Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
322 Cards in this Set
- Front
- Back
|
sensitivity
|
the ability to detect small abnormalities in the body
LOW = freq false negatives HIGH = few false negatives |
|
|
specificity
|
The degree to which the results are exclusive for the condition
LOW=freq false positives HIGH=few false positives |
|
|
Prevalence
|
# of persons w/disease in tested population
|
|
|
Gold Standard
|
method of testing that has been proven to be accurate for sensitivity and specificity that is used for comparison.
|
|
|
Reproducibility
|
getting same results when test is repeated on same specimen
|
|
|
Accuracy
|
The correct answer.
|
|
|
"Normal" reference ranges
|
In a Gaussian distribution, 95% of "normal" will fall within 2 standard deviations from the mean value. Means 5% will fall above or below 2 SD
|
|
|
Problems w/normal ranges
|
1-may have subclinical disease
2-too small of case #s 3-population not same as case population 4-values obtained fm one method applied to other methods 5-different reagents or equipment produce different results 6-not a random population |
|
|
on a 12 test profile there is a ______% probability that 1 test will be falsely abnormal
|
46%
|
|
|
Comparison with ____________ values can help detect changes
|
baseline
|
|
|
Specimen problems occur when______________ and ___________________
|
clean catch collections not used and too small a volume is collected
|
|
|
a 24 hour urine specimen with a small volume can indicate
|
dehydration or missed collection
|
|
|
eating cooked meat can elevate __________ excretion by 10-20% over 24 hours
|
creatinine
|
|
|
What can influence lab values
|
age, race, sex, meals, body position, and drugs
|
|
|
Stat means what and when should it be used?
|
Emergency Only during true emergency
|
|
|
The study of three basic cellular elements of blood: RBC, WBC, Platelets
|
hematology (CBC)
|
|
|
Hemoglobin (Hb)
|
oxygen carrying compound in RBCs
|
|
|
Hemoglobin (Hb) reference values
|
12-18 gm/100ml
|
|
|
T or F Boys and girls under 11 have different ranges for Hb
|
False They are the same
|
|
|
**BQ** African Americans average 0.5 - 1.0 gm higher or lower Hb
|
lower
|
|
|
factors that affect Hb levels
|
Patient position
Diurnal cycle: Peak 9 am low 8pm varies day to day |
|
|
Smoking increases or decreases Hb levels
|
increases
|
|
|
Pregnancy increases or decreases Hemoglobin levels d/t dilution
|
decreases
|
|
|
Hb may decrease with age T or F
|
true
|
|
|
In newborn capillary Hb (heel stick) and Hct are higher or lower than venous blood
|
higher (avg 3.5 to 10gr)
|
|
|
High WBC can falsely increase or decrease Hb counts both automated and manually
|
increase
|
|
|
Hematocrit(Hct)
|
ratio of RBCs to plasma
|
|
|
RBCs/ml is a direct estimate of Hb T or F
|
false, indirect
|
|
|
hemocytometer is what?
It's error rate is what? |
Manual counting of RBCs
Error rate is 7-14% |
|
|
Automated counting of RBCs reduces the error rate to ?
|
4%
|
|
|
Hematocrit (Hct)
|
ratio of RBC's to plasma
|
|
|
Hemocrit depends on the ______ of RBC's but is slightly effected by the average
RBC _______. |
number, size
|
|
|
Hematocrit is not measured directly it is calculated from the _____ ______ and _____
__________ __________. |
RBC count, mean corpuscular volume (MVC)
Mean corpuscular volume (MCV) is a measurement of the average size of your RBCs. The MCV is elevated when your RBCs are larger than normal (macrocytic), for example in anemia caused by vitamin B12 deficiency. When the MCV is decreased, your RBCs are smaller than normal (microcytic) as is seen in iron deficiency anemia or thalassemias. |
|
|
What factors effect Hct?
|
decrease when recumbent
increase with smoking |
|
|
HB X 3 =
RBC (millions) X 3 = Rbc ( millions) X 9 = |
Hct
Hb Hct |
|
|
Wintrobe Indices is not significant if RBC, WBC, or Hemoglobin are normal. T or F
|
True
|
|
|
MCV
|
Mean corpuscular value
|
|
|
MCH
|
Mean corpuscular Hemoglobin
|
|
|
MCHC
|
Mean Corpuscular Hemoglobin Concentration
|
|
|
RDW
|
Red blood cell Distribution Width
|
|
|
Hct X 10/RBC count =
|
MCV
|
|
|
Femto
|
one-quadrillionth of the designated unit
|
|
|
MCV is measured in
|
femtoliters
|
|
|
Smoking decreases MCV. T or F
|
False, increases size of cell
|
|
|
Macrocytosis
|
Increased MCV
|
|
|
Decreased MCV
|
Microcytosis
|
|
|
Name two causes of Macrocytosis **BQ**
|
Folic acid and B12 deficiency
|
|
|
Name a cause of Microcytosis
**BQ** |
Chronic iron deficiency
|
|
|
Reticulocytosis
|
Immature RBC's
|
|
|
MCH _________ with macrocytosis and _________ with microcytosis and hypochromia
|
increases, decreases
|
|
|
MCHC is increased by ______
___________ |
heavy smoking
|
|
|
Chronic iron deficiency __________ a MCHC.
