Term
What is the benefits of a CBC? |
|
Definition
It helps in evaluating symptoms (weakness, fatigue, fever, bruising), diagnosing conditions/diseases (anemia, infection, leukemia), and determining the stages of particular disease |
|
|
Term
What should be done if a significantly abnormal CBC is obtained? |
|
Definition
A peripheral blood smear should be prepared and examined |
|
|
Term
What does a CBC consist of? |
|
Definition
Total WBC count
WBC differential
RBC count
Hemoglobin (Hb) concentration
Hematocrit
Platelet count
RBC indices (mean corpuscular volume, Hb, Hb concentration, and RBC distribution width) |
|
|
Term
What is the normal WBC count for males? |
|
Definition
|
|
Term
What is the normal range for RBC count in male and females? |
|
Definition
Male: 4.3 - 6.0
Female: 3.5 - 5.5 |
|
|
Term
What is a normal range from hemoglobin in males and females? |
|
Definition
Males: 13.6 - 17.5
Females: 12 - 15.5 |
|
|
Term
What are normal levels of hematocrit in women and men? |
|
Definition
Men: 39 - 49%
Females: 35 - 45% |
|
|
Term
What is a normal platelet count? |
|
Definition
|
|
Term
What is a reason for an increased number of RBCs? |
|
Definition
Hemoconcentration (Dehydration) |
|
|
Term
When there is a decrease in RBCs, it is called? |
|
Definition
|
|
Term
|
Definition
Hemoglobin is the major protein of erythrocytes that transports O2 from the lungs to the peripheral tissues |
|
|
Term
What would be considered an abnormally low Hb level? |
|
Definition
|
|
Term
What are two reasons for a false high reading of Hb? |
|
Definition
Hypertriglyceridemia and a very high WBC count |
|
|
Term
An increase in Hb can be attributed to what? |
|
Definition
|
|
Term
A decrease in hemoglobin can be attributed to what? |
|
Definition
Macrocytic anemia
Normocytic anemia
Microcyctic anemia |
|
|
Term
|
Definition
The average volume of RBCs |
|
|
Term
What are some reasons for MCV to be increased? |
|
Definition
Liver disease, alcohol abuse, & megaloblastic anemia |
|
|
Term
What are some reasons for MCV to be decreased? |
|
Definition
Iron deficiency and thalassemia |
|
|
Term
How much energy (kcal/gram) is in each Macronutrient? |
|
Definition
Carbohydrates: 4 kcal/gram Protein: 4 kcal/gram Fats: 9 kcal/gram Alcohol: 7 kcal/gram |
|
|
Term
What is the only energy source for RBCs? |
|
Definition
|
|
Term
What is the preferred energy for the brain, central nervous system, placenta, and fetus? |
|
Definition
|
|
Term
What is weight management dependent upon? |
|
Definition
The balance of energy intake and enerygy expenditure, regardless of the proportions of fats, carbs, and protein in the diet. |
|
|
Term
What are the fat soluable vitamins? |
|
Definition
|
|
Term
A high level of what type of cholesterol is good, what type is bad? |
|
Definition
An increase in LDL cholesterol increases the risk of CHD An increase in HDL is a benefit |
|
|
Term
A high cholesterol is a risk factor for what? |
|
Definition
|
|
Term
Is there a positive relationship between serum triglycerides and the incidence of CHD? |
|
Definition
|
|
Term
High triglyceride is one of the diagnostic criteria for what? |
|
Definition
|
|
Term
In a high risk person, what is the recommended LDL cholesterol goal? |
|
Definition
|
|
Term
If a person is a very high risk, what is the LDL cholesterol goal? |
|
Definition
|
|
Term
When a person is moderately high, what is the recommended goal for LDL cholesterol? |
|
Definition
|
|
Term
What is Kwashiorkor Syndrome? |
|
Definition
Deficiency of protein in the presence of adequate energy |
|
|
Term
What is Marasmus Syndrome? |
|
Definition
Deficiency of protein and energy |
|
|
Term
What vitamin is essential for normal retinol function? |
|
Definition
|
|
Term
What vitamin deficiency can cause blindness? |
|
Definition
|
|
Term
What is the earliest symptom of vitmin A deficiency? |
|
Definition
|
|
Term
Large doses of B-carotenes can do what? |
|
Definition
Stain the skin yellow-orange color (hypercatotenosis) |
|
|
Term
Vitamin C deficiency can lead to what disease? |
|
