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171 Cards in this Set

  • Front
  • Back
A caloric study is used to evaluate Cranial nerve ___ and the _____ portion of the cerebrum by irrigationg the external auditory canal with hot or cold water
Cranial Nerve VIII; temporal
A _____ study is when you irrigate the external auditory canal with hot or cold water testing cranial nerve VIII
Caloric study
In a caloric study, cold water normally causes a rotary nystagmus _____ from the ear being irrigated
In a caloric study, hot water normally causes a rotary nystagmus _____ the ear being irrigated
T/F a caloric study should be done on an empty stomach?
true; patients should experience nausea and dizziness
In a caloric study, most patients will experience _____ and _____ during the test
nausea; dizziness
In a caloric study, which ear should be tested first? (suspected or innocent ear)
suspected ear
In a caloric study, if no symptoms occur within ___ minutes, stop the test.
In a caloric study, after approximately ___ minutes, repeat the test on the other side
After a caloric study is performed, _____ _____ for 30 - 60 minutes is recommended
bed rest
The normal finding of a cardiac stress test is that the patient was able to maintain ___% of maximal heart rate for age and gender with no cardiac symptoms
Name 2 interfering factors of a cardiac stress test
1. Heavy meals (diverts blood to the GI tract)
2. Nicotine (can cause coronary artery spasms)
A cardiac stress test can help identify coronary artery _____ disease
manometry is the measurement of _____
Normal findings of an esophageal manometry is that the acid should be gone in _____ than 10 swallows
In esophageal monometry, what can be introduced into the stomach and the esophages for testing?
What is the Bernstein test?
whan dilute acid and saline solution are alternately introduced into the esophagus. If the patient feels discomfort with the acid, bud not the saline, the test is positive for esophagitis
When this test is performed, if the patient feels discomfort with the acid, but not the saline, the test is positive for esophagitis
Bernstein test
_____ is synchronous contraction of the esophagus which traps food between the areas of contraciton. (Very painful)
_____ is the absence of of tone in the LES, which allows reflux of gastric contents (a common cause of vomiting in newborns)
Chalasia is the absence of _____ in the LES which allows reflux of gastric contents. (a common cause of vomiting in _____)
tone; newborns
_____ is when the LES does not relax and obstructs the passage of food into the stomach. (most commonly occurs in young adults)
Achalasia is more common in newborns or young adults?
young adults
Plethysmography can also be used to rule out _____
What 2 things does a tourniquet test evaluate?
1. capillary fragility
2. platelet disorders
What is the normal finding for a tourniquet test?
<2 petechiae
A _____ test is when a blood pressure cuff is inflated to around ___ mm/Hg and left on for ___ minutes
tourniquet test; 70 mm/Hg; 5 minutes
What test is used to detect the presence or absence of bacteria in the blood?
Blood C&S
A blood C&S is used to detect the presence or absence of _____ in the blood
in a blood C&S. how many hours may be required to grow and identify the organism?
48-72 hours
in a blood C&S, if the patient is currently taking antibiotics, when should the specimen be drawn? (before or after next dose)
right before the next dose
In a blood C&S, what is applied to the skin and allowed to air dry (before venipuncture is performed)
An overall decrease in the concentration of what is called anemia?
hemoglobin, RBC's, hematocrit (all possible answers)
Overhydration or rehydration of a dehydrated patient may cause what temporary phenomenon in the blood?
Factor deficiency anemia is when you're deficient in at least one of what 3 things?
iron, B12, folic acid
When you are deficient in iron, B12 or B9, what type of anemia is this?
factor deficiency anemia
When blood forming organs fail to produce or deliver RBC's to the blood, what is this called?
Product Defect anemia
Name the 3 types of anemias based on morphology
"MnM" - Microcytic, Normocytic, Macrocytic
Where specifically in the blood is most iron found (70%)?
What supplement increases absorption of iron?
vitamin c
What is the most common cause of anemia?
Iron is ingested in the _______ state and converted to the _________ within the body.
ferric, ferrous
What test is the gold standard for iron deficiency testing?
