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Diagnostics > Introduction and chemical pathology lab > Flashcards

Introduction and chemical pathology lab Flashcards

1
Q

What are the different tubes for collecting blood and what do they contain?

A 
Red top= no anticoagulant
Yellow top= have gel to speed up clot
Purple top= have potassium EDTA
Grey top= have fluoride oxalate (poison)
Blue top= citrate (anticoagulant)
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2
Q

What does the potassium EDTA do?

A

It keeps the cells alive and stops blood clotting -

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3
Q

What does fluoride oxalate do and when is it used?

A

Poison to red blood cells, it is used if you want to measure blood glucose- if cells are alive they will consume glucose

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4
Q

What is HbA1c?

A

Glycated haemoglobin

-haemoglobin with glucose attached to it and is a measure of glucose in blood over a longer period (3 months_

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5
Q

What would you expect to find in terms of HbA1c when performing electrophoresis on the blood of someone with poorly controlled diabetes?

A

More HbA1c which will be found at bottom

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6
Q

For what period of time does the electrophoresis show you how good blood glucose control has been?

A

3 months because that’s how long red blood cells survive

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7
Q

What is the difference between serum and plasma?

A

Serum contains no clotting factors

plasma = serum + clotting factors

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8
Q

What is serum useful for measuring?

A

Electrolytes

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9
Q

How would you get just the serum from the blood?

A

Add it to a yellow top tube, the gel will speed up coagulation and use up all the clotting factors,

  • the serum and cells are then separated by centrifuge because the cells are more dense than the gel and the gel is more dense than the serum so it separates the two,
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10
Q

What is a problem with poor blood collection?

A

Cells are full of potassium
If you do a poor collection and pull hard on syringe you will lyse cells and there will be extra potassium in the plasma which will affect results- you can notice it because it looks pink- needs to be discarded

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11
Q

Why is citrate useful as an anticoagulant?

A

It is reversible

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12
Q

What is citrate used to measure?

A

Clotting factors

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13
Q

How does citrate act as an anticoagulant?

A

It binds to calcium and prevents clotting

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14
Q

How do you measure clotting factors once you have a sample in the citrate bottle?

A

Clotting factors: blue tube. It has citrate which removes calcium to prevent clotting. You must fill it to the top. (from which you get APTT or PT when you add calcium

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15
Q

When do you need to contact a chemical pathologist?

A
  • need sample to be rapidly centrifuged out of hours
  • need to measure labile hormones such as insulin
  • urgently need CSF glucose and protein to be measured as Meningitis- if there is bacteria they will consume glucose
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16
Q

If someones results contained low sodium and high potassium what would you consider?

A

Adrenal failure

17
Q

What is the link between urea and creatinine?

A

The kidneys excrete both

18
Q

Where is creatinine produced?

A

In the muscle and produced constantly

19
Q

Why does the amount of creatinine that you produce stay the same through adult life?

A

Your muscle mass normally roughly stays the same

20
Q

As the creatinine production rate is fixed, what does the level of creatinine in the blood show you?

A

How well your kidneys are functioning- marker of GFR

21
Q

How much do urea levels vary?

A

A little bit depending on your diet- it comes from protein

22
Q

What is urea a marker of?

A

How dehydrated you are

23
Q

What happens in the kidney when you are dehydrated in terms of urea?

A

You start reabsorbing more water and accidentally absorb some urea

24
Q

If someone had high urea and normal creatine, what would you suspect?

A

Dehydrated with normal kidney function

25
Q

What will happen to urea and creatine levels in renal disease?

A

Both will rise

26
Q

What will your potassium, sodium, urea and creatine levels be like in addison’s disease?

A

High potassium
Low sodium
High urea
Normal creatine

27
Q

Where are liver enzymes found?

A

In the liver within hepatocytes

Tiny amount leaks into blood

28
Q

In terms of liver enzymes, what happens during liver disease?

A

lots leak into the blood

29
Q

What common enzymes are measured in liver function tests?

A

Alanine Aminotransferase (ALT)
Bilirubin
Alkaline phosphate (ALP)
Albumin

30
Q

What is TBil?

A

Total bilirubin (excreted in the faeces through bile) (increases with liver failure or biliary tree problems)

31
Q

What happens when the liver fails in terms of albumin?

A

Liver albumin will fall

32
Q

What do you need to measure if a patient has jaundice?

A

measure four liver enzymes +

AST- Aspartate Aminotransferase/Transaminase
GGT- Gamma Glutamyl Transpeptidase

33
Q

What is the first thing you do when you have a patient presenting with heart attack type symptoms?

A

ECG to see if they’re having an acute heart attack

34
Q

If you suspect a heart attack, what enzyme do you check?

A

Troponin

35
Q

What other cardiac enzymes are there which will be elevated when there is damage to the heart muscle?

A

like liver, lots of cardiac enzyme leak into blood

  1. Troponin
  2. Creatinine kinase (CK)
  3. Aspartate aminotransferase (AST)
  4. Lactate dehydrogenase (LDH)
36
Q

Give two examples of anticoagulants

A

EDTA
Heparin

  • when using an anticoagulant clothing factors remain unused
  • Blood can be separated into red cells and plasma
37
Q

When else, apart form liver damage may ALP rise?

A

Post-fracture as osteoblasts secrets ALP as they make new bone

38
Q

Describe the levels of hormones that would probably be seen in liver damage

A

Albumin low

Bilirubin, ALP, ALT, AST high

39
Q

What would you put the following tests in:

U&E 
Glucose 
HBA1c
TFT
Liver function tests
A

U&E (ureas and electrolytes) : serum in yellow/red top

Glucose: plasma in grey top

HBA1c: plasma in purple top

TFT: serum in yellow/red top

Liver function tests: in yellow/red top

Diagnostics (5 decks)

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