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99 Cards in this Set
- Front
- Back
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What is the purpose and significance of RPR?
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RPR is a non-troponemal test for the antibody reagin for infection of syphilis caused by treponema pallidum
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What is a Reagin?
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It is a phospholipid which is produced in pts infected with treponema pallidum.
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What is the causative agent of syphilis?
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Treponema pallidium
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Where would you find the reagin in Pts?
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in the serum or plasma
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What is the vehicle or antigen used to see RPR results macroscopically?
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Carbon Charcoal Particles
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For RPR testing, what supplies are needed for the test?
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RPR card antigen suspension
disposable bottle 20 guage galvanized blunt tip needle Test card pipettes or stirrer RPR test Control Cards |
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What type of water is used for this QC of blunt needle and used to reconstitute dried serum in test card?
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Distilled water
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How long should RPR specimen cards be placed on rotator? How many RPM's?
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8 Minutes at
100 RPM |
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What shows a reactive sample?
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Flocculation ranging from slight but definate
Minimum to moderate Marked and intense |
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Reactive RPR must be confirmed using what method?
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Fluorescent Treponemal Antibody Absorbtion Test
FTA-ABS |
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How long do you mix the antigen suspension for RPR testing prior to opening ampule
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10-15 sec
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What shows no Flocculation?
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Non-reactive RPR test
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Why do we perform QA?
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to ensure the accuracy and reliability of test results
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QCing the antigen needle, how do you ensure it is calibrated?
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Make sure that 1ml of fluid equals 60 gtts +/- 2
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How do we test for Epstein Bar Virus?
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Monospot for mononucleosis
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Mono is typically seen in which age group?
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Children under 5 years of age and young adults
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How will mono present?
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Maliase
lethargy sore throat ENLARGED LYMPH NODES on neck Enlarged spleen |
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What would you see on a blood smear for mono?
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Atypical lymphocytes and monocytes, they occumulate in the lymph nodes causing the formation of heterophil antibodies
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How long do we have to test the blood for monospot?
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24 hours and stored at 2-8 degrees celcius
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How do you report results of monospot
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Pos or Neg.
You will see the presence of agglutination or a smooth homogenius solution which is neg for agglutination |
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How long do you rotate slide for monospot?
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3 minutes between 60 to 100rpms
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For monospot how should control reagents be treated
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As patients and run every time an unknown sample is run
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What are the clinical reasons for performing urinalysis testing
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a. Indicator of health
b. Cost-effective diagnostic test c. Non-invasive d. Simple to perform |
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What does urinalysis Test to detect and assess
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1. Renal function/disorder
2. Endocrine or Metabolic function/disorder 3. Urinary tract infection 4. Systemic diseases |
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How long do you have to analyze a fresh urine specimen
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1-2 hrs
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What will happen to a urine specimen if held too long at room temperature
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It will begin to decompose due to bacteria in the sample and decomposition will cause delivery of inaccurate results.
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During decomposition of urine what causes an increase in urine pH
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Ammonia
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During decomposition of urine what will disolve any present casts
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High pH
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In decomposition of urine what causes results in false negative glycosuria
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If glucose is present, the bacteria may use it as a source of energy resulting in false negative glycosuria
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Which urine preservative
1. Preserves acetone, diacetic acid and proteins by floating on top of urine (airtight seal) 2. Flammable, difficult to separate from specimen |
Toluene
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Which urine preservative
1. Inhibits bacteria/fungus 2. usually causes false positive for protein |
Thymol
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Which urine preservative
1. Preserves urine aldosterone levels 2. Settles to bottom of containers |
Chloroform
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Which urine preservative method
1. Is For specimen transport 2. May destroy formed elements |
Freezing
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What urine preservative
1. Preserves urinary sediment/cells. 2. Interferes with glucose elevation |
Formaldehyde
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Which urine preservative
1. Stabilizes steroids 2. Hazardous liquid & fumes. Formed elements are destroyed |
Hydrogen Chloride (HCL)
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Which urine preservative
1. Preserves chemical and formed elements 2. Uric acid may precipitate |
Boric acid
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Which urine preservative
1. Preserves urine for dipstick chemical analysis and sediment evaluation, if transport is necessary 2. Unsuitable for sodium, potassium and hormone analysis |
Preservation tablet
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What are 4 types of non-instrumented urine collection
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a. First-morning void
b. Random urine specimen c. Clean catch urine specimen d. 24-hour urine specimen |
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What type of urine collection is the Recommended specimen for chemical and microscopic examination
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First morning void
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Which urine collection specimen is Most convenient and most common
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Random
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How soon must a urine culture be preformed after collection
and what type of collection sample is best suited for cultures |
within 12 hours after collection (refrigerated specimen) and clean catch
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Which urine collection specimen gives quantitative results and May require preservative
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24 hr urine
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Which urine collection method is choice for markedly obese patients
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Urethral Catheterization
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Which urine collection method is not recommended for bateriologic examaninations but may be used if no other way to collect urine
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Urethral catheterization
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Which urine collection method is choice on infants and young children
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Suprapubic Needle Catheterization
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Which urine collection method yields optimum cellular sample of bladder epithelium
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Catheterization and bladder irrigation
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What is the regular urine volume in a 24 hr period
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600-2000ml with an average of 1500ml
depending on: a. fluid intake b. temperature and climate c. amount of perspiration |
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What is the normal color of urine and what is it due to.