Bone Marrow
In men under the age of 40, what is the most common cause of bleeding leading to factor deficiency anemia?
peptic ulcers
In men OVER the age of 40, what is the most common cause of bleeding leading to factor deficiency anemia?
What trimester of pregnancy is a woman most likely to suffer from iron deficiency?
third trimester
The TIBC (total iron binding capacity) test is an estimate of serum _________?
Which test is most sensitive for iron deficiency anemia?
a. serum iron
b. transferrin saturation
c. total iron binding capacity
b. transferrin saturation (it isn't specific though)
What is the most sensitive test for iron deficiency besides bone marrow test?
serum ferritin
With the serum ferritin test, less than __ ng/ml is virtually diagnostic of iron deficiency.
Regarding CHRONIC iron deficiency, what 2 findings would be most suggestive?
a. Decr. serum iron + decr. TIBC
b. Decr. SI + incr. TIBC
c. Decr. SI + decr. Transferrin Saturation
d. Decr. SI + incr. Transferrin Saturation
a. decr SI + decr TIBC
If methylmalonic acid is increased, what happens to your levels of Vitamin B12?
Megaloblastic anemia is caused by ____ or _____ ____ deficiency.
B12, Folic acid
What RBC abnormality is associated with Leptocytes (Target Cells)
thalassemia, hemoglobinopathies
What RBC shape is associated with thalassemia and hemoglobinopathies?
Leptocytes (Target cells)
_____ is associated with iron deficiency, thalassemia or heart disease (RBC color abnormality)
_____ is associated with concentrated hemoglobin, usually caused by dehydration (RBC color abnormality)
Nucleated RBC's are aka?
Heinz bodies are particles of _____.
_____ _____ are particles of hemoglobin
Heinz bodies
Howell-Jolly bodies are associated with what kind of anemias?
hemolytic and megaloblastic
Basophilic _____ is inclusions in the cytoplasm
basophilic stippling is associated with what 2 things?
lead poisoning, reticulocytosis
A bone marrow biopsy is used for what 5 things?
1. confirm megaloblastic anemia
2. to diagnose leukemia
3. confirm iron deficiency
4. confirm fibrosis
5. to diagnose lymphomas
a pap smear is 95% accurate when diagnosing _____ cancer, and 40% accurate when diagnosing _____ cancer.
cervical; endometrial
Go through the 5 classes of cell classification of a pap smear. (ALL CAPS = BLANK IN MANUAL)
Class 1 - normal cells
Class 2 - ATYPICAL cells, usually caused by INFLAMMATION
Class 3 - suggestive but not conclusive of MALIGNANCY
Class 4 - STRONGLY suggestive of malignancy
Class 5 - CONCLUSIVE of malignancy
A stool culture is used to identify _____ and _____ in the GI tract
bacteria and parasites
Name some interfering factors in the occult blood stool test.
bleeding gums, red MEAT, ingestion within THREE days before the test, ingestion of FISH, TURNIPS, or HORSE RADDISH
in acute cholecystitis, you should find increased _____ _____
serum amylase
in Reye's syndrome, you should find increased _____ _____ and decreased _____
increased blood ammonia, decreased phosphorus
in acute viral hepatitis, a common lab finding is _____ and relative _____ with atypical lymphocytes
leukopenia; lymphocytosis
urea is formed in the liver from various sources of ammonia - mostly from protein-splitting _____ in the GI tract
serum bilirubin is a breakdown product of _____
unconjugated bilirubin binds with _____ and is carried to the _____ where it is excreted in the bile
albumin; liver
jaundice is a visible staining of the tissues with _____
main cause of jaundice
hemolysis increases serum _____ bilirubin
in hemolysis, serum conjugated bilirubin levels are _____
in hemolysis, there is no _____ conjugated blirubin because serum levels are normal
Extrahepatic biliary tract obstruction can cause jaundice, because no _____ can be formed, leading to _____ colored stools
urobilinogen; clay
bilirubin is transported by bile to the duodenum, where it is converted to urobilinogen by _____
most urobilinogen is excreted in the _____, but some is reabsorbed
_____ bilirubin cannot pass glomerular filters
_____ and _____ are most responsible for alkaline phosphatase elevation (ALP)
liver and bone
what are the 3 most common causes of chronic elevation of ALP (alk phosphatase) >3x normal? (All should be on test)
1. Common bile duct obstruction
2. metastatic liver tumor
3. primary biliary cirrhosis
when differentiating liver ALP from bone ALP, _____ indicates at least part of the ALP is from the liver.