|
decreases
|
|
|
Most RBC's are the same size. T or F
|
True
|
|
|
Anisocytosis
|
different sizes of cells
|
|
|
RDW is elevated by
|
factor deficiency (Iron, Folate, B12)
|
|
|
RDW never decreases. T or F
|
True
|
|
|
Peripheral blood smears are from _______ or ________.
|
veins or arteries
|
|
|
What stain is used to allow examination of RBC abnormality.
|
Wright stain
|
|
|
Hypochromia
|
Iron deficiency
|
|
|
Oval macrocytes indicate what?
|
Folic Acid and/or vit. B12 deficiency
|
|
|
Round macrocytes indicate what conditions?
|
alcoholism, cirrhosis, hypothyroidism
|
|
|
Hypochromic microcytes =
|
chronic iron deficiency
|
|
|
Normochromic microcytes =
|
Thalassemia minor ( small cells of normal color)
|
|
|
Spherocytes
|
round cells w/o the central clear area
|
|
|
Causes of spherocytes
|
congenital
autoimmune hemolytic anemia some toxins ( snake venom) |
|
|
Name two polychromatophillic RBC's
|
Reticulocytes and Schistocytes
|
|
|
Reticulocytes production stems from
|
bleeding, hemolysis, other malignancies
|
|
|
Schistocytes are _________
______. |
broken cells (usually with one or more sharp points, not uniform)
|
|
|
Acanthocytes
|
sub group of Schistocytes with finger-like projections (look like aliens)
|
|
|
Echinocytes
|
crenated RBC's with uniform triangular projections
|
|
|
Bite cells (Degmacytes)
|
Hemolytic anemia
Heinz body anemia (look like a bite is gone from the cell) |
|
|
Sickle Cells
|
crescent shaped RBC's
|
|
|
Sickle cell anemia
Sickle cell trait |
Hb-SS
Hb-SC (few symptoms) |
|
|
Elliptocytes - Ovalocytes
|
short rod shapes
congenital |
|
|
Target cells
|
Peripheral ring and central disk of Hb (small dark spot in center)
|
|
|
Teardrop cells
|
Myeloid metaplasia
Myeloproliferative syndromes (myolocytic leukemia) |
|
|
Stomatocytes
|
rectangular or slit -like pallor configuration
drug induced or hereditary |
|
|
Rouleaux "Stack of Coins"
|
RBC's stick together in stacks
abnormal serum proteins as in Multiple Myeloma (other diseases cause this also) |
|
|
Basophillic stippling
|
small dark blue dots inside of cell
nuclear remnants |
|
|
What can cause Basophillic stippling?
|
Lead poisoning and other conditions
|
|
|
Howell Jolly bodies
|
Usually one per RBC, larger than stippling
|
|
|
When do you see Howell Jolly bodies?
|
Severe anemia ( following splenectomy)
|
|
|
Pappenheimer bodies
|
small dark hemosiderin granules
occur in small groups |
|
|
Name three inclusions not seen with Wright stain
|
reticulocytes-Retics
Hemoglobin H inclusions Heinz bodies |
|
|
Increased Reticulocytes (AKA Retics) = increased or decreased RBC production and bone marrow activity.
|
Increased
|
|
|
How do you see Hemoglobin H inclusions?
|
with reticulocyte stain
|
|
|
What do Heinz bodies indicate?
|
RBC enzyme defect
|
|
|
WBC reference range is
|
4500-11,000/mm3
|
|
|
African Americans WBC is often around 500/mm3 higher than Europeans. T or F
|
False, WBC is lower
|
|
|
There can be a ____ - _____%
error rate when platelets are counted by hand. |
10-20%
|
|
|
What is the Gold Standard for low iron anemia?
|
Bone Marrow Aspiration even though it is invasive and expensive. Not used except in extreme cases.
|
|
|
Neutrophils are referred to as _______ or _______.
