Lab Part Duex Flashcards
1
Q
Urinalysis screening can test and assess for…
A
Renal Function
Endocrine or metabolic function
Urinary tract infection
Systemic diseases
2
Q
How many methods of urine collection
A
Two, instrumental / non-instrumental
3
Q
Non instrumental collection types
A
First morning void
Random urine specimen
Clean catch
24 hour
4
Q
Instrumental collection types
A
Urethral catheterization
Suprapubic needle aspiration
Cath and bladder irrigation
5
Q
Urine specimens should be analyzed within
A
1 - 2 hours
6
Q
If unable to test immediately refrigerate urine within
A
3 - 6 hours
7
Q
Specimens left at room temperature will soon decompose due to
A
Presence of bacteria
8
Q
Changes in pH in urine will
A
Dissolve any casts that are present
9
Q
If glucose is present in urine bacteria may..
A
Use it as a source of energy resulting in false negative glycosuria
10
Q
Blood and casts may..
A
Deteriorate if left standing without any preservatives
11
Q
Advantages/disadvantages of freezing urine
A
Advantage: transport or storage no cost
Disadvantage: may destroy formed elements
12
Q
First morning void
A
Most concentrated
Recommended for chemical and microscopic examination
13
Q
Random urine specimen
A
Collected anytime
Most convenient and common
14
Q
Clean catch specimen
A
Specimen of choice for bacterial cultures
15
Q
24 hour specimen
A
Gives quantitative results
16
Q
Urethral catheterization
A
Not recommended for bacterial examination
If no other way can use
Marked obese patients
17
Q
Suprapubic needle aspiration
A
Replaces cath for single urine sample
Avoids vaginal contamination
Bladder obstruction
Infants and young children
18
Q
Cath and bladder irrigation
A
Vigorous transcatheter agitation
50-72 mL saline inserted into bladder
Optimum cellular sample for bladder epithelium
19
Q
Types of sample analysis
A
Physical
Chemical
Microscopic
20
Q
Normal volume urine in 24 hours
A
600-2000 mL average is 1500mL
21
Q
Urine output can be related to
A
Fluid intake
Temp and climate
Amount of perspiration that occurs
22
Q
Normal color of urine
A
Straw (light yellow) to dark amber
23
Q
Dark orange urine due to
A
Pyridium used for UTI
24
Q
Milky white urine due to
A
Chyle
25
Olive green to brown black urine due to
Phenols
26
Yellow to brown urine due to
Presence of bile
27
Red or red-brown urine due to
Presence of blood
28
Physical characteristics of Urine
```
Volume
Color
Turbidity
Odor
Specific gravity
```
29
Normal urine turbidity is
Clear
30
Turbid alkaline due to
Amorphous phosphate or carbonate
31
Turbid acidic urine due to
Amorphous urates (pinkish)
32
Characteristic odor of urine is due to
Volatile acids (not considered to be of diagnostic importance
33
Sweet or fruity urine smell due to
Ketones
34
Pungent smell due to
Ammonia from bacteria
35
Maple syrup smell due to
Maple syrup urine disease
Congenital metabolic disorder
36
Musty or foul odor
Infant with phenylketonuria
37
Sweaty feet urine smell due to
Isovsleric acidemia
38
Specific gravity of urine
Weight of the urine / fluid intake
Random urine: 1.003 - 1.035
24 hour: 1.015 - 1.025
39
Chemical finding in urine analysis
```
Glucose
Ketones
Occult blood
Bilirubin
Urobilibogen
pH
Protein
Nitrite
Leukocyte esterase (LE)
```
40
Glucose will appear in urine once the threshold level of ________ in the blood is exceeded
160-180 mg/dL
41
Ketones present in the urine may indicate
Diabetes Mellitus
Starvation
Keto diet
Eclampsia
42
Occult blood in urine may have what color
Red and “Smokey”
43
Presence of blood in urine is termed
Hematuria
44
RBCs present in urine may be from..
