836-955 Flashcards
REFERENCE METHOD FOR CHOLESTEROL AND TRIGLYCERIDES: GC-MS
CHOLESTEROL: Abell-Kendall ➡️GC-MS
TRIGLYCERIDE: Modification of van Handel and Zilversmit ➡️ GC-MS
CHOLESTEROL MEASUREMENT
In the past, the reference method for cholesterol involved hexane extraction after hydrolysis with alcoholic KOH followed by reaction with Liebermann-Burchard color reagent, which comprises sulfuric and acetic acids and acetic anhydride.
Recently, the reference method has changed to a gas chromatography–mass spectrometry (GC–MS) method that now specifically measures cholesterol and does not detect related sterols.
TRIGLYCERIDE MEASUREMENT
Like the reference method for cholesterol, the CDC has recently switched to a GC–MS method that involves the hydrolysis of fatty acids on triglycerides and the measurement of glycerol.
- Urine for routine urinalysis: 10 to 15 ml urine (50 ml-container capacity)
- Urine for drug testing: 30 to 45 ml (60 ml-container capacity)
- Urine for cytology: at least 50 ml urine (Gregorios)
- Venipucture: 15 to 30 degree angle
- Arterial puncture: 45 to 60 degree angle (90 degrees for femoral artery)
- Before blood is collected from the radial artery in the wrist, one should do a MODIFIED ALLEN TEST to determine whether the ulnar artery can provide collateral circulation to the hand after the radial artery puncture.
- Central Venous Assess (CVA) collection: eliminates multiple phlebotomies and surgical situations. Five (5) ml of blood must be drawn and discarded to eliminate contaminants. CVA is not recommended for bacteriology (organisms can contaminate specimen)
- Order of draw from CATHETER LINES: First 3 to 5 ml blood is discarded THEN, blood culture, anticoagulated tubes and clot tubes.
- Donor bleeding: 45 degree angle to the skin, make a quick clean puncture; once in the skin, reduce the angle of the needle to about 10 to 20 degrees
- Anaerobic and require ICE slurry (immediate cooling): Lactic acid, ammonia, blood gas (if not analyzed within 30 min = ↓ pH, and po2), iCa+2 (heparinized whole blood if not analyzed within 30 min)
- C-Peptide test: evaluates hypoglycemia and continuous assessment of beta cell function
- Increased C-peptide: Insulinoma, type 2 DM, ingestion of hypoglycemic drugs
- Decreased C-peptide: Type 1 DM
- Colorimetric method for Triglycerides: van Handel and Zilversmith
- CDC reference method for TAG: Modified van Handel and Zilversmith ➡️GC-MS
- Fluorometric method for Triglycerides: Hantzch condensation
- Largest and least dense: CHYLOMICRONS
- Smallest but the most dense: HDL
- Found in obstructive jaundice and LCAT deficiency: Lipoprotein X
- Floating beta lipoprotein: β-VLDL
- Sinking pre-beta lipoprotein: Lp (a)
- Triglycerides, LDLc: FASTING 12 to 14 hours
- Formula for LDLc: Total cholesterol – HDL – VLDL
- Friedewald VLDLc (mmol/L): Triglycerides/2.175
- De Long VLDLc (mmol/L): Triglycerides/2.825
- Friedewald VLDLc (mg/dL): Triglycerides/5
- De Long VLDLc (mg/dL): Triglycerides/6.5
- REFERENCE METHOD FOR CHOLESTEROL: Abell-Kendall ➡️GC-MS (Bishop)
- REFERENCE METHOD FOR TRIGLYCERIDE: Modification of van Handel and Zilversmit ➡️GC-MS (Bishop)
- TANGIER’S DISEASE: HDL is abnormal and significantly reduced
- Activated at cold temperature: Factors VII and XI (seven, eleven)
- Labile factors, decrease on storage: Factors V and VIII (five, eight)
