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
Malaria
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: srugs
major variations occur in: genetic variations
what are some other variables that cause differences: sex stress menstrual cycle menopause and altitude
a: j
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: needles
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: venipuncture
what is the RBC: calculation of RBCs per cubic millimeter
what else are RBCs called: erythrocytes
what is the principal function of RBCs: transport of oxygen
what do incresed levels indicate: burns
chronic hypoxia
COPD
dehydration
high altitude
polycythemia vera
pulmonary fibrosis
sickle cell disease
thalassemia
what do decreased levels indicate: bone marrow suppression
chemotherapy
chronic inflammation
infection
hemolytic anemia
hemorrhage
Hodgkin's disease
leukemia
multiple myeloma
hemodilution
systemic lupus erythematosus
B6 B12 or folic acid deficiency
what are red blood cell indices: MCH
MCHC
MCV
MCH: mean corpuscular hemoglobin average amount of hemoglobin per cell
MCHC: mean corpuscular hemoglobin concentration average concewntration of hemoglobin in a single cell
MCV: 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: 5
what are they: neuatrophils
eosinophils
bosophils
lymphocytes
monocytes
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: hematocrit
hemoglobin
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: 1.000
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: polyuria
oliguria
nocturia
anuria
hematuria
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: ciliary
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: ALT
protein developed by body protects from an antigen: antibody ****
enzyme made in liver cells made in muscles damaged muscle heart kidney and brain tissue: AST/SGOT ****
part of virus signals body to protect itself: antigen
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: ferritin
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: INR
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 ****
PTT: 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: true
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
CYTOLOGIST SCIENTIST STUDIES CELLS ***
what is histology: study of tissues
HISTOLOGIST SCIENTIST STUDIES 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: 4
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: matrix
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: -cyte
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: fibroblasts
there arepractically NO ACCESSORY CELLS: IN DENSE CONNECTIVE TISSUE PROPER

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