Damage to kidneys or urinary tract
Renal diseases
Menstrual contamination or exercise
45
Bilirubin may appear in urine in patients who have conditions that cause
Jaundice
46
Bilirubin color of urine
Yellow to brown (green with foam when shaken)
47
Bilirubinuria indicates
Hepatocellular disease
| Infra or extra-hepatic biliary obstruction
48
Urobiligen is present in urine in concentrations of
1 EU or less. Amounts up to 1mg/dL is normal
49
pH range of urine
4.6 to 8.0. Average is around 6.0
50
Conditions that may cause acidic urine
```
Respiratory or metabolic acidosis l
UTI
E. Coli
Uremia
Severe diarrhea
Starvation
```
51
Conditions that cause alkaline urine
UTIs caused by proteus or pseudomonas
| Respiratory or metabolic alkalosis
52
Protein in urine is a good indicator of
Renal disease
53
Mechanisms of proteinuria
Glomerular damage
| Defect in reabsorption process
54
Nitrite is formed by the breakdown of nitrates by organisms that cause
UTIs
Bacteria presence in urine indicates UTI
55
Esterase is an
Enzyme
56
Inflammatory process in or around the urinary tract
Leukocyturia
57
Minimal proteinuria value
< .5g/day
58
Moderate proteinuria value
.5 - 3.5g/day
59
Significant proteinuria value
> 3.5g/day
60
A dipstick can detect as few as _____ RBCs HPF (High Power Field)
1-2 RBCs HPF
61
Presence of greater than 3 RBCs is considered
Abnormal
62
Persistent RBCs in urine may indicate
Glomerulonephritis
Kidney Stones
Cancer
Infection
63
Myoglobin is highly suggestive of
Rhabdomyolysis
64
A non-treponemal test for serologic detection of the antibody Reagin
Rapid Plasma Reagin
65
Treponema pallidum is
The causative agent of syphilis
66
Reagin is found in the ______ of patients with syphilis
Serum/plasma
67
Flocculation present the test is
Reactive (positive)
68
Flocculation is NOT present, the test is
Non-reactive (negative)
69
The confirmatory test for RPR testing
Fluorescent treponemal antibody-absorbed (FTA-ABS)
70
Positive FTA-ABS will show _______ if positive
Fluorescence
71
Venous blood for RPR should be collected in
Blood tube without anticoagulant for serum (Red/SST) and with anticoagulant (purple top) for plasma
72
RPR antigen suspension should be shaken vigorously for
10-15 seconds
73
Test card and controls should be on the rotator for how long
8 minutes at 100rpm
74
Reactive test flocculation ranges
Slight but definite
Minimum to moderate
Marked and intense
75
RPR controls should be run…
With each batch of tests
76
Antigen needle should be calibrated to
60 drops per 1mL
77
Purpose of monospot testing
To detect infectious mononucleosis
78
Mononucleosis which is a self limiting disease caused by
The Epstein-Barr Virus
79
Mono is typically seen in
Young adults and children less than 5
80
Collect monospot samples in
Blood tubes with or without anticoagulant
81
Test monospot sample within
24 hours if stored between 2-8 degrees C
82
Latex reagent should reach ______ temperature
Room temperature (20-30 C)
83
Positive monospot shows
Agglutination
84
Negative monospot shows
Smooth, homogenous solution, no agglutination
85
Parasitic infection caused by the introduction of protozoan organisms into the blood by the female anopheles mosquito
Malaria
86
Plasmodium is the parasite in
Malaria
87
Female anopheles inject _______ into humans
Sporozoites
88
Sporozoites enter parenchymal cells of the liver and become
Schizonts
89
Further sporozoite development in the _______ after RBC invasion
Liver
90
Merozoites develop to form
Immature (ring stage) trophozoites
91
Mature trophozoites develop into
Schizonts
92
Gametocytes are derived from
Merozoites
93
________ ingested by mosquito
Gametocyte
94
Beginning of sexual reproduction, production of
In the Gametocyte and produces zygote
95
