Lab Part Duex Flashcards

1
Q

Urinalysis screening can test and assess for…

A

Renal Function
Endocrine or metabolic function
Urinary tract infection
Systemic diseases

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2
Q

How many methods of urine collection

A

Two, instrumental / non-instrumental

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3
Q

Non instrumental collection types

A

First morning void
Random urine specimen
Clean catch
24 hour

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4
Q

Instrumental collection types

A

Urethral catheterization
Suprapubic needle aspiration
Cath and bladder irrigation

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5
Q

Urine specimens should be analyzed within

A

1 - 2 hours

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6
Q

If unable to test immediately refrigerate urine within

A

3 - 6 hours

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7
Q

Specimens left at room temperature will soon decompose due to

A

Presence of bacteria

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8
Q

Changes in pH in urine will

A

Dissolve any casts that are present

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9
Q

If glucose is present in urine bacteria may..

A

Use it as a source of energy resulting in false negative glycosuria

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10
Q

Blood and casts may..

A

Deteriorate if left standing without any preservatives

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11
Q

Advantages/disadvantages of freezing urine

A

Advantage: transport or storage no cost

Disadvantage: may destroy formed elements

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12
Q

First morning void

A

Most concentrated

Recommended for chemical and microscopic examination

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13
Q

Random urine specimen

A

Collected anytime

Most convenient and common

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14
Q

Clean catch specimen

A

Specimen of choice for bacterial cultures

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15
Q

24 hour specimen

A

Gives quantitative results

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16
Q

Urethral catheterization

A

Not recommended for bacterial examination

If no other way can use
Marked obese patients

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17
Q

Suprapubic needle aspiration

A

Replaces cath for single urine sample

Avoids vaginal contamination

Bladder obstruction

Infants and young children

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18
Q

Cath and bladder irrigation

A

Vigorous transcatheter agitation

50-72 mL saline inserted into bladder

Optimum cellular sample for bladder epithelium

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19
Q

Types of sample analysis

A

Physical
Chemical
Microscopic

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20
Q

Normal volume urine in 24 hours

A

600-2000 mL average is 1500mL

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21
Q

Urine output can be related to

A

Fluid intake
Temp and climate
Amount of perspiration that occurs

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22
Q

Normal color of urine

A

Straw (light yellow) to dark amber

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23
Q

Dark orange urine due to

A

Pyridium used for UTI

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24
Q

Milky white urine due to

A

Chyle

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25
Q

Olive green to brown black urine due to

A

Phenols

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26
Q

Yellow to brown urine due to

A

Presence of bile

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27
Q

Red or red-brown urine due to

A

Presence of blood

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28
Q

Physical characteristics of Urine

A
Volume
Color
Turbidity
Odor
Specific gravity
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29
Q

Normal urine turbidity is

A

Clear

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30
Q

Turbid alkaline due to

A

Amorphous phosphate or carbonate

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31
Q

Turbid acidic urine due to

A

Amorphous urates (pinkish)

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32
Q

Characteristic odor of urine is due to

A

Volatile acids (not considered to be of diagnostic importance

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33
Q

Sweet or fruity urine smell due to

A

Ketones

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34
Q

Pungent smell due to

A

Ammonia from bacteria

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35
Q

Maple syrup smell due to

A

Maple syrup urine disease

Congenital metabolic disorder

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36
Q

Musty or foul odor

A

Infant with phenylketonuria

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37
Q

Sweaty feet urine smell due to

A

Isovsleric acidemia

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38
Q

Specific gravity of urine

A

Weight of the urine / fluid intake

Random urine: 1.003 - 1.035
24 hour: 1.015 - 1.025

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39
Q

Chemical finding in urine analysis

A
Glucose
Ketones
Occult blood
Bilirubin
Urobilibogen
pH
Protein
Nitrite
Leukocyte esterase (LE)
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40
Q

Glucose will appear in urine once the threshold level of ________ in the blood is exceeded

A

160-180 mg/dL

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41
Q

Ketones present in the urine may indicate

A

Diabetes Mellitus
Starvation
Keto diet
Eclampsia

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42
Q

Occult blood in urine may have what color

A

Red and “Smokey”

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43
Q

Presence of blood in urine is termed

A

Hematuria

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44
Q

RBCs present in urine may be from..

