Ischemic stroke laboratory findings: Difference between revisions

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{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
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! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Blood test }}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Blood test }}
! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Test result}}
! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Test result}}
! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Rationale}}
! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Rationale}}
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| style="padding: 5px 5px; background: #F5F5F5;" |[[Complete blood count|'''Complete blood count''']]
| style="padding: 5px 5px; background: #F5F5F5;" |[[Complete blood count|'''Complete blood count''']]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
* To look for underlying infection (leukocytosis), [[thrombocytosis]] and [[thrombocytopenia|thrombocytopenia,]] [[polycythemia]]
*[[Leukocytosis]] and [[Thrombocytosis]]
*[[polycythemia]]
*[[Thrombocytopenia|thrombocytopenia,]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*May suggest underlying infection
*Increased risk of thrombotic event
*May increase the risk of bleeding in pateints eligible for thrombolytic therapy
|-
|-
| style="padding: 5px 5px; background: #F5F5F5;" |[[Lipid profile|'''Lipid profile''']]
| style="padding: 5px 5px; background: #F5F5F5;" |[[Lipid profile|'''Lipid profile''']]
| style="padding: 5px 5px; background: #F5F5F5;" |Increased [[LDL]], [[triglycerides]] and [[cholesterol]] increases risk for ischemic stroke
| style="padding: 5px 5px; background: #F5F5F5;" |*Increased [[LDL]], [[triglycerides]] and [[cholesterol]]  
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*May increase the risk of thromboembolic event
|-
|-
| style="padding: 5px 5px; background: #F5F5F5;" |[[PT|'''PT''']]'''/[[APTT]]/[[INR]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |[[PT|'''PT''']]'''/[[APTT]]/[[INR]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |To rule out underlying bleeding risk for anticoagulant administration
| style="padding: 5px 5px; background: #F5F5F5;" |Increased PT/APTT/INR
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*May increase the risk of bleeding in patients eligible for anticoagualant therapy
*May suggest underlying coagulation disorder
|-
|-
| style="padding: 5px 5px; background: #F5F5F5;" |[[BUN|'''BUN''']]'''/[[Creatinine]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |[[BUN|'''BUN''']]'''/[[Creatinine]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |Renal function tests to look for underlying kidney disease
| style="padding: 5px 5px; background: #F5F5F5;" |*Increased BUN and creatinine
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Mild to moderate renal dysfunction is an independant risk factor for ischemic stroke
*May be associated with poor prognosis in patients with ischemic stroke
|-
|-
| style="padding: 5px 5px; background: #F5F5F5;" |'''Serum [[Homocysteine|homocystein]] level'''
| style="padding: 5px 5px; background: #F5F5F5;" |'''Serum [[Homocysteine|homocysteine]] level'''
| style="padding: 5px 5px; background: #F5F5F5;" |Increased levels associated with increased risk of thromboembolic event
| style="padding: 5px 5px; background: #F5F5F5;" |*Increased levels of serum homocysteine levels
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*May be associated with increased risk of thromboembolic event
|-
|-
| style="padding: 5px 5px; background: #F5F5F5;" |[[Basic metabolic panel|'''Basic metabolic panel''']]
| style="padding: 5px 5px; background: #F5F5F5;" |[[Basic metabolic panel|'''Basic metabolic panel''']]
| style="padding: 5px 5px; background: #F5F5F5;" |To rule out electrolyte abnormalities which may mimic or complicate ischemic stroke
| style="padding: 5px 5px; background: #F5F5F5;" |*Increased or decreased serum NA2+, K+, Ca2+
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*May mimic or complicate patients with ischemic stroke
|-
|-
| style="padding: 5px 5px; background: #F5F5F5;" |[[HbA1C|'''HbA1C''']]
| style="padding: 5px 5px; background: #F5F5F5;" |[[HbA1C|'''HbA1C''']]
| style="padding: 5px 5px; background: #F5F5F5;" |Underlying [[diabetes mellitus]], major risk factor for ischemic stroke
| style="padding: 5px 5px; background: #F5F5F5;" |*Increased levels of HbA1c
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
*May suggest control of diabetes in past few months
*Increased levels associated with increased risk of ischemic stroke
*May be associated with poor prognosis in patients with ischemic stroke
|-  
| style="padding: 5px 5px; background: #F5F5F5;" |'''Blood glucose levels'''
| style="padding: 5px 5px; background: #F5F5F5;" |'''Blood glucose levels'''
| style="padding: 5px 5px; background: #F5F5F5;" |[[Hyperglycemia]] is associated with poor prognosis of ischemic stroke
| style="padding: 5px 5px; background: #F5F5F5;" |*Increased or decreased levels of blood glucose
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[Hyperglycemia]] is associated with poor prognosis of ischemic stroke
*Hypoglycemia may complicate or mimic patients with ischemic stroke
|-
|-
| style="padding: 5px 5px; background: #F5F5F5;" |[[Cardiac enzymes|'''Cardiac enzymes''']]
| style="padding: 5px 5px; background: #F5F5F5;" |*[[Cardiac enzymes|'''Cardiac enzymes''']]
| style="padding: 5px 5px; background: #F5F5F5;" |To rule out underlying [[Coronary heart disease|coronary artery disease]]
| style="padding: 5px 5px; background: #F5F5F5;" |*Increased serum levels of Trop I, Trop T, CK-MB
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*May suggest ongoing myocardial ischemia
|-
|-
| style="padding: 5px 5px; background: #F5F5F5;" |[[Pregnancy test|'''Pregnancy test''']]
| style="padding: 5px 5px; background: #F5F5F5;" |[[Pregnancy test|'''Pregnancy test''']]
| style="padding: 5px 5px; background: #F5F5F5;" |To rule out pregnancy in female patients with ischemic stroke as t-PA is a class C agent.
| style="padding: 5px 5px; background: #F5F5F5;" |Serum and urine B-HCG
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Rule out pregnancy in all female patients with ischemic stroke since t-PA is a class C agent
|-
|-
|}
|}

