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Lab and Path


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what is a lab test
medical procedure sample of blood urine or other tissues or substances in body is checked for features
when are such tests used
part of a routine checkup identify changes in health before symptomns appear
why else
checked for changes from previous tests
why are lab tests analyed
determine results fall within normal ranges
why are normal test values given as a range rather than number
normal values vary from person to person
what can affect test results
sex age race medical history general health
what can affect tests sometimes
specific foods drugs how closely patienat follows pre-test insturctions
why is patient asked not to eat or drink for several hours before test
tests are affected by foods
what varies from lab to lab
common normal ranges
what do tests provide
some precise reliable indicators specific health problems others provide general info give clues to possible health problems
what is done with info from tests
help decide whether other tests or procedures are needed to diagnose
how else is the info helpful
helps doc develop or revise patient's treatment plan
how must the lab tests be interpreted
in context of overall health of patient
what are lab tests genereally used along with
other exams or tests
lab tests important role in diagnosis when person has
symptoms *******
lab test medical procedure in whic sample of ______ urine other tissues checked
blood ******
MT's shoud hav understanding of lab medicine to be able to catch
errors ******
all lab test _______must be interpreted in context
results ******
info obtained from lab tests help doctors decide whether other tests needed to make a
diagnosis ******
what may be ____ to one person may be ______to another
normal abnormal
name some other reasons why lab tests results vary and why certain number doesn't necessarily mean anything without the other medical data to accompany it
Labs are different may interpret values or perform testing in different way than another
name 2 more reasons
patient may be fasting or non-fasting

patient may be pregnant
why are athlete's different
they have slight elevations of urea nitrogen lowered pulse rate after physical exercise results may be significantly elevated compared to non-athlete
why must age be taken into consideration
different normal ranges exist for young and elderly
why is posture a consideration
reported to change normal range of many tests such as protein albumin calcium hemoglobin and hematocrit higher when in upright position
what happens in a standing postion
venous pressure in lower body increases chain reaction to cfause other tests to increase in value
why does body weight make a big difference
creatinine clearance and blood volumes require this data
medical judgement is needed why
significance of few red cells in urine sample depends on catheterization menstruation sex computer can not classify as normal or abnormal
what are some tests that have NO normal because ANY quantity is considered abnormal
Alcohol and other toxins
VDRL serologic tests for syphilis
Urine glucose ketones blood bile nitrite
why does food and nutrition make a diff
some tests require fasting state fasting blood sugar lipid profile iron iron binding capacity glucose tolerance tests
what does prolonged fasting increase
serum bilirubin up to 240% after a 48-hour fast
what happens with blood test drawn immediately after a meal
eleabvated potassium depressed phosphorus elevated triglycerides other tessts hightly elevated after fatty meal
what does a high protein diet show
elevated BUN ande ammonia
what does alcohol cause immediate increases
uric acid lactate and acetone
what does oral contraceptives increase
certain thyroid tests and as many as 100 lab tests
hemolysis from hemolyatic anemia or venipuncture causes increases in what
associated with release of thromboplastins an may invalidate results of coagulation tests
what are circadian rhythms
24-hour cycle
during circadian rhythms what fluctuates
cortisol growth hormone serumn acid phosphatase serum iron and creatinine some test only drawn specificd hours of day
what should be done with lots in specimens
should be anticoagulated or generate misleading results
what other specimen mishandling may cause misleading results
tube exposure to sunlight sunlight causes bilirubin decrease in teswt tubew as it does in an infant
why do sampling problems cause problems
best not to draw blood from exstremity in an IV infusion site may have dilutional changes invalid
what happens with a tourniquet
lead to build-up of high potassium and lactic acid and pH will decrease
why may capillary punctures be misleading
possibley introduce tissue juices
arterial specimens differ to venous normal ranges how
for tests pertaining to oxygen levels lactic acid pO2 and oxygin saturation
what play a factor in relaying incorrect values
instrumentation failure
genetic variations exist in how individuals metabolize
major variations occur in
genetic variations
what are some other variables that cause differences
sex stress menstrual cycle menopause and altitude
what are necessary in the lab
precautions to protect lab workers and patient
what disease is an increasing risk for health care workers
HIV more prevalence risk increased workers will be exposed to blood from patients
what do most hospitals now practice
Universal Precautions
what is Universal Precautions
presupposed ALL patients are potentially infective
