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Clin Lab Test 2 > Clin Lab Test 2 > Flashcards

Clin Lab Test 2 Flashcards

1
Q

What is the functional unit of the kidney?

A

Nephron

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2
Q

Substances with a molecular weight less than______pass through the glomerulus into filtrate.

A

70,000 daltons

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3
Q

How does Angiotensin II effect tubular reabsorption and excretion?

A

Increases Na+ reabsorption

Increases K+ excretion

Increases water retention

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4
Q

What is the NORMAL adult daily urine output?

A

1200-1500 ml/day

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5
Q

Increased daily urine output >3 L/day that looks dilute but has a high osmolarity is known as?

A

Polyuria

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6
Q

Greatly reduced urine volume <400 ml/day; commonly caused by dehydration is known as?

A

Oliguria

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7
Q

Urine volume <100 ml/day is known as?

A

Anuria

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8
Q

What is a three-glass collection used for?

A

Prostatic infection

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9
Q

What is a suprapubic aspiration collection used for?

A

Bladder urine for bacterial culture

*Cytology

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10
Q

What is a midstream clean-catch collection used for?

A

Routine screening

Bacterial culture

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11
Q

What is a catheterized specimen collection used for?

A

Bacterial culture

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12
Q

What is a 24-hour specimen collection used for?

A

Quantitative chemical tests

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13
Q

What is a 2-hour postprandial collection used for?

A

Diabetic monitoring

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14
Q

What is a First morning specimens test used for?

A

Routine screening
Pregnancy tests
Orthostatic protein

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15
Q

What is a second morning or fasting specimen collection used for?

A

Diabetic screening

Diabetic monitoring

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16
Q

Unreserved urine can have what major changes occur?

A

Increased:
pH
Nitrite
Bacteria

Decreased:
   Glucose
   Ketones
   Bilirubin 
   Urobilinogen 
   RBC/WBC
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17
Q

Dark amber urine suggests the presence of what?

A

Conjugated Bilirubin

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18
Q

What is commonly prescribed to patients that turns their urine dark orange?

A

Pyridium (phenazopyridine)

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19
Q

What is the confirmatory test you do if the glucose test shows a trace on the chemstrip?

A

Clinitest Tablet

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20
Q

Glucosuria without hyperglycemia is caused by what?

A

Pregnancy

Heavy metal poisoning

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21
Q

Glucosuria with hyperglycemia is caused by what?

A

Diabetes
Gestational Diabetes
Hyperthyroidism

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22
Q

A normal Glucose test is reported as what?

A

Negative

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23
Q

A normal Ketone test is reported as what?

A

Negative

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24
Q

A chemstrip only detects what ketone?

A

Acetoacetic Acid

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25
Q

What are the significance of a positive ketone result?

A 
Starvation/acute dieting
Diabetes mellitus 
Alcoholism 
Severe exercise 
Frequent Vomiting/Diarrhea
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26
Q

What is a prehepatic disorder that has excessive hemolysis or breakdown of red blood cells that increase the amounts of bilirubin?

A

Hemolytic Jaundice

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27
Q

What is a post hepatic disorder that is caused by a blockage of bilirubin in the bile duct?

A

Biliary Obstruction

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28
Q

What is formed in the intestinal tract by bacterial breakdown of conjugated bilirubin?

A

Urobilinogen

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29
Q

What method is better for testing for a decreased level of urobilinogen?

A

Stool sample

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30
Q

How many decimal places is specific gravity reported to?

A

Third decimal place

i.e., 1.015

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31
Q

Diabetes insipidus is related to what hormone?

A

ADH

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32
Q

A consistent specific gravity of 1.010 in a patients urine reflects what condition?

A

Isosthenuria

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33
Q

What is a count of the number of particles in a fluid sample?

A

Osmolality

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34
Q

What is a more exact measurement of urine concentration than the urine specific gravity test?

A

Osmolality

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35
Q

What 3 things will turn a chemstrip positive for hemoglobin?

A 
Intact RBCs
   - hematuria 
Presence of hemoglobin
   - hemoglobinuria 
Presence of myoglobin
   - myoglobinuria
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36
Q

What can cause hematuria?

A

Glomerulonephritis
Lower UTI
Strenuous exercise

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37
Q

What are common causes of hemoglobinuria?

A 
Intravascular hemolysis
   - hemolytic anemia
   - transfusion reactions
Strenuous Exercise 
Free hemoglobin damages nephron
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38
Q

What are common causes of myoglobinuria?

A

Significant muscle damage

  • crushing musculoskeletal injuries.
  • rhabdomyolysis
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39
Q

What is the urine appearance of a urine test with RBCs?

A

Cloudy red

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40
Q

What is the urine appearance of a urine test with hemoglobin?

A

Clear red

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41
Q

What is the urine appearance of a urine test with myoglobin?

A

Clear red-brown

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42
Q

What protein is synthesized by the distal tubular cells and are involved in cast formation?

A

Tamm-Horsfall protein

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43
Q

A chemstrip is most sensitive to the presence of what protein?

