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Analytic Variables
Problems with test performance in lab - turbidity, hemolysis, hypoalbuminemia
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Analytic specificity
Ability to detect a single specific substance
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Accuracy
Clonesness with which an obtained rsult aggres with a known accepted true value
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Normal Range
- Range of values in which a healthy person's test result is expected to fall
- Most fall fall +/- 2SD
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Standard Chemical Profile
- Lytes
- Renal Function
- Carbohydrate/Nutritional Status
- Enzyme/Liver Screen
-
Electrolytes
- Sodium
- Potassium
- Chloride
- CO2
- Anion Gap
-
Basic Panel
- Electrolytes + Glucose
- BUN
- Creatinine
-
Cardiac Panel
- CPK
- CKMB
- Troponin-I
- Myoglobin
-
Lipid Panel
- Cholesterol
- Triglycerides
- HDL
- LDL
-
Liver Panel
- AST
- ALT
- Bilirubin
- Alkaline Phosphatase
- Total Protein
- Albumin
-
-
Bone/Mineral Test
- Calcium
- Phosphorus
- Magnesium
- PTH
- Alk Phos
-
Diabetes Chemistry
- Glucose
- HA1C
- Ketones
- Lactic Acid
- C-Peptide
-
Inflammatory Marker
C-Reactive Protein
-
Tumor Markers
- PSA (prostate)
- CEA (colorectal)
- hCG (pregnancy)
- AFP (liver,ovarian)
-
Alanine Transaminase
- ALT
- Liver, skeletal muscle
-
Alkaline phosphatase
Bone, liver, intestine
-
Aspartate Aminotrasnferase
- AST
- Heart, liver, red cells, skeletal muscle
-
Lactic Dehydrogenase
- LDH
- heart, liver, lung, kidney, red cell
-
Amylase
pancreas, salivary glands
-
-
High albumin indicates
dehydration
-
Hight alkaline phosphatase
- bone growth/disease
- liver disease
- leukemia
- mlaignancies to bone/liver
-
High direct bilirubin
- hepatitis
- cirrhosis
- neoplasm
- biliary disease
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High total bilirubin
- hepatitis
- cirrhosis
- neoplasm
- alcoholism
- hemolytic disease
- biliary obstruction
- anorexia
-
High calcium
- dehydration
- hyperparathyroidism
- kidney disease
- bone cancer
- high vitamin D/A or Calcium intake
-
High BUN
impaired kidney function
-
-
High chloride
- dehydration
- high sodium
- kidney disase
-
high creatinine
- kidney damage or infection
- prostate disease
- Urinary tract obstruction
-
-
High Potassium
- excessive potassium intake
- hyperkalemia
- kidney failure/damage
-
High total protein
- dehydration
- high levels of albumin/globulin
-
High ALT
- liver disease
- hepatocyte injury
- hepatitis
- drug therapy
- biliary disease
-
High AST
- alcoholism
- cirrhosis
- hepatitis
- drug therapy
- biliary disease
-
-
-
Low albumin
- liver disease
- nephrotic syndrome
- heart failure
- low intake/absorption of protein
-
Low alkaline phosphatase
- zinc deficiency
- hypothyroidism
- Vicamin C/B6 deficiency
- Excessive Vitamin D intake
-
Low Direct/Total Bilirubin
Not a concern/not monitored
-
Low BUN
not usually monitored
-
Low Caclium
- parathyroid gland problems
- intestinal absorption problems
-
-
Low Chloride
- low sodium
- emphysema
