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MCD Diagnostics [Personal] > Introduction and Chemical Pathology Lab [Complete] > Flashcards

Introduction and Chemical Pathology Lab [Complete] Flashcards

1
Q

What is lymphadenopathy? What are the usual causes?

A

Enlargement of the lymph nodes

Viral illnesses

Glandular fever

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2
Q

Give examples of common investigative tests.

Which tests can be performed by the GP?

A

FBC

ESR (Erythrocyte sedimantary rate) [Indicates inflammation]

CRP (C-reactive protein) [Indicates infection]

LFT (Liver function test) (measure enzymes in liver enzymes in blood, if in blood indicates liver damage)

U&Es: Urea and electrolytes

Blood glucose

Stool culture (Bacteriology)

GP tests:

LFTs

Blood glucose

U&Es

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3
Q

What is ESR and how does it change in infection?

A

Erythrocyte Sedimentation Rate: The rate at which red blood cells settle out of suspension in blood plasma, measured under standard conditions

High ESR indicates inflammatoin (e.g infection)

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4
Q

What is ESR and how does it change in infection?

A

Erythrocyte Sedimentation Rate – the rate at which red blood cells settle out of suspension in blood plasma, measured under standard conditions

ESR increases in infection

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5
Q

What does U&Es test for?

A

Urea

Creatinine

Na

K

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6
Q

What does liver function tests measure? What can be tested in paticualr as an indicator of liver damage?

A

Alkaline phosphatase(ALP)

Albumin (Alb)

Alanine aminotransferase (ALT)

Total billirubin (TBil)

Alkaline phosphatase indicates liver damage as this enzyme is produced in the liver and shouldnt be in circulation.

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7
Q

Fever is normally a sign of infection. How is it possible for some autoimmune conditions to cause fever?

A

Fever is caused by the immune system rather than the organism

Hence it can occur in autoimmune disease in the absence of an organism

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8
Q

What are the four tube colours for blood collection and what do the colours mean?

A

Red – no anticoagulant

Yellow – gel – makes the coagulation occur faster Purple – potassium EDTA

Grey – fluoride oxalate (poison)

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9
Q

Which tubes for the following:

1) U&Es
2) Glucose
3) HBA1c
4) TFT
5) Liver function tests

A

U&Es: Serum in yellow/red top

Glucose: Plasma in grey top

HBA1c: Plasma in purple top

TFT: Serum in yellow/red top

LFT: In yellow/red top

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10
Q

What are the purple cap bottles used for?

A

Potassium EDTA keeps the cells alive It is used when measuring cell counts or anything in general to do with the cells

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11
Q

What are the grey cap bottles used for?

A

Fluoride oxalate kills the red blood cells – this is used for measuring blood glucose because live red blood cells will consume the glucose

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12
Q

Which bottle is used for measuring HbA1c?

A

Purple Top – potassium EDTA

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13
Q

What is serum and what is it useful for measuring?

A

When blood clots and you remove the clot you are left with serum

Serum contains electrolytes but NO clotting factors

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14
Q

How is gel designed so that it separates serum from the rest of the blood?

A

It is more dense than serum but less dense than cells so it separates the serum from the cells when centrifuged

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15
Q

What is contained in plasma?

A

Serum and the clotting factors

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16
Q

What can skew the electrolyte measurements of the serum?

A

Haemolysis – red cells contain a lot of potassium so haemolysis caused by poor collection or the sample being left out too long will result in an increased serum potassium concentration

17
Q

What does the blue top mean?

A

Contains citrate

It is reversible and used to measure clotting factors

Citrate binds to calcium and prevents clotting

When you get a sample of blood in a citrate bottle, you add just the right amount of calcium to trigger the clotting cascade

18
Q

What is the blue top used to measure?

A

Prothrombin time (PT) - measures integrity of extrinsic system

Active partial thromboplastin time (APTT) - measures integrity of intrinsic system

19
Q

what are the main anticoagulants used?

A

EDTA and heparin

20
Q

what is the effect of using anticoagulants in the blood sampling?

A

Clotting factors remain unused so the plasma can be separated from the RBCs with CFs still there

21
Q

What is used to measure clotting factor levels?

A

Blue top reversible

22
Q

When should you contact a chemical pathologist? [3]

A

Need for rapid centrifugation out of hours

Measuring labile hormones like insulin

Urgently need CSF glucose and protein measurements (meningitis rapidly consumes glucose)

23
Q

What is creatinine a marker of?

A

Renal function (GFR) – it is produced by the body at a constant rate and it is excreted at a constant rate provided that the kidneys are functioning normally with little absorbed or secreted

24
Q

What is urea a marker of?

A

High levels indicate dehydration

It is also excreted by the kidneys

(Dehydration indicated especially if creatinine levels are normal)

25
Q

How do urea and creatinine change in renal disease?

A

They increase, urea rises first

26
Q

What are the three main liver enzymes? What do they indicate?

A

Alanine aminotransferase (ALT)

Aspartate aminotransferase (AST)

Alkaline phosphatase (ALP)

They indicate liver damage/disease as only tiny amounts leak into the blood so high levels are concerning.

Type of liver disease can be determined based on pattern of leakage.

27
Q

How does albumin change in liver disease?

A

Albumin levels fall in liver disease

28
Q

What other cells, other than hepatocytes, contain alkaline phosphatase?

A

Osteoblasts

29
Q

Other than liver disease, when else might ALP be high?

A

After a fracture – osteoblasts use ALP to build more bone

30
Q

What can high billirubin levels indicate in terms of liver funtcion?

A

If this is up, then there may be something wrong with the biliary tree.

31
Q

What is the first thing you do if a patient presents with heart attack type symptoms?

A

ECG

32
Q

What is measured to confirm a heart attack?

A

Measure cardiac enzymes such as troponin levels

33
Q

List the main cardiac enzymes.

A

Troponins

Creatine Kinase (CK)

Aspartate aminotransferase (AST)

Lactate dehydrogenase (LDH)

34
Q

What else could cause heart attack type symptoms?

A

A bleeding peptic ulcer

35
Q

What is HbA1c?

A

HBA1c is glycated heamoglobin; if glucose sticks to Hb –> Hb is heavier –> moves less on electrophoresis; poorly-controlled diabetes = more HBA1c + stronger band

MCD Diagnostics [Personal] (5 decks)

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