OTC devices Flashcards by o e

How do urine tests work?

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

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

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How are urine samples collected?

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

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How accurate are urine tests?

-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

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What is detected by pregnancy tests?

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

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

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

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How sensitive should a pregnancy test be?

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

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When should patients seek medical consultation for pregnancy tests?

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

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What triggers a false positive pregnancy test?

-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)

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

-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

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When can a fertility test be considered?

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

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What are different fertility test devices?

-> predict OVULATION

-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

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How are patients tested for UTIs?

-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

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Reasons for OTC UTI testing:

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

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What are the triggers for errors in UTI tests?

-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

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What are ways to test for drugs?

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

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What are ways to test for drugs?

-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)

How do urine drug tests work?

-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

What are the limitations of urine tests?

-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

What can cause false results of drug tests?

-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

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

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

-Hair tests: detects long-term use

HIV prodispones

How do HIV Blood Tests work?

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

How do HIV home tests work?

-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

How does Hepatitis C tests work?

-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

What are the categories for blood pressure?

-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)

How accurate are blood pressure devices?

-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

Advantages of blood pressure monitors:

-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

Disadvantages of BP monitors:

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

What are the BP measurement instructions?

-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)

What are other wearable devices?

-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

What is Transcutaneous Electrical Nerve Stimulation (TENS)?

-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)

What are Phone app add-ons?

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