CM LECTURE / Sir Errol Coderes Flashcards
1
Q
Chain of infection require a continuous link between:
A
“SMS”
Source
Method of transmission
Susceptible host
2
Q
What are the 6 components of the chain of infection?
A
“IREMES”
Infectious agent
Reservoir
Exit of portal
Mode of transmission
Entry portal
Susceptible host
3
Q
Personal protective equipment
A
Gloves
Gowns
Eye and face shields
Countertop shields
4
Q
The primary method of infection transmission
A
Hand contact
5
Q
The best way to break the chain of infection or best way to prevent infection
A
Handwashing
6
Q
Handwashing procedure
A
Wet hands with warm water
Apply antimicrobial soap
Rub to form a lather, create FRICTION and loosen debris
Thoroughly clean between fingers, including thumbs, under fingernails and rings, and up to the wrist for at least 15 or 20 seconds
Rinse hands in a DOWNWARD position
Dry with a paper towel
Turn off faucet with a clean paper towel to prevent contamination
7
Q
If hands are visibly soiled, ______
A
Wash hands
8
Q
If hands are NOT visibly soiled, ______
A
Apply sanitizer
9
Q
The handwashing song
A
Happy Birthday Song (twice)
10
Q
All biological waste, must be placed in appropriate containers labeled with _______ symbol, except _____.
A
Biohazard; Urine
11
Q
The accepted biohazard label is _______ color
A
Fluorescent Orange
12
Q
Discard urine by pouring it into the ________ , avoid splashing , and then flush with water
A
Laboratory sink
13
Q
True or False.
Empty urine containers can be discarded as nonbiologically hazrdous waste
A
TRUE
14
Q
Disinfection of the sink using a _________ should be done ______
A
1:5 or 1:10 dilution of Sodium Hypochlorite (10% bleach) ; Daily
15
Q
_______ eliminates many or all pathogenic microorganisms, except the bacterial spores
A
Disinfection
16
Q
Disinfectant is effective for ______
A
1 month
17
Q
The basic outline of the biohazard symbol is a plain trefoil, which is ___________ .
A
Three circles overlapping each other equally
18
Q
Sharps are disposed in _________
A
Red puncture-resistant containers
19
Q
An accidental needlestick must be reported to the ______
A
Supervisor
20
Q
Best first aid for Chemical spills
A
Flush the area with amounts of water for at least 15 minutes then seek for medical attention
21
Q
For alkali or acid burns in the eye, wash out eye thoroughly with _____ for _____
A
Running water ; for 15 minutes
22
Q
True or False.
Neutralize chemical that come in contact with the skin
A
FALSE
DO NOT NEUTRALIZE chemicals that come in contact with the skin
23
Q
True or False.
Acid spills on floors can be neutralized and then soaked up with wet rags or spill pillows
A
True
24
Q
In chemical handling always add _____ to _____
A
Always add ACID to WATER, to avoid plashing. An explosion can occur if water is added to acid
25
Color of Reactivity / Stability hazard in the NFPA symbol
Yellow
26
Color of Specific hazard in the NFPA symbol
White
27
Color of Health hazard in the NFPA symbol
Blue
28
Color of Flammability / Fire hazard in the NFPA symbol
Red
29
In reactivity or stability hazard, what number is classified as violent chemical change
Number 2
“SUV in SM”
0 - Stable
1 - Unstable if heated
2 - Violent Chemical Change
3 - Shock and heat may detonate
4 - May detonate / detonate
30
In health hazard, what number is classified as extreme danger
Number 3
“NSHED”
0 - Normal
1 - Slightly hazardous
2 - Hazardous
3 - Extreme danger
4 - Deadly
31
In flammability or fire hazard, what number is classified as below 73 F
Number 4
0 - Will not burn
1 - Above 200 F
2 - Below 200 F
3 - Below 100 F
4 - Below 73 F
32
Degree of hazard classified as number 3
Serious
“No SMS Ex”
0 - No / minimal
1 - Slight
2 - Moderate
3 - Serious
4 - Extreme / severe
33
True or False.
Do NOT operate electrical equipments with wet hands
True
34
All electrical equipment is grounded in a _______ to avoid electric shock
3-pronged plug
35
If electrical shock occurs, never touch the person or the equipment involved. What are the three things you should do? (In order)
TURN OFF the circuit breaker
UNPLUG the equipment
MOVE the equipment
36
Flammable chemicals should be stored in _______ and _______ away from heat sources.
Safety Cabinets and Explosion-proof Refrigerators
37
All laboratory personnel must be involved in laboratory fire drills at least _______
Annually / once a year or every year
38
When fire is discovered what should you do?
