1 / 50

ANCILLARY PROCEDURES

ANCILLARY PROCEDURES. Done in the patient. CBC Na, K Creatinine SGOT, SGPT 12-L ECG. CBC. Complete Blood Count. broad screening test to check for such disorders as anemia, infection, and many other diseases Red blood cell (RBC) count

ashely-mullins
Download Presentation

ANCILLARY PROCEDURES

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. ANCILLARY PROCEDURES

  2. Done in the patient • CBC • Na, K • Creatinine • SGOT, SGPT • 12-L ECG

  3. CBC

  4. Complete Blood Count • broad screening test to check for such disorders as anemia, infection, and many other diseases • Red blood cell (RBC) count • count of the actual number of red blood cells per volume of blood • Hemoglobin • measures the amount of oxygen-carrying protein in the blood • Hematocrit • measures the percentage of red blood cells in a given volume of whole blood

  5. Complete Blood Count • Mean corpuscular volume (MCV) • measurement of the average size of RBCs • Elevated: macrocytic • ex.: vitamin B12 deficiency • Decreased: microcytic • ex.: iron deficiency anemia or thalassemias • Mean corpuscular hemoglobin (MCH) • average amount of O2-carrying hemoglobin inside a red blood cell • Macrocytic RBCs have a higher MCH, while microcytic red cells have a lower value

  6. Complete Blood Count • Mean corpuscular hemoglobin concentration (MCHC) • calculation of the average concentration of hemoglobin inside a red cell • Decreased: hemoglobin is abnormally diluted inside the red cells • ex.: iron deficiency anemia and thalassemia. • Increased: (hyperchromia); hemoglobin is abnormally concentrated inside the red cells • ex.: burn patients and hereditary spherocytosis

  7. Complete Blood Count • Red cell distribution width (RDW) • calculation of the variation in the size of your RBCs • Platelet count • number of platelets in a given volume of blood

  8. Complete Blood Count

  9. Anemia • Low RBC, Hgb, Hct • Due to insufficient production of EPO by the diseased kidneys (CKD stage 3)

  10. Thrombocytosis • Occurs as an acute phase response to infection

  11. Complete Blood Count • White blood cell (WBC) count • count of the actual number of white blood cells per volume of blood • White blood cell differential • looks at the types of white blood cells present • five different types of white blood cells: neutrophils, lymphocytes, monocytes, eosinophils, and basophils

  12. Complete Blood Count

  13. Leukocytosis • With predominance of neutrophils connotes active bacterial infection

  14. Blood Chemistry

  15. Biochemical Blood Tests • Liver Function test • AST/ ALT • Kidney Profile test • Creatinine • Electrolytes • ( Na, K, Ca, PO) • BUN • Uric Acid • Lipid Profile test • TG • Total Cholesterol • LDL, HDL, VLDL

  16. Biochemical Blood Tests • Liver Function test • AST/ ALT • Kidney Profile test • Creatinine • Electrolytes • ( Na, K, Ca, PO) • BUN • Uric Acid • Lipid Profile test • TG • Total Cholesterol • LDL, HDL, VLDL

  17. Biochemical Blood Tests • Liver Function test • AST/ ALT • Kidney Profile test • Creatinine • Electrolytes • ( Na, K, Ca, PO) • BUN • Uric Acid • Lipid Profile test • TG • Total Cholesterol • LDL, HDL, VLDL

  18. Biochemical Blood Tests • AST / ALT • Test associated with the cellular integrity of the Liver, indicates hepatocellular injury and necrosis

  19. Biochemical Blood Tests • AST / ALT • Active liver insult probably drug induced (aspirin).

  20. Biochemical Blood Tests • Liver Function test • AST/ ALT • Kidney Profile test • Creatinine • Electrolytes • ( Na, K, Ca, PO) • BUN • Uric Acid • Lipid Profile test • TG • Total Cholesterol • LDL, HDL, VLDL

