CMN 548 MODULE 2 STUDY GUIDE
What is the most reliable indicator of a patients blood sugar status if they have been
taking a 2nd generation antipsychotic? - Correct Answers --Fasting blood glucose levels
and glycosylated hemoglobin levels (hemoglobin A1C)
-these medications can cause abnormal glucose tolerating and may lead to diabetes.
agents associated with abnormalities in serum glucose levels, including development of
diabetes melitus and hyperglycemia , monitoring levels on a quarterly or semiannual
basis - Correct Answers -atypical antipsychotics
how often to monitor hemoglobin A1C, fasting blood glucose for 2nd generation
antipsychotics? - Correct Answers -monitor at 12 weeks, 1 year, then annually
how long can alcohol be detected in urine? - Correct Answers -7-12 hours..table says
12 hours for light drinking
how long can marijuana be detected in urine? - Correct Answers -2-7 days - for single
use
..or 30-60 days- for chronic use
how long can benzodiazepines be detected in urine? - Correct Answers -3 days.-for
short acting benzodiazepines (ex: Xanax, Ativan)
..or up to 40 days-long-acting benzodiazepines (ex: librium, diazepam)
how long can amphetamines be detected in urine? - Correct Answers -48-72 hours (2-3
days)
what are some likely causes of a decrease in blood urea nitrogen (BUN)? - Correct
Answers -1. liver failure (severe liver disease) such as that resulting from hepatitis,
drugs, or poisoning
2. Acromegaly
3. Malnutrition, low-protein/high carb diets
4. Impaired absorption (celiac disease)
5. Nephrotic syndrome (occasional)
6. Syndrome of inappropriate antidiuretic hormone (SIADH)
,Interfering factors for causes of decrease in blood urea nitrogen (BUN) - Correct
Answers --women and children because they have less muscle mass than adult men
-overhydration (Exclusive IV feedings)
-late pregnancy r/t increased plasma volume (physiologic hydremia)
-many drugs
drug to increase BUN levels - Correct Answers -lithium
antipsychotics
Elevated BUN indications: - Correct Answers -Kidney dysfunction, and symptoms may
include fatigue, swelling (Edema), frequent urination, confusion, dry mouth and
excessive thirst, pale skin, and rapid heart rate as the body compensates for reduced
kidney function
Elevated BUN is common with - Correct Answers -dehydration
psych drugs linked to elevated BUN - Correct Answers --lithium
-second gen (atypical) antipsychotics- olanzapine, quetiapine, and risperidone
-antidepressants-fluoxetine (prozac) and amitriptyline (elavil)
What do basophils do? - Correct Answers -constitute a small percentage of the total
leukocyte count and are
considered phagocytic.
what do basophils contain? - Correct Answers -heparin, histamines, and
serotonin.
what are tissue basophils called - Correct Answers -mast cells and are similar to blood
basophils. Normally, mast cells are not found in peripheral blood and are rarely
seen in healthy bone marrow.
Basophil counts are used to study what? - Correct Answers -chronic inflammation
basophil normal findings-absolute count: - Correct Answers -15 to 50/mm3 or 0.02 to
0.05 Å~ 10 9 /L
Normal findings: basophil differential: - Correct Answers -0% to 1.0% of total WBC
count
basophilia (>50) common associations: - Correct Answers -granulocytic leukemia, acute
basophilic leukemia, myeloid
metaplasia, meta proliferative disorders, Hodkin disease.