A

Albumin

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44
Q

What procedure is performed if a 24-hour specimen is > 150 mg/day?

A

Protein Electrophoresis

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45
Q

Levels of protein loss over 3.5 g/day is defined as what?

A

Proteinuria

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46
Q

What is associated with non-renal diseases causing an increase in low-molecular-weight plasma proteins such as hemoglobin and myoglobin?

A

Prerenal Proteinuria

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47
Q

What is a malignancy of plasma cells causing production of excess immunoglobulin light chains?

A

Multiple myeloma

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48
Q

What is defective tubular reabsorption characterized by increased levels of low-molecular weight proteins?

A

Tubular Proteinuria

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49
Q

What is an ascending urinary tract infection that has reached the pyelum or pelvis of the kidney?

A

Pyelonephritis

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50
Q

A positive nitrite chemstrip would suggest would?

A

Urinary Tract Infection

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51
Q

What does a positive Leukocyte Esterase indicate?

A

Increased number of WBC’s in urine

  • increased WBC suggests UTI
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52
Q

Dark amber urine may be due to what?

A

Bilirubin

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53
Q

Which chemical is released in response to high blood plasma osmolality?

A

Antidiuretic Hormone (ADH)

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54
Q

Urine specific gravity is an index of the ability of the kidney to do what?

A

Concentrate the urine

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55
Q

The fluid of Bowman’s capsule normally has a specific gravity of what?

56
Q

You suspect pregnancy, what is the most appropriate urine sample to submit?

A

First morning collection

57
Q

A 17-year old girl decided to go on a starvation diet. After 1 week of starving herself, what substance would most likely be found in her urine?

58
Q

After completing his APFT , you get a positive blood reaction on urine dipstick. Urine appears red and cloudy. Intact RBCs seen on during microscopic evaluation. What is the most appropriate pathology classification?

59
Q

When performing a routine urinalysis, the technologist notes a 2+(pos) protein result. They should:

A

Report the result without further testing

60
Q

A urine specimen with an elevated urobilinogen and a negative bilirubin may indicate?

A

Intravascular Hemolysis

61
Q

Hematuria associated with urinary tract infections will be associated with what?

A

Pyuria (WBCs)

62
Q

Bleeding in the urinary tract from the renal pelvis to the urethra, seen without other cell types would suggest what?

A

Prostatitis

Kidney Stones

63
Q

Presence of WBCs in the urine indicates the presence of what?

A

Infection

Inflammation

64
Q

If you see more that 2 renal tubular epithelial cells in a urine sample if indicates what?

A

Tubular injury

65
Q

The presence of cellular cases indicates what?

A

Serious renal disease

66
Q

What is the A1C levels that would suggest Diabetes?

A

6.5 or above

67
Q

What is the fasting plasma gulcose levels that would suggest Diabetes?

A

126 or above

68
Q

What is the oral glucose tolerance test levels that would suggest Diabetes?

A

200 or above

69
Q

What is the most important ion in the regulation of water?

70
Q

What is defined as a decreased plasma Na+ concentration?

A

Hyponatremia

71
Q

What is defined as an increased plasma Na+ concentration?

A

Hypernatremia

72
Q

How does bicarbonate effect pH levels???

A

Increase bicarbonate = pH increase

Decrease bicarbonate = pH decrease

73
Q

What states that. The sum of positive charged cations exactly equals the sum of negative charged anions in the plasma?

A

Law of Electroneutrality

74
Q

After a person consumes a meal, the levels of which ion rises in the blood in response to more acid being produced in the stomach?

A

Bicarbonate

75
Q

Potassium ions are found in the highest concentrations in which of the following fluid compartments?

A

Intracellular fluid

76
Q

When water is lost but electrolytes are retained, the osmolarity of the ECF rises and osmosis then moves water:

A

out of the ICF and into the ECF until isotonicity is reached

77
Q

A patient with a serum Potassium < 3.5mmol/L, and a 24hr K+ < 22 mmol/day suggests?

78
Q

What is detected by decreased plasma bicarbonate?

A

Metabolic acidosis

79
Q

What occurs when either excess base is added to the system, base elimination is decreased, or acid-rich fluids are lost?

A

Metabolic alkalosis

80
Q

If the PCO2 is elevated, the primary process would be what?

A

Respiratory acidosis

81
Q

If the HCO3 is low, the primary process would be what?

A

Metabolic acidosis

82
Q

If the PCO2 is low, the primary process would be what?

A

Respiratory alkalosis

83
Q

If the HCO3 is elevated, the primary process would be what?

A

Metabolic alkalosis

84
Q

What is the compensation for respiratory acidosis?

A

Metabolic alkalosis

85
Q

What is the compensation for metabolic acidosis?

A

Respiratory alkalosis

86
Q

What is the compensation for respiratory alkalosis?

A

Metabolic acidosis

87
Q

What is the compensation for metabolic alkalosis?

A

Respiratory acidosis

88
Q

The primary role of the carbonic acid–bicarbonate buffer system is to:

A

Prevent changes in pH caused by organic and fixed acids in the ECF

89
Q

When a normal pulmonary response does not reverse respiratory acidosis, the kidneys respond by:

A

Increasing the rate of hydrogen ion secretion into the filtrate

90
Q

What are the factors affecting renal function?