what has Center for Disease Control recommended
specific guidelines for protecting healthcare worker washing hands thoroughly before and after testing using appropriate barrier precautions prevent skin and mucous membrane exposure when contact with blood or other bodily fluids is anticipated
careful handling of ____ is very importants to the healthcare worker
most hospitals have guidelines in place to prevent injuries caused by
needles scalpels other sharp instruments or devices during procedures when cleaning or didsposing of uised instruments
what should not be done to needles when disposing
not be recapped purposely bent or broken by hand removed from syringes or manipuilated in any way
where shoulod needles be placed
in puncture-proof containers for disposal
why should needles never bew recapped
increases risk healthcare worker will miss the cap and stick his/her finger
what can be very useful in dagnosing a patient
blood tests
what is blood made up of
different cells and compounds
where is blood taken from
vein or artery
how much blood is needed
sometimes only a few drops fingerprick test
when is a fingerprick test done
to test blood sugar in diabetic patients
what other methods are there to test blood
finger puncture
heel puncture
venous puncture
arterial puncture
capillary puncture
what is another name for venous puncture
what is the RBC
calculation of RBCs per cubic millimeter
what else are RBCs called
what is the principal function of RBCs
transport of oxygen
what do incresed levels indicate
chronic hypoxia
high altitude
polycythemia vera
pulmonary fibrosis
sickle cell disease
what do decreased levels indicate
bone marrow suppression
chronic inflammation
hemolytic anemia
Hodgkin's disease
multiple myeloma
systemic lupus erythematosus
B6 B12 or folic acid deficiency
what are red blood cell indices
mean corpuscular hemoglobin average amount of hemoglobin per cell
mean corpuscular hemoglobin concentration average concewntration of hemoglobin in a single cell
mean corpuscular volume average volume or sizse of a single red blood cell
Hematocrit Hct
percentage of RBC mass to original blood volume
what can increased levels indicate
life-threatening crises hemoconcentration or polycythemia overtransfusion
decreased levels Hct
life-threatening crises hemodilution or blood loss
what are critical values of Hct
15% or over 60%
what is Hemoglobin Hgb
main intracellular protein of erythrocytes oxygen-carrying compound contained in RBCs
Increased levels of Hgb
hemoconcentration or polycythemia overtransfusion
severeliy decreased levels Hgb
hemodilution or blood loss
critical values Hgb
less than 5g/dL
what is WBC
body fights infecion using WBCs or leukocytes
how many types of WBCs are there
what are they
increased levels of WBCs
leukemia trauma tissue injury infection from bacteria death of tissue burns MI gangrene
severely decreased levels of WBCs
bone marrow depression viral infections bone marrow disorders pernicious anemia or aplastic anemia iron deficiency anemia
critical values WBCs
less than 500 cells per cubic millimeter or more than 30,000 cells/mm3
what is CBC
combination report of sewries of blood tests
what is identified
quantity percentage variety concentrations and qualify of blood cells
which tests are included in a CBC
redcell count
what is the hematocrit test
also known as Hct Crit PCV packed cell volume used to evaluate anemia decrease of red blood cells decreased hematocrit anemia
what is hemoglobin test
diabetes test
red blood cell test what
meassurements descibe size and oxygen-carrying protein hemoglobin contedt of red blood cells anemia
another name for venous puncture
venipuncture ******
blood is taken from vein or
artery *****
body fights infections using WBCs or
leukocytes ******
CBC combination report of series of
blood ******* test
red blood cells called
erythrocytes *****
name a urine test
24-hour urine collection
what is a good collecton of a 24-hour urine test
discard first morning specimen day one
collect all specimens throughout day and evening include first morning specimen day two
how much fluid for a 24-hour collection
normal fluid intake allowed sometimes dietary restricions required
name another urine test
12-hour urine collection
what is examined looking at a uirine specimen
color odor specific gravity *****
what color should urine be
yellow to amber include analysis of color and cloudiness
what is noted in odor of urine
normal urine aromatic odor develops into ammonia-like oros on standing due to decompensation overripe apple fecal odor fruity new mown hay or fishy all helps learn info
what is specific gravity *****
ratio of weight of certain volume of urine to same volume of water at temp of 4 degrees celsius
what specific gravity does water have
what SG does urine have
1.010 to 1.030 depending on concentration
how will dictator usually dictate specific gravity
one oh one oh no decimels
what is microscopic examination
urine examined under microscope for evidence of casts pus cells redblood cells and epithelial cells *****
what is bacteriologic exam
may yeild valuable info infections of urinary tract ****
what are some common urinary conditions
what is polyuria
urine in excess of two quarts a day *****
what is oliguria
decreased urinary output ****
what is nocturia
excessive passage of urine at night ****
what is anuria
complete inability to urinate *****
what is hematuria
blood in urine *****
describe CSF
clear colorless fluid surrounds brain and spinal cord
what is the diagnostic procedure called
