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Clin Lab > Derm > Flashcards

Derm Flashcards

1
Q

Why do we use medical diagnostics?

A

Use as confirmation, not the end all be all. 6 billion used annually.

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2
Q

What are the modalities for medical diagnostics?

A

Imaging, Direct visualization, measurement, cellular analysis, chemical analysis, molecular analysis, microbiology.

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3
Q

What are the purposes for diagnostic tests?

A

Screening, diagnosis, staging/prognosis, monitor disease progression, drug selection, treatment monitoring. Grade an injury, localization of biopsy, establish diagnosis or narrow a differential.

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4
Q

What are the types of imaging?

A

Radiography (X-ray technology), Computed Tomography (CT), Fluoroscopy, Ultrasound (US), MRI, Nuclear Medicine Imaging, Positron emission test (PET).

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5
Q

What is Radiography?

A

X-ray technology, traditional x-rays (‘plain films’) and anything -graphy/gram.

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6
Q

What is Computed Tomography (CT)?

A

Lots of x-rays from many different angles and computer creates composite.

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7
Q

What is Fluoroscopy?

A

Lots of x-rays from the same angle, computer creates video.

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8
Q

What is MRI?

A

Soft tissues better seen with ligaments and tendons.

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9
Q

What is Nuclear Medicine Imaging?

A

Uses radioactive tracer; darker areas indicate hypermetabolism and are indicative of cancer.

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10
Q

What is a Positron emission test (PET)?

A

Radioactive tracer uptake scan.

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11
Q

What is Direct visualization?

A

Scopy indicates the insertion of a camera into a space.

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12
Q

What is Measurement of function?

A

Recording of organ activity, e.g., ECG/EKG, EEG, PFTs.

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13
Q

What are the broad categories of lab methods?

A

Microbiology, chemical analysis, cellular analysis/Hematology, Histology/tissue analysis, Molecular/Genetic analysis, microscopy.

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14
Q

Define Microbiology Diagnostics.

A

Staining, culture and identification, antimicrobial sensitivity testing.

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15
Q

What is Microbiology staining?

A

Chemical is added to a sample that provides color to help differentiate microorganisms.

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16
Q

What is a Basic stain?

A

Stains everything.

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17
Q

What is a Gram stain?

A

Most bacteria, differentiates into gram + and gram -.

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18
Q

What is India Ink?

A

Used for cryptococcus, visualize cell wall of bacteria with capsule.

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19
Q

What is Acid Fast staining?

A

Used for mycobacteria (TB).

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20
Q

Define Microbiology culture and ID.

A

Agar plates and microtiter plates.

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21
Q

Define Chemistry Diagnostics.

A

Many chemical tests use color change to detect the chemical/molecule.

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22
Q

What types of chemistry diagnostics are there?

A

Electrode management, chromatography/spectrometry, enzyme assays, immunoassays, Gel Electrophoresis.

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23
Q

What is electrode measurement?

A

Used to measure small changed molecules, e.g., Na, Cl, K, Ca.

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24
Q

What is chromatography/spectrometry?

A

Molecules are separated by chromatography then analyzed by spectrometry.

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25
Q

What is an enzyme assay?

A

Procedure: A substrate is added to the well. A sample from a patient is added to the well. If the sample contains the enzyme, there will be a color change.

26
Q

Define Immunoassays.

A

Detection of a specific antigen or antibody of interest using antibodies for detection.

27
Q

What are methods of Immunoassays?

A

Agglutination/precipitation, ELISA.

28
Q

What is gel electrophoresis?

A

Separates based on size. Gel provides barrier that selects for size.

29
Q

What is flow cytometry?

A

Cells passed single file past a detector, can be separated based on size.

30
Q

What is Histology/Tissue Analysis?

A

Biopsy of tissue examined under microscopy.

31
Q

Define Molecular and Genetic Diagnostics.

A

Detection and/or analysis of DNA/RNA (mRNA).

32
Q

What is the PCR process?

A

Genetic material isolated, primers and components added, sample heated to cause separation of strands.

33
Q

What is nucleic acid amplification?

A

Simplified PCR process on a smaller scale, mostly used with microorganisms.

34
Q

What is detection of mutations?

A

Single mutations: primers with a single mutation are added to the patient’s sample.

35
Q

What is whole chromosome analysis?

A

Karyotype: dividing cells-chromosomes separated by size into pairs.

36
Q

What is microscopy?

A

Analysis of body fluids under the microscope.

37
Q

What are some things to consider when ordering tests?

A

Purpose of the test, timeliness, harm of false results, cost effectiveness, invasiveness, special preparations, follow-up likelihood.

38
Q

What are some differential diagnoses?

A

Possible diagnoses that guide your selection of tests.

39
Q

What are some testing sequencing?

A

Initial test should be high yield, cost effective, low risk.

40
Q

What is important to know about patient education?

A

Provide patient/family info on indications, contradictions, risks, special preparations, when results can be expected.

41
Q

What is important to know about test performance?

A

Tests that PAs can perform include lumbar puncture, joint aspiration, wound culture, swab, biopsy, skin scraping, urinalysis.

42
Q

What do we know about interpretation of tests?

A

Types of results depend on the type of test; results are compared to a standard for interpretation.

43
Q

What are some factors that can affect test results?

A

Age, gender, body mass, fasting vs non-fasting, time of day, temp, timing of collection, interfering factors.

44
Q

What is important to consider in reporting of results?

A

HIPAA considerations and critical values.

45
Q

What are our test characteristics?

A

An ideal diagnostic test would perfectly identify those who do have a disease vs those who don’t.

46
Q

What are some important test characteristics?

A

All diagnostic tests have overlap between values of people with disease vs people without disease.

47
Q

Define Precision vs Accuracy.

A

Precision: obtaining results close together; Accuracy: obtaining results close to the true value.

48
Q

Define Sensitivity vs. Specificity.

A

Sensitivity: helps rule something out; Specificity: correctly identifies all individuals without the disease.

49
Q

What are the four outcomes for a diagnostic test?

A

True positive (TP), False negative (FN), True negative (TN), False positive (FP).

50
Q

Define Prevalence and Incidence.

A

Prevalence: number of people with a disease at a specific time; Incidence: number of people with a disease over a given time frame.

51
Q

Define predictive value.

A

Likelihood that a test yields a true result.

52
Q

What is an odds-likelihood ratio?

A

Likelihood ratio (LR) incorporates sensitivity and specificity into a single measure.

53
Q

What is an LR?

A

A number used to assess how much impact a test result has on the patient’s likelihood of having the disease.

54
Q

What are Derm diagnostics?

A

Visual exam, skin scraping, biopsy, allergy testing, and specific tests for infections.

55
Q

What is dermoscopy?

A

Portable microscopy for evaluating pigmented skin lesions.

56
Q

Define Diascopy.

A

Evaluation of a red pigmented lesion for blanchability.

57
Q

What is KOH prep?

A

Can be used with skin scrapings to visualize pathogens.

58
Q

What is a biopsy?

A

Remove intact layers of skin for examination.

59
Q

What are biopsy indications?

A

Concerning lesions, bullous disorders, inflammatory disorders, failed treatment.

60
Q

What are allergy testing methods?

A

Prick/scratch test, intradermal, patch.

61
Q

What is serum used for?

A

Tested for IgE antibodies to specific antigens.

62
Q

What are some tests for skin infections?

A

Woods lamp, Tzanck smear.

Clin Lab (3 decks)

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