Brett Shared "Clin Lab Block 2" - 14 Picmonics
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Clin Lab Block 2
Hypernatremia
- Assessment
- > 145 mEq/L Na+
- Change in LOC
- Extreme Thirst
- Orthostatic Hypotension
- Dry Flushed Skin
- Muscle Twitching
- Seizures
- Priority Interventions
- Treat and Prevent Dehydration
- Hypotonic Solutions (0.225% or 0.45% NaCl)
- Sodium Restriction
- Diuretics
2 mins
Hyponatremia
- Assessment
- < 135 mEq Na+
- Nausea and Vomiting
- Decreased LOC
- Confusion / Lethargy
- Seizures
- Priority Interventions
- Assess Airway
- Reduce Diuretic Dosage
- Fluid Excess Hyponatremia
- Mannitol (Osmitrol)
- Fluid Restriction
- Fluid Deficit Hyponatremia
- Hypertonic Solution (3% or 5% NaCl)
2 mins
Hyperkalemia
- Assessment
- > 5.0 mEq/L K+
- Abdominal Cramps
- Muscle Weakness
- Diarrhea
- Arrhythmia
- Tall, Peaked T Waves
- Interventions
- IV Calcium
- Infusion of Glucose and Insulin
- Loop or Thiazide Diuretics
- Kayexalate
- Dialysis
- Prevention Education
2 mins
Hypercalcemia Causes
- Two CHIMPANZEES Acronym
- Thyroid Disorders
- Calcium Supplements
- Hyperparathyroidism
- Iatrogenic (Drugs, immobility)
- Milk-Alkali Syndrome
- Paget's Disease of Bone
- Acromegaly or Addison's Disease
- Neoplasms
- Zollinger-Ellison Syndrome
- Excessive Vitamin A
- Excessive Vitamin D
- Sarcoidosis
2 mins
Anion Gap Metabolic Acidosis
- Pathophysiology
- Increased Anion Gap
- MUDPILES
- Methanol
- Uremia
- Diabetic Ketoacidosis (DKA)
- Propylene Glycol
- Isoniazid or Iron
- Lactic Acid
- Ethylene Glycol
- Salicylates
1 min
Oral Glucose Tolerance Test (OGTT)
- Used for Diabetes Screening
- Fasting State
- Samples Drawn
- Baseline
- Normal < 100 mg/dL
- 30 and 60 Minutes
- Normal < 200 mg/dL
- 120 Minutes
- Normal < 140 mg/dL
2 mins
Diabetic Ketoacidosis (DKA) Diagnosis and Labs
- Diagnosis
- Blood glucose Increased > 250 mg/dL
- Anion gap metabolic acidosis
- Decreased pH < 7.3
- Decreased serum bicarbonate < 18
- Plasma ketones
- Other Labs
- Hyperkalemia
1 min
Cardiac Enzyme Evaluation: Creatine Kinase CK-MB
- Measures
- Skeletal or Cardiac Muscle Injury
- Time Ranges
- Onset: 4-8 Hours
- Peak: 12-24 Hours
- Return to Normal: 2-3 Days
1 min
Cardiac Enzyme Evaluation: Troponin
- Measures
- Cardiac Muscle Injury
- Time Ranges
- Detection in Blood: 4 Hours
- Peak: 24 - 36 Hours
- Return to Normal: 5 - 14 Days
- Considerations
- Most Specific for Cardiac Muscle
- Treat Aggressively
2 mins
Liver Enzyme Tests: AST and ALT
- AST/ALT Ratio
- AST: 8-20 U/L
- ALT: 8-20 U/L
1 min
Hyperammonemia
- Pathophysiology
- Hereditary Urea Cycle Defects
- Acquired Through Liver Disease
- Inhibits the Citric Acid Cycle
- Signs & Symptoms
- Somnolence
- Slurring of Speech
- Tremor
- Cerebral Edema
- Vomiting
- Blurring of Vision
- Treatment
- Limit Protein in Diet
- Lactulose
- Benzoate Binds Amino Acid for Excretion
- Phenylbutyrate
4 mins
Hyperbilirubinemia
- Cause/Mechanism
- Increased Unconjugated Bilirubin
- Assessment
- Jaundice
- Kernicterus
- Interventions
- Early Feedings
- Heme Oxygenase Inhibitors
- Phototherapy
- Protect Eyes
- Monitor for Dehydration
- Considerations
- Monitor Bilirubin Levels
3 mins
Gilbert's Syndrome
- Pathophysiology
- Decreased UDP-Glucuronosyltransferase Activity
- Decreased Bilirubin Conjugation
- Signs and Symptoms
- Often Asymptomatic
- Jaundice (Mild)
- Fasting
- Stress
- Alcohol Intake
- Labs
- Increased Unconjugated Bilirubin
2 mins
Crigler-Najjar Syndrome Type 1
- Pathophysiology
- Autosomal Recessive
- Absent UDP-glucuronosyltransferase
- Symptoms
- Neonatal Jaundice
- Kernicterus
- Diagnosis
- Normal Liver Function Tests
- Elevated Unconjugated Bilirubin
- Treatment
- Phototherapy
- Plasmapheresis
- Calcium Phosphate and Orlistat
- Death often by Age 2
- Considerations
- No Response to Phenobarbital
3 mins
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