|
Segs or Polys. Due to segmented nucleus usually 3 or 4 segments
|
|
|
Five or more segments in a neutrophil nucleus indicates what?
|
Folic acid deficiency
|
|
|
Always order a CBC w/_________ to include WBC breakdown
|
differential
|
|
|
Differential values for:
Neutrophils Lymphocytes Monocytes Eosinophils Basophils |
Neutrophils 60%
Lymphocytes 30% Monocytes 3.5% Eosinophils 2.5% Basophils .5% Never Let My Elephant Bounce |
|
|
The most important WBC abnormailty. **BQ**
|
Pelger-Huet
|
|
|
Many of the WBC nuclei hyposegment into a dumbbell or hour glass shape.
|
Pelger-Huet (can be congenital most often seen in bone marrow disorders such as myeloproliferative disorders.
|
|
|
Neonates have high WBC from birth to around four years. This is referred to as
|
Neonatal Leukocytosis
|
|
|
The most common cause of Neutrophilic leukocytosis is
|
Inflammation
bacterial infection and some viral infections (ECHO) |
|
|
ECHO Virus stands for
|
Enteric Cytopathic Human Orphan virus
|
|
|
Shift to left indicates
**BQ** |
immature cells
|
|
|
Neutrophillic Leukocytosis occurs when?
|
Tissue destruction from burns, trauma, hemorrhage, infarction, cirrhosis, cancer
Metabolic toxicity Drug and chemical toxicity Cigarette smoking, severe hemolytic anemia |
|
|
WBC remain normal or may even be low with some infections, such as:
|
most viral infections, TB, Typhoid fever, overwhelming infection of a debilitated person
|
|
|
In neonates and young children _______ can result in normal or low WBC's while ____ ____ elevates WBC
|
sepsis, violent crying
|
|
|
Lymphocytosis occurs usually with a low or normal WBC. Causes amy be :
|
viral infection, Addison's Disease, pertussis, lymphocytic leukemia, toxoplasmosis
|
|
|
Atypical lymphocytes suspect infectious __________, adult _____________, viral _________.
|
Mononeucleosis, adult cytomegalovirus infection, viral hepatitis
|
|
|
Monocytosis may occur without leukocytosis. T or F
|
True
|
|
|
Causes of Monocytosis:
|
sub-acute bacterial endocarditis
disseminated TB Recovery of acute infections Malignant lymphomas/carcinomas Typhoid fever Malaria |
|
|
Eosinphilia is casued by:
|
parasites (roundworms, flukes)
acute allery attacks(asthma, hayfever) Chronic skin diseases Scarlet fever and Brucellosis Cancer, Hodgkin's Disease, etc |
|
|
Basophilia is caused by:
|
Chronic myelogenous leukemia
Myeloproliferative Disease some non-malignant conditions (usually indicates patient is very ill) |
|
|
Fasting Glucose reference range is
|
70-105 mg/dl (age2-Adult)
|
|
|
Glucose is controlled by __________ and __________.
**BQ** |
insulin, glucagon
|
|
|
Stress hormones such as corticosteroids and epinephrine effect what ?
|
glucose
|
|
|
What two tests are ordered if diabetes is suspected?
|
Glucosolated Hemoglobin or Glucose Tolerance Test
|
|
|
Insulinoma, a pancrease tumor, produces too much or too little insulin. This decreases or increases glucose.
|
too much insulin, decreases glucose
|
|
|
What is another name for the Glucose Tolerance Test (GTT)?
|
Oral Glucose Tolerance (OGT)
|
|
|
Glucose Tolerance Test reference ranges are?
|
Fasting 70-115 mg/dl
30 min. <200 mg/dl 1 hr. <200 mg/dl 2 hrs. <140 mg/dl 3 hrs. 70-115 mg/dl 4 hrs. 70-115 mg/dl |
|
|
Why do you check the Glucose Tolerance Test at 3 hrs and then again at 4 hrs.?
|
To see if the level drops any lower than the normal range of 70-115 mg/dl.
|
|
|
Why do you perform a Glucose Tolerance Test?
|
When diabetes is suspected.
|
|
|
When should you not perform a Glucose Tolerance Test?
|
Current infection or endocrine disorders
Patient vomits part or all of the glucose meal. |
|
|
If you perform a two hour post prandiol insulin test during a Glucose Tolerance Test what would you expect to see?
|
If the patient is insulin intolerant they will have a high insulin level at this time.
|
|
|
Dizziness, anxiety, sweating, fainting, tremors, euphoria during a Glucose Tolerance Test is normal. T or F
|
False, generally indicates hypoglycemia.
