Term
| Hypernatremic (dehydration) |
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Definition
| Na > 145 mEq/L; also caused by lithium, foscarnet, demeclocycline |
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Term
| Hyponatremic (hypervolemic) |
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Definition
| Na < 136 mEq/L; also caused by SSRIs, carbamazepine, cyclophosphamide |
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Term
|
Definition
| fractional excretion of sodium; kidneys regulate most body sodium |
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Term
| Note about Sodium abnormalities |
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Definition
| generally represent a water abnormality, more than a sodium abnormality |
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Term
| Renal tubular damage (increased excretion) |
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Definition
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Term
| Prerenal dysfunction (increased retention) |
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Definition
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|
Term
| Note about Potassium (K) Reference Range |
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Definition
| a small change in serum level reflects a LARGE change in total body level |
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Term
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Definition
| K > 5 mEq/L; caused by renal failure, drugs (ACE inhibitors, K-sparing diuretics); symptoms include arrhthmias |
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Term
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Definition
| K < 3.5 mEq/L; due to excessive loss (diarrhea, nausea/vomiting) or drugs (loop diuretics, amphoB); causes arrhythmias |
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Term
|
Definition
| generally used to confirm acid-base disorders |
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Term
|
Definition
| Cl < 96 mEq/L; caused by vomiting, diarrhea, GI suction, excessive diuresis |
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Term
|
Definition
| Cl > 106 mEq/L; caused by use of NSAIDs, corticosteroids, acetazolemide |
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Term
|
Definition
| occurs in metabolic alkalosis |
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Term
|
Definition
| occurs in metabolic acidosis |
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Term
| MUDPILES: Methanol intoxication, Uremia, Diabetic ketoacidosis, Paraldehyde, Isoniazid, Lactic acid, Ethanol, Salicylates |
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Definition
| causes of elevated gap acidosis |
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Term
| Causes of elevated BUN (azotemia) |
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Definition
| acute renal failure, dehydration, GI bleed, postrenal obstruction |
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Term
| Factors affecting Creatinine (Cr) levels |
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Definition
| diseases, protein, muscle mass, drugs taht inhibit tubular secretion or are nephrotoxic |
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Term
|
Definition
| indicates dehydration or indicators of other prerenal causes (shock, severe Heart Failure) |
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Term
|
Definition
| caused by diabetes mellitus, impaired fasting glucose, or drugs (corticosteroids, atypical antipsychotics, diuretics) |
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Term
|
Definition
| represents an average glucose level over the past 3 months; 7% --> 170 mg/dL; 8% --> 205 mg/dL; 9% --> 240 mg/dL |
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Term
|
Definition
| causes seizures, fatigue, memory loss, hallucinations |
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Term
|
Definition
| causes GI disturbance, lethargy, psychosis, and calcification in soft tissues when extra is combined with phosphate |
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Term
| Factors Affecting Ca levels |
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Definition
| parathyroid hormone, vitamin D levels, dietary intake, serum phosphate |
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Term
|
Definition
| Symptoms: disorientation, prolonged QT interval, muscle fasciculation; Causes: diarrhea, alcoholism, diuretics, pancreatitis |
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Term
|
Definition
| Symptoms: bradycardia, sweating, GI complaints; Causes: supplementation, renal failure |
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Term
|
Definition
| causes weakness, cardiac & respiratory failure in severe cases; mild cases may be asymptomatic |
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|
Term
| Factors affecting Serum Phosphate levels |
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Definition
| PTH, serum Ca levels, renal function, Vitamin D, dietary intake |
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Term
|
Definition
| infection, drugs (corticosteroids) |
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Term
|
Definition
| made up of neutrophils, eosinophils, & basophils; phagocytize bacteria, fungi, & yeast |
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Term
|
Definition
| may occur in severe immunosuppression, chemotherapy, radiation therapy, & cancer of bone marrow |
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Term
|
Definition
| immature neutrophils released from bone marrow in the presence of an acute infection; when elevated, called a "left-shift" or "bandemia" |
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Term
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Definition
| caused by parasitic infections, hypersensitivity reactions, autoimmune diseases |
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Term
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Definition
| caused by chronic inflammation, leukemia, hypersensitivity reactions |
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Term
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Definition
| caused by viral infections, fungal infections, and mononucleosis, syphilis, and lymphomas; may decrease as a normal response to increasing #s of neutrophils |
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Term
|
Definition
| caused by disseminated tuberculosis, endocarditis, recovery from a bacterial infection |
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Term
| Rationale for Ordering Lab Tests |
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Definition
| Discover disease (screening), confirm a diagnosis (diagnostic), determine stage or severity of disease, assess effectiveness of drug therapy, monitor adverse effects of drug therapy |
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Term
|
Definition
| substance or sample obtained from the body for the purpose of testing |
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Term
|
Definition
| tests fluids or tissues obtained by a needle or other device and by penetrating skin or entering body |
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Term
|
Definition
| tests a substance obtained without the use of a device and without penetrating skin or entering body |
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Term
|
Definition
| results are measured by units, accompanied by a reference range |
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Term
|
Definition
| results reported in context of presence or absence or positive or negative |
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Term
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Definition
