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CLIN PATH > BODY FLUIDS 2 > Flashcards

BODY FLUIDS 2 Flashcards

1
Q

Evaluation of Stone Disease

A
  • Routine Blood and Urine Tests
  • Stone Analysis
  • 24hrs urine metabolic profile
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2
Q

Renal Stone Analysis yields fundamental information about:

A
  • Metabolic abnormality
  • Presence of infection
  • possible artifacts
  • drug metabolism
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3
Q

Calcium Stone Characteristics: Pure Calcium Stones

A
  • More acid in urine
  • Low urine volume
  • high oxalate excretion
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4
Q

Calcium Stone Characteristics: Mixed Stone Formers

A
  • pH is higher
  • high calcium
  • high calcium excretion
  • high recurrence rate
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5
Q

Calcium Stone Characteristics: Co-oxalate Monohydrate

A
  • hypo-megnesuria
  • acidic urine
  • low urine volume
  • hardness (+)
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6
Q

Calcium Stone Characteristics: Ca-oxa Dihydrate

A
  • hypercalciuria
  • alkaline urine
  • hypocitraturia
  • hardness; less
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7
Q

Renal Tubular Acidosis: Carbonate apattite

A
  • COnsider RTA

- Increases with amount (5-39%)

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8
Q

Renal Tubular Acidosis: Brushite Stones

A

consider RTA

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9
Q

Characteristics:

Struvite Stone: Magnesium Ammonium Phosphate

A
  • Mixed Stone: Infection
  • “Proteus’
  • Strains of Staphylococci, pseudomonas and klebsiella
  • Rarely; E. coli
  • Urine pH: <7.5
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10
Q

Characteristics of Ammonium Urate

A
  • Calcium oxalate- containing calculi, may start hyperuricosuria
  • Elders: ass. w/ infection
  • Children: may as result of hyperuricosuria, but no UTI
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11
Q

Characteristics of Dahilite (Carbonic apetite)

A
  • phosphate stones
  • infection in body
  • may not accompanying sign of disease
  • RTA
  • Disorder of phosphate metabolism
  • rare in pure form (2-3%)
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12
Q

Characteristics of Uric Acid

A
  • hyperuricemia, hyperuricosuria
  • low urine pH: <6.2
  • Causes: gout, myeloproliferative dis., chemotherapy, radiotherapy
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13
Q

Causes of Cystine:

A
  • Cyateinuria
  • Autosomal recessive disorder
  • Occurs predominantly in pure form
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14
Q

Causes of Xenthene:

A
  • Xanthinuria
  • Absence of xanthene oxidase
  • genetic autosomal hereditary recessive enzyme disorder
  • Trigger: Allopurinol treating gout
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15
Q

is a fibrin degradation product (or FDP), a small protein fragment present in the blood after a blood clot is degraded through fibrinolysis, by enzyme plasmin.

A

D-dimer

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16
Q

is of clinical use when there is a suspicion of deep venous thrombosis (DVT), pulmonary embolism (PE) or disseminated intravascular coagulation (DIC). It is under
investigation in the diagnosis of aortic dissection.

A

D-dimer testing

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17
Q

A negative D-dimer test will virtually rule out

A

thromboembolism

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18
Q

Reference Ranges for D-dimer:

  • Non pregnant adult
  • 1st Trimester
  • 2nd Trimester
  • 3rd Trimester
A
  • Non pregnant adult: <0.5mg/L or ug/mL
  • 1st Trimester: 0.05–.95mg/L or ug/mL
  • 2nd Trimester: 0.32-1.29 mg/L or ug/mL
  • 3rd Trimester: 0.13-1.7mg/L or ug/mL
19
Q

False positive readings of D-dimer can be due to various causes:

A
  • liver disease,
  • high rheumatoid factor,
  • inflammation,
  • malignancy,
  • trauma,
  • pregnancy,
  • recent surgery
  • advanced age
20
Q

False negative readings can occur if:

A
  • sample is taken either too early after thrombus formation
  • testing is delayed for several days
  • presence of anticoagulation since it prevent thrombus extension
21
Q

is defined as excretion of albumin between 20 and 200 micrograms/min

A

Microalbuminuria

22
Q

Uses of Micral Test

A

(a) in diabetes, for early diagnosis of diabetic nephropathy;
(b) in patients with hypertension, as an indicator of end-organ damage associated with a lowered life expectancy;
(c) in pregnancy, as a possible predictor of developing preeclampsia.

