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Medical Assistant Exam Review > Laboratory Dianostics > Flashcards

Laboratory Dianostics Flashcards

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USMLE® Step 1 flashcards
1
Q

Bx, bi

A

Biopsy

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2
Q

CBC

A

Complete blood count

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3
Q

C&S

A

Culture and sensitivity

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4
Q

DNA

A

Deoxyribonucleic acid

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5
Q

EEG

A

Electroencephalogram

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6
Q

FBS

A

Fasting blood sugar

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7
Q

H&H, H/H

A

Hemoglobin and hematocrit

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8
Q

HCG

A

Human chorionic gonadotropin

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9
Q

POCT

A

Point of care testing

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10
Q

Pap

A

Papanicolaou test

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11
Q

PH

A

Potential hydrogen

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12
Q

QRS

A

Ventricular deplorazation

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13
Q

STAT

A

Immediately

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14
Q

STD

A

Sexual transmitted disease

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15
Q

TC

A

Throat culture

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16
Q

UA

A

Urinalysis

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17
Q

UC

A

Urine culture

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18
Q

U

A

Unit

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19
Q

MU

A

Milliunit

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20
Q

Standard universal precautions

A
  • treat all blood and body fluid as infection
  • use personal protective equipment: sterile/non sterile gloves, lab coat, shoes cover, gown
  • protect patient from you, yourself from patients
  • use special care to avoid injury from sharp instrument/equipment
  • never use needles, other sharps unnecessarily
  • dispose of sharp in puncture/leak proof containers
  • report all accidental contaminated sharp injuries to supervisor
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21
Q

Environmental safety

A
  • employee training in workplace hazard is supplied
  • employer accidental exposure plan must be in place
  • each hazardous substance must be identified with hazardous label: display name of contained material, list effects of chemical
  • material safety data sheet used for hazardous agents
  • all puncture proof sharp container, biohazard bag, eyewash station must be correctly labeled
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22
Q

Quality control

A
  • specimen collected for pathological testing in formalin preservative
  • microbiological culture, treat sterilely, do not expose to formalin
  • give pt verbal/written procedure performance instruction, confirm pt understands
  • employee get lab procedure training every year
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23
Q

Quality maintenance

A
  • check expiration date: collection container, tube, swab, reagents
  • calibrate lab instruments, each recorded in quality control log, perform on set of standards alone, verify every 6 months
  • standard is specimen like one you would normally process
  • perform/document control test each day
  • control sample used 1st every time pt sample is processed
  • positive/negative control samples used with test yield a quantitative test response
  • other control sample show results fall within normal range, sample use to test that give quantitative test results
  • when testing, adhere to procedure design to identify problems with equip calibration, errors in test procedure, defective test supplies
  • perform/ document equip maintenance: clean, adjust, part replacement
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24
Q

Microscope

A

Essential component of lab illuminates/magnifies specimens, to view/analyzed. Shouldn’t be moved around unless necessary. If must move, grasp arm, support weight with base

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25
Q

Light source

A

Microscope

-built in light bulb located under center of stage

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26
Q

Ocular lens/biocular

A

Eye piece of microscope

  • located at top
  • magnifies field of view 10 times
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27
Q

Objective

A

Contains magnifying lens

  • located center of microscope just above stage, mounted on swivel base
  • the two are dry
  • dry lens magnification are 10x (lower), 40x (high)
  • one is oil immersed, 100x
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28
Q

Stage

A
  • Prepared slide placed here, held in place with metal clips

- opening allows light passage to prepared slide

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29
Q

Condenser

A
  • on sub stage, it directs, focus light through slide

- can be raised or lowered

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30
Q

Iris

A

Diaphragm

  • located within condenser
  • can be opened/closed to regulate intensity of light passing through condenser
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31
Q

Microscope objective maginification

A
  • low power: 10x used for-urine sediment for cast/epithelial cells, scan blood smears
  • high power: 40x used-wet preparation: urine sediment for RBC, WBC, bacteria, yeast, parasite
  • oil immersion: 100x used-microorganism, blood films: blood cell morphology, count, WBC differential
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32
Q

Microbiology

A

Study of minute unicellular, multicellular, acellular organism

  • includes area of bacteriology, virology, mycology, parasitology
  • most microorganism live on body: normal flora
  • small number are pathogenic in body falls in category of infectious disease
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33
Q

Microorganism

A

5 major groups: bacteria, fungi, algae, Protozoa, virus

-normally found everywhere: in food, water, air, soil, skin, within body

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34
Q

Morphology

A

Study of form/structure of organism, the special features specific to it

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35
Q

Normal flora

A

Microorganism found on skin/within body, normally do not cause disease
-some beneficial to body, they destroy potentially harmful microorganism within intestinal tract

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36
Q

Pathogens

A

Microorganism cause disease
-infectious agent capable of transmitted from 1 living being to another, which they grow and multiply, cause infection without sign of disease

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37
Q

Virulence

A

Capacity of microorganisms cause illness

For example: HIV

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38
Q

Bacteria

A

Single-cell organism: prokaryote, consider vegetable matter

-antibiotic affective lay fight/control bacterial infection

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39
Q

Aerobes

A
  • 1 way bacteria is identified
  • condition which thrive
  • Require oxygen to survive
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40
Q