basophilia (>50) LESS common associations: - Correct Answers -Inflammation, allergy,
sinusitis, polycythemia vera, chronic
hemolytic anemia, post-splenectomy, post-ionizing radiation, hypothyroidism, infections
,(TB, smallpox, chickenpox, influenza), foreign protein injection
Basopenia (<20, difficult to diagnose) - Correct Answers -Acute phase of infection,
hyperthyroidism, stress reactions (pregnancy, MI), prolonged
steroid therapy, chemotherapy, radiation, hereditary absence, acute rheumatic fever in
children
Identify what might create a false positive blood sugar value above 140? - Correct
Answers -a. Steroids, diuretics, other drugs (see Appendix E)
b. Pregnancy (a slight blood glucose elevation normally occurs)
c. Surgical procedures, anesthesia, and hospitalization in intensive care unit (ICU)
d. Obesity or sedentary lifestyle
e. Parenteral glucose administration (e.g., from total parenteral nutrition)
f. Intravenous (IV) glucose (recent or current)
g. Heavy smoking
what is the dawn phenomenon occur in? - Correct Answers -both non-insulin-dependent
and insulindependent
diabetes mellitus.
what happens during the dawn phenomenon? - Correct Answers -There is an increase
in blood glucose, typically between
4:00 a.m. and 8:00 a.m., due to counter-regulatory hormones, including growth
hormone, cortisol, and glucagon.
Dawn phenomenon happens at what time? - Correct Answers -between 4:00 a.m. and
8:00 a.m
drugs that can cause a false positive: - Correct Answers -Antidepressants:
-Bupropion (Wellbutrin): can cause false positive for amphetamines and
methanphetamines
-Sertraline (zoloft): May cause a false positive for benzodiazepines and LSD
-Trazodone: can cause a false positive for amphetamines
-Venlafaxine (Effexor): Has been reported to cause a false positive for PCP
-Fluoxetine (Prozac): Can cause false positives for amphetamines and LSD
-Amitriptyline: A tricyclic antidepressant (TCA) that has been linked to false positives for
LSD
Antipsychotics:
-Quetiapine (Seroquel)
-Chlorpromazine
-Aripiprazole (Abilify)
-Promethazine
The most common drug-induced factor that causes hypercalcemia? - Correct Answers -
Thiazide diuretics
, Which medications or supplements cause hypercalcemia? - Correct Answers -Thiazide
diuretics may impair urinary calcium excretion and result in hypercalcemia
(the most common drug-induced factor).
Calcuim supplements taken shortly before specimen collection will cause falsely high
values.
Excessive intake of vitamin D, milk, and antacids
For patients with renal insufficiency undergoing dialysis, a calcium-ion exchange
resin is sometimes used for hyperkalemia. This resin may increase calcium levels.
Lithium can reduce the sensitivity of the parathyroid cells to calcium, leading to an
increased threshold for suppressing PTH.
Increased by: aldesleukin, alkaline antacids, aluminum, anabolic steroids, antacids,
basiliximab, calcitriol, calcium gluconate, captopril, cefotaxime, chlorothiazide,
chlorpropamide, chlorthalidone, dihydrotachysterol, doxorubicin, estramustine,
estropipate, fluoxymesterone, hydralazine, hydrochlorothiazide, iron, leuprolide,
lithium, magnesium, methyclothiazide, methyltestosterone, metolazone,
mycophenolate, nandrolone, nisoldipine, oral contraceptives, oxymetholone,
parathyroid hormone, paroxetine, pentostatin, phenobarbital, polystyrene sulfonate,
polythiazide, progesterone, propranolol, riluzole, sirolimus, spironolactone,
tamoxifen, teriparatide, theophylline, thiazides, toremifene, trastuzumab, tretinoin,
trichlormethiazide, vitamin D, zalcitabine
can cause hyperparathyroidism, leading to hypercalcemia - Correct Answers -lithium
describe the chromosomal abnormality found in down syndrome - Correct Answers -
Trisomy 21
The most common chromosomal abnormality leading to intellectual disability. - Correct
Answers -Most often the
result of nondisjunction of chromosome 21.
More than 80 clinical features characterize the phenotype of Down Syndrome including
- Correct Answers -cognitive impairments, hypotonia, facial dysmorphisms, and
congenital heart disease.
