Clin Lab Test 2 Flashcards
1
Q
What is the functional unit of the kidney?
A
Nephron
2
Q
Substances with a molecular weight less than______pass through the glomerulus into filtrate.
A
70,000 daltons
3
Q
How does Angiotensin II effect tubular reabsorption and excretion?
A
Increases Na+ reabsorption
Increases K+ excretion
Increases water retention
4
Q
What is the NORMAL adult daily urine output?
A
1200-1500 ml/day
5
Q
Increased daily urine output >3 L/day that looks dilute but has a high osmolarity is known as?
A
Polyuria
6
Q
Greatly reduced urine volume <400 ml/day; commonly caused by dehydration is known as?
A
Oliguria
7
Q
Urine volume <100 ml/day is known as?
A
Anuria
8
Q
What is a three-glass collection used for?
A
Prostatic infection
9
Q
What is a suprapubic aspiration collection used for?
A
Bladder urine for bacterial culture
*Cytology
10
Q
What is a midstream clean-catch collection used for?
A
Routine screening
Bacterial culture
11
Q
What is a catheterized specimen collection used for?
A
Bacterial culture
12
Q
What is a 24-hour specimen collection used for?
A
Quantitative chemical tests
13
Q
What is a 2-hour postprandial collection used for?
A
Diabetic monitoring
14
Q
What is a First morning specimens test used for?
A
Routine screening
Pregnancy tests
Orthostatic protein
15
Q
What is a second morning or fasting specimen collection used for?
A
Diabetic screening
Diabetic monitoring
16
Q
Unreserved urine can have what major changes occur?
A
Increased:
pH
Nitrite
Bacteria
Decreased: Glucose Ketones Bilirubin Urobilinogen RBC/WBC
17
Q
Dark amber urine suggests the presence of what?
A
Conjugated Bilirubin
18
Q
What is commonly prescribed to patients that turns their urine dark orange?
A
Pyridium (phenazopyridine)
19
Q
What is the confirmatory test you do if the glucose test shows a trace on the chemstrip?
A
Clinitest Tablet
20
Q
Glucosuria without hyperglycemia is caused by what?
A
Pregnancy
Heavy metal poisoning
21
Q
Glucosuria with hyperglycemia is caused by what?
A
Diabetes
Gestational Diabetes
Hyperthyroidism
22
Q
A normal Glucose test is reported as what?
A
Negative
23
Q
A normal Ketone test is reported as what?
A
Negative
24
Q
A chemstrip only detects what ketone?
A
Acetoacetic Acid
25
What are the significance of a positive ketone result?
```
Starvation/acute dieting
Diabetes mellitus
Alcoholism
Severe exercise
Frequent Vomiting/Diarrhea
```
26
What is a prehepatic disorder that has excessive hemolysis or breakdown of red blood cells that increase the amounts of bilirubin?
Hemolytic Jaundice
27
What is a post hepatic disorder that is caused by a blockage of bilirubin in the bile duct?
Biliary Obstruction
28
What is formed in the intestinal tract by bacterial breakdown of conjugated bilirubin?
Urobilinogen
29
What method is better for testing for a decreased level of urobilinogen?
Stool sample
30
How many decimal places is specific gravity reported to?
Third decimal place
| i.e., 1.015
31
Diabetes insipidus is related to what hormone?
ADH
32
A consistent specific gravity of 1.010 in a patients urine reflects what condition?
Isosthenuria
33
What is a count of the number of particles in a fluid sample?
Osmolality
34
What is a more exact measurement of urine concentration than the urine specific gravity test?
Osmolality
35
What 3 things will turn a chemstrip positive for hemoglobin?
```
Intact RBCs
- hematuria
Presence of hemoglobin
- hemoglobinuria
Presence of myoglobin
- myoglobinuria
```
36
What can cause hematuria?
Glomerulonephritis
Lower UTI
Strenuous exercise
37
What are common causes of hemoglobinuria?
```
Intravascular hemolysis
- hemolytic anemia
- transfusion reactions
Strenuous Exercise
Free hemoglobin damages nephron
```
38
What are common causes of myoglobinuria?
Significant muscle damage
- crushing musculoskeletal injuries.
- rhabdomyolysis
39
What is the urine appearance of a urine test with RBCs?
Cloudy red
40
What is the urine appearance of a urine test with hemoglobin?
Clear red
41
What is the urine appearance of a urine test with myoglobin?
Clear red-brown
42
What protein is synthesized by the distal tubular cells and are involved in cast formation?
