Urinalysis and Hematology Overview

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Questions and Answers

What is the characteristic stool color associated with hematochezia?

White, chalky

Pale yellow

Black, tarry

Red, bloody (correct)

Which of the following conditions can result in a high specific gravity (Sp.Gr.) in urine?

Steatorrhea

Diabetes Insipidus (DI)

Malabsorption

Diabetes Mellitus (DM) (correct)

What is the term used to describe a stool sample containing fat, indicative of malabsorption?

Melena

Hematochezia

Fecal occult blood

Steatorrhea (correct)

What is the common underlying cause of melena?

Upper gastrointestinal bleeding Signup and view all the answers

Which of the following laboratory test results could be indicative of colorectal cancer?

Positive fecal occult blood test Signup and view all the answers

What is the reference range for Hemoglobin levels in g/L?

115-165 g/L Signup and view all the answers

Which of the following is the correct reference range for White Blood Cells (WBC)?

4.0-11.0 x 10^9/L Signup and view all the answers

What does a Packed Cell Volume (PVC) value within the reference range indicate?

0.36-0.46 L/L indicates normal hydration levels Signup and view all the answers

If a patient's urine is colored according to levels 1, 2, or 3, what can be inferred?

The patient is likely hydrated Signup and view all the answers

What is the normal reference range for Reticulocytes in x 10^9/L?

50-100 x 10^9/L Signup and view all the answers

What is the normal reference range for Mean Cell Hemoglobin (MCH)?

27-34 pg Signup and view all the answers

Which type of white blood cells has the highest normal percentage in WBC count?

Neutrophils Signup and view all the answers

What is a sign of dehydration as indicated by urine color?

Colors numbered 4 to 8 Signup and view all the answers

What is the normal range for Mean Cell Hemoglobin Concentration (MCHC)?

31.5-34.5 g/dL Signup and view all the answers

Which component is NOT typically included in parenteral nutrition sources?

Dietary fiber Signup and view all the answers

Which of the following electrolytes is commonly provided in parenteral nutrition?

Sodium Signup and view all the answers

What is the primary function of kidneys?

Filtering blood and producing urine Signup and view all the answers

In the context of PN, which nutrient provides essential fatty acids?

Lipid emulsions Signup and view all the answers

What is the main purpose of enteral nutrition?

To support nutritional intake through tubes inserted into the stomach or small intestine Signup and view all the answers

What indicates the use of Total Parenteral Nutrition (TPN)?

Long-term nutritional support for over 30 days Signup and view all the answers

What is a key requirement for compounding a parenteral nutrition solution?

It needs to be compounded using a laminar flow hood Signup and view all the answers

What is a critical note regarding the stability of vitamins in parenteral nutrition solutions?

Vitamins should be added at the time of infusion for stability Signup and view all the answers

What is peripheral/partial parenteral nutrition primarily used for?

To provide limited nutritional support for short-term use Signup and view all the answers

How long must a parenteral nutrition solution be infused or discarded after hanging?

Within 24 hours Signup and view all the answers

Which of the following does NOT describe parenteral nutrition?

It requires an accessible GI tract for effective use. Signup and view all the answers

What is the role of electrolytes and trace elements in nutrition preparation?

They help to support metabolic functions in the body. Signup and view all the answers

Study Notes

Urinalysis

Normal urine is sterile, pale yellow, with a pH of 4.5-8.
Specific gravity (sp. gr.) measures solute concentration, ranging from 1.002 to 1.030.
High sp. gr. indicates concentrated urine (e.g., in diabetes mellitus and nephrosis).
Low sp. gr. indicates diluted urine (e.g., in diabetes insipidus).
Urine color can indicate hydration status: numbers 1-3 are hydrated, 4-8 indicate dehydration.

Hematology

Complete blood count (FBC): measures hemoglobin (115-165 g/L), white blood cells (4.0-11.0 x 10⁹/L), and platelets (150-450 x 10⁹/L).
Red blood cells (RBC): 3.8-4.8 x 10¹²/L.
Reticulocytes: 50-100 x 10⁹/L.
Packed cell volume (PCV): 0.36-0.46 L/L.
Mean cell volume (MCV): 83.101 fL
Mean cell hemoglobin (MCH): 27-34 pg
Mean cell hemoglobin concentration (MCHC): 31.5-34.5 g/dL.
White blood cell (WBC) differential: categorizes WBCs into neutrophils (40-75%), lymphocytes (5-15%), monocytes (2-10%), basophils (<1%), and eosinophils (1-6%).
Neutrophils: 2.0-7.0 x 10⁹/L,
Lymphocytes: 1.5-4.0 x 10⁹/L,
Monocytes: 0.2-0.8 x 10⁹/L,
Basophils: <0.1 x 10⁹/L,
Eosinophils: 0.04-0.4 x 10⁹/L
Coagulation tests: prothrombin time (PT) is 10-14 seconds; activated partial thromboplastin time (APTT) is 35-45 seconds.
Fibrinogen levels are 1.5-4 g/L

