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117 Cards in this Set
- Front
- Back
What is the source of amylase?
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Saliva, salivary glands, pancreas (from acinar cells)
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How sensitive / specific is amylase?
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Sensitive test for not specific to pancreas disease
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What is the main cause of elevated amylase?
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Pancreatitis
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What is the source of Lipase?
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Pancreas
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What is the normal function of lipase?
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Break down triglycerides
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What is the normal function of amylase?
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Break down carbs
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What is the PSA? How is to be used?
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Prostate Specific Antigen. It is not entirely conclusive for prostate cancer. Healthy prostate tissue makes it. It is more accurate when monitoring response to tumor after therapy than in diagnosing initial tumor.
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What is the PSA test done in conjuction with?
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Prostate exam
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What are the four electrolytes tested for? What is important about their relationship to each other?
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Na, K, Cl, Bicarb - positives need to equal negatives
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What is the normal value for sodium?
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135 to 145
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What are the critical values for sodium?
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<120 or >160
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What is the major extracellular cation?
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Sodium
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What hormone causes sodium reabsorption at the distal tibule?
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Aldosterone
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What hormone causes loss of sodium?
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Natiuretic
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What is the normal value for potassium?
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3.5 to 5
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What are critical levels?
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<2.5 >6.5
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What is the major intracellular cation?
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Potassium
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What is needed in order to interpret potassium?
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Acid base balance of patient
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What three factors affect potassium levels?
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1) Aldosterone - increases loss of K through kidneys
2) Sodium resorption - as sodium is resorbed, K is lost. 3) Acid / base balance. More acidic states raise K (push it out of cells) More basic states lower K (push it into cells) |
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What is the most common cause for loss of potassium?
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GI tract
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What are the normal values for chloride?
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98 to 106
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What are the critical values?
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< 80 or >115
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What is the normal value of bicarb?
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23 to 30
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What is clinically important about CO2?
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It is a major role in acid-base balance
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Where is bicarb regulated?
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Kidneys
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What are the normal values for bicarb?
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21 to 28
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Where is bicarb found? Where is CO2 found?
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arterial blood / venous blood
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How is an anion gap determined?
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#1: Na + K
#2: Cl- +HCO3- +12 If #1 exceeds #2 by more than 25, anion gap exists AG = (Na + K) - (Cl- + Bicarb) Cations greater than anions by 25 |
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What are causes of increased anion gaps?
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Diabetic ketoacidosis, ethylene glycol (antifreeze), drugs, lactic acidosis, starvation, renal failure, ketogenic diets, MI, starvation
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In what two forms is calcium stored?
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Ionized and bound to albumin.
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What is significant about the ionized and non-ionized form of calcium?
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Ionized form is the active form. Non-ionized is bound to albumin so if albumin is low, calcium will be too.
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What is the relationship between total calcium and albumin?
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Total will decrease by .8mg for every 1g decrease of albumin.
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Where is calcium regulated?
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Parathyroid
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What is the main cause of increased calcium?
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Cancer in particular with metastatic bone disease and tumors that produce PTH-like substances
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What is the relationship between calcium and phosphate?
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When calcium goes down, phosphate goes up.
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What is the most common cause of phosphate increase?
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Renal insufficiency. Hypoparathyroidism as well.
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What is magnesium needed for?
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Using ADP as source of energy. Organs need it.
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What suppresses magnesium?
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High phosphate and calcium
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What is the normal total cholesterol?
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<200
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What is the normal HDL cholesterol
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>55
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What is the normal LDL cholesterol?
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<130
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What is the normal triglycerides?
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40 - 160
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What are the "good cholesterols"?
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HDL
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What are the "bad cholesterols"?
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LDL
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What is the Friedwald formula?
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LDL = Total - HDL - (triglycerides/5)
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What three things are bound to protein in blood?
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bilirubin, thyroxine, calcium
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What does total thyroxine (t4) provide?
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Measure of overall thyroid function
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What protein to thyroxines bind to?
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Thyroid-Binding Globulin (TBG)
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How does Triiodyothyronine (T3) compare to T4?
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More accurate?
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What is the single best test to diagnose hypothyroidism?
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Thyroid Stimulating Hormone. Low T3 and T4 stimulate this.
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What is the T3 Resin Uptake test useful for? What is normal?
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TBG levels. Low results means high TBG and vice versa. 25 to 35%
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What is the advantage of the Free Thyroxine Index?
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Measures active T4 that is not bound to TBG, so TBG abnormalities can't interfere with the test.
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What is pathway of urine creation? What happens at each step?
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Blood enters from afferent arteriole and into glomerulus where blood portion is sent away through efferent arteriole. Remaining parts enter boman's capsule > proximal convuluted tubal where protein water and glucse are reabsorbed. Then loop of henley where water is reabsorbed. Then distal convuluted tubual where secretion (glucose) happens. Then collecting ducts.
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How long can urine be stored?
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Up to 4 hours if refrigeration starts within 30 minutes of collection.
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What is specific gravity?
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Measure of concentration of dissolved solids
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What is normal range of specific gravity? What does the range depend on?
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1.002 to 1.040. Hydration.
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Specific gravity provides information about the function of which part of the nephron?
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Tubules
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What is the confirmatory test for glucose in the urine? What is it based on?
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Clinitest - cooper's copper reduction
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What is the confirmatory test for proteins in the urine?