Down syndrome : Inheritance: - Correct Answers -sporadic
Down syndrome : Prevalence - Correct Answers -1/2500-1/32 based on maternal age
Down syndrome : Recurrence: low unless due to translocation - Correct Answers -low
unless due to translocation
What is the most reliable indicator of a patients blood sugar status if they have been
taking a 2nd generation antipsychotic? - Correct Answers --Fasting blood glucose levels
and glycosylated hemoglobin levels (hemoglobin A1C)
-these medications can cause abnormal glucose tolerating and may lead to diabetes.
agents associated with abnormalities in serum glucose levels, including development of
diabetes melitus and hyperglycemia , monitoring levels on a quarterly or semiannual
basis - Correct Answers -atypical antipsychotics
how often to monitor hemoglobin A1C, fasting blood glucose for 2nd generation
antipsychotics? - Correct Answers -monitor at 12 weeks, 1 year, then annually
how long can alcohol be detected in urine? - Correct Answers -7-12 hours..table says
12 hours for light drinking
how long can marijuana be detected in urine? - Correct Answers -2-7 days - for single
use
..or 30-60 days- for chronic use
how long can benzodiazepines be detected in urine? - Correct Answers -3 days.-for
short acting benzodiazepines (ex: Xanax, Ativan)
..or up to 40 days-long-acting benzodiazepines (ex: librium, diazepam)
how long can amphetamines be detected in urine? - Correct Answers -48-72 hours (2-3
days)
what are some likely causes of a decrease in blood urea nitrogen (BUN)? - Correct
Answers -1. liver failure (severe liver disease) such as that resulting from hepatitis,
drugs, or poisoning
2. Acromegaly
3. Malnutrition, low-protein/high carb diets
4. Impaired absorption (celiac disease)
5. Nephrotic syndrome (occasional)
6. Syndrome of inappropriate antidiuretic hormone (SIADH)
,Interfering factors for causes of decrease in blood urea nitrogen (BUN) - Correct
Answers --women and children because they have less muscle mass than adult men
-overhydration (Exclusive IV feedings)
-late pregnancy r/t increased plasma volume (physiologic hydremia)
-many drugs
drug to increase BUN levels - Correct Answers -lithium
antipsychotics
Elevated BUN indications: - Correct Answers -Kidney dysfunction, and symptoms may
include fatigue, swelling (Edema), frequent urination, confusion, dry mouth and
excessive thirst, pale skin, and rapid heart rate as the body compensates for reduced
kidney function
Elevated BUN is common with - Correct Answers -dehydration
psych drugs linked to elevated BUN - Correct Answers --lithium
-second gen (atypical) antipsychotics- olanzapine, quetiapine, and risperidone
-antidepressants-fluoxetine (prozac) and amitriptyline (elavil)
What do basophils do? - Correct Answers -constitute a small percentage of the total
leukocyte count and are
considered phagocytic.
what do basophils contain? - Correct Answers -heparin, histamines, and
serotonin.
what are tissue basophils called - Correct Answers -mast cells and are similar to blood
basophils. Normally, mast cells are not found in peripheral blood and are rarely
seen in healthy bone marrow.
Basophil counts are used to study what? - Correct Answers -chronic inflammation
basophil normal findings-absolute count: - Correct Answers -15 to 50/mm3 or 0.02 to
0.05 Å~ 10 9 /L
Normal findings: basophil differential: - Correct Answers -0% to 1.0% of total WBC
count
basophilia (>50) common associations: - Correct Answers -granulocytic leukemia, acute
basophilic leukemia, myeloid
metaplasia, meta proliferative disorders, Hodkin disease.