Revision as of 20:23, 17 November 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Overview

Laboratory Findings

Labortary tests may help determine the risk factors complications of ischemic stroke. Blood tests which may be performed include:

Blood test Test result Rationale
Complete blood count
  • May suggest underlying infection
  • Increased risk of thrombotic event
  • May increase the risk of bleeding in pateints eligible for thrombolytic therapy
Lipid profile *Increased LDL, triglycerides and cholesterol
  • May increase the risk of thromboembolic event
PT/APTT/INR Increased PT/APTT/INR
  • May increase the risk of bleeding in patients eligible for anticoagualant therapy
  • May suggest underlying coagulation disorder
BUN/Creatinine *Increased BUN and creatinine
  • Mild to moderate renal dysfunction is an independant risk factor for ischemic stroke
  • May be associated with poor prognosis in patients with ischemic stroke
Serum homocysteine level *Increased levels of serum homocysteine levels
  • May be associated with increased risk of thromboembolic event
Basic metabolic panel *Increased or decreased serum NA2+, K+, Ca2+
  • May mimic or complicate patients with ischemic stroke
HbA1C *Increased levels of HbA1c
  • May suggest control of diabetes in past few months
  • Increased levels associated with increased risk of ischemic stroke
  • May be associated with poor prognosis in patients with ischemic stroke
Blood glucose levels *Increased or decreased levels of blood glucose
  • Hyperglycemia is associated with poor prognosis of ischemic stroke
  • Hypoglycemia may complicate or mimic patients with ischemic stroke
*Cardiac enzymes *Increased serum levels of Trop I, Trop T, CK-MB
  • May suggest ongoing myocardial ischemia
Pregnancy test Serum and urine B-HCG
  • Rule out pregnancy in all female patients with ischemic stroke since t-PA is a class C agent

References


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