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171 Cards in this Set
- Front
- Back
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Fasting time for a Lipid panel
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12 hrs
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Fasting time for a fasting glucose
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8 hrs
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Fasting timeS for glucose tolerance
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30 min, 1 hr, 2 hr, 3 hr
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You are asked to draw blood but not told what tubes. Which tubes should you automatically get?
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-red
-blue -purple |
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What is the difference btwn plasma and serum?
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-plasma contains clotting components and serum does not
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Red top tube
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-no anticoag
-serum -added clotting factors so will clot |
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Blue top tube
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-uses sodium citrate as anticoag so that clotting factors will be perseved
-evaluates for the ability of the blood to clot -used for PT, INR, PTT |
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Purple top tube
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-contains anticoag EDTA
-perserves the cells -used for CBC |
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EDTA
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-anticoagulating agent
-blocks the binding of Ca2+ |
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T/F: You can use a purple top tube for coagulation studies
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False: Ca2+ is a coagulation factor and you are blocking it with EDTA
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Tiger top tube
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-aka serum separator
-contains a gel that forms a barrier btwn the serum and cells |
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Gray top tube
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-contains NaF oxidase
-prevents glycolysis -used for glucose tolerance testing |
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Yellow top tube
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-used for blood culture
-use aerobic or anaerobic bottles |
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Green top tube
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-contains heparin, prevents clotting
-provides plasma-ammonia & carboxyhemoglobin testing -can order a platelet count |
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45% of the blood is...
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-RBCs, WBCs, and platelets
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55% of the blood is...
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-Plasma (which is 90% water)
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10% of the blood is...
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-proteins, salts, enzymes, lipids
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Hematology
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-study of the formed elements in the blood
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Blood collected w/o an anticoag produces...
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-serum
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Blood collected w/ an anticoag produces...
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-plasma
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Buffy coatq
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-middle layer after centrifuge
-contains WBCs and platelets |
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With high sensitivity, people with the disease will test...
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-positive (there are few false negatives)
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With high specificity tests, people will test...
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-negative (few false positives)
-used to confirm dx |
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As cells mature, the nucleus gets ____ and the cytoplasm gets _____
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-nucleus gets smaller
-cytoplasm gets larger |
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Granulocytes
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-neutrophils
-eosinophils -basophils -possess a multilobed nucleus |
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Agranular, mononuclear cells
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-lymphocytes
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Neutrophils aka...
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-polys
-segs -PMN |
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WBCs are highest at...
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-birth
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Hb highest at...
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-birth
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Panic values of Hb
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<8
>20 |
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Hct
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-usually 3x the Hb
-panic: <24% |
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MCV
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-ave vol of red cells
MCV = (Hct x 10) / RBC |
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MCH
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-wt of Hb of the ave RBC
MCH= (Hb x 10) /RBC |
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MCHC
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-ave conc of Hb in a give vol of red cells
MCHC = (Hb x 100)/ Hct |
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RDW
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-red cell distribution width
-measures anisocytosis -helps in distinguishing Thalessemia from Fe def. -NL = 11.5-14.5 |
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Critical values of platelets
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<50,000
> 1 million |
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The more mature the neutrophil, the more lobulations of the...
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-nucleus
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mature neutorphils are called...
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segs
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immature neutrophils are called...
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bands
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Left shift of neutrophils
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-less mature forms are released
-seen in inflammation and hemorrhage |
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right shift of neutrophils
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-release of hypersegmented ones
-seeen in megablastic anemias and liver disease |
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What do eosinophils respond to?
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-NAACP
-counts are lower in the morning |
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What do basophils contain?
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-heparin
-histamine -serotonin |
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neutrophilia
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-increase in absolute number in response to invading organisms or tumor cells
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neutropenia
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-may be due to decreased production, excess stored in blood vessel margin,
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eosinophilia
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-NACCP and PIE
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eosinopenia
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-steriods, drugs, prostaglandins, stress, burns
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Monocytosis
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-recovery state of acute infection, TB, subacute endocarditis
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monocytopenia
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-prednisone treatment, RA, hairy cell leukemia
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Lymphocytosis
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-inverted or reversed diff, ALL, CLL, viral
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Lymphopenia
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-chemo, radiation
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Thrombocytosis
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-sudden exercise, post trauma, post-surgical esp. after splenectomy
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Thrombocytopenia
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-ITP, TTP, DIC, burns, snakes and insect bites, marrow suppressants
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Anisocytosis
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-variation in size of RBC
-normocytic -microcytic -macrocytic |
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Ex of microcytic anemias
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-Thalassemia
-Fe def |
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Ex of macrocytic anemia
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-folate def
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Poikilocytosis
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-variation in shape of RBC
-spherocyte -ovalocyte -target cells -schistocytes -acanthocytes -stomatocytes -hemet cells |
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basophilic stippling
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- numerous dark purple dots throughout the RBC
-Lead or heavy metal poisoning, thalassemia |
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Howell-Jolly Bodies
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- small dark purple dot near RBC periphery, represent a DNA remnant
-post splenectomy |
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Pappenheimer bodies
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-aka siderocytes
- bluish, purple dots in small groups in the RBC, represent iron particles |
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Heinz Bodies
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-denatured or precipitated protein
-G6PD Deficiency, drug-induced hemolytic anemia |
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Rouleaux Formation
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- stack of coins, due to abnormal proteins
-multiple myeloma |
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Reticulocytes
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-last stage of development prior to becoming a mature RBC
-have remenant of RNA |
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reticulocyte count
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-measures the ability of the bone marrow to react to anemia and make RBCs
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Why do a Sed rate?
