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PATHOLOGY > Laboratory Medicine > Flashcards

Laboratory Medicine Flashcards

1
Q

Anatomic pathology includes

A

autopsy services, surgical pathology, cytology

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2
Q

Autopsy service

A

infrequent due to costs, imaging procedures, malpractice

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3
Q

Virtual autopsy

A

detailed body scan without dissection (becoming popular)

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4
Q

Surgical pathology

A

specimen collected from surgery must be examined (gross appearance, tissue processing (paraffin) and staining (H&E, special stain)

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5
Q

Cytology

A

pap smear, tissue brushings

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6
Q

Should cancer be diagnosed by cytology tissue brushing?

A

No, cannot see cell arrangement, use biopsy

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7
Q

Rembrandt, Dutch painter born in

A

1606

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8
Q

Liffey Swim

A

annual swim in dublin

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9
Q

Rembrandt had what famous painting in 1632

A

Abduction of Europa (oil-based)

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10
Q

Who performs a fine-needle aspiration?

A

pathologist

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11
Q

Pathologist do what procedures

A

fine-needle biopsy and surgical removal of tissue

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12
Q

Clinical pathology includes:

A

Hematology, transfusion, microbiology, chemistry, immunology, STAT lab, point-of-care testing

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13
Q

What type of specimen is used for ON-SITE diagnosis

A

frozen section

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14
Q

Panic value

A

sufficiently abnormal lab result value that indicates an immediate threat

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15
Q

Hematology - CBC

A

Measures Hgb, RBC count, and MCV; Calculates HCT, MCH, MCHC; WBC, platelets, % of WBCs, and RDW

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16
Q

Hematology - CBC with diff

A

CBC + count of normal/abnormal WBCs, morphology included

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17
Q

Hemoglobin is measured

A

measured from whole blood using CYANOMETHEMOGLOBIN formation

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18
Q

Counts of RBC, WBC, and platelets are obtained by

A

cell counter that measures conductance of cells passing through a small aperture (electrical impulse indicates cell type)

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19
Q

WBC population analysis

A

RBC lysis -> WBC automated flow cytometry (size, granules, shape, etc)

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20
Q

Automated flow cytometry

A

single cell characterization by size, shape, biochemical, or antigenic composition, by a scattering of light beam

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21
Q

Forward scatter in flow cytometry

A

diffraction = cell volume

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22
Q

Side scatter in flow cytometry =

A

refraction = measures internal cellular granularity

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23
Q

Pre-analytic phase

A

decision to perform test, specimen collection, etc

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24
Q

Analytic phase

A

Specimen analyzed

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25
Q

Post-analytic phase

A

report + interpretation and response to result

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26
Q

Peripheral blood smear procedure

A

blood smear, Wright stain, view whole slide (large cells at edge)

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27
Q

Blood clotting times - initial screening

A

PT and PTT

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28
Q

PT (prothrombin factor) measures

A

extrinsic pathway and common pathway factors (thromboplastin + Ca + plasma) [warfarin]

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29
Q

PTT (partial thromboplastin time)

A

evaluates intrinsic pathway and common pathway (partial thromboplastin + activator + Ca + plasma) [heparin]

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30
Q

Coagulation factor assay is based on

A

PT: thromboplastin for factors II, V, VII, and X
PTT: partial thromboplastin for factors VIII, IX, XI, and XII *ONLY patient’s plasma contains factors = clotting time

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31
Q

2 Sickle cell screening tests

A

sickling test and solubility test

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32
Q

Sickle cell test - sickling test

A

Blood + reducing agent (to reduce oxyhemoglobin to hemoglobin to accelerate sickling), examined for sickling cells presence

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33
Q

Sickle cell test - solubility test

A

lysed RBCs (saponin): deoxyhemoglobin S is insoluble in phosphate buffer; HbS = crystal formation; HbA is soluble

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34
Q

Hgb electrophoresis test

A

purified RBC hemolysate is separated by electrophoresis; PRINCIPLE for diagnosing hgb abnormalities