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Sulfosalicyclic Acid Precipitation
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What is the confirmatory test for ketones?
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Acetest (nitroprusside reaction)
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High dose of vitamin C can cause what on the urine dipstick?
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False negative for glucose
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A high urine pH can cause what on the urine dipstick?
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false positive protein
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What is the ratio of urine to water for the clinitest?
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5 drops urine to 10 drops water
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How much time should elapse after urine drop is added to Acetest before interpretting results?
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30 seconds
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What can cause a false negative for SSA testing?
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Alkaline urine
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What can cause a false positive for the SSA test?
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x-ray contrasts, antibiotics
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What is the ratio of urine to SSA for the SSA test?
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1o drops of urine to 10 drops SSA
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What does SSA stand for of the SSA Urine Test?
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Sulfosalicylic acid
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What are the three normal layers of anti-coagulated blood in a test tube? What percent of each is in the blood?
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Top layer: plasma 55%
Middle layer: buffy coat (WBC) 1% Bottom layer: RBCs 45% |
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What is the additive in the red top tube? What is it used for?
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None / blood banking, serology
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What is the additive in the lavender blood collection tube? What is it used for?
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Na or K-EDTA, whole blood, hematology CBC
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What is the additive in the light blue blood collection tube? What is it used for?
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Sodium citrate, plasma
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What is the additive in the green blood collection tube? What is it used for?
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Heparin, plasma
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What is the additive in the dark blue blood collection tube?
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sodium heparin
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What is the additive in the gray blood collection tube?
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Potassium oxalate / sodium flouride
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What are three considerations to make when drawing blood?
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How old is the patient? What is the minimum amount of blood needed? Are there any special prep considerations?
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What vein is used for venipuncture in the arm?
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Antecubital vein
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Which finger should be used for finger sticks?
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Ring or middle on non-dominant hand
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What can be done to make heelstick and fingerstick blood draws more plentiful?
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Warm the area for 5 to 10 minutes > arteriole vasodilation
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When should phlebotomy not be performed?
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infection, mastectomy, burns
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How does OSHA define bloodborne pathogen?
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Pathogen that can spread via blood, body fluid, and tissue
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What are the three major bloodborne pathogens?
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Hep B, Hep C, HIV
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What procedure should be followed to limit exposure?
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Methods of Compliance
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What document provides a list of safety protocols?
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Exposure Control Plan
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What is the primary airborne pathogen?
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Tuberculosis
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When are TB patients infectious?
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When symptoms develop. Risk is greatest with ACTIVE TB.
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What is important about MDR-TB
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Resistant to antibiotics.
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75% of blood exposure incidents happen how?
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Needle sticks
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What is clinical sensitivity?
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Likelihood a test will be positive in presence of disease.
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What is clinical specificity?
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Likelihood that a test will be negative in the absence of a particular disease
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What is a screening test?
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Very sensitive and not highly specific (HIV ELISA, glucose, etc.)
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What is a confirmatory test?
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More specific than screening test. Eliminates false positive.
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What is a profile?
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Series of tests by function or organ.
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Difference between parametric and non-parametric data?
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Parametric - fits bell shaped curve
Non-parametric - uses percentiles instead |
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What is biological variability?
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A person may not be diseased based on a test results
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What is analytical variability?
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Glucose, for example, is + / - 3% based on the lab doing the testing
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What is the difference between traditional units and system international units?
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Traditional: mg/dL or mEq/L
SI: mmol |
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What is the normal pH of the vagina?
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3.8 to 4.2
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What can a pH of >4.5 in the vagina indicate?
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Bacterial vaginosis or trichomonas
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What regulation allows PAs to use microscopy as a medical tool?
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Clinical Laboratory Improvement Amendments
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What % KOH should be used? What does it do?
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10 to 20%. Wipes out everything except mycelia or pseudomycelia.
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What does the KOH whiff test for?
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Trichomonas and BV.
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What can be verified using cultures?
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candidiasis and trichomonas
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Where is pin worm test completed?
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perianal skin
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What is the most common cause of blood in the stool?
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Hemorrhoids and anal fissures
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What does dark stool indicate?
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Bleeding from upper GI
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What does light stool indicate?
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Bleeding from lower GI
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What is the normal amount of blood in stool?
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2.0 to 2.5 ml
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What is the sensitivity of the occult blood test?
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5 to 10 ml
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What food should be avoided two days prior to occult blood test?
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Foods with peroxidase (radish, broccoli, etc.)
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What drugs interfere with the occult blood test?
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Salicylates, steroids, indomethacin, colchicine, iron (high dose), rauwolfia derivatives
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What are the three types of fungal diseases?
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Dermatophytoses - athlet's foot
Subcutaneous mycoses - subcut tissue Systemic mycoses - deep tissue and organs |
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What does a wood's light lamp test for?
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Fungus
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What is bacterial vaginosis?
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Overgrowth of the normal flora in the vagina (decreased lactobacilli and increased anearobic)
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What are the four items of Amsel's Criteria?
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Presence of homogenous thing gray/white discharge
Vagina pH > 4.5 Positive whiff test Clue cells present |
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What is trichomonas? When do symptoms worsen?
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Motile parasite, STI, menstration
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What is the most common helminthic infection in the US? How is it transmitted?
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Enterobius vermicularis (pin worm), fecal oral
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