NSG 550/ NSG550 Exam 1 V2 – Diagnostic Reasoning for Nurse Practitioners Guide| Wilkes (Latest 2026/ 2027 Update) 100% Verified Questions & Answers | Grade A

NSG 550/ NSG550 Exam 1 V2 – Diagnostic Reasoning for Nurse Practitioners Guide| Wilkes (Latest 2026/ 2027 Update) 100% Verified Questions & Answers | Grade A Clinical decision making involves the: - Patient - Clinical problem - Practitioner's perspective What is knowledge? The integration of theory, research, personal experience, professional experience, cognitive processes, & reflective inquiry to inform sound clinical decisions What is metacognition? The combination of knowledge & cognition Metacognition is required for _____ _____ Clinical reasoning T/F: To be effective in the role of an NP, the NP must be able to critically think T: To be effective in the role of an NP, the NP must be able to critically think T/F: To be effective in the role of an NP, the NP must be able to integrate clinical judgment for clinical decision making T: To be effective in the role of an NP, the NP must be able to integrate clinical judgment for clinical decision making The NP must be able to collect data & develop a _____ _____ Health history When collecting data & developing a health history, the NP should use _____ communication skills Therapeutic The NP must be able to complete a _____ examination Physical The NP must be able to _____ diagnostic studies to formulate diagnoses Interpret What 4 factors should we consider when ordering tests? - Accuracy - Precision - Sensitivity - Specificity _____ ensures that the test measures what it was designed to measure Accuracy _____ ensures that the test reproduces the sam results when repeated on the same patient/sample Precision What is sensitivity? - The ability of the test to determine who has the disease - The ability of a test to correctly identify individuals who have a specific disease or condition by producing a positive result What is specificity? The ability of the test to correctly identify individuals who do not have a particular disease A highly sensitive test reduces _____ _____ False negatives A highly sensitive test is less/more likely to miss people with the condition of interest Less Tests with high specificity can help to _____ _____ diseases which avoids further testing Rule out Urine dipsticks have _____ sensitivity Moderate Urine dipsticks have _____ specificity High Urine dipsticks can be helpful than for ruling out _____ _____ _____ Urinary tract infections (UTIs) Which is more helpful in verifying the presence of a UTI, a urine dipstick or a urinalysis? A urinalysis Why is a urinalysis more helpful than a urine dipstick when verifying the presence of a UTI? A urinalysis has a higher sensitivity & a lower specificity than a urine dipstick A urinalysis has a higher sensitivity & a lower specificity than a urine dipstick; what does this mean? A urinalysis will identify almost everyone who has a UTI, but it may also falsely identify a UTI in some people who do not have a UTI Since urine dipsticks are less sensitive for UTI but more specific than urinalysis, what are they useful for? Ruling out UTI A urinalysis is more/less beneficial than a urine dipstick to rule in a diagnosis of UTI More If a patient has a negative dipstick with S/S strongly suggestive of UTI, then what test should be ordered? A urinalysis & culture should be ordered What is purpose of the American College of Radiology (ACR) Appropriateness Criteria? To help providers choose the most appropriate imaging & interventional procedures What is the Relative Radiation Level (RRL)? A system within the ACR criteria which indicates the estimated radiation dose of a given imaging procedure T/F: The Relative Radiation Level allows providers to make informed decisions by providing a clear indication of the radiation dose involved in a particular test T: The Relative Radiation Level allows providers to make informed decisions by providing a clear indication of the radiation dose involved in a particular test Why is considering the Relative Radiation Level important? It helps providers to select the most appropriate imaging test for a patient while considering risks versus benefits _____ _____ _____ symbols are assigned to each procedure which represents its relative radiation exposure Symbolic scale radiation The _____ _____ _____ is the quantity of radiation used to estimate the overall risk of radiation exposure from an imaging procedure Effective radiation dose The effective radiation dose doesn't tell you if you will get sick now; it helps doctors estimate the very small increase in the probability of _____ over a lifetime Cancer Radiologists follow the ALARA (As Low as Reasonably Achievable) principle to ensure they use the highest/lowest possible radiation dose needed to get a clear image Lowest What is the ACR select? A tool that allows providers to consult the appropriateness criteria & it that shows the relative radiation level alongside other information, like relative costs Relative Radiation Levels allow for _____-_____ decision making Evidence-based Relative Radiation Levels are part of the evidence-based guidelines that help providers choose the most _____ imaging