Liquides biologiques (Biochimie) Flashcards
(160 cards)
1
Q
The functions of the CSF include all of the following except:
- removing metabolic wastes
- producing an ultrafiltrate of plasma
- supplying nutrients to the CNS
- protecting the brain and spinal cord
A
2 - producing an ultrafiltrate of plasma
2
Q
The CSF flows through the:
- choroid plexus
- pia mater
- arachnoid space
- dura mater
A
3 - arachnoid space
3
Q
Substances present in the CSF are controlled by the:
- arachnoid granulations
- blood-brain barrier
- presence of one-way valves
- blood-CSF barrier
A
2 - blood-brain barrier
4
Q
What department is the CSF tube labeled 3 routinely sent to:
- hematology
- chemistry
- microbiology
- serology
A
1 - hematology
5
Q
The CSF tube that should be kept at room temperature is:
- tube 1
- tube 2
- tube 3
- tube 4
A
2 - tube 2
6
Q
Even distribution of blood in all tubes is an indicator of a traumatic tap or of an intracranial hemorrhage.
A
Intracranial hemorrhage
7
Q
Xantochromic supernatant is an indicator of a traumatic tap or of an intracranial hemorrhage.
A
Intracranial hemorrhage
8
Q
Concentration of blood in tube 1 is greater than in tube 3 is an indicator of a traumatic tap or of an intracranial hemorrhage.
A
Traumatic tap
9
Q
Specimen contains clots is an indicator of a traumatic tap or of an intracranial hemorrhage.
A
Traumatic tap
10
Q
The presence of xantochromia can be caused by all the following except:
- immature liver function
- RBC degredation
- a recent hemorrhage
- elevated CSF protein
A
3 - a recent hemorrhage
11
Q
A web-like pellicle in a refrigerated CSF specimen indicates:
- tubercular meningitis
- multiple sclerosis
- primary CNS malignancy
- viral meningitis
A
1 - tubercular meningitis
12
Q
CSF can be differentiated from serum by the presence of:
- albumin
- globulin
- prealbumin
- tau transferrin
A
4 - tau transferrin
13
Q
In serum, the second most prevalent protein is IgG; in CSF, the second most prevalent protein is:
- transferrin
- prealbumin
- IgA
- ceruloplasmin
A
2 - prealbumin
14
Q
Elevated CSF protein values can be caused by all of the following except:
- meningitis
- multiple sclerosis
- fluid leakage
- CNS malignancy
A
3 - fluid leakage
15
Q
The integrity of the blood-brain barrier is measured using the:
- CSF/serum albumin index
- CSF/serum globulin ratio
- CSF albumin index
- CSF IgG index
A
1 - CSF/serum albumin index
16
Q
The finding of oligoclonal bands in the CSF and not in the serum is seen with:
- multiple myeloma
- CNS malignancy
- multiple sclerosis
- viral infections
A
3 - multiple sclerosis
17
Q
CSF lactate will be more consistently decreased in:
- bacterial meningitis
- viral meningitis
- fungal mengitis
- tubercular meningitis
A
1 - bacterial meningitis
18
Q
Measurement of which of the following can be replaced by CSF glutamine analysis in children with Reye syndrome:
- ammonia
- lactate
- glucose
- alpha-ketoglutarate
A
1 - ammonia
19
Q
The functions of synovial fluid include all of the following except:
- lubrication for the joints
- removal of cartilage debris
- cushioning joints during jogging
- providing mutrients for cartilage
A
2 - removal of cartilage debris
20
Q
The primary function of synoviocytes is to:
- provide nutrients for the joints
- secrete hyaluronic acid
- regulate glucose filtration
- prevent crystal formation
A
1 - provide nutrients for the joints
21
Q
The procedure for collecting synovial fluid is called:
- synovialcentesis
- arthrocentesis
- joint puncture
- arteriocentesis
A
2 - arthrocentesis
22
Q
Is gout noninflammatory, inflammatory, septic or hemorrhagic:
A
Inflammatory
23
Q
Is Neisseria gonorrhoeae infection noninflammatory, inflammatory, septic or hemorrhagic:
A
Septic
24
Q
Is systemic lupus erythematosus noninflammatory, inflammatory, septic or hemorrhagic:
A
Inflammatory
25
Is Osteoarthritis noninflammatory, inflammatory, septic or hemorrhagic:
