8- Clinical Laboratory Tests Flashcards
Bense Jones (BJ) protein test aka
immunoglobulin light chain urine test
BJ proteins are produced by
neoplastic plasma cells
What can can detect BJ proteins
Only immunoelectrophoresis of urine
what’s the normal amount of BJ protein in urine?
0
BJ proteins in urine indicates abnormal growth of
plasma cells
abnormal growth of plasma cells can be an indicator for
(what diseases)
- *- multiple myeloma
- chronic lymphocytic leukemia (CLL)
- lymphoma
- metastatic lytic bone lesions**
- Waldenström’s macroglobulinemia
- end-stage of renal failure
- amyloidosis
BJ proteins are found in 50-80% of patients with
multiple myeloma
a type of white blood cell normally responsible for producing antibodies is called
plasma cells
a cancer of plasma cells is called
Multiple Myeloma
In mm, a collections of abnormal plasma cells
accumulate in
bone marrow
abnormal plasma cells interfere with the
production of normal ______
blood cells
MM symptoms
CRAB:
C = Calcium (elevated) R = Renal failure A = Anemia B = Bone lesions
MM Clinical manifestations
bone pain
fractures
low RBC, WBC, platelets
kidney damage
nervous system symptoms
in MM, fracture of the bone is due to
lytic processes
In mm, kidneys can be damaged by the tubulopathic effects of
proteins or BJ light chains
MM nervous system symptoms and signs includes:
stroke-like manifestations
numbness, weakness
Human chorionic gonadotropin (HCG) is a hormone
produced by
placenta or malignant tumors
Normally HCG is only found during
pregnancy
Abnormal HCG can be found in
(which population)
males or non-pregnant females with certain disorders
disorders that can lead to formation of HCG
- testicullar (seminoma) and ovarian cancers
- choriocarcinoma in females (malignant trophoblastic cancer, usually of the placenta)
- some types of cancers: stomach, pancreas, lungs,
liver - teratoma
Low HCG in a pregnant women indicates
- *- miscarriage
- death of baby or embryo
- ectopic pregnancy**
High blood HCG can be used for screening for
Down’s syndrome
(weeks 15-20)
Not 100% accurate
2nd trimester screening chart
(picture)
Schilling’s test is used to determine which deficiency
B12
B12 deficiency can indicate
- megaloblastic anemia (e.g. pernicious anemia)
- nervous system pathology
- general malabsorption syndrome
Schilling (B12) test is usuall performed in how many stages
4
Schilling stage I is can detect
low B12 in diet
(megaloblastic anemia)
Schilling stage II is can detect
low intrinsic factor
(chronic atrophic gastritis, gastrectomy pernicious anemia)
Low intrinsic factor can be due to problems with the _____
stomach
Schilling stage III is can detect
abnormal bacterial growth in ileum
(Tropical sprue, Celiac disease, Crohn’s disease)
Schilling stage IV is can detect
pancreas problems
(malabsorption syndrome, pancreatitis)
Toxicology screens are often ordered by
- hospital emergency
- sports
- workplace
hospital emergency uses toxicology test when patients are
- appear to be unconscious
- demonstrate change in mental status
- in dementia
toxicology tests for the presence of
parent drugs or their metabolites
