(E) 201-300 Flashcards
- Family Coronaviridae includes the genera Torovirus and Coronavirus (CoV) and contains many species of both human and animal origin
- Coronaviruses are pleomorphic, roughly spherical, medium-sized, enveloped RNA viruses.
Prefix corona- results from the viral structure and the crown-like surface projections on the external surface of the virus that can be seen with electron microscopy.
Human respiratory coronaviruses cause colds and occasionally pneumonia in adults.
Together the rhinoviruses and coronaviruses cause more than 55% of the “common colds” in the human populations.
Viral transmission is person to person via contaminated respiratory secretions or aerosols.
Virus is present in the highest concentration in the nasal passages, where it infects the nasal epithelial cells.
- In November, 2002, SARS (SARS CoV-1) was identified as the cause of a worldwide outbreak. It first emerged in the Guangdongprovince in China.
Because of its sensitivity and specificity, molecular testing by RT-PCR remains the recommended method for laboratory diagnosis.
Although nucleic acid testing by RT-PCR is the most useful diagnostic test available, the virus is capable of growth in cell culture using the Vero-E6 cell line.
The characteristic viral CPE appears as a rapid cell rounding, refractivity and detachment.
BSL 3 or higher is required for propagation and manipulation of cell cultures containing this virus. (Bailey)
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiologic agent of the current rapidly growing outbreak of coronavirus disease (COVID-19), originating from the city of Wuhan, Hubei Province, China.
Coronavirus disease 2019 (COVID-19) is caused by a new coronavirus first identified in Wuhan, China, in December 2019.
Although most people who have COVID-19 have mild symptoms, COVID-19 can also cause severe illness and even death.
Some groups, including older adults and people who have certain underlying medical conditions, are at increased risk of severe illness.
On February 11, 2020, the World Health Organization announced an official name for the disease that is causing the 2019 novel coronavirus outbreak. The new name of this disease is coronavirus disease 2019, abbreviated as COVID-19. In COVID-19, ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease. Formerly, this disease was referred to as “2019 novel coronavirus” or “2019-nCoV.”
Microbiology and pathology laboratories performing diagnostic tests on stool or respiratory specimens should handle potential SARS-CoV specimens using standard Biosafety Level (BSL)-2 work practices in a Class II biological safety cabinet.
CDC recommends virus isolation in cell culture, and initial characterization of viral agents recovered in cultures of novel SARS-CoV-2 should be conducted in a Biosafety Level 3 (BSL-3) laboratory using BSL-3 practices.
- SYMPTOMS OF COVID-19 (WHO)
The most common symptoms of COVID-19 are
Fever
Dry cough
Fatigue
Other symptoms that are less common and may affect some patients include:
Loss of taste or smell
Nasal congestion
Conjunctivitis (also known as red eyes)
Sore throat
Headache
Muscle or joint pain
Different types of skin rash
Nausea or vomiting
Diarrhea
Chills or dizziness
Symptoms of severe COVID‐19 disease include:
Shortness of breath
Loss of appetite
Confusion
Persistent pain or pressure in the chest
High temperature (above 38 °C)
Other less common symptoms are:
Irritability
Confusion
Reduced consciousness (sometimes associated with seizures)
Anxiety
Depression
Sleep disorders
More severe and rare neurological complications such as strokes, brain inflammation, delirium and nerve damage.
- The time from exposure to COVID-19 to the moment when symptoms begin is, on average, 5-6 days and can range from 1-14 days. This is why people who have been exposed to the virus are advised to remain at home and stay away from others, for 14 days, in order to prevent the spread of the virus, especially where testing is not easily available.
- Both isolation and quarantine are methods of preventing the spread of COVID-19.
Quarantine is used for anyone who is a contact of someone infected with the SARS-CoV-2 virus, which causes COVID-19, whether the infected person has symptoms or not. Quarantine means that you remain separated from others because you have been exposed to the virus and you may be infected and can take place in a designated facility or at home. For COVID-19, this means staying in the facility or at home for 14 days.
Isolation is used for people with COVID-19 symptoms or who have tested positive for the virus. Being in isolation means being separated from other people, ideally in a medically facility where you can receive clinical care. If isolation in a medical facility is not possible and you are not in a high risk group of developing severe disease, isolation can take place at home. If you have symptoms, you should remain in isolation for at least 10 days plus an additional 3 days without symptoms. If you are infected and do not develop symptoms, you should remain in isolation for 10 days from the time you test positive.
