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Lab diagnostics > Microscopic > Flashcards

Microscopic Flashcards

1
Q

What tests can be performed to find mycobacterium?

A
  1. BACTEC
  2. Urine
  3. Sputum
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2
Q

what kind of receptor masks should staff wear when performing a acid fast test?

A

N5 Receptor mask

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3
Q

How many urine specimens should be obtained and confirmed for mycobacterium URINE?

A

3-5 (they all must contain the specimen for it to be diagnostic)

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4
Q

Prior to initiation of abx for a wound, what should be performed?

A

a wound culture

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5
Q

What should a wound culture be performed in conjunction with?

A

Gram staining

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6
Q

What are the 2 main tests for renal function?

A

Urea and creatinine

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7
Q

What is creatinine directly related to?

A

Skeletal muscle mass

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8
Q

What is creatinine a bi product of?

A

muscle breakdown

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9
Q

Who would have high creatinine levels?

A

older women, men, those that have increased protein intake

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10
Q

Why is creatinine clearance a suitable measure of Glomerular infiltration?

A

because creatinine is metabolized at a stable and constant rate the creatinine clearance makes it a suitable test for glomerular filtration

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11
Q

Creatinine is a screening or diagnostic test?

A

screening

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12
Q

Urea is a screening or diagnostic test?

A

screening

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13
Q

You should have no urea in the blood (T/F)

A

False- a small stable amount of urea should be in the blood due to its constant filtering process

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14
Q

What is urea?

A

waste product developed by the body to rid the body of acidic nitrogen

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15
Q

What plays a role in excretion of urea?

A

kidneys and “gut”

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16
Q

what does a build up of urea usually mean?

A

kidney disease

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17
Q

the initial indicator of a kidney problem could be found by using what test?

A

BUN:Cr ratio

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18
Q

What level will rise when the kidneys cannot filter Urea out of the body anymore?

A

BUN

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19
Q

high BUN:Cr ratio indicates?

A

(high BUN: normal Creatinine) - usually indicates there is a blockage or not enough fluid for the kidneys to filter

  • BPH (obstruction)
  • dehydration
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20
Q

Low BUN:Cr ratio indicates?

A

(normal BUN: high Cr)

  • muscle breakdown
  • malnutrition
  • liver disease
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21
Q

Azotemia

A

abnormal buildup of waste products in the blood due to dysfunction of the kidneys and inability to clear these substances

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22
Q

Uremia

A

The symptomatic phase of renal failure

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23
Q

What symptoms are associated with uremia?

A

fatigue, loss of interests, loss of appetite

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24
Q

What kind of patients would you associate with uremia?

A

alcoholics and those with liver disease

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25
Q

What are the 3 tests to test for GFR?(renal function/disease)?

A
  1. 24 hour creatinine clearance
  2. cockcroft-gault formula
  3. MDRD - modification of diet and renal disease
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26
Q

What is a good initial screening urine test for renal dysfunction?

A

24- hour creatinine clearance

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27
Q

What does a 24 hour creatinine clearance measure?

A

creatinine levels of the urine VS creatinine levels in the serum

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28
Q

over the age of ____, ______ declines by _____.

A

over the age of 30-40 - creatinine clearance - declines by 0.8ml/min

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29
Q

What does the GFR measure?

A

measure of serum Cr levels to determine the amount of plasma filtered by the kidneys in a given time

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30
Q

What do you need to make sure you do when a patient performs a 24 hour creatinine clearance ?

A

Get a serum creatinine within those 24 hours

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31
Q

What are the measurable waste products excreted by the kidneys?

A

urea, creatinine, uric acid

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32
Q

What happens as GFR is reduced?

A

Waste retention is occuring (since the kidneys are not filtering)

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33
Q

what does a steady decline in GFR potentially mean?

A

end stage renal disease

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34
Q

What does the cockcroft-gault formula adjust for?

A

age, weight, gender

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35
Q

what goes MDRD take into account?

A

age, race, gender

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36
Q

is serum or urine creatinine levels used in cockcroft gault and MDRD

A

serum

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37
Q

How much protein is being lost in nephrotic syndrome?

A

> 3.5 g/day

38
Q

what are the ways to analyze protein ?

A
  1. Total protein
  2. Spot albumin: creatine ratio
  3. Spot Protein:creatinine ratio
  4. 24-hr urine collection
39
Q

What is a spot albumin:creatinine ratio an accurate estimate of?

A

24 hour urine albumin excretion

40
Q

what is a 24 hour creatinine clearance testing for?

A
  1. proteinuria

2. creatinine clearance

41
Q

abnormal protein level in urine

A

150mg/24 hrs

in diabetics = >30 mg/24 hours

42
Q

what is microalbuminuria indicative of?