Tamm-Horsfall protein
43
A chemstrip is most sensitive to the presence of what protein?
Albumin
44
What procedure is performed if a 24-hour specimen is > 150 mg/day?
Protein Electrophoresis
45
Levels of protein loss over 3.5 g/day is defined as what?
Proteinuria
46
What is associated with non-renal diseases causing an increase in low-molecular-weight plasma proteins such as hemoglobin and myoglobin?
Prerenal Proteinuria
47
What is a malignancy of plasma cells causing production of excess immunoglobulin light chains?
Multiple myeloma
48
What is defective tubular reabsorption characterized by increased levels of low-molecular weight proteins?
Tubular Proteinuria
49
What is an ascending urinary tract infection that has reached the pyelum or pelvis of the kidney?
Pyelonephritis
50
A positive nitrite chemstrip would suggest would?
Urinary Tract Infection
51
What does a positive Leukocyte Esterase indicate?
Increased number of WBC's in urine
* increased WBC suggests UTI
52
Dark amber urine may be due to what?
Bilirubin
53
Which chemical is released in response to high blood plasma osmolality?
Antidiuretic Hormone (ADH)
54
Urine specific gravity is an index of the ability of the kidney to do what?
Concentrate the urine
55
The fluid of Bowman's capsule normally has a specific gravity of what?
1.010
56
You suspect pregnancy, what is the most appropriate urine sample to submit?
First morning collection
57
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?
Ketones
58
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?
Hematuria
59
When performing a routine urinalysis, the technologist notes a 2+(pos) protein result. They should:
Report the result without further testing
60
A urine specimen with an elevated urobilinogen and a negative bilirubin may indicate?
Intravascular Hemolysis
61
Hematuria associated with urinary tract infections will be associated with what?
Pyuria (WBCs)
62
Bleeding in the urinary tract from the renal pelvis to the urethra, seen without other cell types would suggest what?
Prostatitis
| Kidney Stones
63
Presence of WBCs in the urine indicates the presence of what?
Infection
| Inflammation
64
If you see more that 2 renal tubular epithelial cells in a urine sample if indicates what?
Tubular injury
65
The presence of cellular cases indicates what?
Serious renal disease
66
What is the A1C levels that would suggest Diabetes?
6.5 or above
67
What is the fasting plasma gulcose levels that would suggest Diabetes?
126 or above
68
What is the oral glucose tolerance test levels that would suggest Diabetes?
200 or above
69
What is the most important ion in the regulation of water?
Sodium
70
What is defined as a decreased plasma Na+ concentration?
Hyponatremia
71
What is defined as an increased plasma Na+ concentration?
Hypernatremia
72
How does bicarbonate effect pH levels???
Increase bicarbonate = pH increase
Decrease bicarbonate = pH decrease
73
What states that. The sum of positive charged cations exactly equals the sum of negative charged anions in the plasma?
Law of Electroneutrality
74
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?
Bicarbonate
75
Potassium ions are found in the highest concentrations in which of the following fluid compartments?
Intracellular fluid
76
When water is lost but electrolytes are retained, the osmolarity of the ECF rises and osmosis then moves water:
out of the ICF and into the ECF until isotonicity is reached
77
A patient with a serum Potassium < 3.5mmol/L, and a 24hr K+ < 22 mmol/day suggests?
Diarrhea
78
What is detected by decreased plasma bicarbonate?
Metabolic acidosis
79
What occurs when either excess base is added to the system, base elimination is decreased, or acid-rich fluids are lost?
Metabolic alkalosis
80
If the PCO2 is elevated, the primary process would be what?
Respiratory acidosis
81
If the HCO3 is low, the primary process would be what?
Metabolic acidosis
82
If the PCO2 is low, the primary process would be what?
Respiratory alkalosis
83
If the HCO3 is elevated, the primary process would be what?
Metabolic alkalosis
84
What is the compensation for respiratory acidosis?
Metabolic alkalosis
85
What is the compensation for metabolic acidosis?
Respiratory alkalosis
86
What is the compensation for respiratory alkalosis?
Metabolic acidosis
87
What is the compensation for metabolic alkalosis?
Respiratory acidosis
88
The primary role of the carbonic acid–bicarbonate buffer system is to:
Prevent changes in pH caused by organic and fixed acids in the ECF
89
When a normal pulmonary response does not reverse respiratory acidosis, the kidneys respond by:
Increasing the rate of hydrogen ion secretion into the filtrate
90
What are the factors affecting renal function?
