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Diagnostics > 1. Chemical pathology lab > Flashcards

1. Chemical pathology lab Flashcards

1
Q

How does an increase in body temperature affect metabolism?

A

Increased metabolism (speeds up immune response)

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2
Q

What 3 tests are done in chemical pathology?

A
  • Liver function test - albumin, total bilirubin, alkaline phosphatase (ALP), alanine amino-transferase (ALT)
  • Urea and electrolytes - Na, K, urea, creatinine
  • Blood glucose
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3
Q

Who can take blood at a GP?

A
  • GP
  • Practice nurse
  • Junior doctor
  • Medical student
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4
Q

What happens if you fill the wrong tube with blood?

A

Throw it away

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5
Q

What does a blood tube with a red top contain?

A

Nothing

• blood will clot within 5 minutes

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6
Q

What does a blood tube with a yellow top contain?

A

Gel to speed up clotting

• helpful to separate serum and red cells

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7
Q

What does a blood tube with a purple top contain?

A

Potassium EDTA

• anticoagulant, preserves red cells for 6 hours

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8
Q

What does a blood tube with a grey top contain?

A

Fluoride oxalate
• poison, kills red cells, stops anaerobic respiration so gives true glucose result
• otherwise would be falsely low

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9
Q

Which blood tube do you use for U+E (urea and electrolytes)?

A

Serum in yellow/red top

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10
Q

Which blood tube do you use for HbA1c?

A

Plasma in purple top (more HbA1c, worse diabetes)

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11
Q

Which blood tube do you use for a thyroid function test (FT)?

A

Serum in yellow/red top

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12
Q

Which blood tube do you use for liver function tests?

A

Yellow/red top

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13
Q

If you perform electrophoresis on red cells, what does the HbA band look like in diabetes and why?

A

• Blurred band
• Haemoglobin is glycated
• Glucose sticks to the haemoglobin randomly (more glucose, more sticking, broader band)
(• same happens with HbA1c)

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14
Q

What’s the difference between serum and plasma?

A
  • Serum - no clotting factors

* Plasma - has clotting factors

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15
Q

How can you obtain serum from a blood test?

A
  • Mix blood with no anticoagulant
  • Blood will clot
  • Clotting factors are consumed
  • Clot can be removed, serum is left behind
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16
Q

What happens to the clotting factors if you use an anticoagulant, and how can blood be separated then?

A
  • Clotting factors are unused

* Separation into red cells and plasma with a centrifuge

17
Q

What does a green top blood tube contain?

A

Heparin

18
Q

What does a blue top blood tube contain, what is it used for and how?

A
  • Citrate
  • Anticoagulant - removes calcium, preventing clotting
  • Used to measure clotting factors
  • Need to be filled to the top
  • Remove sample => add calcium => blood clots - measure time taken to clot
  • Can measure PT (prothrombin time) or PTTK (partial thromboplastin time)
19
Q

When do you contact the chemical pathologist?

A
  • Want sample rapidly centrifuged out of hours
  • Want to measure labile hormones e.g. insulin (breaks down quickly)
  • Urgently need CSF glucose and protein to be measured
20
Q

Where are blood test results available?

A
  • Computer

* If urgent - communicated to requesting clinician by telephone

21
Q

What should come to mind when you see low Na and high K?

A

Primary adrenocortical failure -> aldosterone problem

22
Q

What happens to the blood cells if you take blood from a difficult vein, and the needle is small?

A
  • Damaged as they squeeze through the needle
  • Haemolysis
  • High K as red cells contain a lot
23
Q

What can you measure to test renal function?

A
  • Creatinine - marker of GFR (very little absorbed or secreted by tubules)
  • Urea - rises when patient is dehydrated
24
Q

Are liver enzymes meant to leak into the blood?

A

Normally only a tiny amount

25
Q

What happens to ALT (alanine amino-transferase) in viral hepatitis?

A

Elevated

26
Q

What happens to ALP (alkaline phosphatase) in a liver/biliary obstruction?

A

Elevated

27
Q

How can you tell if someone has high bilirubin?

A

Jaundice

28
Q

What are the cardiac enzymes that can be measured?

A
  • Troponins - if high, definitely a problem
  • Creatine kinase (CK) - muscle damage, not specific for cardiac muscle
  • Aspartate amino transferase (AST) - also in the liver
  • Lactate dehydrogenase (LDH) - also in the liver

Diagnostics (5 decks)

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