Blood Chemistry and Immunology Flashcards
Blood Chemistry
The quaNtitative measurements of chemical substances in the blood
Comprehensive Metabolic Profile (CMP)
- Used to detect any changes in the body biological process
- Also when the patients symptoms are vague and the provider can not provide a clinical diagnosis
Automated Blood Chemistry Analyzers
- -Quantitatively measures the amount of chemical substances, or analyses, in the blood
Analyte
A substance that is being identified or measured in a lab test
Calibration
A mechanism use to check the precision and accuracy of a blood chemistry analyzer to determine whether the system is providing accurate results
- Frequency is determined by manufacture instructions but at least performed when new lot number of testing reagents is used
Controls
- Used to detainee if the testing reagents are preforming properly to detect any errors in technique by the individual preforming the test
- Should be performed when each new lot number for reagent or once a month
Low-level Control
Produce results below the reference range
High-level control
Produces results above the reference range
Failure of Control
- Due to deterioration of the testing comments b/c of aspired or stored improperly
- Improper environmental conditions
- Erros in the techinque used to preform the procedure
Blood Glucose
-Body maintains constant blood glucose levels to ensure a continuous source of energy
Glycogen
Ingested glucose that is not needed for energy can be stored for later use in muscle and liver tissue. No more tissue storage then excess glycogen is converted to triglycerides a stored an adipose tissue
Insulin
A hormone recreated by the Beta cells of the pancreas. Insulin enables glucose to enter the body’s cells to be converted to energy
Blood Glucose Testing
Detects abnormalities in carbohydrates metabolism.
- Ex. prediabetes, gestational, diabetes, hypoglycemia, and liver adrenocortical dysfunction
Fasting Blood Glucose (FBG) Test
- Collecting a fasting blood sample and measuring the amount of glucose in it
- No food or drink (except water) 12 hours before test
- Some meds must be stoped 3 days before
- Schedule in the morning to minimize inconveniences
- Performed on patients with diabetes to evaluate process and to regulate treatment. Also as routine screening test to detect prediabetes and diabetes
FBG results
- Normal: 70-99 mg/dL
- Predibedies (also called impaired fasting glucose): 100-125 mg/dL
- Diabetes: 126 mg/dL or above
Two- Hour Postprandial Blood Glucose (2-hour PPBG) Test
- Used to screen for diabetes and monitor the effects of insulin dosage in patients with diabetes
- Patients eats 100g carb meal or 100g test load glucose solution
- Specimen is taken exactly 2 hours after consumption
- Nondiabetic glucose levels return within 1.5 to 2 hours
- Diabetic will have postprandial glucose level of 140 g/dL or higher
Oral Glucose Tolerance test (OGTT)
- Used to assist in the diagnosis or prediabetes, diabetes, gestational diabetes, hypoglycemia, and live and abdrebocortial dysfunction. More thorough then BFG and 2-hour PPBG
OGTT Testing Requirments
- Patient consumes high- carb diet of 150g of carbs per day for 3 meals before OGTT
- Morning of the test
- Blood test for FBG
- After FBG they drink 75g of glucose within in a 5 minutes time frame
- Regular blood test are taken to determine the patients ability to handle the increased amount of glucose
- Do not smoke b/c it increase the blood glucose level and minimize activity during test
OGTT Side Effects
- Weakness, feeling faintness, and perspiration
- Severe hypoglycemia symptoms: headache; pale, cold, and clammy skin; irrational speech or behavior; profuse perspiration; and fainting
OGTT Results
- Nondiabetec blood glucose level increases to a peak of 160 to 180 mg/dL ~30-60 min after glucose solution is consumed
- Diabetes individual peaks remain high
- Normal: 130 mg/dL
- Prediabetes: 140-199 mg/dL
- Diabeties:200 mg/dL or above
Hypoglycemia
- A condition where the glucose in the blood is abnormally low (FBG ^70 mg/dL). It is being removed from blood at an excessive rate or from decrease of secretion of glucose into the blood
- Overdose of insulin can cause Addison disease, bacterial sepsis, carcinoma of the pancreas, hepatic necrosis, or hypothyroidism
Self- Monitoring of Blood Glucose (SMBG)
Helps anticipate and treat day to day or hour to hour fluctuations
Frequency of Testing
- 4 times a day: morning, before lunch, before dinner, and at bedtime
- Factors: severity of diabetes, diet, activity level, and special conditions such as prego
- Contionus 180 mg/dL cause damage to body organs, result in blindness, kidney disease, nerve damage, and circulation problems
Test Results of Blood Glucose
- Before Meals: 80 -120 mg/dL
- 1-2 h after Meal: 100-180 mg/dL
- At bedtime: 100-140 mg/dL
Hemoglobin A1c Test (A1c test)
- Provides valuable information for determining whether a diabetic patient’s blood glucose level is under control.
