Medical Tests and Their Indicators

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Questions and Answers

What does a blue color change indicate in a fecal occult blood test?

  • Presence of hCG
  • Absence of colon disease
  • Presence of hidden blood (correct)
  • Presence of dietary fiber

What is a key advantage of the fecal occult blood test?

  • Requires invasive procedures
  • Provides immediate results
  • Low cost and non-invasive (correct)
  • Can identify the exact cause of bleeding

In a pregnancy test, when do hCG levels typically become detectable?

  • One week after implantation (correct)
  • Before ovulation
  • At the end of the first trimester
  • Immediately after fertilization

Which of the following conditions can a positive fecal occult blood test indicate?

<p>Colon cancer (B)</p> Signup and view all the answers

What is required for urine specimens used in pregnancy tests?

<p>1st morning urine for highest concentration (C)</p> Signup and view all the answers

Which condition is NOT associated with low chloride levels in the body?

<p>Chronic renal failure (C)</p> Signup and view all the answers

What does a positive result in a urine chloride test indicate?

<p>Presence of chloride (D)</p> Signup and view all the answers

Which of the following materials is NOT required for performing the urine chloride test?

<p>Potassium chloride (C)</p> Signup and view all the answers

Which factor is NOT critical when performing a microscopic examination of urine?

<p>Presence of bacteria (B)</p> Signup and view all the answers

What is the primary purpose of performing a microscopic examination of urine?

<p>To detect insoluble substances (D)</p> Signup and view all the answers

In metabolic alkalosis, what happens to the pH levels in the blood?

<p>Increases above normal range (B)</p> Signup and view all the answers

What visual result indicates a positive urine chloride test?

<p>White cloudy precipitate (A)</p> Signup and view all the answers

Which renal disorder is least likely to be detected by urine chloride testing?

<p>Diabetes mellitus (A)</p> Signup and view all the answers

What hormone does the pregnancy test primarily detect?

<p>Human chorionic gonadotropic (A)</p> Signup and view all the answers

Which body fluids can HCG be detected in aside from urine?

<p>Colostrum, milk, and blood (A)</p> Signup and view all the answers

Which classification does the Latex Agglutination Inhibition Test belong to?

<p>Immunological Tests (D)</p> Signup and view all the answers

What is the result when HCG is absent in a non-pregnant individual during the Latex Agglutination Inhibition Test?

<p>Latex agglutinates, indicating a positive reaction (D)</p> Signup and view all the answers

What is a primary purpose of pregnancy testing?

<p>To confirm cases of pregnancy (B)</p> Signup and view all the answers

What is a key component of the reagents used in the Latex Agglutination Inhibition Test?

<p>Phenol and sodium azide (A)</p> Signup and view all the answers

Which test uses immature female white mice?

<p>Aschheim-Zondek Test (B)</p> Signup and view all the answers

What happens when HCG is present in the sample during the Latex Agglutination Inhibition Test?

<p>Latex does not agglutinate, indicating a positive reaction (D)</p> Signup and view all the answers

What is the minimum volume of urine that must remain in the test tube after decantation?

<p>0.5 mL (B)</p> Signup and view all the answers

What is the first procedure step in microscopic urinalysis after placing the urine sample in a test tube?

<p>Perform urinary reagent strip testing (B)</p> Signup and view all the answers

Which type of cell is NOT typically expected to be observed in a normal urine microscopic examination?

<p>Bacteria (A)</p> Signup and view all the answers

What is the purpose of resuspending the sediment by agitation after centrifugation?

<p>To ensure equal distribution of cells (C)</p> Signup and view all the answers

Which urinary component would indicate a potential renal disease when found in abnormal amounts?

<p>Casts (A)</p> Signup and view all the answers

During microscopic examination, what does a high count of White Blood Cells typically suggest?

<p>Infection or inflammation (D)</p> Signup and view all the answers

Which of the following parameters is NOT analyzed using a urinary reagent strip?

<p>Color (A)</p> Signup and view all the answers

What kind of urine sample should be used for microscopic examination?

