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Basic Lab Interpretation

Basic Lab Interpretation. Nicholee Roesler. Labs. The use of labs are essentially instruments for you.

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Basic Lab Interpretation

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  1. Basic Lab Interpretation NicholeeRoesler

  2. Labs • The use of labs are essentially instruments for you. • Imagine being a pilot: you can fly without the use of the instruments when its clear and sunny. Once there’s a storm or darkness, clouds the picture and makes it much harder to see the overall situation- therefore, pilots use instruments to fly and guide their next moves. Lab values are similar to the clinician

  3. Lab Interpretation • Always treat your patients, however, don’t simply treat labs. • Use the labs to put the problem together clinically with your PE

  4. CBC • A complete blood count (CBC) is a blood test used to evaluate your overall health and detect a wide range of disorders, including anemia, infection and leukemia. • A complete blood count test measures several components and features of your blood, including: • Red blood cells, which carry oxygen • White blood cells, which fight infection • Hemoglobin, the oxygen-carrying protein in red blood cells • Hematocrit, the proportion of red blood cells to the fluid component, or plasma, in your blood • Platelets, which help with blood clotting • Abnormal increases or decreases in cell counts as revealed in a complete blood count may indicate that you have an underlying medical condition that calls for further evaluation. Mayo Clinic, 2018. https://www.mayoclinic.org/tests-procedures/complete-blood-count/about/pac-20384919

  5. WBCs • Watch trends. • NV: 4.5-11 • If day one is 4.5 and next day is 10.5 you’re trending up- possible causes? • Made up of bands, segmented neutrophils

  6. CBC

  7. Leukocytosis • 1. Infection: most common reason • HPI, PE, s/sx of infection • Infection rule out: CXR, UA, CT abd?, and LP • 2. Steroids • Causes WBC to elevate • Elevates due to demargination, delayed migration, and band release from BM. • Will only cause elevation to about 20, anything above or an increase in bands/seg then likely infection • 3. Cancers/Leukemias • ALL, CLL, AML, CML • Suspicious then get a peripheral smear • 4. Catastrophic event • MI, surgery, etc • Rises quickly and resolves fairly quickly

  8. BMP/CMP • BMP: fluid and electrolytes • CMP: adds liver enzymes Important for electrolyte imbalances caused by several diseases: - water status, DM emergencies, CHF, kidney injury/failure, liver dz, meds High yield information

  9. FISHBONE • Na+, K+: cat ions • Cl-, HCO3: anions • BUN, Cr: renal status • Glucose Pneumonic: “Salty BUN with a pot of coffee and cream with sugar”

  10. Sodium • NV: 135-145 mmol/L • Think of as a salt and/or water problem • Hyper- and hyponatremia, high sodium and low sodium, respectively. • Controlled by ADH and RAAS

  11. Hyponatremia • Common causes: CKD, CHF, liver cirrhosis, SIADH, adrenal insufficiency • Meds: Diuretics, SSRI, morphine

  12. Hypernatremia • Common causes: • Diarrhea • Excessive sweating • Overuse of diruetics • Diabetes Incipidus • hyperaldosteronism

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