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Ongoing Meical Care > Lab 2 > Flashcards

Lab 2 Flashcards

1
Q

What does a UA detect and assess?

A
  • Renal function/disorder
  • Endocrine or Metabolic function/disorder
  • UTI
  • Systemic disease
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2
Q

Clinical Reasons for performing a Urinalysis

A
  • Important indicator of health
  • Screening Test
  • Cost effective In-vitro diagnostic test
  • Non invasive procedure
  • Simple to perform
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3
Q

For urinalysis, it is a screening test to detect and assess

A
  • Renal function/disorder
  • Endocrine or metabolic disorders/functions
  • UTI
  • Systemic Diseases
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4
Q

What are the two methods of Urine collection

A

Non-instrumented and Instrumented collection

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5
Q

What are the non-instrumented collections for urine

A
  • First morning void
  • Random Urine specimen
  • Clean Catch
  • 24 hour
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6
Q

What are the instrumented urine collection

A

Urethral Catheterization
Suprapubic Needle Aspiration
Catherization and bladder irrigation

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7
Q

Urine specimen should be analyzed while Fresh, preferably within how many hours

A

1-2 hours

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8
Q

If urine is left at room temperature, what will happen?

A

Begin to decompose and deliver inaccurate results

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9
Q

How many hours do you have to refrigerate urine specimen if unable to test at the time of delivery

A

3-6 hours

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10
Q

What does urea splitting bacteria produce and what happens if it combines with hydrogen ions in the urine

A

Produce ammonia; Increases pH

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11
Q

What happens if the changes of pH happens in the urine

A

Dissolves any casts present

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12
Q

What happens if glucose is present in the urine

A

Bacteria may use it as a source of energy resulting in false negative glycosuria

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13
Q

What method of preservative has:

  • Advantages: For specimen transport or storage, no cost. Simple to perform
  • Disadvantages: May destroy Formed elements
A

Freezing

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14
Q

Which collection of urine is:

  • Most concentrated
  • Increase number of abnormal elements
  • Decreased deterioration of formed elements
  • Recommended specimen for chemcial and microscopic exams
A

First morning Void

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15
Q

Which collection of urine is:

  • Collected anytime
  • Most convenient for patients and most common
  • Can detect abnormalities but not as sensitive as first morning void
A

Random Urine Specimen

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16
Q

Which collection of urine is:

- Specimen of choice for bacterial cultures

A

Clean Catch urine specimen

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17
Q

In how many hours do cultures need to be preformed after collection, only if specimen was refrigerated

A

12 hours

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18
Q

Which collection of urine is:

  • Gives quantitative results
  • Preservatives may be needed
A

24 hour urine specimen

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19
Q

Which collection of urine is:

  • NOT recommended for bacteriological examination
  • Use only if no other way to collect urine
  • Commonly used on marked obese patients with difficulty in urine collection
A

Urethral Catherization

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20
Q

Which collection of urine is:

- Choice on infants and young children

A

Suprapubic Needle Aspiration

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21
Q

Which collection of urine is:

- Removing the bladder content for cytologic study

A

Catheterization and bladder irrigation

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22
Q

How much mL is inserted for catheterization and bladder irrigation?

A

50-72 mL

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23
Q

The normal volume of urine in a 24 hour period are in the ranges of?

A

600-2000 mL

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24
Q

What is the average mL in 24 hours

A

1500 mL

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25
Q

The amount of urine is directly related to

A
  • Fluid intake
  • temperature and climate
  • Amount of prespiration that occurs
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26
Q

The normal color of urine

A

Color straw (light yellow) to dark amber

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27
Q

What pigmentation concentration changes the color of urine

A

urochrome

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28
Q

What happens if the urine is Blue Green

A

Methylene Blue (dye or stain in diagnostic procedures)

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29
Q

What happens if the urine is Dark orange

A

Pyridium (used for UTI infection)

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30
Q

What happens if the urine is Milky White

A

Caused by Chyle (Fat or lipids in urine)

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31
Q

What happens if the urine is Olive green to brown black

A

Phenols (poisonous compound for antimicrobial agent)

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32
Q

What happens if the urine is Yellow to brown (turning greenish with foam when shaken)

A

Presence of bile

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33
Q

What happens if the urine is Red or red-brown (Smokey apperance)

A

Presence of Blood

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34
Q

What is the normal turbidity of urine

A

Clear

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35
Q

What is turbidity of urine?