<p>Freshly collected sample (D)</p> Signup and view all the answers

What is the reference range for calcium in plasma concentration?

<p>8.8 – 10.4 mg/dL (A)</p> Signup and view all the answers

Which type of calcium comprises the largest percentage of circulating calcium in the body?

<p>Protein bound calcium (C)</p> Signup and view all the answers

What condition is characterized by an increase in total plasma calcium concentration?

<p>Hypercalcemia (B)</p> Signup and view all the answers

Which factor does NOT affect calcium absorption in the body?

<p>Vitamin C (A)</p> Signup and view all the answers

What symptoms are associated with hypocalcemia?

<p>Pins and needles, tetany, paralysis (A)</p> Signup and view all the answers

What does a heavy or milky turbidity indicate in a Sulkowitch test?

<p>High calcium level (B)</p> Signup and view all the answers

In the context of metabolic alkalosis, an increased urine chloride level indicates which type?

<p>Chloride-Resistant MA (D)</p> Signup and view all the answers

During a urine chloride test, what reagent is used to precipitate chloride as silver chloride?

<p>Nitric acid (C)</p> Signup and view all the answers

What is the primary purpose of the Sulkowitch test?

<p>To detect urine calcium levels (D)</p> Signup and view all the answers

Which reagent is NOT included in the composition of the Sulkowitch reagent?

<p>Sodium chloride (D)</p> Signup and view all the answers

What does a positive result in the Sulkowitch test indicate?

<p>Turbidity with precipitate (A)</p> Signup and view all the answers

Which of the following is an indicator of heavy turbidity in the Sulkowitch test?

<p>3+ Heavy turbidity with fine precipitate (D)</p> Signup and view all the answers

What can lead to elevated chloride levels in the urine?

<p>Dehydration from vomiting (B)</p> Signup and view all the answers

Which electrolyte is most commonly associated with chloride in the body?

<p>Sodium (A)</p> Signup and view all the answers

For which condition could a chloride test potentially indicate a problem?

<p>Kidney disease (D)</p> Signup and view all the answers

Which method of collection can be used for a chloride test?

<p>Random urine sample (D)</p> Signup and view all the answers

Flashcards

Fecal Occult Blood Test (FOBT)

A test that detects hidden blood in stool. It can be used to screen for colorectal issues like colon cancer.

FOBT Advantages

Non-invasive (no surgery) and relatively cheap.

FOBT Disadvantages

Only detects blood, not the cause. Can have false positive or negative results.

Pregnancy Test

Detects human chorionic gonadotropin (hCG) in urine or blood, a hormone produced during pregnancy.

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Why 1st Morning Urine for Pregnancy Tests?

First morning urine usually has the highest concentration of hCG.

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Calcium in the Body

The human body contains 1-2 kg of calcium, with 99% located in bones. Calcium exists in three forms: ionized (biologically active), protein-bound (inactive), and complexed (bound to anions).

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Reference Range for Calcium

The normal range for total calcium in blood is 8.8-10.4 mg/dL (2.2-2.6 mmol/L). This reflects the combined levels of all calcium forms.

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Factors Affecting Calcium Absorption

Factors that influence calcium absorption include acidic pH, vitamin D, parathyroid hormone (PTH), and a high protein diet.

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Ionized Calcium

Ionized calcium represents 50% of circulating calcium and is the biologically active form. It is diffusible, meaning it can move freely across cell membranes.

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Complexed Calcium

Complexed calcium accounts for 10% of circulating calcium and is bound to ions like phosphate, bicarbonate, and citrate. It is also diffusible.

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Protein-Bound Calcium

Protein-bound calcium represents 40% of circulating calcium and is biologically inactive. It is not excreted and not freely diffusible.

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Hypocalcemia

Hypocalcemia is a decrease in total plasma calcium levels. It can lead to hyper-excitability of the neuromuscular junction, causing symptoms like pins and needles, tetany, paralysis, and convulsions.

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Hypercalcemia

Hypercalcemia is an increase in total plasma calcium levels. It can cause kidney damage, calcium stones, constipation, dehydration, tiredness, and depression.