- chronic lung disease
-
Low creatinine
not a concern but may be due to decreased muscle mass/pregnancy
-
-
Low potassium
- hypokalemia
- dehydration
- acetaminophen overdose
-
Low total protein
liver or kidney disorder
-
Low ALT
not generally a concern/monitored
-
Low AST
- uremia
- Vitamin B6 deficiency
- Drug Therapy
-
Low Sodium
- hyponatremia
- Fluid retention
- too much water intake
-
Low Phosphorus
- hypercalcemia
- overuse of diuretics
- hypothyroidism
- Chronic antacid use
-
Manifestation of Low sodium
neurologic depression
-
manifestation of high sodium
neurologic excitation
-
manifestation of low potassium
arrhythmias
-
Manifestation of high potassium
- bradycardia
- cardiac arrest
-
Manifestation of low calcium
tetany
-
Manifestation of high calcium
- muscle weakness
- polydipsia, anorexia, dehydration
-
Manifestation of low phosphorus
muscle weakness - respiratory
-
Manifestation of low magnesium
- anorexia, nausea, twitching
- Changes in reflexes
-
Manifestation of high Magnesium
- muscle weakness
- confusion
- decreased reflexes
-
Manifestation of low glucose
- altered mental status
- coma
-
Manifestation of high glucose
- Extreme thirst
- excessive urination
- fatigue
- coma
-
Manifestation of high liver enzymes
-
Manifestation of high lipids
stroke
-
Manifestation of high cardiac enzymes
cardiac damage
-
Manifestation of low thyroid hormones
- fatigue
- slow movement and slow speech
- cold intolerance
-
Manifestation of high thyroid hormones
- warm moist skin
- sweating
- hair/weight loss
- palpitations
- tachycardia
- nervousness
-
CBC count
WBC, RBC, HGB, HCT, MCV, MCH, MCHC, PLT, RDW
-
Reticulocyte Count
ability to make red cells
-
Hemoglobin electrophoresis
analyzes type of hemoglobin and defects
-
Anemia Profile
- Iron
- TIBC/UIBC
- TSAT
- Ferritin
-
B12/Folate deficiency
Megaloblastic anemias
-
PT/INR testing
- Coagulation
- extrinsic pathway defects
- Monitoring Coumadin therapy
-
PTT Testing
- Partial Thromboplastin Time
- Monitoring heparin therapy
-
DIC
- Disseminated Intravascular Clotting
- Bleeding and Clotting at the same time
-
Serology
presence or absence of antigens or antibodies to infectious agents
-
Serology Screening Tests
- Rapid Strep
- C-Diff Toxin
- RPR/VDRL
- Monospot
- Hepatitis
- HIV
-
-
Crossmatch
assures blood to be transfused is compatible with recipient
-
RhIG screen
Screens for pregnant women who are Rh(D) negative
-
Hemoglobin
Oxygen carrying capacity
-
hematocrit
% blood volume occupied by RBCs
-
Mean cell Volume (MCV)
average size RBC
-
Mean cell hemoglobin (MCH)
Average heme in RBC smear
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Mean Cell Hemoglobin Concentration (MCHC)
Average concentration of heme per unit volume of RBC
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Reticulocyte count
% new or young RBC
-
-
-
WBC Differential Pneumonic
Newborn Little Monkeys Eat Bananas
-
Granulocytes
- neutrophils
- Basophils
- Eosinophils
-
Agranulocytes
- Lymphocytes (T/B cells)
- Monocytes
-
Drug induced increased WBC
- heparin
- ASA
- Steroids
- Adrenaline
- Allopurinol
- Chloroform
- epinephrine
