Blood Gas
State the reference ranges for pH,pC02, and HC03.
pH= 7.35 – 7.45
pCO2= 35 - 44
HCO3= 23 – 29
A urine sample sat out at RT for 12 hours, you will see a decrease in:
a) nitrite
b) bilirubin
c) pH
d) turbidity
b) bilirubin (exposure to light)
You will also see a decrease in:
glucose, ketones, urobilinogen and cells/casts.
You will see an increase in:
nitrite, pH and turbidity
Bleach causes a false positive in:
a) glucose
b) bilirubin
c) ketones
d) protein
A) glucose
a) IGG
b) IGA
c) IGM
d) IGE
d) IDD
a) IGG
a) respiratory alkalosis
b) respiratory acidosis
c) metabolic alkalosis
d) metabolic acidosis
a) respiratory alkalosis
Urines can be colorful, ranging from orange to black.
A black urine may be due to:
a) RBCs
b) porphyrins
c) melanin
d) chlorophyll
c) melanin
Black urine can be caused by melanin or homogentisic acid
Red - hemoglobin, rbc, beets
Pink - hemoglobin, porphyrins
Brown - hemoglobin, myoglobin, methemoglobin, homogentisic acid
Green/Blue - Indican, chlorophyll, pseudomonas infections, dyes, medication
Which of the following is considered most diagnostically significant in a urine microscopic and is always pathological?
a) white blood cell cast
b) red blood cell cast
c) fatty cast
d) waxy cast
b) rbc cast
DAILY DOUBLE!!!!
IGE
Most heat-liable immunoglobulin
Does not cross the placenta
Does not fix complement, does not participate in agglutination or opsonization
Hypersensitivity 1- Allergic reaction
Triggers release of histamines from mast cells
Binds with great affinity to Eosinophils, basophils, and mast cells
Attracts eosinophils to a parasitic infection site
The patients results :
pH = 7.20 , pco2 = 40, hco3 =19
This correlates to which clinical condition listed?
a) Diabetic keto acidosis
b) Vomiting
c) Potassium Depletion
d) COPD
a) Diabetic keto acidosis
Uncompensated Metabolic Acidosis
A high ketone result on a dipstick can correlate the following clinical condition:
a) diabetes mellitus
b) hemolytic anemia
c) uti
d) liver damage
a) diabetes mellitus
You can also see a positive/high ketone result in people with a high protein diet or dehydration
BOC: A false negative result may occur for the nitrite reagent test strip pad if the sample:
a) contains a nitrate reducer
b) is contaminated with skin flora
c) is contaminated with a cleaning agent
d) does not incubate in the bladder long enough
d) Bacteria must have sufficient time to convert nitrates to nitrite; insufficient incubation can results in a false negative result. First morning collections are preferred due to the long incubation time in the bladder. (>4 hours incubation will increase likelihood of detection)
BOC:
The total CO2 concentration is comprised of which components?
a) H2CO3 + HCO3
b) pCO2 + HCO3
c) H2CO3 + pCO2
d) TCO2 + H2CO3
A. Total CO2 is comprised of carbonic acid (H2CO3) and bicarbonate (HCO3)
*** DAILY DOUBLE***
Increased urinary protein
Increased concentration
Decreased flow
Decreased pH
MATH TIME!
A 24 hour creatinine clearance was performed and the following results were obtained:
Serum creatinine: 1.5 mg/dL
Urine creatinine: 125 mg/dL
24 hour urine Total Volume: 1350 ml
Calculate the creatinine clearance.
(urine % / serum %) x RF = mL/min
RF = TV/1440
RF = 1350/1440= 0.9375 mL/24 hr
CC = 125/1.5 * 0.9375 = 78.1 mL/min
BOC: Specimens from a patient with chronic lung disease show the following results:
pH = 7.32, pCO2 = 78, HCO3 = 39, pO2 = 89
These results indicate:
a) metabolic compensation by renal retention of bicarbonate
b) metabolic compensation by renal excretion of bicarbonate
c) respiratory compensation by retention of CO2
d) combined retention by excretion of CO2
These results indicate a respiratory acidosis.
This shows metabolic compensation by renal retention of bicarbonate.
BOC:
A patient's urinalysis revealed a positive bilirubin and a normal urobilinogen level. These results are associated with:
a) hemolytic disease
b) biliary tract obstruction
c) hepatic disease
d) urinary tract infection
b) Conjugated bilirubin is normally transported to the intestines, where it is converted into urobilinogen. A BTO may cause it to enter the bloodstream and then filtered into the urine leading to a positive bilirubin result. The impedance causes less urobilinogen to be formed, resulting in a low value but the strips can only detect normal and high.
You would see a high urobilinogen result for a hemolytic event/hepatocellular disease.
List 4 steps of the collection process/criteria that are needed for an accurate 24-hour urine collection.
Patient information must be correct (ID, accession, test ordered)
Specimen must have been properly stored for the specific test
TV must be noted along with # of jugs. If more than 1 jugs exist total volume of the jugs
Start and end time must be 24 hours and recorded on the tag
Chemicals must be noted for the correct test ordered
Urine must be well mixed before pouring over into aliquot tubes and cups