Flashcards in Basic Laboratory Testing Deck (116)
A sample positive for proteinuria can become negative when what calculation is applied, and why?
urine is more concentrated in the morning than at night, so we apply the creatitine calculation.
what disease tipicallt causes an excess of albuminuria?
glomerular disease, followed by kidney disdease, damage to kidney from HTN, and tubular proteinuria.
Which disease has a great increase of mortality when albuminuria is present?
diabetes- d/t cardiovascular mortality
albumin makes up approx. one half of urinary protein excretion. What diease, causes that percentage to increase
kidney disease. early stages, cause minor changes, when the level is between 30-300, the condition is microalbuminuria, when its above that its called albuminuria.
IF urine test +ve for glucose what test is reflexed on the BW?
when should a blood sample be collected, in terms of amount of glucose in the urine?
when its greater than 0.05g/dL.
what is leukocyte esterase, and hemoglobin?
an ezyme present in WBC, a protein present in RBC.
If a urine test is +ve for Leukocyte esterase
examined by flow cytometery (sophisticated automated microscope) to count RBC and WBC.
what are some possible explinations to why there is hematuria?
infection, glomerulonephritis, kidney-ca, and UTI, disease of metabolism, or possible collection of adftifact in menstruating females.
what is the magic number of RBC to be considered a risk?
what level of hematuria appears to be associated with increased risk for females > 60 years old or less?
what are urine casts?
aggregates of proteins or red or white cells. theyre formed from the inside wall of the kidney tubules.
in 2010, what was the leading cause of accidental death in young females?
many drug samplings are the same, use cocaine as an example. How is cocaine usage determined?
when sample is +Ve for metabolits, the presence is varified by gas chromatography mass spectroscopy (GCMS) or by LCMSMS,. each drug produces a unique finger print.
Every insurance company tests for cocaine, what are some other common tests run by insurance companies?
marijuana, and amphetamine. The following are just common drugs of abuse:
opiates, PCP, barbituates,
what is the half-life of nicotine (through the blood system)
one to two hours, but a smoker will typically test positive for cotinine 1-3 days after last sue.
what is cotinine? How long is it in the body?
it is the metabolite of nicotine, converted by the liver. The clearance rate is 16-18 hours. Teh specificity of this test is 99.0% accurate.
Cotinine, is detected in 9-29% of insurance samples. Approx. How many of the cotinine possitive samples are applying as non-tobacco users?
1/3-1/2. When confronted with a denial of use, the original sample can be tested with GCMS or LCMSMS, to confirm.
can a cotinine test differentiate between cigar, or nicotine substitutes from cigarrette smoking?
does UTI affect the morality of a person?
no, the exception to this could be chronic infection of the kidney or bladder
what 3 tests are typically run on saliva?
HIV, cotinine, and cocaine. the normal range for saliva test results is different than for urine and blood.
is the preverlance of HIV, cocaine, and contine higher in the savlia-tested population than in any other proposed insurance group?
how long does it take for infected individuales to produce antibodies (HIV) ?
4-8 weeks. thats why all initially reactive samples are tested in duplicate to verify the result.
what test is prefroemd, when repeating HIV +ve sampled?
western blot. This confirms +ve diagnosis, although with increasing sensitivity of the initial antibody test, this test may be replaced by HIV_RNA.
in most insurances cases, a -ve test will be reported to the UW, but a +ve would be reported to the MD. True or false?
what is hepatitis?
inflammation of the liver.
What is acute hepatitis?
caused by infection of hep virus, (A,-E) or by viral infection (mononucleosis), non-viral infection (drugs, alcohol, metal poisoning, toxins, acute obstruction of blood vessles that drain into the liver).
what is the marker for acute hepatitis?
Liver enzyme elevated from 3-10x normal, and will return to wnl, in 6 months.
What is chronic hepatitis?
liver enzyme elevations lasting longer than six months. caused by non-alcoholic fatty liver, anti-inflammatory drugs, hepatitis c or b, and alcohol.