|
|
|
What factors can interfere with a Oral Glucose Tolerance test?
|
Smoking or exercise during the test, stress, fasting or low calorie intake previous days before test, drugs that cause glucose intolerance.
|
|
|
What drugs cause glucose intolerance and should be avoided prior to a Glucose Tolerance Test?
|
antihypertensives, aspirin, beta blockers, furosemide, nicotine, oral contraceptives, steroids, psycotropics
|
|
|
Glycosolated Hemoglobin is also known as
|
Glycohemoglobin, Hemoglobin A1C, HbA1c, GHb, Diabetic Control Index
|
|
|
Glycosolated Hemoglobin indicates __________ blood glucose over the past _____ days.
|
average blood glucose, 100-120 days (lifespan of a RBC)
|
|
|
Glycohemoglobin can be performed fasting or non-fasting. T or F
|
True
|
|
|
Hemoglobin A1c is useful for what?
|
Differentiating diabetes from short term hyperglycemia in a non-diabetic patient
Evaluating the success of diabetic treatment |
|
|
Factors that interfere with a Diabetic Control Index are:
|
hemoglobinopathies
lengthening or shortening of RBC lifespan |
|
|
GHb will show increased levels in :
|
newly diagnosed diabetic patients
poorly controlled diabetic patients chronic non-diabetic hyperglycemia pregnancy |
|
|
HbA1c shows decreased levels because of :
|
Hemolytic anemia
Chronic blood loss Chronic renal failure |
|
|
Blood Urea Nitrogen (BUN) AKA Urea Nitrogen, Serum urea nitrogen measures the function of what two organs?
|
Liver and kidneys
|
|
|
Bun is made in the kidneys and excreted through the liver.
T or F |
False, made in liver excreted through kidneys
|
|
|
Azotemia is what?
|
Elevated Blood Urea Nitrogen
|
|
|
When your BUN is high which organ is not functioning well?
|
kidney
|
|
|
Low Serum Urea Nitrogen indicates what?
|
The liver is not functioning well.
|
|
|
What two blood levels together assess renal function?
|
BUN and Creatinine
|
|
|
What can interfere with the results of a Urea Nitrogen test?
|
changes in protein intake either low or high,
advanced pregnancy overhydration/dehydration meds |
|
|
Increased BUN indicates ____ disease or failure.
|
renal
|
|
|
Hypovolemia from burns, shock, dehydration can __________ BUN results.
|
increase
|
|
|
Decreased BUN results can be due to
|
liver failure
overhydration negative nitrogen balance early pregnancy Nephrotic syndrome |
|
|
Congestive heart failure, MI, starvation Sepsis, G.I. bleeding lead to increased or decreased BUN levels?
|
increased
|
|
|
Impaired renal function is diagnosed with what test?
|
Creatinine
|
|
|
Creatinine can increase slightly with intake of large amounts of meat. T or F
|
True
|
|
|
Increased Creatinine is indicative of ______ disease, Rhabdomolysis, _________, and acromegaly
|
kidney, gigantism
|
|
|
Decreased muscle mass, debilitation, MD, MG all lead to __________ creatinine.
|
decreased
|
|
|
High concern is shown when a test result reaches what value?
|
Critical value
|
|
|
Uric Acid is used to evaluate ________ or ________ ______.
|
gout, urinary calculi
|
|
|
Uric acid is the final breakdown of what substance?
|
Purine
|
|
|
What are uric acid soft tissue deposits called? In what condition are they most seen?
|
tophi, gout
|
|
|
Uric acid can be increased by _________, high protein infusion and some _______.
|
stress, drugs
|
|
|
X-ray contrast agents and some drugs _________ uric acid.
|
decreased
|
|
|
Uric acid is increased due to ________ purine consumption.
|
increased
|
|
|
Chronic renal failure, break down of muscle, cancer acidosis, toxicity of pregnancy all lead to ___________ uric acid.
|
increased
|
|
|
The most common cause of increase in uric acid is
|
idiopathic
|
|
|
Monitors fluid and electrolyte balance and is the major extracellular cation.
|
Sodium
|
|
|
Increased ________ is due to excess salt intake, decreased sodium loss (Cushings), loss of water.
|
Sodium
|
|
|
Insufficient intake, loss of sodium (Addsion's, vomiting, excess water intake) all lead to _________ sodium levels.
|
decreased
|
|
|
The major cation _______ the cell is Potassium.
|
within
|
|
|
Potassium is important for ______ ______, and ________.
|
Heart rate, contractility
|
|
|
Making a fist with a tourniquet on, hemolysis, drugs, abnormal acid/base balance all interfere with ___________ levels.
