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Microscopic Flashcards

(90 cards)

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1
Q

What tests can be performed to find mycobacterium?

A
  1. BACTEC
  2. Urine
  3. Sputum
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2
Q

what kind of receptor masks should staff wear when performing a acid fast test?

A

N5 Receptor mask

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3
Q

How many urine specimens should be obtained and confirmed for mycobacterium URINE?

A

3-5 (they all must contain the specimen for it to be diagnostic)

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4
Q

Prior to initiation of abx for a wound, what should be performed?

A

a wound culture

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5
Q

What should a wound culture be performed in conjunction with?

A

Gram staining

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6
Q

What are the 2 main tests for renal function?

A

Urea and creatinine

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7
Q

What is creatinine directly related to?

A

Skeletal muscle mass

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8
Q

What is creatinine a bi product of?

A

muscle breakdown

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9
Q

Who would have high creatinine levels?

A

older women, men, those that have increased protein intake

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10
Q

Why is creatinine clearance a suitable measure of Glomerular infiltration?

A

because creatinine is metabolized at a stable and constant rate the creatinine clearance makes it a suitable test for glomerular filtration

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11
Q

Creatinine is a screening or diagnostic test?

A

screening

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12
Q

Urea is a screening or diagnostic test?

A

screening

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13
Q

You should have no urea in the blood (T/F)

A

False- a small stable amount of urea should be in the blood due to its constant filtering process

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14
Q

What is urea?

A

waste product developed by the body to rid the body of acidic nitrogen

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15
Q

What plays a role in excretion of urea?

A

kidneys and “gut”

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16
Q

what does a build up of urea usually mean?

A

kidney disease

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17
Q

the initial indicator of a kidney problem could be found by using what test?

A

BUN:Cr ratio

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18
Q

What level will rise when the kidneys cannot filter Urea out of the body anymore?

A

BUN

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19
Q

high BUN:Cr ratio indicates?

A

(high BUN: normal Creatinine) - usually indicates there is a blockage or not enough fluid for the kidneys to filter

  • BPH (obstruction)
  • dehydration
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20
Q

Low BUN:Cr ratio indicates?

A

(normal BUN: high Cr)

  • muscle breakdown
  • malnutrition
  • liver disease
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21
Q

Azotemia

A

abnormal buildup of waste products in the blood due to dysfunction of the kidneys and inability to clear these substances

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22
Q

Uremia

A

The symptomatic phase of renal failure

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23
Q

What symptoms are associated with uremia?

A

fatigue, loss of interests, loss of appetite

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24
Q

What kind of patients would you associate with uremia?