“RACE”
Rescue
Alarm
Contain
Extinguish / Evacuate / Exit
39
To operate a fire extinguisher …
“PASS”
Pull
Aim
Squeeze
Sweep
40
Type of fire: Ordinary combustible solids
Class A fire
“A tigas” — solids
41
Type of fire: Flammable liquids
Class B fire
“B-asa”— liquids
42
Type of fire: Electrical equipment
Class C fire
“eleCtrical” — eleCtric
43
Type of fire: Flammable metals
Class D fire
“meDals” — metals
44
Type of fire: Detonation (Arsenal Fire)
Class E fire
“E-xplosives” — detonate/explode
45
Type of fire: Cooking media like oils, fats …
Class K fire
“K-itchen”
46
Water can be used as fire extinguisher for what class of fire?
Class A fire
47
Dry chemical can be used as fire extinguisher for what class of fire?
Classes A, B and C fire
48
Dry chemical and halon can be used as fire extinguisher for what class of fire?
Classes B and C fire
49
The most common all purpose extinguisher
Dry Chemical Extinguisher
50
Type of fire/s that should be handled only by trained personnel
Class D and Class E fire
51
These hazards are work-related and include strain due to repeated positions
Ergonomic Hazards
52
These are hazards due to extremely low temperatures
Cryogenic Hazards
53
These hazards include centrifuges, refrigerators, autoclaves, homogenizers, and glasswares
Mechanical Hazards
54
Centrifuge accidents or improper removal of rubber stopper from test tubes may produce _____
Aerosol
55
The kidney weighs _____ and measures ____ in length, ____ in width and _____ in depth
The kidney weighs 150 g, and measures 12.5 cm x 6 cm x 2.5 cm
56
How long is the ureter in cm?
Ureter is 25 cm long
57
Bladder when approximately _____ ml urine accumulates a nerve reflex is initiated
150 ml
58
Urethra is ___ cm long in men and ___ cm long in men
Urethra is 4 cm long in women and 24 cm long in men
59
About how many seconds does small amounts of urine are emptied into the bladder from the ureters
10 - 15 seconds
60
True or False.
Urine is actually a fluid biopsy of the kidney
True
61
It is the basic structural and functional unit of the kidney
Nephron
62
How many nephrons are there in PER kidney
1 to 1.5 million nephrons per kidney
63
Two types of nephron
Cortical and Juxtamedullary nephrons
64
Order of Urine Formation
“Go Pro LDC CaRe”
Glomerulus
Proximal Convoluted Tubule (PCT)
Loop of Henle
Distal Convoluted Tubule (DCT)
Collecting Duct
Calyx
Renal Pelvis ( “ RUBU “ Renal pelvis — Ureter — Bladder — Urethra )
65
In renal blood flow, the kidneys receive ____ % of the total cardiac output
25 %
66
Total renal blood flow = ____
1200 mL / min
67
Total renal plasma flow = _____
600 - 700 mL / min
68
Renal blood flow order
“RAGE PVR”
Renal Artery (blood in)
Afferent Arteriole
Glomerulus
Efferent Arteriole
Peritubular Capillaries
Vasa recta
Renal Vein (blood out)
69
The “working portion” of the kidney
Glomerulus
70
Resembles a sieve
Glomerulus
71
Non-selective filter of plasma substances with MW of ____
<70 kDa
72
Approximately ___ % of the filtered plasma volume is actually excreted in the urine
1 %
73
Albumin is negative, unless at pH ___
< 4.9
74
Glomerular filtrate specific gravity = ____
1.010
75
The first function to be affected in renal disease
Renal tubular reabsorption
76
The plasma concentration at which active transport stops
Renal Threshold
77
Renal threshold for glucose
160 - 180 mg/dL
78
True or False.