A

Renal blood flow
Glomerular filtration
Tubular reabsorption
Tubular secretion

91
Q

Measuring ammonia is used for measuring the function of what?

92
Q

Chronic Kidney Disease(CKD) is defined as what?

A

Kidney damage or GFR less than 60mL/min

For at least 3 months

93
Q

The principal excretory form of nitrogen is?

94
Q

Creatinine clearance is used to estimate what?

A

Glomerular filtration rate

95
Q

A U/N Creatinine ration of < 10 may suggest what?

A

Malnutrition

96
Q

What cardiac biomarker is used for the detection of acute myocardial infarction?

97
Q

What is an acute phase reactant made by the liver and secreted into the bloodstream within a few hours of an infection or inflammation?

A

C-Reactive Protein

98
Q

What is a specific marker of vascular inflammation and is produced by the vascular endothelial cells, vascular smooth muscle cells, macrophages, and neutrophils?

A

Pentraxin 3 (PTX-3)

99
Q

What is an early marker for atherosclerosis?

A

Interleukin-6 (IL-6)

100
Q

What is a marker for plaque instability?

A

Myeloperoxidase (MPO)

101
Q

What indicates plaque rupture and subsequent myocardial infarction?

102
Q

Elevated levels of what are indicative of recurrent non-fatal myocardial infarction or fatal cardiovascular event?

103
Q

What is a predictive biomarker of mortality following acute coronary syndrome?

A

Heart fatty acid-binding protein (H-FABP)

104
Q

What is secreted in response to excessive stretching of the heart muscle cells, and is helpful in identifying patients with congestive heart failure?

A

B-type Natriuretic Peptide (BNP)

105
Q

What enables early identification of ischemia?

A

Ischemia-modified albumin (IMA)

106
Q

The presence of which cardiac biomarker is best for identifying acute myocardial infarction?

107
Q

Which myocardial necrosis marker aid in the early identification of ischemia?

108
Q

What occurs when increased amounts of unconjugated bilirubin are brought to the liver cell, most commonly from increased RBC destruction?

A

Pre-hepatic Jaundice

109
Q

What occurs from direct damage to the liver cell?

A

Hepatic Jaundice

110
Q

What occurs from the blockage of the flow of bile from the liver?

A

Post Hepatic Jaundice

111
Q

Alanine Aminotransferase is found primarily where?

A

Liver

Kidney

112
Q

Aspartate Aminotransferase is found in the liver and kidney, but also found where?

A

Heart
Pancreas
Skeletal muscle

113
Q

Typically increased AST and ALT indicates what?

A

Liver disease

114
Q

Typically increased ALP and GGT indicates what?

A

Biliary disease

115
Q

A chronic alcohol abuser will have elevated what, due to hepatocyte mitochondrial damage?

A

Gamma-glutamyltransferase (GGT)

116
Q

Elevated levels of ALP are typically associated with what?

A

Bone disorders

Liver disease

117
Q

The greatest activities of serum AST and ALT are seen in what disease?

A

Metastatic Hepatic Cirrhosis

118
Q

Elevation of ALP with normal AST, ALT, GGT levels may be associated with what?

A

Osteogenic Sarcoma

119
Q

What is the most specific enzyme test for acute pancreatitis?

120
Q

An in creased albumin level is seen in what?

A

Dehydration

121
Q

A decrease albumin level is observed in what conditions?

A

Malnutrition
Liver disease
Burns

122
Q

Which Alpha-1 Globulin is speculated to protect the fetus from attack from the mother’s immune system?

A

Alpha-1 Fetoprotein (AFP)

123
Q

Low levels of Alpha-1 Fetoprotein during pregnancy is associated with an increased risk of what?

A

Down’s Syndrome

124
Q

Increased levels of hemopexin are associated with what?

A

Malignant melanoma (skin cancer)

125
Q

What synthesizes most of the plasma proteins?

126
Q

Which plasma protein transports iron?

A

Transferrin

127
Q

What disease is characterizes by a decrease in serum albumin, alpha 1, beta, and gamma but increased alpha-2 detected by protein electrophoreses?

A

Nephrotic Syndrome

128
Q

A deficiency in which plasma protein leads to pulmonary insufficiency?

A

Alpha-1 Antitrypsin

129
Q

Which of the following results would be most adversely affected by a non fasting sample?

A

Triglycerides

130
Q

Which lipid or lipoprotein class is more important for therapeutic decision making?

131
Q

Which of the following apoproteins is inversely related to risk for coronary heart disease and is a surrogate maker for HDL?

132
Q

What does T3 stand for?

A

Total Triiodothyronine

133
Q

What does T4 stand for?

A

Total Thyroxine

134
Q

Thyroid hormones are derived from which amino acid?

135
Q

What is the most appropriate single screening test for thyroid disease?

136
Q

The serum TSH level is almost always absent in what?

A

Primary Hyperthyroidism

Clin Lab Test 2 (1 decks)

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