A

How clear it is

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36
Q

What happens if the urine has a Sweet/Fruity smell

A

Ketones

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37
Q

What happens if the urine has a pungent smell

A

Due to ammonia produced by bacteria

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38
Q

What happens if the urine has a maple syrup smell

A

“maple syrup urine disease” a congenital metabolic disorder

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39
Q

What happens if the urine has a Musty or mousy smell

A

Infants with phenylketouria

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40
Q

What happens if the urine has a Sweaty feet smell

A

Isovaleric acidemia, presence of butyric or hexanoic acid in urine

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41
Q

Specific gravity of random urine and 24 hour urine and what can this be a indication for?

A

Specific: 1.003 - 1.035
24: 1.015 - 1.025

Dehydration

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42
Q

What will appear in the urine once the threshold level of 160-180 mg/dL in the blood is exceeded

A

Glucosuria/Glycosuria

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43
Q

What is glucosuria indicating?

A

Diabetes mellitus or any condition that causes hyperglycemia

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44
Q

What does Ketonuria indicating?

A

Diabetes Mellitus

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45
Q

What conditions are associated with Ketosis and what is Ketosis

A

Ketosis: Increase ketone in blood and urine

  • > intake of carbs (Starvation)
  • > Utilization of carbs (diabetes mellitus)
  • Digestive disturbance or dietary imbalance ( high fat, low carb diet)
  • Eclampsia
  • Prolonged vomiting
  • Diarrhea
46
Q

What is hematuria

A

Presence of blood in urine

47
Q

Intact RBC present in the urine may indicate:

A
  • Damage/trauma to the kidney or urianry tract
  • Renal Disease
  • May aslo be due to menstrual contamination or exercise
48
Q

Which renal diseases can cause hematuria?

A
  • Glomerulonephritis
  • Malignant HTN
  • Polycystic kidney diseases
49
Q

What is normal for bilirubin in normal urine

A

Negative for bilirubin

50
Q

What condition will result in apperance of bilirubin in urine

A

Any condition that causes jaundice (hepatitis)

51
Q

What is normal for urobilinogen in normal urine

A

Normally presented in the urine in concentrations of 1 EU or less

52
Q

Normal range of pH for urine and the average of it

A

4.6 - 8.0 with the average being 6.0

53
Q

What are some conditions that may cause acidic urine

A
  • Respiratory and metabolic acidosis
  • UTI by E. Coli*
  • Uremia
  • Severe Diarrhea
  • Starvation
54
Q

Pathologic conditions that cause alkaline urine are

A
  • UTI caused by Proteus and Pseudomonas species*

- Respiratory and metabolic alkalosis

55
Q

How are nitrates formed?

A

By breakdown of nitrates by organisms that cause UTI’s - E coli

56
Q

What is considered normal for Leukocyte esterase (LE) in urine

A

Negative

57
Q

What is an indication for Leukocyte esterase (LE) in urine?

A

Detects esterase released by the neutrophils in the urine and is an indirect test for bacteriuria

58
Q

What test is a non-treponemal test for serologic detection of the antibody reagin, which is produced in response to an infection of syphilis caused by Treponema pallidum

A

Rapid Plasma Reagin

59
Q

What is produced in patients infected with Treponema pallidum, the causative agent of syphilis, and acts like a antigen

A

Reagin (phospholipids)

60
Q

Where is Reagin found in with patients with syphilis

A

Serum/Plasma (purple or red top tubes to draw)

61
Q

What is the vehicle or “antigen” that is used to see results of RPR macroscopically

A

Carbon Charcoal particle

62
Q

What type of diagnostic test is RPR

A

Screening test (Requires confirmatory)

63
Q

What happens in a RPR if:

  • Flocculation is present
  • Flocculation is NOT present
A

Present: Reactive

Not Present: Non Reactive

64
Q

What is the confirmatory test for RPR and what is considered positive and negative

A

Fluorescent treponemal antibody-absorbed test (FTA-ABS)

Positive: Fluoresce
Negative: no fluoresce

65
Q

Where is infectious mononucleosis commonly found in what demographic of patients

A

young adults and children less than 5 years of age

66
Q

Which test is used to detect infectious mononucleosis which is a self limiting disease caused by the Epstein-Barr Virus

A

Monospot test

67
Q

What antibody is formed from infectious mononucleosis

A

Heterophile

68
Q

What type of bodily fluids will you be testing monospot on?

A

Serum/Plasma and it should be clear and non-hemolyzed

69
Q

What is the amount of time to test the specimen if stored between 2-8 degrees Celsius for monospot

A

24 hours

70
Q

The rotatory shaker should be set how much rpm for RPR

A

100 rpm

71
Q

The rotatory shaker should be set how much rpm for monospot

A

60-100 rpm

72
Q

How long should you rotate a RPR and a Monospot test?