- Wintrobe tube: 11.5 cm long, 3 mm bore
- Westergren tube: 30 cm long, 2.5 mm bore
- Capillary tube: 7 to 7.5 cm (70-75 mm) long, 1 mm bore (1.2 mm)
- Macrohematocrit: Centrifuge at 2,000 to 2,300 g for 30 minutes
- Microhematocrit: Centrifuge at 10,000 to 15,000 g for 5 minutes (five minutes)
- Normocytic, normochromic: Acute blood loss, hemolytic anemia, aplastic anemia
- Microcytic, hypochromic: Anemia of chronic disease, thalassemia, IDA and sideroblastic anemia
- Macrocytic, normochromic: MEGALOBLASTIC ANEMIA
- Poikilocytosis: DECREASED ESR
- Correction for WBC count, Adult: 5 or more nucleated RBCs/100 WBC differential
- Correction for WBC count, Neonate: 10 or more nucleated RBCs/100 WBC differential
- Increased EDTA: Decreased hematocrit, decreased ESR
- Hemoglobinopathies: QUALITATIVE defect in hemoglobin
- Thalassemia: QUANTITATIVE defect in hemoglobin
- Responsible for clot retraction: THROMBOSTHENIN
- Electromechanical detection of fibrin clot: FIBROMETER
- Photo-optical detection: Electra, COAG-A-MATE, Ortho-Koagulab
- Complement-dependent cytotoxicity: INVERTED PHASE CONTRAST microscop
- Stains for the BASEMENT MEMBRANE: PAS and azocarmine
- Fixatives for H & E: All fixatives can be used except those that contain osmic acid. Osmic acid (like Flemming’s) inhibits hematoxylin
- Manual H & E staining: REGRESSIVE STAINING, it includes a differentiation step
- Harris hematoxylin: Primary/Basic/Nuclear stain
- Eosin: Secondary/Counterstain/Acid/Cytoplasmic stain
- Stain of choice for cytology: ORIGINAL Pap’s stain
- Pap’s stain consists of 3 stains: Harris hematoxylin, Orange green (OG6) and Eosin Azure (EA)
- Harris hematoxylin: stains the nucleus
- OG 6: stains the cytoplasm of mature cells (superficial cells)
- EA 36/50/65: stains the cytoplasm of immature cells (parabasal, intermediate cells)
LEGACY OF PAMET PRESIDENTS
901. FIRST PRESIDENT: Charlemagne T. Tamondong “Emergence of the Profession” (1963-1967)
902. Nardito D. Moraleta “Professional Recognition” (1967-1970)
903. Felix E. Asprer “Legislative Agenda” (1970-1971, 1973-1976)
904. Bernardo T. Tabaosares “Celebration of the Practice” (1971-1973)
905. Angelina R. Jose “Career Advocacy” (1973)
- Venerable C.V. Chua (Venerable OCA) “Educational Enhancement” (1977-1981)
- Carmencita P. Acedera “Image Building” (1982-1991)
- Marilyn R. Atienza “Proactivism” (1992-1996)
- Norma N. Chang “International Leadership” (1997-2000)
- Agnes B. Medenilla “Organizational Dynamism” (2001-2002, 2005-2006)
LEGACY OF PAMET PRESIDENTS
911. Shirley F. Cruzada “Interdisciplinary Networking” (2003-2004)
912. Leila M. Florento “Beyond Expectations” (2007-2012)
- Romeo Joseph J. Ignacio “Soar Higher through V.O.I.C.E.” Visibility, Oneness, Integrity, Commitment and Excellence (2013 - 2015)
- Ronaldo E. Puno (2015-2020)
- CURRENT PAMET PRESIDENT IS SIR ROMMEL SACEDA (NOVEMBER 2020 TO PRESENT) ***
- FATHER OF PAMET: CRISANTO ALMARIO
- PAMET was originally organized on SEPTEMBER 15, 1963
- PAMET HYMN Music: Francis Jerota Pefanco
- PAMET HYMN Lyrics: Hector Gentapanan Gayares, Jr.
- Current PAMET President: Rommel Saceda
- Current PASMETH President: Bernard U. Ebuen
- Board of MT Head: Dr. Marilyn Barza
- Board of MT Member: Ma’am Leila Lani Florento
- PRC CHAIRPERSON: Atty. Charito Zamora
- DOH OFFICER-IN-CHARGE: Dr. Maria Rosario Singh-Vergeire