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ICM Week 2 > Into Lab Med > Flashcards

Into Lab Med Flashcards

1
Q

qualitative testing definition

A

either positive/ negative
present/absent
yes/no

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2
Q

quantitative testing definition

A

measured amount reported in mass or volume; how much

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3
Q

Sensitivity Definition

A

presence of disease

compare true positives and false negatives

Highly sensitive test that is NEGATIVE is highly good at ruling out disease (SNout)
True positive
————————————-
True positive + False Negative

68% sensitivity = if you take 100 ppl w/ disease you are looking for, how many pt with the disease are going to test positive? 68, so that means 32 people that actually have the disease will get a negative result

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4
Q

Specificity Definition

A

absence of disease; compares true negatives and false positives

Highly Specific test that is Positive is good for ruling IN the disease (SPin)

      True Negative --------------------------------------- True negative + false positive

77% specificity = if you take 100 ppl who do not have the disease, how many pt w/ disease are going to test negative? 77 are going to test negative for the disease, 23 people will get a positive result even though they are negative

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5
Q

List the different kinds of chemistry panels and the tests within them

A

BMP- Na+, K+, Cl-, CO2, glucose, BUN, Creat, Ca2+

CMP- all of BMP + TP, ALB, AST, ALT, ALP, T. Billi

Liver Function- ALB, AST, ALT, ALP, T. Billi. D, Billi

Renal Function- BMP + ALB, Inor P.

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6
Q

Cell types measured in CBC

A

WBC, RBC, Platelets

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7
Q

Which type of lab test would you want to order to know types of WBC present?

A

CBC + WBC Differential

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8
Q

What type of RBC counts are included in a CBC

A
  • RBC count: actualy # of RBC
  • Hgb: amount of 02 carrying protein in blood
  • Hematocrit: % of RBC
  • Reticulocytes: not really part of CBC, but they may be useful in determining acute vs chronic bleed
  • A lot of reticulocytes=chronic bleed
  • Few= acute bleed

-RBC indices: MCH, MCV, MCHC, RDW

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9
Q

Why do you take careful consideration when ordering specific lab test?

A
  • need to have diagnosis for every lab test
  • only order when necessary- be cost effective
  • only order test if it changes the treatment plan of patient
  • if patient cannot endure test- do not order. ex: Stress test
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10
Q

Precision Definition

A

is a measure of the tests reproducibility

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11
Q

Coefficient of Variation Definition

A

precise tests vary slightly upon repetition.

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12
Q

Accuracy Definition

A

determined by its correspondence with the true value

*maximized by calibration of lab equipment with standard reference material

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13
Q

Normal result: lab test definition

A

within the reference range

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14
Q

Abnormal result: lab test definition

A

outside of the reference range

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15
Q

Average result:

lab test definition

A

mean of reference range

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16
Q

Concepts of risk-benefit- and cost effectiveness in the choice of diagnostic procedures

A

cost effectiveness- ordering single test may be less expensive than the whole panel or vice versa. dont order test unless it will change your management

  • risk/benefit: risks/benefits of types of tests. ex: cerebral angio, stress test
  • ALWAYS ask yourself, will the results of testing change management
17
Q

Reference Intervals are ___ & ____ dependent

A

lab and population (“healthy”)

18
Q

Pretest Probability

A

the likelihood the patient has the abnormality that you are testing for based on risk factors, symptoms, history, and physical exam.

*Range 0-1
0= disease absent
1= disease present
higher the pretest prob. the more likely you will get a true result

19
Q

Diagnosis-related-Groups (DRG) assignment of appropriate lab testing

A

are grouped by diagnosis and other factors to determine how much medicare pays for each “product”

20
Q

CPT and ICD code for….

A 
CPT= procedures
ICD= diagnosis
21
Q

Advantages/ Distadvantages of order a single vs profile lab test

A

advantage of single- get exactly what you want, may save money

advantage of profile- may be more cost effective than single, extra info that may lead to other findings.
ex. cholesterol testing @ fair, found to have high cholesterol so you end up needing to order another test (lipid panel) prior to treating the patient.

disadvantages of profile &/or single - may be more expensive,

22
Q

Identify various units of measurements

A 
G (grams)
mg/L (milligram/liter) 
ml (milliliters)
mmHg (millimeters of mercury)
mmmol (millimole)
ng/ml (nanogram/milliliter)
U/ml (units/ milliliter)
Pg (picograms) 
Ng (nanograms) 
mcg (microgram)
mcL (microliter)
mcmol/L (micromoles/liter) 
fL (femtoliter)
23
Q

Indication for use of each chemistry: ALB

A

Albumin:
Indication for use:
checks kidney and liver function

-helps determine cause of swelling of ankles, abdomen, or fluid collection in the lungs

24
Q

Indication for use of each chemistry: AST

-what does it stand for

A

Aspartate Amino Transferase

Indication of use:
-check for liver damage and liver disease (hept. & cirrhosis)

-AST is an enzyme (normally found in blood) that increases during organ disease or damage

25
Q

Indication for use of each chemistry: ALT

-what does it stand for?

