Term
The diagnostic value of a test is defined by it's
4 |
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Definition
1-sensitivity
2-specificity
3-predictive value
4-efficiency |
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Term
1-Sensitivity
2-Specificity |
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Definition
1-probability of a positive test in a diseased person (TP)-true positive
2- probability of a negative test in a non-diseased person (TN)-true negative |
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Term
Equations
1-Predictive Value of a Positive Result (%)
2- Predictive Value of a Negative Result (%) |
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Definition
1) __TP___ X 100
TP + FP
2) __TN___ X 100
FN + TN |
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Term
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Definition
The efficiency of a test is the percentage of the times the test give the correct answer compared to the total number of tests.
___TP + TN______ X 100 = Efficiency of a Test Result (%)
TP + TN + FP + FN |
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Term
Ideal Characteristics of Dx Tests
4 |
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Definition
High Sensitivity
High Specificity
High Predictive Values
High Test Efficiency
MOST TESTS DO NOT MEET ALL THESE CHARACTERISTICS |
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Term
1-Types of Tests 3
2-Normal ranges |
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Definition
1- qualitative, semi-quantitative, quantitative
-Normal Ranges are + 2 S.D. of normal healthy population
Test Precision (free of random error—reproducible)
Test Accuracy (closeness to true value) |
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Term
| Clinical Laboratory Divisions |
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Definition
Hematology
Blood Bank
Urinalysis
Microbiology
Serology
Chemistry
Special Chemistry
Histology/Cytology |
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Term
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Definition
CBC (Complete Blood Count)
WBC
RBC MCV-Mean cell volume
Hgb-hemoglobin MCH- Mean Cell (Corpuscular) Hemoglobin
Hct-hematocrit MCHC-Mean Cell (Corpuscular) Hemoglobin Concentration
Platelet count |
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Term
Normal Values for CBC
1-Platelets (count and volume)
2)Terms for abnormalities |
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Definition
1) Normal 140,000-440,000/uL
Mean Platelet Volume 7-11 fL
2) —thrombocytopenia-decreased platlet count (bone marrow failure)
—thrombocythemia or thrombocytosis- Elevated platelet count |
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Term
Normal Values for CBC
1) Hemoglobin
males, females
2) Hematocrit
males, females |
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Definition
1) Hemoglobin
—14-18 g/dL males
—12-16 g/dL females
2) Hematocrit
-42-52% males
-37-47% females |
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Term
Normal Values for CBC
-what do these abnormalities mean
anemia
polycythemia
macrocytosis
microcytosis
Pancytopenia |
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Definition
anemia- iron deficiency
polycythemia- increase in RBCs (expanded blood volume and blood viscosity)
macrocytosis-is the enlargement of rbc with near-constant hgb concentration, and is defined by a mean corpuscular volume (MCV) of greater than 100 femtolitres
microcytosis- RBCs are unusually small when their MCV is measured
Pancytopenia-a reduction in the number of red and white blood cells as well as platlets |
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Term
1-Reticulocyte Count
2-ESR (Erythrocyte Sedimentation Rate) |
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Definition
Reticulocyte Count
indirect measure of hematopoiesis
# reticulocytes/1000 RBC’s
ESR (Erythrocyte Sedimentation Rate)
measures how far a column of RBC’s falls in one hour’s time |
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Term
| 4 main Hematology Test Indications |
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Definition
—Anemia-low RBC count
—Infection
—Bleeding, bruising
—Leukemia-proliferation of blood cells |
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Term
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Definition
(CBC with RBC morphology)
(Reticulocyte count)
Ferritin level
Serum iron and TIBC
[Serum folic acid level, B12 levels]
[Lead levels and porphyrins] |
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Term
Coagulation Tests
—PT (Prothrombin Time)
1-measures what
2- used to monitor
3-the normal INR reading in healthy people?
