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171 Cards in this Set
- Front
- Back
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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
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Cranial Nerve VIII; temporal
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A _____ study is when you irrigate the external auditory canal with hot or cold water testing cranial nerve VIII
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Caloric study
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In a caloric study, cold water normally causes a rotary nystagmus _____ from the ear being irrigated
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away
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In a caloric study, hot water normally causes a rotary nystagmus _____ the ear being irrigated
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toward
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T/F a caloric study should be done on an empty stomach?
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true; patients should experience nausea and dizziness
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In a caloric study, most patients will experience _____ and _____ during the test
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nausea; dizziness
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In a caloric study, which ear should be tested first? (suspected or innocent ear)
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suspected ear
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In a caloric study, if no symptoms occur within ___ minutes, stop the test.
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3
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In a caloric study, after approximately ___ minutes, repeat the test on the other side
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5
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After a caloric study is performed, _____ _____ for 30 - 60 minutes is recommended
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bed rest
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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
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85
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Name 2 interfering factors of a cardiac stress test
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1. Heavy meals (diverts blood to the GI tract)
2. Nicotine (can cause coronary artery spasms) |
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A cardiac stress test can help identify coronary artery _____ disease
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occlusive
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manometry is the measurement of _____
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pressure
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Normal findings of an esophageal manometry is that the acid should be gone in _____ than 10 swallows
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less
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In esophageal monometry, what can be introduced into the stomach and the esophages for testing?
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Acid
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What is the Bernstein test?
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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
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When this test is performed, if the patient feels discomfort with the acid, but not the saline, the test is positive for esophagitis
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Bernstein test
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_____ is synchronous contraction of the esophagus which traps food between the areas of contraciton. (Very painful)
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presbyesophagus
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_____ is the absence of of tone in the LES, which allows reflux of gastric contents (a common cause of vomiting in newborns)
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chalasia
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Chalasia is the absence of _____ in the LES which allows reflux of gastric contents. (a common cause of vomiting in _____)
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tone; newborns
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_____ is when the LES does not relax and obstructs the passage of food into the stomach. (most commonly occurs in young adults)
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achalasia
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Achalasia is more common in newborns or young adults?
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young adults
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Plethysmography can also be used to rule out _____
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malingering
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What 2 things does a tourniquet test evaluate?
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1. capillary fragility
2. platelet disorders |
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What is the normal finding for a tourniquet test?
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<2 petechiae
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A _____ test is when a blood pressure cuff is inflated to around ___ mm/Hg and left on for ___ minutes
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tourniquet test; 70 mm/Hg; 5 minutes
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What test is used to detect the presence or absence of bacteria in the blood?
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Blood C&S
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A blood C&S is used to detect the presence or absence of _____ in the blood
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bacteria
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in a blood C&S. how many hours may be required to grow and identify the organism?
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48-72 hours
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in a blood C&S, if the patient is currently taking antibiotics, when should the specimen be drawn? (before or after next dose)
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right before the next dose
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In a blood C&S, what is applied to the skin and allowed to air dry (before venipuncture is performed)
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betadine
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An overall decrease in the concentration of what is called anemia?
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hemoglobin, RBC's, hematocrit (all possible answers)
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Overhydration or rehydration of a dehydrated patient may cause what temporary phenomenon in the blood?
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"pseudoanemia"
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Factor deficiency anemia is when you're deficient in at least one of what 3 things?
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iron, B12, folic acid
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When you are deficient in iron, B12 or B9, what type of anemia is this?
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factor deficiency anemia
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When blood forming organs fail to produce or deliver RBC's to the blood, what is this called?
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Product Defect anemia
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Name the 3 types of anemias based on morphology
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"MnM" - Microcytic, Normocytic, Macrocytic
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Where specifically in the blood is most iron found (70%)?
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hemoglobin
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What supplement increases absorption of iron?
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vitamin c
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What is the most common cause of anemia?
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bleeding
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Iron is ingested in the _______ state and converted to the _________ within the body.
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ferric, ferrous
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What test is the gold standard for iron deficiency testing?