- Quinine
- Triamterine
-
Drug induced decreased WBC
- Chemotherapy
- Antibiotics
- Diuretics
- AnticonvulsantsAntihistamines
- Antithyroid drugs
- barbiturates
- Sulfonamides
-
Appendicitis Tests
- WBC
- Lytes
- BUN
- Creatinine
- CT scan
-
Pancreatitis Tests
- Lipase
- Amylase
- Serum Trypsin
- Abd X-ray
- Abd CT/US
- MRCP/ERCP
-
-
-
Cholecystitis Tests
- WBC
- HIDA Scan - obstructed duct
- US - shows inflammation/dilation of ducts but not obstruction
- CT
-
Abdominal Obstruction Test
- Adominal X-Ray
- Lytes
- BUN
- Creatinine
- CBC
- BE, EGD, Colonoscopy
-
Abdominal Pain Testing
- CBC
- Lytes
- BUN
- Creatinine
- Calcium
- Albumin
- Urinalysis
- Amylase
- Lipase
-
Gastritis Tests
- Serial Hb
- INR
- PTT
- Platelet
- NGT/EGD
-
Abdominal ulcer labs
- Serial Hb
- INR
- PTT
- Platelet
- EGD/NGT
-
Varices labs
- Serial Hb
- PT
- PTT
- Platelet count
- EGD
-
Mallory-Weiss Syndrome Tests
Serial HbPTPTTPlatelet countEGD
-
UGI Bleeding Tests
- CBC
- INR
- PTT
- Lytes
- BUN
- Creatinine
- AST
- ALT
- Albumin
- Calcium
-
Diverticulosis/AVM testst
- Bleeding Scan
- Arteriogram
- Colonoscopy
- Serial Hb
- PT
- PTT
- Platelet count
-
Abdominal Tumor labs
- CBC
- INR
- PTT
- bleeding scan/ateriogram
- Colonoscopy
-
Fistula Labs
- CBC
- INR
- PTT
- Arteriogram
- colonoscopy
-
-
Colitis labs
- CBC
- INR
- PTT
- Colonoscopy
- Arteriogram
-
LGI Bleed Labs
- CBC
- INR
- PTT
- Lytes
- BUN
- Creatinine
- AST
- ALT
- Albumin
- Calcium
- colonoscopy
- +/- Bleeding scan/arteriogram
-
CNS N/V labs
- Lytes
- BUN
- Creatinine
- Calcium
- CBC
- CT/MRI
-
Common N/V causing medications
- Erythromycin
- PPI
- HIV
- Narcotics
- NSAID
- Steroids
- Tetracycline
- ASA
-
Food Poisoning Labs
- CBC
- Lytes
- Creatinine
- BUN
- calcium
- abd X-ray
-
Inferior MI N/V labs
- CBC
- Lytes
- BUN
- Creatinine
- Calcium
- Troponin
- EKG
-
Viral Gastroenteritis Labs
- CBC
- Lytes
- BUN
- Creatinine
- Calcium
- AST
- ALT
- Abd X-ray
-
N/V Labs
- CBC
- Lytes
- BUN
- Creatinine
- ALT
- AST
- Calcium
- urinalysis
- Troponin
- EKG
- Abd X-ray
-
Diarrhea Labs
- Fecal leukocytes/Ova & parasites
- Stool culture
- CBBC
- Lytes
- BUN
- Creatinine
- Calcium
- C diff toxin
-
RBC Size abnormalities
- Microcytes - IDA, Hereditary spherocytosis, Thalassemia
- Macrocytes - Vit B12/folic acid deficiency, reticulocytosis, liver disorder, postsplenectomy anemia
-
RBC Shape Abnormalities
- Spherocytes
- Elliptocytes
- Leptocytes
- Spicule cell
-
RBC color abnormalities
- Hypochromasia - IDA, Thalassemia, Cardiac Disease
- Hyperchromasia - concentrated hemoglobin
-
-
-
Reticulocyte
premature RBC
-
S&S of low Hgb
- fatigability
- HA
- tachycardia
- palpitations
-
Deficiency in globin
Small uniformly shaped cells
-
Sideroblastic anemia
storage disorder of iron in macrophages of bone marrow
-
IDA
- hgb 4-12
- MCV low
- RDW high
- Fe low
- ferritin low
- TIBC high
-
Anemia of Chronic dz
- Hgb 8-12
- MCV Normal/low
- RDW Normal
- Fe low
- Ferritin Normal/high
- TIBC Low
-
Thalaseemia
- Hgb 9-14
- MCV very low
- RD normal
- Fe normal
- Ferritin Normal
- TIBC normal
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