Stacy E. F. Melanson, Author at Oncology Nurse Advisor - Page 6

Stacy E. F. Melanson

All articles by Stacy E. F. Melanson

Altered Urinary pH

Differential Diagnosis Respiratory or metabolic acidosis Respiratory or metabolic alkalosis Defect in renal tubular secretion and reabsorption Continue Reading Don't Miss – Dangerous Situations Severe acidosis or alkalosis could result in a lethal outcome in the short term and should be addressed immediately. Commonly Encountered Situations There are many causes of acidosis and alkalosis with…

Abnormal Test Result in the Lipid Profile

Differential Diagnosis Elevated total cholesterol Elevated LDL cholesterol Continue Reading Decreased HDL cholesterol Increased fasting triglyceride Suggested Additional Lab Testing Total cholesterol level Can be performed on serum or plasma Can be obtained fasting or non-fasting HDL cholesterol Can be performed on serum or plasma Can be obtained fasting or non-fasting LDL cholesterol level Pt…

Abnormal Platelet Aggregation Studies

Differential Diagnosis Acquired causes of platelet dysfunction: Ingestion of aspirin or aspirin-like compounds or NSAIDs Impaired renal functionContinue Reading Myeloproliferative disease Exposure to cardiopulmonary bypass Presence of a paraprotein Congenital causes of platelet dysfunction: Storage pool disease Glanzmann thrombasthenia Bernard-Soulier syndrome Disorders of thromboxane production or action Suggested Additional Lab Testing Platelet aggregation studies with…

Abnormal Liver Function Tests: Elevations in ALT and AST, Which Predominate Over Elevations of Alkaline Phosphatase (ALP), 5'-NT, and/or Gamma Glutamyltransferase (GGT)

Differential Diagnosis If the diseases in the list below increase in severity, there may be findings suggestive of cirrhosis with or without hepatic failure: Viral hepatitis, multiple forms (see chapters on Viral Hepatitis A, B, and C) HemochromatosisContinue Reading Wilson disease Alpha-1-antitrypsin deficiency Hepatocellular carcinoma Suggested Additional Lab Testing Total bilirubin and unconjugated bilirubin are…

A Positive Test for Hypercoagulability

Differential Diagnosis Presence of factor V Leiden (can be heterozygous or homozygous) Presence of prothrombin 20210 mutation (can be heterozygous or homozygous) Continue Reading Presence of antiphospholipid antibody; could be manifested as lupus anticoagulant or anticardiolipin antibodies or anti-beta 2 glycoprotein 1 antibodies (IgG, IgM, IgA) Elevated homocysteine Deficiency of protein C not produced by…

Abnormal Liver Function Tests: Elevated Serum Bilirubin and/or Predominant Elevations in ALP, 5'-NT, and/or Gamma Glutamyltransferase (GGT)

Differential Diagnosis Red blood cell (RBC) hemolysis from a variety of causes Obstruction of the biliary tract from any of the several possibilities Continue Reading Intrahepatic biliary diseases: primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC) Hereditary conjugated hyperbilirubinemias: Dubin-Johnson syndrome, Rotor syndrome Hereditary unconjugated hyperbilirubinemias: Criggler-Najjar syndrome type I, Criggler-Najjar syndrome type II, Gilbert…

Thrombocytopenia

Differential Diagnosis Splenomegaly with platelet sequestration Increased platelet destruction by an immune mechanism; can occur as a result of: Continue Reading Heparin-induced thrombocytopenia (HIT) Idiopathic or immune thrombocytopenic purpura (ITP) Drug (other than heparin)-induced thrombocytopenia Post-transfusion purpura (PTP) Increased platelet destruction by non-immune mechanisms, as caused by: DIC Hemolytic uremic syndrome (HUS) Thrombotic thrombocytopenic purpura…

Leukopenia

Differential Diagnosis Most cases of leukopenia are associated with a low number of granulocytes. Decreased production of granulocytes may be caused by marrow failure, infiltration of the marrow by leukemic cells or metastatic cancer cells, suppression of granulocyte production by certain drugs, and vitamin B12 or folate deficiency. There may be an accelerated removal of…

Hyperglycemia

Differential Diagnosis Type I diabetes is an absolute deficiency of insulin secretion. Type II diabetes represents various degrees of insulin resistance. Continue Reading Gestational diabetes may be from unrecognized type I diabetes or subclinical and incipient type II diabetes. Diabetes may result from heterogeneous causes, such as exocrine pancreatic disease, toxins to islet cells, or…

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