Basic Lab Tests Flashcards
(102 cards)
1
Q
Serum and Plasma are
A
The liquid portion of blood
2
Q
An individual who is _____ for a laboratory test has a test result that is on the unhealthy/abnormal side of the lab test value cut-off
A
“Positive”
3
Q
An individual who is ____ for a lab test has a test result that is on the healthy/normal side of the lab test value cut-off
A
“Negative”
4
Q
False positives are
A
people who tested “positive” but do not have the disease
5
Q
False negatives are
A
people who tested “negative” but do have the disease
6
Q
Sensitivity is the
A
measure of the test’s ability to detect persons who have the disease or abnormal health condition (true positives)
7
Q
Specificity is
A
the measure of how well the test excludes the possibility of of a particular disease or abnormal health condition (true negatives)
8
Q
_____ are composed of amino acids and have highly defined molecular structures that determine their function inside and outside of the body’s cells
A
Proteins
9
Q
Are a special class of proteins
A
Enzymes
10
Q
Enzymes
A
build or break down other proteins, sugars, lipids, or genetic structures
11
Q
Abnormally high levels of glucose in blood and/or urine are a potential indication of what?
A
Impaired glucose tolerance and/or Diabetes
12
Q
Hemolysis is
A
the rupture of RBCs
13
Q
Lipemia is
A
The presence of high concentrations of lipid (fats) in serum
14
Q
2 origins of lipemia include
A
- Postprandial hyperlipidemia following a high fat meal
2. Genetic makeup
15
Q
Glycolysis is
A
The loss of glucose due to RBCs and WBCs consuming (metabolizing) the glucose
16
Q
Are tests that provide a more reliable estimates of a proposed insured’s average glucose level (2)
A
Hemoglobin A1c and Fructosamine
17
Q
The pre-fix milli indicates
A
1 thousandth
18
Q
The pre fix micro indicates
A
1 millionth
19
Q
The pre-fix nano indicates
A
1 billionth
20
Q
Blood samples are collected by
A
Venipuncture
21
Q
A non fasting status has the largest effect on
A
Trigs
22
Q
What is the preferred method for samples collected internationally
A
Dried Blood Spot (DBS)
23
Q
Dried Blood Spot (DBS) can detect (6)
A
- ) HIV
- ) Cocaine
- ) Cotinine
- ) Cholesterol
- ) GGT
- ) Hemoglobin A1c
24
Q
Routine Testing for urine only can include: (6)
A
- Cotinine
- Cocaine
- Protein
- Antibody to HIV
- Presence of RBCs and WBCs
25
Oral fluid is
not saliva but a fluid extracted from the gum by the blotting material on a swab)
26
_____, _____, ______ samples require no processing prior to testing
Urine
Oral Fluid
Whole Blood
27
A "reflex" test occurs when
in response or is a reflex to an initial lab test result
28
The best measure of renal filtration function is
the Glomerular filtration rate (GFR)
29
eGFR is calculated by
using age, sex, and serum creatinine
30
Urine Creatinine is
a breakdown product of muscle metabolism
31
Excess loss of ___ into the urine is an indicator of glomerular disease
albumin
32
Causes for albuminuria include
damage to the kidney from HBP and/or impairment of the kidney's ability to reabsorb small proteins (tubular proteinuria)
33
____ is a worrisome finding in a diabetic because it is associated with a substantial increase in both all-cause and cardiovascular mortality
Albuminuria
34
When urine albumin level is between 30-300 mg/day the condition is referred to as
Microalbuminuria
35
What is the definitive test for classification of the degree of diabetic risk
Hemoglobin A1c
36
Clinical diagnosis of diabetes is made when
A1c is greater than 6.4%
37
Hematuria is
the presence of RBCs in the urine
38
Leukocyte esterase
is an enzyme present in WBCs
39
Hemoglobin is
the protein present in RBCs
40
Why is Cotinine used in the detection of tobacco rather than Nicotine
The clearance rate from the body for cotinine is substantially longer than nicotine at 16-18 hrs (it has a long-term retention)
41
True or false
Second hand smoke will cause a positive test result
False
42
True or false
Cotinine testing cannot differentiate cigar or nicotine substitutes from cigarette smoking
True
43
The 3 tests routinely run on oral fluid samples are
HIV
Cocaine
Cotinine
44
Which tested population has the highest prevelance of HIV, Cocaine, and Cotinine
Oral fluid
45
Repeat positive samples for HIV are tested with
a recombinant protein dot blot
46
Acute Hepatitis can be caused by (6)
1. viral infection (mononucleosis)
2. drugs
3. alcohol abuse
4. heavy metal poisoning
5. environmental toxins
6. acute obstruction of the portal vascular system (blood vessels) that drains the liver
47
LFTs elevated from 3-10 times the upper limit of normal are a marker of what?