4-what is the reading in pt's on coumadin that is therapuetic |
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Definition
1-measures extrinsic and common pathway of coagulation
2-used to monitor warfarin therapy (coumadin)
-INR (international normalized ratio)
-patient test result/control result
3-normally 1.0 in healthy individuals
4)2.0-3.0 in patients on coumadin is therapeutic |
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Term
Coagulation Tests
aPTT (Activated Partial Thromboplastin Time)
1-measures what?
2-used to monitor
3-abnormal reading in persons w/?
4-what unit of time does it report in?
5-how long does it take to coag? in normal people? |
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Definition
measures the intrinsic and common pathways of coagulation sequence
used to monitor old heparin therapy—not needed with LMW heparin commonly used today
abnormal in persons with Factor VIII deficiency
reported in seconds
normal in healthy persons 21-45 seconds |
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Term
Coagulation Tests
D-Dimer
1-measures what
2-what color top tube do you use
3-Used in pt's with suspected what 3 |
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Definition
measures breakdown products of fibrin
blue-top tube required
used in patients with suspected= PE, DVT, DIC
PE-pulmonary embolism, DVT-Deep Vein Thrombosis, DIC- Disseminated intravascular coagulation |
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Term
Immunohematology
1-Bloodtyping
2- Crossmatching
3-Coombs' Test
-Direct
-Indirect |
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Definition
1- Bloodtyping-ABO and Rh typing by antigen/antibody agglutination testing
2-Crossmatching-testing patient’s serum against donor antigens on RBC’s
3- Coombs’ Test
Direct--detect antigens on patient RBC’s
Indirect--detect unusual antibodies in patient serum |
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Term
Microbiology/Virology
1-name the 3 kinds of cultures
-DNA probes
-PCR testing(polymerase Chain Reaction)
-Sensitivity testing
2-Name he thre stains of clinical specimens |
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Definition
1- Bacterial, Myobacterial, Viral
2-Gram's, Acid fast, Silver |
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Term
Serology Tests
1- Tests for syphilis
2-testd for HIV
3- tests for Mononucleosis |
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Definition
1-Tests for syphlis
-RPR/VDRL (Rapid Plasma Reagin/Venereal Disease Research Lab)
-FTA-ABS (Fluorescent Treponemal Antibody-Absorption)
2- Tests for HIV
-ELISA (Enzyme Linked Immunosorbent Assays)
-Western Blot
3- Tests for Infectious Mononucleosis
Mono Spot/Heterophile
(CBC with WBC Differential)
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Term
Serology Tests
1-Hepatitis tests 4
2-Rheumatologic Tests (think autoimmune with the soft tissues and joints) |
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Definition
1-(LFT’s) liver function tests
-Hep A antibody
-Hep B surface antigen, core antigen, antibody,..
-Hep C antibody
2- (Sed rate, or ESR)-Erythrocyte sedimentation rate- tests for auto immune shit (may indicate an inflammatory process)
-RF, ANA, Anti-DNA (Rheumatoid Factor-tests for mainly rheumatoid arthritis; Anti-nuclear Antibodies-good test for SLE, Anti-DNA- good tesst for SLE) |
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Term
Urinalysis
—Macroscopic
—Biochemical
—Microscopic |
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Definition
—Macroscopic
—color, clarity, odor
—Biochemical
—pH, S.G.-specific gravity, protein, glucose, ketones, leukocyte esterase, nitrites, blood (RBC’s, hemoglobin), bilirubin, ...
—Microscopic
—casts, parasites, epithelial/tubular/renal cells,
—RBC’s, WBC’s, bacteria, crystals, mucus |
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Term
Miscellaneous Chemistries
Serum Magnesium-1
Acid Phosphatase-2
PSA (Prostatic Specific Antigen)
Hormones
Drug Levels
Therapeutic monitoring
Drug screens for drugs of abuse |
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Definition
1-
2-Acid Phosphatase- in tissues like the prostate, High levels in semen, good test for swabs of rape victims rectums and vaginas |
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Term
Chemistry
-“Profiles”-screen for specific disorders
LFT’s, RFT’s, T(hyroid)FT’s, Cardiac Profile, Lipid Profile, Electrolytes,...