A

Damage to kidneys or urinary tract
Renal diseases
Menstrual contamination or exercise

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45
Q

Bilirubin may appear in urine in patients who have conditions that cause

A

Jaundice

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46
Q

Bilirubin color of urine

A

Yellow to brown (green with foam when shaken)

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47
Q

Bilirubinuria indicates

A

Hepatocellular disease

Infra or extra-hepatic biliary obstruction

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48
Q

Urobiligen is present in urine in concentrations of

A

1 EU or less. Amounts up to 1mg/dL is normal

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49
Q

pH range of urine

A

4.6 to 8.0. Average is around 6.0

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50
Q

Conditions that may cause acidic urine

A
Respiratory or metabolic acidosis l
UTI
E. Coli
Uremia 
Severe diarrhea 
Starvation
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51
Q

Conditions that cause alkaline urine

A

UTIs caused by proteus or pseudomonas

Respiratory or metabolic alkalosis

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52
Q

Protein in urine is a good indicator of

A

Renal disease

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53
Q

Mechanisms of proteinuria

A

Glomerular damage

Defect in reabsorption process

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54
Q

Nitrite is formed by the breakdown of nitrates by organisms that cause

A

UTIs

Bacteria presence in urine indicates UTI

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55
Q

Esterase is an

A

Enzyme

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56
Q

Inflammatory process in or around the urinary tract

A

Leukocyturia

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57
Q

Minimal proteinuria value

A

< .5g/day

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58
Q

Moderate proteinuria value

A

.5 - 3.5g/day

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59
Q

Significant proteinuria value

A

> 3.5g/day

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60
Q

A dipstick can detect as few as _____ RBCs HPF (High Power Field)

A

1-2 RBCs HPF

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61
Q

Presence of greater than 3 RBCs is considered

A

Abnormal

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62
Q

Persistent RBCs in urine may indicate

A

Glomerulonephritis
Kidney Stones
Cancer
Infection

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63
Q

Myoglobin is highly suggestive of

A

Rhabdomyolysis

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64
Q

A non-treponemal test for serologic detection of the antibody Reagin

A

Rapid Plasma Reagin

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65
Q

Treponema pallidum is

A

The causative agent of syphilis

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66
Q

Reagin is found in the ______ of patients with syphilis

A

Serum/plasma

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67
Q

Flocculation present the test is

A

Reactive (positive)

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68
Q

Flocculation is NOT present, the test is

A

Non-reactive (negative)

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69
Q

The confirmatory test for RPR testing

A

Fluorescent treponemal antibody-absorbed (FTA-ABS)

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70
Q

Positive FTA-ABS will show _______ if positive

A

Fluorescence

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71
Q

Venous blood for RPR should be collected in

A

Blood tube without anticoagulant for serum (Red/SST) and with anticoagulant (purple top) for plasma

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72
Q

RPR antigen suspension should be shaken vigorously for

A

10-15 seconds

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73
Q

Test card and controls should be on the rotator for how long

A

8 minutes at 100rpm

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74
Q

Reactive test flocculation ranges

A

Slight but definite
Minimum to moderate
Marked and intense

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75
Q

RPR controls should be run…

A

With each batch of tests

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76
Q

Antigen needle should be calibrated to

A

60 drops per 1mL

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77
Q

Purpose of monospot testing

A

To detect infectious mononucleosis

78
Q

Mononucleosis which is a self limiting disease caused by

A

The Epstein-Barr Virus

79
Q

Mono is typically seen in

A

Young adults and children less than 5

80
Q

Collect monospot samples in

A

Blood tubes with or without anticoagulant

81
Q

Test monospot sample within

A

24 hours if stored between 2-8 degrees C

82
Q

Latex reagent should reach ______ temperature

A

Room temperature (20-30 C)

83
Q

Positive monospot shows

A

Agglutination

84
Q

Negative monospot shows

A

Smooth, homogenous solution, no agglutination

85
Q

Parasitic infection caused by the introduction of protozoan organisms into the blood by the female anopheles mosquito

