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106 Cards in this Set

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  • Back
blood test that provides information on liver and kidney function as well as electrolytes
CMP
What test is good for monitoring and diagnosing DM?
glucose
What two parameters for blood sugars signify a diagnosis of DM?
fasting >126 and two hours after glucose load >200
what four components within the CMP make up the electrolyte panel?
K+, Na+, Cl, CO2
Which four components of the CMP tell about liver function?
ALT, AST, ALP, Bilirubin
What does creatinine tell you about a patient?
it diagnosis impaired renal function, and is a catabolic product of creatine phosphate from skeletal muscle.
Liver problems do not affect BUN. True or False

Total Protein is a combination of?
False, liver problems can minimally affect BUN

GAP-Globulins, Albumin, Prealbumin
where is albumin formed? and what does it do?
in the liver and it makes up 60% of the total protein, albumin's main purpose is to maintain colloidal osmotic pressure in the blood.
Increased albumin levels can mean...

Decreased albumin levels can mean...
patient is dehydrated

liver disease, hepatitis, cirrhosis, hepatocellular necrosis and malnutrition
which lab finding is used to evaluate & monitor fluid and electrolyte balance and therapy?
Sodium (Na+)
Which lab finding within the CMP is especially important for persons taking diuretics and heart medications?
Potassium (K+)
Which electrolyte is important in maintaining membrane electrical potential ie neuromuscular cells.
K+
Which serum electrolyte is a major extracellular anion, serves as a buffer to assist in acid base balance and affects water balance?
Chloride
What can an increased chloride level mean?
Dehydration
Increased levels of CO2 signify ...

What can a decreased chloride level mean?
metabolic acidosis, ketoacidosis

overhydration
If a pt presents with jaundice and you order a CMP and it comes back with normal ALT, what could be going on with this pt?
RBC hemolysis
If the same patient has a elevated ALT and jaundice, what could it signify?
hepatitis, hepatic necrosis, liver failure
Used to monitor and identify hepatocellular diseases.
ALT alanine aminotransferase
Used in the evaluation of suspected coronary artery occlusion and or hepatocellular disease.
AST aspartate aminotransferase
This enzyme is found in highly metabolic tissue like heart tissue, liver cells and skeletal muscle.
AST apartate aminotransferase
The higher the level of AST in the blood the greater amount of _______________________.
damage has been done to cells.
used to evaluate hemolytic anemias in adults and jaundice in neonates
bilirubin
used to detect and monitor diseases of the liver and the bone and is increased in intra and extrahepatic disorders
ALP alkaline phosphatase
Most sensitive test for Liver Cancer
ALP alkaline phosphatase
increased ALP can be caused by:
primary cirrhosis, biliary obstruction, primary or metastatic liver tumor, childhood and fracture repair
WHich two test are used to detect inflammation? Which one is more specific?
Erythrocyte Sedimentation rate (ESR) and C-reactive protein (CRP). CRP is more specific.
Which one of the CRP or the ESR is believed to be of value in predicting coronary events?
CRP is also used in evaluating a pt with a MI
AN acute phase protein used to indicate an inflammatory illness?
CRP
A nonspecific test used to detect acute and chronic inflammation
ESR-sometimes not elevated in the face of active disease.
what process of collecting urine would be appropriate for an uncomplicated (no fever) UTI?
midstream clean catch
Red cell clasts in the urine sediment are associated with what pathologic process?
Glomerulonephritis
A urine specific gravity of 1.001 (normal 1.005-1.025) indicates what condition?
concentrated urine, dehydration
using a urine sample, what finding in the urine would signal kidney damage the most?
proteinuria
Urinary sediment containing calcium oxalate and uric acid crystals might signal?
Renal stone formation
what lab test can differentiate between jaundice and RBC hemolysis?
ALT
A patient on diuretics needs to have what electrolyte measured often?
Potassium (K+)
What lab test can monitor hyperparathyroidism, renal failure and or renal transplant?
Calcium
Name two non-specific lab test indicators for infection:
CRP and ESR
define cretinism and its common physical presentations:
cretinism-severe hypothyroidism causing under development and possible mental retardation and goiter.
thyroiditis and hypothyroidism occurs when the TSH is low or high?
high
High levels of T4 can also be a seen with acute thyroiditis. T or F
True
Hypothyroidism occurs when the T4 level is increased or decreased
decreased
which test measures the average amount of glucose in the blood in the previous 3-4 months?
A1c (HbA1c)
post splenectomy patients are more apt to have increased or decreased A1c's?
increased
name the systolic murmurs:
-Congenital pulmonic stenosis, -Congenital aortic stenosis, -Innocent murmurs,
-Mitral regurgitation (insufficiency),
-Tricuspid regurgitation. (insufficiency),
-Ventricular septal defect
name the diastolic murmurs:
-mitral stenosis and