-“Panels” -general screening
SMA-12, SMAC, Chem-18, Chem -6/7
Workshop Cases |
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Definition
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Term
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Definition
Troponins—total; cTnT; cTnI
CK—Total; MB fraction, MB:total ratio
LDH—Total; LDH1:LDH2
AST
Cholesterol--HDL, LDL, HDL:LDL ratio
(ECG, exercise ECG, Echocardiogram) |
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Term
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Definition
Cholesterol
LDL, HDL, HDL-C
Triglycerides
Lipoprotein Electrophoresis |
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Term
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Definition
TSH level (Thyroid Stimulating Hormone)
T3 Uptake, T4, T7
T3 RIA
Free T4 |
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Term
Liver Function Tests
1-enzymes (5)
2-Anabolism-building up (3)
3-Catabolism (1) |
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Definition
1-Enzymes=AST, ALT, GGT, LDH, ALK Phos
2-Anabolism=Proteins (TP, Albuman, Globulins)
-Glucose
-Lipids
3-Catabolism= Bilirubin, direct and indirect |
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Term
| Why do we test for free enzymes in the blood? |
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Definition
| Because when there is cell death, the cell breaks down and the enzymes that where inside the cell are now floating freely in the blood. The free enzymes in the blood prove cell damage to a certain area, because different tissues of different organs have cells that contain specific enzymes |
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Term
non-specific enzymes that are released from damaged/dead cells of organs of the body
5 |
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Definition
AST--aspartate aminotransferase
ALT--alanine aminotransferase
GGT--gamma glutamyl transferase
LDH--lactate dehydrogenase
AP--alkaline phosphatase |
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Term
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Definition
—AST--aspartate aminotransferase
—formerly known as SGOT
—found in highest concentration in heart
—also found in liver, skeletal muscle, kidneys, brain, pancreas,…
—released with cell damage/death
—non-specific enzyme |
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Term
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Definition
ALT: alanine aminotransferase
found primarily in liver; lower concentrations in heart, skeletal muscle, kidney
prior name: SGPT
released with cell necrosis
more specific for liver disorders than AST |
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Term
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Definition
GGT--gamma glutamyl transferase
Most sensitive marker for liver disease, ETOH consumption, or obstructive jaundice
Found in kidneys, liver, prostate, spleen. |
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Term
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Definition
AP--alkaline phosphatase
found primarily in bone, liver, and placenta; lesser quantities in kidneys and intestines
five measurable iso-enzymes
1. Liver
2. Bone
3. Intestine
4. Kidney
5. Placenta |
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Term
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Definition
LDH--lactate dehydrogenase
found in multiple body tissues
highest concentrations in heart, liver, brain, skeletal muscles, kidneys, and RBC’s
five isoenzymes
LDH 1-5
1-2 flip flop in MI= (LDH2 is usually higher than LDH1, but with an MI they are reversed) |
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Term
Products of Anabolism
—Total Proteins
1- composed of how many diffeent protiens
2-which protein comprises the largest fracion of total proteins
3-
4-
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Definition
—composed of ~100 different proteins
—Albumin comprises largest fraction of Total Proteins
—Globulins, lipoproteins, coag factors
—A/G ratio= Albumin/Globulin ratio
(TP-Albumin=globulins) TP may be normal, but albuman may be decreased and globulins increased. |
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Term
Products of Anabolism
-Glucose
1-Primary sorce of?
2-Stored where? as what?
-Cholesterol
1-formed by what organ?
2-component of what kind of hormones? |
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Definition
Glucose
1-primary source of energy for all body functions
2-stored in liver as glycogen
Cholesterol
1-formed by liver
2-component of steroid hormones |
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Term
Products of Catabolism
Bilirubin
1-byproduct the degradation of what?
2-direct and indirect fractions?
