Soal+answer Clinical Laboratory

CLINICAL LABORATORY 1. What is the function of screening? ➢ Detect subclinical disease ➢ Detect and quantify the risk of future disease 2. Role of the laboratory test

➢ Absolutely specific for a specific disease ➢ Easily measurable ➢ Early detection ➢ Not affected by other biological disturbances 7. Function of Troponin 1 is a

➢ Screening

marker of MI because

➢ Diagnoses

➢ Found predominately in

➢ Helpful patient management 3. What are the steps in investigation of a patient? ➢ Imaging techniques ➢ diagnosis ➢ Evaluation 4. Why are laboratory tests

cardiac tissue ➢ Released into the blood stream following cell death ➢ Highly specific marker 8. Inter-individual varation ➢ Age ➢ Sex

ordered?

➢ Race

➢ Prevent malpractice

➢ Genetic

➢ Educating residents

➢ Long term health issue

➢ Monitor effectiveness!! ➢ Identify complication of treatment ➢ Check accuracy and unexpected data 5. What are normal biological specimens?

BUC (Comprise the majority of ➢ Blood all specimens ➢ Urine analyzed) ➢ Cerebrospinal fluid

9. Intra-individual variation ➢ Diet ➢ Exercise ➢ Drugs ➢ Time of venipucture ➢ Length of time tourniquet is applied ➢ Posture ➢ Sleep pattern 10.Pre-analytical variation ➢ Transport

➢ Stools

➢ Exposure to UV light

➢ Tissue specimen

➢ Storage condition

6. What is the function of a

➢ Centrifugation time

marker? Ps (Ten): Just can only know these questions… Anywhere, Others question all in pictures form lo!! All the best guy~ Good lUck Page 1

CLINICAL LABORATORY ➢ Standing time be4 separation of cell

➢ Increases Potassium, Magnesium and

11.Analytical variation

phosphorous

➢ Random errors

17.Lipemia and proteinemia

➢ Systemic errors 12.Post-analytical ➢ Transcription errors ➢ Result reported to wrong patient 13.Prolonged venous stasis

cause: ➢ Serum and plasma to become turbid!! 18.Blood composition with anticoagulant (Chelating agent EDTA, Citrate /

(tourniquet put in a long

Heparin enhance

period) will cause?!

antithrombin)!

➢ Increase( Total

➢ 3 layers (PLASMA,

protein, Proteins, iron Fe, Cholesterol, and bilirubin) ➢ Decreases potassium (K+) 14.Supine position ( reduces

BUFFY COAT, and RBC) ➢ Buffy coat (WBC and platelets) ➢ Plasma (55% whole blood – protein, sugar, vitamin,

700ml blood volume)

mineral, lipids,

➢ Decrease 5-15% of

lipoprotein, and clotting

(Total protein,

factors)

albumin, lipids, iron,

(95% of plasma is

Calcium and

water)

Enzymes) 15.Specimens which required

19.Blood composition without anticoagulant

special handling technique:

➢ 2 layers

➢ Lactate

➢ Serum and blood clot

➢ Ammonia

➢ Serum same as plasma

➢ Acid phosphatase

but without clotting

➢ Plasma catecholamines

factors

16.Hemolysis will cause: ➢ Serum and plasma into red

➢ Blood clot (Clotting factors, fibrin, platelets, and RBCs) 20.Collection tube

Ps (Ten): Just can only know these questions… Anywhere, Others question all in pictures form lo!! All the best guy~ Good lUck Page 2

CLINICAL LABORATORY ➢ Red (X anticoagulant)

• Urea; BUN; Creatinine

➢ Gold (Gel barrier)

• GFR

➢ Grey (Glucose)

➢ Endocrine (DM)

➢ Green (Anticoagulant) ➢ Lavender (EDTA; Inhibit coagulation) ➢ Light blue (Coagulation studies) ➢ Brown and Royal Blue (Trace metal studies) 21.Complete blood count is? ➢ Haemoglobin ➢ WBC count ➢ Platelets count ➢ MCV ➢ MCH

DIAGNOSA • fasting glucose • 2h post prandial glucose • OGTT • C-peptide (DD type 1 and type 2 DM) MONITORING • C.B.C, Urinalisa • Lipid profile

➢ MCHC

• Renal function

➢ RDW

• Electrolyte

➢ Haematocrit

• Blood gas analysis

➢ RBC count

• Ketone bodies

➢ Erythrocyte

• Hb A1C

sedimentation rate ➢ Blood smear evaluation 22.POCT (Point of care testing) ➢ Blood glucose