- Done periodically until levels are stable then done 2x a year.
Glycosylation
The process of glucose attaching to hemoglobin
Hemoglobin A1c (HbA1c
Glucose + protein (hemoglobin) > HbA1c
- The attachment of glucose to hemoglobin is permanent for the life of the red blood cells (90-120 days)
HbA1c Results
- Without diabetes is 4% to 6%
- Recommended that it be less then 7% and anything over 8% require management
Glucose Reagent Test Strips
- Sensitive to heat, light, and moisture
- Discolored or that have darkened should not be used
Cholesterol
- White, waxy, fat like substance (piped) that is essential for the body’s normal function
High Blood Cholesterol
- Excessive amounts of cholesterol is present in the blood.
- May cause fatty deposits, plaque, to build up on the walls of the arteries, a condition call atherosclerosis
Lipoprotein
A complex molecule that cholesterol is transported in the blood. There is HDL and LDL
Low-Density Lipoprotein (LDL)
- “Bad” cholesterol because in excess amounts of it in the blood can cause plaque to build up on the arterial walls, resulting in atherosclerosis
High-Density Lipoprotein (HDL)
-Removes excess cholesterol from the cells and carries it to the liver to be excreted. Often called “good” cholesterol
Cholesterol Testing
Adults 20+ should test once every 5 years
Total Cholesterol Determination
Combine measures LDL and HDL
Cholesterol Results
- Desirable: Less then 200 mg/dL
- Borderline high:200-239 mg/dL
- High: 240+ mg/dL
HDL Results
Women
- Optimal: 60 mg/dL
- Desirable: 50-60 mg/dL
- Risk: Less then 50 mg/dL is at risk of CAD
Men
- Optimal: 60 mg/dL
- Desirable:40 to 50 mg/dL
- Risk: Less then 40 mg/dL is at risk of CAD
Coronary Artery Disease (CAD)
- Most common system is chest pain known as angina pectoris
Lipid Profile
- Includes cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides
- Patient must fast 12 hours before test
Triglyxerides
The chemical form in which most fat exists in food as well as in the body. 2 sources: synthesized by the body and food
- Most triglycerides in the bloodstream are carried by lipoprotein known as low density lipoprotein (VLDL)
- Too much triglycerides can increase risk of CAD
Triglycerides Results
- Normal: less then 150 mg/dL
- Borderline high: 150-199 mg/dL
- High: 200-499 mg/dL
- Very High: 500+ mg/dL
Blood Urea Nitrogen (BUN)
- Kidney fxn test
Immunology
The study of an antigen and antibody rxn
Antiogen
A substance that is cable of stimulating the formation off antibodies in an individual
Blood Antigen
A protein present on the surface of the red blood cells that determines a person’s blood type
Immunolgic test
- Hep tests, HIV, Syphulis, Mono, Rheumatoid fever, antistreptoysin O, C- reactive protein, Cold agglutinins, ABO and Rh Blood typing, Rh antibody titer
Rapid Mononucleosis Testing
- Caused by Epstein- Barr (EBV)
- Symptoms: mental and physical fatigue, fever, sore throat, severe weakness, headache, and swollen lymph nodes
Agglutination
Clumping of blood cells