A

Alanine Amino Transferase

Indication for use:

  • enzyme found in liver
  • checks for liver damage and liver disease (hept & cirrhosis)
  • low levels normally found in blood, w/ damage ALT is increased in blood.
26
Q

Indication for use of each chemistry:ALP

-what does it stand for?

A

Alkaline Phosphatase

indication-

  • checks for liver disease
  • bone problems such as rickets,, bone tumors, etc
27
Q

Indication for use of each chemistry: CO2

-what does it stand for?

A

Carbon Dioxide

Indication for use:

  • acts as buffer, keeps pH of blood from becoming too acidic or basic
  • tests for kidney disease, lung disease, and metabolic problems that affect bicarbonate levels
28
Q

Indication for use of each chemistry:T. Bili & D. Bili

-what doe it stand for?

A

Total Bilirubin & Direct Bilirubin

Indication of use-

  • jaundice
  • check for liver function & disease (hept & cirrhosis)
  • find if bile duct blocked (gall stones, tumor of pancreas)
  • detect conditions that cause increased RBC destruction (such as hemolytic anemia, or hemolytic disease of the newborn)

-direct bili is soluble and made by liver from indirect bili.

29
Q

Indication for use of each chemistry: Glucose

-what does it stand for?

A

Glucose

Indication for use:

  • measures glucose levels in the blood
  • check for pre/diabetes
  • monitor treatment of diabetes
  • check for gestational diabetes
  • detect hypoglycemia
30
Q

Indication for use of each chemistry: BUN

-what does it stand for?

A

Blood Urea Nitrogen

indication for use:

  • measures nitrogen in blood from waste product urea
  • tests kidney function (if tx is working, if disease is getting better or worse)
  • Kidney disease: increase BUN
  • Liver diease: decrease BUN
  • checks levels of severe dehydration (BUN to creatinin ratio)
31
Q

Indication for use of each chemistry: Creat

-what does this stand for?

A 
Creatinine 
 Indication:
-measures level of waste product in blood and urine
-test kidney to see if it is working
-tests to see if tx is working

*BUN to creatinine ratio for dehydrations

32
Q

Indication for use of each chemistry: Cl

-what does this stand for?

A

Chloride

Indication:
- maintains proper blood volume, pressure, and pH of body fluids
-muscle twitching, spasms, breathing problems, weakness, or confusion
-to find out if you have kidney or adrenal gland problems
- find cause for increased
blood pH

33
Q

Indication for use of each chemistry: Ca

-what does this stand for?

A

Calcium

indication-

  • check for parathyroid or kidney problems
  • inflammation of pancreas
  • find reason for abnormal ekg
  • after kidney transplant
  • check calcium levels
  • low is muscle spasm, twitching
  • high weakness lack of energy nausea vomiting constipation
34
Q

Indication for use of each chemistry: TP

-what does it stand for?

A

Total Serum Protein

indication-

  • measures albumin and globulins
  • check for kindey and liver function
  • if diet contains enough protein
  • help determine cause of edema
35
Q

Indication for use of each chemistry:K

-what does it stand for?

A

Potassium

indication

  • indirectly related to Na+
  • check pts in dialysis
  • monitor levels of Kt
  • check ppl w/ high BP and trouble with kidney or adrenal disease
36
Q

Indication for use of each chemistry:Na

-what does it stand for?

A

Sodium

indication-

  • check water and electrolyte balance
  • check progress of disease in kidney or adrenal gland
  • find cause of high/low sodium
37
Q

Indication for use of each chemistry:Inor P

-what does it stand for?

A

Inorganic Phosphate

indications-

  • check phosphate levels if you have kidney or bone disease
  • find probs w/ parathyroid glands
  • find reason for abnormal vit. D levels

ICM Week 2 (8 decks)

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