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Sulkowitch Test

A test that measures the level of calcium in urine. It helps diagnose conditions like kidney stones or hyperparathyroidism.

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Positive Sulkowitch Test

A positive result indicates calcium presence in the urine, causing cloudiness or precipitate formation.

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Negative Sulkowitch Test

A negative result indicates no detectable calcium in the urine.

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Chloride Test

Measures the amount of chloride ions in blood or urine. It assesses fluid balance and electrolyte levels.

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High Chloride Levels

Can be caused by dehydration, excessive salt intake, kidney disease or parathyroidism.

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Electrolyte

Minerals like chloride that carry an electric charge in bodily fluids. They maintain fluid balance and regulate many bodily functions.

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Fluid Balance

The proper distribution of water between body compartments (intracellular and extracellular).

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Blood Pressure

The force of blood pushing against the walls of blood vessels.

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Low Urine Chloride

This occurs when the body retains too much water, often due to conditions like SIADH, Addison's disease, metabolic alkalosis, heart failure, and persistent vomiting.

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Urine Chloride Test

This test checks for the presence of chloride in urine by reacting it with silver nitrate and nitric acid, forming a white precipitate if positive.

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Microscopic Urine Examination

This part of urinalysis examines urine under a microscope to detect insoluble substances that might indicate renal disorders.

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Purpose of Microscopic Urine Examination

This helps identify and quantify insoluble substances in urine, providing valuable information for diagnosing renal diseases.

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Factors Influencing Microscopic Examination

Specimen preparation, volume, and centrifugation are crucial for reliable results in microscopic urine examination.

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Correlation in Urinalysis

Combining physical, chemical, and microscopic urine examination findings is crucial for accurate and valid results.

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Why is microscopic examination important?

It is the most time-consuming part of urinalysis but essential for detecting insoluble substances in urine that might indicate renal disorders.

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What parameters are important for a valid microscopic examination?

Specimen preparation, volume, and the centrifugation process are all crucial factors to consider for an accurate and reliable microscopic examination.

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Microscopic Urinalysis

A laboratory test that examines urine sediment under a microscope to identify cells, casts, crystals, and other components.

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Urine Sediment

The solid particles that settle at the bottom of a urine sample after centrifugation.

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Red Blood Cells in Urine

May indicate bleeding in the urinary tract, ranging from mild irritation to serious conditions.

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White Blood Cells in Urine

High WBC counts suggest infection or inflammation in the urinary tract.

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Epithelial Cells in Urine

Cells lining the urinary tract, usually present in small numbers. Increased amounts can indicate irritation, infection, or other conditions.

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Casts in Urine

Tiny molds of the tubules in the kidneys, formed from protein and other substances. Their presence can indicate kidney disease.

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Crystals in Urine

Can form in the urine due to various factors, often harmless but some may indicate kidney stones or other issues.

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Bacteria in Urine

Can indicate a urinary tract infection (UTI), a common infection in the bladder or kidneys.

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HCG

A hormone produced by the placenta during pregnancy. It's detectable in urine, blood, and other body fluids.

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Pregnancy Test Types

Pregnancy tests can be biological (using animal tests) or immunological (using antibodies).

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Latex Agglutination Inhibition Test

This test uses latex particles coated with HCG to detect pregnancy. The presence of HCG in the sample prevents agglutination (clumping).

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Positive Pregnancy Test

The latex particles do not clump, indicating the presence of HCG and therefore pregnancy.

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Negative Pregnancy Test

The latex particles clump, indicating the absence of HCG, and therefore no pregnancy.

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Why is HCG important?

HCG helps confirm pregnancy, investigate abortions, and differentiate pregnancy from other conditions like a hydatidiform mole.

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What are the reagents used in Latex Agglutination Inhibition Test?

The test requires HCG-bound latex particles, anti-HCG antibody reagent, and positive and negative controls.

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How is the Latex Agglutination Inhibition Test conducted?

A drop of urine is added to a test plate, followed by a drop of anti-HCG reagent and HCG-bound latex particles.