Anaerobes

A

2 way bacteria identified

Bacteria thrive without oxygen, some die if exposed too oxygen

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41
Q

Morphology

A

Form and shape of organism

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42
Q

Cocci

A

Form/shape of organism:
Round
Singular: coccus
Disease: pneumonia, streptococcal throat, gonorrhea

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43
Q

Bacilli

A

Shape/form of organism: rod-shaped
Singular: bacillus
-disease: tuberculosis, tetanus, urinary tract infection, whooping cough

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44
Q

Spirilla

A

Shape/form: spiral
Singular: spirillum
-disease: syphillis, Lyme disease

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45
Q

Staphylo

A
  • form/shape: grapelike clusters
  • methicillin-resistant staphylococcus aureus (MRSA), resistant to antibiotic, most often occur in people who are hospitalized, health care setting
  • if acquired in hospital: nosocomial infection
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46
Q

Form of bacteria

A
  • May have spores:hard-shelled formation, resistant to heat, disinfectants, making difficult to kill
  • some have flagellae: projection enable movement
  • bacteria arrangement: chain=strepto-, pairs=diplo-, clusters=staphylo-
  • pattern of reproduction: colony appearance/patterns as grown on culture medium
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47
Q

Staining for bacteria smear

A
  • use to identify bacteria, most often with gram stain
  • gram-positive: purple-botulism, diphtheria, pneumonia, rheumatic fever, staphylococcal infection, tetanus, streptococcal throat
  • gram negative: pink-gonorrhea, meningitis, UTI, cholera, pertussis, plague, thyroid fever, dysentery
  • acid fast stain: may be use if gram staining does not stain specimen sufficiently
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48
Q

Fungi

A
  • fungus
  • single cell organism, larger than bacteria
  • fungal infection may produce in heart, lung, skin, hair, nails, other organs
  • resistant to antibiotic
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49
Q

Mold

A

Multicellular fungi produces spores

  • important species of mold: penicillium
  • first penicillin developed this mold
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50
Q

Tinea

A

Fungal skin infection

  • athlete’s foot
  • ringworm
  • thrush (oral
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51
Q

Tinea pedis

A

Athlete’s foot

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52
Q

Parasites

A
  • live on or in another organism
  • use organism for nourishment, growth, reproduction
  • host is harmed as parasite thrives
  • infection caused by parasite: infestation
  • most parasites identified in microscopic exam of urine, feces, tissue fluids, biopsies
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53
Q

Type of parasites

A
  • helminths (worm): roundworm, whipworms, tapeworm, pinworm
  • insect: spread viral, bacteria, Protozoa disease
  • mosquitoes, ticks, lice, mites
  • single cell Protozoa: cause malaria, dysentery
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54
Q

Viruses

A
  • smallest living organism, can only be seen in a microscope
  • simpler life form than cell
  • can live only within living cell
  • relies on host cell to grow, produce, then invade more host cells
  • most virus treated only for symptoms
  • antibiotic is ineffective treatment, host must endure until it runs it course
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55
Q

Blood borne viral infection

A
  • disease live in host blood.
  • transmitted from host to host by contact with infected body fluid, blood, blood products, mucous membranes
  • others if have trace of blood in them: vomitus, urine, sputum, feces, perspiration, tears, saliva, nasal secretion
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56
Q

Hepatitis A (HAV)

A

Acute infective

-transmitted by fecal or oral contamination

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57
Q

Hepatitis B (HBV)

A

Most common

Infection transmitted by contaminated serum, plasma, needle, entry through all entry portals

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58
Q

Hepatitis C (HCV)

A

Transmitted by blood transfusion, needle sharing

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59
Q

Hepatitis D (HDV)

A

Delta hepatitis

  • occur in patient with hep B
  • transmitted by mucosal contact, needle sharing, sexual contact
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60
Q

Hepatitis E (HEV)

A
  • acute
  • occur mostly outside of U.S.
  • transmitted by fecally, contaminated water or food
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61
Q

Human immunodeficiency virus (HIV)

A
  • Transmitted acutely: blood to blood, sexual contact modes of transmission
  • may be present in all body fluids
  • of those infected, 70% will progress into acquired immunodeficiency syndrome (AIDS)
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62
Q

Stages of HIV

A
  • stage 1: acute HIV infection, patient becomes a carrier
  • stage 2: asymptomatic latency (may be years)
  • stage 3: AIDS related complex (ARC)
  • final stage: AIDS- may have kaposi’s sarcoma (cancerous skin lesion), pneumocystis carinii (severe pneumonia), patient has no immunity
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63
Q

Before collection

A
  • verify patient identity (name, DOB)
  • review requisition slip, confirm patient proper test preparation
  • assemble needed collection equipment, supplies
  • wash hands before/after
  • wear gloves
  • site cleansed with alcohol, spiral technique inside to out, allow to air dry or with sterile gauze
  • use sterile collection containers/equipment
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64
Q

After collection

A
  • label container with patient name, date, time, specimen source, your initials
  • use biohazard label bag or puncture proof container to dispose all hazardous waste
  • incubate culture plates with agar side up, so moister droplets will not fall on growing surface
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65
Q