• Fructosamine • Micro-albuminuria • Insulin-Fasting and 2 h pp

➢ Urinalysis ➢ Blood gases ➢ Electrolytes ➢ Cardiac markers (troponin 1 and T) ➢ Drugs screen 23.Routine clinical chemistry in laboratory examination ➢ Renal function test

➢ Lipid profile • Total cholesterol • Trygliceride • HDL • LDL • Lp(a) • ApoA, ApoB

• Urinalysis Ps (Ten): Just can only know these questions… Anywhere, Others question all in pictures form lo!! All the best guy~ Good lUck Page 3

CLINICAL LABORATORY ➢ Liver function test Hepatobilier

➢ Hematuria ➢ Myohemoglobinuria???

function • Synthesis function:

肌红蛋白尿症 ➢ Myoglobinuria??

CHE, albumin, coagulation factors

肌红蛋白尿 ➢ Hemoglobinuria??

• Hepatocellular functions: AST, ALT • Obstructive functions: GGT, ALP • Excretions: Bilirubin,

血红素尿 28.Observe the tube with graphic paper background is to? ➢ Observe the clarity of the urine

bile acid 24.Markers for hepatitis:

29.Clarity of urine influenced

➢ AFP

by

➢ Ceruloplasmin

➢ Leucocyturia

➢ Serum iron

➢ hematuria

➢ Feritin

➢ Bacteriuria

25.Type of macroscopic examination ➢ Colour ➢ Clarity

➢ Mucus from vagina ➢ Phosphate precipitation 30.Dipstick examination: ➢ Provide information-

➢ Volume (count by

• Carbohydrate

urinometer)

metabolism

➢ pH

• Kidney function

➢ odor

• Liver function

26.Chemical examination ➢ Glucose ➢ Blood (haemoglobin) ➢ Leukocyte esterase ➢ Protein ➢ Urobilinogen ➢ Bilirubin ➢ Ketone ➢ Nitrite 27.Red urine is caused by

• Acid-base balance • UTI Dip not longer than 1 second

31.Indicator used in the dipstick: ➢ Glucose (Blue-brown) • Glucosa oxidase

Ps (Ten): Just can only know these questions… Anywhere, Others question all in pictures form lo!! All the best guy~ Good lUck Page 4

CLINICAL LABORATORY • Peroxidase ➢ Bilirubin (Yellow-brown) • Diazotized dicholororaniline salt ➢ Ketone • Nitroprusid ➢ SG

➢ Acid sulfosalisilat ➢ Protein Bence Jones • +ve or –ve 33.Glucose test ➢ Benedict (5 ml) and 8 drops (1/10 of urine) • Negative (Blue) • +1 (Bight yellowish)

• Bromthymol blue

• +2 (Yellow + green)

• Polyelectrolyte

• +3 (Orange)

(Polymethylvinyl ether/ maleic acid) ➢ Blood (Yellow-green) • Tetramethylbenzidine ➢ pH

• +4 (Brownish red) ➢ Reduction test Others redactor: • Vit C • Lactose

• Bromthymol blue

• Asam salisilat

• Methyl red

• Galactose

➢ Protein (Green) • Tetrablomphenol

• Fructose 34.Picture!!

➢ Urobilinogen (Red)

➢ Erythrocyte

• Diazonium salt

➢ Leukocytes

➢ nitrite (pink) • P-arsanilic acid ➢ Leucocyte • Indoxyl ester 32.Urine protein test ➢ 2ml of urine + 3-5 drops acetic acid

➢ Hyaline cast ➢ Erythrocyte cast • Glomerulonephritis ➢ Leukocyte cast • Pyelonephritis ➢ Granular cast (Coarsely) 35.Oval Fat bodies +

• Negative

➢ Nephrotic syndrome

• +1 white

➢ Tubular cells that have

• +2 white cloudy

absorbed lipoproteins

• +3 white yellowish

with cholesterol and

• +4 white yellowish

triglycerides leaked

cloudy

from nephritic glomeruli

Ps (Ten): Just can only know these questions… Anywhere, Others question all in pictures form lo!! All the best guy~ Good lUck Page 5

CLINICAL LABORATORY 36.Leukocyte cast + ➢ Pyelonephritis 37.Erythrocyte cast + ➢ GLomerulonephritis 38.Fever ➢ Upper UTI 39.Burning sensation ➢ Lower UTI

Ps (Ten): Just can only know these questions… Anywhere, Others question all in pictures form lo!! All the best guy~ Good lUck Page 6