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Flashcards in Into Lab Med Deck (37):
1

qualitative testing definition

either positive/ negative
present/absent
yes/no

2

quantitative testing definition

measured amount reported in mass or volume; how much

3

Sensitivity Definition

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

4

Specificity Definition

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

5

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

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.

6

Cell types measured in CBC

WBC, RBC, Platelets

7

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

CBC + WBC Differential

8

What type of RBC counts are included in a CBC

-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

9

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

-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

10

Precision Definition

is a measure of the tests reproducibility

11

Coefficient of Variation Definition

precise tests vary slightly upon repetition.

12

Accuracy Definition

determined by its correspondence with the true value

*maximized by calibration of lab equipment with standard reference material

13

Normal result: lab test definition

within the reference range

14

Abnormal result: lab test definition

outside of the reference range

15

Average result:
lab test definition

mean of reference range

16

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

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

Reference Intervals are ___ & ____ dependent

lab and population ("healthy")

18

Pretest Probability

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

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

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

20

CPT and ICD code for....

CPT= procedures
ICD= diagnosis

21

Advantages/ Distadvantages of order a single vs profile lab test

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

Identify various units of measurements

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

Indication for use of each chemistry: ALB

Albumin:
Indication for use:
checks kidney and liver function

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

24

Indication for use of each chemistry: AST
-what does it stand for

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

Indication for use of each chemistry: ALT
-what does it stand for?

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

Indication for use of each chemistry:ALP
-what does it stand for?

Alkaline Phosphatase

indication-
-checks for liver disease
-bone problems such as rickets,, bone tumors, etc

27

Indication for use of each chemistry: CO2
-what does it stand for?

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

Indication for use of each chemistry:T. Bili & D. Bili
-what doe it stand for?

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

Indication for use of each chemistry: Glucose
-what does it stand for?

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

Indication for use of each chemistry: BUN
-what does it stand for?

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

Indication for use of each chemistry: Creat
-what does this stand for?

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

Indication for use of each chemistry: Cl
-what does this stand for?

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

Indication for use of each chemistry: Ca
-what does this stand for?

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

Indication for use of each chemistry: TP
-what does it stand for?

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

Indication for use of each chemistry:K
-what does it stand for?

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

Indication for use of each chemistry:Na
-what does it stand for?

Sodium

indication-
-check water and electrolyte balance
-check progress of disease in kidney or adrenal gland
-find cause of high/low sodium

37

Indication for use of each chemistry:Inor P
-what does it stand for?

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