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MCA-L Pg 11-15

Lab results

CBC w/o differential 1. evaluate hematology system 2. identify blood loss (Hbg, Hct) 3. identify infection, allergy immunosuppress, or neoplasm (WBC) 4. Identify bleeding (platelet count)
CBC with differential breaks down WBC: neutrophils, basophils, eosinophils, monocytes, lymphocytes
neutrophils bands, "shift to the left", decreased level indicative of immunosuppressed, infection risk
basophils allergic reaction
eosinophils allergic reaction
monocytes phagocytes, incrased in presence of bacterial infection
lymphocytes T-cell: cellular type immune reaction (HIV); B-cell: antibody production
Chemistry 7 Na, Cl, BUN, K, CO2, Cr, and Glucose
Chemistry 10 Na, Cl, BUN, K, CO2, Cr, Glucose, Ca, Mg, Phos
Na 135-145 : cation; determinant serum osmolality.
Cl 95-105: anion follows Na losses and serves as a buffer in acid-base balance.
BUN 10-20; renal function; liver function as urea is an end product of protein metabolism.
K 3.5-5 cation
CO2 23-30; bicarbonate anion, acid-base balance.
Cr 0.5 - 1.2 ; use to diagnose impaired renal function.
Glucose 70-110 ; elevated in physiologic stress, DM, carbo food.
Ca normal varies; bone synthesis; parathyroid function, renal failure, malnutrition, osteoporosis, large blood loss.
Mg 1.8 -2.2 ; mg deficiency, organ function esp. cardiac.
Phos 3.0 - 4.5 inverse with calcium, parathyroid function.
Coagulation Studies PTT, aPTT, PT, INR
Partial thromboplastin time (PTT) 60-70 secs. measures the intrinsic system of the clotting cascade, a common pathway of clot formation. elevated: prolong cloting time(risk bleeding). Factors: I, II, V, VIII, IX, X, XI, XII
Activated PTT (aPTT) 30-40 sec. shorter than PTT test. with heparin, elevated mean heparin works in preventing clots. w/o heparin, elevated time indicates coagulopathy (not clotting properly) and possible impaired liver function.
Prothrombin Time (PT) 11 - 12.5 secs. evaluate extrinsinc factors I, II, V, VII, X. Elevate due to Coumadin, hepatocellular liver disease, obstructive biliary disease.
International Normalized Ratio (INR) developed by WHO. Evaluated for therapeutic anticoagulation for DVT tx, status-post ortho sx, prevention of emboli in afib pt, mgmt of pul emboli, and prosthetic valve prophylaxis, indicator of abnormal clotting time and coagulopathy.
Liver Function Test (LFT) Alk Phos, Bilirubin, AST, ALT, GGT.
Alkaline phosphatase (Alk Phos) identifies liver disease and types of bone malignancies.
Alanine aminotransferase (ALT) identifies hepatocellular disease.
Aspartate aminotransferase (AST) or (SGOT) elevated in hepatocellular disease, cardiac injury, or skeletal muscle injury.
Gamma glutamyl transpeptidase (GGT) indicator in alcohol abuse and hepatobiliary disease.
Bilirubin total = sum of indirect (unconjugated) and direct (conjugated) levels; evaluates liver functions.
Cardiac Enzyme Markers CK (CPK), Troponin I and T, and Myoglobin
Creatine Kinase (CK) (CPK) an enzyme found in brain tissue, skeletal and heart muscle, but CK-MB(CK-Muscle & Brain) is specific to heart muscle damaage. Level rise in muscle or nerve cell injuries.
Troponin I and T specific to heart muscle damage; gold standard for cardiac ischhemia, injury, and infarction.
Myoglobin found in muscle damage, therefore not cardiac specific marker. Value rise in people who run marathons, suffer skeletal muscle trauma, or suffer Myocardial infarction.
Inflammation Markers ESR and CRP
ESR - erythrocyte sedimentation rate not specific indicator of inflammation or disease process, but help if sx is vague. use to monitor tx of illness or disease.
CRP - C-reactive Protein non specific to inflmmation. elevated in the presense of bacterial infections and tissue necrosis. It appears more rapidly than ESR.
LIPID Panel Cholesterol, HDL, LDL, TG
Cholesterol <200 mgdL; elevated = hyperlipidemia (HLD), increasing the risk of heart disease and HTN.
Low-density lipoprotein (LDL) 60-180 mg/dL; bad cholesterol; High level indicates risk for heart disease
High-density lipoprotein (HDL) Male: >45; female:>55; good cholesterol; remove cholesterol from tissues. low level indicates risk for heart disease
Triglycerides (TG) fat in the bloodstream; High level indicates risk for heart disease
Serum Osmolality 285-295 mmol/kg; measures concentration of dissolved particles in blood. amt of free water inversely proportion to osmolality. H2O increase = osmolality decrease and vice versa.
Created by: rt-study
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