OTC devices

Question 1

How do urine tests work?

Answer 1

-Immunoassay: antibody binds to a substance in the urine (Protein, hormone (hCG), compound, drug)

-A color-changing reaction takes place indicating a positive result

Question 2

How are urine samples collected?

Answer 2

-Use first-morning urine – most concentrated
-apply midstream or dip into the clean urine collection cup
-wait and read the results

Question 3

How accurate are urine tests?

Answer 3

-High specificity, so a positive result is likely positive
-Vary in sensitivity -> a negative result might be a false negative -> an additional consideration might be needed

Question 4

What is detected by pregnancy tests?

Answer 4

-for hCG (human chorionic gonadotropin) released by the embryo

Question 5

On which day of the cycle should a pregnancy test be considered?

Answer 5

-Earliest: 5 days after ovulation
-most test are 99% accurate on day of missed period

Question 6

How sensitive should a pregnancy test be?

Answer 6

• <25mIU/mL hCG is best
• First Response has 6.3mIU/mL - high hCG sensitivity!

Question 7

When should patients seek medical consultation for pregnancy tests?

Answer 7

-If 2nd test is negative and menstruation has not begun (missed period)

Question 8

What triggers a false positive pregnancy test?

Answer 8

-Recent birth or miscarriage
-use of some fertility medications
-women who are perimenopausal
-women who have ovarian cysts
-ectopic pregnancy (egg grows outside of the uterus)

Question 9

Questions to ask to determine if a pregnancy test should be considered?

Answer 9

-Ask about the last menstrual cycle and the number of days since the last intercourse
-ask for medications, to check for interactions
-past use of pregnancy test and difficulties

Question 10

When can a fertility test be considered?

Answer 10

After 1 year of intercourse without becoming pregnant in women <35

Question 11

What are different fertility test devices?

-> predict OVULATION

Answer 11

-Digital thermometer: Detect 0.5-1℉ increase in temperature -> Movement, infections, food, talking, can throw off results

-Urine test: Detects LH surge and sometimes estrogen (not good for those with PCOS (hormone problems) bc of irregularities)
80% with 5-day testing, 95% with 10-day testing

-Monitoring with apps

Question 12

How are patients tested for UTIs?

Answer 12

-Urine culture

-infection often caused by E.coli and Klebsiella pneumonia

-Detects Leukocyte Esterase enzymes and/or Nitrite (increased sensitivity when both substrates are combined)
-90% detection rate when used properly

-morning urine, midstream
-if negative, test again on the 3 following days

Question 13

Reasons for OTC UTI testing:

Answer 13

-recurrency of UTI
-check if UTI is cleared after taking antibiotics

Question 14

What are the triggers for errors in UTI tests?

Answer 14

-False negative: Strict vegetarian diet (Nitrite), tetracycline,
vitamin C (blocks the enzyme and nitrite reaction)

-False positive: Dyes, blood, or medication that can change
color of urine or strip

Question 15

What are ways to test for drugs?

Answer 15

-Urine test
-Hair test
-Saliva test (only for employer-based programs, not OTC)

Question 16

What are ways to test for drugs?

Answer 16

-Urine test
-Hair test: Detects drug use over a 90-day period in a 1.5 inch
sample (has to grow 5-7 days from scalp)
-Saliva test (only for employer-based programs, not OTC)

Question 17

How do urine drug tests work?

Answer 17

-mostly dip test, test for specific substances; single or up to 14 panels
-make sure the device actually detects the preferred substance
-for home or can be sent to the lab

Question 18

What are the limitations of urine tests?

Answer 18

-It doesn’t determine the route of ingestion or the quantity
-substances show up in urine after a couple of hours and can last for days or weeks

Question 19

What can cause false results of drug tests?

Answer 19

-Medications: Decongestants, dextromethorphan,
antidiarrheals, or cough medicines containing codeine can
cause false positives -> may have similar drug structure

-Food: large quantities of poppy seeds -> interacts with opioids

Question 20

How to choose an OTC drug test?
Urine or hair test?

Answer 20

-Urine tests can be done at home or sent to the lab
-> better for detecting low-level

-Hair tests: detects long-term use

Question 21

HIV prodispones

Question 22

How do HIV Blood Tests work?

Answer 22

-Has to be mailed to a lab
-result in 3-7 days
-some come with telemedicine to start treatment, and support for patients

Question 23

How do HIV home tests work?

Answer 23

-can be done at home
-results in 20 min
-HIV is unlikely if the test was negative and the risk event was longer than 3 months ago
-Don’t eat, drink, or use oral care products (toothpaste) for 30 minutes before testing
-if positive make an appointment with the doctor immediately

Question 24

How does Hepatitis C tests work?

Answer 24

-Blood test -> has to be mailed to the lab 99% accurate
-results in 2-7 days
-positive results should be confirmed with a HepC RNA test and get vaccinated for Hep B and A

Question 25

What are the categories for blood pressure?

Answer 25

-Normal: <120 (systolic) and <80 (diastolic)
-Elevated: 120-129 and <80
HTN 1: 130-139 to 80-89
HTN 2: >140 to >90

systolic: heart contracts (higher number of pressure, cut off circulation on the arm and slowly loosen it -> the first pressure measured is the systolic)
diastolic: heart ventricles are relaxing (measured when the pressure on the arm cuff is loosened further)

Question 26

How accurate are blood pressure devices?

Answer 26

-home devices are less accurate than FDA-approved ones, especially for patients with big arms

-digital devices should meet the standards of ANSI (must not differ by >3 mmHg or 2% from referent device)

most accurate: manual blood pressure device (if done correctly) -> then automatic arm devices (for patients with big arms, the wrist device should be used) -> wrist devices

Question 27

Advantages of blood pressure monitors:

Answer 27

-Shown to improve BP control, medication adherence, and
allow for more frequent measuring
-Can distinguish sustained HTN from white coat HTN
-Can assess response to antihypertensive medications
-cost-effective, widely available, automated devices

Question 28

Disadvantages of BP monitors:

Answer 28

-Lack of validation to ensure consistent accuracy and reliability
-Possible self-modification of drug therapy
-Lack of medical supervision

Question 29

What are the BP measurement instructions?

Answer 29

-don’t smoke, drink alcohol or caffeine, no exercise 30 min before measurement
-rest in a chair for 5 min with your arm resting on the table
-sit still, with the feed flat on the ground and the back should be supported
-take two readings, 1 min apart
-place the cuff above the elbow - elevated to heart level
-take pressure at the same time every day (morning and evening before taking meds)

Question 30

What are other wearable devices?

Answer 30

-Smartwatches, rings, bracelets, sensors that can measure ECG, blood oxygen (many watches), blood pressure, temperature
-devices must be FDA approved
-FDA approved Electrocardiogram (ECG) monitors can detect Atrial Fibrillation (Apple, Samsung, Google Pixel devices -put finger on it)
-Oura ring: monitor oxygen levels, track HR, temperature, sleep, and cycle tracing

Question 31

What is Transcutaneous Electrical Nerve Stimulation (TENS)?

Answer 31

-treat pain with low electric current, which can block pain or sensation of pain
-pads are placed near the site of pain, but not on the head
-watch out for pacemakers
-used for Osteoarthritis, fibromyalgia, tendonitis, low back pain, diabetes-related neuropathy, peripheral artery disease
-no real evidence of efficacy (some studies say it work, some say its placebo)

Question 32

What are Phone app add-ons?

Answer 32

-Microscopes, Skin Analysis, Ocular, Otoscope
-look at eyes or eyes, take pictures or videos to be sent to health care provider
-FDA approved