basophilia (>50) LESS common associations: - Correct Answers -Inflammation, allergy,
sinusitis, polycythemia vera, chronic
hemolytic anemia, post-splenectomy, post-ionizing radiation, hypothyroidism, infections
,(TB, smallpox, chickenpox, influenza), foreign protein injection
Basopenia (<20, difficult to diagnose) - Correct Answers -Acute phase of infection,
hyperthyroidism, stress reactions (pregnancy, MI), prolonged
steroid therapy, chemotherapy, radiation, hereditary absence, acute rheumatic fever in
children
Identify what might create a false positive blood sugar value above 140? - Correct
Answers -a. Steroids, diuretics, other drugs (see Appendix E)
b. Pregnancy (a slight blood glucose elevation normally occurs)
c. Surgical procedures, anesthesia, and hospitalization in intensive care unit (ICU)
d. Obesity or sedentary lifestyle
e. Parenteral glucose administration (e.g., from total parenteral nutrition)
f. Intravenous (IV) glucose (recent or current)
g. Heavy smoking
what is the dawn phenomenon occur in? - Correct Answers -both non-insulin-dependent
and insulindependent
diabetes mellitus.
what happens during the dawn phenomenon? - Correct Answers -There is an increase
in blood glucose, typically between
4:00 a.m. and 8:00 a.m., due to counter-regulatory hormones, including growth
hormone, cortisol, and glucagon.
Dawn phenomenon happens at what time? - Correct Answers -between 4:00 a.m. and
8:00 a.m
drugs that can cause a false positive: - Correct Answers -Antidepressants:
-Bupropion (Wellbutrin): can cause false positive for amphetamines and
methanphetamines
-Sertraline (zoloft): May cause a false positive for benzodiazepines and LSD
-Trazodone: can cause a false positive for amphetamines
-Venlafaxine (Effexor): Has been reported to cause a false positive for PCP
-Fluoxetine (Prozac): Can cause false positives for amphetamines and LSD
-Amitriptyline: A tricyclic antidepressant (TCA) that has been linked to false positives for
LSD
Antipsychotics:
-Quetiapine (Seroquel)
-Chlorpromazine
-Aripiprazole (Abilify)
-Promethazine
The most common drug-induced factor that causes hypercalcemia? - Correct Answers -
Thiazide diuretics
, Which medications or supplements cause hypercalcemia? - Correct Answers -Thiazide
diuretics may impair urinary calcium excretion and result in hypercalcemia
(the most common drug-induced factor).
Calcuim supplements taken shortly before specimen collection will cause falsely high
values.
Excessive intake of vitamin D, milk, and antacids
For patients with renal insufficiency undergoing dialysis, a calcium-ion exchange
resin is sometimes used for hyperkalemia. This resin may increase calcium levels.
Lithium can reduce the sensitivity of the parathyroid cells to calcium, leading to an
increased threshold for suppressing PTH.
Increased by: aldesleukin, alkaline antacids, aluminum, anabolic steroids, antacids,
basiliximab, calcitriol, calcium gluconate, captopril, cefotaxime, chlorothiazide,
chlorpropamide, chlorthalidone, dihydrotachysterol, doxorubicin, estramustine,
estropipate, fluoxymesterone, hydralazine, hydrochlorothiazide, iron, leuprolide,
lithium, magnesium, methyclothiazide, methyltestosterone, metolazone,
mycophenolate, nandrolone, nisoldipine, oral contraceptives, oxymetholone,
parathyroid hormone, paroxetine, pentostatin, phenobarbital, polystyrene sulfonate,
polythiazide, progesterone, propranolol, riluzole, sirolimus, spironolactone,
tamoxifen, teriparatide, theophylline, thiazides, toremifene, trastuzumab, tretinoin,
trichlormethiazide, vitamin D, zalcitabine
can cause hyperparathyroidism, leading to hypercalcemia - Correct Answers -lithium
describe the chromosomal abnormality found in down syndrome - Correct Answers -
Trisomy 21
The most common chromosomal abnormality leading to intellectual disability. - Correct
Answers -Most often the
result of nondisjunction of chromosome 21.
More than 80 clinical features characterize the phenotype of Down Syndrome including
- Correct Answers -cognitive impairments, hypotonia, facial dysmorphisms, and
congenital heart disease.
Down syndrome : Inheritance: - Correct Answers -sporadic
Down syndrome : Prevalence - Correct Answers -1/2500-1/32 based on maternal age
Down syndrome : Recurrence: low unless due to translocation - Correct Answers -low
unless due to translocation