tests Appropriate Relative Radiation Levels promote safer imaging practices by minimizing unnecessary exposure to _____ Radiation T/F: Relative Radiation Levels ensure regulatory compliance T: Relative Radiation Levels ensure regulatory compliance The Protecting Access to Medicare Act (PAMA) established the _____ _____ _____ _____ Appropriate Use Criteria Program What is the Appropriate Use Criteria Program? A program that requires providers to consult evidence-based guidelines via clinical decision support mechanisms when ordering advanced imaging for Medicare beneficiaries When assessing patients, you can/cannot rely only upon the patient's symptoms Cannot _____ _____ is often required to prevent medical missed diagnoses Diagnostic testing In the primary care setting, missed diagnoses due to delays in screening/testing & failure to consult specialists results in the most _____ _____ Malpractice claims T/F: You should not be afraid to consult with your collaborating physician &/or to refer to a specialist T: You should not be afraid to consult with your collaborating physician &/or to refer to a specialist When we consult with our collaborating physician &/or refer to a specialist, this must be _____ in our notes Documented When we refer to a specialist, we must document that we informed the patient of the _____ & _____ _____ - Referral - Its purpose The use of _____ _____ _____ helps to decrease medical errors by allowing us to monitor diagnostic tests Electronic health records What is an electrodiagnostic study? A diagnostic test that measures the electrical activity of muscles & nerves to identify the cause of symptoms like pain, numbness, tingling, or weakness What are examples of electrodiagnostic tests? - Nerve conduction studies - Cardiac stress test - Electrocardiography (ECG) - Electroencephalography - Electromyography - Holter monitoring - Non-stress test - Pelvic floor sphincter electromyography What is a nerve conduction study? A diagnostic procedure that measures how fast & effectively electrical signals travel through nerves What is a cardiac stress test? - A diagnostic procedure that measures the heart's ability to respond to external stress in a controlled clinical environment - The stress response is induced by exercise or by IV pharmacological stimulation What is electrocardiography (ECG)? A noninvasive diagnostic procedure that records the heart's electrical activity over a short period of time What is electroencephalography (EEG)? A diagnostic procedure that records the brain's spontaneous electrical activity using electrodes placed on the scalp What is electromyography? A diagnostic procedure that evaluates the health of muscles & the nerve cells that control them What is Holter monitoring? - The patient wears a monitor at home that constantly records the heart's activity for 24 to 48 hours - The patient keeps a diary of symptoms so they can be compared with the monitor's readings What is a non-stress test? A common, non-invasive prenatal test used in the third trimester of pregnancy to monitor a baby's heart rate in response to their own movements What is a pelvic floor sphincter electromyography? A diagnostic test that measures the electrical activity of the anal or urethral sphincter muscles & their supporting nerves to assess how well they contract & relax What are examples of endoscopic studies? - Colonoscopy - Sigmoid colonoscopy - Colposcopy - Bronchoscopy - Hysteroscopy - Cholangiopancreatography (ERCP) - Esophogastroduodenoscopy (EGD) What is a colonoscopy? A visual exam of the lining of the entire large intestine What is a sigmoid colonoscopy? A procedure that examines the rectum & the sigmoid colon What is a colposcopy? A procedure that visualizes the vagina & cervix What is a bronchoscopy? - Procedure in which the bronchi are visualized through a fiberoptic tube - May be used to obtain biopsy specimens & to assess for changes resulting from treatments What is a hysteroscopy? - A procedure that provides visualization of the interior uterus - Used to treat adhesions, polyps, & myxomas What is a cholangiopancreatography (ERCP)? An endoscope is guided through the mouth & into the small intestine to inject dye & clear blockages, remove stones, or place stents What is an esophagogastroduodenoscopy (EGD)? The visual examination of the esophagus, stomach, & duodenum by means of a fiberoptic endoscope What are examples of fluid/analysis studies? - Arthrocentesis with synovial fluid analysis - Amniocentesis - Human Papillomavirus (HPV) - Alpha defensin test - Breast cyst & nipple discharge - Lumbar puncture/CSF fluid - Semen analysis - Sexual assault testing - Thoracentesis/pleural fluid analysis What is an arthrocentesis with synovial fluid analysis? A medical procedure using a needle & syringe to remove synovial fluid from a joint space for diagnostic testing (synovial fluid analysis) & to relieve pain & pressure What is an amniocentesis? - A prenatal diagnostic procedure, where a small amount of amniotic fluid is removed from the uterus for testing - Used to assess for genetic, chromosomal, or neural tube defects What is HPV fluid analysis? A fluid sample is collected from the cervix/vagina & is assessed for