Laboratory Medicine Flashcards
(94 cards)
1
Q
Anatomic pathology includes
A
autopsy services, surgical pathology, cytology
2
Q
Autopsy service
A
infrequent due to costs, imaging procedures, malpractice
3
Q
Virtual autopsy
A
detailed body scan without dissection (becoming popular)
4
Q
Surgical pathology
A
specimen collected from surgery must be examined (gross appearance, tissue processing (paraffin) and staining (H&E, special stain)
5
Q
Cytology
A
pap smear, tissue brushings
6
Q
Should cancer be diagnosed by cytology tissue brushing?
A
No, cannot see cell arrangement, use biopsy
7
Q
Rembrandt, Dutch painter born in
A
1606
8
Q
Liffey Swim
A
annual swim in dublin
9
Q
Rembrandt had what famous painting in 1632
A
Abduction of Europa (oil-based)
10
Q
Who performs a fine-needle aspiration?
A
pathologist
11
Q
Pathologist do what procedures
A
fine-needle biopsy and surgical removal of tissue
12
Q
Clinical pathology includes:
A
Hematology, transfusion, microbiology, chemistry, immunology, STAT lab, point-of-care testing
13
Q
What type of specimen is used for ON-SITE diagnosis
A
frozen section
14
Q
Panic value
A
sufficiently abnormal lab result value that indicates an immediate threat
15
Q
Hematology - CBC
A
Measures Hgb, RBC count, and MCV; Calculates HCT, MCH, MCHC; WBC, platelets, % of WBCs, and RDW
16
Q
Hematology - CBC with diff
A
CBC + count of normal/abnormal WBCs, morphology included
17
Q
Hemoglobin is measured
A
measured from whole blood using CYANOMETHEMOGLOBIN formation
18
Q
Counts of RBC, WBC, and platelets are obtained by
A
cell counter that measures conductance of cells passing through a small aperture (electrical impulse indicates cell type)
19
Q
WBC population analysis
A
RBC lysis -> WBC automated flow cytometry (size, granules, shape, etc)
20
Q
Automated flow cytometry
A
single cell characterization by size, shape, biochemical, or antigenic composition, by a scattering of light beam
21
Q
Forward scatter in flow cytometry
A
diffraction = cell volume
22
Q
Side scatter in flow cytometry =
A
refraction = measures internal cellular granularity
23
Q
Pre-analytic phase
A
decision to perform test, specimen collection, etc
24
Q
Analytic phase
A
Specimen analyzed
25
Post-analytic phase
report + interpretation and response to result
26
Peripheral blood smear procedure
blood smear, Wright stain, view whole slide (large cells at edge)
27
Blood clotting times - initial screening
PT and PTT
28
PT (prothrombin factor) measures
extrinsic pathway and common pathway factors (thromboplastin + Ca + plasma) [warfarin]
29
PTT (partial thromboplastin time)
evaluates intrinsic pathway and common pathway (partial thromboplastin + activator + Ca + plasma) [heparin]
30
Coagulation factor assay is based on
PT: thromboplastin for factors II, V, VII, and X
PTT: partial thromboplastin for factors VIII, IX, XI, and XII *ONLY patient's plasma contains factors = clotting time
31
2 Sickle cell screening tests
sickling test and solubility test
32
Sickle cell test - sickling test
Blood + reducing agent (to reduce oxyhemoglobin to hemoglobin to accelerate sickling), examined for sickling cells presence
33
Sickle cell test - solubility test
lysed RBCs (saponin): deoxyhemoglobin S is insoluble in phosphate buffer; HbS = crystal formation; HbA is soluble
34
Hgb electrophoresis test
purified RBC hemolysate is separated by electrophoresis; PRINCIPLE for diagnosing hgb abnormalities
35
Blood banking procedure
Collect anti-coagulated whole blood -> spin to isolate RBCs and platelet-rich plasma -> spin to isolate platelets and plasma
36
Plasma contains
Igs, albumin, cryprecipitate (factor VIII, XIII, fibronectin, etc)
37
Cryopoor plasma
plasma without cryprecipitate (factor VIII, XIII, fibronectin, etc)
38
ABO/Rh forward typing tests
detects antigens on patient's RBCs; mix RBC with anti-sera A/B/Rh; agglutination = blood type
39
ABO/Rh reverse typing tests
detects Abs in the patient's plasma; mix patient's plasma with reagent cells-A/B antigen; agglutination = presence of antibody
40
Apheresis
removal of blood, followed by separation of blood components (some components may be returned)
41
RBCs can be stored for
35-42d @ 4C
42
Platelet-rich fraction can be stored for
<5 days @ 25C
43
Therapeutic plasma exchange procedure
blood continuously withdrawn, separated into cellular and plasma, cellular component is mixed with FFP or colloid solution and returned to patient
44
Use for Therapeutic plasma exchange
Guillain Barre: to remove Ab's against self
45
Gram Stain procedure
1. Crystal violet (1m) 2. Iodine (1m) 3. Destain EtOH 4. Counterstain Safranin (1m); rxn, shape, arrangement
46
Plating
plate microbe in culture medium
47
Antimicrobial susceptibility test - disc diffuse method
discs embedded with different antimicrobial agents + suspension of organism; zones of inhibition are measured to determine susceptibility, intermediate, or resistant to antibiotic
48
Antimicrobial susceptibility test - dilution method
determines MIC (minimal inhibitory concentration); increasing dilutions of antimicrobial + agent; MIC = 1st tube which shows NO growth
49
Automated chemical profile includes
total protein, albumin, Ca2+, inorganic phosphate, cholesterol, glucose, creatinine, uric acid, Bilirubin, alkaline phosphatase, lactate dehydrogenase, aspartate aminotransferase (may include more)
50
Complete Chemical Profile
```
Albumin.