|
potassium
|
|
|
Potassium is ___________ with excess intake, renal failure, Addison's, etc...
|
increased
|
|
|
Licorice ingestion can lower your potassium levels. T or F
|
True
|
|
|
Diuretics can _________ both potassium and sodium.
|
decrease
|
|
|
With other electrolytes _____helps evaluate acid/base balance and hydration status.
|
Chloride
|
|
|
Chloride is increased with overhydration and decreased with dehydration. T or F
|
False, increased with dehydration and decreased with overhydration.
|
|
|
Used to investigate parathyroid and calcium abnormalities
|
phosphorus
|
|
|
Hyperparathyroidism _______ calcium and _____ phosphorus. **BQ**
|
increase CA and decreases Phosphorus
|
|
|
________ with sodium phosphate interfere with phosphorus testing
|
Laxatives
|
|
|
______parathyroidism leads to increased levels of phosphorus.
|
hypo
|
|
|
Chronic ________ ingestion can lead to low phosphorus.
|
antacid
|
|
|
_______parathyroidism, chronic alcoholism, viatmin D deficiency, hypercalcemia all _____________phosphorus.
|
hyper, decreased
|
|
|
Levels help evaluate parathyroidism and calcium metabolism.
|
Calcium
|
|
|
Factors that interfere with calcium levels:
|
Vitamin D intoxication, excessive milk intake, prolonged tourniquet time.
|
|
|
Hyperparathyroidism , metastic tumor, Paget's disease,prolonged immobilization, and hyper thyroidism all can lead to __________ calcium
|
increased
|
|
|
Rickets, Vit D defiency, renal failure, osteomalacia, hypoparathyroidism lead to decreased ___________.
|
calcium
|
|
|
The Albumin/globulin ratio (AG ratio) should always be1.0 or greater. T or F
|
true
|
|
|
What test do you order if you want to check the A/G ratio?
|
Protein Electrophoresis
|
|
|
What is Protein Electrophoresis used for ?
|
Used to diagnose and monitor pts with cancer, protein wasting states, immune disorders, liver dysfunction, impaired nutrition, and chronic edema
|
|
|
Gamma globulins are
|
antibodies
|
|
|
_________ makes up 60% of the total protein and is synthesized in the liver.
|
Albumin
|
|
|
_________ remains normal during liver disease even though albumin is decreased.
|
Globulin
|
|
|
The liver synthesizes _______ and the reticuloendothelial system sysnthesizes _______
|
albumin, globulin
|
|
|
Most common cause of _____ albumin is dehydration.
|
increased
|
|
|
__________ disease, malnutrition, pregnancy, overhydration, protein-losing conditions cause decreased albumin.
|
liver
|
|
|
Increased gamma globulins is indicative of _______ _______, Waldenstrom's, macrogloulinemia, malignancy, cirrhosis.
|
Multiple Myeloma
|
|
|
Decreased _________ globulins are caused by immune disorders, secondary immune deficiency, AIDS
|
gamma
|
|
|
Albumin/globulin ratio reference range is >
|
1.0
|
|
|
An A/G ratio <1.0 is referred to as an inverted _________ and is bad.
|
A/G ratio
|
|
|
Bilirubin is used to evaluate the function of the spleen. T or F
|
False, evaluates liver function
|
|
|
RBC's breakdown , mostly in the ________, and release _________ and globin.
|
spleen, heme
|
|
|
Heme converts to _________ and then bilirubin.
|
biliverdin
|
|
|
Indirect bilirubin is also known as ______________ bilirubin.
|
unconjugated
|
|
|
Bilirubin is _________ in the liver with ___________ to become conjugated or direct bilirubin
|
conjugated, glucuronide
|
|
|
AN obstruction such as ________, tumor, trauma, inflammation, liver metastasis will increase direct (conjugated ) bilirubin.
|
Gall Stones
|
|
|
Increased indirect (unconjugated) bilirubin ______ with erythoblastosis fetalis, transfusion reaction, Sickle cell anemia, hemolytic anemia, pernicius anemia, hepatitis, cirrhosis, neonatal hyperbilirubinemia
|
increases
|
|
|
Bilirubin will be elevated when blood breaks down too fast. this is _________ bilirubin.
|
Indirect (unconjugated)
|
|
|
Bilirubin is elevated when some kind of obstruction in the liver prohibits excretion. This is ____________ bilirubin.
|
direct (conjugated)
|
|
|
Elevated bilirubin (either kind) creates a condition where the skin turns yellow. this is called ________________.