A

Malaria

86
Q

Plasmodium is the parasite in

A

Malaria

87
Q

Female anopheles inject _______ into humans

A

Sporozoites

88
Q

Sporozoites enter parenchymal cells of the liver and become

A

Schizonts

89
Q

Further sporozoite development in the _______ after RBC invasion

A

Liver

90
Q

Merozoites develop to form

A

Immature (ring stage) trophozoites

91
Q

Mature trophozoites develop into

A

Schizonts

92
Q

Gametocytes are derived from

A

Merozoites

93
Q

________ ingested by mosquito

A

Gametocyte

94
Q

Beginning of sexual reproduction, production of

A

In the Gametocyte and produces zygote

95
Q

Fertile zygote penetrates midgut wall of mosquito forming

A

Oocyst

96
Q

Oocyst matures, ruptures and releases

A

Sporozoites

97
Q

Sporozoites migrate to the salivary gland and then

A

Injected into new host

98
Q

How many species of malaria

A

Four

99
Q

Species of malaria

A

Plasmodium Falciparum
Plasmodium Vivax
Plasmodium Ovale
Plasmodium Malariae

100
Q

Characteristics of plasmodium Falciparum

A
Erythrocytic cycle (malignant teritan)
Fever every 48 hours or every 2nd day

Most fatal (intravascular hemolysis)

101
Q

Characteristics of plasmodium vivax

A
Eeythrocytic cycle (benign teritan)
Fever every 48 hours or every 2nd day

Most common

102
Q

Characteristics of plasmodium ovale

A
Erythrocytic cycle (benign teritan)
Fever every 48 hours or every 2nd day
103
Q

Characteristics of plasmodium malariae

A
Erythrocytic cycle (benign quartan)
Fever every 72 hours or every 3rd day
104
Q

Capillary collection for malaria

A

Lancet and collect in EDTA capillary tube

105
Q

Collection for venous blood for malaria

A

EDTA (purple top)

106
Q

Venous blood for malaria may be stored at 2-30 C for up to

A

3 days. If refrigerated allow warming to room temp (15-30 C)

107
Q

What must be present for malaria test to be valid

A

“C” control line

108
Q

Test result of T1 for malaria

A

Positive for P. Falciparum

109
Q

T2 result for malaria

A

Positive for P. Vivax, Malariae, or Ovale

110
Q

T1 and T2 result for malaria

A

Positive for P. Falciparum and other types of malaria

111
Q

Malaria test is negative if

A

Only the “C” line results

112
Q

Malaria samples must be obtained when

A

The patient is febrile

113
Q

Rapid malaria kit limitations

A

Patient must be febrile
Will only detect antigens
Must be confirmed by the NEPMU
Not used to monitor treatment

114
Q

Highly contagious, acute, viral infection of the respiratory tract

A

Influenza A and B

115
Q

Most common type of influenza

A

Influenza A

116
Q

Symptoms of Influenza

A
Fever
Cough
Sore throat
Runny nose
Muscle/body aches
Headaches
Fatigue
Double dragon
117
Q

Negative flu results show

A

Blue control line in the bottom third turns pink/purple. No other lines appear

118
Q

Flu A positive shows

A

Pink/purple control line AND second pink/purple line in middle third window

119
Q

Flu B positive test shows

A

Pink/purple control line AND second pink/purple in top third window

120
Q

When flu disease prevalence is low in a community what may occur

A

False positives

121
Q

When flu disease is high in the community what may occur

A

False negatives

122
Q

Basic Metabolic panel provides what?

A

Important baseline of patients basic physiology

123
Q

Hyponatremia may indicate

A

Over hydration

124
Q

Hypernatemia may indicate

A

Dehydration and need for water

125
Q

Low Urea nitrogen may indicate

A

Over hydration or liver disease

126
Q

Elevated urea nitrogen may indicate

A

Impairment of renal function (50-150 mg/dL)

127
Q

99% of the bodies calcium is located where?

A

Bones and teeth

128
Q

High and low CO2 levels made associated with

A

High: respiratory acidosis
Low: respiratory alkalosis

129
Q

How long do you shake the antigen suspension for monospot

A

10-15 seconds

130
Q

What is creatinine

A

Byproduct of creatine and produced in muscle. Can be used to measure renal insufficiency

131
Q

Most abundant extra cellular anion

A

Chloride

132
Q

Second most prevalent intercellular cation

A

Magnesium

If low can cause refractory hypokalemia

133
Q

What is involved in normal metabolism and energy production and needed for muscle contractility and neurologic functions

A

Phosphorous

134
Q

ALT and AST measure what

A

Hepatocellular damage

135
Q

What does albumin help maintain

A

Oncotic pressure

136
Q

Alkaline phosphates refer to

A

A group of enzymes. Can indicate biliary disease or liver damage

137
Q

What are bilirubin

A

A byproduct of breakdown of heme pigments in RBC

Can cause jaundice

138
Q

If the AST is twice the ALT and AST is rarely over 300… may indicate?