HPV What is an alpha defensin test? - A small amount of synovial fluid is collected from the joint suspicious for infection - This test is used to identify periprosthetic joint infection What is a lumbar puncture (CSF fluid analysis)? - A diagnostic procedure where a needle is inserted between lumbar vertebrae to collect cerebrospinal fluid (CSF) for lab analysis - May be used to diagnose infections, bleeding, meningitis, cancer, & multiple sclerosis What is a thoracentesis (pleural fluid analysis)? A medical procedure, often guided by ultrasound, used to remove excess fluid from the pleural space (between the lungs & chest wall) for both diagnostic analysis & to relieve symptoms like shortness of breath What are manometric studies? Tests that measure muscle pressure & movement within the body What are examples of manometric studies? - Tilt-table testing - Urodynamic studies - Esophageal function studies - Arterial plethysmography Urodynamic studies are also known as _____ _____ studies Urine flow What is tilt-table testing? A diagnostic procedure used to determine the cause of unexplained fainting, dizziness, or lightheadedness (syncope) by evaluating how heart rate & blood pressure respond to changes in body position What is an arterial plethysmography? A diagnostic test that measures blood volume changes & blood flow in the extremities to detect peripheral artery disease, arterial blockages, or spasms What is an esophageal function study? A diagnostic procedure that evaluates how well the esophagus moves food into the stomach & checks if the sphincter muscles open & close properly What are examples of microbiologic studies? - Renal biopsy - Liver biopsy - Endometrial biopsy - Cervical biopsy - Lung biopsy - Acid fast bacilli - Blood culture & sensitivity - Sputum culture & sensitivity - Pap smear - Fungal testing - Viral testing - Molecular testing for the lung - TB screen & culture - Sexually transmitted infection - Varicella test - Wound culture & sensitivity - Herpes simplex - HPV testing Biopsies are examples of which kind of test? Microbiologic studies What is an acid fast bacilli test? A microscopic smear & culture that identifies infections caused by bacteria that resist decolorization by acid, primarily Mycobacterium tuberculosis (TB) Blood & sputum culture & sensitivity are examples of _____ _____ Microbiologic studies Why is a pap smear a type of microbiological study? The microscopic examination of the stained cervical cells allows for the identification of microorganisms, infections, & inflammation in the vaginal flora Why is fungal testing a type of microbiological test? It involves the identification, culture, & analysis of fungi, which are considered microorganisms Why is viral testing a type of microbiological study? It involves the detection, identification, & analysis of viruses, which are considered microorganisms Why is molecular testing for the lung a type of microbiological study? It identifies specific pathogens (bacteria, viruses, or fungi) by detecting their genetic material (DNA or RNA) in respiratory samples Why is a TB screen & culture a type of microbiological study? It involves the direct identification, cultivation, & analysis of the microorganism Mycobacterium tuberculosis from a patient's clinical sample Why is STI testing considered a type of microbiological study? It involves the direct identification, cultivation, or molecular detection of pathogenic microorganisms—bacteria, viruses, fungi, or parasites—responsible for infections Why is a varicella test a type of microbiological study? It directly identifies or detects the genetic material, antigens, or immune response to the Varicella-zoster virus Why is a wound culture & sensitivity a type of microbiological study? It isolates, identifies, & analyzes microorganisms (bacteria or fungi) from a tissue or fluid sample to diagnose infection & determine effective antimicrobial treatment Why is heres simplex testing an example of a microbiological study? It directly involves the detection, isolation, or molecular identification of a living, infectious pathogen—the Herpes Simplex Virus (HSV-1 or HSV-2)—from clinical samples Why is HPV testing a type of microbiological study? It is a diagnostic method used to detect the presence, type, & quantity of the Human Papillomavirus (HPV) What are examples of nuclear scanning? - Renal scan - Thyroid scan - Gallbladder scan - Parathyroid scan - Lung scan (V/Q Scan) - Scrotal nuclear scan - Sentinel lymph node scan -- Lymphoscintigraphy - WBC scan - Bone scan - Brain scan - Cardiac nuclear scan - PET scan - PET/CT scan - ProstaScint scan Scans are examples of _____ _____ Nuclear scanning What is a sentinel lymph node scan (lymphoscintigraphy)? A nuclear medicine imaging procedure used to locate the first lymph node(s) that drain fluid from a tumor site, typically for cancer staging What is a ProstaScint scan? A nuclear medicine imaging test used to detect the spread or recurrence of prostate cancer What are examples of stool studies? - Clostridium difficile - DNA stool sample - Stool culture - Stool cancer screening - Stool for occult blood - Fecal Immunochemical Test (FIT) - Stool for ova & parasites - Stool for