Alkaline Phosphatase.
Alanine Aminotransferase (ALT).
Aspartate Aminotransferase (AST).
Bilirubin (total and direct).
Blood Glucose.
Blood Urea Nitrogen.
Calcium (Ca) in Blood.
Carbon Dioxide (Bicarbonate).
Chloride (Cl).
Cholesterol and Triglycerides Tests.
Creatinine and Creatinine Clearance.
Gamma-Glutamyl Transferase (GGT).
Lactate Dehydrogenase.
Phosphate in Blood.
Potassium (K) in Blood.
Sodium (Na) in Blood.
Total Serum Protein.
Uric Acid in Blood.
```
51
(alanine aminotransferase) ALT/SGPT indicate pathology in
Liver, heart, skeletal muscle
52
Amylase indicates pathology in
pancreas, salivary gland
53
LDH indicates pathology in
most organs, esp heart, liver, lung, kidney
54
PSA indicate pathology in
prostate
55
LDH1:
heart, kidney, RBCs
56
LDH2/LDH3
lung, lymphocyte, platelets
57
LDH4
some types of leukemia
58
LDH5:
liver, skeletal muscle, neutrophils, prostate
59
What is all enzymes are high?
shock or infectious mononucleosis
60
International unit of enzyme
amount that catalyzes 1 umol of substrate/min under defined conditions
61
Alkaline phosphatase
bone, liver, all tissues
62
GGT/P
Liver, bile duct
63
AST (SGOT)
heart, liver, RBCs, skeletal muscle
64
isozyme
molecular variant of an enzyme or DIFFERENT enzyme that catalyzes the same reaction
65
LDH1 > LDH2 suspect
necrosis (infarction) of heart or kidney or hemolysis
66
High LDH5 suspect
liver and skeletal muscle damage
67
High LDH3 suspect
pulmonary infarct
68
Urinanalysis examines
appearance, specific gravity (density), pH, leukocytes, nitrites, protein, glucose, ketones, urobilinogen, bilirubin, and blood
69
Microscopic analysis of urine
examine sediment: cells, casts, crystals, microorganisms
70
Antinuclear antibody testing tests for
autoimmune disorders such as lupus erythematous, rheumatoid arthritis, and Sjogren Syndrome
71
Antinuclear antibody testing Procedure
patient's serum + Hep2 cells; rinse; + anti-human IgG-fluorescent tag; Fluorescence microscopy detects presence/absence and pattern/titer of fluorescence
72
Immunoassay
any (colorimetric) assay that relies on antigen/antibody complex; used to detect and quantitate proteins, hormones, and amino acids
73
Non-competitive immunoassay (Type I)
Excess antibody + antigen; # of complexes DIRECTLY relates to [antigen]
74
Competitive immunoassay (Type II)
excess antibody + analyte + labeled-analyte; labeled and non-labeled compete; amt of signal from label-bound-antigen INVERSELY relates to [antigen]
75
Flow cytometry is used to diagnose
leukemia and lymphoma; precise identification of tumor cell types
76
Flow cytometry + mAB-tag
label cell surface antigens with mAb-tag; side scatter, forward scatter, and intensity determine cell type
77
Agglutination reactions procedure
large particle-antigen or particle-antibody; aggregates = presence of antigen or antibody in specimen
78
Agglutination reaction use
detect antibodies or antigens in specimen
79
Protein electrophoresis
detect presence and relative concentration of proteins (from serum, urine, or CSF)
80
Stat tests include tests
whose results are ESSENTIAL for patient care, lab runs test before continuing other work
81
Direct ELISA
Plate with specificity for antigen + patient unknown [antigen] + antibody-tag + substrate; colorimetric (primary Ab)
82
Indirect ELISA
Plate with antigen + patient unknown [antibody] + anti-human IgG-tag + substrate; colorimetric (Primary and Secondary Ab)
83
Sandwich ELISA
Plate with antibody + patient's unknown [antigen] + primary Ab + secondary Ab + substrate
84
Electrolyte Panel includes
Na, K, Cl, CO2, glucose, BUN, creatinine
85
Stat tests usually involve
electrolytes, gases, chemistry profile, clotting/coagulation test, gram stain
86
Blood gases measure
pH, pCO2, pO2, O2 sat, total CO2
87
Blood gas requires
whole blood + 3 electrodes
88
Hydrogen electrode measures
pH
89
Carbon dioxide electrode works by
measuring pH change due to CO2 diffusion; [CO2] is directly related to pH change
90
ELISA spot used for
monitoring cellular immune responses by visualizing secretory products of individual activated cells
91
ELISA spot procedure
sandwich ELISA: immobilized specific antibody + secreting cells, remove cells and add primary antibody for secreted antigen + secondary-enzyme + substrate; visualize
92
Immunoflourescence immunoassay
cells from patient + antibody of interest + secondary-tag; visualize for presence/titer/pattern
93
oxygen probe for blood gas testing
complete electrochemical cell producing a current as oxygen migrates; current is DIRECTLY related to [O2]
94
Point-of-care testing
specimen testing outside of a lab/hospital, hand-held portable analyzers, miniaturized test