spinal tap spinal puncture long needle inserted into vertebral canal
how is pressure of cfs obtained
patient lying on side
increased or decreased CSF clues to
cetain illnesses and diseases
what is sputum
exudate produced in excwessive quantity in bronchial pulmonary and tracheal infections
____ movements cause sputum to move up trachea
what happens next
coughing discharges them into mouth to be expelled
example of sputum test
TB test also dermatologically
what is bacterial exam
body secretion exudates and fluids are performed by stained smears and cultures
why are stained smearss and cultures performed
determine specific bacteria causing illness treat with antibiotics specific to bacteria
what may bacteria in blood represent
bacteremia or septicemia
what is bacteremia
short-lived occurrence bacteria in blood no clinical evidence infection
what is septicemia
invasion of micro-organisms into blood stream multiply and cause toxins
what is gram stain
organisms referred to as gram-positive/negative
who was the Gram stain invwented by
Dr.Gram always capitalized; use lower case letters whwen referring to gram-positive or gram-negative
protein often used as tumor marker for liver cancer
AFP ****
magor protein in blood made only by liver
albumin *****
also known as Alk Phos enszyme made in liver's bile ducts bone kidney and intestine
alkaline phosphatase ****
an enzyme meade in liver cells if liver cells damage or die this leaks into bloodstream
protein developed by body protects from an antigen
antibody ****
enzyme made in liver cells made in muscles damaged muscle heart kidney and brain tissue
part of virus signals body to protect itself
tesst for all blood cells RBCs WBCs
CBC *****
synthesiszed in liver build hormones vitamins and cell membranes high levels atheriosclerosis
cholesterol ***
breakdown oproduct of creatine phosphate protein found in mucscle made by kidnesy
creatinine *****
primary storage form of iron saturated in blood in body high levels liver disease or hemochromatosis
test positive currently infected hepatitis B virus
Hepatitis B antigen ****
measures percentage of RBCs per volume of blood sample
hematocrit ****
protein protion of RBCs carries oxygen
hemoglobin ****
System reporting results of blood clotting tests
WBCs produce antibodies fight viral infections
lymphocytes ***
white blood cells destroy foreign bacteria
monocytes *****
white blood cells play role inflammation allergic reactions etc
neutrophils ****
small blood cells help blood clot
platelets ****
includes large particles blood made of albumin and globulins Total___
Protein ****
measure of time takes for blood to clot
Prothrombin Time ****
Partial thromboplastin time ******
small cells carry oxygen in blood low levels anemia
RBCs ****
thyroid tests
T3 T4 ******
breakdown product from hemoglobin old RBCs removed from blood by liver broken down sent to intestines trhough bile ducts Total____
bilirubin ****
hormone cause other thyroid hormones T3 T4 to be produced thyroid hormones help body function
TSH ****
fatty substances in blood
triglycerides *****
five types neutophil eosinophils basophils monocytes lymphocytes fighting infections
WBCs ****
albumin 3.6 mg/dl
AFP 5 ng/ml
true ***
PT 13 seconds
true ***
WBCs 4.8/mm 3
true ***
creatinine .9mg/dl
true ***
basos 0.01 k/fl
True ***
ferritin 350 fg/l
false ****
PTT 22.0 sec
false ***
Hct 42%
True ***
lymphs 1K/fl
true ***
monos 0.1 K/fl
false ***
cholesterol 260 mg/dl
false ***
Iron 55%
true ***
Alk phos 170 U/L
false ****
total protein 6.0 g/dl
true ***
Hgb 18 g/dl
true ****
what is cytology
study of cells
what is histology
study of tissues
what is pathology
study of tissue
what is tissue
group of similar cells work together to perform particular functions in body
how many basic categories of tissue with EVERY CELL in body
epithelial tissue
covers body surfaces lines hollow organs body cavities blood vessels forms glands ***
connective tissue
protects and supports body and organs holds organs together stores energy provides immunity ***
bone cartilage and blood
specialized connective tissue
muscle tissue
responsible for movement ***
nerve tissue
carries info as electrical impulses throughout body ***
why does epithelial tissue make a good covering or lining for body surfaces
Epithelial cells are CLOSE together little space between them ***
what are epithelial tissues
skin hollow organs stomach body cavities blood vessels
what is the top surface of epithelial tissue
apical surface ***
what is apical surface
that which is exposed to its ewnvironment
name some apical surfaces
lining blood vessels exposed to blood
skin exposed to air
stomach lining exposed to food
what exception of epithelial tissue has no apical surface
endocrine glands
what is the bottom surface of epithelial tissue
basal surface
describe the basal surface of epithelial tissue
gives off a substance that glues it to underlying tissue to hold it in place
due to ongoing wear and tear what happens to epithelial cells
constantly reproducing
what are the two types of epithelial tissue
lining or covering epithelia

glandular epithelial ****
describe lining or covering epithelia
comprised of SEVERALO LAYERS of epithelial cells can be thick protects other types of tissue covers from phyusical damage drying out and infections
where are some locations for multi-layer epithelial tissue
skin mouth tongue esophagus vagina mammary glands salivary glands sweat glands urethra ureters bladder eye
some epithelial tissue comprised of ONE LAYER
thin fragile main function to allow various substances to pass bwetween different cavities lines their surrounding tissues