Definition
|
|
Term
What vitamin allows intestines to absorb calcium? |
|
Definition
|
|
Term
Deficiencies in vitamin D can lead to what? |
|
Definition
It can lead to a deficiency of calcium absorbtion, which can cause osteomalacia and rickets |
|
|
Term
What vitamin is involved with coagulation? |
|
Definition
|
|
Term
Where can you find vitamin K? |
|
Definition
Leafy vegetables and synthesis by intestinal bacteria |
|
|
Term
Which vitamin dificiency can cause bleeding? |
|
Definition
|
|
Term
What is the purpose of Niacin? |
|
Definition
Can decrease LDL and increase HDL cholesterol |
|
|
Term
What does high doses of Niacin do? |
|
Definition
Can cause flushing and gastic irritation |
|
|
Term
What is a deficiency of Thiamine attributed to? |
|
Definition
|
|
Term
Thiamine deficiencies lead to what diseases? |
|
Definition
|
|
Term
What does wet beriberi involve? |
|
Definition
Involves the cardiovascular system and high-output cardiac failure |
|
|
Term
What does dry beriberi involve? |
|
Definition
Involves the nervous system |
|
|
Term
Wernicke-Korsakoff syndrome is related to what deficiency and what specifically? |
|
Definition
Thiamine dificiency and Dry beriberi |
|
|
Term
What should be prescribed with isoniazid? |
|
Definition
|
|
Term
Where do you find a lot of B12? |
|
Definition
|
|
Term
People with pernicious anemia, its common for them to have what deficiency? |
|
Definition
|
|
Term
If vitamin B12 is borderline low, what follow up blood tests can be useful? |
|
Definition
Methylmalonic acid and parietal cells |
|
|
Term
What are the essentials to diagnosing anorexia nervosa? |
|
Definition
Disturbance of body image and intense fear of becoming fat Weight loss leading to body weight 15% below expected In females, absence of three consecutive menstrual cycles Concept of thinness is unrealistic |
|
|
Term
People with anorexia nervosa, what is the percentage of women? |
|
Definition
90% of the people with anorexia nervosa are females |
|
|
Term
Amenorrhea is almost always present in what illness? |
|
Definition
|
|
Term
What is the treatment for anorexia nervosa? |
|
Definition
The goal of treatment is restoration of normal body weight and resolution of psychological difficulties All patients with dianosed anorexia nervosa should be co-managed with a psychiatrist |
|
|
Term
What are the essential of diagnosis for Bulimia Nervosa? |
|
Definition
Uncontrolled episodes of binge eating at least twice weekly for 3 months Recurrent inappropriate compensation to prevent weight gain such as self-induced vomiting, laxatives, diuretics, fasting, or excessive exercise |
|
|
Term
What is the common age range for bulimia nervosa? |
|
Definition
|
|
Term
In which eating disorder is the menstrual cycle preserved? |
|
Definition
|
|
Term
A person with bulimia nervosa will sometimes vomit, what is the physical damage that can be done from vomiting on a regular basis? |
|
Definition
Can result in poor dentition |
|
|
Term
|
Definition
RDW is a measure of the degree of anisocytosis (variation of RBC size) |
|
|
Term
RDW is increased when...? |
|
Definition
When there is some type of anemia
Liver disease |
|
|
Term
|
Definition
An acute infection, inflammatory disorders, acute and chronic leukemias, corticosteroids, stress, and smoking |
|
|
Term
|
Definition
Infections, myelosuppression, autoimmune neutropenia, and alcoholism |
|
|
Term
The neutrophil count will be increased when..? |
|
Definition
Infection Acute stress Acute and chronic inflammation |
|
|
Term
The lymphocyte count will be increased when..? |
|
Definition
Viral infection ALL and CLL |
|
|
Term
THe lymphocyte count will be decreased if you have what? |
|
Definition
Immune deficiency syndromes (HIV) |
|
|
Term
The monocyte count will be decreased when..? |
|
Definition
They will be depleted in an overwhelming bacterial infection |
|
|
Term
The eosinphils will be increased when..? |
|
Definition
Allergic states Drug sensitivity reactions Tissue invasion by parasites |
|
|
Term
The basophil count will be increased when..? |