Handling collection

A
  • Store specimen according to instruction: refrigerate, separate blood components
  • avoid contaminating specimen or oneself
  • transport disease causing microorganism use agar as a medium to ensure nutrition for microorganism
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66
Q

Urinalysis

A
  • Provide more information about general condition of body than any other tests.
  • kidney filters 1,000 L of blood a day, average adult produce 1,250 mL/day
  • composed 95% water, 5% waste product
  • usually sterile, does not contain bacteria or infection-causing organism
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67
Q

Urine collection

A
  • must be tested as soon as possible
  • if unrefrigerated: test well mixed specimen within 1 hour
  • if refrigerated: wait until specimen at room temp, no more than 2 hours
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68
Q

Random urine collection

A

Most common sample type, use for routine screening, collection of 3 oz or more

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69
Q

First morning urine collection

A

Highest solute concentration, used in pregnancy test for human chorionic gonadotropin, has highest specific gravity

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70
Q

Fasting urine collection

A

Second morning collection, must for diabetic monitoring

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71
Q

Clean-catch midstream urine collection

A

Best for bacterial cultures/cultural & sensitivity test

  • analyze for type of bacteria/identifies best antibiotic to use
  • inside container kept sterile, free as possible of bacteria surrounding urethra
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72
Q

24 hour urine collection

A
  • for quantities analysis
  • study of calcium, potassium, creatinine, urea nitrogen, protein, lead levels
  • begun after first morning void
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73
Q

Cauterization urine collection

A
  • collected if patient cannot urinate normally

- performed if specimen must be completely sterile

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74
Q

Physical exam urine analysis

A
  • color: pale straw - dark amber
  • clarity: rate from transparent - turbid
  • specific gravity: density measurement compared to distilled water: normal range: 1.005-1.030, measure by urinometer, refractometer, on Reagan strip
  • odor: fruity-diabetes, foul odor- infection, ammonia scent-high concentration of bacteria from sitting in room temperature
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75
Q

Urinalysis color indicator

A
  • colorless: drink excessive amount of water
  • red: blackberry, cranberry, beet consumption, blood
  • neon yellow: b complex vitamin, excess riboflavin
  • orange: pyridium - drug to treat bladder infection
  • dark yellow: dehydration, early sign of liver problem
  • brown: bean, rhubarb comsumption, old disintegrated blood clots
  • blue: methylene blue (drug ingredient for bladder spasm/discomfort
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76
Q

Reagent pads

A
  • located on strips, dipped in urine
  • pad react by changing colors
  • measurement taken timed
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77
Q

PH scale reagent pad

A

measure follows:

  • normal range: 4.5-8
  • pH of 7 neutral
  • pH above 7 alkaline
  • pH below 7 acidic
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78
Q

Albumin reagent pad

A

Protein

-result indicate: UTI, kidney disease, vigorous exercise

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79
Q

Bilirubin reagent pad

A

Degenerated RBC

-results indicate: points of liver damage, obstructive jaundice, hepatitis

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80
Q

Blood reagent pad

A

Result indicate: kidney damage, UTI, severe burns, muscle injury, menstrual period

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81
Q

Ketone bodies reagent pad

A
  • acetone

- result indicate: fat diet, severe diabetes mellitus, starvation, dehydration, exposure to cold, excessive exercise

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82
Q

Glucose reagent pad

A

Possible diabetes mellitus if above renal threshold

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83
Q

Nitrate reagent pad

A

Result indicate: pathogen pretense (UTI), false positive if specimen left out more than 2 hours
-bacteria creat nitrite in vivo

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84
Q

Urobilinogen reagent pad

A

Converted bilirubin

-result indicate: point of heart disease, liver disease, hemolytic anemia

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85
Q

Microscope exam

A
  • not CLIA waived
  • finding should correlate with physical and chemical analyses
  • procedure: after centrifuging, pour off supernatant, set up wet mount to examine urine sediment, unstaffed sediments best viewed using high power, low light
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86
Q

Epithelial cells in urine

A

Come from genitourinary tract
-renal tubular cells
—morphology: round, large nucleus. High number indicate tubular damage or acute infection
-transitional cells:
—morphology: round to oval, may have tail. High number indicate bladder disease or renal pelvis disease
-squamous cell:
—morphology: large, flat, irregular cells. High number indicate vaginal contamination in women

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87
Q

RBC in urine

A

Normal: 0-2 cells seen using high power field

  • morphology: may be round, colorless, from hemolysis
  • increase number indicate bleeding somewhere along urinary tract
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88
Q

WBC in urine

A

Normal: 0-5 cells seen HPF

-increase number indicate inflammation of genitourinary tract

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89
Q

Crystals in urine

A

-common in all urine specimens, especially if allowed to cool
-type/number vary with pH of urine
-not usually clinically significant unless found in large numbers
-abnormal urine crystals: possible cause are disease state, inherited metabolic disorder, medication, treatment
—cystine (six sided) indicate calculi/congenital defect, can cause mental retardation
—uric acid indicate gout
—cholesterol indicate severe UTI