-aortic regurgitation
What is a Systolic murmurs:
systolic murmur - a heart murmur that occurs during a heart muscle contraction. Systolic murmurs are divided into ejection murmurs (due to blood flow through a narrowed vessel or irregular valve) and regurgitant murmurs.
What is a diastolic murmur:
diastolic murmur - a heart murmur that occurs during heart muscle relaxation between beats. Diastolic murmurs are due to a narrowing (stenosis) of the mitral or tricuspid valves, or regurgitation of the aortic or pulmonary valves.
An abnormal heart sound (murmur) resulting from pulmonary or aortic congestion:
systolic murmur
audible systolic murmur heard best in the 2nd right ICS and often radiates to the carotids:
aortic stenosis
a diastolic rumbling murmur heard best at the apex and after pt is positioned on their left lateral decubitus position?
aortic regurgitation
leaning forward and exhaling while listening at the 2nd RICS would make which murmur louder?
MItral
What is happening during S2?
aortic valves are closing
What is happening during S1?
Mitral valve closes
Which heart sound is heard best at the base of the heart?
S2
Lying in the lateral decubitus position accentuates what type of murmur?
Mitral Murmurs
holosystolic murmur occurs:
begins with S1 and is continuos until the end of S2
a holosystolic murmur that can be heard at the apex and radiates to the left axilla:
mitral regurgitation
a diastolic mumur that has a decrescendo, low-pitched rumble heard best with the bell:
mitral stenosis
S3 and S4 are heard best with the bell or diaphragm?
bell
hematocrit is used in evaluating what:
Circulating RBC's by %
test used to measure the total blood volume that is made up of RBC's?
(MCV) Mean Corpuscular Volume
If hemoglobin is 15, then hematocrit would be__________________?
45% (#x3)
test used to measure if bone marrow is functioning in a response to an anemia?
Reticulocyte count
When MCV is decreased, how are the RBC's described?
microcytic
hypochromasia is seen in RBC's when MCHC is increased or decreased?
decreased MCHC
Which WBC type is elevated during a viral infection?
Lymphocytes
An increase in immature neutrophils represents:
a shift to the left
band or stab cells in the peripheral circulation indicate what clinical problem?
a bacterial infection
Which WBC is elevated in an allergic reaction?
Eosinophils
Lab test to evaluate the adequacy of the extrinsic system of the coagulation cascade?
Prothrombin time (PT)
Lab test to evaluate the adequacy of the intrinsic system of the coagulation cascade?
Partial thromboplastin tie (PTT)
Troponin T & I
an important indicator of cardiac muscle injury
Creatine Kinase:
(What is it for.)
used to diagnose myocardial muscle injury, but also can indicate neurologic or skeletal muscle disease.
HDL when increased is associated with a decrease in CAD. T or F?
True
What test in the lipid profile is elevated during pregnancy?
Triglycerides
BNP is used to evaluate the progression of which clinical condition?
CHF
When does troponin T levels return after an acute increase?
10 days
Cotton Wool patches typically present:
are ovoid lesions with irregular soft borders that result from infarcted nerve fibers and are seen with HTN.
Papilledema occurs most often from what condition?
Venous Stasis
Glaucomatous cupping occurs most often from which condition?
Hypertension-increased pressure within the eye.
What is the first step to performing a funduscopic exam?`
turning off the lights
absence of a red reflex is indicative of what?
Lens opacities
how far away does Bates state you should be when first examining a pt with your ophthalmoscope?
15 inches
WHere is the fundus of the eye located?
in the posterior portion of the eye
described as undigested cellular debris in the eye that can sometimes be mistaken for cotton wool spots
Drusen
Where within the eye would you look for A/V nicking?
on the retina
what is the difference between a thrombosis and thrombophlebitis?
thrombosis-a clot formation deep within a vein. thrombophlebitis- a clot formation and acute inflammation in a superficial vein.
what angle should the catheter of an IV be during insertion?
15-30 degrees
which vein is the largest and least painful for IV insertion?
Median cubital vein
WHich test in a lipid profile, when increased is associated with CAD
Low density lipids LDL's
Which test is used to determine MI's directly after onset of a potential MI?
Troponin T&I
What is a split S2?
a delay in the pulmonic valve closure, when both pulmonic and aortic valves should close at the same time (s2), resulting in the pulmonic valve closure splitting the aortic valve closure and causing a split sounding S2.
the difference between systolic and diastolic?
systole is pumping and diastole is filling
pulmonic valve murmurs are usually best heard where?
2nd and 3rd ICS but sometimes at higher or lower levels.
describe decrescendo:
one with an intensity that gradually decreases. Heard during diastole in aortic or pulmonary valvular insufficiency.
describe crescendo
one marked by progressively increasing loudness
displacement of PMI lateral to the midclavicular line or greater than 10 cm lateral to midsternal line suggests:
Left ventricular hypertrophy.
which valves make up the semilunar valves?
aortic and pulmonic
which valves make up the atrioventricular valves?
tricuspid and mitral
closure of the mitral valve produces: S1 or S2?
S1
closure of the aortic valve produces S1 or S2?
S2
Murmur that usually disappears when patient sits up
innocent murmur
Where do systolic and diastolic murmurs present in regard to S1 and S2?
-systolic murmurs present between S1 and S2 and
-diastolic murmurs present S2 and S1.
Murmurs that coincide with carotid upstroke are systolic. T or F
True
high levels of creatine kinase may signify:
muscle trauma and can be increased with heavy work out regimine.