PCT, LH, DCT & CD alter urine concentration
True
79
It is the major site (65 %) of reabsorptiion of plasma substances
PCT
80
Renal concentration begins in the _____ and ____
Descending and Ascending LH
81
Solute concentration is highest in the ____
LH (Renal Medulla)
82
It is highly impermeable to water
Ascending Loop of Henle
83
Reabsorbs water
Descending Loop of Henle
84
Reabsorbs salt, but NOT water
Ascending Loop of Henle
85
Active transport substnaces
Glucose
Amino acids
Salts
Sodium
Chloride
86
Passive transport substances
Water
Urea
Sodium
87
It is the movement of a substance across cell membranes into the bloodstream by electrochemical energy
Active Transport
88
It is the movement of molecules across a membrane by diffusion because of a physical gradient
Passive Transport
89
It regulates water reabsorption in the DCT and CD
ADH / Vasopressin
90
Condition associated to ADH deficiency
Diabetes Insipidus
91
Condition associated with ADH excess
SIADH (Syndrome of Inappropriate ADH secretion
92
Regulates sodium reabsorption in the DCT
Aldosterone
93
Converts angiotensinogen to angiotensin I
Renin
94
Inactive form
Angiotensin I
95
Converts angiotensin I to angiotensin II
ACE (Angiotensin Converting Enzyme)
96
Effects of angiotensin II
Release of Aldosterone and ADH ( Increases Sodium and Water Reabsorption )
Vasoconstriction (Increase Blood Pressure )
Corrects renal blood flow
97
Cells that produces the renin in the afferent arteriole
JG cells
98
Detects decrease in BP
Macula Densa
99
Actions of RAAS
Dilates afferent arteriole and constricts efferent arteriole
Stimulates sodium reabsorption in the PCT
Triggers adrenal cortex to release aldosterone to cause sodium reabsorption and potassium excretion in the DCT and CD
Triggers release of ADH by the hypothalamus o stimulate water reabsorption in the CD
100
Two major functions the renal tubular secretion
Regulation of acid-base balance in the body through secretion by hydrogen ions
Elimination of waste products not filtered by the glomerulus
101
The major site or removal of nonfiltered substances
PCT
102
Failure to produce an acid urine due to inability to secrete hydrogen ions
Renal Tubular Acidosis
103
Blood pH in RTA
Acidic
104
Urine pH in RTA
Alkaline / Basic
105
Used to evaluate glomerular filtration
Clearance Tests
106
Most common clearance test
Creatinine
107
Gold standard or reference method for clerance tests
Inulin
108
Better marker of renal tubular function than GFR
Beta 2 -microglobulin
109
It is a measure of the completeness of a 24 hr urine collection
Creatinine Clearance
110
By far the greatest source of error in any clearance procedure utilizing urine is ____
The use of improperly timed urine specimens
111
Around ___ % of creatinine is secreted by the renal tubules
7-10 %
112
Useful to detect and monitor kidney disease
eGFR ( Estimated GFR )
113
Variables in the estimated GFR formula developed by Cockgroft and Gault
Age
Sex
Body Weight in kg
114
Variables in MDRD System formula
Ethnicity
BUN
Serum Albumin
115
Recommended formula by the NKDEP for GFR
MDRD - IDMS
116
Used to evaluate tubular reabsorption
Concentration Test
117
A test wherein patient is deprived of fluid for up to 24 hrs
Fishberg Test
118
Test wherein patient maintains normal diet and fluid intake
Mosenthal Test
119
Recently used tests for tubular reabsorption, influenced by the number and density of particles in a solution
Specific Gravity
120
Recently used tests for tubular reabsorption, influenced by the number of particles in a solution, more accurate and preferred than SG determiantion
Osmolality
121
Most commonly used and reference method for tubular secretion and renal blood flow
PAH test (p-aminohippuric acid)
122
Discovered uroscopy, one who first documented the importance of sputum examination
Hippocrates
123
Discovery of albuminuria by boiling urine
Frederik Dekkers
124
He wrote a book about “pisse prophets” (charlatans)
Thomas Bryant
125
Introduced examination of urine sediment
Thomas Addis
126
Introduced urinalysis as part of doctor’s routine patient examination
Richard Bright
127
Discovered urochrome
Ludwig Thudichum
128
Cerebrospinal fluid
Domenico Cotugno
129
Phenylketonuria
Ivan Folling
130
Alkaptonuria
Archibald Garrod
131
Orthostatic or cyclic proteinuria
Frederick William Pavy
132
Cystine Calculi
William Wollaston
133
Benedict Reagent
Stanley Benedict
134
Urine is composed of ___ % water and ____ % solids
95-97 % water and 3-5 % solids
135
Total solids in urine for 4 hrs
60 grams solids = 35 g organic and 25 g inorganic
136
Major organic component of urine
Urea
137
Major inorganic component of urine
Chloride > Sodium > Potassium
138
Principal salt in urine composition
NaCl ( sodium chloride )
139