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90
Q

Mucus threads in urine

A

Normally present in small amounts

-long wavy threads/pointed ends

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91
Q

Spermatozoa in urine

A

Common both men and women

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92
Q

Bacteria in urine

A

Should not normally exist in urinary tract

-more than a few indicate specimens contamination or UTI

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93
Q

Parasites in urine

A

-

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94
Q

Yeast in urine

A

indicate diabetic patient/vaginal contamination cause by candida albicans

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95
Q

Cast in urine

A
  • cylindrical structure formed in lumen of nephrons tubules within kidney
  • made up of hardened material within lumen are flushed out into urine, indicate disease condition
  • counted under low power field, low light, identified under HPF
96
Q

Hyaline cast in urine

A

Pale, colorless cylinder with round edges

-indicate kidney disease or normal for heavy exercise

97
Q

Granular cast

A

Either coarse/finely granular in appearance

-indicate heavy proteinuria, acute/chronic renal disease, congestive heart failure

98
Q

Cellular cast

A

Named for organized structures they contain

99
Q

WBC casts

A

Indicate pyelonephritis (chronic renal disease)

100
Q

RBC casts

A

Indicate pathological condition

-acute glomerulonephritis, lupus nephritis, severe nephritis

101
Q

Renal tubular epithelial cast

A

Indicate ischemia

102
Q

Waxy cast

A

Indicate severe renal disease

103
Q

Hematology

A

Analysis of blood

  • blood content examine/tested give general health information, to identify disease causing organism
  • MA may perform blood cell morphology exam, cell counts, various chemical analyses
104
Q

Serum

A

Sample blood collected in tube without additive

  • once collected, left standing in upright position at room temp for 10-30 minutes allow clot to form
  • watery portion of blood contains antibodies, does not contain any clotting factors
  • mostly for blood chemistry test, pregnancy test, viral studies, HIV antibodies
105
Q

Whole blood

A

Collected in tube with anticoagulant additive

-for hematology test: CBC, coagulation studies, blood glucose, other blood chemistry test

106
Q

Plasma

A

Obtain from whole blood collected in tube with anticoagulant additive, then centrifuged

  • centrifuged: top layer plasma, middle layer WBC, platelets Buffy layer, bottom layer RBC
  • 90% water, 10%: proteins, carbs, fates, amino acids, mineral salt, hormones, enzymes, waste
107
Q

Plasma

A

90% water
9% protein
1% fat, carb, gases, waste products, clotting factor, minerals

108
Q

Formed elements

A
  • erythrocytes: RBC
  • leukocytes: WBC
  • Thrombocytes: platelets
  • cell formed mostly in red bone marrow
109
Q

Reticulocytes

A

Newly released RBC from bone marrow, circulates in peripheral blood for 24-36 hours before becomes mature RBC
-normally make up 1% peripheral RBC

110
Q

White blood cells

A

5 types, fight infection

  • agranulocytes: formed in lymphatic system- lymphocytes, monocytes
  • granulocytes: formed in red bone marrow-neutrophils (most numerous), basophils, eosinophils
111
Q

Neutrophils

A
  • Granulocytes
  • 58%-68% of WBC
  • Fight bacterial infection : phagocytosis
  • primary defense against infection
  • segmented nucleus, small granular cytoplasm
112
Q

Basophils

A

Granulocytes

  • 0%-1% of WBC
  • fight allergies
  • use phagocytosis
  • secrete heparin, histamine, serotonin
  • large nucleus, large granular cytoplasm
113
Q

Eosinophils

A
  • granulocytes
  • 2%-4% of WBC
  • fight allergies/parasitic infection
  • use phagocytosis
  • segmented nucleus, large granular cytoplasm
114
Q

Lymphocytes

A

Nongranulocytes

  • 21%-30% WBC
  • produce antibodies to foreign antigens
  • backbone of immune system
  • large nucleus
115
Q

Monocytes

A

Nongranulocytes

  • largest WBC
  • 4%-8% of WBC
  • eliminate dead fragments, dead cells
  • use phagocytosis
  • produce interferon
  • large kidney shaped nucleus
116
Q

Micropuncture

A

Finger stick

  • use great middle or ring finger of non dominant hand for
  • on infants: underside, outer edge of heel
  • cleanse with alcohol pad
  • allow to dry or wipe with sterile gauze
  • puncture should be no deeper than 2.4 mm
  • wipe away first droplet of blood, contains more tissue fluid
117
Q

Venipuncture

A
  • most commonly performed hematological test
  • common site: median cubical vein
  • other sites: chephalic (thumb side on forearm), basilic vein, back of hand veins
118
Q

Venipuncture site to avoid

A
  • extensive scar from burns, surgery
  • veins subject to numerous punctures
  • upper extremity on side of previous mastectomy
  • hematoma
  • edematous extremities
  • intravenous therapy, blood transfusion
  • arm with fistula/cannula
119
Q

Needles

A
  • usual gauge is 19-23
  • higher gauge number, higher risk of hemolysis
  • butterfly technique: 21-25 gauge-for small veins, geriatric, pediatric, burned patient, patient with limited range of motion, receiving frequent needle sticks
120
Q

