Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/322

Click to flip

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