Clinical Application of CBC and Strep Tests
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Questions and Answers

What is the relationship between total bilirubin and its components?

  • Total bilirubin is an independent measure of liver function.
  • Total bilirubin is equal to direct bilirubin only.
  • Total bilirubin equals indirect bilirubin minus direct bilirubin.
  • Total bilirubin is the sum of direct and indirect bilirubin. (correct)

    • Which enzyme is primarily associated with liver cell injury?

  • Aspartate aminotransferase (AST)
  • Alanine aminotransferase (ALT) (correct)
  • Alkaline phosphatase (ALP)
  • Bilirubin

    • Which scenario would likely lead to an increased level of aspartate aminotransferase (AST) in the bloodstream?

  • Increased alkaline phosphatase activity.
  • Injury to skeletal or cardiac muscles. (correct)
  • Normal liver function without any injuries.
  • Decrease in direct bilirubin levels.

    • Which of the following enzymes is primarily involved in pathological evaluations across multiple systems?

    <p>Alkaline phosphatase (ALP)</p> Signup and view all the answers

    What condition is associated with elevated total bilirubin in the blood?

    <p>Hyperbilirubinemia</p> Signup and view all the answers

    Which organ is primarily responsible for the production of bilirubin?

    <p>Liver</p> Signup and view all the answers

    What does a high specificity in a test indicate about its positive results?

    <p>It is highly accurate in predicting the disease when the result is positive.</p> Signup and view all the answers

    What is the normal range for white blood cell count (WBC)?

    <p>4.5 – 11 x10^3/mm3</p> Signup and view all the answers

    Which index would indicate the average size of red blood cells?

    <p>MCV</p> Signup and view all the answers

    In a Complete Blood Count (CBC), what does hematocrit (Hct) measure?

    <p>The volume percentage of blood that contains erythrocytes.</p> Signup and view all the answers

    What classification would characterize cells that are larger than normal with lower hemoglobin concentration?

    <p>Macrocytic, hypochromic</p> Signup and view all the answers

    Which of the following options best describes thrombocytopenia?

    <p>Decreased platelet count.</p> Signup and view all the answers

    What is the normal range for hemoglobin in females?

    <p>12 – 16 g/dL</p> Signup and view all the answers

    Which of the following values is within the normal range for MCHC?

    <p>35 g/dL</p> Signup and view all the answers

    What hormone is detected by a urine pregnancy test?

    <p>Human chorionic gonadotropin (HCG)</p> Signup and view all the answers

    How long after conception can HCG levels typically be detected in urine?

    <p>2 weeks</p> Signup and view all the answers

    Which of the following statements about pregnancy testing is true?

    <p>The presence of HCG confirms pregnancy.</p> Signup and view all the answers

    In individuals with vulvas, what should always be considered when diagnosing symptoms?

    <p>Pregnancy as a possibility</p> Signup and view all the answers

    Which component can be found in urine and is related to diagnostics?

    <p>Skin cells from surrounding organs</p> Signup and view all the answers

    What is the primary purpose of conducting a urine microscopy test?

    <p>Analyzing and diagnosing infections or abnormalities</p> Signup and view all the answers

    Which is NOT true about HCG in relation to urine pregnancy tests?

    <p>It indicates the exact week of gestation.</p> Signup and view all the answers

    Which method of testing provides an early indication of pregnancy?

    <p>Urine pregnancy test</p> Signup and view all the answers

    What percentage range of segmented neutrophils is considered normal?

    <p>54 – 62%</p> Signup and view all the answers

    Which white blood cell type is associated with allergic reactions and parasitic infections?

    <p>Eosinophils</p> Signup and view all the answers

    Which method is NOT typically used for counting white blood cells?

    <p>Spectrophotometry</p> Signup and view all the answers

    What does a 'No growth after 48 hours' result in blood cultures indicate?

    <p>Absence of bacteremia</p> Signup and view all the answers

    Which test is primarily used to evaluate kidney function?

    <p>Blood Urea Nitrogen (BUN)</p> Signup and view all the answers

    What does an increased bicarbonate (HCO3) level indicate regarding acid-base status?

    <p>Metabolic alkalosis</p> Signup and view all the answers

    Which component is included in a Comprehensive Metabolic Panel (CMP) but NOT in a Basic Metabolic Panel (BMP)?

    <p>Albumin</p> Signup and view all the answers

    What is the role of the minimum inhibitory concentration (MIC) in susceptibility testing?

    <p>Determines the smallest amount of antibiotic needed to inhibit growth</p> Signup and view all the answers

    Which of the following values represents normal potassium levels in the blood?

    <p>3.5 – 5.0 mEq/L</p> Signup and view all the answers

    When blood cultures are being collected, why are two sets obtained from different sites?

    <p>To avoid contamination from skin bacteria</p> Signup and view all the answers

    What is the main form of calcium present in serum?

    <p>Ionized calcium and bound to albumin</p> Signup and view all the answers

    How is ionized calcium primarily assessed in a clinical setting?

    <p>By a specific test or calculation</p> Signup and view all the answers

    What does a CMP generally evaluate?

    <p>Liver function tests, total bilirubin, and calcium</p> Signup and view all the answers

    Which of the following urine test values is considered normal?