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Study Notes

Urine Calcium Determination

  • Sample of Choice: A 24-hour urine collection provides a comprehensive measure of ion levels over a full day, aiding in diagnosing and monitoring health conditions.
  • 24-Hour Collection Advantages: Accounts for daily fluctuations in urine output and concentration, giving a complete picture of excretion rates.
  • Colorimetric Method (Calcium Arsenazo III): This method uses Arsenazo III reagent to form a blue-colored complex with calcium ions, the color intensity proportional to calcium concentration.
  • Atomic Absorption Spectroscopy (AAS): Measures light absorption by calcium atoms in a sample. Highly accurate, detects low calcium levels.
  • Ion-Selective Electrode (ISE) Method: Uses an electrode selective to calcium ions. The measured potential difference is proportional to calcium concentration.
  • Complexometric Titration (EDTA Titration): EDTA (ethylenediaminetetraacetic acid) forms a complex with calcium ions. The amount of EDTA is measured to determine the concentration.
  • Sulkowitch Reagent Method: This method adds Sulkowitch reagent to a urine sample. The reaction creates a precipitate, and the amount of precipitate is measured to determine calcium levels. The reagent is composed of oxalic acid, ammonium oxalate, glacial acetic acid, and distilled water. A milky precipitate of calcium oxalate indicates the presence of calcium.

Urine Chloride Determination

  • Methods: Volhard-Harvey Method, Mohr's Method, Ion-Selective Electrode Method.
  • Volhard-Harvey Method: Involves a titration process using silver nitrate and ammonium thiocyanate. Add a measured excess of silver nitrate to the urine sample. Filter to remove silver chloride precipitate and titrate the excess silver nitrate with ammonium thiocyanate using ferric ammonium sulfate as an indicator.
  • Mohr's Method: Uses mercurimetric titration with silver nitrate and potassium chromate as an indicator. Dissolve the urine sample in distilled water and add potassium chromate. Slowly add silver nitrate until a red-brown precipitate of silver chromate forms.
  • Ion-Selective Electrode Method: Uses an ion-selective electrode to directly measure chloride concentration.

Calcium and Chloride Determination: AUBF Laboratory

  • Calcium in the Body: Calcium (Ca) is the most abundant mineral in the body, primarily found in bones (99%).
  • Calcium Types: Ionized, protein-bound, and complexed.
  • Calcium Reference Range: 8.8 - 10.4 mg/dL (2.2 - 2.6 mmol/L).
  • Factors Affecting Calcium Absorption: Acidic pH, vitamin D, parathyroid hormone (PTH), high protein diet.
  • Calcium Distribution: 50% ionized/free (biologically active), 40% protein bound (biologically inactive), and 10% complexed.

Fecal Occult Blood Test (FOBT)

  • Purpose: Non-invasive test to detect hidden blood in stool, often used to screen for colorectal disease (e.g., colon cancer).
  • Types: Guaiac smear test and flushable reagent pads.
  • Positive Result Interpretation: May indicate colon polyps, colon cancer, esophagitis, gastritis, GI trauma, hemorrhoids, fissures, peptic ulcers, or complications from recent GI surgery.
  • Procedure: Collect consecutive stool samples. Smear the stool on a paper card. Add testing solution to the opposite side of the card. A blue color change indicates a positive reaction (hidden blood).

Pregnancy Test

  • Principle: Based on the detection of human chorionic gonadotropin (hCG) produced by the placenta after implantation. hCG levels rise during pregnancy.
  • Urine Test: Urine specimen collected without preservatives; first morning urine usually has highest hCG concentration.
  • Blood Test: Quantitative or qualitative hCG blood tests are available.
  • Methods: Inhibition Agglutination Method, Immunochromatographic Assay , Digital Midstream Device, Electrochemiluminescence (ECL) technology, Enzyme-Linked Immunosorbent Assay (ELISA).
  • Test By Strips or Cassettes: Rapid immunoassay. Immerse test strip in urine, observe if colored lines appear within 5 minutes.

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