Collection tubes for blood

A
  • adults: 3-10 mL tubes
  • children: 2-4 mL tubes
  • tube color determined by tube content
121
Q

Venipuncture steps

A
  • apply tourniquet 3-4 inch above planned puncture site, have patient make fist, palpate for site
  • release tourniquet, clean with alcohol pad, allow to dry
  • reapply tourniquet
  • tourniquet must be release within 1 minute
  • anchor vein below site
  • enter vein with bevel up 10-15 degrees angle
  • release tourniquet when blood flow is established
  • use correct order of draw
  • gently invert tube 5-10 times to mix collected blood with additives in tube
122
Q

Yellow or yellow/black

A

First order of draw

  • additive: sodium polyanetholsulfonate
  • blood cultures in microbiology, blood bank studies
123
Q

Red

A

Second order of draw

  • no additive
  • serum chemistry study, immunology studies, blood clotting time, blood bank
124
Q

Red/black: tiger top

A

Third order of draw

  • additive: serum separator tube, clot activator
  • serum chemistry studies
125
Q

Light blue

A

Fourth order of draw

  • additive: sodium citrate
  • coagulation Studies
126
Q

Green top

A

Fifth order of draw

  • additive: sodium heparin, lithium, anticoagulant
  • plasma chemistry studies, lithium, ammonia level, arterial blood gases
127
Q

Lavender, pink

A

Sixth order of draw

  • additive: EDTA, anticoagulant
  • whole blood hematology (CBC, WBC), whole blood immunohematology test, lead studies, sedimentation rate
128
Q

Pale yellow

A

Seventh order of draw

  • additive: acid citrate, dextrose A and B
  • HLA tissue typing, paternity test, DNA studies
129
Q

Gray

A

Eight order of draw

  • additive: potassium oxalate, sodium fluoride, anticoagulants
  • glucose studies (GTT, FBS), lactic analysis, blood alcohol levels
130
Q

Failed attempts

A
  • if 1st attempt to fail to collect specimen, remove needle, try other arm
  • if 2nd attempt fails, change needle position, try using another tube, loosen tourniquet
  • after 2nd attempt fail, call another experienced phlebotomist for help
131
Q

Loss of blood flow into tube

A
  • cause by vein collapse
  • resecure tourniquet to increase filling
  • remove needle to redraw
  • reposition needle, may be no longer in vein
132
Q

Hemolysis

A

Rupturing of RBC cause release of hemoglobin into blood specimen
-following may be cause: needle gauge too small, shaking collection tube, draw blood begun before alcohol is dry

133
Q

Hemostasis

A

Stoppage of bleeding in damage blood vessel

134
Q

Flash

A

First appearance of blood drawn into vacuum tube, tube, syringe during venipuncture procedure, gives confidence to phlebotomist

135
Q

Blood counts

A

Quantitative study look at total number of blood cells, percentage of each type of cell that makes in entire sample
-CBC, WBC, RBC, WBC differential, platelet count

136
Q

Blood cell morphology

A
  • Analyze shape, size, grouping of cells
  • by creating blood smears
  • from fresh blood specimen contain anticoagulant, prepared on glass slide
  • spreader slide pull blood thinly on slide
  • slide stained to complete preparation, examine under microscope
  • perform wbc differential
137
Q

Hemoglobin

A

Quantitative analysis of protein in RBC containing iron,

  • iron attract, binds oxygens which transported body tissue
  • hb main component in RBC
  • normal range: men-14-18, women-12-16
138
Q

Hematocrit

A
  • measure of percentage by volume of RBC in whole blood
  • normal: men 42% to 52%, women 37% to 47%
  • duplicate hct result should not vary by more than 2% of each other
  • layer in centrifuged: hct, plasma, platelet, RBC
  • ratio: 3:1 multiply by hb value by 3. Round number to whole number
  • formula: hb x 3 = hct +/- 3
139
Q

Bleeding time

A

Evaluate blood ability to clot

Normal range 2-7 minutes

140
Q

Blood typing and ABO antigens

A

Agglutination points to type of blood

141
Q

O+

A

Antigens/antibodies: Rh+ is antigen D, anti-A, anti-B antibodies

  • may donate to: O+, A, B, AB
  • may receive: O
142
Q

O-

A
  • no antigens, no antibodies
  • universal donor
  • may receive from: O-
  • rare
143
Q

A

A

Most common

  • A-antigens, anti-B antibodies
  • may donate to: A, AB
  • may receive from: A, O
144
Q

B

A

B antigens, anti-A antibodies

  • may donate to: B, AB
  • may receive from: B, O
145
Q

AB

A

Rarest blood type

  • A, B antigens
  • no antibodies
  • may donate to: AB
  • universal recipient
146
Q

Rh factor

A

A, D antigen found on RBC surface

  • if RBC contains Rh factor, then it is Rh+ without factor, called Rh-
  • if Rh- blood given to Rh+ blood, becomes sensitize, develop anti-Rh antibodies, if same person given Rh+ blood again, anti-Rh antibodies will attack Rh+ blood
  • 85% population is Rh+
147
Q

RhoGAM

A

Given to Rh- women who just given birth to prevent possible Rh+ blood of newborn from triggering the development of anti-Rh antibodies