Non inflamatory
26
Is hemophilia noninflammatory, inflammatory, septic or hemorrhagic:
Hemorrhagic
27
Is rheumatoid arthritis noninflammatory, inflammatory, septic or hemorrhagic:
Inflammatory
28
Is heparin overdose noninflammatory, inflammatory, septic or hemorrhagic:
Hemorrhagic
29
Normal synovial fluid ressembles:
1. egg white
2. normal serum
3. dilute urine
4. lipemic serum
1 - egg white
30
Before testing, very viscous synovial fluid should be treated with:
1. normal saline
2. hyaluronidase
3. distilled water
4. hypotonic saline
2 - hyaluronidase
31
Addition of a cloudy, yellow synovial fluid to acetic acid produces a:
1. yellow-white precipitate
2. easily dispersed clot
3. solid clot
4. opalescent appearance
2 - easily dispersed clot
32
Which of the following could be the most significantly affected if a synovial fluid is refrigerated before testing:
1. glucose
2. crystal examination
3. mucin clot test
4. differential
2 - crystal examination
33
The highest WBC count can be expected to be seen with:
1. non inflammatory arthritis
2. inflammatory arthritis
3. septic arthirtis
4. hemorragic arthritis
3 - septic arthritis
34
The lowest percentage of neutrophils would be seen in:
1. noninflammatory arthirtis
2. inflammatory arthirtis
3. septic arthirtis
4. hemorrhagic arthirtis
1 - noninflammatory arthritis
35
Synovial fluid crystals that occur as a result of purine metabolism of chemotherapy for leukemia are:
1. monosodium urate
2. cholesterol
3. calcium pyrophosphate
4. apatite
1 - monosodium urate
36
Synovial fluid crystals associated with inflammation in dialysis patients are:
1. calcium pyrophosphate dihydrate
2. calcium oxalate
3. corticosteroid
4. monosodium urate
2 - calcium oxalate
37
Crystals associated with pseudogout are:
1. monosodium urate
2. calcium pyrophsophate dihydrate
3. apatite
4. corticosteroid
2 - calcium pyrophosphate dihydrate
38
Synovial fluid for crystal examination should be examined as a:
1. wet preparation
2. wright`s stain
3. gram stain
4. acid-fast stain
1 - wet preparation
39
Crystals that have the ability to polarize light are:
1. corticosteroid
2. monosodium urate
3. calcium oxalate
4. all of the above
4 - all of the above
40
In an examination of synovial fluid under compensated polarized light, rhomboid-shaped crystals are observed. What color would these crystals be when aligned parallel to the slow vibration:
1. white
2. yellow
3. blue
4. red
2 - yellow
41
Negative birefringence occurs under red-compensated polarized light when:
1. slow light is impeded more than fast light
2. slow light is less impeded than fast light
3. fast light runs against the molecular grain of the cyrstal
4. both b and c
3 - fast light runs agains the molecular grain of the crystal
42
The most frequently performed chemical test on synovial fluid is:
1. total protein
2. uric acid
3. calcium
4. glucose
4 - glucose
43
The primary purpose of serous fluid is to:
1. remove waste products
2. lower capillary pressure
3. lubricate serous membranes
4. nourish serous membranes
3 - lubricate serous membranes
44
The membrane that lines the wall of a cavity is the:
1. visceral
2. peritoneal
3. pleural
4. parietal
4 - parietal
45
During normal production of serous fluid, the slight excess of fluid is:
1. absorbed by the lymphatic system
2. absorbed through the visceral capillaries
3. stored in the mesothelial cells
4. metabolized by the mesothelial cells
1 - absorbed by the lymphatic system
46
Production of serous fluid is controlled by:
1. capillary oncotic pressure
2. capillary hydrostatic pressure
3. capillary permeability
4. all of the above
4 - all of the above
47
An increase in the amount of serous fluid is called a:
1. exudate
2. transudate
3. effusion
4. malignancy
3 - effusion
48
Pleural fluid is collected by:
1. pleurocentesis
2. paracentesis
3. pericentesis
4. thoracentesis
4 - thoracentesis
49