leukocytes - Fecal fat - APT test - Fecal calprotectin - Lactoferritin What is a clostridium difficile test? Analyzes a stool sample to detect toxins or genetic material produced by the C. difficile bacteria What is a DNA stool sample? A noninvasive at-home screening method for colorectal cancer What is a stool culture? A laboratory test that analyzes a fecal sample to detect, grow, & identify bacteria, viruses, or fungi causing gastrointestinal infections What are examples of stool studies for cancer screening? - Fecal occult blood test - Fecal Immunochemical Test (FIT) What is a fecal immunochemical test (FIT)? An annual, at-home screening for colorectal cancer that detects hidden blood in stool, which can indicate precancerous polyps or cancer What is a stool study for ova & parasites? A stool sample that examines the stool for ova & parasites What is a stool study for leukocytes? A study that detects the presence of immune cells in a stool sample, indicating inflammation in the digestive tract What is a fecal fat study? A diagnostic test that measures the amount of fat in a stool sample, usually collected over 24 to 72 hours, to determine if the body is properly digesting & absorbing fats What is an apt test? A diagnostic study that determines if blood present in a neonate (e.g., in diapers or vomit) is swallowed maternal blood or from a neonatal gastrointestinal bleed What is fecal calprotectin? A non-invasive laboratory analysis that measures levels of the protein calprotectin in a stool sample to detect inflammation in the intestines What is a lactoferritin test? A fecal lactoferrin test detects a protein released by white blood cells into the stool, serving as a sensitive, noninvasive biomarker for intestinal inflammation What are examples of ultrasounds? - Carotid artery duplex scan - Breast ultrasound - Abdominal ultrasound - Pelvic ultrasound - Scrotal ultrasound - Thyroid ultrasound - Vaginal ultrasound - Prostate ultrasound - Rectal ulrasound - Echocardiography - Contraceptive device utilization/placement - Vascular ultrasound What is a carotid artery duplex scan? An ultrasound that combines traditional ultrasound imaging & doppler technology to evaluate blood flow & to detect stenosis or blockages in the carotid arteries of the neck T/F: A CT scan is a sophisticated type of X-ray T: A CT scan is a sophisticated type of X-ray What are examples of x-rays? - CT of the abdomen -- May be contrast or non-contrast - CT of the pelvis -- May be contrast or non-contrast - CT of the kidney -- May be contrast or non-contrast - KUB - Mammography - Cystography - Arteriography - Barium enema - Bone densitometry - Long bone x-ray - Spinal x-ray - Skull x-ray - Chest x-ray (CXR) - Swallowing exam - Upper GI exam - Venography What is a KUB? A kidney, ureter, & bladder x-ray What is mammography? A low-dose X-ray of the breast used to detect & diagnose breast cancer What is a cystography? A bladder x-ray What is an arteriography? An x-ray of the arteries What is a barium enema? An x-ray that uses contrast dye to visualize the lower GI tract What is bone densitometry? A low-dose X-ray procedure measuring bone mineral density to diagnose osteoporosis, determine fracture risk, & monitor treatment efficacy What is a long bone x-ray? - A specialized imaging technique that uses low-dose radiation to measure the length & alignment of extremity bones from joint to joint - Typically evaluates the femur, tibia, & humerus What is a spinal x-ray? A diagnostic imaging test that uses a small amount of radiation to create pictures of the vertebrae, discs, & joints in the neck (cervical), middle back (thoracic), or lower back (lumbar) What is a skull x-ray? A diagnostic imaging test that uses low-level radiation to produce pictures of the bones surrounding the brain, including the cranium, nose, sinuses, & facial structure What is a CXR? A common diagnostic imaging test that uses low-dose radiation to create images of the heart, lungs, airways, blood vessels, & chest bones When should a CXR be ordered? When we suspect pneumonia, heart failure, lung cancer, or fractured ribs What is a swallowing exam? X-ray technology is used to track a patient swallowing barium-coated food or liquid in real-time What is an upper GI x-ray? A diagnostic imaging test that uses a form of real-time X-ray called fluoroscopy & a barium contrast liquid to visualize the esophagus, stomach, & duodenum What is a venogram? - An x-ray of the veins - Used to detect blood clots, blockages, or structural abnormalities What are types of miscellaneous tests? - Allergy skin test - Breast cancer genomics - Chorionic villus sampling - Helicobacter pylori testing - Magnetic resonance imaging (MRI) - Oximetry - Pulmonary function test - Sleep studies - Urea breath test - TB skin testing - Small intestine bacterial overgrowth test What is an allergy skin test? - A diagnostic procedure used to identify specific substances (allergens) causing allergic reactions by introducing small amounts of them into the skin & assessing for wheal development - Also known as a skin prick test What is breast cancer genomics? The study of specific genetic mutations, alterations, & gene expression patterns within tumor