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35
Q

Blood banking procedure

A

Collect anti-coagulated whole blood -> spin to isolate RBCs and platelet-rich plasma -> spin to isolate platelets and plasma

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36
Q

Plasma contains

A

Igs, albumin, cryprecipitate (factor VIII, XIII, fibronectin, etc)

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37
Q

Cryopoor plasma

A

plasma without cryprecipitate (factor VIII, XIII, fibronectin, etc)

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38
Q

ABO/Rh forward typing tests

A

detects antigens on patient’s RBCs; mix RBC with anti-sera A/B/Rh; agglutination = blood type

39
Q

ABO/Rh reverse typing tests

A

detects Abs in the patient’s plasma; mix patient’s plasma with reagent cells-A/B antigen; agglutination = presence of antibody

40
Q

Apheresis

A

removal of blood, followed by separation of blood components (some components may be returned)

41
Q

RBCs can be stored for

A

35-42d @ 4C

42
Q

Platelet-rich fraction can be stored for

A

<5 days @ 25C

43
Q

Therapeutic plasma exchange procedure

A

blood continuously withdrawn, separated into cellular and plasma, cellular component is mixed with FFP or colloid solution and returned to patient

44
Q

Use for Therapeutic plasma exchange

A

Guillain Barre: to remove Ab’s against self

45
Q

Gram Stain procedure

A
  1. Crystal violet (1m) 2. Iodine (1m) 3. Destain EtOH 4. Counterstain Safranin (1m); rxn, shape, arrangement
46
Q

Plating

A

plate microbe in culture medium

47
Q

Antimicrobial susceptibility test - disc diffuse method

A

discs embedded with different antimicrobial agents + suspension of organism; zones of inhibition are measured to determine susceptibility, intermediate, or resistant to antibiotic

48
Q

Antimicrobial susceptibility test - dilution method

A

determines MIC (minimal inhibitory concentration); increasing dilutions of antimicrobial + agent; MIC = 1st tube which shows NO growth

49
Q

Automated chemical profile includes

A

total protein, albumin, Ca2+, inorganic phosphate, cholesterol, glucose, creatinine, uric acid, Bilirubin, alkaline phosphatase, lactate dehydrogenase, aspartate aminotransferase (may include more)

50
Q

Complete Chemical Profile

A 
Albumin.
Alkaline Phosphatase.
Alanine Aminotransferase (ALT).
Aspartate Aminotransferase (AST).
Bilirubin (total and direct).
Blood Glucose.
Blood Urea Nitrogen.
Calcium (Ca) in Blood.
Carbon Dioxide (Bicarbonate).
Chloride (Cl).
Cholesterol and Triglycerides Tests.
Creatinine and Creatinine Clearance.
Gamma-Glutamyl Transferase (GGT).
Lactate Dehydrogenase.
Phosphate in Blood.
Potassium (K) in Blood.
Sodium (Na) in Blood.
Total Serum Protein.
Uric Acid in Blood.
51
Q

(alanine aminotransferase) ALT/SGPT indicate pathology in

A

Liver, heart, skeletal muscle

52
Q

Amylase indicates pathology in

A

pancreas, salivary gland

53
Q

LDH indicates pathology in

A

most organs, esp heart, liver, lung, kidney

54
Q

PSA indicate pathology in

A

prostate

55
Q

LDH1:

A

heart, kidney, RBCs

56
Q

LDH2/LDH3

A

lung, lymphocyte, platelets

57
Q

LDH4

A

some types of leukemia

58
Q

LDH5:

A

liver, skeletal muscle, neutrophils, prostate

59
Q

What is all enzymes are high?