|
Definition
Hypersensitivity reactions |
|
|
Term
Why are platelets important? |
|
Definition
They are important for normal hemostasis |
|
|
Term
There will be an increase in platelet count when..? |
|
Definition
Acute blood loss Post-splenectomy |
|
|
Term
There will be an increase in platelet count when..? |
|
Definition
Acute blood loss Post-splenectomy |
|
|
Term
There is little tendency to bleed until the platelet count falls below what? |
|
Definition
|
|
Term
Bleeding due to low platelet counts typically presents as what? |
|
Definition
Epistaxis Petechiae Gingival bleeding |
|
|
Term
If you are going to have a invasive procedure, what are desirable platelet counts? |
|
Definition
|
|
Term
What is the purpose of a peripheral blood smear? |
|
Definition
Peripheral blood smear provides important information about defects in red cell production. The blood smear also reveals variations in cell size (anisocytosis) and shape (poikilocytosis) |
|
|
Term
What makes up the basic metabolic panel? |
|
Definition
NA K Cl BUN Creatinine CO2 Glucose Calcium |
|
|
Term
What makes up the comprehensive metabolic panel? |
|
Definition
Albumin Total protein Alkaline phosphatase ALT AST Bilirubin |
|
|
Term
What are normal levels for NA? What are panic levels? |
|
Definition
Normal: 135-145 meq/L Panic: <125 or >155 meq/L |
|
|
Term
What can cause an increase in Na? |
|
Definition
|
|
Term
What is the normal range for K? What is the panic range for K? |
|
Definition
Normal: 3.5-5.0 meq/L Panic: <3.0 or >6.0 |
|
|
Term
Elevated or depressed K concentrations can interfere with what? |
|
Definition
|
|
Term
K can be increased because of..? |
|
Definition
Potassium-sparing diuretics ACE inhibitors ACE-receptor blockers |
|
|
Term
K can be decreased because of..? |
|
Definition
|
|
Term
Spurious hyperkalemia can occur when? |
|
Definition
Hemolysis of sample Delayed seperation of serum from erythrocytes Prolonged fist clenching during blood drawing Prolonged tourniquet placement |
|
|
Term
BUN is directly related to what? |
|
Definition
Protein intake and nitrogen metabolism |
|
|
Term
BUN is inversely related to what? |
|
Definition
Rate of excretion of urea |
|
|
Term
What are normal levels of creatinine? |
|
Definition
|
|
Term
Creatinine clearance is an acceptable clinical measure of what? |
|
Definition
Glomerular filtration rate (GFR) |
|
|
Term
For each 50% reduction in GFR, serum creatinine approximately what? |
|
Definition
|
|
Term
Creatinine levels are increased when..? |
|
Definition
Acute or chronic renal failure Neprhotoxic drugs |
|
|
Term
Diagnosis of diabetes mellitus requires what? |
|
Definition
A fasting plasma glucose of >126 mg/dL on more than one occasion. Or a casual plasma glucose level 200 mg/dL along with symptoms of DM |
|
|
Term
Hypoglycemia is defined as what? |
|
Definition
Men: <50 mg/dL Women: <40 mg/dL |
|
|
Term
Level of ionized calcium is regulated by what? |
|
Definition
Parathyroid hormone and Vitamin D |
|
|
Term
ALT (SGPT) is released when..? |
|
Definition
Released with tissue damage, particularly liver injury |
|
|
Term
AST (SGOT) is released into the blood stream when? |
|
Definition
When tissue is damaged, especially liver injury |
|
|
Term
What is the preferred enzyme for evaluation of liver injury? |
|
Definition
|
|
Term
Where is alkaline phosphatase found? |
|
Definition
Liver, bone, intestine, and placenta |
|
|
Term
In 90% of liver disease patients this is elevated/ |
|
Definition
|
|
Term
GGT is used for what purpose? |
|
Definition
It is used to confirm hepatic origin or elevated serum alkaline phosphatase |
|
|
Term
|
Definition
Bilirubin a product of hemoglobin metabolism, is conjugated in the liver and excreted in bile |
|
|
Term
|
Definition
It provides color to the bile, feces, and urine and accounts for discoloration of the skin in jaundice |
|
|
Term
Elevated serum bilirubin occurs when..? |
|
Definition
Liver disease Biliaary obstruction Hemolysis |
|
|
Term
What is indirect bilirubin? |
|
Definition