cells to understand the cancer's behavior, aggressiveness, & likelihood of recurrence What is chorionic villus sampling? A first-trimester prenatal diagnostic test, that removes a small sample of placental tissue (chorionic villi) to detect genetic conditions like Down syndrome, cystic fibrosis, or chromosome abnormalities What is Helicobacter pylori testing? - Sample may be a stool antigen test, urea breath test, blood antibody test, or a stomach biopsy - This test detects a Helicobacter pylori bacterial infection in the stomach or small intestine, often causing ulcers, gastritis, & stomach pain What is oximetry? A test that measures the percentage of oxygen saturation in the blood (SpO2) & the pulse rate What is a pulmonary function test? A non-invasive breathing test that measures how well your lungs are working by assessing their volume, capacity, & the rate at which air moves in & out What is a sleep study? - An overnight test that monitors your brain waves, heart rate, breathing, oxygen levels, & eye & leg movements to diagnose sleep disorders - Helps to diagnose sleep apnea & narcolepsy What is a urea breath test? - A diagnostic procedure used to detect an active Helicobacter pylori infection in the stomach - The test involves ingesting a special capsule or liquid containing urea, then breathing into a bag to measure for increased CO2 produced by the bacteria What is TB skin testing? - Also known as a Mantoux test - A diagnostic tool used to determine if a person has been infected with the bacteria that causes tuberculosis (TB) What is a small intestine bacterial overgrowth test? - A non-invasive, 2-to-3-hour breath test that measures hydrogen & methane gas levels to detect excess bacteria in the small intestine - Patients consume a sugary solution & breathe into vials every 15–20 minutes to measure gas production What is an MRI? - Non-invasive imaging technology that produces three dimensional detailed anatomical images by using technology that excites & detects the change in the direction of the rotational axis of protons found in the water that makes up living tissues - A diagnostic medical imaging technique that uses strong magnets, radio waves, & a computer to create detailed pictures of organs, soft tissues, bone, & other internal body structures What is an MRI used to visualize? Soft tissues -- Muscles -- Tendons -- Ligaments -- Organs What is an ultrasound? A medical imaging technique that uses high-frequency sound waves to create real-time images & to assess blood flow, without using radiation Ultrasounds are typically used to visualize _____ tissues Soft CT scans use x-rays to generate images & are used to visualize _____, _____ _____, and _____ _____ - Bone - Soft tissue - Blood vessels Ultrasound and MRIs do/do not use radiation Do not Mammography, computerized tomography & fluoroscopy are examples of _____-_____ X-rays Thyroid nodules & thyroid malignancy detection has decreased/increased in recent years Increased The increase in thyroid nodule & thyroid malignancy detection is thought to largely be related to early detection by _____ & discovery of sub-clinical thyroid nodules which are often incidentally found on ultrasounds Ultrasound A comprehensive metabolic panel (CMP) is an example of a _____ test Blood A comprehensive metabolic panel (CMP) shows us _____, _____, & _____ values - Liver - Kidney - Electrolyte A basic metabolic panel (BMP) is an example of a _____ test Blood A basic metabolic panel (BMP) provides us with which 8 values? - Glucose - Calcium - Blood urea nitrogen (BUN) - Creatinine - Sodium - Potassium - Chloride - Bicarb/CO2 What is the difference between a CMP & BMP? A CMP includes all 8 BMP values & it also provides liver enzyme & protein levels When we suspect metabolic acidosis or diabetic ketoacidosis, which test should be ordered? Anion gap An anion gap test is a _____ test Blood When we suspect anemia, which blood test should be ordered? A complete blood count (CBC) & differential A complete blood count (CBC) is an example of a _____ test Blood Thyroid stimulating hormone (TSH) is an example of a _____ test Blood What is thyroid stimulating hormone (TSH)? A hormone that stimulates thyroid gland to secrete thyroid hormone When we suspect a thyroid disorder, _____ should be the initial test completed TSH Thyroid stimulating immunoglobulin is an example of a _____ test Blood What is thyroid stimulating immunoglobulin? An antibody that binds to TSH receptors on the thyroid gland, mimicking TSH & causing overproduction of thyroid hormones (hyperthyroidism) Thyroxine (T4) (total & free) is an example of a _____ test Blood T/F: Thyroxine (T4) is the main form of thyroid hormone circulating in the blood T: Thyroxine (T4) is the main form of thyroid hormone circulating in the blood Triiodothyronine (T3) is an example of a _____ test Blood T3 is useful in the diagnosis of hypothyroidism/hyperthyroidism & determining its severity Hyperthyroidism Patients with hyperthyroidism have a low/high TSH Low Patients with hyperthyroidism have a low/high T3 High Patients with hyperthyroidism have a low/high T4 High Patients with hypothyroidism have a low/high TSH High Patients with hypothyroidism have a low/high