Usmle 2 Lab Info

Front 1

First signs in labs with renal failure

Back 1

At GFR < 60 mL/min: source of erythropoietin decrease and anemia is present

GFR < 30% of normal: concentrating and diluting urine is no longer maintained (hyponatremia, hyperkalemia, hyperphosphatemia, metabolic acidosis due to fall of plasma bicarbonate).

Front 2

Poor prognosis in PTs with primary biliary cirrhosis

Back 2

Rising serum bilirubin

Note: bilirubin may be normal if cirrhosis is well-compensated.

Front 3

Alcoholic hepatitis

Back 3

AST:ALT ratio > 2; both values usually being < 300 IU/L

Front 4

Suggest acute hepatocellular injury

Chronic hepatocellular injury

Back 4

AST, ALT, LDH, alkaline phosphatase

Those that represent hepatic function: albumin, bilirubin, prothrombin time

Front 5

New diagnosis of heart failure

Back 5

ECK, echo CBC, UA, serum creatinine, K, albumin, thyroid

Note: Not Holter monitoring since it is used to identify arrhythmia; cath or stress test unless ischemia is ruled in.

Front 6

Of all the lipid values, what is the single best predictor of an adverse outcome?

Back 6

Low HDL

Front 7

New diagnosis of hypertension

Back 7

CBC, Chem-7, UA, fasting glucose, fasting lipid panel, resting ECG

Front 8

Seizures, stupor, and coma generally do not occur until sodium concentrations fall below

Back 8

120 mEq/L.

Front 9

Diagnostic for peritonitis

Back 9

A neutrophil count >250/mL

Front 10

Alkaline phosphatase

Back 10

o Is elevated in conditions affecting the bones, liver, small intestine, and placenta.
o The addition of elevated 5'-nucleotidase suggests the liver as the focus of the problem.

Front 11

Prolonged QT

Back 11

QTc >460 msec in females and >440 msec in males.

Front 12

Normal ejection fraction

Back 12

55 – 75%, measured by echocardiography

Front 13

In patients with renal failure, the risk for death and serious cardiovascular events is increased

Back 13

with higher hemoglobin levels (≥13.5 g/dL), and it is therefore recommended that levels be maintained at 10-12 g/dL.

Studies have also demonstrated less mortality and morbidity when the dosage of epoetin alfa (Procrit and Epogen) is set to achieve a target hemoglobin of <12 g/dL.

Front 14

Significant microscopic hematuria as

Back 14

≥3 RBCs/hpf

Front 15

A positive dipstick for hemoglobin without any RBCs noted in the urine sediment indicates either

Back 15

free hemoglobin or myoglobin in the urine.

Front 16

Alcoholics with recurrent pancreatitis

Back 16

may have normal serum amylase levels; in such cases, serum lipase would be a better test.

Front 17

Preferred for detecting tumors?

Back 17

MRI

Front 18

Streptococcus bovis bacteremia or endocarditis

Back 18

Is associated with a high incidence of occult colorectal malignancies. It may also occur with upper gastrointestinal cancers.

Front 19

Platelet count of more than 30,000 have

Back 19

very few symptoms and do not require treatment (or does this just pertain to immune thrombocytopenia??)

Front 20

Benign heart murmurs

Back 20

Asymptomatic, grade 2 or less, normal S2, no audible clicks, normal pulses, and varies with position

Front 21

Pathological heart murmurs

Back 21

SOB, syncope, etc, grade 3 or higher, abnormal S2, pansystolic murmur, loudest at upper left sternal border, diminished femoral pulses, quality of murmur is unchanged with position.

Front 22

Extravascular hemolysis doesn't lead to

Back 22

Fe deficiency since macrophages take up the free iron

Front 23

Lymphoblast ALL contains

Back 23

TdT (marker for immature lymphocytes) and PAS + material

Note: CD10 (CALLA)

Front 24

Vitamin K factors.

Mild deficiency of vitamin K

Back 24

II, VII, IX, X

Elevated PT and normal PTT

Front 25

Helmet cells

Back 25

Fragmented RBCs from DIC, HUS, TTP

Front 26

Basophilic stippling

Back 26

Ribosomal precipitates

Seen in thalassemia, heavy metal or lead poisoning

Front 27

G6PD

Back 27

Heinz bodies--aggregates of denatured Hgb

Front 28

Thalassemia vs. iron deficiency anemia

Back 28

Thalassemia: Microcytic anemia with normal RDW

Iron deficiency anemia: Microcytic with high RDW, low reticulocyte count.

Front 29

Chronic pyelonephritis

Hydronephrosis

Back 29

Seen with intravenous pyelography as blunting of calyces and parenchymal scarring

Seen with IVP as dilation of calyces, pelvis and ureter, depending on the level of obstruction

Front 30

When and where does jaundiced begin?

Back 30

Greater than 2.5

Under the tongue first

Front 31

Pre-renal failure clinical values

Back 31

Oliguria, azotemia, and elevated BUN/creatinine ratio > 20:1

Note: oliguira (<400 cc or 6 cc/kg output per day).