Lab Results (introduction) Flashcards
Generally, laboratory tests should be ordered only if the
results of the test will affect decisions about the care of the
patient. True or false?
True
Where are mast cells only found?
Tissue (not in circulation)
B and T cells are responsible for innate immunity. True or false?
False. (They are responsible for adaptive immunity)
Relating to neutrophils, the shift from MP to CP due to stress, trauma, catecholamines, etc. is called —— ?
Pseudoneutrophilia - transient leukocytosis
(Note that these neutrophils are mature NOT band type -which appear to increase due to infections-)
وكمان ملاحظة قلنا انه pseudo لانه ما بزيد انتاج خلايا نيوتروفيلز انما بس بتنتقل من مكانها لمكان ثاني (ارتفاع كاذب)
Relating to neutrophils, ——— shift is seen as an increase in the number of bands and is common with acute infection.
Left shift
The shift of cells from CP to MP due to viral infections or hypothermia is called
Pseudoneutropenia
Note that certain types of viral infections are intracellular which cause the CP neutrophils to migrate to the peripheral walls and become MP.
Which type of WBC that play large role in ingesting cellular debris and become “activated” when direct contact with microorganisms occurs. Also play a role in immunity by releasing cytokines?
Macrophages (monocytes)
_____ lymphocytes are produced in the
bone marrow but also mature there. Meanwhile, precursors of ___ lymphocytes leave the bone marrow and mature in the thymus (which accounts for their designation)
B / T
B cells remains in the bone marrow and produce antibodies that work in the blood. True or false
True
Steroids increase the number of neutrophils and decrease the number of lymphocytes. True or false
True
The % neutrophils indicates ____________;
The total WBC reflects __________
severity of the infection / the quality of the immune system(prognosis)
ملاحظة لما يعطيني كيس كيف بنعرف انه infection؟ بكون حاط بالسؤال اسم انفكشن مثل pneumonia
If %neutrophils is 75% and band% is 1, this might be an indicator for:
A) pathologic neutrophilia
B) Pseudoneutropenia
C) Pseudoneutrophilia
C
Mature cells shift from MP to CP… bands elevate in infection
What are normal CSF values?
Normal CSF values
• • • • •
Clear color
< 5 RBC’s
< 5 WBC’s
Protein 23-38mg/dl (alt. 14-45)
Glucose - 60% of serum level (75-100)
During CSF assessment:
1. Increased WBC with PMN predominance may indicate for _____ . While an increase in WBC with lymphocytes predominance might indicate _____.
- If glucose levels in the csf sample was normal in a meningitis patient, the patient might be susceptible of having _____ infection
If low ______
If very low < 18% it is a strong indication of ______
- Bacterial meningitis/ viral vs. fungal vs. TB vs. malignancy
- Viral infection
Bacterial meningitis or TB or fungal
Bacterial meningitis
بدون جواب بس للحفظ
Comparing typical bacterial meningitis to typical viral meningitis related percentages in CSF tests:
CSF WBC : <250 in viral and >1000 in bacterial (both are elevated)
CSF Proteins : <150 in viral and > 500 bacterial (both elevated)
CSF Glucose : normal in viral and <45 bacterial (decrease in bacterial)
Bonus :)
What are common causes of Bacterial meningitis in 3 or less year olds?
Listeria monocytogenes
Escherichia coli
Streptococcus agalactia (most commom cause in neonates)
Note that E. Coli and S. agalactia are transmitted through the vagina of the mother commonly
Which is the most suitable agar for culturing each of the following:
Gram-negative bacteria : _________
Nesseria: _______
Differentiating S. agalactia from S. pneumonia: _______
Macconkey agar
Chocolate agar
Blood agar
Note: If there is a bacteria that doesn’t make colonies in Macconkey agar- > grams positive bacteria
the urine collection method that contains the highest numbers of bacteria?
first-voided method (morning urine optimal)
لما نوخد عينة بول الصبح بتكون كمية البكتيريا كبيرة لانو صارلها طول الليل بتعمل proliferation
most common and ideal method for urine collection?
midstream urine specimens
we do not take the first part of urine that comes out which contains urethral commensals
its the best because it avoids contamination of the sample
in indwelling catheter method, urine is collected by ___
and its not allowed to be collected from ___
- needle inserted directly into catheter
- catheter tips
when do we use the suprapubic method of urine collection?
(اللي هي انو نسحب البول بابرة من الbladder مباشرة)
used for infants and children
whats the normal count of bacteria in urine when collected by suprapubic method?
NO COUNT IS NORMAL
bladder is normally sterile so any small count of bacteria ➡️ positive test
types of urine analysis?
− Macroscopic Examination
– Microscopic Examination
− Chemical Analysis (Urine Dipstick)
− Culture
− Cytological Examination
most important indicators that are analyzed by urine dipstick?
pH
Nitrite
Leukocyte esterase
reference range of urine pH?
4.5-8
at high H+ conc in the urine (low pH), H+ interacts with ___
whereas at low H+ conc (high pH), H+ interacts with ___
methyl red
bromthymol blue
called dual indicator system
significance of urine pH detection?
يعني اذا كان الpH للبول حمضي كثير او قاعدي كثير ع شو ممكن يدلنا هاد الاشي؟
acidic (<4.5): metabolic acidosis, high protein diet
alkaline (>8): renal tubular acidosis
limitations of urine pH detection?
1) interference by bacterial overgrowth
2) run over effect of protein pad on pH pad
توضيح النقطة التانية: بالdipstick بكون الpH indicator فوق الprotein indicator فممكن يحلوا ع بعض ويتغير اللون وبتطلع عندي نتيجة غلط
other tests to determine urine pH?
غير الdipstick
- Titrable acidity
- Blood gases to determine acid-base status
if urine analysis results are nitrite +
the type of bacteria present is most likely ____
gram negative (Enterobacteriaceae)
bacteria that reduce nitrate to nitrite?
gram negative bacteria
significance of leukocyte estrase test on dipstick?
اذا كان positive ع شو بدلني؟
WBCs are active
- Pyuria
- Acute inflammation
- Renal calculus
in microscopic examination
what are the abnormal findings in HPF 400x?
— (> 3 erythrocytes)
— (> 5 leukocytes)
— (> 2 renal tubular cells)
— (> 10 bacteria)
in microscopic examination
what are the abnormal findings in LPF 200x?
(>3 hyaline casts or > 1 granular cast)
(>10 squamous cells) ➡️ indicative of contaminated specimen
Any other cast (RBCs, WBCs)
other abnormal findings in microscopic analysis
Presence of:
– Fungal hyphae or yeast, parasite, viral inclusions
– Pathological crystals (cystine, leucine, tyrosine)
– Large number of uric acid or calcium oxalate crystals
مش سؤال بس للتذكير
:)
colony counting in urine
count of 100, 000 CFU/ml ➡️ positive
count between 10, 000 – 100, 000 CFU/ml ➡️ suspected.
count <10, 000 CFU/ml ➡️ negative
برضو تذكير
:0
which colony count is considered significant in the case of catheterized urine collection?
plate count >=1000 CFU/ml
which colony count is considered significant in the case of voided urine specimen?
plate count >=105
كمان ملاحظة انو حتى لو الكاونت اقل من هيك بس نوعهم باثوجين خطير زي ال N. gonorrhoeae مثلا برضو بعتبر التست positive