T3 Low Patients with hypothyroidism have a low/high T4 Low Thyroxine binding globulin is an example of a _____ test Blood What is thyroxine binding globulin? A liver-produced protein that serves as the primary carrier in the blood for thyroid hormones What test should be ordered when hyperparathyroidism or hypoparathyroidism are suspected? Parathyroid hormone (PTH) Parathyroid hormone testing is a _____ test Blood What is parathyroid hormone (PTH)? A protein hormone secreted by four tiny parathyroid glands in the neck that acts as the primary regulator of calcium & phosphorus levels in the blood T/F: An overactive parathyroid gland produces too much PTH, leading to high blood calcium, weak bones, & potential kidney stones T: An overactive parathyroid gland produces too much PTH, leading to high blood calcium, weak bones, & potential kidney stones What is hypoparathyroidism? Insufficient parathyroid hormone (PTH), causes low blood calcium & high phosphorus levels resulting in muscle cramping and nerve issues When we suspect rhabdomyolysis or kidney disease, which labs should we order? - Phosphate - Phosphorus Phosphate & phosphorus levels are examples of _____ tests Blood Why should we assess phosphate & phosphorus in cases of suspected rhabdomyolysis? Damaged muscle cells release large amounts of intracellular phosphate, leading to hyperphosphatemia, which directly correlates with an increased risk of severe acute kidney injury (AKI) Why should we assess phosphate & phosphorus in cases of suspected kidney disease? Damaged kidneys cannot effectively filter excess phosphorus, leading to dangerous accumulation, which causes weak, brittle bones, severe vascular calcification, & increased cardiovascular risks When we suspect a pituitary tumor, what test should be ordered? Prolactin level Prolactin level is an example of a _____ test Blood What is prolactin? A hormone produced by the pituitary gland that stimulates breast development and the production of milk for breastfeeding _____ prolactin levels (hyperprolactinemia) are commonly caused by prolactin-producing pituitary tumors (prolactinomas), various medications, thyroid disorders, & stress Elevated Testosterone level is an example of a _____ test Blood What is the role of testosterone in the body? The development of male reproductive organs & the production of sperm Testosterone levels are used to evaluate: ambiguous sex characteristics, precocious puberty, virilizing syndromes in the female, & infertility or impotency in the male - Ambiguous sex characteristics - Precocious puberty - Virilizing syndromes in the female - Infertility in the male - Impotency in the male Testosterone may be used as a _____ _____ for rare tumors of the ovary & testicle Tumor marker Thyroglobulin is an example of a _____ test Blood Thyroglobulin is a tumor marker for _____ cancer Thyroid Thyrotropin releasing hormone is an example of a _____ test Blood What is thyrotropin releasing hormone? A hormone produced in the hypothalamus that stimulates the pituitary gland to release thyroid stimulating hormone (TSH) & prolactin T/F: Thyrotropin releasing hormone is a key regulator of the _____-_____-_____ axis Hypothalamic-pituitary-thyroid (HPT) axis When we suspect hyperparathyroidism, vitamin D abnormalities, or certain cancers, we should order what lab? Calcium Calcium level is an example of a _____ test Blood An anti-thyroglobulin antibody is an example of a _____ test Blood If anti-thyroglobulin antibodies are present, then this may indicate the presence of an _____ thyroid condition, such as Hasimoto's Thyroiditis or Grave's Disease Autoimmune Antithyroid peroxidase antibody is an example of a _____ test Blood What is an antithyroid peroxidase antibody test used for? To differentiate between thyroid diseases such as Hashimoto's thyroiditis & chronic lymphocytic thyroiditis (in children) What is antithyroid peroxidase antibody? An enzyme involved in thyroid hormone production If we suspect prostate cancer, then what test should be ordered? Prostate-specific antigen (PSA) A prostate-specific antigen (PSA) helps to screen for & monitor _____ _____ Prostate cancer Prostate-specific antigen (PSA) is an example of a _____ test Blood If we suspect gout, kidney stones, or leukemia, then what test should be ordered? Uric acid Uric acid is an example of a _____ test Blood If we suspect hyperlipidemia, then which test should be ordered? A lipid panel A lipid panel is an example of a ____ test Blood If we suspect diabetes, then we should order which test? Hemoglobin A1c (HbA1c) Hemoglobin A1c (HbA1c) is an example of a _____ test Blood When screening for prediabetes & monitoring prediabetes, which test should be ordered? Hemoglobin A1c (HbA1c) When we suspect type 1 diabetes mellitus, which test should be ordered? Diabetes mellitus autoantibody panel Why do we have to order a diabetes mellitus autoantibody panel to diagnose type 1 diabetes mellitus? To confirm the autoimmune nature of type 1 diabetes & distinguish it from type 2 A diabetes mellitus autoantibody panel is an example of a _____ test Blood T/F: Postprandial glucose is used to confirm a diagnosis of diabetes mellitus T: Postprandial glucose is used to confirm a