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Bone Marrow
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In men under the age of 40, what is the most common cause of bleeding leading to factor deficiency anemia?
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peptic ulcers
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In men OVER the age of 40, what is the most common cause of bleeding leading to factor deficiency anemia?
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carcinoma
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What trimester of pregnancy is a woman most likely to suffer from iron deficiency?
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third trimester
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The TIBC (total iron binding capacity) test is an estimate of serum _________?
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transferrin
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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)
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What is the most sensitive test for iron deficiency besides bone marrow test?
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serum ferritin
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With the serum ferritin test, less than __ ng/ml is virtually diagnostic of iron deficiency.
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10
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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
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If methylmalonic acid is increased, what happens to your levels of Vitamin B12?
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decreases
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Megaloblastic anemia is caused by ____ or _____ ____ deficiency.
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B12, Folic acid
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What RBC abnormality is associated with Leptocytes (Target Cells)
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thalassemia, hemoglobinopathies
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What RBC shape is associated with thalassemia and hemoglobinopathies?
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Leptocytes (Target cells)
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_____ is associated with iron deficiency, thalassemia or heart disease (RBC color abnormality)
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Hypochromia
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_____ is associated with concentrated hemoglobin, usually caused by dehydration (RBC color abnormality)
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hyperchromia
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Nucleated RBC's are aka?
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normoblasts
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Heinz bodies are particles of _____.
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hemoglobin
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_____ _____ are particles of hemoglobin
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Heinz bodies
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Howell-Jolly bodies are associated with what kind of anemias?
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hemolytic and megaloblastic
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Basophilic _____ is inclusions in the cytoplasm
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stippling
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basophilic stippling is associated with what 2 things?
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lead poisoning, reticulocytosis
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A bone marrow biopsy is used for what 5 things?
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1. confirm megaloblastic anemia
2. to diagnose leukemia 3. confirm iron deficiency 4. confirm fibrosis 5. to diagnose lymphomas |
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a pap smear is 95% accurate when diagnosing _____ cancer, and 40% accurate when diagnosing _____ cancer.
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cervical; endometrial
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Go through the 5 classes of cell classification of a pap smear. (ALL CAPS = BLANK IN MANUAL)
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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 |
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A stool culture is used to identify _____ and _____ in the GI tract
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bacteria and parasites
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Name some interfering factors in the occult blood stool test.
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bleeding gums, red MEAT, ingestion within THREE days before the test, ingestion of FISH, TURNIPS, or HORSE RADDISH
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in acute cholecystitis, you should find increased _____ _____
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serum amylase
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in Reye's syndrome, you should find increased _____ _____ and decreased _____
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increased blood ammonia, decreased phosphorus
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in acute viral hepatitis, a common lab finding is _____ and relative _____ with atypical lymphocytes
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leukopenia; lymphocytosis
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urea is formed in the liver from various sources of ammonia - mostly from protein-splitting _____ in the GI tract
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bacteria
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serum bilirubin is a breakdown product of _____
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hemoglobin
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unconjugated bilirubin binds with _____ and is carried to the _____ where it is excreted in the bile
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albumin; liver
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jaundice is a visible staining of the tissues with _____
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bilirubin
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main cause of jaundice
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hemolysis
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hemolysis increases serum _____ bilirubin
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unconjugated
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in hemolysis, serum conjugated bilirubin levels are _____
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normal
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in hemolysis, there is no _____ conjugated blirubin because serum levels are normal
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urine
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Extrahepatic biliary tract obstruction can cause jaundice, because no _____ can be formed, leading to _____ colored stools
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urobilinogen; clay
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bilirubin is transported by bile to the duodenum, where it is converted to urobilinogen by _____
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bacteria
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most urobilinogen is excreted in the _____, but some is reabsorbed
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feces
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_____ bilirubin cannot pass glomerular filters
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unconjugated
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_____ and _____ are most responsible for alkaline phosphatase elevation (ALP)
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liver and bone
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what are the 3 most common causes of chronic elevation of ALP (alk phosphatase) >3x normal? (All should be on test)
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1. Common bile duct obstruction
2. metastatic liver tumor 3. primary biliary cirrhosis |
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when differentiating liver ALP from bone ALP, _____ indicates at least part of the ALP is from the liver.