Renal blood flow
Glomerular filtration
Tubular reabsorption
Tubular secretion
91
Measuring ammonia is used for measuring the function of what?
Liver
92
Chronic Kidney Disease(CKD) is defined as what?
Kidney damage or GFR less than 60mL/min
For at least 3 months
93
The principal excretory form of nitrogen is?
Urea
94
Creatinine clearance is used to estimate what?
Glomerular filtration rate
95
A U/N Creatinine ration of < 10 may suggest what?
Malnutrition
96
What cardiac biomarker is used for the detection of acute myocardial infarction?
Troponin
97
What is an acute phase reactant made by the liver and secreted into the bloodstream within a few hours of an infection or inflammation?
C-Reactive Protein
98
What is a specific marker of vascular inflammation and is produced by the vascular endothelial cells, vascular smooth muscle cells, macrophages, and neutrophils?
Pentraxin 3 (PTX-3)
99
What is an early marker for atherosclerosis?
Interleukin-6 (IL-6)
100
What is a marker for plaque instability?
Myeloperoxidase (MPO)
101
What indicates plaque rupture and subsequent myocardial infarction?
CD40L
102
Elevated levels of what are indicative of recurrent non-fatal myocardial infarction or fatal cardiovascular event?
TNF-a
103
What is a predictive biomarker of mortality following acute coronary syndrome?
Heart fatty acid-binding protein (H-FABP)
104
What is secreted in response to excessive stretching of the heart muscle cells, and is helpful in identifying patients with congestive heart failure?
B-type Natriuretic Peptide (BNP)
105
What enables early identification of ischemia?
Ischemia-modified albumin (IMA)
106
The presence of which cardiac biomarker is best for identifying acute myocardial infarction?
Troponin
107
Which myocardial necrosis marker aid in the early identification of ischemia?
IMA
108
What occurs when increased amounts of unconjugated bilirubin are brought to the liver cell, most commonly from increased RBC destruction?
Pre-hepatic Jaundice
109
What occurs from direct damage to the liver cell?
Hepatic Jaundice
110
What occurs from the blockage of the flow of bile from the liver?
Post Hepatic Jaundice
111
Alanine Aminotransferase is found primarily where?
Liver
| Kidney
112
Aspartate Aminotransferase is found in the liver and kidney, but also found where?
Heart
Pancreas
Skeletal muscle
113
Typically increased AST and ALT indicates what?
Liver disease
114
Typically increased ALP and GGT indicates what?
Biliary disease
115
A chronic alcohol abuser will have elevated what, due to hepatocyte mitochondrial damage?
Gamma-glutamyltransferase (GGT)
116
Elevated levels of ALP are typically associated with what?
Bone disorders
| Liver disease
117
The greatest activities of serum AST and ALT are seen in what disease?
Metastatic Hepatic Cirrhosis
118
Elevation of ALP with normal AST, ALT, GGT levels may be associated with what?
Osteogenic Sarcoma
119
What is the most specific enzyme test for acute pancreatitis?
Lipase
120
An in creased albumin level is seen in what?
Dehydration
121
A decrease albumin level is observed in what conditions?
Malnutrition
Liver disease
Burns
122
Which Alpha-1 Globulin is speculated to protect the fetus from attack from the mother’s immune system?
Alpha-1 Fetoprotein (AFP)
123
Low levels of Alpha-1 Fetoprotein during pregnancy is associated with an increased risk of what?
Down’s Syndrome
124
Increased levels of hemopexin are associated with what?
Malignant melanoma (skin cancer)
125
What synthesizes most of the plasma proteins?
Liver
126
Which plasma protein transports iron?
Transferrin
127
What disease is characterizes by a decrease in serum albumin, alpha 1, beta, and gamma but increased alpha-2 detected by protein electrophoreses?
Nephrotic Syndrome
128
A deficiency in which plasma protein leads to pulmonary insufficiency?
Alpha-1 Antitrypsin
129
Which of the following results would be most adversely affected by a non fasting sample?
Triglycerides
130
Which lipid or lipoprotein class is more important for therapeutic decision making?
LDL
131
Which of the following apoproteins is inversely related to risk for coronary heart disease and is a surrogate maker for HDL?
Apo A-I
132
What does T3 stand for?
Total Triiodothyronine
133
What does T4 stand for?
Total Thyroxine
134
Thyroid hormones are derived from which amino acid?
Tyrosine
135
What is the most appropriate single screening test for thyroid disease?
TSH
136
The serum TSH level is almost always absent in what?
Primary Hyperthyroidism