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-Inflammation and necrotic processes cause an alteration in blood proteins resulting in the aggregation of red cells
-Sed rates should not be performed on blood older than 12 (4) hours. |
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Major systems involved for maintaining hemostasis
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-vascular
-platelets -coagulation -finbrinolosis |
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bleeding from aterioles produce...
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-petechia
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bleeding from venules produce...
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-ecchymosis
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all coagulation factors are produced in the liver except...
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-factor VIII
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What is the end stage of both intrinsic and extrinsic coagulation?
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-fibrinogen
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PTT tests for all factors but...
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-III and VII
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PT tests for...
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-I, II, V, VII, and X
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PT tests for which coagulation system?
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-extrinsic
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PTT tests for which coagulation system
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-intrinsic
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Coag factor III is
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-tissue factor
-aka thromboplastin |
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Coag factor VII
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-stable factor
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Coag factor IV
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-Ca 2+
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Coag factor VIII
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-antihemophilic factor
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what is an antidote to Vit K
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-warfarin
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What interfers with PT
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-ETOH
-high fat diets or green veggies -drugs |
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INR
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-International Normalized Ratio
- standardizes the results from lab to lab |
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What is bleeding time an indicator of?
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-platelet function
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Heparin
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-accelerates the binding of antithrombin III to thrombin
-antidote: protamine sulfate |
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Fibrin D-dimers are increased where?
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-DIC, PE, and DVT
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What is thrombin time used for?
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-Used to detect presence of heparin, decreased fibrinogen, aids in evaluation of prolonged PTT.
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What labs should you order with bleeding disorders?
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-CBC with diff, platelet count, bleeding time, PT, PTT, TT
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Myelopoesis
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-production of neutrophils, eosinophils, basophils, and monocytes
-maturation process takes 7-10 days |
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components of a CBC
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-total WBC
-total RBC -Hb -Hct |
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Hb consists of...
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-globin, protoporphyrin, and iron
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Hct is increased in...
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-polycythemia vera, smokers, high altitudes, dehydration
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Hct is decreased in...
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-folate def anemia, blood loss, drug or alcohol addiction, Fe def or sickle cell anemia, pregnancy
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How do you differentiate btwn Thalassemia and Fe def anemia?
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-use the RDW
-Thalessemia: NL RDW -Fe def: high RDW |
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T/F: Eosinophils are bacterial-cidal
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False: are phagocytic, but only Ag-Ab complexes
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Basophilia
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- CML, Hodgkin’s disease
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Basopenia
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-hyperthyroidism, acute phase of infection, stress
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The largest cell of NL blood...
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-the monocyte
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What is the monocyte's job?
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-to remove dead cells from circulation
-NL 2-6% |
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When monocytes go to the tissues they are...
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-macrophages
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B cell lymphos
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-involved with ab response to ag
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T cell lymphos
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-involved in cell mediated immunity
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Amt of lymphos in circultion
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-20-40%
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Atypical lymphocytes found in...
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-infectious mono, CMV infection, viral hepatitis, toxoplasmosis
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Erythropoesis
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-red blood cell production in the bone marrow
-Cells develop through four stages of mitosis -taking 4-5 days |
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Ave lifespan of erythrocytes?
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-120 days
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spherocyte
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-no central area of pallor
-osmotic fragility (can burst) -hemolytic anemia, ABO transfusion reactions |
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ovalocytes
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-oval shaped with white centers
-sickle cell, Fe def, thalessemia, megaloblastic anemia |
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target cells
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-small clump of Hb in center surrounded by pallor
-Liver disease, thalessemias, hemoglobinopathies, post-splenectomy |
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schistocytes
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-fragmented cells
-prosthetic heart valves |
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Burr cells
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-rounded projections
-Severe liver disease, uremia, DIC, TTP, carcinoma |
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acanthocytes
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-thorny projections
-anorexia, severe burns and hypothroidism |
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tear drop cells
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-fibrotic bone marrow, ineffective erythropoesis
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stomatocytes
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-smiley cells bc of the slit-like area of pallor
-liver disease, artifact, lupus |
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Helmet cells
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-Pac man
-G6PD crisis, DIC, pulmonary emboli |
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What disease would a Sed rate be useful?