|
jaundice
|
|
|
ALP is also known as________ _________.
|
Alkaline Phosphatase
|
|
|
What lab test is used for detecting and monitoring diseases of liver and bone?
|
Alkaline phosphatase
|
|
|
Causes for increase of Alkaline Phosphatase (ALP)?
|
primary cirrhosis,bilary obstruction, primary or metastatic liver tumor, late pregnancy, Paget's, metastatic bone tumors
|
|
|
Scurvy, Pernicious anemia, malnutrition, Hypophosphatemia all _____ Alkaline Phosphatase.
|
decrease
|
|
|
AST (Aspartate Aminotransferase) formerly SGOT evaluates what?
|
coronary artery occlusion or liver disease
|
|
|
Where is AST found?
|
heart muscle, liver cells, skeletal muscle
|
|
|
What is the window for testing AST levels?
|
levels increase in 8 hrs, peak in 12-24 hours, become normal in 3-7 days
|
|
|
Facotrs that can interfere with an AST level are?
|
Pregnancy decreses levels
exercise may increase Medications can alter |
|
|
M.I., or other myocardium injury, hepatitis, cirrhosis or liver injury, skeletal muscle trauma and MD all do what to an AST level?
|
increase
|
|
|
Decreased AST results from
|
acute renal disease, Berberi, diabetic ketoacidosis, pregnancy
|
|
|
ALT formerly SGPT also called
|
Alanine Aminotransferase
|
|
|
ALT is more specific for heart or liver?
|
liver
|
|
|
Identifies and monitors liver disease
|
ALT
|
|
|
ALT is both sensitive and ________ for liver damage.
|
specific
|
|
|
Indicates cell damage in heart, liver, RBCs, kidneys, brain, lungs, skeletal muscle
|
Lactic Dehydrogenase (LDH)
|
|
|
LDH-1 is a
sensitive indicator for |
M.I. and RBC disease
|
|
|
increased LDH-2 and LDH-3 indicate what
|
pulmonary disease
|
|
|
Hepatic and skeletal muscle disease are indicated by what
|
LDH-5
|
|
|
Creatine phosphokinase (CPK) or (CK)
|
indicates injury to the myocardium
|
|
|
Factors that interefere with CPK
|
I.M. injections, strenuous exercise, early pregnancy
|
|
|
CPK is related to what factor?
|
muscle mass
|
|
|
Increased total CPK indicates injury to _____, skeletal muscle and _______,
|
heart, brain
|
|
|
Increased CPK-BB indicates
damage to ________,_______, and _____ |
brain, breast, breathe
(CNS Disease, Breast cancer, pulmonary disease/lung cancer |
|
|
Increased CPK-MB is indicative of what
|
Myocardium damage
|
|
|
Increased CPK-MM indicates
|
Muscle (mm) damage
|
|
|
Gamma-Glutamyl Transpeptidase (GGTP) AKA
|
Gamma -Glutamyl Transferase (GGT) most common
|
|
|
This indicates hepatobiliary disease or heavy chronic alcohol use
|
GGTP AKA GGT
|
|
|
Elevated GGTP together with elevated ALP suggest?
|
liver disease
|
|
|
Normal GGTP with elevated ALP suggest _____________ disease.
|
bone
|
|
|
Increased GGTP most often suggests _______ disease
|
liver
(can indicate M.I., alcohol ingestion, Epstein-Barr virus, Cytomegalovirus, Reye's syndrome) |
|
|
Serum Iron, TIB, & Transferrin is __________ but not specific
|
sensitive
|
|
|
Iron poisoning and hemochromatosis result in _________ serrum iron
|
increased
|
|
|
What is the main cause for iron poisoning
|
overconsumption of vitamins and supplements containing iron by men and postmenopausal women
|
|
|
iron poisoning oxidizes ____
|
LDL
|
|
|
chronic blood loss malabsorption, dietary deficiency, neoplasia and late pregnancy result in _________
serum iron |
decreased
|
|
|
Most body fat is in the form of
|
Triglyceriedes
|
|
|
Triglyceride indicates cardiovascular ________ and ______ metabolism disorders
|
risk, lipid
|
|
|
Factors that interfere with a tryglyceride level?
