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interpreting test result Flashcards

1
Q

what is the basic clinical process?

A

it is a consultation that is a history or exam and then a lab request and then a report

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2
Q

what is the purpose of the tests?

A

to rule in or rule out - most will rule out and form a differential diagnosis

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3
Q

how many diagnoses depend on laboratory tests?

A

up to 70%

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4
Q

what is the service discipline of chemical pathology?

A

diagnosis, screening, monitoring and therapeutic control

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5
Q

who does the service discipline provide advice to?

A

individual cases and clinical care protocols

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6
Q

what is the role of the major clinical science in chemical pathology?

A

it is research into the biochemical basis of disease, it provides support for clinical trials, science for diagnosis and bridges pre-clinical and clinical subjects

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7
Q

what are the major subjects of chemical pathology?

A

metabolism, endocrinology, homeostasis and physiological systems

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8
Q

what is the normal range?

A

it is the range of results that can be expected in a healthy population - it defines the values of biochemical tests found in a healthy population against which the patient values can be compared

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9
Q

what is the issue with the normal range?

A

it is not really normal - all patients differ and we do not use ‘normal’ patients all the time when defining - artificial concept - no clear boundaries exist

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10
Q

what is the reference range?

A

it is the frame of reference to make a decision against - you take a normal distribution of patients and put +/- 2SDs to find the range - they are a guide - not fixed

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11
Q

what are the difficulties of ideal tests?

A

they are rarely available - sensitivity and specificity rarely coexist - there is always overlap

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12
Q

how would you improve tests?

A

chose a more appropriate sample normal population,. use a combination of tests with low cost sensitive test first line and high cost specific test second line and combine tests to test for multiple things at once - e.g. PKU and hypothyroidism in neonatals

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13
Q

what are appropriate normal populations?

A

same presenting symptom, same age, gender, hospitalised normals and same underlying condition

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14
Q

explain the factors affecting reference ranges?

A 
age 
gender 
diet - change status 
ethnicity 
time of month and day - hormones
time of year - vit D and calcium 
weight 
stimulus 
glucose tolerance
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15
Q

what are the factors that affect interpretation?

A

different therapeutic ranges for different drugs in different patients and action limits - may not be a normal range or may be more interested in risk factors

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16
Q

what is the lower and upper ranges for therapeutic control?

A

lower - effectiveness

upper - toxicity

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17
Q

what is the therapeutic range for cholesterol?

A

we want people on the lower part of the curve - ideal is 5.2, range is from around 6.5-12 - when lower than this want to focus on diet and in this want to focus on medications

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18
Q

what is the therapeutic control for phenytoin?

A

want to be at a level where are neither under treated nor over but are fit free. Titrate the dose and monitor levels of drugs to see: effectiveness, if they are taking and toxicity.

19
Q

how would you treat a patient with paracetamol poisoning?

A

take dose and read to see if need antidote. Find out how much taken and replace glutathione to divert toxic products into harmless - prevent liver failure - methionine if given soon enough can reverse - by 12 hours

20
Q

what must you ensure when interpreting biochemical values?

A

they are read in light of appropriate reference range, they are taken at right conditions and you understand normal physiological regulation for each patient `

21
Q

what is protein glycosylation?

A

protein + glucose = advanced glycosylated endproducts
non-enzymatic process
rate dependent on time and glucose concentration

22
Q

what it HbA1c?

A

it is a stable glycosylated haemoglobin - percentage concentration indicates cumulative glucose exposure

23
Q

what is aspirin often used for?

A

over dose - salicylate OD

24
Q

what can paracetamol OD result in?

A

acidosis

25
Q

what is surveillance?

A

it is a process of gathering information to preempt disease outbreak or identify early

26
Q

what is trimethoprim?

A

it is a dihydrofolate reductase inhibitor that is used in treatment in UTIs

27
Q

what is commonly used to treat cytomegalovirus?

A

ganciclovir

28
Q

what is disinfection?

A

it is a method of removing sufficient numbers of potential harmful micro-organisms to make an item safe to use

29
Q

what is the last line drugs for multiresistant enterobacteriacae?

A

meropenem

30
Q

what parasitic disease commonly causes diarrhoea?

A

cryptosporidiosis

31
Q

what enables the horizontal transfer of resistance?

A

transponons

32
Q

what is zidovudine?

A

it is a nucleoside reverse transcriptase inhibitor that is a analogue of thymidine

33
Q

what is fluconazole?

A

it is a commonly used triazole drug

34
Q

what is commonly used to treat anaerobic bacterial infection?

A

metronidazole

35
Q

what are tetracyclines?

A

they are protein synthesis inhibitors - inhibit RNA translocation

36
Q

what disease is notifiable, preceded by Koplik’s spots and it caused by paramyxovirus?

A

measles

37
Q

what is a adverse side effect of azole treatment?

A

hepatotoxicity

38
Q

what is a common method of reducing susceptibility to infection?

A

immunisation

39
Q

what is ergosterol and what is peptidoglycan?

A

ergosterol is a component of fungal cell membranes and peptidoglycan is the main component of bacterial cell walls

40
Q

what is sterilisation?

A

is is exposing single use disposable equipment to ionising radiation

41
Q

what group of bacteria may have acquired resistance to vancomycin?

A

enterococci

42
Q

what is aspergillosis?

A

it is a condition due to chronic pulmonary fungal infection

43
Q

what is nevirapine?

A

it is a non nucleoside reverse transcriptase inhibitor

44
Q

what is a devastating disease in pregnancy?

A

rubella - non specific rash but usually mild if not pregnant

CP (38 decks)

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