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Chemical Pathology > Introduction To Chemical Pathology > Flashcards

Introduction To Chemical Pathology Flashcards

1
Q

What is the function of the chemical pathologist

A

To study the changes of the chemical constitution and the biochemical mechanisms of the body as a result of a disease

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2
Q

What is chemical pathology

A

The systematic study of biochemical processes with health and disease and the measurement of the constituents of body fluids to facilitate diagnosis of diseases

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3
Q

What are the various disciplines in clinical laboratory testing

A

Immunology
Virology
Genetics
Clinical biochemistry
Cytology
Clinical microbiology
Histopathology
Hematology and transfusion

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4
Q

What are the roles of chemical pathology in healthcare

A

Diagnosis
Treatment
Screening
Prognosis
Monitoring

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5
Q

What is a sample

A

Material for a patient for the investigation of the condition or disease

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6
Q

The quality of the results depends on the quality of …………..

A

The specimen/sample

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7
Q

What are some samples taken for analysis

A

White blood (plasma or serum)
Urine (spot collection - early morning, random, midstream or timely)
Body fluids (CSF, gastric fluid)
Solid tissues (hair and nail clippings potentially for drugs and heavy metal analysis)

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8
Q

What are some of the analytes tested for in the lab

A

Blood glucose
Electrolytes
Proteins and enzymes
Hormones
Lipids
Other metabolic substances

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9
Q

What is an analyte

A

A substance whose concentration is being tested for in the lab

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10
Q

Name some lipid profile tests

A

TG
TC
LDL
HDL
VLDL

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11
Q

List some tumor marker tests

A

PSA
CA 125

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12
Q

Mention some therapeutic drug monitoring test

A

Digoxin test

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13
Q

Blood tubes include a preservative and are color coded consistent with the anticoagulant used
True or false

A

True

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14
Q

What information do the color coded tubes communicate to you

A

It tells you which preservative is found the tube

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15
Q

What is the preservative used in a gray cap tube

A

Fluoride oxalate (for blood glucose analysis)

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16
Q

What is the function of fluoride oxalate in the gray colored tube

A

It prevents glucose metabolism (inhibition of glycolysis) in the tube. Anaerobically, the RBC can metabolize glucose in the sample thus giving you likely false reduced glucose levels

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17
Q

What is the preservative in the purple (mauve) cap tube

A

EDTA (to run glycated Hb - also used to monitor glucose levels in diabetic patients)

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18
Q

What is the preservative in the green cap tube

A

Heparin (for acid base analysis)

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19
Q

What is the function of the yellow cap tube (gel separator tube)

A

Used to separate the whole blood into serum and plasma

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20
Q

What are some factors to consider before collecting specimen

A

Patient’s diet (glucose, lipids)
Patient’s current medication (oral contraceptives, cough mixtures- could increase sugar concentration)
Time of day (diurnal variation) - iron and cortisol
Specimen container

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21
Q

What is venostasis

A

It is the prolonged use of tourniquet which raises plasma levels of analytes

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22
Q

How are samples preserved in transit

A

Blood gas analysis samples (PCO2 and PO2) must be kept at 4 degrees from the time sample is drawn or plasma is separated from cells)
Place the sample in a container of ice
Specimen from bilirubin and carotene must be kept from sunlight and fluorescent light to avoid photodegradation
Specimen for hormonal assays such as gastrin, rennin and parathyroid hormones must be separated from the cells in a refrigerated centrifuge

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23
Q

How are samples stored

A

Refrigeration keeps sample stable for about 7 days
For long term, store at <-80 degrees Celsius to prevent substantial degradation

24
Q

What are other names of chemical pathology

A

Medical biochemistry
Clinical chemistry
Clinical biochemistry
Pure blood chemistry
Physiological chemistry

25
Q

………. is at the center of all laboratory testing

A

The patient

26
Q

…………. is the clinical decision reached by a clinician after initial history and examination and laboratory investigations

A

Diagnosis

27
Q

………… is the application of medicine to treat/cure a diagnosed condition

A

Treatment

28
Q

…………… is the use of diagnostic testing to evaluate disease changes such as progression or response to therapy

A

Monitoring

29
Q

…………….. is used to investigate for presence of disease in an apparently healthy population or detection of disease before it is clinically evident