Fertile zygote penetrates midgut wall of mosquito forming
Oocyst
96
Oocyst matures, ruptures and releases
Sporozoites
97
Sporozoites migrate to the salivary gland and then
Injected into new host
98
How many species of malaria
Four
99
Species of malaria
Plasmodium Falciparum
Plasmodium Vivax
Plasmodium Ovale
Plasmodium Malariae
100
Characteristics of plasmodium Falciparum
```
Erythrocytic cycle (malignant teritan)
Fever every 48 hours or every 2nd day
```
Most fatal (intravascular hemolysis)
101
Characteristics of plasmodium vivax
```
Eeythrocytic cycle (benign teritan)
Fever every 48 hours or every 2nd day
```
Most common
102
Characteristics of plasmodium ovale
```
Erythrocytic cycle (benign teritan)
Fever every 48 hours or every 2nd day
```
103
Characteristics of plasmodium malariae
```
Erythrocytic cycle (benign quartan)
Fever every 72 hours or every 3rd day
```
104
Capillary collection for malaria
Lancet and collect in EDTA capillary tube
105
Collection for venous blood for malaria
EDTA (purple top)
106
Venous blood for malaria may be stored at 2-30 C for up to
3 days. If refrigerated allow warming to room temp (15-30 C)
107
What must be present for malaria test to be valid
“C” control line
108
Test result of T1 for malaria
Positive for P. Falciparum
109
T2 result for malaria
Positive for P. Vivax, Malariae, or Ovale
110
T1 and T2 result for malaria
Positive for P. Falciparum and other types of malaria
111
Malaria test is negative if
Only the “C” line results
112
Malaria samples must be obtained when
The patient is febrile
113
Rapid malaria kit limitations
Patient must be febrile
Will only detect antigens
Must be confirmed by the NEPMU
Not used to monitor treatment
114
Highly contagious, acute, viral infection of the respiratory tract
Influenza A and B
115
Most common type of influenza
Influenza A
116
Symptoms of Influenza
```
Fever
Cough
Sore throat
Runny nose
Muscle/body aches
Headaches
Fatigue
Double dragon
```
117
Negative flu results show
Blue control line in the bottom third turns pink/purple. No other lines appear
118
Flu A positive shows
Pink/purple control line AND second pink/purple line in middle third window
119
Flu B positive test shows
Pink/purple control line AND second pink/purple in top third window
120
When flu disease prevalence is low in a community what may occur
False positives
121
When flu disease is high in the community what may occur
False negatives
122
Basic Metabolic panel provides what?
Important baseline of patients basic physiology
123
Hyponatremia may indicate
Over hydration
124
Hypernatemia may indicate
Dehydration and need for water
125
Low Urea nitrogen may indicate
Over hydration or liver disease
126
Elevated urea nitrogen may indicate
Impairment of renal function (50-150 mg/dL)
127
99% of the bodies calcium is located where?
Bones and teeth
128
High and low CO2 levels made associated with
High: respiratory acidosis
Low: respiratory alkalosis
129
How long do you shake the antigen suspension for monospot
10-15 seconds
130
What is creatinine
Byproduct of creatine and produced in muscle. Can be used to measure renal insufficiency
131
Most abundant extra cellular anion
Chloride
132
Second most prevalent intercellular cation
Magnesium
If low can cause refractory hypokalemia
133
What is involved in normal metabolism and energy production and needed for muscle contractility and neurologic functions
Phosphorous
134
ALT and AST measure what
Hepatocellular damage
135
What does albumin help maintain
Oncotic pressure
136
Alkaline phosphates refer to
A group of enzymes. Can indicate biliary disease or liver damage
137
What are bilirubin
A byproduct of breakdown of heme pigments in RBC
Can cause jaundice
138
If the AST is twice the ALT and AST is rarely over 300… may indicate?
