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PPS - obesity > Point of care testing > Flashcards

Point of care testing Flashcards

1
Q

What is the first thing needed to be done in order to diagnose a patient?

A

Take an extensive history

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2
Q

What are the next steps after taking history?

A

Investigations required to confirm or reject diagnosis

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3
Q

What are characteristics of type II diabetes?

A

Polyuria

Foot ulcer

Thirst

Obesity

High blood pressure

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4
Q

What are questions to ask to obtain a good history?

A

Smoking

Drinking

Diet

Levels of activity

Family history

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5
Q

What is point of care testing?

A

Tests that can take place beside the patient to confirm the diagnosis

Diagnosis is rapid

Confirm or refute the diagnosis

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6
Q

What are the advantages of POCT?

A

Convenient and quick

Care must be taken to train and monitor operators to ensure quality and accuracy

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7
Q

What are examples of POCTs?

A

Blood pressure measurement

Ultrasound using portable devices

Dipstick urinalysis

Blood glucose measurement

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8
Q

What are characteristics of type II diabetes?

A

A metabolic disorder associated with obesity

Characterised by

  • hyperglycemia
  • resistance to insulin
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9
Q

What are diabetic neuropathies?

A

Affect those with both type I and type II diabetes

Family of nerve problems which produce a variety of symptoms including

  • numbness
  • balance problems
  • muscle weakness
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10
Q

Which factors contribute to diabetic neuropathies?

A

Microvascular disease - may reduce blood supply to the nerves

Aberrant glycation of proteins - alters their structure and function

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11
Q

What percentage of people with type II diabetes show signs of complications by the time they are diagnosed?

A

50%

Include

  • poor wound healing
  • gangrene
  • foot ischaemia
  • ulceration
  • intermittent claudication
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12
Q

What apparatus is used to measure blood pressure?

A

Sphygmomanometer

Blood pressure chart

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13
Q

What is used to measure BMI?

A

Tape measurement around the waist

BMI chart

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14
Q

What do urinalysis tests test for?

A

Blood

Glucose

Leukocytes

Ketones

Nitrite

pH

Protein

Specific gravity

Urobilinogen

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15
Q

How do dipstick tests test for glucose?

A

Oxidation reaction in the strip pad

Glucose oxidase enzyme in the strip catalyses the oxidation of glucose to form gluconic acid and hydrogen peroxide

H2O2 reacts with a reduced dye in the test strip producing a colour change

The colour change is proportional to the amount of hydrogen peroxide produced

The colour produced is compared to a reference chart to estimate the concentration of glucose present

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16
Q

How is urine collected for urine dipstick tests?

A

Urine should be collected midstream in a sterile container by the patient

17
Q

How is urine placed on the urine dipstick test stick?

A

Test operator dips the dipstick into the urine

Gently wipes away excess using the container rim

Dipstick should be held horizontally for the required time (30s-120s) to prevent chemicals from the strip from mixing

18
Q

What are the colour changes on the dipstick used for?

A

Used to approximate the levels of the various compounds by comparison to the chart on the side of the bottle

19
Q

What are other types of tests that can be ordered?

A

More complex tests

20
Q

What do more complex tests require?

A

Processing in a specialist pathology laboratories

Samples must be collected from the patient and sent to the correct department

Critical that the patient samples are accurately and fully labelled

21
Q

How are pathology requests sent?

A

Online system

22
Q

What information does the request form contain?

A

Patient identity - name, DOB, hospital number

Who and where the request is from

Type of sample

Date and time of collection

Clinical details, why test has been requested, urgency

23
Q

What tests are ordered by the GP in suspicion of diabetes?

A

Full blood count

Blood test for type 2 diabetes - glycated haemoglobin

Lipid profile

24
Q

How is a lipid profile carried out?

A

Performed after overnight fast of 10 hours

Patient attends blood test clinic

Regulates an aspect of the lipid profile

PPS - obesity (6 decks)

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