3.5 - 5.3 mmol/L Increased with Renal Failure or Internal Bleeding Decreased with Diarrhea or Starvation
What is the RR for Sodium (Na)?
135-147 mmol/L Increased with Dehydration and Cushings Decreased with Severe burns and Severe diarrhea
What is the RR for Triglycerides (Trig)?
Desirable: < 150 mg/dl Borderline high: 150-199 mg/dl High: 200-499 mg/dl Very high: 500 mg/dl or GREATER
If Plasma is the antibody then....
Your plasma cannot have the antibody of the SAME as your antigen.
What is the Rh factor?
Rhesus Factor: is an inherited trait that refers to a specific protein found on the surface of red blood cells. If your blood has the protein, you're Rh positive — the most common Rh factor. If your blood lacks the protein, you're Rh negative.
When is the Rh Factor an issue?
During pregnancy: If you're Rh negative and your baby is Rh positive, however, your body might produce Rh antibodies after exposure to the baby's red blood cells. If you are Rh Positive....no issue exists.
What is the percentage of people who are Rh (+) and (-)?
15% of white people are NEGATIVE 7% of African American are NEGATIVE
The rest are positive.
What is the percentage that the doctors prefer an A1c remain under and why?
Reduce complications of diabetes
Where do we get our blood antigens?
What specimen do serological chem tests require for testing?
What are 'Controls'?
A quality control method. A solution that is used to monitor a blood chemistry analyzer to ensure the reliability and accuracy of the test results.
Why are Controls used?
To determine if the testing reagents are performing properly and to detect any errors in technique by the performer of the test. Come in: High and low control; performed similarly to test itself
What is Calibration?
Mechanism used to check the precision and accuracy of a blood chemistry analyzer and to determine if the system is providing accurate results.
What does a calibration check detect?
Errors caused by lab equipment not working properly.
When is Calibration typically performed?
Using a calibration device called a standard, they are done at a minimum when a new lot number of testing reagents is put into use; or according to manufacturer's instructions.
What are the characteristics of cholesterol?
it is a white, waxy, fatlike substance (lipid) that is essential for normal function of the body.
What is a CMP and what purpose does it serve?
Comprehensive Metabolic Profile: Contains numerous blood chemistry tests and is used primarily in routine health screenings.
When is a CMP appropriate to order?
When the doctor needs more information because the symptoms are vague.
As a routine health screening.
What type of measurement will a blood chemistry analyzer produce?
What may cause a failure of a control to produce expected results?
As often as manufacturer's instructions indicate OR at a minimum on each new lot number of testing reagents and thereafter on a regular basis such as MONTHLY.
The condition caused by fatty deposits in the blood vessels is known as?
What is glucose?
The end product of carb. metabolism; is the chief source of energy for the body.
What is glycogen?
It is the ingested glucose that is NOT needed for energy can can be stored in muscle or liver for later use./ if not tissue storage is available, it will be converted to TRIG and stored as fat tissue.
What is Insulin?
1. A hormone from the pancreas. 2. Required for normal use of glucose. 3. Enables glucose to enter cells and be converted to energy. 4. Needed for proper storage of glycogen in liver and muscle cells.
What are the three glucose testings?
FBG 2 hour PPBG OGTT
Describe the FBG?
Pt fasts for 12 hours Certain meds may be discontinued for 3 days Morning testing to minimize inconvenience Done to screen/detect pre diabetes and diabetes Evaluate and regulate treatment
Describe the 2 hour PPBG?
Used to screen for DM and monitor effects of insulin dosage Fast for 12; Then breakfast with 100g of carbs (OJ, Cereal with sugar, toast and milk) OR 100g load of glucose solution Blood specimen collected exactly 2 hours after consumption. Fail this and you are usually given the OGTT
Describe the OGTT?
More detailed information is obtained by assessing insulin response to a glucose load. DX of prediabetes, DM, Gestational Diabetes, hypoglycemia and liver and adrenocortical dysfunction. Consule high carb diet, 150g of carbs X3 days. then FAST when test begins. IF hyperglycemic at this point, do not proceed with test. Otherwise 75g of glucose load and blood specimens taken after that.
What occurs during the OGTT load phase?
A nondiabetic individual will peak at 160 to 180 mg/dl approx. 30 to 60 minutes. BG returns to normal within 2 hours.
How is hypoglcemia diagnosed via the OGTT?
The glucose in the blood is abnormally low (FBG <70 mg/dl)
What are the advantages of SMBG?
1. Self monitoring blood glucose allows patients with feedback for maintaining normal blood glucose levels 2. Assists them in anticipating and treating day to day or even hour to hour issues 3. Avoids extremes 4. Relieves symptoms helps delay or prevent LT complications.
What is the antigen-antibody reaction?
Immune reaction- involves binding antigens to antibodies.
How often should the blood glucose level for an insulin dependent patient be measured?
4 X a day Morning (after 8 hour fast) Before lunch, dinner and at bedtime.
Which measurement is the most accurate indicator of control on a blood glucose meter check?