Fluid:serum protein and lactic dehydrogenase ratios are performed on serous fluids:
1. when malignancy is suspected
2. to classify transudates and exudates
3. to determine the type of serous fluid
4. when a traumatic tap has occured
2 - to classify transudates and exudates
50
Which of the following requires the most additional testing:
1. transudate
2. exudate
2 - exudate
51
An additional test performed on pleural fluid to classify the fluid as a transudate or exudate is the:
1. WBC count
2. RBC count
3. fluid:cholesterol ratio
4. fluid-to-serum protein gradient
3 - fluid: cholesterol ratio
52
A milky-appearing pleural fluid indicates:
1. thoracic duct leakage
2. chronic inflammation
3. microbial infection
4. both A and B
4 - both A and B
53
A pleural fluid pH of 6.0 indicates:
1. esophageal rupture
2. mesothelioma
3. malignancy
4. rheumatoid effusion
1 - esophageal rupture
54
Plasma cells seen in pleural fluid indicate:
1. bacterial endocarditis
2. primary malignancy
3. metastatic lung malignancy
4. tuberculosis infection
4 - tuberculosis infection
55
Another name for a peritoneal effusion is:
1. peritonitis
2. lavage
3. ascites
4. cirrhosis
3 - ascites
56
A test performed primarily on peritoneal lavage fluid is a:
1. WBC count
2. RBC count
3. absolute neutrophil count
4. amylase
2 - RBC count
57
The recommended test for determining whether peritoneal fluid is a transudate or an exudate is the:
1. fluid: serum albumin ratio
2. serum ascites albumin gradient
3. fluid: serum lactic dehydrogenase ratio
4. absolute neutrophil count
2 - serum ascites albumin gradient
58
Differentiation between bacterial peritonitis and cirrhosis is done by performing a:
1. WBC count
2. differential
3. absolute neutrophil count
4. absolute lymphocyte count
3 - absolute neutrophil count
59
Detection of the CA 125 tumor marker in peritoneal fluid indicates:
1. colon cancer
2. ovarian cancer
3. gastric malignancy
4. prostate cancer
2 - ovarian cancer
60
Chemical tests primarily performed on peritoneal fluid include all of the following except:
1. lactose dehydrogenase
2. glucose
3. alkaline phsophatase
4. amylase
4 - amylase
61
Which of the following is not a function of amniotic fluid:
1. allows movement of the fetus
2. allows carbon dioxide and oxygen exchange
3. protects fetus from extreme temperature changes
4. acts as a protective cushion for the fetus
2 - allows carbon dioxide and oxygen exchange
62
What is the primary cause of the normal increase in amniotic fluid as a pregnancy progresses:
1. fetal cell metabolism
2. fetal swallowing
3. fetal urine
4. transfer of water across the placenta
3 - fetal urine
63
Which of the following is not a reason for decreased amounts of amniotic fluid:
1. fetal failure to begin swallowing
2. increased fetal swallowing
3. membrane leakage
4. urinary tract defects
1 - fetal failure to begin swallowing
64
Why might a creatinine level be requested on an amniotic fluid:
1. detect oligohydramnios
2. detect polyhydramnios
3. differentiate amniotic fluid from maternal urine
4. evaluate lung maturity
3 - differentiate amniotic fluid from maternal urine
65
Amniotic fluid specimens are placed in amber-colored tubes prior to sending them to the laboratory to prevent the destruction of:
1. alpha-fetoprotein
2. bilirubin
3. cells for cytogenetics
4. lecithin
2 - bilirubin
66
How are specimens for FLM testing delivered to and stored in the laboratory:
1. delivered on ice and refrigerated
2. immediately centrifuged
3. kept at room temperature
4. delivered in a vacuum tube
1 - delivered on ice and refrigerated
67
Why are amniotic specimens for cytogenetic analysis incubated at 37oC prior to analysis:
1. to detect the presence of meconium
2. to differentiate amniotic fluid from urine
3. to prevent photo-oxidation of bilirubin to biliverdin
4. to prolong fetal cell viability and integrity
4 - to prolong fetal cell viability and integrity
68