the most reliable method to distinguish liver ALP form bone ALP is ______
AST/ALT ratio greater than ___ is considered a SERIOUS sign and can be related to alcoholic cirrhosis, liver congestion and metastatic tumor
greater than 1
elevated ALT (serum alanine aminotransferase) is usually from _____ disease
LDH-5 is found predominantly in the _____ and _____ _____
liver and skeletal muscle
PT is _____ _____ dependant
vitamin K
Bile acids are _____ soluble components of bile derived from _____ metabolism by the liver
water; cholesterol
The 2 primary forms of serum bile acids are _____ acid and _____ acid
cholic; chonodeoxycholic
serum _____ usually decreases with liver dysfunction
hepatitis is associated with _____ _____ levels
gamma globulin
biliary obstyruction is associated with _____ _____ levels
beta globulin
with cirrhosis, you have decreased _____ and elevetion of _____ _____
albumin; gamma globulin
Methyl malonic acid assay is a functional test for a ____ deficiency.
Macrocytic anemia with oval macrocytes and megaloblastic changes in the bone marrow describes what condition?
pernicious anemia
Gastritis is most likely to cause what type of anemia?
What test is definitive for pernicious anemia?
Shilling test
Less than __% recovery of isotopic B12 in the urine from a Shilling test indicates pernicious anemia.
For the Shilling test, what is the next step following the isotopic B12 urine results?
Test is repeated with Intrinsic Factor
_________ deficiency causes megaloblastic anemia that is indistinguishable from pernicious anemia except for the Shilling test.
folic acid
Vitamin __ is needed for synthesis of a precursor of heme.
B6 deficient patients develop anemia that resemble ______ iron deficiency
B6 deficiency leads to what type of anemia?
Sideroblastic anemia
If a ring of cytoplasmic granules are formed around the nucleus of a normoblast in the bone marrow, this indicates what type of anemia?
________ anemia is when there's decreased marrow function without cell abnormality or repacement (often caused by radiation/chemicals).
____________ is a neoplasm of plasma cells leading to a rouleaux formation.
Multiple myeloma
Name a condition of depletion anemia that involves hemoglobin synthesis abnormalities.
Name a condition of depletion anemia that involves RBC enzyme deficiencies.
glucose 6 phosphate dehydrogenase deficiency
Name a condition of depletion anemia that involves RBC membrane abnormalities.
congenital spherocytosis
A complex of one iron atom within 4 protoporphyrin structures is describing ____________.
What is the most common hemoglobin abnormality in the Western hemisphere?
Sickle hemoglobin
True/False? Babies' hemoglobin have a lower affinity for oxygen since their respiratory system is immature.
False - Hb F has a greater affinity
What % of Hb in an infant is Hb F?
What chains are on normal Hb A1?
one alpha, one beta
What chains are on normal Hb A2?
two alpha, two delta
What chains are on a normal Hb F molecule?
two alpha, two gamma
What is the screening test for sickle hemoglobin?
peripheral blood smear test
If someone has the sickle cell trait, what kind of Hb's do they have?
Hb S and Hb A
If someone has sickle cell anemia, what kind of Hb do they have?
What type of sickle anemia is milder than Hb SS, and often causes aseptic nervosis of the femur head?
Sickle Hb-HbC
True/False? Target cells are absent in a person with the Hemoglobin C trait.
Hemoglobin C disease has what % of target cells?
What test determines if hemoglobin is unstable or has denatured?
Heinz body test
What is the nickname for Thalassemia major?
Cooley's anemia
Cooley's anemia is another name for what?
Thalassemia major
In cooley's anemia, what chains are affected?
BOTH BETA chains
Thalassemia major is more likely to affect people from what area of the world?
Mediterranean origin
What is the difference between thalassemia minor and chronic iron deficiency?