The FBG in the morning
What type of complications can occur from long term maintenance of an elevated BSG > 180 ?mg/dl
Convenience of testing at home. Greater involvement in self management decisions Reliable decision making regarding insulin dosage Delay in or prevention of LT complications.
The A1c test supplies the physician with an assessment of ?
The average amount of glucose in the blood over a 3 month period.
What is the normal A1c for an individual without diabetes?
4% to 6%
Brief explanation of the table comparison of Hemoglobin A1c percentage and the average daily blood glucose level it represents.
4%-12% Starts at 65 for 4% Climbs 35 points each % thereafter
When is the A1c test ordered? How often is it ordered?
It is ordered periodically for patients already dx with DM to evaluate effectiveness of their diabetes management plan.
If stable, the test is typically ordered at least 2 times a year.
How should the Glucometer and Reagent Strips be stored and handled?
Strips are sensitive to heat, light and moisture and must be stored in a cool, dry area at RT. Cap tightly closed. Keep the dessicant in it to absorb moisture.
How long is the control solution good for?
3 mos. Store at 36 to 86 degrees F
When should a control test be scheduled?
1. Meter is new 2. Daily before first use 3. If cap is left off vial of strips 4. New container of strips 5. Meter is dropped 6. Test results do not agree with the way pt. feels 7. If test has been repeated and BG is still lower or higher than expected.
Where does cholesterol in the blood come from?
Most of it is manufactured by the LIVER A portion (dietary cholesterol) is found from animal products such as organ meats, egg yolks and dairy products.
What does it mean when it's said that someone's cholesterol is high?
An excessive amount of cholesterol is present in the blood.
Can an individual who eats well still have high cholesterol?
Yes, an individual's cholesterol level is determined by his or her genetic makeup, by the amounts of dietary cholesterol, saturated fat and trans fat consumed.
Describe LDL and HDL.
LDL is considered 'bad' because an excess amount of it can cause plaque to build on arterial walls.
HDL is considered 'good' because it removes cholesterol from the wall of blood vessels.
Should a patient having a total cholesterol and HDL determination be in a fasting state?
No, not unless the physician would prefer it. Total cholesterol and HDL are NOT affected significantly by food consumption.
How is a patient instructed for preparation for a Lipid Profile?
The should fast for at least 12 hours because TRIGs are affected by food consumption.
What is the primary use of cholesterol testing?
To screen for the presence of high blood cholesterol related to CAD, but also as a study of thyroid and liver function.
What are triglycerides?
They are the chemical form in which most fat exists in food, as well as in the body.
Where are triglycerides derived from?
Two sources: Synthesis by the body as ingested glucose that is NOT needed for energy (glucogen) in muscle and liver tissue as adipose tissue. AND Secondly by eating foods containing fat.
What type of test is BUN?
Blood urea nitrogen Kidney function test
What does immunology testing consist of?
Studying antigen-antibody reactions Assist with dx of disease
Immunologic tests are used for the early dx of disease and are used to follow the course of the disease.
How many types of Hepatitis is there?
Five - A, B, C, D, and E
What does Hepatitis testing detect?
Not only the presence of viral hepatitis but also determines the type of hepatitis present.
What causes Syphilis?
The MO Treponema Pallidum.
What is the name of the most common test used to detect the presence of syphilis?
VDRL = Venereal Disease research Laboratories and the rapid plasma reagin or RPR test.
How is a weakly reactive result interpreted?
As a positive and must have more testing.
Is a negative HIV test conclusive for the absence of HIV infection?
No, it means the antibodies many not have had time to develop as yet.
Generally takes 2 to 12 weeks to appear in the blood.
What causes Mono?
EBV or Epstein Barr Virus
What are the symptoms of Mono?
Affects children and young adults Kissing disease = transmitted by saliva SX are: Mental and physical fatigue, fever, sore throat, severe weakness, headache and swollen lymph nodes.
What test is used to test in the medical office for mono?
The CLIA waived rapid mono test.
What test is performed when a woman is pregnant?
Rh antibody titer- detects Rh incompatibility with a mother and her unborn child.
Mother is negaive, child is positive.
Guidelines for blood donor criteria.
Age: at least 17 sometimes 16 Last Donation: 56 (8 weeks) days between Weight: at least 110 or 105, no upper wt limit Temperature: can not exceed 99.5 Pulse: 50-110 BP: 180/100 Hgb: 12.5 g/dl men or women
What is the blood donating process?
Takes approx. 1 hour Health HX, mini physical, vitals and hgb level I pint taken using sterile needle and sterile plastic bag No pain during it Takes approx 8-10 minutes NOT possible to contract AIDS donating blood
Each blood donation is tested for?
AIDS, Hepatitis and Syphilis Blood is TYPED with its ABO and Rh blood type
What antigen and antibody does an AB type blood have?
AB has BOTH A and B antigens but NEITHER antibody A or B