What does a colorless amniotic fluid mean:
Normal
69
What does a dark green amniotic fluid mean:
presence of meconium
70
What does a red-brown amniotic fluid mean:
Fetel death
71
What does a yellow amniotic fluid mean:
Presence of bilirubin
72
A significant rise in the OD of amniotic fluid at 450 nm indicates the presence of which analyte:
1. bilirubin
2. lecithin
3. oxyhemoglobin
4. sphingomyelin
1 - bilirubin
73
Plotting the amniotic fluid OD on a Liley graph represents the severity of hemolytic disease of the newborn. A value that is plotted in zone II indicates what condition of the fetus:
1. no hemolysis
2. mildly affected fetus
3. moderately affected fetus that requires close monitoring
4. severely affected fetus that requires intervention
3 - moderately affected fetus that requires close monitoring
74
The presence of a fetal neural tube disorder may be detected by:
1. increased amniotic fluid bilirubin
2. increased maternal serum alpha-fetoprotein
3. decreased amniotic fluid phsophatidyl glycerol
4. decreased maternal serum acetylcholinesterase
2 - increased maternal serum alpha-fetoprotein
75
When severe HDN is present, which of the following tests on the amniotic fluid would the physician not order to determine whether the fetal lungs are mature enough to withstand a premature delivery:
1. AFP levels
2. foam stability index
3. lecithin/sphingomyelin ratio
4. phsophatidyl glycerol detection
1 - AFP levels
76
True or false: prior to 35 weeks gestation, the normal L/S ratio is less than 1.6
True
77
When performing an L/S ratio by thin-layer chromatography, a mature fetal lung will show:
1. sphingomyelin twice as concentrated as lecithin
2. no sphingomyelin
3. lecithin twice as concentrated as sphingomyelin
4. equal concentrations of lecithin and sphingomyelin
3 - lecithin twice as concentrated as sphingomyelin
78
True or false: phsophatidyl glycerol is present with an L/S ratio of 1:1
True
79
A rapid immunolgic test for FLM that does not require performance of thin-layer chromatography is:
1. AFP levels
2. amniotic acetylcholinesterase
3. aminostat-FLM
4. bilirubin scan
3 - aminostat-FLM
80
Does the failure to produce bubbles in the Foam stability index indicate increased or decreased lecithin:
Decreased
81
The presence of phosphatidyl glycerol in amniotic fluid fetal lung maturity tests must be confirmed when:
1. hemolytic disease of the newborn is present
2. the mother has maternal diabetes
3. amniotic fluid is contaminated by hemoglobin
4. neural tube disorder is suspected
2 - the mother has maternal diabetes
82
In what part of the digestive tract do pancreatic enzymes and bile salts contribute to digestion:
1. large intestine
2. liver
3. small intestine
4. stomach
3 - small intestine
83
Where does the reabsorption of water take place in the primary digestive process:
1. large intestine
2. pancreas
3. small intestine
4. stomach
1 - large intestine
84
Which of the following tests is not performed to detect osmotic diarrhea:
1. clinitest
2. fecal fats
3. fecal neutrophils
4. muscle fibers
3 - fecal neutrophils
85
The normal composition of feces includes all of the following:
1. bacteria
2. blood
3. electrolytes
4. water
2 - blood
86
What is the fecal test that requires a 3-day specimen:
1. fecal occult blood
2. APT test
3. elastase I
4. quantitative fecal fat testing
4 - quantitative fecal fat testing
87
The normal brown color of the feces is produced by:
1. cellulose
2. pancreatic enzymes
3. undigested foodstuffs
4. urobilin
4 - urobilin
88
Diarrhea can result from all of the following except:
1. Addition of pathogenic organisms to the normal intestinal flora
2. disruption of the normal intestinal bacterial flora
3. increased concentration of fecal electrolytes
4. increased reabsorption of intestinal water and electrolytes
4 - increased reabsorption of intestinal water and electrolytes
89
Stools from persons with steatorrhea will contain excess amounts of:
1. barium sulfate
2. blood
3. fat
4. mucus
3 - fat
90
Which of the following pairings of stool appearance and cause does not match:
1. black, tarry: blood
2. pale, frothy: steatorrhea
3. yellow-gray: bile duct obstruction
4. yellow-green: barium sulfate
4 - yellow-green: barium sulfate
91
Stool specimen that appear ribbon-like are indicative of which condition:
1. bile-duct obstruction
2. colitis
3. intestinal constriction
4. malignancy
3 - intestinal constriction
92
A black tarry stool is indicative of:
1. upper GI bleeding
2. lower GI bleeding
3. excess fat
4. excess carbohydrates
1 - upper GI bleeding
93
Chemical screening tests performed on feces include all of the following except:
1. APT test
2. clinitest
3. pilocarpine iontophoresis
4. quantitative fecal fats
3 - pilocarpine iontophoresis
94
Secretory diarrhea is caused by:
1. antibiotic administration
2. lactose intolerance
3. celiac sprue
4. vibrio cholerae
4 - Vibrio cholerae
95
The fecal osmotic gap is elevated in which disorder:
1. dumping syndrome
2. osmotic diarrhea
3. secretory diarrhea
4. steatorrhea
2 - osmotic diarrhea
96
Microscopic examination of stools provides preliminary information as to the cause of diarrhea because:
1. neutrophils are present in conditions caused by toxin-producing bacteria
2. neutrophils are present in conditions that affect the intestinal wall
3. red and white blood cells are present if the cause is bacterial
4. neutrophils are present if the condition is of nonbacterial etiology
2 - neurophils are present in conditions that affect the intestinal wall
97
True or false: the presence of fecal neutrophils would be expected with diarrhea caused by a rotavirus:
False
98
Large orange-red droplets seen on direct microscopic examination of stools mixed with Sudan III represent:
1. cholesterol
2. fatty acids
3. neutral fats
4. soaps
3 - neutral fats
99
Microscopic examination of stools mixed with Sudan III and glacial acetic acid and then heated will show small orange-red droplets that represent:
1. fatty acids and soaps
2. fatty acids and neutral fats
3. fatty acids, soaps, and neutral fats
4. soaps
3 - fatty acids, soaps, and neutral fats
100
When performing a microscopic stool examination for muscle fibers, the structure that should be counted:
1. are coiled and stain blue
2. contain no visible striations
3. have two-dimensional striations
4. have vertical striations and stain red
3 - have two-dimensional striations
101
A value of 85% fat retention would indicate:
1. dumping syndrome
2. osmotic diarrhea
3. secretory diarrhea
4. steatorrhea
4 - steatorrhea
102
Which of the following tests would not be indicative of steatorrhea:
1. fecal elastase I
2. fecal occult blood
3. sudan III
4. van de Kamer
2 - fecal occult blood
103
The term occult blood describes blood that:
1. is produced in the lower GI tract
2. is produced in the upper GI tract
3. is not visibly apparent in the stool specimen
4. produces a black, tarry stool
3 - is not visibly apparent in the stool specimen
104
What is the recommended number of samples that should be tested to confirm a negative occult blood result:
1. one random specimen
2. two samples taken from different parts of three stools
3. three samples taken from the outermost portion of the stool
4. three samples taken from different parts of two stools
2 - two samples taken from different parts of three stools
105
The immunochemical tests for occult blood:
1. test for human globulin
2. give false-positive reactions with meat hemoglobin
3. can give false positive reactions with aspirine
4. are inhibited by porphyrin
1 - test for human globulin
106
Guaiac tests for detecting occult blood rely on the:
1. reaction of hemoglobin with hydrogen peroxide
2. pseudoperoxidase activity of hemoglobin
3. reaction of hemoglobin with ortho-toluidine
4. pseudoperoxidase activity of hydrogen peroxide
