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PASS 613
Test 1 Material
190
Science
Graduate
01/31/2011

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Cards

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
4500 - 11,000
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
150,000 - 450,000
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
Anemia
Term
What is hemoglobin?
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
<7-8 g/dL
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
hemoconcentration
Term
A decrease in hemoglobin can be attributed to what?
Definition

Macrocytic anemia

Normocytic anemia

Microcyctic anemia

Term
What is  MCV?
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
Glucose
Term
What is the preferred energy for the brain, central nervous system, placenta, and fetus?
Definition
Glucose
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
A
D
E
K
Carotenoids
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
CHD
Term
Is there a positive relationship between serum triglycerides and the incidence of CHD?
Definition
Yes
Term
High triglyceride is one of the diagnostic criteria for what?
Definition
Metabolic syndrome
Term
In a high risk person, what is the recommended LDL cholesterol goal?
Definition
Less than 100 mg/dl
Term
If a person is a very high risk, what is the LDL cholesterol goal?
Definition
Less than 70 mg/dl
Term
When a person is moderately high, what is the recommended goal for LDL cholesterol?
Definition
Less than 130 mg/dl
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
Vitamin A
Term
What vitamin deficiency can cause blindness?
Definition
Vitamin A
Term
What is the earliest symptom of vitmin A deficiency?
Definition
Night blindness
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
Scurvy
Term
What vitamin allows intestines to absorb calcium?
Definition
Vitamin D
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
Vitamin K
Term
Where can you find vitamin K?
Definition
Leafy vegetables and synthesis by intestinal bacteria
Term
Which vitamin dificiency can cause bleeding?
Definition
Vitamin K
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
Alcoholism
Term
Thiamine deficiencies lead to what diseases?
Definition
Wet and Dry Beriberi
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
Vitamin B6
Term
Where do you find a lot of B12?
Definition
Meat and Dairy
Term
People with pernicious anemia, its common for them to have what deficiency?
Definition
Vitamin B12
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
Anorexia Nervosa
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
Females from 17-25
Term
In which eating disorder is the menstrual cycle preserved?
Definition
Bulimia Nervosa
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
What is RDW?
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
WBC is increased when..?
Definition
An acute infection, inflammatory disorders, acute and chronic leukemias, corticosteroids, stress, and smoking
Term
WBC is decreased when..?
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
20,000/mcL
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
Above 50,000/mcL
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
Dehydration
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
Muscle contraction
Term
K can be increased because of..?
Definition
Potassium-sparing diuretics
ACE inhibitors
ACE-receptor blockers
Term
K can be decreased because of..?
Definition
Diuretics
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
0.6 to 1.2 mg/dL
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
Doubles
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
ALT
Term
Where is alkaline phosphatase found?
Definition
Liver, bone, intestine, and placenta
Term
In 90% of liver disease patients this is elevated/
Definition
GGT
Term
GGT is used for what purpose?
Definition
It is used to confirm hepatic origin or elevated serum alkaline phosphatase
Term
What is bilirubin?
Definition
Bilirubin a product of hemoglobin metabolism, is conjugated in the liver and excreted in bile
Term
What does bilirubin do?
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
Albumin
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
True
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
0-4 ng/mL
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
IgG
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
Fecal-oral primarily
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
Blood or sexual
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
HEP B e antigen/antibody
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
ANA is elevated in..?
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
What is an ASO titer?
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
When is RPR used?
Definition
RPR is used as a screening test and in suspected primary and secondary syphilis
Term
What is VDRL used for?
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
VDRL
RPR
Term
Iron-binding capacity, total (TIBC) levels are increased during..?
Definition
Iron deficiency anemia
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
Prothrombin time (PT)
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
INR 2.0-3.0
Term
Partial Thromboplastin Time (PTT) is commonly used to monitor what?
Definition
Heparin therapy
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
Pernicious Anemia
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
Creatine Kinase
Term
Creatine Kinase is released by what?
Definition
Tissue damage
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
DVT and PE
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
No
Term
What test is not generally required for diagnosis of DM?
Definition
Glucose tolerance test
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
Diabetes
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
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