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Lab di Lab FINAL
| Question | Answer |
|---|---|
| what is serology? | the study of antigen-antibody reactions IN VITRO |
| What are serologic tests used for? | identify infactions without culturing the causative agent (hiv, syph, lyme, hep), allowing diagnosis to be made in a more timely manner |
| What are the two types of seologic principles? | 1. tests to detect antibody production (MC) 2. tests for antigen production |
| What are three serologic tests that detect antibody production? | 1. monospot 2. aso 3. rf |
| what type of antibodies does one with mono(EBV) produce? | heterophile antibodies |
| what do heterophile antibodies react with? | with paul-bunnell antigens on sheep and other mammal RBCS |
| How does monospot test for EBV? | uses a reagnent containing latex particles, coated with highly purified antigen from bovine red cell membranes. Latex particles allow visula observation of antien-antibody rxn (agglutination_ |
| what is a name for antibody-antigen rxn? | agglutination |
| What does an elevated level of antistreptolysin O indicate? | Past recent infection with group A beta-hemolytic streptococci, and can aid in diagnosis of conditions with post-strpt infections such as rheumatic fever and acute glomerulonephritis |
| How does the rheumajet ASO kit show a positive test | A reagent containging latex particles coated with recombinant streptolysin O, if the serum contains abnormally high levels of antistreptolysin O agglutination will be visible. |
| what is Rheumatoid factor? | an IgM autoantibody that acts as an antibody to bind with the Fc region of IgG(antigen) |
| what are two other possible types of rheumatoid factor? | IgA and IgG |
| What does the Rheumatoid Factor kit use? | a reagent containing latex particles coated with human gammaglobulin, if RF is there will agglutinate d/t IgG coated to the latex particles. |
| What are the three tests for antigen production? | CRP (c-reactive protein) 2. rapid group A strep 3. hCG |
| what can c reactive protein activate? | complement |
| Does ESR or CRP increase and decrease more rapidly? | CRP |
| CRP increases within ______ hours of onset of inflammation | 4-6 hours |
| Is CRP found in normal serum? | yes in very low concentrations. |
| High CRP lacks value when what? | when the pts illness is not defined |
| CRP is high in what illnesses? | infectious states, rheumatic fever, RA, MI, malignant tumor, abdomincal abcesses |
| CRP levels are useful for? | monitoring illnesses, and a dif dx in certain dz states |
| What does the rheumajet CRP kit use? | a reagent containing latex particles coated with IgG fraction of an antihuman CRP specific serum. |
| What is high sensitivity CRP (hsCRP) used for? | as a predictor of increased risk of acute MI and stroke, it is more sensitive and can detect lower amounts of CRP associtaed with chornic inflammation |
| What is in the cell walls of group A streptococci which is an antigenic determinant? | Carbohydrate A |
| what illnesses are caused by group A strept? | tonsillitis, pharyngitis, and scarlet fever, which can lead to rheumatic fever and acute glomerulonephritis. (S. pyogenes) |
| What does the Rapid group A strept test kit do? | extracts Carbohydrate A from the thraot swab, then the sample migrates by capillary action thru a test pad containing anti-strep A antibody. If antigen is present there will be a pink-to purple precipitate on the test pad |
| How is the hCG kit used? | serum or urine placed on sample well of test cassette, if hCG is present it reacts with an antibody specific to the beta subunit of hCG resulting in a pink to purple precipitate on the test pad. |
| glucose in urine indicates? | diabetes, or large amounts of carb intake |
| bilirubin in urine indicates? | biliary obstruction, or hepatitc or liver dz |
| ketone in urine indicates? | decreased intake of carbds dt starvation prolonged vomitting, dehydration, fever, diasbetes insipiidus |
| what causes specific gravity? | concentrating or diluting ability of kidney |
| low specific gravity? | diabetes insipidus or tubular damage |
| high SG? | diabetes mellitus, dehydration, feverm congestive heart failure |
| what does hemoglobinuria indicate? | intravascular hemolysis |
| what can cause blood in urine? | renal dz, trauma, renal stones, strenuous exercise, hemolytic anemia, transfusion rxns |
| acidic urine? | diabetes, starving, high protein diet |
| basic urine? | after meals, bacterial infections, chronic renal failure |
| first indication of renal dz is? | proteinuria |
| increased protein in urine? | renal abnormality, glomerular, tubular damaged or excess overflow |
| non dz reasons for proteinuria? | strenuous exercise, exposure to cold, fever |
| at what time is the highest excretion of urobilinogen in the urine? | between 2 and 4 pm |