23
Q

is a test strip now available that makes a semiquantitative assessment of the albumin concentration in the urine at various levels (0, 10, 20, 50, 100 mg/L).

A

Micral-Test

24
Q

For screening, a concentration of 20-200 mg/L of____ in the first morning urine has been proven to be a suitable indicator in Micral TEST.

A

albumin

25
Q

Advantage of Micral Test

A

no influence on the measurement from interfering factors such as glucose concentration, pH value, ketonuria, storage of the sample, or bacterial contamination in the urine

26
Q

This utilizes monoclonal antibodies tagged with fluorochromes which bind specifically to ‘GPI-AP’ on peripheral blood cells or FLAER [bacterial aerolysin tagged with fluorescent antibody] which binds directly to GPI anchor itself.

A

Multicolour Flow Cytometry Test

27
Q

Gold standard test for diagnosis of PNH.

A

Multicolour Flow Cytometry Test

28
Q

The name lupus was derived from the Latin for ”wolf”. Autoantibodies are a characteristic feature of systemic lupus erythematosus (SLE).

A

LE cell

29
Q

Abortive nucleus in the process of being extruded, undergoes ‘nucleophagocytosis’ by Neutrophils is seen in:

A
  • LE cells
  • bone marrow, peripheral blood, synovial fluid, cerebrospinal fluid and pericardial and pleural effusions from patients with SLE.
30
Q

The detection of this in serum facilitates the diagnosis of patients with systemic lupus erythematosus (SLE) and related autoimmune diseases.

A

antinuclear antibodies (ANA)

31
Q

ANA titers higher than 1/500 are usually very significant clinically, often found in:

A

spontaneous or drug-induced SLE and few other Auto-immune diseases.

32
Q

is an immunologic marker in the body, found in low titer in a number of diseases, including infectious mononucleosis and other viral diseases, chronic bacterial infections, and other acute and chronic conditions.

A

RHEUMATOID FACTOR (RH FACTOR TEST)

33
Q

The highest levels of rheumatoid factor are usually found in

A

rheumatoid arthritis

34
Q

higher titers of RH factor tend to correlate with

A
  • more severe and sustained disease,
  • joint deformities,
  • rheumatoid nodules,
  • other extra-articular features of the disease.
35
Q

present in an estimated 60 to 80% of people with RA, according to the Arthritis Foundation.

A

ANTI-CYCLIC CITRULLINATED PEPTIDE (ANTI-CCP) TEST

36
Q

Interpret anti-CCP >20 units per milliliter (u/ml)

A

increased risk of RA

37
Q

detects the presence of CRP, which the liver produces in response to inflammation in the body.

A

C-reactive protein (CRP) Test

38
Q

The presence of CRP can indicate

A
  • inflammation anywhere in the body, just like RA

- obesity and infecton, increase CRP in blood

39
Q

evaluates the risk that a seriously ill person is developing a systemic bacterial infection, (including chronic bacterial diseases such as tuberculosis)

A

PROCALCITONIN TEST

40
Q

Uses of PROCALCITONIN TEST

A

a) It helps detect or rule out sepsis (it is best used during the first day of presentation.)
b) distinguish between viral and bacterial meningitis,
c) detect/rule out bacterial pneumonia in those who are seriously ill and in fever of unknown origin.
d) in post- trauma or post-operative patient with viral pneumonia in order to detect the development of a secondary bacterial infection.
e) may be used to monitor the effectiveness of antimicrobial treatment.

41
Q

Low levels of procalcitonin indicates

A

= low risk of sepsis but do not exclude it.
= indicate a localized infection that has not yet become systemic
= or a systemic infection that is less than six hours old.
= the person’s symptoms are likely due to another cause

42
Q

High levels of procalcitonin indicate:

A

high probability of sepsis

43
Q

Reference Range of procalcitonin in Adult

A

<0.10 ng/mL

44
Q 
Neonate reference ranges of procalcitonin:
Ages in hours: 
At birth - 
18-20 hours - 
48 hours -
A

Ages in hours:
At birth - <2.00
18-20 hours - <20.00
48 hours - <5.00

CLIN PATH (19 decks)

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