A

RPR: 8 minutes

Monospot: 3 minutes

73
Q

What is considered for a positive and negative monospot test

A

Positive: Shows Agglutination
Negative: Smooth, homogenous solution. No agglutination

74
Q

What is a parasitic infection caused by the introduction of the protozoan organisms into the blood by the bite of a female anopheles mosquito

A

Malaria

75
Q

Where do the pre-erythrocytic cycle start?

A

In the liver

76
Q

What happens during the exoerythrocytic cycle?

A

Further development in the liver after RBC invasion

77
Q

What are macrogametocyte (females)

A

Curved sausage/banana shaped with central large chromatin dot covered

78
Q

What are microgametocyte (male)

A

Short and wider than female with rounded ends

79
Q

Which malaria has:

  • Malignant tertian
  • Fever every 48 hours or every 2nd day
  • Most fatal: likely to caused intravascular hemolysis (destruction of RBC)
    • Fever is prolonged and intensified
A

Plasmodium Falciparum

80
Q

Which malaria is:

  • Benign Tertian
    • Fever every 48 hours or every 2nd day
  • Most common
A

Plasmodium Vivax

81
Q

Which malaria is:

  • Benign tertian
    • Fever q48h or every 2nd day
A

Pplasmodium Ovale

82
Q

Which Malaria is:

  • Benign quartan
    • Fevery every 72 hours or every 3rd day
A

Plasmodium Malariae

83
Q

If drawing a blood sample for malaria, how many days can it be stored and what temp

A

3 days; 2-30 degrees C (36-86 degrees F)

84
Q

Which one is positive by itself for malaria?

A

T1: Plasmodium Falciparum

85
Q

When will a test be considered non-valid for malaria

A

If the Control “C” line does not appear

86
Q

What are some rapid malaria kit limitations

A
  • Sample aquired when patient is febrile
  • Only detects antigens
  • Must be confirmed with a thick and thin smear for confirmation, sent to NEPMU
87
Q

What are the false positive results in patients with the following conditions

A
  • Rheumatoid arthritis
  • Chronic Viral infections - HEP C
  • Patient with other blood parasite - Babesia
88
Q

Smears should be done frequently but no more than:

A

hourly

89
Q

What is a highly contagious, acute, viral infection of the respiratory tract

A

Influenza

90
Q

How can influenza be transmitted

A

Coughing and sneezing of aerosolized droplets containing live virus

91
Q

Which influenza is more common and produces more serious illness

A

Influenza A

92
Q

The best diagnoses of influenza is during?

A

the first 2-3 days

93
Q

Benefits of doing the influenza test

A
  • Enable appropriate therapy
  • Facilitate prompt treatment
  • Some antivirals are only effective if adminstered within 48 hours of symptoms onset
  • Reduce healthcare cost
94
Q

When will a false-positive may occur for influenza

A

When disease prevelance in the community is low (beginning and end of the season)

95
Q

When will a false-negative may occur for influenza

A

When disease prevalence is high in the community (at the height of the season)

96
Q

Over time, What does the metabolic panel provide?

A

An important baseline of a patient’s basic physiology

97
Q

What is hyponatremia and what can it indicate

A

Low sodium; over hydration

98
Q

What is hypernatremia and what will it indicate

A

high sodium; need for water

99
Q

What can a low BUN (urea nitrogen) indicate

A

Sign of overhydration or liver disease

100
Q

What is the body’s total percentage of calcium located in bones and teeth and in the blood

A

99% bones and teeth

1% in blood

101
Q

90% of hypercalcemia is caused by:

A

Eithera malignancy or hyperthyroidism

102
Q

High levels of CO2 is seen in

A

Respiratory acidosis and low levels are associated with respiratory alkalosis

103
Q

Hyperchloremia is seen in:

A

Dehydration and acidemia

104
Q

Hypochoremia may be the result of

A

Vomiting, over hydration, and alkalemia

105
Q

Low magnesium (MG) can cause

A

refractory hypokalemia

106
Q

Elevated levels of bilirubin are responsible for:

A

Jaundice

107
Q

What nutrient when decreased leads to malnutrition, liver diseases and severe skin disease

A

Total protein

108
Q

What is recommended for lipids for adults over 20

A

Fasting lipids screening every 5 years

109
Q

Measurement of A1C is indicative of

A

Glucose control during the preceding 2-3 months

110
Q

What is A1C

A

A component of the hemoglobin molecule, during the 120 lifespan of RBC

111
Q

What are cardiac markers used for

A

Biomarkers that measure the damage to the heart and the functions

Ongoing Meical Care (7 decks)

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