| what may cause increased amounts of urobilinogen? | hemolytic anemia, and liver damage |
| when is there negative urobilingoen? | in biliary obstruction |
| nitrites in urine indicate? | indicator of UTI by e. coli, klebsiella, enterobacter, pseudomonas |
| leukocyte esterase indicates? | increased whbs of inflammation, uti |
| Alanine aminotransferase (ALT) | ltrasaminase primarily of hepatic origin |
| albumin (ALB) | largest single fraction of plasma proteins |
| Alkaline Phosphatase (ALK PHOS) | found mainly in liver and bone (also placenta and intestine), in bone is elevated whenever osteoblastic activity occurs (PAGETS, growth, blastic tumors, healing fracs, etc) |
| Amylase | pancrease, greatly increased with acute pancreatitis, variable in chronic pancreatitis |
| Aspartate amino transferase (AST) | transaminase mainly found in mm, including cardiac and liver. |
| Indirect bilirubin | unconjugated (increased prehepatic -- intravascular hemolysis) |
| direct bilirubin | conjugated (hepatic, dz or postbepatic, biliary blockage) |
| Blood Urea Nitrogen (BUN) | produced by protein catabolism in liver, but cleared by and used to assess kidneys (renal clearance), affected by dietary protein intake. |
| Calcium | serum levels dependent on hormonal regulation, increased by PTH and calcitrol, decreased by calcitonin |
| what causes 90% of hypercalcemia? | hyperparathyroidism or malignancy (bone, mets primary, mult myeloma) |
| Carbon dioxide | important buffer in acid-base balance, maintaining blood pH lung and kidney function |
| chloride | major extracellular anion, important in water balance |
| cholesterol TOTA | liver performs lipid metabolism, and monitored to help assess risk of cardiovasc dz |
| HDL | produced by liver, cardioprotective |
| LDL | produced by liver, increased associated with CAD risk |
| where is creatine kinase found? | found in straited mm and brain |
| when is creatine kinase elevtaed (CK, CPK) | with mm damage, brain injury, cardiac damage associated with CK isoenzymes |
| CK-MB | cardiac specific creatine kinsase elevated after mi |
| creatinine (creat) | waste product of creatine metabolism by mm for energy prodctuion, BUT assess renal function as it is cleared by the kidneys |
| Gamma-glutamyl transferase (GGT) | found in many tissues, but major source is liver |
| first enzyme to increase in hepatic dz? | GGT |
| glucose (FBS, FPG) | used to assess for glycemic control, dz and monitoring of DM |
| lactate dehydrogenase (LDH) | in tissues, mainly liver, mm, heart lung and kidneys, also found in RBCS |
| when is LDH increased? | hemolytic conditions |
| lipase | pancreatic enzyme, increased in pancreatitis |
| Magnesium | found mostly in bone, and mm (involced with mm contraction) |
| what can increased levels of magnesium cause? | respiratory paralysis and cardiac arrest |
| Phosphorus | most found in bone some in mm, cleared by kidney. Serum levels dependent on hormonal cotrol, increasted by calcitonin, decreased by PTH and calcitrol |
| when is there increased levels of phos? | renal failure (kidneys can't clear phos) |
| potassium | moves into cells along with insulin |
| when is K increased? | renal failure (failure to clear) and renal tubular acidosis |
| Sodum | important in water distribution and maintaining osmotic pressure |
| when is Na increased? | dehydration |
| triglycerides | main storage lipid, not considered an independent risk factors for atherosclerosis, but if HDL decreased theres increased risk of pancreatitis |
| All other proteins other than albumin are referred to as? | globulins |
| where are almost all plasma proteins produced? | liver |
| What does total protein assess? | livers synthetic ability, dependent on nutritional status and normal GI function |
| decrease in total protein with? | hepatic dz, nephrotic dz |
| increase in total protein? | most commonly with dehydration, also multiple myeloma and other plasma cell dyscrasias |
| Uric acid | end prod of purine metabolism, cleared by kidenys, increased in gout and renal dz |
| What is included in a lipid panel? | total cholest, HDL, LDL< Trigs, and may also include HDl/LDL ratio, high sensitivity CRP |
| Liver/hepatic function panel consists of? | ALT, AST, GGT, Totaly protein, albumin, total bilirubin, direct bilirubin (may also include indirect bili, and A/G ratio) |
| whats included in an electrolyte panel? | Na, K, Cl, CO2(HC03) |
| what is included in a renal function panel? | BUN, creatinine, Na, K, Cl, CO2, uric acid, glucose, phos, total protein, albumin, creatinine clearance (24 hr urine collection for golmerular filtration assessment( |
| What is included in cardiac markers? | CK, LDH, AST, CK-isoenzymes (CK-MB), Troponins, myoglobin |
Created by:
margaretrhager
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