A

alcoholics and those with liver disease

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25
What are the 3 tests to test for GFR?(renal function/disease)?
1. 24 hour creatinine clearance 2. cockcroft-gault formula 3. MDRD - modification of diet and renal disease
26
What is a good initial screening urine test for renal dysfunction?
24- hour creatinine clearance
27
What does a 24 hour creatinine clearance measure?
creatinine levels of the urine VS creatinine levels in the serum
28
over the age of ____, ______ declines by _____.
over the age of 30-40 - creatinine clearance - declines by 0.8ml/min
29
What does the GFR measure?
measure of serum Cr levels to determine the amount of plasma filtered by the kidneys in a given time
30
What do you need to make sure you do when a patient performs a 24 hour creatinine clearance ?
Get a serum creatinine within those 24 hours
31
What are the measurable waste products excreted by the kidneys?
urea, creatinine, uric acid
32
What happens as GFR is reduced?
Waste retention is occuring (since the kidneys are not filtering)
33
what does a steady decline in GFR potentially mean?
end stage renal disease
34
What does the cockcroft-gault formula adjust for?
age, weight, gender
35
what goes MDRD take into account?
age, race, gender
36
is serum or urine creatinine levels used in cockcroft gault and MDRD
serum
37
How much protein is being lost in nephrotic syndrome?
>3.5 g/day
38
what are the ways to analyze protein ?
1. Total protein 2. Spot albumin: creatine ratio 3. Spot Protein:creatinine ratio 4. 24-hr urine collection
39
What is a spot albumin:creatinine ratio an accurate estimate of?
24 hour urine albumin excretion
40
what is a 24 hour creatinine clearance testing for?
1. proteinuria | 2. creatinine clearance
41
abnormal protein level in urine
150mg/24 hrs | in diabetics = >30 mg/24 hours
42
what is microalbuminuria indicative of?
kidney disease
43
what makes albumin?
the liver
44
Anything that causes injury to a cell will cause ___ to rise?
Potassium
45
Ca2+ and ____ have an inverse relationship?
PO4^3- (phosphate)
46
sodium (intracellular or extracellular)
extracellular cation
47
Potassium (intra or extra)
intracellular cation
48
Chloride (intra or extra)
extracellular anion
49
Calcium (intra or extra)
extracellular cation
50
phosphate (intra or extra)
intracellular anion
51
Protein (intra or extra)
intracellular
52
Aldosterone affects what portion of the kidneys?
DCT
53
ADH affects what portion of the kidneys?
Collecting ducts
54
recommended amount of dietary sodium
<1500
55
What 2 hormones regulate the amount of Na+
ADH and aldosterone
56
HYPOnatremia is caused by
fluid loss - diarrhea, vomiting, HF, addison's disease( addison eats low sodium - hyponatremia)
57
HYPERnatremia is caused by
trauma, shock, surgery, - decreased blood flow to the kidneys, any free water loss
58
HYPOnatremia symptoms
nausea, seizures, coma, death
59
HYPERnatremia symptoms
thirst, dry flushed skin, fatigue, confusion, muscle twitch, death
60
What usually follows closely with sodium?
Chloride (Cl)
61
What causes chloride levels to fluctuate?
same thing that causes Na to fluctuate
62
Hypochloremia symptoms
muscle tetany, hypotension, shallow breathing
63
Hyperchloremia symptoms
lethargy, weakness, deep breathing
64
if potassium levels are abnormal what do you do?
retake the levels
65
what could elevate potassium?
hemolysis, potassium sparing diuretics, cardiac arrest, chronic or acute renal failure, drugs (abx, K sparing diuretics, ace inhibitors, lithium), dehydration , ACIDOSIS
66
What could decrease Potassium levels?
drugs (loop diuretics, laxatives, insulin, kayexalate) dietary deficiency, diarrhea and vomiting, cushing syndrome, ALKALOSIS
67
what will irregularities of potassium cause?
heart issues
68
How do you treat high potassium?
the meds that lower potassium
69
Bicarbonate is what
the level of CO2 in the blood
70
What does Bicarb do?
acts as acid/base buffer for the body
71
What decreases Bicarbonate?
renal failure, DKA, starvation, metabolic acidosis (CKD with decreased renal function is common in this)
72
Increase in bicarbonate
COPD (causes a build up in PCO2 )which is used in making bicarb, metabolic alkalosis
73
increased bicarbonate levels is seen in _____osis
alkalosis
74
decreased bicarbonate levels are seen in _____osis
acidosis
75
Lab tests test for _____ calcium
total
76
you need to know what to find the free level of calcium
serum albumin
77
If someone is having a neuromuscular issue, what could it be?
calcium
78
what is pertinent in neuromuscular conduction and many metabolic processes?
Magnesium
79
What is calcium usually bound to?
a protein- albumin
80
most common cause of hypercalcemia
hyperparathyroidism
81
Low Phosphate = ____ calcium
high calcium
82
Hypercalcemia symptoms
anorexia, nausea and vomiting, somnolence, confusion, constipation
83
What is associated with hypercalcemia?
Bones , Stones , Groans, Psychic overtones
84
What could chronic renal failure mean?
Vitamin D deficiency --> in turn calcium deficiency
85
Why would you have hypocalcemia with pancreatitis?
the pancreas is key in absorption of nutrients
86
Why would magnesium deficiency potentially cause hypocalcemia ?
magnesium plays a key role in parathyroid hormone production and regulation
87
symptoms of hypocalcemia
convulsions, arrhythmias, tetany (also in hypochloride), paresthesias
88
Chvostek's sign
twitch of the facial muscles in response to tapping over the facial nerve
89
Trousseau's sign
carpopedal spasm that results from ischemia, pressure placed to upper arm causes spasm
90
What determines phosphorus levels?
Calcium metabolism, PTH, renal excretion, intestinal absorption

Lab diagnostics (6 decks)

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