3- too much in the body causes what? |
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Definition
Bilirubin
1-byproduct of hemoglobin degradation
2-direct-(conjugated bilirubin) indirect-(free or unconjugated bilirubin before it is converted in the liver and excreted as bile)
3-jaundice
prehepatic
hepatic
posthepatic |
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Term
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Definition
(Urinalysis)
BUN and Creatinine
Uric Acid
Total Protein
Albumin, A/G ratio
Calcium, Phosphorus
Arterial blood gases
Osmolality |
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Term
Electrolytes
name 4 and then the other 3 |
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Definition
Sodium--Na
Potassium--K
Chloride--
CO2
(Calcium, Phosphorus, Magnesium) |
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Term
Electrolytes
1-Sodium (Na) is the main what and where in relation to the cell?
2-Potassium (K) is the main what and where in relation to the cell?
3-Chloride is predominantly located where in relation to the cell and has what charge |
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Definition
1-Sodium--main extracellular cation
2-Potassium--principle intracellular cation
3-Chloride--predominately extracellular anion-(negativly charged ion)
CO2
(Calcium, Phosphorus, Magnesium) |
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Term
Creatinine
1-Breakdown product of what
2-what kind of rat is this produced
3-Dependent on what for each individual
4-what organ normally excretes creatinine |
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Definition
Breakdown product of muscle metabolism
Produced at constant rate
Dependent on muscle mass of individual
Kidneys normally excrete creatinine |
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Term
Uric Acid
1- Nitrogen containing end product of what?
2-Excreted in what?
3-Increased levels more commonly associated with __________ than ___________. |
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Definition
Nitrogen containing end product of purine metabolism
Excreted in urine dependent upon renal function--glomerular filtration and tubular secretion
Increased levels more commonly associated with renal failure than gout |
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Term
BUN
1-what does is it stand for
2-End product of ______ metabolism formed in the liver as _________, then detoxified and transported to the __________ for excretion
3-Levels are influenced by _____ and rate of _______ catabolism as well as _________
4-measure of what in body? |
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Definition
BUN (Blood urea nitrogen)
end product of protein metabolism formed in liver as ammonia, then detoxified and transported to the kidneys for excretion
levels influenced by diet and rate of protein catabolism as well as excretion
measure of toxin accumulation in body |
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Term
Calcium and Phosphorus
1- Calcium--most abundant _________ in body
-50% bound to ______ and 50% _______
-decreased TP=decreased total _______
2-Phosphorus
-storage/liberation of body ___________
-regulation of body ______
-formation of ________
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Definition
1-Calcium--most abundant cation in body
-50% bound to protein; 50% free
-decreased TP-->decreased total calcium
2-Phosphorus
-storage/liberation of body energy (ADP/ATP)
-regulation of body pH
-formation of bone |
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Term
Ca/P Levels in Disease States
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Disease/Condition
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Calcium Level (total)
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Phosphorus Level
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Hyperparathyroidism
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________
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__________
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Hypoparathyroidism
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_________
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__________
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Renal Insufficiency
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__________
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__________
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Rickets, Osteomalacia
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___________
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_________
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Growing children
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___________
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__________
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Bone cancer, Multiple myeloma
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____________
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__________
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Definition
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Disease/Condition
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Calcium Level (total)
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Phosphorus Level
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Hyperparathyroidism
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Increased
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Decreased
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Hypoparathyroidism
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Decreased
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Increased
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Renal Insufficiency
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Decreased
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Increased
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Rickets, Osteomalacia
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Decreased
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Decreased
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Growing children
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Increased
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Increased
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Bone cancer, Multiple myeloma
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Increased
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Normal
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Term
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Definition
pH
pCO2
pO2
Bicarbonate |
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Term
Chemistry Panels
—Screening tests
—Relatively inexpensive
—Single specimen for multiple analyses
—Number of false positive results increases with number of tests performed |
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Definition
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Term
Biochemical Profiles
Chemistry Profiles (4) |
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Definition
1-Chem Panel
2-SMA-12 or -24 (Simultaneous Multiple Analyses)
3-chem 19
4-chem 7 |
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Term
|
Definition
1)Electrolytes
-NA
-K
-Cl
-Cl
2)BUN
3)Creatinine
4)Glucose
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