2 - pseudoperoxidase activty of hemoglobin
107
What is the significance of an APT test that remains pink after addition of sodium hydroxide:
1. fecal fat is present
2. fetal hemoglobin is present
3. fecal trypsin is present
4. vitamin C is present
2 - fecal hemoglobin is present
108
In the Van de Kamer m ethod for quantitative fecal fat determinations, fecal lipids are:
1. converted to fatty acids prior to titrating with sodium hydroxide
2. homogenized and titrated to a neutral endpoint with sodium hydroxide
3. measured gravimetrically after washing
4. measured by spectrophotometer after addition of sudan III
1 - converted to fatty acids prior to titrating with sodium hydroxide
109
A patient whose stool exhibits increased fats, undigested muscle fibers, and the inability to digest gelatin may have:
1. bacterial dysentery
2. a duodenal ulcer
3. cystic fibrosis
4. lactose intolerance
3 - cystic fibrosis
110
A stool specimen collected from an infant with diarrhea has a pH of 5.0. This result correlates with a:
1. positive APT test
2. negative trypsin test
3. positive clinitest
4. negative occult blood test
3 - positive clinitest
111
Which of the following tests differentiates a malabsorption cause from a maldigestion cause in steatorrhea:
1. APT test
2. D-xylose test
3. lactose tolerance test
4. occult blood test
2 - D-xylose test
112
Which of the following chemistry tests can be performed on synovial fluid to determine the severity of RA:
1. glucose
2. protein
3. lactate
4. uric acid
3 - lactate
113
Serologic tests on patients' serum may be performed to detect antibodies causing arthritis for all of the following disorders except:
1. pseudogout
2. rheumatoid arthritis
3. systemic lupus erythematosus
4. lyme arthritis
1 - pseudogout
114
Quels sont les fonctions du LCR:
1. forunit des nutriments aux tissu nerveux
2. retire les déchets métaboliques
3. barrière mécanique de protection pour le cerveau et la moelle épinière
115
quels sont les deux raisons pourquoi on fait une ponction lombique:
1. suspecte un hémorragie
2. suspecte une méningite
116
Circulation du LCR:
1. le plexus choroide du ventricule latéral laisse sécréter le LCR
2. pie-mère
3. arachnoide
4. dure-mère
5. réabosorbé par les granulations arachnoidiennes (ou Pancchioni)
117
Signification clinique de l'apparence du LCR
1. clair
2. turbide, laiteux
3. huileux
4. saignant
5. xantochromique
6. caillot
7. pellicule
* clair: normal
* turbide, laiteux:
* GB: méningite
* Microorganismes: méningite
* Protéines: barrière endommagé ou production de IgG dans le SNC
* huileux: produits de contrastes radiographiques
* saignant:
* GR: hémorragie ou ponction traumatique
* xantochromique:
* hémoglobine: vieille hémorragie ou cellules lysées d'une ponction traumatique
* bilirubine: dégradation des GR
* Caillot:
* protéines: barrière endomagée
* Pellicule:
* protéines: barrière endomagée
118
Différents échantillons du LCR:
* tube 1: tests chimiques et sérologiques (gelée)
* tube 2: microbiologie (température de la pièce)
* tube 3: hématologie (réfrigéré)
* tube 4: microbiologie (test additionnels)
119
Différence entre une ponction traumatique et une hémorragie:
Ponction: le sang est plus concentré dans le premier tube et il y a formation de caillot en cause du fibrinogène.
Hémorragie: le sang est distribué également et il n'y a pas de fibrinogène donc pas de caillots.
120
Quelle est la valeur normale des protéines dans le LCR
0.15-0.45 g/L
121
Quels sont trois conditions pathologiques qui peuvent produire une augmentation des protéines du LCR:
1. méningite (dommage)
2. hémorragie (dommage)
3. sclérose en plaque (production IgG)
122
Comment on fait la différence entre un dommage à la barrière céphalorachidienne et une production d'IgG.
Pendant un dommage de la barrière, tout augmente proportionnellement (IgG et albumine) tandis qu'une production par le SNC, seulemetn les IgG augmetne.