- PITUITARY GLAND - MASTER GLAND
- CARBON DIOXIDE - DRIVING FORCE of the bicarbonate-carbonic acid buffer system
- Measured by potentiometry - pH, pCO2
- Measured by amperometry - pO2
- POTASSIUM - integral part of nerve impulse transmission; movement across the nerve tissue membrane permits the neural signal to move down the nerve fiber
- YELLOW FLAME - sodium
- VIOLET FLAME - potassium
- RED FLAME - lithium and rubidium
- BLUE FLAME - magnesium
- Beer’s law states that the concentration of a substance is directly proportional to the amount of radiant energy absorbed: A = abc or ebc; where a (or e) is molar absorptivity (a constant for a given molecule); b is the length of the path traveled by the light; and c is the concentration of absorbing molecules
- Majority of cases of laboratory-related infections - INFECTIOUS AEROSOLS
- Lean Six sigma - DMAIC (Define, Measure, Analyze, Improve, and Control) methodology
- Antitussive drug - CODEINE
- Ethanol (grain alcohol) - most common abused drug
- Methanol (wood alcohol) - associated with blindness
- CYANIDE “Odor of bitter almonds”
- ARSENIC “Odor of garlic”; “metallic taste”; affinity to keratin
- SPECIMEN REQUIREMENTS FOR BLOOD GAS ANALYSIS
Arterial blood is collected in a glass or plastic syringe. Capillary specimens can also be used (blood must be “arterialized”).
Lyophilized or liquid heparin is the preferred anticoagulant.
No air bubbles should exist in the sample because they lower the pCO2 value.
The specimen must be placed on ice and transported to the laboratory in 15 minutes at 4◦C and tested immediately. Otherwise, pH values decrease, and pCO2 values increase.
Blood clots are unacceptable.
- Floating B lipoprotein: Β-VLDL
- Sinking pre-beta lipoprotein: Lp (a)
- Drug associated with rhabdomyolysis: side effect in certain patients taking the cholesterol-lowering STATIN medications; example: Flavostatins
- Rotting fish odor of urine: TRIMETHYLAMINURIA
- Renal stones may form in: RENAL PELVIS AND CALYCES, URETER and BLADDER
- RENAL CALCULI
Uric acid and urate stones - yellow to brown-red and are moderately hard
Phosphate stones - pale and friable
Calcium oxalate stones - very hard and have a rough surface
Cystine stones - Yellow-brown, resembling an old soap and feel somewhat greasy
- Person submitting urine for drug test: DONOR /CLIENT
- Anti-neutrophilic cytoplasmic antibody (ANCA): WEGENER’S GRANULOMATOSIS
- Anti-glomerular basement membrane antibody: GOODPASTURE’S SYNDROME
- Compare results with those of its peers: BENCHMARKING
- Hepatocellular damage: ALT and AST
- Hepatobiliary damage: ALP and GGT
- Abnormality of bile duct epithelium: SERUM ALP
- Cholesterol and triglyceride in hypothyroidism: INCREASED
- Cholesterol and triglyceride in hyperthyroidism: DECREASED
- Long term glucose monitoring: GLYCOSYLATED HEMOGLOBIN (HBA1C)
- Short-term glucose monitoring: FRUCTOSAMINE
- Pre-renal azotemia: caused by reduced blood flow, poor perfusion of the kidneys resulting to decrease GFR
- Renal azotemia: produced by kidney failure, damage to the filtering structures of the kidneys
- Post-renal azotemia: caused by an obstruction anywhere in the renal system
- SLIDE COAGULASE: detects for cell-bound coagulase or clumping factor
- TUBE COAGULASE: detects for free coagulase
- Calcoflour white: binds to chitin in the walls of fungal cells and fluoresces white or apple green
- Molar tooth colonies: ACTINOMYCES ISRAELII
- Autofluorescence: CYCLOSPORA CAYATENENSIS
- Presence of Philadelphia chromosome in CML: BETTER PROGNOSIS
- Absence of Philadelphia chromosome in CML: POOR PROGNOSIS
- Darkly staining mass of sex chromosome attached to the end of the nucleus of somatic cells: BARR BODIES
- Manual WBC count: routine dilution of 1:20
Above 30 x 10 9th/L WBCs: dilution of 1:100
WBCs 100 to 300 x 10 9th/L: dilution of 1:200
WBCs below 3 x 10 9th/L: dilution of 1:10
- Marker for hematopoeitic stem cells: CD34
- Corrected WBC count
Adult ≥5 NRBCs/100 WBC differential
Neonate ≥10 NRBCs/100 WBC differential
- Poor man’s platelet aggregation: EXAMINATION OF FILM OF FRESH CAPILLARY BLOOD
- SPUN HEMATOCRIT
First layer of spun hematocrit: FATTY LAYER (barely visible unless lipemic)
Second layer: PLASMA
Third layer: BUFFY COAT (1 mm = 10,000 WBCs/cu.mm)
Bottom layer: PACKED CELLS
- Differentiates acute myelogenous and MONOCYTIC leukemias from acute lymphocytic leukemia: PEROXIDASE
- Differentiates acute myelogenous and MYELOMONOCYTIC leukemias from acute lymphocytic leukemia: SUDAN BLACK B