    <p>Protein levels in males of 70 mg/24 hrs</p> Signup and view all the answers

    In a urinalysis, what does the presence of nitrites indicate?

    <p>Possible urinary tract infection</p> Signup and view all the answers

    What is the normal range for urine pH?

    <p>4.6-8.0</p> Signup and view all the answers

    Which test is NOT included in a basic urinalysis?

    <p>Total bilirubin</p> Signup and view all the answers

    What condition does an elevated alkaline phosphatase level in children often indicate?

    <p>Bone growth</p> Signup and view all the answers

    What is the normal value range for specific gravity in urine?

    <p>1.002-1.028</p> Signup and view all the answers

    What does the presence of glucose in urine indicate?

    <p>Potential diabetes mellitus</p> Signup and view all the answers

    Study Notes

    Strep Test and Specificity

    • High specificity tests ensure accurate disease diagnosis, minimizing false positives.
    • In a group with negative strep tests, evaluation of true negatives is critical for clinical confidence.

    Complete Blood Count (CBC) Overview

    • Normal ranges:
      • WBC: 4,500-11,000/mm3
      • RBC (male): 4.3 - 5.9 million/mm3
      • RBC (female): 3.5 - 5.5 million/mm3
      • Hemoglobin (Hgb): male 13.5 – 17.5 g/dL, female 12 – 16 g/dL
      • Hematocrit (Hct): male 41-53%, female 36-46%
      • Other values include MCV, MCH, MCHC, RDW, and Platelet counts.

    Function of CBC Components

    • WBC count helps diagnose leukocytosis (high) or leukopenia (low).
    • RBC count determines erythrocytosis (high) or erythrocytopenia (low).
    • Hemoglobin indicates oxygen-carrying capacity of blood.
    • Hematocrit assesses the volumen of RBCs in blood.

    Erythrocyte Indices

    • MCV (Mean Corpuscular Volume): Indicates RBC size, aids in identifying macrocytic, microcytic, or normocytic conditions.
    • MCH (Mean Corpuscular Hemoglobin): Quantifies hemoglobin per RBC, impacting classification as hyperchromic or hypochromic.
    • RDW (Red Blood Cell Distribution Width): Measures variation in RBC size.

    White Blood Cell Differential

    • WBC types and their significance:
      • Neutrophils: Acute infections and inflammation
      • Eosinophils: Parasitic infections and allergies
      • Lymphocytes: Viral infections
      • Monocytes: Chronic infections
      • Bands: Immature neutrophils, indicating acute infection.

    Blood Culture Protocol

    • Blood cultures require aerobic and anaerobic bottles to prevent contamination.
    • Cultures help diagnose bacteremia, caused by conditions like sepsis or endocarditis.
    • Inoculation time is generally 3-5 days for results; bacteria grow within 24-48 hours.

    Susceptibility Testing

    • Follow-up testing on positive cultures to determine antibiotic susceptibilities.
    • Minimum Inhibitory Concentration (MIC) is assessed to find the least amount of antibiotic needed for effective treatment.

    Basic Metabolic Panel (BMP)

    • Key values:
      • Sodium: 136 – 145 mEq/L
      • Potassium: 3.5 – 5.0 mEq/L
      • Chloride: 95 – 105 mEq/L
      • Bicarbonate: 22-28 mEq/L
      • Glucose: Fasting 70 – 99 mg/dL
      • BUN: 7-18 mg/dL
      • Creatinine: 0.6 – 1.2 mg/dL
      • GFR: >60 mL/min/1.73 m3

    Clinical Significance of Electrolytes

    • Sodium: Regulates hydration and volume status.
    • Potassium: Critical for muscle function and cell metabolism.
    • Glucose: Main energy source, levels indicate hypoglycemia or hyperglycemia.
    • Bicarbonate: Essential for acid-base balance, indicates acidosis or alkalosis.

    Comprehensive Metabolic Panel (CMP)

    • Includes all BMP tests plus:
      • Albumin: 3.5-5.5 g/dL
      • Total Protein: 6.0-7.8 g/dL
      • Total Bilirubin: 0.1-1.0 mg/dL
      • Liver enzymes: AST, ALT, Alkaline Phosphatase
      • Calcium: 8.4-10.2 mg/dL

    Urinalysis Overview

    • Normal values include clear appearance, yellow color, pH of 4.6-8.0, negative for leukocyte esterase, nitrites, and ketones, and presence of 0-4 WBC and ≤2 RBC.

    Importance of Urinalysis

    • Assesses for metabolic, renal, infectious, inflammatory, and hepatic disorders.
    • Components evaluated include appearance, pH, protein, specific gravity, glucose, and presence of blood.

    Pregnancy Testing

    • Detects human chorionic gonadotropin (HCG) levels in urine post-conception.
    • Results may not be detectable until approximately 2 weeks after conception, critical for women of childbearing age.

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    Description

    This quiz focuses on the clinical application of Complete Blood Count (CBC) tests and the implications of negative strep test results. Understand the importance of test specificity in clinical diagnosis and the normal ranges for CBC parameters. Enhance your knowledge on how these tests assist healthcare providers in making informed decisions.

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