Severe jaundice but no bilirubin in the urine. Due to an increase in heme production that overwhelms the conjugation pathway, diminished or absent conjugation |
|
|
Term
What is direct bilirubin? |
|
Definition
Bilirubin is found in the urine. Cojugated bilirubin is being formed in the hepatocyte, but it cannot be transported adequately into bile |
|
|
Term
What is a major binding protein? |
|
Definition
|
|
Term
Amylase is primarily derived from where? You see an increase of amylase when..? |
|
Definition
Pancreas. It is increased with inflammation or obstruction of pancreas |
|
|
Term
What may be a more reliable test than serum amylase for initial diagnosis of acute pancreatitis? |
|
Definition
Lipase becasue lipase remains elevated longer than amylase |
|
|
Term
True or false. Daily measurments of amylase and lipase are of no value in assessming the patient's clinical progress |
|
Definition
|
|
Term
What does a fecal occult blood screen do? |
|
Definition
Measures blood in the stool |
|
|
Term
What is a normal value for prostate normal antigen (PSA) |
|
Definition
|
|
Term
Immunoglobulin IgG is what? |
|
Definition
It predominates late in immune response. They are the memory cells. |
|
|
Term
What immunoglobulin can cross the placenta? |
|
Definition
|
|
Term
IgM is the immunoglobulin that predominates when? |
|
Definition
Early in the immune response. They are the immediate attackers! |
|
|
Term
How is Hepatitis A passed? |
|
Definition
|
|
Term
What are some of the symptoms of hepatitis A? |
|
Definition
Flu-like illness (arthralgias, N/V, anorexia, fatigue and fevers) |
|
|
Term
How is Hepatitis B passed? |
|
Definition
|
|
Term
What is the window period of Hep B? |
|
Definition
Time when no surface antigen or antibody, but there are anticore |
|
|
Term
If you test for Hep B and you only see the surface antigen, what does this mean? |
|
Definition
You have caught the disease early. |
|
|
Term
In Hep B, if you test and have Anti surface and anti core then..? |
|
Definition
You have a chronic case of HEP B |
|
|
Term
In HEP B, if you test and only have surface antibody then..? |
|
Definition
You have only the surface antibody then you are more than likely vaccinated |
|
|
Term
HEP B core antibodies will show up when? |
|
Definition
HEP B antibody will be positive about 2 months after exposure of HEP B |
|
|
Term
What indicated viral replication and infectivity in HEP B? |
|
Definition
|
|
Term
How is HEP C normailly transmitted? |
|
Definition
Blood borne-especially IV drug users Until 1990, blood transfusion. There is no vaccine for HEP C |
|
|
Term
When you test for HEP C Antibody, what does it tell you? |
|
Definition
Positive result says previous exposure, not necessarily acute infection |
|
|
Term
Physiologically, what inhibits pituitary secretion of TSH |
|
Definition
unbound T4 and T3 in plasma that are active and inhibit pituitary secretion of TSH |
|
|
Term
What are some hypothyroid symptoms? |
|
Definition
Weight gain, fatigue, lethargy, depression, weakness, muscle cramps, cold intolerance, constipation, dry skin, menorrhagia, thin brittle nails, thinning of the hair, peripheral edema, puffy face and eyelids, delayed relaxation of deep tendon reflexes |
|
|
Term
What are some hyperthyroid symptoms? |
|
Definition
Heat intolerance, sweating, weight loss, nervousness, fine resting tremor, hyperreflexia, upper eyelid retraction, moist warm skin, fine hair, palpitations, sinus tachycardia, thyroid storm |
|
|
Term
Thyroid stimulating Hormone (TSH) Where does it come from and what does it do? |
|
Definition
TSH is an anterior pituitary hormone that stimulates the thyroid to produce thyroid hormones |
|
|
Term
In hyperthryoidism you will see an increase or decrease in TSH? In hypothyroidism you will see an increase of decrease in TSH? |
|
Definition
Hyperthyroidism: Decreased TSH Hypothyroidism: Increased TSH |
|
|
Term
When measuring T3 and T4, you will see an increased level in hyper or hypo thyroidism? |
|
Definition
Hyperthyroidism: Increased T3/T4 levels Hypothyroidism: Decreased T3/T4 levels |