Alcoholic hepatitis
139
Almost all prescription drugs can increase
ALT/AST levels
140
Total protein is a screening for
Nutritional deficiencies and gammopathies
141
What does a lipid panel measure
Total cholesterol
High density lipoprotein (HDL) cholesterol
Low density lipoprotein (LDL) cholesterol
Triglycerides
142
How often should adults over 20 get a fasting lipid screening
Every 5 years
143
Thyroid function tests check the function of what
Thyroid
144
Free thyroxine (FT4) measures
Unbound T4 in serum
145
What is the most accurate reflection of thryrometabolic status
Free thyroxine (FT4)
146
Thyroid Stimulating Hormone (TSH)
Glycoprotein secreted by anterior pituitary gland.
Assesses true metabolic status
Hypo is high tsh
Hyper is low tsh
147
A1C gives the big pictures of
2-3 months average glucose due to the 120 day life cycle of RBC
148
Glucose normal value
70-100mg/dL
4-6% A1C
149
Critical glucose levels
Low: < 40
| High > 500
150
What is the best indication of glucose homeostasis
Fasting glucose
151
Major cause of high glucose
Type 1 and 2 diabetes
152
Major cause of low glucose
Insulin overdose. Sulfonylureas and hypoglycemic agens
153
An A1C of greater than 6.5% suggests
Poor control of glucose
154
What are cardiac markers
Bio markers measured to evaluate heart function and cardiac muscles
155
What is troponin
Protein located in the cardiac muscles
156
Increase in troponin is indicative of
Myocardial infarction
157
Troponin levels begin to rise within
3-12 hours and peak in 24 hours
158
What is CK-MB
Enzyme found in cardiac muscles
159
CK-MB begin to rise in
3-12 hours and peak in 24 hours
160
Once Schizonts rupture, they release______
Merozoites
161
Ring form of P. Falciparum color
Light blue circular structure with red chromatin dot
162
Gametocyte (macro) of P. Falciparum of female look like
Curved sausage/banana with central large chromatic dot
163
Gametocyte (micro) of male look like
Shorter and wider than female with rounded ends, diffused chromatin
164
How is the flu transmitted
Coughing sneezing of aerosolized droplets
165
Benefits of flu testing
Enable correct treatment
Reduce costs
Decrease inappropriate antibiotic use
166
Read influenza test results how many minutes
15 minutes
167
Test for flu within how many days
2-3 days
168
Antivirals can be used for flu if within how long
48 hours
169
What organ does malaria affect
Liver
170
How does malaria travel through the body
Bloodstream / RBC
171
Most deadly type of malaria
P. Falciparum, destroys RBCs
172
Gold standard for confirming malaria
Thin and thick smear
173
Hyperchloremia is seen in
Dehydration and acidemia
174
Hypochloremia may result from
Vomiting or over hydration and alkalemia
175
Hypokalemia is seen with…
Alkalosis, diuretic, alcoholism and fluid loss
176
Potassium is the primary cation in
Intracellular space
177
Low magnesium can cause
Refractory hypokalemia
178
What is required for all urine tests
Confirmation test
179
What gives urine its color
Urachrome
180
Blue green urine due to
Methylene Blue
181
What is the vehicle or antigen used to see the result of RPR
Carbon charcoal
182
Mono causes increase of lymphocytes and monocytes causing the formation of
Heterophile antibody
183
Malaria fevers coincide with the rupture of what
RBCs
184
Most common malaria
Vivax
185
How many microliters of blood used for malaria test
15
186
How is Malaria Reagin added to test kit
2 drops on first pad, 4 on second pad
187
What would constitute an invalid test
Control line not present
188
malaria False positives could be caused from
Rheumatoid arthritis
Hep C
Babesia
189
Smears should be done no more than
Hourly
190
Flu pipette should have how many microliters
100
191
If low potassium what do you need to fix first
Magnesium
192
Total protein what levels will you see with malnutrition
Low