Hematology (RBC, WBC, Platelets details)

RBC (Erythrocytes): carry oxygen from lungs to tissues and carbon dioxide back to lungs.
Stimulus for increased RBC production is decreased oxygen-carrying capacity.
Kidneys secrete erythropoietin (EPO) to stimulate erythropoiesis in the bone marrow.
Increased RBCs increase oxygen-carrying capacity, relieving the initial stimulus for EPO secretion.
WBC (Leukocytes): crucial for immunity.
Differentials (percentage of types) and counts given.
Platelets (Thrombocytes): essential for blood clotting;
Decreased platelets (thrombocytopenia) could lead to spontaneous bleeding.

Fecal Analysis (Fecalysus)

Fecal consistency analysis is used to diagnose potential problems.
Different stool types are indicated in the analysis.
Severe constipation and diarrhea descriptions are given.

Hematocrit

Hematocrit (Hct) is the percentage of red blood cells in blood.
Normal range for hematocrit is 37%-47% (male) and 42%-52% (female)
Depressed hematocrit %= Anemia, elevated hematocrit %= Polycythemia

Additional Laboratory Tests

Glucose: Negative in normal urine. abnormal results indicate diabetes or renal glycosuria.
Protein, Blood, Ketone, Bile, Urobilinogen, Nitrites and Casts. Descriptions of abnormal results for these tests are indicated.
Creatinine: measures kidney function. Clearance is calculated for dosage adjustments in renally impaired patients using the Cockcroft-Gault formula.
Creatinine Clearance (CrCl): related to glomerular filtration rate. This is part of kidney function testing.
BUN: Blood Urea Nitrogen, increased levels suggest renal dysfunction or high protein intake.
Cystatin C: level increases in renal issues.
CK (Creatine Kinase), AST (Aspartate Transaminase), ALT (Alanine Transaminase) Enzyme values. These are associated with muscle damage and liver function.
Bilirubin: a breakdown product of hemoglobin; levels related to jaundice (elevated bilirubin). Unconjugated or conjugated bilirubin might increase due to certain causes.
Electrolytes (Sodium, Potassium): levels affect nerve and muscle function, and are involved in acid-base balance. Low (hyponatremia) or high (hypernatremia) Sodium levels and low (hypokalemia) or high (hyperkalemia) Potassium levels can indicate specific conditions.
Inflammatory markers (ESR, CRP): indicate inflammation; values helpful in assessing inflammatory conditions.
Procalcitonin: used to predict sepsis.
Uric Acid: a product of purine metabolism; elevated levels can contribute to gout.
Other markers: (CA125, PSA, etc) used for cancer screening, diagnosis, and monitoring.

Blood Chemistry

Blood urea nitrogen (BUN): Indicates renal and other health conditions. 8-18 mg/dL.
Creatinine: measures kidney function, above given normal levels imply renal dysfunctions.
Cystatin C: indicates kidney function; increased levels imply kidney dysfunction
Creatinine Clearance: calculated to adjust doses for drugs in kidney patients.
Electrolytes (Sodium, Potassium: electrolyte imbalances can lead to nerve and muscle disorders.
Bilirubin: Elevated levels indicate liver or gallbladder issues.
LDH (Lactate dehydrogenase): enzyme levels reflecting tissue damage, high LDH1 & 2 indicates MI, increased LDH3 indicates malignancies.
Troponin I and T: Elevated heart-specific proteins, suggesting heart issues.
Hematology (RBC, WBC, Platelets details): Specific measurements are listed, like MCV, MCH,MCHC for RBC.

Additional Topics

Anemia: Anemia is discussed, including different classifications based on mechanisms and descriptions of symptoms, such as different cellular characteristics
Coagulation: Testing procedures, including INR and APTT, to monitor blood clotting.
Nutritional Support: Enteral and parenteral nutrition approaches for patients with malnutrition.
Iron Deficiency: potential causes, symptoms and implications are included.
Defective Nuclear Maturation: (Megaloblastic Anemia) causes and symptoms, emphasizing vitamin deficiencies and their effect on blood cell development.
Increased Destruction: (Hemolytic Anemia) Potential causes and symptoms of abnormal blood cell destruction are given.
Marasmus and Kwashiorkor: malnutrition types associated with deficiencies in protein and calories and their symptoms.
ABG (Arterial Blood Gases): Interpretation of ABG results (pH, PaCO2, PaO2, HCO3)
Magnesium/Hypomagnesemia/Hypermagnesemia
Calcium/Phosphate Imbalances: Relevant conditions, effects, and testing indicators are described.
Other markers: Tumor markers are listed for specific cancers.

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Description

This quiz covers essential concepts in urinalysis and hematology, including normal urine characteristics and components of a complete blood count. Understand how various measurements reflect hydration status and blood health. Test your knowledge of specific gravity, blood cell counts, and more.