|
|
Term
Thyroperoxidase (TPO) Antibody will be increased when..? |
|
Definition
Hashimoto thyroiditis Graves disease |
|
|
Term
What does parathyroid hormone do? |
|
Definition
It mobilizes calcium from bone Increases distal renal tubular reabsorption of calcium Decreases proximal renal tubular reabsorption of phosphorus Stimulates 1,25-hydroxy vitamin D synthesis from 25-hydroxy vitamin D |
|
|
Term
Where is the prolactin secreted from? |
|
Definition
The anterior pituitary gland |
|
|
Term
What is the primary purpose of testing prolactin levels? |
|
Definition
Used primarily in work-up of suspected pituitary tumor (60% of pituitary adenomas secrete PRL) |
|
|
Term
What is the clinical presentation of persons with an increase prolactin level? |
|
Definition
Is usually amenorrhea and galactorrhea in women Impotence in men |
|
|
Term
Free testosterone levels should be tested when? |
|
Definition
Free testosterone should be measured in symptomatic patients with noramal total testosterone levels |
|
|
Term
Follicle-stimulating hormone levels rise when? |
|
Definition
FSH levels rise during the preovulatory phase of the menstrual cycle |
|
|
Term
Human Chronic Gonadotropin (HCG)levels elevate when? |
|
Definition
During the normal pregnancy, serum levels double every 2-3 days |
|
|
Term
HCG is elevated during what coniditions? |
|
Definition
Pregnancy Some germ cell tumors Ectopic hcG production by other malignancies |
|
|
Term
|
Definition
Systemic lupus erythmatosus (SLE) Rheumatoid arthritis Scleroderma |
|
|
Term
Does a negative ANA test rule out SLE? |
|
Definition
No, but alternate diagnosis should be considered |
|
|
Term
Rheumotoid factor will be positive during what? |
|
Definition
Rheumotoid arthritis, however a positive RF test is only one of several criteria needed to make the diagnosis of rheumatoid arthritis |
|
|
Term
An increase titer of a Double-Stranded DNA Antibody test is a sign of what? |
|
Definition
SLE - Systemic Lupis Erythematosus |
|
|
Term
Erythrocyte Sedimentation Rate (ESR) is increased in..? |
|
Definition
Infections Inflammatory disease Malignant neoplasms |
|
|
Term
C-Reactive Protein can tell you what? |
|
Definition
CRP is very sensitive of imflammation, but it does not tell you where the inflamamation is at in the body |
|
|
Term
Rapid marked increases of CRP occur with what? |
|
Definition
Inflammation Infection Trauma Tissue Necrosis Malignancies Autoimmune disorders |
|
|
Term
|
Definition
It detects the presence of antibody to the antigen streptolysin O produced by group A streptococci |
|
|
Term
You may see an increase of ASO levels in? |
|
Definition
Recent infection with group A hemolytic streptococci Scarlet Fever Erysipelas Tonsillitis Rheumatic fever Poststreptococcal glomerulonephritis |
|
|
Term
Infectious mononucleosis is what? It is caused by what? |
|
Definition
An acute saliva-transmitted infectious disease due to the Epstein-Barr virus |
|
|
Term
Heterophile antibodies appear when? |
|
Definition
Appear 60% of mononucleosis patients within 1-2 weeks and in 80-90% within the first month |
|
|
Term
What is helicobacter pylori and what are the symptoms? |
|
Definition
Helicobacter pylori is a gram-negative spiral bacterium that is found on gastic mucosa It induces acute and chronic inflammation in the gastic mucosa |
|
|
Term
What is Lyme's disease? What transmit Lyme's disease? |
|
Definition
Lyme disease is an inflammatory disorder transmitted by ticks |
|
|
Term
|
Definition
RPR is used as a screening test and in suspected primary and secondary syphilis |
|
|
Term
|
Definition
VDRL is used as a syphilis screening test and in suspected cases of primary and secondary syphilis |
|
|
Term
What test would you order if you suspect syphilis? |
|
Definition
|
|
Term
Iron-binding capacity, total (TIBC) levels are increased during..? |
|
Definition
|
|
Term
Ferritin levels are decreased in the body when..? |
|
Definition
When there is an iron deficiency |
|
|
Term
What can cause ferritin levels to increase? |
|
Definition
