Lab Analysis & Diagnostic

Question 1

What is the normal range for sodium (Na)?

Answer 1

135-145 mEq/L

Question 2

What is the normal range for potassium (K)?

Answer 2

3.5-5 mEq/L

Question 3

What is the normal range for chloride (Cl)?

Answer 3

96-106 mEq/L

Question 4

What is the normal range for Carbon dioxide (C02)?

Answer 4

22 - 26 mEq/L

Question 5

What is the normal range for blood urea nitrogen (BUN)?

Answer 5

8 - 23 mg/dL

Question 6

What is the normal range for creatinine (Cr)?

Answer 6

0.7 - 1.4 mg/dL

Question 7

What is the normal range for glucose?

Answer 7

70 - 110 mg/dL

Question 8

What is hyponatremia?

Answer 8

<135 mEq/L

Caused By:
CHF 
Liver Disease 
Heavy Exercise 
Dehydration

[ Below 125 mEq/L can cause behavioral problems, muscle twitching, cardiac abnormalities]

Question 9

What is hyperkalemia?

Answer 9

> 5.0 mEq/L

Caused By:
Tissue breakdown
Drug administration
Metabolic acidosis
Acute renal failure

[EKG will show tall peaked T waves]

Question 10

What is the treatment for hyperkalemia?

Answer 10

Push K into the cells:
Bicarb, insulin, D 50, albuterol

Get rid of excess K:
Lasix, Kayexalate (poop it out)

[Calcium Gluconate to prevent VTach]

Question 11

What is hypokalemia?

Answer 11

<3.5 mEq/L

Caused By:
Cellular shift via insulin or hypothermia
Too much Lasix

Causes:
Malaise, weakness, poor dietary intake

[EKG will show depressed, inverted, or flattened T waves]

Question 12

What is the treatment for hypokalemia?

Answer 12

Oral potassium 60 mEq
IV potassium 10 mEq

[NEVER bolus, rapid administration is fatal]

Question 13

What are two facts about chloride?

Answer 13

1. It is a Extracellular anion

2. It’s shifts with sodium Na

Question 14

What are two facts about carbon dioxide?

Answer 14

1. It’s the same as HC03 on an ABG

2. It’s important for maintaining the acid base balance

Question 15

What are two facts on blood urea nitrogen (BUN)?

Answer 15

1. Helps provide a picture of renal clearance

2. BUN tends to increase with age

Question 16

What is a fact about creatinine?

Answer 16

High levels can result in permanent kidney damage

Question 17

What is a fact about glucose?

Answer 17

High levels can potentially result in coma and death

Question 18

What is Chvostek’s Sign?

Answer 18

The cheek muscle spasms when the facial nerve (CN VII) is tapped
[CN VII is located in front of the ear]

Question 19

What is Trousseau’s Sign?

Answer 19

Forearm tetany when BP cuff is inflated

[Treat with Calcium Gluconate]

Question 20

What is anion gap acidosis and how is it factor?

Answer 20

It’s the “Poor man’s ABG“

Sodium, chloride, bicarb are factor together to determine the anion gap

Question 21

What is a normal anion gap?

Answer 21

12 (+/-4)

[If >15 the patient has an anion gap metabolic acidosis]

Question 22

What is MUDPILES?

Answer 22

Methanol 
uremia 
DKA 
Propylene glycol
Isoniazid iron
Ethylene glycol
Salicylates

Question 23

What is GOLDMARK?

Answer 23

Glycols
Oxyproline
L-Lactate
D-Lactate
Methanol
Aspirin
Renal Failure
Ketoacidosis

Question 24

What is a complete blood count?

Answer 24

Red blood cells
5 million

Hemoglobin
15 g/dL

Hematocrit
45%

White Blood cells
4500/uL - 11,000/uL

Platelets
150K/uL - 400K/uL

Question 25

What are some additional lab values?

Answer 25

Total protein 6.0 - 8.0 g/dL Albumin 3.5 - 5.5 g/dL Lactate 0.5-1 mmol/L Amylase 25-125 Units/L Lipase 5-60 Units/L Osmolality 275 - 295 mOsm/L ``` Urine Output “2/1/0.5” Infant 2 ml/kg/hr Child 1 ml/kg/hr Adult 0.5 ml/kg/hr [Average for adults is 30 - 50 ml/hr] ```

Question 26

What triggers intrinsic pathways?

Answer 26

Endothelial damage with collagen exposure

Question 27

What triggers extrinsic pathways?

Answer 27

Damaged tissue/organs

Question 28

What drugs affect the coagulation panels?

Answer 28

Heparin (Lovenox) and Coumadin (Warfarin)

Question 29

What is a liver function test?

Answer 29

It measures the levels of protein enzymes in Bilirubin in your blood

Question 30

What does a liver function test consist of?

Answer 30

``` Alanin transaminase (ALT) 7 - 55 units/L ``` ``` Aspartame transaminase (AST) 8 - 48 Units/L ``` ``` Alkaline phosphatase (ALP) 45 - 115 Units/L ``` Albumin 3.5 - 5.5 g/L Bilirubin 0.1 - 1.2 mg/dL

Question 31

How low is pH, when a patient is in severe shock?

Answer 31

pH <7.2

Question 32

How bad is your CO2 during ventilatory failure?

Answer 32

CO2 >55

Question 33

How bad is your PaO2 during an Oxygenation Failure?

Answer 33

PaO2 <60

Question 34

What is the pH in CO2 formula?

Answer 34

For every 10mmHg of ETCO2, the pH will change 0.08 the OPPOSITE direction

Question 35

What is the pH and bicarb formula?

Answer 35

For every 0.15 in pH, the HCO3 will change 10 mmol/L the SAME direction

Question 36

What is the pH and potassium formula?

Answer 36

Every PH change of 0.10, the K will shift 0.6 the OPPOSITE direction

Question 37

What is the CO2 and potassium formula?

Answer 37

Every see CO2 change of 10 mmHg, changes K by 0.5 mEqs in the SAME direction

Question 38

If your PAO2 is 40, What is your SAO2?

Answer 38

70