A

shock or infectious mononucleosis

60
Q

International unit of enzyme

A

amount that catalyzes 1 umol of substrate/min under defined conditions

61
Q

Alkaline phosphatase

A

bone, liver, all tissues

62
Q

GGT/P

A

Liver, bile duct

63
Q

AST (SGOT)

A

heart, liver, RBCs, skeletal muscle

64
Q

isozyme

A

molecular variant of an enzyme or DIFFERENT enzyme that catalyzes the same reaction

65
Q

LDH1 > LDH2 suspect

A

necrosis (infarction) of heart or kidney or hemolysis

66
Q

High LDH5 suspect

A

liver and skeletal muscle damage

67
Q

High LDH3 suspect

A

pulmonary infarct

68
Q

Urinanalysis examines

A

appearance, specific gravity (density), pH, leukocytes, nitrites, protein, glucose, ketones, urobilinogen, bilirubin, and blood

69
Q

Microscopic analysis of urine

A

examine sediment: cells, casts, crystals, microorganisms

70
Q

Antinuclear antibody testing tests for

A

autoimmune disorders such as lupus erythematous, rheumatoid arthritis, and Sjogren Syndrome

71
Q

Antinuclear antibody testing Procedure

A

patient’s serum + Hep2 cells; rinse; + anti-human IgG-fluorescent tag; Fluorescence microscopy detects presence/absence and pattern/titer of fluorescence

72
Q

Immunoassay

A

any (colorimetric) assay that relies on antigen/antibody complex; used to detect and quantitate proteins, hormones, and amino acids

73
Q

Non-competitive immunoassay (Type I)

A

Excess antibody + antigen; # of complexes DIRECTLY relates to [antigen]

74
Q

Competitive immunoassay (Type II)

A

excess antibody + analyte + labeled-analyte; labeled and non-labeled compete; amt of signal from label-bound-antigen INVERSELY relates to [antigen]

75
Q

Flow cytometry is used to diagnose

A

leukemia and lymphoma; precise identification of tumor cell types

76
Q

Flow cytometry + mAB-tag

A

label cell surface antigens with mAb-tag; side scatter, forward scatter, and intensity determine cell type

77
Q

Agglutination reactions procedure

A

large particle-antigen or particle-antibody; aggregates = presence of antigen or antibody in specimen

78
Q

Agglutination reaction use

A

detect antibodies or antigens in specimen

79
Q

Protein electrophoresis

A

detect presence and relative concentration of proteins (from serum, urine, or CSF)

80
Q

Stat tests include tests

A

whose results are ESSENTIAL for patient care, lab runs test before continuing other work

81
Q

Direct ELISA

A

Plate with specificity for antigen + patient unknown [antigen] + antibody-tag + substrate; colorimetric (primary Ab)

82
Q

Indirect ELISA

A

Plate with antigen + patient unknown [antibody] + anti-human IgG-tag + substrate; colorimetric (Primary and Secondary Ab)

83
Q

Sandwich ELISA

A

Plate with antibody + patient’s unknown [antigen] + primary Ab + secondary Ab + substrate

84
Q

Electrolyte Panel includes

A

Na, K, Cl, CO2, glucose, BUN, creatinine

85
Q

Stat tests usually involve

A

electrolytes, gases, chemistry profile, clotting/coagulation test, gram stain

86
Q

Blood gases measure

A

pH, pCO2, pO2, O2 sat, total CO2

87
Q

Blood gas requires

A

whole blood + 3 electrodes

88
Q

Hydrogen electrode measures

A

pH

89
Q

Carbon dioxide electrode works by

A

measuring pH change due to CO2 diffusion; [CO2] is directly related to pH change

90
Q

ELISA spot used for

A

monitoring cellular immune responses by visualizing secretory products of individual activated cells

91
Q

ELISA spot procedure

A

sandwich ELISA: immobilized specific antibody + secreting cells, remove cells and add primary antibody for secreted antigen + secondary-enzyme + substrate; visualize

92
Q

Immunoflourescence immunoassay

A

cells from patient + antibody of interest + secondary-tag; visualize for presence/titer/pattern

93
Q

oxygen probe for blood gas testing

A

complete electrochemical cell producing a current as oxygen migrates; current is DIRECTLY related to [O2]

94
Q

Point-of-care testing

A

specimen testing outside of a lab/hospital, hand-held portable analyzers, miniaturized test

PATHOLOGY (18 decks)

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