  • done to ensure 2nd baby, future babies will not develop erythroblastosis fetalis
  • can be life threatening to newborn
148
Q

Erythrocytes sedimentation rate

A

Rate which RBC settle at bottom of blood specimen

  • measure in millimeter per hour
  • determine degree of inflammation in body
  • wintrobe and westerners method used
149
Q

Glucose

A

Chemistry test
Normal range: 70-110 mg/dL
-fasting blood glucose: 12 hour fast, except water, above normal results, glucose tolerance test needed

150
Q

Glucose tolerance test

A

Timed

Routine at 6 months of pregnancy

151
Q

HbA1c

A

Used to monitor patient with diabetes

  • measure amount of glucose lasted hb in blood
  • reveals diabetic patient compliance with prescribed diabetes treatment
152
Q

Carbohydrate metabolism

A
  • to prepare: eats high carb diet for 3 days, fast 8-12 hours before
  • may have little water
  • first blood draw should be less than 150 mg/dL
  • half an hour later, blood and urine drawn each hour as MD prescribes
153
Q

Cholesterol

A
  • white, waxy, fat like substance essential for normal function of body
  • important component of cell membrane
  • used in production of hormones and bile
  • normal total cholesterol should be less than 200 mg/dL
154
Q

Low density lipoprotein

A

Bad cholesterol (LDL)

  • should be less than 130 mg/dL
  • pick up, carries fat to blood vessels, cause plaque to build up on arterial wall, result atherosclerosis
155
Q

High density lipoprotein

A 
Good cholesterol (HDL)
-remove excess cholesterol from cells, carry it to liver to be excreted
156
Q

Triglycerides

A

Blood fat related to risk of heart disease

-should be less than 250 mg/dL

157
Q

Serology

A

Immunology

  • study of body defense against foreign substance
  • study of fluid component of blood, especially measurement reaction between antigens, antibodies within blood serum
  • may use urine, body fluids
158
Q

Antigens

A

Substance considered foreign by body immune system

  • cancer antigen, disease causing microorganism
  • cause immune system create antibodies against it
159
Q

Antibodies

A

Flow freely through blood, found in blood serum

  • measure by titer
  • titer measure presence, concentration of substance
160
Q

Titer

A
  • hormone detection
  • used in ABO and Rh blood typing
  • assist I’d diagnosis of bacterial, viral disease: duodenal ulcer (helicobacter pylori), infectious mononucleosis (Epstein-Barr virus), Lyme disease, streptococcal (streptococcus progenes), rheumatoid arthritis, human immunodeficiency virus, influenzas virus
161
Q

Electrocardiogram

A

Record heart activity

162
Q

Cardiac cycle

A

-complete in 0.8 seconds
-regulated by electrical impulse transmitted through heart wall tissues
-4 heart chambers
—contract: depolarization
—relax: repolarization
- atria contract first, follow by contraction of ventricle
-contraction of ventricle moves blood out of heart to body
-normal rate of rhythm is 60-100 beats per minute

163
Q

Diastole

A

Rapid filling phase

164
Q

Diastole 1st phase

A
  • atria receive blood from superior and inferior vena cava/coronary sinus
  • ventricle expelled all blood into aorta
  • pressure cause atrioventricular valves to open (tricuspid/mitral valve)
165
Q

Diastole 2nd phase

A

Pressure in atria, ventricle begin to equalize

166
Q

Diastole 3rd phase

A
  • atria contracts to push out last remainder of blood

- final phase of diastole seen as P wave on EKG

167
Q

Systole

A

QRS waves

168
Q

Systole 1st phase

A

Ventricle are full, begin to squeeze down on themselves to build pressure inside to force semilunar valves to open

169
Q

Systole 2nd phase

A

Semilunar valves open

170
Q

Systole 3rd phase

A

Ventricular contraction continues until last of blood exits

171
Q

Systole 4th phase

A

Ventricles relax

172
Q

Sinoatrial node

A
  • pacemaker
  • generate electrical impulse that activates cardiac cycle
  • responsible for atrial contraction
  • triggers AV node action
  • controls rate of heart contraction
173
Q

AV node

A
  • gatekeeper
  • briefly delays impulses from SA node
  • this delay keeps ventricles from contracting too soon
  • delay allows atria to contract completely, get all blood out and flowing into ventricles
  • passes the impulse at 46-60 beats per minute
174
Q

Bundle of His

A
  • is triggered into action by AV node
  • carry impulse to left/right bundle branches, eventually to purkinje fibers
  • bundle branches and prukinje fibers responsible for ventricle contractions
  • rate of ventricle cell contraction 20-40 beats per minute
175
Q

Final phase

A

Heart relaxes (repolarization)

176
Q

Holter monitor

A
  • Used for patient experiencing intermittent chest pain or discomfort, who had normal results on resting ECG
  • uses 5 leads, record cardiac activity for 24 hours
177
Q

12 lead ECG

A

-use 3 bipolar leads, 3 unipolar leads, 6 chest leads (precordial) to record heart activity

178
Q

Bipolar leads (12 lead ECG)