A

Screening

30
Q

…………… is the prediction of the clinical outcome of a disease or providing information on disease susceptibility. Eg. cholesterol can predict the risk of coronary artery disease

A

Prognosis

31
Q

List some examples of liver function tests

A

AST
ALT
ALP
GGT
BIL
TP

32
Q

List some bone profile tests

A

Calcium
Phosphate
ALP
ALB

33
Q

List some thyroid function tests

A

TSH
Free T4

34
Q

Give some examples of acid base tests

A

pH
pCO2
H2CO3
PO2

35
Q

Give some examples of carbohydrate metabolism tests

A

FBG
RBG
Ketone bodies
HBA1C

36
Q

List some examples of cardiac markers

A

Troponin
CK

37
Q

Give some examples of sex hormone tests

A

Estrogen
Testosterone

38
Q

Give some examples of adrenal hormone tests

A

Aldosterone
Cortisol

39
Q

Give some examples of specialized testing

A

Insurance testing
Occupational health testing
Drug of abuse testing
Environmental testing

40
Q

List the stages of the biochemical investigation process

A

Clinical question/Biochemical answer
Request form with clinical data
Patient sample
Transit to lab
Reception and ID
Analysis
Quality control
Collation
Interpretation
Reporting

41
Q

Every sample must be accompanied with a …………… for proper sample identification

A

Filled request form

42
Q

Mention three things the filled request form of the sample should have

A

Patient’s name, address and DOB
Time and date of sampling
The requests
Other information which might help interpretation (Eg. Patient’s sex, LMP, drug monitoring information)
Requesting clinician’s name

43
Q

What are some factors to consider at the time of collecting the specimen

A

Specimen container
Identification of specimen
Appropriate selection of equipment
Patient posture
Venostasis
Site of venipuncture
Haemolysis
Not collecting specimen through lines or catheters

44
Q

Point of care testing is also called

A

Ancillary testing
Alternative site testing
Near patient testing
Bedside testing
Physician office laboratory testing
Limited service laboratory testing
Out of laboratory testing

45
Q

What is point of care testing

A

It refers to tests performed outside the hospital laboratory by untrained healthcare professionals or non-laboratory personnel (bedside, clinic, by patients themselves at home)

46
Q

What are the categorizations of side room tests

A

Qualitative
Semi-quantitative or quantitative

47
Q

Qualitative tests are mostly performed on ……..

A

Urine

48
Q

An example of a qualitative test

A

Urine dipstick test

49
Q

Quantitative tests are mostly performed on …………….

A

Blood specimen

50
Q

An example of a quantitative test

A

Testing blood sugars using the glucometer

51
Q

What are some advantages of SRT

A

Spot/Small blood volume/
Turn around time (relatively short analysis time with immediate results)
Early treatment and shortens patient’s wait
Ease of use (can be performed by less trained personnel or by the patient themselves)
Promoter stabilization of life-threatening crisis (eg. drug overdose)
Closer therapeutic management
Better patient compliance with therapy (diabetes, hyperlipidemia)
Reduces repeat clinic/patient visits and length of stay in the hospital

52
Q

What are some disadvantages of SRT

A

Analytical performance can be inferior to lab
Risk of poor operator competence
Risk of poor equipment maintenance
Cost per test is relatively more expensive

53
Q

List some examples of qualitative commercially available POC tests

A

hcG
Drugs of abuse
Urinalysis

54
Q

List some examples of quantitative commercially available POC tests

A

Glucose
Blood gases
Electrolytes
Creatinine
HBA1c
Troponin

55
Q

Where are NPT devices useful

A

Accident and emergency (diagnosis of acute MI with a whole blood troponin NPT device, drug overdoses - plasma p’mol, cocaine)
Drug addiction clinics (alcohol breath test, roche diagnostics)
General practice, out-patient, clinics and wards (using urine dipstick testing for screening patients - UTI, urine protein)
Neonatal care and adult intensive care (Neonatal units: determination of blood bilirubin using bilirubinometers)
Patient self testing (eg. pregnant self-testing using over-the-counter pregnancy test kits)

56
Q

Roche diagnostics is used for qualitative testing in ………….

A

Ethanol in either saliva or urine

Chemical Pathology (16 decks)

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