RDW is normal with thalassemia
What syndrome is another name for abetalipoproteinemia?
Bassen-Kornsweig syndrome
Unrestrained growth of leukocytes and their precursors defines:
a. Leukemia
b. Aleukemic leukemia
c. Lymphoma
d. Leukemic Lymphoma
a. leukemia
Abnormal leukocytes that are confined to the bone marrow:
a. Leukemia
b. Aleukemic leukemia
c. Lymphoma
d. Leukemic Lymphoma
b. aleukemic leukemia
When there's neoplastic growth that's confined to the lymph tissue, this condition is called:?
a. Leukemia
b. Aleukemic leukemia
c. Lymphoma
d. Leukemic Lymphoma
c. lymphoma
A lymphoma that spreads to the bone marrow and the periphreal blood:
a. Leukemia
b. Aleukemic leukemia
c. Lymphoma
d. Leukemic Lymphoma
d. leukemic lymphoma
Name the 2 types of leukemic stem cells (based on where they come from)?
Myeloid, Lymphoid
With acute leukemia, what is the expected lifespan without treatment?
days to weeks
Which of the following types of leukemia are often seen in children?
a. AML
b. ALL
c. CML
d. CLL
b. ALL (acute lymphoblastic leukemia)
The most common leukemia in the western hemisphere?
What type of leukemia may have a viral etiology?
Which of the following includes all acute leukemias involving cells other than lymphocytes?
a. AML
b. ALL
c. CML
d. CLL
a. AML
Which of the following would be primarily seen in adults, and is characterized by pancytopenia?
a. AML
b. ALL
c. CML
d. CLL
a. AML
Which of the following is characterized by a Philadelphia Chromosome? MACA
a. AML
b. ALL
c. CML
d. CLL
b, c
Which of the following would provide lab findings of lymphocytosis in the peripheral blood, variable lymphocyte size, and smudge cells?
a. AML
b. ALL
c. CML
d. CLL
d. CLL
What type of specific, unique cells are found in patients with Hodgkin's Disease?
Reed-Sternberg cells
What is the life expectancy of a patient with Hodgkin's Dz without treatment?
1-2 years
What lymph nodes are most likely to be enlarged (but painless) in a person with non-hodgkin's lymphoma?
cervical nodes
A substance that causes the formation of antibodies is called a/an _________?
Proteins produced by lymphocytes and plasma cells in response to antigens are called _______?
An antigen found on the surface of an RBC is called a/an ____________?
If an agglutinogen lyses a RBC, it is then called ___________.
What types of cells produce antibodies in the body's response to antigens?
lymphocytes, plasma cells
What test is used for hemolytic disease of newborns, hemolytic anemia, & hemolytic transfusion reactions?
Direct Coomb's test
What test uses rabbit serum with antibodies against human IgG or IgM?
Direct Coomb's test
What human antibodies might be tested against in a Direct Coomb's test?
IgG and IgM
Specifically, what test is used to type blood?
Indirect Coombs test - Forward typing
What antibody test proves the existence of antibodies AND identifies them?
Indirect Coomb's test - Reverse typing
What phenotype has no ABO antigens?
Bombay phenotype
What is the term for your genetic expression infuenced by many factors in addition to your genes?
What Agglutinins are considered the universal donor? What blood type is this?
Anti A&B, Type O
Agglutinogens are (antigens/antibodies) and agglutinins are (antigens/antibodies)?
Agglutinogens are antigens

Agglutinins are antibodies.
What blood type is the universal acceptor?
What agglutinins are found on type AB blood?
none - this is why it's the universal acceptor
What antibodies are found in the body at birth?
Trick question - None
What type of antibodies are formed in erythroblastosis fetalis?
D antibodies
What's the term for the condition where a G2P1 mother is Rh+ and a fetus is Rh+?
erythroblastosis fetalis
When >20 mg/dl of bilirubin is found in the blood, what is this condition called?
Kernicterus (note: Jaundice is a symptom, not a condition)
What specific WBC antigen is seen in rheumatoid arthritis?
What specific WBC antigen is seen in patients with multiple sclerosis and celiac disease?