A

Limb leads

  • 1st leads read on ECG
  • lead I: measure current traveling between left arm, right arm
  • lead II: measure current traveling between left leg, right arm
  • lead III: measure current traveling between left leg, left arm
179
Q

Unipolar limb leads

A

AV: augmented voltage

  • aVR: right side-trace current traveling toward right arm from midway - left leg, left arm. RA- (LL + LA)
  • aVL: left side-trace current traveling toward left arm from midway -right arm, left leg. LA-(RA+LL)
  • aVF: foot-trace current travel toward left leg midway - right arm, left arm. LL-(RA+LA)
180
Q

V1 lead placement

A

4th inter coastal space, right of sternum

181
Q

V2 lead placement

A

4th intercostal space, left off sternum

182
Q

V4 lead placement

A

5th intercostal space, midclavicular

183
Q

V3 lead placement

A

5th intercostal space, midpoint between V2 and V4

184
Q

V6 lead placement

A

5th intercostal space, left mad axillary line

185
Q

V5 lead placement

A

5th intercostal space, midpoint between V4, V6

186
Q

Common source of ECG errors

A
  • poor skin preparation
  • loose connection
  • touching an electrode, any metal during recording
187
Q

Electrodes

A
  • Chest leads: 6, placed on upper torso, one electrode placed on each limb
  • Right leg: Used as ground electrode to minimize any possible electric shock to patient, to stabilize ECG
  • placed on fleshy part of upper arm, lower leg to decrease possibility of muscle voltage (artifacts)
188
Q

Somatic tremor

A

Artifact

-body muscle movement

189
Q

Electrical interference

A

Artifact

-machine not well grounded, close to other electrical device

190
Q

Baseline interruption

A

Artifact

-broken or dislodge lead

191
Q

Wandering baseline

A

artifact

Poor skin connection, loose electrode

192
Q

P waves

A
  • represent depolarization of atria
  • measure atrial activity
  • seen as small, rounded, upright
193
Q

PR segment

A
  • part of atrial contraction
  • between P wave, QRS wave complex
  • no electrical activity
194
Q

PR intervals

A
  • time takes electrical impulse to be conducted through atria, AV node to beginning of ventricular contraction
  • from beginning of P wave to begin of QRS complex
  • measure heart efficiency at transmitting impulse down pathway
195
Q

QRS complex

A
  • represent depolarization of ventricle

- atrial repolarization, usually not seen, occur same time as QRS complex

196
Q

ST segment

A
  • part of ventricular contraction
  • between QRS complex and T waves
  • no electrical activity
197
Q

T waves

A
  • represent heart repolarization (relaxing)

- round, usually higher/broader than P waves

198
Q

U waves

A
  • Late repolarization
  • Not normally seen
  • Should be shallow, rounded, upright
199
Q

ECG paper

A
  • standard mark is 10 mm high
  • if baseline off centered, stylus position needs to be adjusted
  • lines on paper grid 1 mm apart
  • each small box: represent 0.04 seconds
  • each large box: represent 0.20 seconds
  • cardiac cycle represent by 4 large box
  • RL is not displayed, it is ground electrode
200
Q

Pulmonary function test

A

Measure:
-air taken into lungs
-air expelled from lungs
-how fast air pushed out of lungs
Includes:
-spirometers, pulse oximetry, diffusion capacity, lung volume, arterial blood gases, cardiopulmonary exercise test
-assist: monitor effectiveness of treatment, classify/detect pulmonary problems-chronic obstructive pulmonary disease, asthma, various allergies, chronic bronchitis, cystic fibrosis

201
Q

Forced spirometry

A
  • Simple, noninvasive screening test use spirometer measure breathing capacity
  • most frequently performed PFT
202
Q

Forced vital capacity

A

Measure lung capacity

  • inhales deeply as possible, expels rapid/forced expiration. Greatest possible volume of air
  • must continue to expel air for total of 6 seconds
  • must be repeated 3 times for accuracy
  • age, sex, age, weight, height are calculated factors affecting normal results
  • result below 80% is abnormal
203
Q

Contradiction for pulmonary function test

A

Recent myocardial infarction

  • angina
  • other serious medical condition
  • smoking/eating meal within 6 hours of test
  • viral infection
  • illness past 2 weeks
  • use of some medication may affect test results
204
Q

Radiology

A
  • Use of radiographic imaging to visualize, diagnose disease within body
  • use of radioactive substance to treat disease
  • X-ray tube generates beam of xray, aimed at patient
  • pass through patient, strike undeveloped film, developed an image appears on film
205
Q

Computed tomography

A
  • procedure cross-sectional image of body area,
  • series of xray transferred to computer, puts together cross-sectional view
  • provides rapid, thin, detailed tissue planes
206
Q

Intravenous pyelogram (IVP)

A
  • visualize urinary structure, colon
  • use iodine injection as contrast medium
  • pt prepare: clear liquid day before, nothing by mouth 8 hours before
207
Q

KUB

A

Flat plate

  • frontal supine xray of kidney, ureters, bladder
  • use to diagnose abdominal complaints
208
Q

Cholecystography

A
  • visualize gallbladder
  • use contrast medium
  • pt prepare: no food/drink 12-14 hours before
209
Q