|
Eating high fat meal, alcohol, pregnancy, medications
|
|
|
Increased Triglyceride can indicate
|
hyperlipidemia, high refined carb diet, hypothyroidism, poorly controlled diabetes, chronic renal disease
|
|
|
Decreased triglycerides indicate malabsorption, ______, _______,
|
malnutrition and hyperthyroidism
|
|
|
elevated Cholesterol should always be verified by repeatin the test. T or F
|
true
|
|
|
A 12-14 hour fast after eating a ______ fat meal is required for a cholesterol test
|
low
|
|
|
familial hyperlipidemia, diabetes, high saturated fat diet will _________ cholesterol
|
increase
|
|
|
Decreased cholesterol can be a sign of __________, hyperthyroidism, ________ disease, pernicious anemia
|
advanced cancer, liver
|
|
|
Ominous sign if all blood tests are the same and then cholesterol drops. T or F
|
true
|
|
|
Lipoproteins test for what?
|
HDL, LDL, VLDL
|
|
|
HDL is primarily __________
LDL is primarily ___________ VLDL is primarily___________ |
HDL is protein and some cholesterol
LDL is cholesterol VLDL is Triglycerides |
|
|
_______ takes cholesterol from tissue to the liver for processing
|
HDL
|
|
|
Cholymicrons are primarily _____________
|
triglycerides
|
|
|
HDL is made in the ______ and _________.
|
liver, intestines
|
|
|
Hdl removes ________ from the tissues and carries it to the liver for __________.
|
cholesterol, excretion
|
|
|
LDL deposits ______ in peripheral tissues
|
cholesterol
|
|
|
cholesterol Risk factor =
|
total cholesterol /HDL
|
|
|
Elevated VLDL is a risk factor for coronary artery disease but not as serious as elevated ____
|
LDL
|
|
|
Interfering factors for Lipoproteins level
|
smoking and alcohol lower HDL
binge eating medications high fat meal |
|
|
Increased HDL is caused by
|
familial HDL lipoproteinemia
"excessive exercise" chronic exercise of 30 min X 3 days wk |
|
|
Decreased HDLs caused by
|
familial tendency, liver disease, malnutrition
|
|
|
Increased LDL/VLDL
|
familial, alcohol consumption, hypothyroidism, chronic liver disease, bad diet/sedentary lifestyle
|
|
|
ACID Phosphatase AKA
|
prostatic acid phosphatase (PAP)
|
|
|
ACID Phosphatase AKA
|
prostatic acid phosphatase (PAP)
|
|
|
Acid phosphatase is used for what?
|
diagnose and stage prostate cancer
|
|
|
Acid phosphatase is used for what?
|
diagnose and stage prostate cancer
|
|
|
Where does prostate cancer usually spread to?
|
Bone
|
|
|
Where does prostate cancer usually spread to?
|
Bone
|
|
|
High levels of _______ ________ indicate that prostate cancer has spread.
|
Acid Phosphatase
|
|
|
High levels of _______ ________ indicate that prostate cancer has spread.
|
Acid Phosphatase
|
|
|
A Prostate exam should be performed before or after an Acid Phosphatase level?
|
After
Prostate exams or intercourse can change the results. Levels will appear 25-50% higher up to 48 hrs. after the exam or intercourse. |
|
|
A Prostate exam should be performed before or after an Acid Phosphatase level?
|
After
Prostate exams or intercourse can change the results. Levels will appear 25-50% higher up to 48 hrs. after the exam or intercourse. |
|
|
Conditions that cause high levels of ALP ( Alkaline Phosphatase) may also raise PAP (Acid Phosphatase. T or F
|
true
|
|
|
Acid Phosphatase increases indicate
|
Prostatic carcinoma
benign Prostatic hypertrophy Multiple Myeloma |
|
|
PSA-Prostate Specific Antigen
reference range is |
<4ng/ml
|
|
|
PSA is used to ____________ prostate cancer
|
Screen
|
|
|
Along with a prostate exam PSA can detect almost ______% of significant cancers.
|
90
|
|
|
What exam may elevate PSA?
|
Rectal exam
|
|
|
PSA is more or less sensitive and specific than other prostatic tumor markers.
|
More
|
|
|
PSA can be elevated by
|
Prostate biopsy
ejaculation within 24 hrs recent Urinary Tract Infection (as much as 5X baseline for up to 6 weeks) |
|
|
Increased PSA caused by
|
prostate cancer
prostatitis BPH |
|
|
Amylase is used to diagnose and monitor
|
pancreatitis
|
|
|
When would amylase be ordered
|
For those experiencing severe abdominal pain
|
|
|
Increased amylase can indicate
|
pancreatitis, acute cholecystitis,
renal failure, intestinal disease, mumps, ruptured ectopic pregnancy |
|
|
Lipase evaluates the
|
pancreas
|
|
|
Most common cause of elevated lipase is
|
acute pancreatitis
( cholecystitis, renal failure, intestinal disease) |
|
|
Carbon Dioxide Content is increased with
|
severe vomiting, COPD, Metabolic Alkalosis
|
|
|
Carbon Dioxide Content is decrease when
|
chronic diarhea, renal failure, diabetic ketoacidosis, starvation
|
|
|
Cortisol measures
|
adrenal gland function
|
|
|
Cortisol is performed at least _________ in an eight hour period
|
Twice ( 4 times in a 16 hour period is better)
|
|
|
Stress has no effect on Cortisol.