Liver disease increases serum ferritin levels and may mask the diagnosis of iron deficiency |
|
|
Term
What is the most commonly used test to monitor warfarin therapy? |
|
Definition
|
|
Term
Prothrombin time (PT) is most sensitive to what? |
|
Definition
It is most sensitive to deficiencies in the K-dependent clotting factors |
|
|
Term
Prothrombin is less sensitive to what? |
|
Definition
It is less sensitive to fibrinogen deficiency and heparin |
|
|
Term
What is the Warfarin therapeutic range? |
|
Definition
|
|
Term
Partial Thromboplastin Time (PTT) is commonly used to monitor what? |
|
Definition
|
|
Term
When do you screen for lead in a child? |
|
Definition
Child screening occurs at 12 months and 4-6 years of age |
|
|
Term
What is carboxyhemoglobin? |
|
Definition
When carbon monoxide binds to hemoglobin with a much greater affinity (240X) than oxygen, forming carboxyhemoglobin (COhb) |
|
|
Term
What is the result of carboxyhemoglobin? |
|
Definition
Results in impaired oxygen transport/delivery and utilization |
|
|
Term
High uric acid levels can be associated with what? |
|
Definition
Gout or uric acid kidney stones |
|
|
Term
Vitamin B12 levels is decreased in what? |
|
Definition
|
|
Term
Intermediate levels of vitamin B12 should be followed up with what test? |
|
Definition
By a serum methylmalonic acid test |
|
|
Term
90% of patients with pernicious anemia will also have what? |
|
Definition
Antibodies to parietal cells have been detected in >90% of patients with pernicious anemia |
|
|
Term
Serum Methylmelanic acid is used to what? |
|
Definition
Serum MMA is used to indirectly evaluate vitamin B12 status, mainly for confirming B12 deficiency |
|
|
Term
Skeletal muscle, myocardium, and brain are rich in what enzyme? |
|
Definition
|
|
Term
Creatine Kinase is released by what? |
|
Definition
|
|
Term
CK-MB is a test relatively specific for what? What is the time period for this? |
|
Definition
Myocardial Infarction, about 4 hours after, peaks at 12-24 hours, and declines over 48-72 hours |
|
|
Term
When may you find Troponin-I in serum when? |
|
Definition
Troponin-I appears in serum approximately 4 hours after onset of chest pain, peaks 8-12 hours, and persist 5-7 days |
|
|
Term
A negative D-dimer test essentially rules out what? |
|
Definition
A negative D-dimer test essentially rules out thrombosis, but a positive test does not confirm the diagnosis |
|
|
Term
D-dimer assay is a very sensitive test for what? |
|
Definition
|
|
Term
B-type Natriuretic Peptide (BNP)is useful for what? |
|
Definition
BNP is useful for guiding and monitoring heart failure treatment and for prognosis prediction |
|
|
Term
The level of glycated hemoglobin is related to what? |
|
Definition
The level of glycated hemoglobin is related to the mean plasma glucose level during the prior 3 months |
|
|
Term
Is glycohemoglobin recommended for initial diagnosis of diabetes? |
|
Definition
|
|
Term
What test is not generally required for diagnosis of DM? |
|
Definition
|
|
Term
When you do a urinalysis, what are you looking for? |
|
Definition
Specific gravity, pH, Protein, Bilirubin, Glucose, Ketones, Nitrites, Leukocyte esterase, blood |
|
|
Term
What type of urine will have high specific gravity? |
|
Definition
High - Volume depletion, concentrated Low - Diluted |
|
|
Term
If you have a positive finding for glucose in the urine, what should you evaulate for? |
|
Definition
|
|
Term
If a person tests positive for nitrites in the urine, that suggests..what? |
|
Definition
Many gram-negative bacteria can reduce nitrate to nitrate, thus an indicator of bacteriuria |
|
|
Term
If there are elevated leukocyte esterase in the urine, that can suggest? |
|
Definition
The dipstick detects leukocytes in the urine, which is thus suggestive but not diagnostic for bacteria |
|
|
Term
What is it suggestive of epithelial cells in the urinary sediment? |
|
Definition
The presence of squamous epithelial cells in the urinary sediment is indicative of contamination and thus requires a repeat collection |
|
|