Barium enema

A

Lower GI series

  • visualize lower portion of gastrointestinal system
  • use barium as contrast medium
  • prepare: clear liquids day before
210
Q

Barium swallow

A

Upper GI series

  • use barium as contrast medium
  • prepare: NPO 8 hours before
211
Q

Angiogram

A
  • visualize heart/ circulation
  • use iodine dye, inject into vessel using catheter
  • prepare: NPO 4-5 hours before
212
Q

Arteriogram

A
  • visualize interior of artery
  • use iodine dye, injected into artery with catheter
  • NPO 4-5 hours before
213
Q

Positron emission tomography

A

Produce color image to assess metabolic/chemical activity

-use radioisotope injection

214
Q

Radiation therapy

A

Treat disease, shrink cancer tumors

215
Q

Magnetic resonance imaging

A
  • produce view of internal structure without use of radiation for soft and hard tissues
  • no patient preparedness needed
  • no metal objects worn, or imbedded
216
Q

Ultrasound

A

-High-frequency sound waves produce imagines of deep body structures
-to prepare: depends on type of study
—no eating for several hours before test: pancreas, liver, gallbladder, spleen exam
—drink specific amount of water, not voiding for obstetrical exam
—no eating for several hours before, additionally taking prescribed laxative, water with no voiding within hour before for abdominal exam
-scan of heart: echocardiogram
-image produced by computer: sonogram, hard copy may be produced

217
Q

Anteroposterior

A

AP

Pt standing up or supine, beam guided from front to back

218
Q

Posteroanterior

A

PA

Pt standing up or supine, bean guided back to front

219
Q

Right lateral

A

RL

-pt lying on right side, beam guided right side to left side

220
Q

Left lateral

A

LL

-pt lying on left side, beam guided from right side to left side

221
Q

Oblique

A

Pt lying at angle

-beam guided through body: left posterior /left anterior oblique; right posterior/right anterior oblique

222
Q

Monitored dosimeter

A

Radiation exposure badge worn by staff present during xray, monitors cumulative exposure to radiation

  • worn outside of clothing, around chest/torso
  • monitors dose received to unprotected parts
223
Q

Lead shield

A

Shield used to cover organs that do not need to be x-rayed

224
Q

Pregnancy

A

As precautionary measure, female pt must be asked if they could possibly be pregnant
-if so, radiologists must be notified before proceeding

225
Q

Xray equipment

A

Maintenance of equipment should be scheduled regularly to ensure it is proper working order

226
Q

Lead aprons/gloves

A

Used by all participating staff members, not behind protective barrier
-all participant staff should preferably be standing behind barrier lined with lead when xray being obtained

227
Q

Proper disposal

A

All staff must follow occupational safety and health administration approved steps use to properly dispose of photo and xray processing waste
-hazardous waste, extremely hazardous waste

228
Q

Creatinine

A
  • normal: 0.4 to 1.5 mg/dL
  • above normal: impaired renal function, chronic nephritis, urinary tract obstruction
  • below normal: muscular dystrophy
229
Q

Blood urea nitrogen

A
  • normal 8-25 mg/dL
  • above normal: Kidney disease, urinary tract obstruction,
  • borderline high: congestive heart failure, internal bleeding
  • below normal: liver failure, negative nitrogen balance, impaired absorption, over hydration, low protein diet
230
Q

Uric acid

A
  • normal: male-3.5-7.2 mg/dL, female-2.6-6 mg/dL
  • above normal: gout, chronic kidney failure, kidney stones, radiation poisoning, toxemia of pregnancy, starvation, diet rich in purines
  • below: not significant
231
Q

Total protein

A
  • normal: 6-8 g/dL
  • above normal: dehydration, lupus erythematosus, rheumatoid arthritis, chronic infection, acute liver disease
  • below: severe liver disease, malabsorption, nephrotic syndrome, diarrhea, exfoliating dermatitis, severe burns
232
Q

Total bilirubin

A
  • normal: 0.3-1.2 mg/dL
  • above: liver disease, bile duct obstruction, hypothyroidism, jaundice
  • below: drug addiction (barbiturates)
233
Q

Alkaline phosphatase

A

Normal: 30-115 mU/mL

  • above: gallstone, liver lesion, hepatitis, cirrhosis of liver, Paget’s disease, metastatic bone disease, osteitis deformans
  • below: osteomalacia, malnutrition, hypothyroidism, pernicious anemia, scurvy, placental insufficiency
234
Q

Serum aspartame aminotransferase

A
  • normal: adult-5-40, children-10-50, infants-20-60 u/l
  • above: myocardial infarction, severe arrhythmias, angina, cirrhosis liver, acute hepatitis, infectious mononucleosis, hepatic necrosis, acute pancreatitis, acute hemolytic anemia, acute renal disease, severe burns, muscular dystrophy
  • below: beriberi, uncontrolled diabetes mellitus with acidosis
235
Q

Serum alanine aminotransferase

A
  • normal: adults-7-56, children 10-35
  • above: hepatocellular disease, obstructive jaundice, active cirrhosis, metastatic liver tumor, mild pancreatitis, liver congestion, hepatic injury in myocardial infarction
  • below: not significant

Medical Assistant Exam Review (10 decks)

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