Relevant Lab Procedures Including Lab Diagnosis And Treatment Of Infectious Disease Flashcards
State six lab investigations
●BLOOD TEST ●BIOPSY ●URINALYSIS ●LIVER FUNCTION TEST ●PAP SMEAR ●CHORIONIC VILLUS SAMPLING ●ENDOSCOPY ●ANGIOGRAPHY ●RENAL BIOPSY ●BONE MARROW ASPIRATION ●AMNIOCENTESIS
What are blood tests and state four uses of em
Blood tests are used to measure or examine cells, chemicals, proteins, or other substances in the blood.
•Blood test also known as blood work is one of the most common types of lab tests and are often included as part of regular checkups and are usually used to;
➢Help diagnose certain diseases and conditions
➢Monitor a chronic disease or condition, such as diabetes or high cholesterol
➢Find out if treatment of a disease working.
➢Check how well your organs are working. Your organs include your liver, kidney, heart, and thyroid.
➢Help diagnose bleeding or clotting disorders
➢Find out if your immune system is having trouble fighting infections
State two types of blood tests
State their uses
Abnormal levels of the components CBC measures indicate what?(mention four)
How long do basic metabolic panel tests require you to fast? And what does the time depend on?
Abnormal results of a BMP may indicate?(name three)
COMPLETE BLOOD COUNT This test measures the different parts of your blood, including red and white blood cells, platelets, and hemoglobin. Abnormal levels of these components may indicate ● nutritional deficiency, such as vitamin B6 or B12 ● Anemia( iron deficiency) ●Clotting problems ●Blood cancer ●Infections ●Immune system disorderS
•BASIC METABOLIC PANEL This is a group of tests that measure certain chemicals in your blood, including glucose, calcium and electrolytes. This test may require you to fast for at least 8 hours before your blood is drawn depending on the instructions of the doctor and what the test is measuring. Abnormal results may indicate ●Kidney disease ●Diabetes ●Hormone imbalance
What is biopsy
What is it used for?
State the five types of biopsies
State four examples of tests under needle biopsy
biopsy is a removal of tissue from any part of the body to examine it for disease.(if it’s benign,malignant or infectious)
•Nb. Biopsies are often done to look for cancers but can also help identify many other conditions.
- Types of biopsies.
- Bone marrow biopsy.
- Endoscopic biopsy.: Your doctor may use an endoscopy to collect tissue samples (biopsy) to test for diseases and conditions, such as anemia, bleeding, inflammation, diarrhea or cancers of the digestive system.
- Needle biopsy:
- Core needle:c ore needle biopsy uses a hollow needle to remove samples of tissue from the breast. It’s the standard and preferred way to diagnose breast cancer.
- Fine needle: Fine needle aspiration (also called fine needle biopsy) removes cells from a suspicious lump in the breast. The needle used is thinner than in core needle biopsy. Fine needle aspiration is only used for lumps that can be felt (palpable masses). While core biopsy obtains a larger tissue sample and provides a degree of architectural information, FNA is considered less invasive and has the advantage of immediate confirmation of adequacy by the attending cytologist.
- Image-guided biopsies.: An image-guided biopsy consists of the placement of a biopsy needle through the patients skin into an organ of interest using imaging for guidance. The most commonly used imaging modality are ultrasonography, and computer thermography (CT).
- Vacuum assisted.: When breast imaging shows up very small abnormalities too small to be felt (i.e. anything unusual in the structure of the breast), Vacuum-assisted core biopsy is used to obtain samples of the breast tissue. Through a small incision or cut in the skin, a special biopsy needle is inserted into the breast and, using a vacuum-powered instrument, several tissue samples are taken. The vacuum draws tissue into the centre of the needle and a rotating cutting device takes the samples.
- Skin biopsy
- Surgical biopsy.
State four conditions that require biopsies
State four complications of biopsies
CONDITIONS THAT REQUIRE BIOPSY.
•bone marrow diseases, such as myelofibrosis
•cancers of the bone marrow, blood such as leukemia or lymphoma.