Type of specimen used for routine screening tests and qualitative urinalysis, ideal for cytologic studies only if with prior hydration and exercise 5 mins before collection
Random / Occasional / Single
140
Ideal specimen for routine screening / urinalysis and pregnancy testing ,often preferred for cytology studies / cytodiagnostic urine testing, most concentrated and most acidic and use for evaluation of orthostatic proteinuria
First Morning
141
2nd voided urine after a period f fasting, use for glucose determination
Second Morning / Fasting
142
Type of specimen used for diabetic screening or monitoring and is preferred for testing glucose
2-Hour Post-Prandial
143
Used in the diagnosis of diabetes
Fractional Specimen
144
For routine screening and bacterial culture (OPD) ,and patients should thoroughly cleanse his glans penis or her urethral meatus before collection
Midstream Clean Catch
145
May be urethral or ureteral, and is used for bacterial culture
Catheterized
146
Abdominal wall is punctured, and urine is directly aspirated from the bladder, bladder urine for anaerobicbacterial culture and cytology
Suprapubic Aspiration
147
Used for prostatic infection
Three Glass Technique
1 — first portion
2 — middle portion
3 — Urine after post massage
148
If the number of WBCs and bacteria in the 3rd spx is 10x greater than aht of the 1st
Prostatitis
149
Serves as a control for bladder and kidney function
2nd specimen
150
The four glass method used for prostatitis
Stamey-Meares Test
151
Number of WBCs in Stamey-Meares Test that is considered to be abnormal
10 - 20 WBCs
152
Specimen used for Addis count (for quantitation of urine sediments)
12 hour urine
153
Specimen used for nitrite determination
4 hour specimen
154
Specimen used for urobilinogen determination
Afternoon
155
Process providing documentation of proper ample ID from the time of collection to the receipt of lab results
COC ( Chain of Custody )
156
Required urine volume for drug specimen
30 - 45 mL
157
Urine container capacity for drug specimen
60 mL
158
Urine temperature for drug specimen
32.5 - 37.7 C
159
Added to the toilet water reservoir to prevent specimen adulteration in drug specimen collection
Bluing Agent ( dye )
160
Urine in drug specimen collection may possibly adulterated if pH is ____ and SG is ____.
ph > 9 and SG is < 1.005
161
Urine containers should have a wide base and has an opening of at least ___ cm
4 cm
162
24 hr urine containers should hold up to ____ and maybe ____ to protect light sensitive analytes
3 L ; colored
163
Addition of urine before the start of 24 hr collection period causes _____
False Increased Results
164
Failure to include urine at the end of 24 hr collection period causes ____
False Decreased Results
165
When both routine UA and culture are requested, the ____ should be performed first
Culture
166
Following collection, urine specimens should be delivered to the laboratory promptly and tested within ____; and ideally within _____.
2 hrs; 30 mins
167
Physical, chemical and microscopic characteristics of urine specimen begin to change as soon as it is ____
As soon as it is VOIDED
168
Increased in unpreserved urine
“PaBaON”
pH
Bacteria
Odor
Nitrite
169
Darkened or modified in unpreserved urine
Color
170
Decreases in unpreserved urine
“CGe Kay BURT”
Clarity
Glucose
Ketones
Bilirubin
Urobilinogen
RBCs / WBCs / Casts
Trichomonas
171
Preservative of choice for routine UA and routine culture, prevents bacterial growth for 24 hrs, but it precipitate amorphous phosphates and urates
Refrigeration
172
Preserves protein and formed elements ell, and does not interfere with routine analyses other than pH, it is bacteriostatic a 18 g/L , and is used for culture transport and C&S, but it interferes with drug and hormone analyses
Boric Acid
173
The excellent sediment preservative, it is the preservative of choice for Addis Count
Formalin or Formaldehyde
174
It prevents glycolysis, good preservative for drug analysis
Sodium Fluoride
175
Preserves cellular elements, and is used or cytology studies ( 50 mL urine )
Saccomano Fixative ( 50 % ethanol and 2 % carbowax )
176
Urine volume normal range (24 hrs)
600 - 2000 mL
177
Urine volume average ( 24 hrs )
1200 - 1500 mL
178
Night urine output
< 400 mL
179
Urine Volume Day:Night ratio
2 - 3 : 1
180
Container capacity for UA
50 mL
181
Required urine volume for routine UA
10 - 15 mL ( average: 12 mL )
182
Increased urine volume
Polyuria ( > 2000 ml / 24 hrs )
183
Decreased urine volume
Oliguria ( < 400 - 500 mL / 24 hrs )
184
Complete cessation of urine flow
Anuria ( < 100 mL /24 hrs )
185
Excretion of more than 500 mL of urine at night
Nocturia
186
Any increase in urine excretion
Diuresis
187
It is the rough indicator of the degree of hydration
Urine color
188
Normal urine color
Colorless to deep yellow
189
Most common abnormal color of urine
Red / Red brown