123
Quel est la valeur normal de la glycorachie:
65% du glucose plasmatique
124
Signification clinique des valeurs diminués de glucose dans le LCR:
* une diminution de glucose + une augmetnation des neutrophiles + augmentation de protéines + une augmetnation de lactate: méningite bactérienne
* une diminution de glucose + une augmentation des lymphocytes + une augmetnation de protéines + une augmentation de lactate: méningite tuberculeux
* glucose normale + une augmentation des lymphocytes + une augmentation des protéines + lactate normale: méningite virale
* une diminution du glucose + une augmentation des lymphocytes + une augmentation des protéines + une augmentation du lactate: méningite fongique
125
Électrophorèse LCR
La présence de deux ou plus bandes oligoclonales dans le SNC qui n'est pas présent dans le sérum peut diagnostiquer la sclérose en plaque
126
Quel est le colorant utilisé pour le dosage des protéines LCR:
Bleu brillant de Coumassie
127
Pourquoi le BCG n'est pas utilisé pour le dosage des protéines du LCR:
Il lie seulement l'albumine et on veut les protéines totales.
128
Pourquoi on fait l'analyse du liquide synoviale:
savoir l'origine de l'arthrite (prélevé sur héparine)
129
Apparence du liquide synovial:
* incolore à jaune pale: normal
* jauen, laiteux, rouge: anormal
* clair: normal
* trouble: anormal
* fil 4-6 cm de long: normal
* pavure viscosité: anormal
* protéines \< 30 g/L: normal
* protéines \> 30g/L: anormal
130
Cristaux retrouvés dans le LS:
1. urate monosodium: forme d'aiguilles: goute
2. calcium pyrophosphate: carrée rhomboide, batonnet, pseudogoute
3. cholestérol: entaillé, inflammation chronique
4. corticostéroides: plat forme variable, injections pour diminuer la réaction immunitaire et la réponse inflammatoire
5. oxalate de calcium: enveloppes, dialyse
6. phosphates de calcium: petites particules, usure, dégénération cartilage
131
Biréfringence des cristaux:
* Lorsque le cristaux parallèle est jaune et perpendiculaire est bleu, c'est une biréfringence négative, ce sont des acides uriques (Goute)
* Lorsque le cristaux parallèle est bleu et perpendiculaire est jaune, c'est une biréfringence positive, ce sont des calcium pyrophosphates (pseudogoute)
132
Spécimens de liquide synoviale:
* Micro: stérile hépariné ou sodium polyanéthol sulfonate
* hématologie: héparine ou EDTA
* glucose: fluorure de sodium
* tout autres tests: sans anticoagulants
133
Quels sont les analyses du LS les plus fréquents:
1. comptes des cellules
2. différentiel
3. identification des cristaux
4. gram
5. culture
134
Classification des liquides synoviales:
* non inflammatoire
* clair, jaune
* bonne viscosité
* GB
* inflammatoire d'origine immunologique
* trouble, jaune
* basse viscosité
* GB \> 1000
* diminution de glucose
* inflammatoire d'origine cristaux
* trouble ou laiteux
* pauvre viscosité
* GB \> 1000
* glucose diminué
* présence de cristaux
* septique
* trouble, jaune-vert
* viscosité variable
* GB \> 1000
* glucose diminué
* culture positive
* Hémorragique
* trouble, rouge
* pauvre viscosité
* GB égal au sang
* glucose normal
135
Quels sont les 4 causes primaires de l'effusion séreuse:
1. augmentation de la pression hydrostatique des capillaires (rétention de sel, maladie congestive du coeur)
2. diminution de la pression oncotique (syndrome néphrotique)
3. augmentation de la perméabilité capillaire (infection, inflammation, cancer)
4. obstruction lymphatique (tumeur)
136
Quelle est la formation du liquide séreux:
Ultrafiltrat du plasma.
La pression colloidial par les protéines sériques est égal dans les capillaires des deux cotés de la membrane.
La pression hydrostatique dans les capillaires pariétales et viscérales cause du liquide à entrer entre les membranes.
137
Quels sont les causes d'une exsudat:
Infection
cancer
trauma
138
Quel est la différence entre un exsudat chyleuse et pseudochyleuse:
* exsudat chyleuse: grande concentration des trig
* exsudat pseudochyleuse: grande concentration du cholestérol
139
Quels sont les fonctions du liquide amniotique:
1. coussin protectrice pour le foetus
2. permet le mouvement du foetus
3. protège le foetus contre des changements extremes de température
4. permet le développement des poumons
140
Quelle est la fonction du liquide séreux:
Lubrification entre les membranes pariétales et viscérales pour empêcher la friction.