diagnosis of diabetes mellitus What is postprandial glucose? Glucose level 2 hours after a meal is ingested Postprandial glucose is an example of a _____ test Blood A glucose tolerance test is ordered to assist with the diagnosis of diabetes mellitus & to evaluate patients with _____ Hypoglycemia What is a glucose tolerance test? A test that measures how the body processes sugar by checking your blood glucose levels after you drink a sugary liquid A glucose tolerance test is an example of a ____ test Blood What is a glycosylated hemoglobin (HbA1c) used for? To diagnose & monitor diabetes treatment What is a glycosylated hemoglobin (HbA1c)? A blood test that shows your average level of blood glucose, over the past 2 to 3 months Glycosylated hemoglobin (HbA1c) is an example of a _____ test Blood If we suspect insulin resistance, then which test should be ordered? Insulin assay Insulin assay is an example of a _____ test Blood To differentiate between type 1 & type 2 diabetes mellitus, a _____-_____ may be ordered C-peptide A C-peptide test is an example of a _____ test Blood If we suspect an acid-base imbalance, which test should we order? Arterial blood gas (ABG) An arterial blood gas (ABG) provides us with which lab values? - Oxygen - CO2 - pH level An ABG is a _____ test Blood If we suspect muscle damage, heart problems, or brain injuries, what test should we order? Creatine kinase (CK) If muscle damage is present, we should expect creatine kinase levels to be increased/decreased Increased Creatine kinase (CK) is an example of a _____ test Blood When an inflammatory illness is suspected, which test should be ordered? C-reactive protein (CRP) C-reactive protein (CRP) decreases/increases with inflammation Increases C-reactive protein (CRP) is an example of a _____ test Blood When inflammatory conditions like arthritis, lupus, & inflammatory bowel disease, as well as certain infections and cancers are suspected, which blood test should be ordered? Erythrocyte sedimentation rate (ESR) Erythrocyte sedimentation rate (ESR) is an example of a _____ test Blood When an autoimmune disorder is suspected, an _____ _____ should be ordered Antinuclear antibody An antinuclear antibody is an example of a _____ test Blood When we suspect adrenal adenoma, adrenal hyperplasia, adrenal insufficiency, & kidney or liver disease, which test should be ordered? Aldosterone Where is aldosterone produced? Adrenal glands When we suspect adrenal adenoma, adrenal hyperplasia, adrenal insufficiency, and kidney or liver disease, why should an aldosterone test be ordered? An aldosterone level helps determine if the adrenal glands are producing excessive hormone (causing high blood pressure/low potassium) or too little Aldosterone is an example of a _____ test Blood If we suspect Cushing Syndrome or Addison's disease, which test should we order? Cortisol Cortisol is an example of a _____ test Blood If we suspect diabetes insipidus or syndrome of inappropriate anti-diuretic hormone, then which lab should we order? Anti-diuretic hormone (ADH) _____ levels are often drawn in patients who complain of polyuria or polydipsia & are found to have marked variations in blood & urine osmolality or sodium levels ADH Anti-diuretic hormone (ADH) is an example of a _____ test Blood If we suspect medullary carcinoma of the thyroid, then which test is typically ordered? Calcitonin What is calcitonin? A hormone secreted by the thyroid that has the effect of lowering blood calcium Calcitonin is an example of a _____ test Blood If we suspect Cushing Syndrome, in addition to a cortisol level, we should order a _____ _____ Dexamethasone suppression T/F: Dexamethasone suppression helps to monitor Cushing Syndrome T: Dexamethasone suppression helps to monitor Cushing Syndrome Dexamethasone suppression is an example of a _____ test Blood If we suspect hypoxia from severe illness, heart failure, or severe anemia, then which test should we order? Lactic acid T/F: Lactic acid is helpful to document & quantify the degree of tissue hypoxemia associated with shock or vascular occlusion T: Lactic acid is helpful to document & quantify the degree of tissue hypoxemia associated with shock or vascular occlusion Blood osmolality testing is conducted when we suspect a _____ & _____ imbalance Fluid & electrolyte What is blood osmolality? A measure of the concentration of dissolved substances (solutes) in the blood's fluid balance & electrolyte status Blood osmolality is an example of a _____ test Blood What does streptococcus serologic testing measure? Antibodies against Group A Streptococcus Streptococcus serologic testing is an example of _____ testing Blood If we suspect autoimmune hemolytic anemia, then what tests should we order? - Cold agglutins - Anticardiolipen antibodies What are cold agglutinins? Autoantibodies (typically IgM) that cause red blood cells to clump together (agglutinate) when exposed to cold temperatures, usually between 0°C & 4°C What are anticardiolipen antibodies? - A type of autoantibody produced by the immune system that mistakenly attack cardiolipin - These antibodies increase the risk for clotting Cold agglutins & anticardiolipen antibodies are examples of _____ tests Blood