| ability to detect a positive result in a truly positive patient (pt actually has disease), used to rule out diagnosis |
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Term
|
Definition
| ability to rule out a disease in patients who are truly negative, used to confirm diagnosis (does he have the disease or not?) |
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Term
|
Definition
| 95% of population falls within this range; calculated as mean +/- 2 standard deviations; preferred over "normal range" |
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Term
|
Definition
| a result far enough outside of the reference range to warrant immediate notification of the treatment team |
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Term
| Factors Affecting Lab Results |
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Definition
| lab errrors, fluid status, food, drugs, organ function |
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Term
|
Definition
| Basic Metabolic Panel, includes: Na, K, Cl, CO2 or HCO3, BUN, Cr, and Glucose |
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Term
|
Definition
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Term
|
Definition
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Term
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Definition
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Term
| Bicarb RR (CO2 first, then HCO3) |
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Definition
| 24 - 30 mEq/L CO2; 22 - 26 mEq/L HCO3 |
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|
Term
Anion Gap RR
-helpful in evaluating causes of metabolic acidosis |
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Definition
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|
Term
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Definition
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|
Term
| Factors affecting serum BUN levels |
|
Definition
| hydration status, intravascular volume, protein breakdown, renal function |
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Term
|
Definition
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|
Term
|
Definition
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|
Term
|
Definition
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|
Term
|
Definition
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|
Term
|
Definition
|
|
Term
|
Definition
| 8.5 - 10.8 mg/dL total or 4.6 - 5.2 mg/dL unbound |
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|
Term
|
Definition
| if Serum albumin < 3.0, correct serum Ca values using this equation: Ca corrected = [(4 - albumin) * 0.8 mg/dL] + Ca measured |
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|
Term
|
Definition
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|
Term
|
Definition
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|
Term
|
Definition
| 4.4 - 11.3 x 10^3 cells/mm^3 |
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Term
|
Definition
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Term
|
Definition
| polycythemia, chronic hypoxia |
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Term
|
Definition
| anemia, acute bleeding, dilutional |
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Term
|
Definition
| Males: 42 - 50%; Females: 36 - 45% |
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|
Term
| Mean Corpuscular Volume (MCV) RR |
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Definition
|
|
Term
|
Definition
| macrocytic anemia, folate or B12 deficiency anemia |
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Term
|
Definition
| microcytic anemia, iron deficiency anemia |
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Term
|
Definition
| normocytic anemia, trauma, hemolysis, mixed anemia |
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Term
|
Definition
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|
Term
| Increased platelets mean... |
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Definition
| thrombocytosis due to acute phase reactant to stress/infection/inflammation, chronic pancreatitis, rheumatoid arthritis, cirrhosis, polycythemia vera |
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|
Term
| Decreased platelets mean... |
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Definition
| thrombocytopenia due to DIC, TTP, ITP, HIT, H2 antagonists, valproic acid, antineoplastics |
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Term
| Patients with Plt < 50 x 10^3/uL places... |
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Definition
| pt at increased risk for bleeding; platelet transfusions contemplated |
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Term
| Patients with Plt count < 20 x 10^3/uL may cause... |
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Definition
| spontaneous bleeding and platelet transfusions are commonly ordered |
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Term
|
Definition
| caused by myoglobin: muscle damage, seizures, electric shock; Hemoglobin: hemolysis, hematuria; Drugs: rifampin, phenazopyridine, senna; Food: beets, blackberries, dyes |
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Term
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Definition
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|
Term
| Decreased urobilinogen in urine |
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Definition
| caused by total biliary obstruction |
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Term
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Definition
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Term
|
Definition
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Term
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Definition
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Term
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Definition
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|
Term
|
Definition
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Term
|
Definition
| Liver Function Tests; indicates hepatocellular injury (AST, ALT, LDH, GGT) |
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Term
|
Definition
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Term
|
Definition
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Term
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Definition
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Term
| Nonhepatic cause of elevated Liver enzymes |
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Definition
| ALP = mildly elevated; GGTP = WNL; AST/ALT = WNL |
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|
Term
| Cholestatic reason for Increased Liver Enzymes |
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Definition
| ALP = moderately elevated; GGTP = markedly elevated; AST/ALP = WNL |
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|
Term
| Hepatocellular Injury causes Elevated Liver Enzymes |
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Definition
| ALP = mildly elevated; GGTP = mildly elevated; AST/ALT = markedly elevated |
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Term
|
Definition
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|
Term
| Albumin's Major Functions |
|
Definition
| osmotic pressure in vessels, drug/element binding and transport, marker of liver fcn, marker of nutrition |
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|
Term
Total Bilirubin (T bili) RR
= unconjugated + conjugated bilirubin |
|
Definition
|
|
Term
| Direct (conjugated) Bilirubin RR |
|
Definition
| 0.1 - 0.3 mg/dL; elevated = biliary obstruction present |
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|
Term
| Indirect (unconjugated) Bilirubin RR |
|
Definition
| 0.2 - 0.7 mg/dL; elevated = increased production of bilirubin (hemolysis) or impaired heaptic function |
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