UA Exam 2 Flashcards

1
Q

What are Bense jones proteins?

A

Small light chains of immunoglobulin produced by the neoplastic plasma cells

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2
Q

BJ proteins are not detected with a routine urinalysis ? T/F

A

True

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3
Q

When there is presence of BJ proteins throughout the urine this signifies?

A

Abnormal growth of plasma cells in the body which could lead to serious disorders

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4
Q

What are some of the serious disorders that can be seen when there is presence of BJ proteins in the Urine ?

A
  • Multiple myeloma (BJ proteins are found in 50-80% of patients with this disease
  • Chronic lymphoblastic Leukemia
  • Lymphoma
  • metastatic lytic bone lesions
  • waldenstrom macrobulinemia
  • end stage of renal failure
  • amyloidosis
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5
Q

What is multiple myeloma?

A

Cancer of the plasma cells, a type of white blood cell normally responsible for producing antibodies.

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6
Q

In multiple myeloma, collections of abnormal plasma cells accumulate in the ______, where they ______ with the production of normal cells.

A

Bone Marrow

Interfere

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7
Q

What are some of the common symptoms for Multiple myeloma ?

A
CRAB 
C= calcium elevated 
R= renal failure 
A= anemia 
B= Bone lesions
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8
Q

What are some clinical manifestations for Multiple Myeloma ?

A
  • bone pain
  • fractures of the bones due to lytic processes
  • low counts of RBC’s,WBC’s, Platelets
  • kidney damage
  • nervous system signs *stroke like manifestations *numbness and weakness
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9
Q

What is human chorionic gonadotropin (hCG) ?

A

Hormone produced by placenta or malignant tumors

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10
Q

When is HCG typically found in the urine?

A

Pregnancy

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11
Q

When HCG is found in the urine of males and non-pregnant women what types of disorders are usually seen?

A
  • testicular and ovarian cancers
  • choriocarcinoma in females
  • some types of cancers, pancreas, liver, lungs
  • teratoma
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12
Q

When there are low levels of HCG in a pregnant woman this may indicate?

A
  • miscarriage
  • death of baby or embryo
  • ectopic pregnancy
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13
Q

High blood level of HCG can be used to screen for what between 15-20 weeks of pregnancy?

A

Downs Syndrome

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14
Q

Schillings test is used to determine?

A
  • Megaloblastic anemia
  • Nervous system pathology due to a vitamin B12 deficiency
  • General malabsorption
  • whether the body adequately absorbs vitamin B12
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15
Q

Low vitamin B12 level in food or diet (megaloblastic anemia) can be seen in what stage of schillings test?

A

Stage 1

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16
Q

Low intrinsic factor (problems with the stomach) causing the low vitamin B12 level (pernicious anemia) can be seen in which stage of schillings?

A

Stage 2

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17
Q

Abnormal bacterial growth causing low vitamin B12 absorption in the illeum (celiac disease, Crohn’s disease) can be seen in which stage of schillings test?

A

Stage 3

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18
Q

Low vitamin B12 absorption caused by problems with the pancreas (malabsorption syndrome, pancreatitis) can be seen in which stage of schillings?

A

Stage 4

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19
Q

When are toxicology screens typically ordered?

A
  1. Hospital emergency
  2. Sports
  3. Workplace
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20
Q

Traces of a drug may remain in the urine longer than in the blood? T/F

A

True

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21
Q

How long is marijuana present in the urine?

A

Present in the urine for 1 hour after use up to 7-10 days

In heavy users- up to 30 days

22
Q

How long is cocaine present in the urine ?

A

Present in the urine 1-4 hours after use for up to 2-5 days

Heavy users= 7-10 days

23
Q

How long are amphetamines in the urine?

A

Present in the urine about 3 hours after use for 1 to 2 days

24
Q

How long can alcohol be present in the urine?

A

6-24 hours

25
Q

How long are steroids found in the urine?

A

3 to 30 days

26
Q

Most toxicology tests determine only the presence of drugs in the body (so called qualitative testing) and not the specific level or quantity? T/F

A

True

27
Q

What is the gold standard for all urinary testing?

A

Urine toxicology test

28
Q

Product of the metabolic breakdown of purine nucleotides?

A

Uric Acid

29
Q

Normal Uric acid concentrations?

A

250-750 milligrams per 24 hours

30
Q

What types of disorders are seen when there is to much Uric acid present in the urine (hyperuricosuria)?

A
  • Gout
  • metastatic cancer
  • multiple myeloma
  • cancer chemo
  • high purine diet
  • leukemias
  • intake of uricosuric drugs- ascorbic acid, calcitonin, estrogens, steroid, salicylates
31
Q

What types of things are seen when there is a decrease in the amount of Uric acid in the urine (hypouricosuria)?

A
  • Kidney diseases
  • eclampsia
  • chronic alcohol ingestion
  • lead toxicity
32
Q

What does the creatinine clearance test measure?

A

Measures how well creatinine is removed from the blood by the kidneys and how well the kidneys are working

33
Q

Does the creatinine clearance test require both a urine sample as well as a blood sample?

A

Yes

34
Q

What substance is formed in the liver through an enzymatic protein breakdown ?

A

BUN )blood urea nitrogen

35
Q

What does BUN measure?

A

Kidneys excretory function

Liver metabolic function

36
Q

What are the normal levels of BUN in the blood?

A

6-20mg/dl in the blood

37
Q

Blood urea nitrogen levels may be increased physiologically through:

A

High dietary protein intake

In athletes with a lot of muscle mass

38
Q

Abnormally high levels of BUN and Creatinine is collectively known as ?

A

AZOTEMIA

39
Q

What are the three types of azotemia?

A
  1. Pre renal - without primary involvement of the urinary system
  2. Renal- due to primary kidney disease
  3. Post renal- due to primary lower urinary tract involvement
40
Q

When there’s a decrease in BUN levels what pathologies may result?

A
  • liver failure
  • over hydration
  • negative nitrogen balance ( a diet low in protein, malabsorption)
41
Q

Which gland contains contains the most Acid phosphatase?

A

Prostate gland

42
Q

Acid phosphatase concentration is high in the blood? T/F

A

False it is usually low in the blood

43
Q

When there is an increase in acid phosphatase what medical conditions may be present?

A
  • prostate cancer that has metastasized to the bone
  • systemic infection
  • anemia
  • multiple myeloma
  • thrombophlebitis
  • Paget’s disease
  • hepatitis
  • kidney disease
44
Q

Blood tests on acid phosphatase can determine from which tissue the enzyme is coming (eg. From the prostate or RBC) ? T/F

A

True

45
Q

What is prostate specific antigen?

A

Protein that is produced by the prostate gland

46
Q

When is prostate specific antigen elevated

A

Elevated in men with prostate problems (benign pathologies or cancer)

47
Q

The Prostate specific antigen test must be analyzed in conjunction with?

A

Digital rectal examination

48
Q

When there is high levels of Prostate specific antigen (PSA) and an enlargement of the prostate during a digital rectal exam this may indicate :

A

Benign prostate hyperplasia

Prostatitis (mostly due to venereal disease)

49
Q

High levels of Protein specific antigen and a normal or small sized prostate on a digital rectal exam may indicate?

A

Prostate Cancer…

50
Q

What is the AKA for aspartate amino transferase (AST)?

A

Serum glutamic oxaloacetic transaminase

Found in Liver, cardiac muscle,skeletal muscle, kidney, pancreas, brain, RBC