  21. Biochemical Blood Tests • Creatinine • used to measure GFR; indicator of renal function Increase in • Acute tubular necrosis, Dehydration, Diabetic nephropathy, Eclampsia, Glomerulonephritis, Kidney failure, Muscular dystrophy, Preeclampsia, Pyelonephritis, reduced kidney blood flow (shock, congestive heart failure), Rhabdomyolysis, Urinary tract obstruction

  22. Biochemical Blood Tests • Creatinine • Impaired Filtering Capacity of the kidneys due to CKD

  23. Biochemical Blood Tests • Liver Function test • AST/ ALT • Kidney Profile test • Creatinine • Electrolytes • ( Na, K, Ca, PO) • BUN • Uric Acid • Lipid Profile test • TG • Total Cholesterol • LDL, HDL, VLDL

  24. Biochemical Blood Tests • Sodium • major extracellular cation • maintains the proper acid-base equilibrium for the proper osmotic balance • osmotic regulation of extra-cellular fluid balance and acid balance, as well as renal, cardiac and adrenal functions

  25. Biochemical Blood Tests Sodium Increased in: Water deficit Water deficit exceeding sodium deficit Excessive intake of sodium Adrenal Cortex Hyper-function Diabetes Pyloric Obstruction Congestive Heart Failure Insufficient Anti-Diuretic Hormone production by the hypothalamic-pituitary complex Alcohol intake reduces the sodium lost in the urine

  26. Biochemical Blood Tests Sodium Decreased in: Pyloric Spasm Hyperglycemia and Diabetes mellitus lo Excess Perspiration leads to loss in the sweat Adrenal Cortex Hypo-function Diarrhea and metabolic alkalosis Excess progesterone blocks the action of aldosterone but insufficient progesterone results in greater loss of sodium in the urine Renal Dysfunction Syndrome of Inappropriate Anti-Diuretic Hormone

  27. Hyponatremia • Sodium • Most probably due to impaired kidney function

  28. Biochemical Blood Tests • Liver Function test • AST/ ALT • Kidney Profile test • Creatinine • Electrolytes • ( Na, K, Ca, PO) • BUN • Uric Acid • Lipid Profile test • TG • Total Cholesterol • LDL, HDL, VLDL

  29. Biochemical Blood Tests • Potassium • major intracellular cation • essential to heart and kidney function as well as to the maintenance of blood and urine pH • increased in: • Renal Dysfunction • Adrenal Cortex under function • Catabolic/Dysaerobic State • Metabolic Acidosis • Respiratory Dysfunction • Bradycardia • Massive Tissue Destruction • Diabetes without adequate insulin

  30. Biochemical Blood Tests Potassium Diets High in Refined Foods due to lack of potassium in the diet Hypertension Insulin use Anabolic/Anaerobic States Decreased in: • Diarrhea and/or vomiting • Adrenal Cortex over function • Several Types of Anemia • Metabolic Alkalosis • Diuretic Use • Familial Periodic Paralysis

  31. Hyperkalemia • Potassium • Most probably due to impaired kidney function

  32. Other ancillary Procedure

  33. ECG • Sinus rhythm • Left ventricular hypertrophy • pathological reaction to cardiovascular disease, or high blood pressure • increase afterload that the heart has to contract against • causes of increased afterload that can cause LVH include aortic stenosis, aortic insufficiency, and hypertension • Peak T-waves • Due to hyperkalemia

  34. Requested but not done • iCA • iPO4 • BUN • Uric acid • Lipid profile • ABG • Ultrasound of KUBP • Sputum GS, proceed to C/S if PMN >25/lpf and epithelial cells <10/lpf • Sputum AFB

  35. Biochemical Blood Tests • Ionized Calcium • is calcium that is freely flowing in blood and not bound to proteins • free calcium • test to monitor patients having kidney and parathyroid problem

  36. Biochemical Blood Tests Increased in: Decreased in: Hypoparathyroidism, malabsorption, osteomalacia, pancreatitis, renal failure rickets, vitamin D deficiency • Hyperparathyroidism, • immobilization, • idiopathic hypocalciuria, • metastatic bone tumor, • milk-alkali syndrome, • multiple myeloma, • paget's disease, • sarcoidosis, • too much vitamin D, • use of thiazide diuretics