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jaundice
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the most reliable method to distinguish liver ALP form bone ALP is ______
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electrophoresis
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AST/ALT ratio greater than ___ is considered a SERIOUS sign and can be related to alcoholic cirrhosis, liver congestion and metastatic tumor
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greater than 1
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elevated ALT (serum alanine aminotransferase) is usually from _____ disease
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liver
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LDH-5 is found predominantly in the _____ and _____ _____
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liver and skeletal muscle
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PT is _____ _____ dependant
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vitamin K
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Bile acids are _____ soluble components of bile derived from _____ metabolism by the liver
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water; cholesterol
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The 2 primary forms of serum bile acids are _____ acid and _____ acid
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cholic; chonodeoxycholic
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serum _____ usually decreases with liver dysfunction
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albumin
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hepatitis is associated with _____ _____ levels
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gamma globulin
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biliary obstyruction is associated with _____ _____ levels
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beta globulin
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with cirrhosis, you have decreased _____ and elevetion of _____ _____
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albumin; gamma globulin
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Methyl malonic acid assay is a functional test for a ____ deficiency.
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B12
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Macrocytic anemia with oval macrocytes and megaloblastic changes in the bone marrow describes what condition?
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pernicious anemia
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Gastritis is most likely to cause what type of anemia?
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pernicious
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What test is definitive for pernicious anemia?
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Shilling test
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Less than __% recovery of isotopic B12 in the urine from a Shilling test indicates pernicious anemia.
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<8%
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For the Shilling test, what is the next step following the isotopic B12 urine results?
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Test is repeated with Intrinsic Factor
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_________ deficiency causes megaloblastic anemia that is indistinguishable from pernicious anemia except for the Shilling test.
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folic acid
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Vitamin __ is needed for synthesis of a precursor of heme.
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B6
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B6 deficient patients develop anemia that resemble ______ iron deficiency
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chronic
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B6 deficiency leads to what type of anemia?
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Sideroblastic anemia
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If a ring of cytoplasmic granules are formed around the nucleus of a normoblast in the bone marrow, this indicates what type of anemia?
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sideroblastic
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________ anemia is when there's decreased marrow function without cell abnormality or repacement (often caused by radiation/chemicals).
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Aplastic
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____________ is a neoplasm of plasma cells leading to a rouleaux formation.
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Multiple myeloma
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Name a condition of depletion anemia that involves hemoglobin synthesis abnormalities.
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Thalassemia
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Name a condition of depletion anemia that involves RBC enzyme deficiencies.
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glucose 6 phosphate dehydrogenase deficiency
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Name a condition of depletion anemia that involves RBC membrane abnormalities.
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congenital spherocytosis
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A complex of one iron atom within 4 protoporphyrin structures is describing ____________.
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hemoglobin
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What is the most common hemoglobin abnormality in the Western hemisphere?
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Sickle hemoglobin
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True/False? Babies' hemoglobin have a lower affinity for oxygen since their respiratory system is immature.
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False - Hb F has a greater affinity
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What % of Hb in an infant is Hb F?
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80%
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What chains are on normal Hb A1?
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one alpha, one beta
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What chains are on normal Hb A2?
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two alpha, two delta
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What chains are on a normal Hb F molecule?
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two alpha, two gamma
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What is the screening test for sickle hemoglobin?
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peripheral blood smear test
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If someone has the sickle cell trait, what kind of Hb's do they have?
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Hb S and Hb A
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If someone has sickle cell anemia, what kind of Hb do they have?
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Hb SS
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What type of sickle anemia is milder than Hb SS, and often causes aseptic nervosis of the femur head?
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Sickle Hb-HbC
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True/False? Target cells are absent in a person with the Hemoglobin C trait.
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False
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Hemoglobin C disease has what % of target cells?