When we suspect lupus, rheumatoid arthritis, Sjögren's syndrome, or a connective tissue disease, which lab should we order? Anti-DNA antibody Anti-DNA antibodies are absent/present in cases of lupus, rheumatoid arthritis, Sjögren's syndrome, & connective tissue diseases Present An anti-DNA antibody is an example of a _____ test Blood When we suspect Sjögren syndrome or lupus, in addition to checking anti-DNA antibodies, we should order which labs? - Anti-SS-A - Anti-SS-B - Anti-SS-C What is Sjögren syndrome? A chronic autoimmune disorder where the immune system mistakenly attacks moisture producing glands, primarily causing dry eyes & dry mouth Anti-SS-A, Anti-SS-B, & Anti-SS-C are example of _____ tests Blood When we suspect liver diseases or bone disorders, we should order which test? Alkaline phosphatase Alkaline phosphatase is an example of a _____ test Blood If we suspect an autoimmune disorder, such as lupus, or frequent infections, then which lab should be ordered? Complement assay Complement assay is an example of a _____ test Blood What is an HIV RNA quantification test? A blood test that is used to determine the amount of HIV viral load in the blood of an infected patient What is HIV serologic & virologic testing? Blood tests that are used to detect HIV infection If we suspect leukemia, then which blood test should be ordered? Human T-cell lymphotrophic virus To monitor immune disorders, such as multiple myeloma, lymphoma, or autoimmune diseases, which blood test should be ordered? Immunoglobulin quantification What is a lupus anticoagulant? Antiphospholipid antibodies in your blood that increase the risk of abnormal blood clots A lupus anticoagulant test is a _____ test Blood When we suspect tick-borne diseases, we should order a _____ _____ blood test Lyme Disease When we suspect rheumatoid arthritis, which blood test should be conducted? Rheumatoid factor assay When we suspect vitamin D deficiency, which blood test should be ordered? Vitamin D When we suspect kidney disease, UTI, or diabetes mellitus, which urine test should be ordered? Urinalysis When we suspect gout or kidney disease, which urine test should be ordered? Uric acid (urine) When we suspect pancreatitis, which urine test should be ordered? Amylase If we suspect multiple myeloma, then which urine test should be ordered? Bence-Jones protein Bladder cancer markers is a type of ____ study Urine _____ _____ _____ are assessed in patients who have had transurethral resection of a superficial bladder cancer to predict or identify tumor recurrence Bladder cancer markers Urine _____ _____ are used by employers & law enforcement to check for illicit drug usage Drug screens/Substance abuse testing Urine drug screens assess for the presence of which drugs? - Amphetamines - Marijuana - Cannabinoids - Cocaine - Opiates - Phencyclidine - Barbiturates - Benzodiazepines - Methadone - Methaqualone Urine drug screen interfering factors include: - Ingestion of poppyseed - Secondhand marijuana smoke - Use of ibuprofen - Use of over the counter cold medicines - Use of diuretics - Use of some antibiotics When we suspect an adrenal insufficiency, which urine test should we order? Cortisol When we suspect nicotine use, which urine test should we order? Nicotine & metabolites If we suspect porphyria then which urine test should we order? Delta-amniolevulinic acid What is porphyria? A rare hereditary disease in which the blood pigment hemoglobin is abnormally metabolized & therefore, porphyrins are excreted in the urine If we suspect kidney disease, diabetes, or stress, which urine test should we order? Glucose T/F: We may assess urine potassium, sodium, & chloride levels to determine electrolyte balance T: We may assess urine potassium, sodium, & chloride levels to determine electrolyte balance When we suspect a urinary tract infection, a patient has a fever of unknown origin, or a urinalysis suggests infection, which urine test should we order? Urine culture & sensitivity When we suspect kidney, heart, or small vessel complications associated with diabetes, which urine test should we order? Microalbumin In nephropathy, will urine albumin be high or low? High If we suspect nephropathy, Fanconi syndrome, heavy metal exposure, rheumatoid arthritis or, viral infections, then which urine test should we order? Microglobulin _____ _____ and _____ _____ diagnose & monitor catecholamine-secreting tumors, such as neuroblastomas & pheochromocytomas - Vanillylmandelic acid (VMA) - Homovanillic acid (HVA) _____ _____ measures the concentration of particles in urine, dehydration, excess fluid intake or diabetes insipidus Urine osmolality Urine osmolality is increased when the urine concentration is high/low High Urine osmolality is decreased when the urine concentration is high/low Low What is a bone turnover marker? A urine test that measures the rate of bone remodeling, specifically bone breakdown & formation T/F: Bone turnover markers help to diagnose osteoporosis, assess fracture risk, & monitor diseases with high bone turnover, such as Paget's disease T: Bone turnover markers help to diagnose osteoporosis, assess fracture risk, & monitor diseases with high bone turnover, such as Paget's disease