Path 4/27 Clinical Path

Front 1

Prothrombin Time

Back 1

PT= coagulation screening test, dependent primarily on Factor VII

Front 2

PTT

Back 2

(Activated) partial thromboplastin time: coagulation screening test dependent primarily on Factors X, VIII, and IX

Front 3

Acquired inhibitor

Back 3

a substance (usually an Ab) circulating in plasma that interferes with the function of one or more procoagulant facotrs. Acquired = not congenital

Front 4

Factor VIII

Back 4

procoagulant factor necessary for normal clot formation and conversion of firbinogen to fibrin

Front 5

Von Willebrand's Factor (vWF)

Back 5

a large protein produced by endothelial cells that circulates in plasma as a multimer; serves as a carrier protein for Factor VIII

Front 6

Fibrinogen (Factor I):

Back 6

Plasma protein that is acted upon by thrombin to make fibrin though cleavage of some portions

Front 7

Fibrin

Back 7

the polypeptide derived from fibrinogen that links together to form the fibrillar basis of clots

Front 8

Reference interval

Back 8

normal range or range not predictive of disease

Front 9

Normal range

Back 9

values in an analysis that are considered normal, usually encompasses ~95% of normal adult values

if distribution in population is Gaussian, range is usually +/- 2 standard deviations

Front 10

Specificity

Back 10

"negativity in health" = the likelihood of a negative (normal) test result when the patient is not sick

(decreases with false positives)

Front 11

Sensitivity

Back 11

"Positivity in disease" = the likelihood of a positive (abnormal) test result if the patient is sick

Front 12

False positive

Back 12

Positive (abnormal) test result when patient is not sick

Front 13

False negative

Back 13

Negative (normal) test result when patient IS truly sick

Front 14

True positive

Back 14

Positive (abnormal) test result when patient is turly sick

Front 15

True negative

Back 15

normal (negative) test result when the patient is truly not sick

Front 16

CK

Back 16

creatine (phospho)kinase, an enzyme found in muscle cells

Front 17

CK-MB

Back 17

an isoform of CK found predominantly in myocardiocytes

Front 18

LD or LDH

Back 18

lactate dehydrogenase, an enzyme found in many tissues, including myocardiocytes

Front 19

Pro-BNP:

Back 19

a form of B-type Natriuretic Peptide found in myocardiocytes and released on their stress; cleaved to BNP

Front 20

ROC Curve

Back 20

Receiver Operating Characteristics Curve: A curve describing the ability of a test to correctly distinguish health from disease

Front 21

Positive predictive value:

Back 21

the probability in a given population that a postive (abnormal) result is due to the presence of disease; that is, if the result is abnormal, what is the change the patient really has this disease

Front 22

Negative predictive value

Back 22

the probability (in a given population) that a negative (normal) result is found in health; that is, if the result is normal, what is the chance the patient really does not have the disease

Front 23

Single Nucleotide Polymorphism

Back 23

a change (mutation) in the genetic code at a single base

Front 24

PCR

Back 24

polymerase chain rxn: analytic method that uses enzymes to amplify a specific section of the genome so that its presence can be detected. uses a "primer" (DNA or RNA complementary to the squence of the genome being sought) and a polymerase to make copies of the targeted section of the genome. occurs in temp-dept "cycles" during which the primer can anneal wiht the genome and be replicated

Front 25

Transcription-mediated amplification

Back 25

a variant of PCR accomplished all at one temperature

Front 26

Internal control:

Back 26

a sample of material similar to the analyte that is added to the sample and that will be acted upon in the testing system in the same manner as the analyte; an expected result documents completion of the system and assay

Front 27

Glomerulonephritis

Back 27

inflammation of the kidney centered in the glomerulus

Front 28

Autoimmune

Back 28

immune disease targeting an Ag native to the patient

Front 29

Crescents

Back 29

reactive cells in the columerular space (leading to fibrosis and obliteration of glomeruli)

Front 30

dendritic cells

Back 30

cells of the immune system that are responsible for recognizing and presenting antigens to T lymphocytes to generate cytotoxic T cells

Front 31

cytotoxic T cells

Back 31

t lymphocytes primed to respond to specific Ags with the ability to kill the cell displaying the Ag

Front 32

cytokines

Back 32

polypeptides produced by one cell (usually lymphocytes) to alter the fxn of another. usual requirements through exposure to unusually large multimers of vWF. usualyl caused by a deficiency of ADAMTS-13 activity leading to vWF not being cleaved on release from endothelial cells; these autopolymerize to unusually large size and activate platelets in the absence of other factors usually required. activation of platelets leads to microthrombi and a hemolytic anemia.

Front 33

ADAMTS-13

Back 33

a metalloproteinase, normally found in plasma, responsible for cleaving vWF to its normal size

Front 34

Apheresis

Back 34

a technique for separating whole blood from a donor or patient into its component parts (returning to the donor/patient) parts not of interest

Front 35

Plasma exchange

Back 35

a form of apheresis in which plasma is removed and replaced with normal donor plasma