A fun little quiz to get you thinking…again 😁
Results
Victory comes to those who try again 🧘🏽♀️
#1. Carl has acute pancreatitis. Which of his labs tell you this is serious & severe ?
Some believe that BUN is only lab you need to determine how severe a case of pancreatitis looks. Several studies indicate that BUN > 25 is a hallmark of severe acute pancreatitis
#2. Vera was revived after a cardiac arrest following a vehicular accident & brought to the ER. Which lab says "HE NEEDS DIALYSIS !"
A crazy high creatinine is a common trick question to confuse students about a dialysis question. Dialysis decision has NOTHING to do with creatinine. The mnemonic AEIOU gives us the indications of dialysis :
A – Acidosis
E – Electrolyte imbalances – example severe Hyperkalemia
I – Ingestions such as Ethylene Glycol
O – Overload (Fluid) not responding to diuretics
U – Uremia
#3. Ravi got drunk and comes with alcohol hepatitis, which of his labs would show us best if his liver is functioning ok?
AST / ALT convey state of liver inflammation while Alkaline Phosphatase tells us about the state of bile flow.
INR , Bilirubin and Albumin tell us about the state of livers capability of synthesizing or performing it’s various functions of bile conjugation and clotting factors / protein synthesis
#4. Jared has been sick in ICU without nutrition for 7 days, after starting Tube Feeds which lab would you especially check ?
Refeeding syndrome can occur after starting nutrition on patients that have starved for a long period, can result in rapid usage and shifts in electrolytes with dangerous drops possible in Phosphorous, Potassium, Magnesium, Thiamine etc.
#5. Kwabena has fatigue for 3-4 weeks, Hemoglobin = 8 (was 12 six mnths ago), no history of bleeds or melena. Which lab could tell you if his anemia is due to blood loss or not ?
Reticulocyte count climbs in acute to subacute anemia from blood depletion. Blood depletion can secondary to either internal or external bleeds or hemolysis. It usually starts climbing 3-4 days after the event causing anemia.
While not always a sensitive test, it’s a good initial screen to get an idea on the overall cause of anemia – blood depletion (bleeds / hemolysis ) versus reduced production (iron def, asplastic, etc) to target our investigations better.