•unexplained anemia, abnormal low blood cell count.: Do you need a bone marrow biopsy? Your doctor may order a bone marrow biopsy if your blood tests show your levels of platelets, or white or red blood cells are too high or too low. A biopsy will help determine the cause of these abnormalities, which can include: anemia, or a low red blood cell count
•skin lesions and rashes.
COMPLICATIONS OF BIOPSY. •excessive bleeding •infection •puncture damage •skin numbness around biopsy site.
What is urinalysis What is it used for? What does it involve? A complete urinalysis tests consists of how many components or examinations? Name em
urinalysis is a test of urine. It is used to detect and manage a wide range of disorders, such as urinary tract infections, kidneys disease and diabetes. A urinalysis involves checking the appearance, concentration and content of urine.
•A complete urinalysis consists of three components or examinations:
Physical,chemical and microscopic
What 5 things does the physical exam done in urinalysis describe?
What is the normal value of the volume of urine in adults?
Any abnormal result may indicate what?(state what it shows when it’s high or low)
What is the normal colour of urine?
If the urine is brown or black what does it mean?
If it’s dark yellow what does I rn mean?
If it’s green or blue what does it mean?
If it’s orange what does it mean?
If it’s pink or red what does it mean?
What is the normal appearance of urine?
Abnormal appearance may indicate what?
Physical examination
Describes the volume, color, clarity, odor and specific gravity.
●volume; normal value of 600 and 2,000 ml daily in adults. Any abnormal result may indicate anuria and oliguria showing a severe dehydration from diarrhea, hemorrhage vomiting or excessive sweating. A higher value may also indicate polyuria as result of alcohol intake or caffeine consumption, diabetes, increased water in take etc.
●Color; normal color is yellow( light or pale). Others colors have different indications for example
brown or black: bile pigments, chloroquine, levodopa
Dark yellow: concentrated specimen(dehydration, exercise)
Green or blue: amitriptyline, cimetidine
Orange: bile pigments, carrots
Pink or red: beets, hemoglobinuria, menstrual contamination.
● clarity; normal appearance is clear or translucent. Abnormal appearance may indicate bacteria infection, blood clots, contrast media, vaginal creams or secretions, yeast or non specific.
What four things does the chemical exam describe?
Urine pH provides insight into what?
What is the pH (slightly base or slightly acidic?)of normal urine and why?
What is the normal pH range of urine
Higher pH value may suggest what?
How values may suggest what?
Normal concentration of protein in urine is what?
Albuminuria of 30mg/day or more is an indicator of what ?
What is normal result of blood cells in the urine?
Hematuria may indicate what?
Hemoglobinuria may indicate what?
When does glycosuria occur?
At what glucose serum concentration does it occur at?
What will cause glucose in urine to be positive?
•CHEMICAL EXAMINATION
●PH
Urine pH is a vital piece of information and provides insight into tubular function. Normally urine is slightly acidic because of metabolic activity. Normal pH value od urine ranges from 4.5 to 8( usually 5.5 to 6)
Higher values may suggest stale or old specimems, hyperventilation, renal tubular acidosis, vegetarian diet.
Low values may also indicate dehydration, diabetes mellitus, DKA high protein diet, emphysema, etc.
●PROTEINS
Proteinuria is another critical finding. In normal conditions, the proteins are present in urine in trace amounts.
Normal concentration of proteins in urine is less than or equal to 150mg/day( typically albuminuria less than 30mg/day. Albuminuria of 30mg/day or more is an indicator of early renal disease, glomerular injury and risk of progression of renal disease.
●BLOOD CELLS; normal result is negative(usually) or less than or equal to 5 RBCs per ml
hematuria may indicate glomerulonephritis, tumors, trauma, anticoagulants, and hemoglobinuria may also indicate hemolytic anemias, RBC trauma strenuous exercise, transfusion reactions, severe burns, infections( ie malaria|)
●GLUCOSE; Glycosuria occurs when the filtered load of glucose exceeds the tubular cells’ ability to reabsord it, which normally happens at a glucose serum concentration of around 180mg per dL. Normal result is negative, however other associations may give a positive results: these associations may include diabetes mellitus, cushing syndrome, pregnancy.
