Exam 5 Geriatric & Pediatric Laboratory Assessment

According to 2011 data from the CDC what was the leading cause of death in people 65 and older?
Heart Disease
According to 2011 data from the CDC what was the 2nd leading cause of death in people 65 and older?
Cancer
What “normal” changes are observed as you get older?
-Decline in total body water (dehydration) and muscle mass
-Increased lipids and adipose tissue
-Decline in lung, heart, liver, kidney, GI, immune and endocrine functions
As Renal Function Decreases, what happens to the risk of toxicity?
Increases
As Renal Function is reduced by half with patients who are 65 or older, what happens to GFR, CrCl, drug clearance?
Decrease; risk of toxicity
What parts of the Lipids are increased with patients who are 65 or older?
Cholesterol & Tg
As Cholesterol & Tg increase in patients who are 65 years or older, what does this raise the risk of?
Atherosclerosis & CHD
What Liver Function parts decrease as you become older?
Albumin and protein
As Renal Function is reduced by half with patients who are 65 or older, what happens to Plasma BUN, Cr and uric acid?
Increase
With Liver Function what is the result of Drug detoxification as you get older?
Drugs/alcohol become more toxic
With Liver Function, what happens to AST, ALT, ALP, GGT, LD as you get older?
Increase
As you get older what happens to pO2?
Decreases
As you get older what happens to pCO2?
Increases
As pCO2 increases as you get older you become more susceptible to what?
Respiratory acidosis
True or False:
Both Hyper- and hypothyroidism are common for patients who are 65 or older
True
What happens to the following Endocrine Function as you get older:
Testosterone
Decreases (andropause)
What happens to the following Endocrine Function as you get older:
Estrogen
Decreases (menopause)
What happens to the following Endocrine Function as you get older:
GH
Decreases
What happens to the following Endocrine Function as you get older:
Hypothalamus
Shrinks, causing dehydration among other things
For patients who are 65 and older, what does a decrease in Estrogen increase the risk of?
Osteoporosis/CHD
What happens to your Glucose Tolerance as you get older?
Declines
What happens to the Prevalance of Type 2 Diabetes as you get older?
Increases
When combined with high lipids, as you age, the risk of _____ increases x 20
AMI
True or False:
Of the 28 conditions that the Arkansas newborn screening tests none can be cured
True
True or False:
Of the 28 conditions that the Arkansas newborn screening tests none can be cured, but many can be controlled
True
Match the following information to the disease:
Decreased T4 & Increased TSH
Cretinism
Congenital Hypothyroidism
Match the following information to the disease:
Children 3 & under get a clinitest
Galactosemia
Match the following information to the disease:
Phenylalanine Defect
Guthrie Bacterial Inhibition
PKU (phenylketonuria)
Match the following information to the disease:
Elevated levels of immunoreactive trypsinogen
Cystic fibrosis
What is immunoreactive trypsinogen (IRT)?
Enzyme secreted by the pancreas
If the IRT is Positive, you should follow up with what?
Genetic testing and sweat chloride
What do Birth trauma and RDS lead to?
respiratory acidosis and tissue hypoxia
As Lactate Increases what happens to pCO2?
Increases
As Lactate Increases what happens to pO2?
Decreases
What is the leading cause of death in preemies?
RDS
What is used as a predictor for pre-term delivery?
Fetal Fibronectin
What is used to assess the source of jaundice in neonatal/pediatric patients?
Bilirubin
Physiologic jaundice of the newborn – bilirubin levels should fall to adult levels by ____ ____
1 month
What is the Rx for Physiologic jaundice of the newborn?
Phototherapy
HDN (pathologic jaundice) is caused by what?
Overproduction of bilirubin from excess RBC lysis
HDN is Mostly what kind of bilirubin
Unconjugated
With HDN, there is a risk of what after birth?
Kernicterus
What type of charts or tests would you perform to determine bilirubin levels in neonatal patients?
OD 450 / Liley Graph
With Gestational Diabetes, what is there a risk of?
Insulin shock, RDS and macrosomia
True or False:
Glucose levels in the newborn should be similar to adult levels
True
What is the most prevalent type of diabetes in the pediatric population?
Type 1
What is the most prevalent type of diabetes in the geriatric population?
Type 2
Infantile diarrhea interferes with what elements absorption?
Calcium
Infantile diarrhea interfering with Calcium absorption is consistent with what condition?
Neonatal tetany
What element is always measured in cases of seizure of unknown origin?
Calcium
What are the 2 Preanalytical concerns with pediatric patients?
Instruments may not accept pediatric collection tubes
Evaporation
Neonatal/Pediatric:
Ammonia is tied to what condition?
Reye’s Syndrome
Neonatal/Pediatric:
Ammonia can lead to what?
Liver disease and encephalopathy
Neonatal/Pediatric- Ammonia is tied to which of the following:
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
Metabolic alkalosis
With the neonatal/pediatric population is Ammonia levels are not diagnosed in a timely manner than what can occur?
High Mortality
x

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