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-polymyalgia rheumatica
-temporal arteritis |
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Sed rate is increased in...
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-infection, inflammation, multiple myeloma, macrocytic disorders, acute MI
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Sed rate is decreased in...
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-microcytic disorders, polycythemia vera, hereditary spherocytosis, sickle cell anemia, hemoglobin C disease
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Sed rate is NL in...
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-allergies, viral infections, cirrhosis, malaria
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Green pee
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-pseudomonas
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Red pee
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-ingestion of beets
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orange pee
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-pyridium
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brown pee
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-macrodantin
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intense yellow pee
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-riboflavin
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pee that smells aromatic
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-NL
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pee that smells like acetone
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diabetics
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pee that has a foul odor
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UTI
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pee that has a fecal odor
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fistula
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NL pH of pee
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4.6-8
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NL specific gravity of pee
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-1.005-1.030
-Measures the concentration of particles in urine -Reflects renal ability to concentrate urine and hydration status |
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Leukocyte esterase
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-Purple (+) for presence of leukocytes, 90% accurate
|
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nitrite
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-If pink(+), indirectly suggests presence of bacteria
|
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Blood-Hemoglobin/myoglobin
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-always be sure to correlate with microscopic.
-If (+) consider infection, nehprolithiasis, menses, exercise regimen |
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Protein
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-normally NOT in urine, present if glomerular membrane is damaged-check
|
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glucose
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-blood glucose > 180 it will exceed renal threshold and spill into urine
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ketones
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--(+) in uncontrolled DM, alcoholism, fasting/starvation states, High protein diets, acute febrile illness
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Bilirubin
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-(+) may be seen in liver disease, gallstones, drug toxicity
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urobilinogen
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-If(+) consider hemolysis
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For casts to form...
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-pH must be acidic and urine must be concentrated
-proteinuria |
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T/F: all areas above the urethra are sterile
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true
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If you see a UTI in a younger male, you should consider...
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STD
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How many organisms would you find on a contaminated plate?
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three or more
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What will appear in urine 10 days after conception?
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-B-HCG
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aspermia
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-no sperm seen
|
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oligospermia
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-count is <20 million
|
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asthenospermia
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-poor mvmt
|
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tetarozoospermia
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-abn morphology
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In the Gram stain, you first fix with...
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methanol
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The second stain you use in the Gram stain is...
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-crystal violet
|
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The third fixing agent in the Gram stain is...
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-iodine
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The counterstain in the Gram stain process is...
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-safranin
|
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gram + cocci in clusters
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staph
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gram + cocci in chains
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strep
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gram + diplococci
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strep pneumonae
|
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gram - diplococci
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neisseria
|
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gram - coccobacillary
|
haemophillus
|
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Giemsa stain
|
-used to identify intracellular organisms such as Chlamydia, malaria, parasites
|
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Acid-fast stain
|
-carbolfuschin
-acid ETOH -brillant green acid fast- dark red to pink non- green |
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enriched agar
|
-most commonly used for primary culture
|
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selective agar
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-selects for certain organisms while inhibiting others
-ex: MacConkey, Martin-Lewis, CNA |
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differential agar
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-colonies of one organism are distinct from colonies of another
-ex: MacConkey, Hektoin |
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What org is catalase +?
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-staph
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What org is catalast -?
|
strep
|
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What org is coagulase +?
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-staph
|
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When using a P disc, a 14mm inhibition zone is indicative of what?
|
-strep
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MIC
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-lowest concentration of antimicrobial agent that will inhibit bacterial growth
|
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MBC
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-lowest concentration of antimicrobial agent needed to yield a 99.9% reduction in colony
|
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serum cidal level
|
-Lowest dilution of a patient’s serum that kills a standard of inoculum of an organism
-monitors endocarditis, osteomyelitis, etc |
|
Pathogens associated with prosthetic joints
|
-Staph epidermidis
-Staph aureus -Cornybacterium sp. -Propionibacterium sp |
|
septicemia
|
-Septicemia-the multiplication of bacteria in blood, bacteria or their products that cause damage to the host
|
|
lumbar puncture showing PMNs, low glucose, high protein
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bacterial
|
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lumbar puncture showing lymphocytes, normal glucose, and normal to moderately elevated protein
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viral
|
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lumbar puncture showing low glucose and elevated protein
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fungal
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