T or F |
False, Stress, emotional and physical, increases Cortisol as does pregnancy
|
|
|
Increased Cortisol results from
|
Stress
Cushing's Disease hyperthyroidism obesity |
|
|
Decreased Cortisol results from
|
Addison's Disease
Hypothyroidism adrenal fatigue |
|
|
C-Peptide AKA
|
Connecting Peptide
|
|
|
C-peptide is used to monitor diabetic patients who may be secretly taking ____________and patients who have ___________
|
Insulin, insulinomas
|
|
|
C-Peptide or Connecting Peptide can be increased by
|
kidney failure and insulinomas
|
|
|
Decreased C-Peptide results from
|
diabetes (Exongenous (synthetic) insulin suppresses endogenous (your own) insulin and C-Peptide)
|
|
|
C-Reactive Protein (CRP)
|
indicates acute inflammatory conditions
|
|
|
C-Reactive Protein is an abnormal protein produced by the _____ during the inflammatory process
|
liver
|
|
|
C-reactive Protein (CRP) indicates the cause of inflammation. T or F
|
False, does not
|
|
|
CRP is ______sensitive than ESR.
|
more
|
|
|
CRP is increased by
|
Acute Inflammatory reaction ( arthritis, Crohn's)
bacterial infection Malignant disease |
|
|
Erythrocyte Sedimentation Rate (ESR)
|
Used to detect acute and chronic inflammation
|
|
|
Interfering factors to an ESR
|
pregnancy, menustration, non-vertical sedimentation tube
|
|
|
In an ESR, _______ settle to the bottom of the tube over time
|
RBCs
|
|
|
Increased ESR indicates
|
acute or chronic inflammation
chronic renal failure malignant disease necrotic disease severe anemia |
|
|
Creatinine Clearance Test is used to determine the ________
_________ ________ |
Glomerular Filtration Rate (GFR)
|
|
|
If patient has only one working normal kidney the kidney increases its GFR so Creatinine Clearance will increase, decrease or stay the same?
|
stay the same
|
|
|
Creatinine Clearance requires a ________ hr urine collection AND a _________creatinine level.
|
24, serum
|
|
|
Interfering factors for a Creatinine Clearance test
|
exercise and high meat diet increase levels.
Incomplete urine collection decreases value |
|
|
Exercise, pregnancy, High cardiac output syndromes __________ creatinine clearnace levels.
|
increase
|
|
|
Congestive Heart Failure, Impaired kidney function, dehydration _____________
Creatinine Clearance |
decrease
|
|
|
Ferritin is the __________ form of iron
|
storage
|
|
|
Ferritin is the most ________ blood test for iron-deficiency anemia.
|
sensitive
|
|
|
What level of ferritin is diagnostic?
|
below 10
|
|
|
THe Gold standard test for Ferritin is
|
bone marrow
|
|
|
Increased ferritin is caused by
|
inflammatory disease
hemochromatosis hemolytic anemia alcoholism |
|
|
Decreased Ferritin indicates
|
iron deficiency anemia
severe protein deficiency dialysis |
|
|
Used primarily for bleeding disorders
|
Fibrinogen
|
|
|
Diets rich in ___________ fats can decrease fibrinogen.
|
polyunsaturated
|
|
|
Increased Fibrinogen results from
|
acute inflammmatory reactions
trauma acute infections vascular disease stroke pregnancy cigarette smoking |
|
|
Decreased fibrinogen results from
|
liver disease
advanced carcinoma malnutrition |
|
|
Number 1 deficiency in the world
|
Folic Acid (Folate)
|
|
|
Folic Acid is decreased by
|
malnutrition
malabsorption pregnancy megablastic anemia hemolytic anemia malignancy chronic renal disease liver disease |
|
|
Increases in Folic Acid
|
Pernicious Anemia (B12 needed to metabolize folate)
Vegetarianism |
|
|
HLA-B27 Antigen (Human Leucocyte Antigen) normal finding
|
Negative
|
|
|
Positive HLA- B27 can indicate
|
Ankylosing Spondylitis
Reiter's Syndrome Ciliac Disease M.S., M.G. , Psoriasis, RA, juvenile diabetes |