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>30%
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What test determines if hemoglobin is unstable or has denatured?
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Heinz body test
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What is the nickname for Thalassemia major?
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Cooley's anemia
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Cooley's anemia is another name for what?
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Thalassemia major
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In cooley's anemia, what chains are affected?
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BOTH BETA chains
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Thalassemia major is more likely to affect people from what area of the world?
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Mediterranean origin
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What is the difference between thalassemia minor and chronic iron deficiency?
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RDW is normal with thalassemia
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What syndrome is another name for abetalipoproteinemia?
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Bassen-Kornsweig syndrome
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Unrestrained growth of leukocytes and their precursors defines:
a. Leukemia b. Aleukemic leukemia c. Lymphoma d. Leukemic Lymphoma |
a. leukemia
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Abnormal leukocytes that are confined to the bone marrow:
a. Leukemia b. Aleukemic leukemia c. Lymphoma d. Leukemic Lymphoma |
b. aleukemic leukemia
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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
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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
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Name the 2 types of leukemic stem cells (based on where they come from)?
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Myeloid, Lymphoid
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With acute leukemia, what is the expected lifespan without treatment?
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days to weeks
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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)
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The most common leukemia in the western hemisphere?
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CLL
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What type of leukemia may have a viral etiology?
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CLL
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Which of the following includes all acute leukemias involving cells other than lymphocytes?
a. AML b. ALL c. CML d. CLL |
a. AML
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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
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Which of the following is characterized by a Philadelphia Chromosome? MACA
a. AML b. ALL c. CML d. CLL |
b, c
ALL, CML |
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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
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What type of specific, unique cells are found in patients with Hodgkin's Disease?
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Reed-Sternberg cells
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What is the life expectancy of a patient with Hodgkin's Dz without treatment?
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1-2 years
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What lymph nodes are most likely to be enlarged (but painless) in a person with non-hodgkin's lymphoma?
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cervical nodes
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A substance that causes the formation of antibodies is called a/an _________?
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antigen
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Proteins produced by lymphocytes and plasma cells in response to antigens are called _______?
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antibodies
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An antigen found on the surface of an RBC is called a/an ____________?
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Agglutinogen
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If an agglutinogen lyses a RBC, it is then called ___________.
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Hemolysin
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What types of cells produce antibodies in the body's response to antigens?
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lymphocytes, plasma cells
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What test is used for hemolytic disease of newborns, hemolytic anemia, & hemolytic transfusion reactions?
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Direct Coomb's test
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What test uses rabbit serum with antibodies against human IgG or IgM?
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Direct Coomb's test
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What human antibodies might be tested against in a Direct Coomb's test?
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IgG and IgM
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Specifically, what test is used to type blood?
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Indirect Coombs test - Forward typing
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What antibody test proves the existence of antibodies AND identifies them?
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Indirect Coomb's test - Reverse typing
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What phenotype has no ABO antigens?
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Bombay phenotype
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What is the term for your genetic expression infuenced by many factors in addition to your genes?
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Phenotype
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What Agglutinins are considered the universal donor? What blood type is this?
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Anti A&B, Type O
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Agglutinogens are (antigens/antibodies) and agglutinins are (antigens/antibodies)?
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Agglutinogens are antigens
Agglutinins are antibodies. |
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What blood type is the universal acceptor?
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AB
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What agglutinins are found on type AB blood?
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none - this is why it's the universal acceptor
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What antibodies are found in the body at birth?
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Trick question - None
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What type of antibodies are formed in erythroblastosis fetalis?
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D antibodies
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What's the term for the condition where a G2P1 mother is Rh+ and a fetus is Rh+?
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erythroblastosis fetalis
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When >20 mg/dl of bilirubin is found in the blood, what is this condition called?
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Kernicterus (note: Jaundice is a symptom, not a condition)
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What specific WBC antigen is seen in rheumatoid arthritis?
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HLA-B27
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What specific WBC antigen is seen in patients with multiple sclerosis and celiac disease?
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HLA-B8
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