What are the two main things ull look for in microscopic exam
Give four examples under each
What are casts
Why will RBC casts be present in urine?
Why who’ll WBC casts be present in urine?
Why will epithelial cell casts be present in urine?
Why will hyaline casts or fatty casts be present in urine?
Casts are divided in cellular and non cellular
URINALYSIS CONT’D
•MICROSCOPIC EXAMINATION
●CASTS
Casts are coagulum composed of the trapped contents of tubule lumen and tam -horsefall mucoprotein.presence of casts indicate more of a kidney disease than a UT disease
•Red blood cell casts are normally absent in urine. May be present due to glomerulonephritis, vasculitis, strenuous exercise.
•White blood cell casts are also absent in urine under normal conditions; its presence may indicate pyelonephritis, glomerulonephritis, renal inflammatory processes.
•Epithelial cell casts; normally absent, associations include acute tubular injury, renal disease, glomerulonephritis.
•Fatty casts: Fatty casts are seen in people who have lipids in urine. This is most often a complication of nephrotic syndrome . Granular casts are a sign of many types of kidney diseases. Red blood cell casts mean there is a microscopic amount of bleeding from the kidney.
•Hyaline casts: yaline casts are considered to be a nonspecific finding— they can be found in both healthy individuals and individuals with pathological conditions. The presence of hyaline casts typically indicates a decreased or sluggish urine flow, which can be a result of strenuous exercise, diuretic medications, severe vomiting, or fever. In combination with other clinical findings, large amounts of hyaline casts may indicate kidney damage due to decreased blood flow to the kidneys.
●CELLS •Red blood cells •White blood cells •Eosinophil •Epithelial cell •Bacteria, fungi or parasite
What is a liver function test
State five things it’s used to assess?
Why will ALt be increased?
Why will AST be increased and which three places is it found?(HML)
Why will ALP be increased and where is it found?(PBP)
Why will GGT be increased and how does it cause cholestasis
An isolated rise of ALP in the absence of GGT may increase suspicion of what?
•A test used to confirm a clinical suspicion of a potential liver disease, liver synthetic function and used to distinguish between hepatocellular injury and cholestasis.
•The LFT may be used to asses the following
●Alanine transaminase(ALT)
It is found in high concentration within hepatocytes and enters the blood following hepatocellular injury. It is therefore a usual marker of hepatocellular injury.
●Aspate amino transferase(AST)
It is found in the liver, muscle tissues and heart; raised levels may indicate liver and muscle damage as well as myocardial infarction.
●Alkaline phosphatase(ALP)
Found in the biliary system, bone and placenta; high levels indicates, bone break down, cholestasis and pregnancy.
●Gamma glutamyl transferase(GGT)
Get into the biliary system and cause cholestasis. Increased levels of GGT may suggest excess alcohol intake.
Increased plasma GGT in cholestasis may be a consequence of increased bile acid concentration or other bile constituents that stimulate the hepatobiliary synthesis and release of GGT similarly to ALP; however, GGT is considered a less sensitive but more specific indicator of cholestasis when compared with ALP.
NB: an isolated rise of ALP in the absence of GGT may increase the suspicion of non hepatobiliary pathology.
●Bilirubin, albumin and prothrombin time
What is bilirubin
What causes high levels of it
Patients with high levels of it may oresent with what
Where is albumin synthesized and what’s it’s function
Low levels of albumin may be caused by?
What doe patients w low albumin usually present with?
What is prothrombin time?
Which part of the body is responsible for clotting factors?
Which two things can increase prothrombin time
•BILIRUBIN
Is a breakdown product of hemoglobin and can be conjugated or non conjugated. An increased RBC distraction, hepatocellular injury, biliary obstruction can caused high levels of bilirubin. Patients with high levels of bilirubin may present with jaundice, dark urine and pale stool.