A

Alcoholic hepatitis

139
Q

Almost all prescription drugs can increase

A

ALT/AST levels

140
Q

Total protein is a screening for

A

Nutritional deficiencies and gammopathies

141
Q

What does a lipid panel measure

A

Total cholesterol
High density lipoprotein (HDL) cholesterol
Low density lipoprotein (LDL) cholesterol
Triglycerides

142
Q

How often should adults over 20 get a fasting lipid screening

A

Every 5 years

143
Q

Thyroid function tests check the function of what

A

Thyroid

144
Q

Free thyroxine (FT4) measures

A

Unbound T4 in serum

145
Q

What is the most accurate reflection of thryrometabolic status

A

Free thyroxine (FT4)

146
Q

Thyroid Stimulating Hormone (TSH)

A

Glycoprotein secreted by anterior pituitary gland.

Assesses true metabolic status

Hypo is high tsh
Hyper is low tsh

147
Q

A1C gives the big pictures of

A

2-3 months average glucose due to the 120 day life cycle of RBC

148
Q

Glucose normal value

A

70-100mg/dL

4-6% A1C

149
Q

Critical glucose levels

A

Low: < 40

High > 500

150
Q

What is the best indication of glucose homeostasis

A

Fasting glucose

151
Q

Major cause of high glucose

A

Type 1 and 2 diabetes

152
Q

Major cause of low glucose

A

Insulin overdose. Sulfonylureas and hypoglycemic agens

153
Q

An A1C of greater than 6.5% suggests

A

Poor control of glucose

154
Q

What are cardiac markers

A

Bio markers measured to evaluate heart function and cardiac muscles

155
Q

What is troponin

A

Protein located in the cardiac muscles

156
Q

Increase in troponin is indicative of

A

Myocardial infarction

157
Q

Troponin levels begin to rise within

A

3-12 hours and peak in 24 hours

158
Q

What is CK-MB

A

Enzyme found in cardiac muscles

159
Q

CK-MB begin to rise in

A

3-12 hours and peak in 24 hours

160
Q

Once Schizonts rupture, they release______

A

Merozoites

161
Q

Ring form of P. Falciparum color

A

Light blue circular structure with red chromatin dot

162
Q

Gametocyte (macro) of P. Falciparum of female look like

A

Curved sausage/banana with central large chromatic dot

163
Q

Gametocyte (micro) of male look like

A

Shorter and wider than female with rounded ends, diffused chromatin

164
Q

How is the flu transmitted

A

Coughing sneezing of aerosolized droplets

165
Q

Benefits of flu testing

A

Enable correct treatment
Reduce costs
Decrease inappropriate antibiotic use

166
Q

Read influenza test results how many minutes

A

15 minutes

167
Q

Test for flu within how many days

A

2-3 days

168
Q

Antivirals can be used for flu if within how long

A

48 hours

169
Q

What organ does malaria affect

A

Liver

170
Q

How does malaria travel through the body

A

Bloodstream / RBC

171
Q

Most deadly type of malaria

A

P. Falciparum, destroys RBCs

172
Q

Gold standard for confirming malaria

A

Thin and thick smear

173
Q

Hyperchloremia is seen in

A

Dehydration and acidemia

174
Q

Hypochloremia may result from

A

Vomiting or over hydration and alkalemia

175
Q

Hypokalemia is seen with…

A

Alkalosis, diuretic, alcoholism and fluid loss

176
Q

Potassium is the primary cation in

A

Intracellular space

177
Q

Low magnesium can cause

A

Refractory hypokalemia

178
Q

What is required for all urine tests

A

Confirmation test

179
Q

What gives urine its color

A

Urachrome

180
Q

Blue green urine due to

A

Methylene Blue

181
Q

What is the vehicle or antigen used to see the result of RPR

A

Carbon charcoal

182
Q

Mono causes increase of lymphocytes and monocytes causing the formation of

A

Heterophile antibody

183
Q

Malaria fevers coincide with the rupture of what

A

RBCs

184
Q

Most common malaria

A

Vivax

185
Q

How many microliters of blood used for malaria test

A

15

186
Q

How is Malaria Reagin added to test kit

A

2 drops on first pad, 4 on second pad

187
Q

What would constitute an invalid test

A

Control line not present

188
Q

malaria False positives could be caused from

A

Rheumatoid arthritis
Hep C
Babesia

189
Q

Smears should be done no more than

A

Hourly

190
Q

Flu pipette should have how many microliters

A

100

191
Q

If low potassium what do you need to fix first

A

Magnesium

192
Q

Total protein what levels will you see with malnutrition

A

Low