Physical or emotional stress, acute suppurative infection, myelocytic leukemia, trauma, cushings, inflammatory disorders, metabolic disorders
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What is a decreased neutrophil count called and name some causes?
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Neutropenia. Aplastic anemia, dietary deficiency, overwhelming bacterial infection, viral infection, radiation, addisons, drug therapy (chemo)
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What is an increased lymphocyte called and name some causes?
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lymphocytosis. Chronic bacterial infection, viral infection, lymphocytic leukemia, multiple myeloma, infectious mono, radiation, infectious hepatits
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What is a decreased lymphcyte count called and name some causes?
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lymphoctyopenia. leukemia, sepsis, immunodeficiency diseases, lupus, drugs (adrenocorticosteroids) radiation
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What is an increased monocyte count called and name some causes?
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monocytosis. Chronic inflammatory disorders, viral increction, TB, chronic ulcerative colitis, parasites (malaria)
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What is a decreased monocyte count called and name some causes?
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Monocytopenia. Drug therapy, prednisone
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What is an increased eosinophil count called and name some causes?
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eosinophilia. Parasitic infections, allergic rxn, eczema, leukemia, autoimmune diseases
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What is a decreased eosinophil count called and name some causes?
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eosinopenia. Increased adrenosteroid production
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What is an increased basophil count called and name some causes?
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basophilia. Myeloproliferative diseases, leukemia
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What is a decreased basophil count called and name some causes?
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basopenia. Acute allergic rxn, hyperthyroidism, stress rxn's.
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What is an increased platelet count called and name some causes?
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thrombocytosis. CA, splenectomy, post op, polycythemia vera, chronic inflammation, acute hemorrhage, myeloproliferative disorders, iron deficiency
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What is a decreased platelet count called and name some causes?
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thrombocytopenia. hypersplenism, hemorrhage, immune thrombocytopenia, leukemia, graves disease, DIC, SLE, pernicious anemia, hemolytic anemia, chemo, infection
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What are the normal lab values for platelets?
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150,000-400,000
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What is a normal lab value for hematocrit
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Male: 42-52% or .42-.52
Femal: 37-47% or .37-.47 |
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What is an increased hematocrit indicative of?
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erythrocytosis, congenital heart disease, polycythemia vera, severe dehydration, COPD
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What is a decreased hematocrit indicative of?
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Anemia, hemoglobinopath, cirrhosis, hemolytic anemia, hemorrhage, dietary deficiency
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What is a normal lab value for sodium?
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136-145
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What is an increased sodium level called and what are some indications
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hypernatremia. Excess free H2O loss, inadequate free H20 intake, Excess Na+ gain, increased dietary intake, excessive sodium IV fluids
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What is a decrease in sodium called and name some indications?
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Hyponatremia. Cushings, hyperaldosteronism, Free body H20 loss: GI loss, sweating, burns, diabetes insipidus, osmotic diuresis
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What are some indications for hyponatremic hypo-osmolar/hypovolemic condition?
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decreased ECF, extrarenal, GI losses, burns, renal diuresis, adrenal insufficiency, addison's, hypoaldosteronism
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What are some indications for hyponatremic hypo-osmolar/hypervolemic conditions?
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increased ECF, CHF, renal failure, cirrhosis, liver failure, nephrosis, sepsis, pregnancy
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What are some indications for hyponatremic hypo-osmolar/euvolemic conditions?
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SIADH, H20 intoxication, hypothyroidism, myxedema, adrenal insufficiency, stress
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What are some indications for hyponatremic iso-osmolar conditions?
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pseudohyponatremia (hyperlipidemia, phyperproteinemia, multple myeloma) ethanol, bladder irrigation (TURP)
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What are some indications for hyponatremic hyperosmolar conditions?
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hyperglycemia, mannitol
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What are the normal lab values for potassium?
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3.5-5.0
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What is an increase level of potassium called and what are some indications?
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hyperkalemia. acidosis, tissue necrosis, crush, hemolysis, bl transfusion, GI bleed, renal failure, addisons, hypoaldosterone, decreased insulin, spironolactone, PCN, b-blockers
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What is a decrease in potassium called and what are some indications?
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hypokalemia: alkalosis, renal losses, diuretics, vomiting, hyperaldosteronism, GI obstruction, diarrhea, laxative abuse, licorice ingestion, ascites, cystic fibrosis, burns,
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What are normal lab values for BUN (blood urea nitrogen)?
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6-20 or 2.2-7.1
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What is an increase in BUN levels indicative of?
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Acute renal failure, prerenal, post renal or chronic renal failure
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What is a decreased level in BUN indicative of?
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overhydration, nephrotic syndrome, hepatic failure, protein malnutrition, low protein intake, low muscle mass, cachexia, malabsorption
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What is an increased creatinine level indicative of?
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Acute and chronic renal failure, rhabdomyolysis
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What is a decreased creatinine level indicative of?