locations for single-layer epithelial tissue
lungs trachea kidneys heart blood vessels lymphatic vessels ovaries uterus entire digestive tract and several glands
what shapes sdo epithelial cells come in
flat squamous
square cuboidal
rectangular columnar
transitional cellshape depends on how tissue is stretched all occur in thick and thin epithelial tissue
what is the most common skin cancer
squamous cell carcinoma afflicts more 200,000 am e/year can occur on all areas of body most common areas exposed to sun
where do most glands come from
epithelial cells specialized for producing secretions
what do glandular epithelia contain
hormones enzymes mucous
what are glands classified as
endocrine glands exocrine glands depending on path of secretion
name some endocrine glands
pituitary thyroid adrenals ovaries and testes
describe these endocrine glands
ductless secreting hormones directly into bloodstream surrounded byi other tissues do not have apical surface
which are exocrine glands
salivary sweat mammary etc
describe exocrine glands
DO HAVE APICAL SURFACE release their many substances ***
most exocrine glands have what
ducts through which their substances are carried to apical surface
what happens to the substances in exocrine glands
are NOT released into blood but secreted into open body cavities
e.g. digestive respiratory reproductive tracts or onto body surfaces
general characteristics of connective tissue
connective tissue are far apart CELLS
what is the large space between cells filled with
matierial forms different kinds of matrices in space
what determines how tissue is structured and how it functions
bone and muscle are both
connective tissue
what are the 2 categories of cells that exist in connective tissue
cells that secrete and maintain matrix of each type of connective tissue

accessory cells which are supported by connective tissue
what does each typed of connective tissue contain
immature cell type secretes matrix these cells have names end in -blast
what does the matrixc do
gives special lcharacteristics to tissues type
what happens when matrixc is produced
immature -blasts lose their ability to multiply and become mature cells
mature cells have names that end in
describe mature -cytes
less active an responsible for maintaining matrix in healthy state
what are accessory cells
fat storing cells support connective tissue providing reserve energy fuel
WBCs mast cells macrophages involved in
body's defensew elemination of dying or dead tissue cells
what is the matrix itself composed
ground substance and fibers
what does the ground substance do
fills the space between cells contains different kinds of finbers composed of fluid cell adhesion proteins and proteogylcans
what lets connective tissue cells attaches to matrix
adhesion proteins
what are proteoglycans
proteins to which polysaccharides are attached
what do polysaccharides do
collect varying amounts of water and forma substance that varies in consisitency from fluid to thick gel the more polysaccharides the more gel-like the ground substance
what do ground substance support
cells binds them together assists in moving nutrients between capillaries and cells
what do fibers in matrix do
give connective tissue strength
what types of fibers are found in connective tissue matrix
collagen fibers
elastic fibers
reticular fibers
describe collagen fibers
white extremely tough high tensile strength able to resist longitudinal stress are found in tendons ligaments
describe elastic fibers
yellow can be stretched to one and on-half times theira length return to original length when releasewd found lungs and blood vessel walls
reticular fibers
fine collagenous fibers brainching network supports several soft organs liver and spleen
what does connective tissues proper do
immature fibroblasts n connective tissue proper secrete matrix mature fibrocytes maintain matrix fibroblasts embedded in matrix
describe connective tissue proper
loose and serve as general packaging material within body may also be dense tendons and ligaments denseness is related to concentration of protein fibers vs ground substance in matrix
describe looswe tissue in connective tissue proper
fibers loosely woven and ground substance is visible
describe dense tissues in connective tissue proper
fibers are tightly packed and sheer number overwhelms ground substance
what is fascia
connective tissue proper of the loose type nearly impossible not to cut through fascia during surgery enverlopes muscles bones and joints holds body together
loose connective tissue proper can be subdivided into 3 types
areolar tissue
adipose tissue
reticular tissue
many accessory cells blood fat etc can be found where
in loose connective tissuse proper
name characteristics function and location of areolar tissue
most widely distributed in connective tissue
general packaging tissue
covers organs wraps small blood vessels and nerves surrounds glands found on skin also in mucous membranes
characteristics function location of adipose tissue
areolar tissue invaded by fat cell adipocytes
insulates body against heat loss supports protects organs shock absorber
accumulates in subcutaneous tissue around kidney and eyeballs bones breast and abdomen
char. function and location of reticular tissue
packed with riticular fibers
forma stroma framework supports blood cells
spleen and bone marrow
most of cells in dense tissue are
there arepractically NO ACCESSORY CELLS

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