141
Apparence du liquide amniotique
* incolore: normal
* sang: ponction traumatique, trauma abdominal
* jaune: maladie hémolitique du nouveau né
* vert foncé: méconium
* rouge brun: décès foetale
142
Comment on fait pour évaluer la bilirubine du bébé:
* la différence entre la densité optique de la ligne de base et celle à 450 nm représente la concentration de la bilirubine amniotique.
* sévérité sur graph lily
143
Quels sont les peaks sur le graph de bilirubine:
oxyhemoglobine à 410
bilirubine à 450
144
Comment on évalue le développement des poumons:
Rapport lécithine-sphingomyéline (\> 2.0)
145
Couleur des selles:
* noir: saignement GI supérieur, bismuth
* rouge: saignement GI inférieur, betraves
* jaune, blanc, gris: obstruction du canal biliaire, barium sulfate
* vert: biliverdine, antibiotiques
* volumineux, mousseux: désordre pancréatique, obstruction du canal biliaire
* ruban: constriction intestinal
* mucus: colite, constipation, dysentérie
146
Quels sont les causes de diarrhée sécrétoire:
Ce qui augmente la sécrétion d'eau et électrolytes qui surpasse l'habilité réabsorptive du gros intestin.
1. infection bactérienne
2. drogues
3. hormones
147
Quels sont les causes de diarrhée osmotique:
1. antibiotiques
2. déficience disaccharidases
3. intolérance au lactose
4. céliac
148
Quels sont trois causes de la stéatorrhée:
1. désordres pancréatiques
2. malabsorption/maldigestion
3. désordres du petit intestin
149
Sudan III et graisses dans les selles:
1. triglycérides: graisse neutre
2. savons: doit être convertit en acide gras par l'ajout d'acide acétique 36% et chaufé
3. acides gras: chaufé donc fondu
4. cholestérol: peuvent être vu par leur croix maltèse sous lumière polarisé ou peuvent être chauffé et ensuite refroidi (en cette forme, ils forment des cristaux visibles sous fond clair)
150
Sudan III et microcope:
Grosses goutelettes rouge/orange
\> 60 goutelettes/HPF est positive pour la stéatorrhée
151
Quel est la drogue administré pour le test de la sueur:
Pilocarpine
152
Valeur normale du chlore dans la sueur:
\>60 mmol/L est positif pour la fibrose kystique
153
Comment se fait l'analyse de sueur:
1. stimulation de la sueur par ionophorèse de pilocarpine
2. collection de la sueur
3. analyse qualitative ou quantitative de chlorure de sueur, sodium, conductivité ou osmolalité
154
Dans l'utérus, l'ovule et le zygote devient:
Blastocyte
155
Quel est le rôle des cellues throphoblastes:
Produisent le placenta et sécrète HCG
156
Faux positif pour test de grossesse:
Protéines, bactéries, GR, GB
tumeurs trophoblastiques
tumeurs des testicules
157
Faux négatifs avec test de grossesse:
Concentration HCG trop faible
grossesse anormale
158
Niveau de détection d'un test de grossesse:
20 u/L (7e jours de grossesse)
159
Quels sont les utilités des test de drogues:
1. agences gouvernementaux, industries et sportives peuvent demander un dépistage de droges de leurs employés et participants
2. Abus de drogues chez les femmes enceintes
3. L’évaluation et la surveillance des patents dans les programmes de traitement par méthadone
4. L’évaluation et traitement d’un patient incontrôlable, incohérent ou suspect d’une surdose
160
Drogues testsé:
1. Amphétamine,méthamphétamines
2. Barbituriques
3. Benzodiazépine
4. Tétrahydrocannabinol
5. Antidépresseur tricyclique
6. Opiacés
7. Méthadone
8. Cocaïne
9. Lysergic acid diethylamide (LSD)
10. Phéncyclidine (PCP)
