Lab Final Review Flashcards
What enzyme is found in the liver and bone?
alkaline phosphatase (ALP)
Which 2 tests from the chemistry profile can be used to assess liver and/or striated muscle (cardiac etc.)?
AST and LDH
How is bilirubin formed?
degradation of hemoglobin
What type of bilirubin can be detected in the urine?
conjugated/direct
____ bilirubin is prehepatic and not water soluble.
unconjugated
____ bilirubin is hepatic and water soluble.
conjugated
What are the tests for renal function?
BUN
creatinine
____ is produced by protein catabolism in the liver, but used to assess the kidneys (renal clearance), and is affected by dietary protein intake.
BUN
What are the fasting blood glucose levels for pre-diabetes and diabetes?
pre = 100-125 mg/dL
diabetes = 126+ mg/dL
What type of hypoglycemia is characterized by loss of glycemic control, often due to misuse of insulin therapy?
Fasting
What laboratory test is used to assess for glycemic control, diagnosis and monitoring of diabetes mellitus?
fasting blood glucose (FBG)
What chemistry profile test is most subject to increase due to hemolysis?
potassium (K+)
According to the ADA, which test is most beneficial in monitoring long-term (6-8 weeks) glycemic control?
HgbA1c
What are the relevant lab findings for hyperparathyroidism?
- ^Ca++
- ⬇️PO4
What are the relevant chemistry profile findings for blastic metastasis?
^ALP
What are the relevant chemistry profile findings for lytic metastasis?
^calcium
⬇️phosphate
What serological test can give evidence of a past Strep infection (weeks or months after infection) that was not initially diagnosed?
ASO (anti-streptolysin O)
All serologic tests are based on what 2 types of serologic principles?
- tests to detect antibody production
- tests to detect antigen production
What immunologic test is a sensitive marker of inflammation?
CRP (most sensitive APR; not specific)
Pregnancy tests use immunologic principles by detecting the presence of what placental hormone in blood or urine?
HCG
What antibody is detected in the patient’s blood when testing for infectious mononucleosis (Mono or EBV)?
heterophile antibodies
What antigen is incorporated in the test kit for infectious mononucleosis?
Paul-Bunnell antigens
(used to find heterophile antibodies)
What test is performed directly from a patient throat swab to detect strep pyogenes?
Rapid group A Strep
What antigen is detected in the patient sample in a positive case of strep pyogenes?
carbohydrate A
(rapid group A strep test)
A throat swab for rapid group A test looks for evidence of what etiologic agent?
strep pyogenes
In testing for RA, we are looking for RF. How would you describe Rheumatoid Factor (RF)?
an IgM autoantibody that binds with the Fc region of patient’s normally circulating IgG (acting as the antigen)
This special procedure uses a reaction well coated with an antibody that will react with an antigen in the patient’s serum. A second antibody conjugated with an enzyme is then added to evidence the immune complex formation.
ELISA-Sandwich enzyme immunoassay
ELISA testing is utilized to screen for what antigen which is the initial screening test for HIV?
P24 antigen
(earliest detector of HIV)
Give an example of a commonly ordered lab test that utilizes the basic principles of flow cytometry.
CBC
(greatest or most used)
Give an example of a specific lab test that utilizes flow cytometry analysis of cell markers in the monitoring of an immunocompromised patient.
CD4:CD8 ratio
What special procedure amplifies DNA by sequentially copying small fragments cut from the original sample using restriction enzymes?
PCR
In a patient with Hepatitis C, what special procedure can be used to monitor the patient and the response to therapy by determining their viral load?
Reverse transcriptase PCR (RT-PCR)
What special procedure incorporates both immunologic and electrophoretic principles?
Western blot
Western blot testing allows visualization of ____ by incubation of the strip with an alkaline phosphatase substrate.
reactive bands
(= reagent strip + pt serum)
The initial screening for Lyme disease is done using ELISA antibody detection method. Any positive test for Lyme disease is confirmed and better evaluated with what test?
Western blot
(Lyme Dz has high false positive rate)
What type of bilirubin is detected by routine urinalysis?
Direct or conjugated
If the chem strip shows positive finding for blood, what are 4 possible causes?
- trauma
- renal system infection
- renal calculi
- renal/bladder carcinoma
Microscopic findings of RBC casts are indicative of ____
glomerular nephritis
(positive: blood, protein, RBC, WBC, casts)
Can the chem strip determine any type of WBC?
no
What specific leukocytes (WBC) can be tested on a chem strip?
neutrophil
What positive chemistries on a urine test strip determine the need for a microscopic exam?
- protein
- blood
- leukocytes esterase
- nitrite
What positive urinalysis findings may be considered normal?
- protein in presence of bacteria or mucous, or w/ strenuous exercise
- crystals after sample sits for a while
What is the best diagnosis for a patient with the following urinalysis and microscopic analysis findings:
Colour: amber
Blood: 2+
Protein: Trace
RBC/HPF: 15-20
Crystals: 2+ uric acid
renal calculi
What is the renal threshold of glucose?
180 mg/dL
What are the 3 parts of a routine urinalysis? (list in order)
- physical
- chemical
- microscopic
What abnormal protein is associated with the formation of urinary casts?
Tamm-Horsfall protein
What other sample is compared to bilirubin?
urobilinogen
If the patient comes with specific symptoms of a UTI, what collection of urine could you use that will be sterile?
midstream clean catch
Bonus
flow cytometry
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