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decreased muscle mass
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What are some causes of an increased BUN and prerenal failure
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volue depletion, dehydration, 3rd spacing, sepsis, diarrhea, vomiting, NG suction, hemorrhage, pancreatitis, fever, sweating
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What are some causes of an increased BUN and renal failure?
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low output state, sepsis, IV contrast, rhabdomyolysis, crush injury, extremity ischemia, transfusion rxn, glomerulonephritis, vascular pathology, myeloma
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What are some causes of an increased BUN and post renal failure?
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clogged foley, stones, blood clots, ligation, BPH, bladder/prostate CA
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What are some causes of an increased BUN and chronic renal failure?
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UGI bleed, high protein diets (PO, enteral, TPN)
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What are some causes for increased osmolality?
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dehydration, DKA, DM, hypernatremia, uremia, diabetes insipidus, toxins (ethanol, methanol, ethylene glycol) mannitol, diuretics, hypercalcemia
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What are some causes for decreased osmolality?
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Hyponatremia, SIADH (syndrome of inappropriate antidiuretic hormone) water toxication, overhydration, adrenocortical insufficiency
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What is a normal anion gap?
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5-15
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What are some indications for an increased anion gap?
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DKA, starvation, alcoholic, lactic acidosis, renal failure, Toxic ASA, methanol, ethylene glycol, or MUDPILES: methanol, uremia, DKA, paraldehyde, iron/isoniazide, lactic acidosis, ethylene glycol, salicylates
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What are some indications for a decreased anion gap?
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pseudohponatremia, hyperlipidemia, hyperporteinemia, multiple myeloma, bromide ingestion
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What is the name for increased levels of calcium and what are some indications?
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hypercalcemia. hyperparathyroidism (adenoma, hyperplasia, CA)thyrotoxicosis, adrenal insufficiency, immobility, pheochromocytoma, meds (thyazides, Vit. A or D toxicity, lithium) granulomatous disease (sarcoid, TB, fungal) S/P ARF, paget's
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What is the name for decreased levels of calcium and what are some indications?
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hypocalcemia. hypoparathyroidism, Vit D def, malabsorption, hepatic or renal failure, gastrectomy, anticonvulsants, hypoalbuminemia, pancreatits, decreased magnesium, alkalosis, loop diuretics
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What are some indications for increased levels of magnesium?
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renal failure, rhabdomyolysis, tumor lysis syndrome, burns, tissue trauma, DKA, severe acidosis, hypothyroidism, cathartic abuse, antacids, eclampsia, adrenal insufficiency
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What are some indications for decreased levels of magnesium?
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alcoholism, cirrhosis, diuretics, chronic diarrhea and fistulas, pancreatitis, malabsorption, NG drainage, vomiting, sepsis, osmotic diuresis, hyperaldosteronism, burns
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What are normal values for total billirubin?
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.2-1.5
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What are some indications for increased total billirubin?
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liver-billiary tract pathology (hepatitis, obstruction, stricture, CA,) CHF induced hepatic congestion, sepsis, TPN, meds (oral contraceptives, allopurinol, abx, steroids, sulfonamides,) infectious mono, liver failure, Gilbert's
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What are some indications for increased direct billirubin?
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conjugated, water soluble, present in urine. Obstructed, hepatitis, sepsis, TPN, billiary cirrhosis, alcoholic induced cirrhosis, Dubin Johnson syndrome, Rotor syndrome, Wilson's disease
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What are some indications for increased indirect billiruben?
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unconjugated. Hemolysis, transfusion rxn, sickle cell, hematoma reabsorption, hepatitis, cirrhosis, sepsis, CHF, CA, liver failure, Gilbert's, Crigler-Najjar
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What are some indications for increased PT
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>13-14 sec. Extrinsic pathway. Coumadin, Vit. K deficiency, Vit K. dependent factors - II, VII, IX, X, DIC factor deficiency VII, X, V, II, prothrombin, I-fibronogen, hepatocellure, biliary disease, excessive heparinization, ASA
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What are some indications for increased PTT?
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>35-40 seconds. Intrinsic pathway. Heparin, DIC, factor deficiency, von Willebrand, Hemophilia B/Christmas disease, hepatic biliary disease, Vit. K deficiency, circulating anticoagulants
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What are some indications for increased bleeding time
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>9-10 min. platelet dysfunction, meds, DIC, thrombocytopenia, von Willebrands disease, uremia, sever liver disease, myeloproliferative diseases, alcohol intxication, amyloidosis
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What might a +D Dimer indicate?
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acute PE, DVT, DIC, tPA, pregnant, CA
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What are normal ESR levels and what are some indications of elevated SED rate?
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15-20. Infections, inflammation, CA, collagen vascular disease, ulcerative colitis, crohns, glomerulonephritis, thyroid abnormalities, multiple myeloma, lymphoma, tissue necrosis, acute MI, subacute bacterial endocarditis
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