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Yellow - dark amber and is due to pigment (urochrome) concentration
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What is blue green urine color indicative of?
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Methylene blue. (used as dye or stain in diagnostic procedures)
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What is dark orange urine color indicative of?
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Pyridium (used in the tx of UTI's)
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What is the milky white urine color indicative of?
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Chyle
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What is olive green to brown black urine color indicative of?
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Phenols (poisionous compounds used for antimicrobial agent)
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What is yellow to brown urine color that turn greenish with foam when shaken indicative of
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Presence of bile
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What is red or red brown (smokey appearance) urine color indicative of?
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Presence of blood
This would be termed hematuria |
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What is turbid alkaline urine due to
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1. Amorphous phosphate
2. Amorphous carbonate |
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What is turbic acidic urine due to
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1. Amorphous urates
2. A pinkish turbidity frequently indicates the presence of urates |
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What is sweet or fruity smell in urine indicative of
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Presence of keytones
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What is a sweet or fruity odor in urine indicative of
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Presence of keytones
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What is a pungent smell of urine due to
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Due to ammonia produced by bacteria
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What is a maple syrup smell in urine indicative of
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a congenital metabolic disorder
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What is musty or mousy smell of urine indicative of
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An infant with phenylketonuria
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When urine smells like sweaty feet what is this indicative of
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Isovaleric acidemia, presence of butyric or hexanoic acid in urine
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What is the normal specific gravity of a random urine
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1.003-1.035
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What is the normal specific gravity of a 24hr urine
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1.015-1.025
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What is urine glucose dependent on
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a. blood glucose level.
b. rate of glomerular filtration c. degree of tubular reabsorption |
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When has Glucosuria occured
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Once the threshhold level of 160-180 mg/dL in the blood is exceeded
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What is Keytonuria a direct result of
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incomplete fatty acid utilization.
It may indicate diabetes mellitus |
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Any condition that causes what will result in billirubin in the urine?
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Jaundice
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What is the normal concentration of Urobilinogen in the urine
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1 EU or less
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What does bilirubinuria indicate
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a. Heptocellular disease
b. Intra or extra-hepatic biliary obstruction |
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What is the normal range of urine pH?