A

kidney disease

43
Q

what makes albumin?

A

the liver

44
Q

Anything that causes injury to a cell will cause ___ to rise?

A

Potassium

45
Q

Ca2+ and ____ have an inverse relationship?

A

PO4^3- (phosphate)

46
Q

sodium (intracellular or extracellular)

A

extracellular cation

47
Q

Potassium (intra or extra)

A

intracellular cation

48
Q

Chloride (intra or extra)

A

extracellular anion

49
Q

Calcium (intra or extra)

A

extracellular cation

50
Q

phosphate (intra or extra)

A

intracellular anion

51
Q

Protein (intra or extra)

A

intracellular

52
Q

Aldosterone affects what portion of the kidneys?

A

DCT

53
Q

ADH affects what portion of the kidneys?

A

Collecting ducts

54
Q

recommended amount of dietary sodium

A

<1500

55
Q

What 2 hormones regulate the amount of Na+

A

ADH and aldosterone

56
Q

HYPOnatremia is caused by

A

fluid loss - diarrhea, vomiting, HF, addison’s disease( addison eats low sodium - hyponatremia)

57
Q

HYPERnatremia is caused by

A

trauma, shock, surgery, - decreased blood flow to the kidneys, any free water loss

58
Q

HYPOnatremia symptoms

A

nausea, seizures, coma, death

59
Q

HYPERnatremia symptoms

A

thirst, dry flushed skin, fatigue, confusion, muscle twitch, death

60
Q

What usually follows closely with sodium?

A

Chloride (Cl)

61
Q

What causes chloride levels to fluctuate?

A

same thing that causes Na to fluctuate

62
Q

Hypochloremia symptoms

A

muscle tetany, hypotension, shallow breathing

63
Q

Hyperchloremia symptoms

A

lethargy, weakness, deep breathing

64
Q

if potassium levels are abnormal what do you do?

A

retake the levels

65
Q

what could elevate potassium?

A

hemolysis, potassium sparing diuretics, cardiac arrest, chronic or acute renal failure, drugs (abx, K sparing diuretics, ace inhibitors, lithium), dehydration , ACIDOSIS

66
Q

What could decrease Potassium levels?

A

drugs (loop diuretics, laxatives, insulin, kayexalate) dietary deficiency, diarrhea and vomiting, cushing syndrome, ALKALOSIS

67
Q

what will irregularities of potassium cause?

A

heart issues

68
Q

How do you treat high potassium?

A

the meds that lower potassium

69
Q

Bicarbonate is what

A

the level of CO2 in the blood

70
Q

What does Bicarb do?

A

acts as acid/base buffer for the body

71
Q

What decreases Bicarbonate?

A

renal failure, DKA, starvation, metabolic acidosis (CKD with decreased renal function is common in this)

72
Q

Increase in bicarbonate

A

COPD (causes a build up in PCO2 )which is used in making bicarb, metabolic alkalosis

73
Q

increased bicarbonate levels is seen in _____osis

A

alkalosis

74
Q

decreased bicarbonate levels are seen in _____osis

A

acidosis

75
Q

Lab tests test for _____ calcium

A

total

76
Q

you need to know what to find the free level of calcium

A

serum albumin

77
Q

If someone is having a neuromuscular issue, what could it be?

A

calcium

78
Q

what is pertinent in neuromuscular conduction and many metabolic processes?

A

Magnesium

79
Q

What is calcium usually bound to?

A

a protein- albumin

80
Q

most common cause of hypercalcemia

A

hyperparathyroidism

81
Q

Low Phosphate = ____ calcium

A

high calcium

82
Q

Hypercalcemia symptoms

A

anorexia, nausea and vomiting, somnolence, confusion, constipation

83
Q

What is associated with hypercalcemia?

A

Bones , Stones , Groans, Psychic overtones

84
Q

What could chronic renal failure mean?

A

Vitamin D deficiency –> in turn calcium deficiency

85
Q

Why would you have hypocalcemia with pancreatitis?

A

the pancreas is key in absorption of nutrients

86
Q

Why would magnesium deficiency potentially cause hypocalcemia ?

A

magnesium plays a key role in parathyroid hormone production and regulation

87
Q

symptoms of hypocalcemia

A

convulsions, arrhythmias, tetany (also in hypochloride), paresthesias

88
Q

Chvostek’s sign

A

twitch of the facial muscles in response to tapping over the facial nerve

89
Q

Trousseau’s sign

A

carpopedal spasm that results from ischemia, pressure placed to upper arm causes spasm

90
Q

What determines phosphorus levels?

A

Calcium metabolism, PTH, renal excretion, intestinal absorption

Lab diagnostics (6 decks)

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