  37. Biochemical Blood Tests • Ionized Phosphate • charged particle (ion) that contains the mineral phosphorus • Helps to build and repair bones and teeth, help nerves function, and make muscles contract • amount of phosphate in the blood affects the level of calcium in the blood • Used to monitor kidney and bone disease

  38. Biochemical Blood Tests Increased in: Decreased in: Hyperparathyroidism Osteomalacia Lack and malbsorption of vitamin D severe burns kidney or liver diseases. Severe malnutrition or starvation. Alcohol dependence High calcium levels • Kidney disease • Hypoparathyroidism • acromegaly • Too much vitamin D in the body • decrease in magnesium levels. • Pregnancy

  39. Relationship of Blood Ca and PO

  40. Biochemical Blood Tests • BUN • measure of the amount of nitrogen in the blood in the form of urea, and a measurement of renal function • Urea is a substance secreted by the liver, and removed from the blood by the kidneys • Normal value: 10–20 mg/dL or 3.6–7.1 mmol/L

  41. Biochemical Blood Tests • BUN • Increased in: • kidney injury or disease • Congestive heart failure • Excessive protein levels in the gastrointestinal tract • Gastrointestinal bleeding • Hypovolemia • Heart attack • Shock • Urinary tract obstruction • Decreased in: • Liver failure • Low protein diet • Malnutrition • Over-hydration

  42. Biochemical Blood Tests • BUA • Most of the uric acid is filtered out by the kidneys and passes out of the body in urine. • if too much uric acid is being produced or if the kidneys are not able to remove it from the blood normally, the level of uric acid in the blood increases • Normal value: 3.4-7.0 mg/dL (men)

  43. Biochemical Blood Tests • BUA • Increased in: • Kidney disease or kidney damage • leukemia, lymphoma, and multiple myeloma or cancer treatments, hemolytic anemia, sickle cell anemia, or heart failure • liver disease (cirrhosis), obesity • Starvation, malnutrition • Medicines: diuretics, vitamin C, lower doses of aspirin (75 to 100 mg daily), niacin, warfarin, cyclosporine, levodopa, tacrolimus, and some medicines used to treat leukemia, lymphoma, or tuberculosis • Foods that are very high in purines: organ meats

  44. Biochemical Blood Tests • BUA • Decreased in: • Severe liver disease, Wilson's disease, or some types of cancer • Syndrome of inappropriate antidiuretic hormone (SIADH), a condition that causes large amounts of fluid to build up in the body • Not eating enough protein • Sulfinpyrazone, large amounts of aspirin (1,500 mg or more daily), probenecid and allopurinol

  45. Lipid Profile • Assess risk of heart disease • Includes: • Total cholesterol: <200 mg/dL • Triglycerides: <150 mg/dL • LDL: <100 mg/dL • HDL: >60 mg/dL

  46. Arterial Blood Gas • used to determine the pH of the blood, the partial pressure of carbon dioxide and oxygen, and the bicarbonate level

  47. Arterial Blood Gas • Expected result: • Metabolic acidosis

  48. Ultrasound of KUBP • used to assess the size, location, and shape of the kidneys and related structures, such as the ureters bladder, and prostate • can detect cysts, tumors, abscesses, obstructions, fluid collection, and infection within or around the kidneys. • can also detect calculi (stones) of the kidneys and ureters

  49. Gram's Stain and Culture of Sputum • Help to identify certain pathogens by their characteristic appearance • To be adequate for culture, a sputum sample must have: • >25 neutrophils and <10 squamous epithelial cells per low-power field • Sensitivity and specificity of the sputum Gram's stain and culture are highly variable

  50. Sputum AFB • used to determine an active Mycobacterium tuberculosis infection or an infection due to another member of the Mycobacterium family, or TB-like symptoms due to another cause • Done in patients having history and symptoms that suggest pulmonary TB such as: • Positive exposure • chronic cough (at least 2weeks), significant weight loss, low grade fever • Positive result: presence of ACID FAST BACILLI

More Related