•ALBUMIN
●It’s synthesize in the liver and help bind water, cations, fatty acids and above all help in maintain oncotic pressure.
●Low levels of albumin may be caused by cirrhosis, nephrotic syndrome.
●Patients with low albumin usually present with edema, ascites.
- PROTHROMBIN TIME
- Is a measure of the blood’s coagulation tendency.
- The liver is responsible for clotting factors, therefore hepatic pathology can impair the process resulting in increased prothrombin time.
- The use of anti coagulants and vitamin K deficiency can increase prothrombin time.
What is a Pap smear
What does it involve
What does the HPV test detect?
What thee things does the Pap smear test detect?
How long does it take for Pap smear results to come back?
A positive result does not confirm a person has cancer but more investigation is necessary true or false?
pap smear, also called a pap test, is a procedure to test for cervical cancer in women. It involves collecting cells from your cervix for screening which allows doctors detect abnormal cells and cancer.
•Doctors also recommend the human papillomavirus(HPV) test which detects DNA from the HPV to reveal both its presence and type.
•These tests can detect
➢Precancerous cell changes
➢The presence of HPV
➢The presence of cancer
•PAP SMEAR RESULTS
The test results usually take 1 to 3 weeks to come back. Most test results are negative but sometimes be positive. Positive result does not confirm that a person has cancer, but more investigation is necessary.
What is endoscopy
What instrument is used to execute it(note that the term doesn’t apply to the other types of endoscopy cuz a cystoscopy is done using a cystocope and so on)
StTe two uses of endoscopy
State seven types of endoscopy
Endoscopy is a procedure thnat is used to view and operate on some internal organs and the blood vessels of the body.
•The instrument used in executing this procedure is known as the endoscoper
•The procedure is mainly done by a doctor or a surgeon
•Endoscopy can be used as a diagnostic tool and a surgical approach in treating some diseases
TYPES OF ENDOSCOPY
●Arthroscopy-joints(Arthroscopy (ahr-THROS-kuh-pee) is a procedure for diagnosing and treating joint problems)
●Bronchoscopy-lungs
●Colonoscopy
●Upper GI endoscopy
●Laparoscopy-pelvic and abdominal area(is a minimally invasive surgery or key hole surgery
●Hysteroscopy-uterus
●Cystoscopy: Cystoscopy is a procedure that lets the healthcare provider view the urinary tract, particularly the bladder, the urethra, and the openings to the ureters
What is an angiogram How is it done? What is it used for? When there’s a problem w the blood vessel what can happen? State five cases that need an angiogram
•Angiography or arteriography is a medical imaging technique used to visualize the inside, or lumen, of blood vessels and organs of the body, with particular interest in the arteries, veins, and the heart chambers.
This is traditionally done by injecting a radio-opaque contrast agent into the blood vessel and imaging using x ray based techniques such as fluoroscopy.
•This test is used to study narrow, blocked, enlarged, or malformed arteries or veins in many parts of your body, including your brain, heart. When blood vessels are blocked, damaged or abnormal in any way, chest pain, heart attack, stroke, or other problems may occur.
- Some suspected cases that you can request for angiography;
- Atherosclerosis – narrowing of the arteries, which could mean you’re at risk of having a stroke or heart attack
- Peripheral arterial disease – reduced blood supply to the leg muscles
- A brain aneurysm – a bulge in a blood vessel in your brain
- Angina – chest pain caused by reduced blood flow to the heart muscles
- Blood clots or a pulmonary embolism – a blockage in the artery supplying your lungs
- A blockage in the blood supply to your kidneys
State some common types of angiogram or angiography
And state three complications
ANGIOGRAPHY
•Common types include
•Coronary angiography – to check the heart and nearby blood vessels
•Cerebral angiography – to check the blood vessels in and around the brain
•Pulmonary angiography – to check the blood vessels supplying the lungs
•Renal angiography – to check the blood vessels supplying the kidneys
•Complications
●Bruising
●Soreness
●A very small lump or collection of blood near where the cut was made