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4.6 - 8.0 with an average of slightly acidic 6.0
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What pathologic conditions may cause acidic urine
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a. Respiratory and metabolic acidosis
b. UTI by E. Coli c. Uremia d. Severe diarrhea e. Starvation |
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What pathologic conditions may cause alkaline urine
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a. UTI caused by proteus and pseudomonos species
b. Respiratory and metabolic alkalosis |
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What 2 mechanisms do protienuria mainly occur by
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1. Glomerular damage
2. Defect in the reabsorption process of the tubules |
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What is the range for MINIMAL proteinuria and what are conditions that cause MINIMAL proteinuria
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0.5 g/day
a. Polycystic kidneys b. Chronic pyelonephritis c. Inactive chronic glomerulonephritis d. Benign orthostatic proteinuria |
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What is the range for MODERATE proteinuria and what are conditions that cause MODERATE proteinuria
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0.5 - 3.5 g/day
a. Nephrosclerosis b. Tubular interstitial disease c. Preeclampsia d. Multiple myeloma e. Diabetes nephropathy f. Malignant hypertension g. Pylonephritis with hypertension h. Toxic nephropathies |
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What is the range for SEVERE proteinuria and what are condition that causes SEVERE proteinuria
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3.5 or greater
a. Glomerulonephritis b. Intercapillary glomerulosclerosis c. Lupus nephritis d. Lipoid nephrosis e. Amyloid disease f. severe venous congestion of the kidney |
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What is the lifecycle of plasmodium (malaria parasite)
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1. Female anopheles bites man
2. Sporozoites inject into mans liver 3. Sporozoites become schizonts. 4. Schizonts replicate asexually into merozoites. 5. Schizonts rupture releasing merozoites to invade the RBC's 6. Inside RBC it enlarges and forms a ring-form-trophozoite 7. The nucleus divides and creates a schizont. 8. The schizonts replicate asexually into merozoites in the RBC and then rupture into the bloodstream 9. This causes the fever and chills. 10. Plasmodium enter a sexual phase when some merozoites in the RBCs develope into gametocytes. 11. They are extracted into the mosquito via the blood. 12. The male and female gameocytes form diploid zygotes which ultimately differintiate into Oocysts. 13. Within the Oocysts repeated mytotic divisions take place producing large numbers of sporozoites. 14. Sporozoites migrate to the salavary glands of the mosquito. Which is injected into the human upon bite starting the lifecycle of the malaria again. |
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What are the four types of Malaria found in humans
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1. Plasmodium falciparum (most fatal)
2. Plasmodium vivax (most common) 3. Plasmodium malariae (quarantine 72hrs) 4. Plasmodium ovale (quarantine 48hrs) |
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What are the two methods of blood collection for a plasmodium specimen
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Capillary collection into EDTA capillary tube or venous collection into purple top tube
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If venous collection is obtained for plasmodium specimen 1.how long can you store the blood, 2. at what temp, 3. What must be done before performing test
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1. up to 3 days
2. at 36-86 F or 2-30 C 3. must be at room temp before testing |
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What is reagent A in the malaria test kit
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Tris buffer containing detergent and sodium azide
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How many drops of reagent A do you prime the reagent pad with
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2 drops. allowing each drop to absorb between drops. Place additional 4 drops just before the mix reaches top of the test strip.
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On a malaria test kit what must appear in order to be valid
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C the control line
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On a malaria test kit what does T1 indicate
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Pos for plasmodium falciparum
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On a malaria test kit what does T2 indicate
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Pos for plasmodium Vivax, Malariae, Ovale, or combination of any or all of the three
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If only the control line appears on a Malaria specimen what is indicated
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Neg for any malaria
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For best results when should you collect a specimen for malaria testing
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Imediately following a fever or before a fever spike
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What does a malaria test kit detect and how is malaria confirmed
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Detects the antigens only and for pos T1, T2, or both it must be confirmed with a thick and thin smear by NEMPU
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What are some conditions that may cause false pos for malaria antigens
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Rhumatoid arthritis
chronic viral infections (Hep C) other blood parasite (babesia) |
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When is influenza best diagnosed
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within 2-3 days
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How is influenza transmitted
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through aerosolized droplets. Coughing / sneezing
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Rapid Influenza test must be read after how many min
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15 min
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How is a negative result for rapid influenza test read
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Blue control line in the bottom third window turns pink-to purple color and no other line appears
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How is a rapid infulenza test read for pos flu A
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Blue control line turns pink and a second pink sample line appears above it in the middle third of the window
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How is a rapid influenza test read for pos flu B
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Blue control line turn pink and a second pink line appears above it in the top third line of the window.
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What must be done if a rapid influenza sample is ran and the control line remains blue
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Test is invalid and must run new test
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What are the 3 controls for malaria
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reactive
weak reactive non-reactive |
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What is the antigen used for FTA-ABS
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The dead bug of treponemum pallidum itself
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