Acute Hepatitis
48
True or False
With acute hepatitis, liver enzyme elevations with return to normal in less than 4 months
False - 6 months
49
Chronic Hepatitis is defined as
Liver enzyme elevations lasting longer than six months
50
Liver enzyme levels in chronic hepatitis can vary from:
normal to 3 times the upper limit
51
Common causes of chronic hepatitis are (4)
Non-alcoholic fatty liver, over the counter anti-inflammatory drugs (NSAIDS), Hep B or C, and alcohol abuse
52
Low ___ and ____ (usually in conjuction with low _____ and high _____ levels) are associated with what
AST and ALT
Albumin
Globulin
high excess mortality
53
True or False
An active infection can be present, even if "e" antigen is negative
True
54
In what percentage of adult infected individuals does Hepatitis B become chronic in
.5 to 2%
55
What is the leading cause of liver failure and transplantation
Hep C
56
True or False
If infected as a child the percentage that hepatitis B becomes chronic is 25-90%
True
57
Hepatitis C becomes chronic in
70-85 % of infected individuals
58
What is the definitive test for HCV
molecular test for Hep C RNA (HCV-RNA)
59
Fructosamine measures the amount of
glucose that becomes attached to sermum proteins
60
What is the gold standard test for the evaluation of diabetic risk
Hemoglobin A1c
61
What are different names for Hemoglobin A1c (4)
HbA1c
Glycohemoglobin
Glycated hemoglobin
glycosylated hemoglobin
62
What are the 4 LFTs
GGT
ALT
AST
AP
63
Except for ____, they lack specificity for liver disease due to their presence in other non-hepatic tissue
ALT
64
ALT and AST are elevated in most
cases of hepatic disease
65
AST elevation can be associated with
Alcohol damage to the liver and fibrosis
66
What are the most frequent causes of minor elevation of ALT (very common) and AST (much less common)
1. fatty liver
2. non-alcoholic steatohepatitis (NASH)
Both of which are associated with obesity
67
Alkaline Phosphatase (AP) elevation by itself can indicate what
extrahepatic origin for the enzyme (usually a bone disorder)
68
If GGT and AP are both elevated what is usually present
biliary obstruction
69
If only GGT is elevated what is the cause
Drugs, alcohol, or other conditions
70
True or False
There is not a strong connection between GGT elevation and cardiovascular risk
False
71
Indirect markers for alcohol use are (4)
1. High HDL levels
2. LFT elevations (esp GGT)
3. Smoking
4. Low BUN
72
What are the 2 alcohol screening tests
CDT and HAA
73
Confirmed CDT positive samples are correlated with
Chronic alcohol abuse
74
LDL transports cholesterol
from the liver to the peripheral tissues
75
High LDL levels are associated with
increased cardiovascular risk
76
HDL transports cholesterol
from peripheral tissues back to the liver
77
Low HDL is a risk factor for development of
Coronary Artery Disease (CAD)
78
ApoE4 is potential marker for what
Alzheimer's disease
79
Metabolic syndrome consists of and how many factors need to be present
1. ) Elevated cholesterol
2. ) Elevated trigs
3. ) Elevated glucose
4. ) HTN
5. ) Low HDL in the presence of Obesity
3 of 5 need to present
80
How is proBNP produced
in response to increased stress on the heart muscle and/or heart failure
81
_____ is an independent predictor of mortality. It can be abnormal when other markers for cardiovascular disease and risk factors are normal
NT-proBNP
82
What is the function of the kidneys
remove waste products, excess water, salts, and toxins from the blood
83
____ act as a selective mechanical filter, allowing for the passage of small proteins and water soluble substances into the urine
Glomeruli
84
What is BUN
a by product from the breakdown of protein
85
Decreased BUN levels occur as a result of
a diet low in protein and with severe liver disease
86
elevated BUN, in combination with creatinine is used to evaluate
renal function
87
Bilirubin is
a breakdown product of the heme component in hemoglobin
88
Increased serum bilirubin can be due
either liver disease or biliary obstruction
89
Globulin is comprised of
immune proteins such as immunoglobulins, or antibodies
90
High levels of immunoglobulins can indicate
1. an acute or chronic infection
2. myeloma
3. or recently cleared infection
91
Myeloma is
a cancer of certain white cells
92
Uric Acid is
a metabolic product from the building blocks of DNA and RNA
93
PSA is screening marker for what
Prostate cancer
94
PSA levels increase in
cancer, benign prostatic hypertrophy (BPH), and prostatitis
95
If free PSA is 25% or higher what does that indicate
cancer risk is lower
96
CEA is a screening marker for what
Gastrointestinal, lung, and breast cancers
97
BRCA1 and BRCA2 are screening marker for
Breast and ovarian cancer
98
CA-19-9 is screening marker for
Gastrointestinal cancer
99
Alpha fetoprotein (AFP) is screening marker for
Liver and germ cell cancer
100
HCG is screening marker for
germ cell cancer
101
The CBC includes (9)
```
RBC count
Erythrocyte count
WBC count
Lymphocyte count
macrophage count
granulocyte count
platelet count
hematocrit
Hemoglobin
```
102
Differential includes (4)
```
The morphology (size and shape) of red cells
% of each white cell type
Absolute percentage of each type
Any unusual cells detected
```
