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Health Careers I Anatomy, Physiology and Disease Chapter 5 Basic Diagnostic Tests: What Do The Tests Tell Us?. Introduction. Diagnostic tests help to provide a more accurate view of patient’s overall condition and disease state including diagnosis , progression , or improvement. - PowerPoint PPT Presentation
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Health Careers IHealth Careers I
Anatomy, Physiology and DiseaseAnatomy, Physiology and DiseaseChapter 5Chapter 5
Basic Diagnostic Tests:Basic Diagnostic Tests:What Do The Tests Tell Us?What Do The Tests Tell Us?
IntroductionIntroduction
Diagnostic testsDiagnostic tests help to provide a more accurate help to provide a more accurate view of patient’s overall condition and disease view of patient’s overall condition and disease state including state including diagnosisdiagnosis, , progressionprogression, or , or improvement.improvement.
Medical diagnosticsMedical diagnostics are like advanced are like advanced diagnostics for your car; tests can be used to diagnostics for your car; tests can be used to verify the verify the obviousobvious or to discover where or to discover where signssigns & & symptomssymptoms are pointing. are pointing.
Important things to keep in mind when Important things to keep in mind when interpreting test resultsinterpreting test results
Normal valuesNormal values for specific tests vary slightly from for specific tests vary slightly from lab to lablab to lab
Even perfectly healthy peopleEven perfectly healthy people will sometimes will sometimes have abnormalities on diagnostic testshave abnormalities on diagnostic tests
Test results must be interpreted in contextTest results must be interpreted in context of of patient’s overall medical history and physical patient’s overall medical history and physical exam; exam; not every abnormal test is significantnot every abnormal test is significant!!!!!!
Blood TestingBlood Testing
Composition of bloodComposition of blood Partly composed of liquid, partly cellsPartly composed of liquid, partly cells Liquid portion called plasmaLiquid portion called plasma Composed of about Composed of about 90% 90% waterwater
Several types of blood cellsSeveral types of blood cells
ErythrocytesErythrocytes ( (Red Blood CellsRed Blood Cells) medium-sized ) medium-sized blood cell; Transports oxygen from lungs to body blood cell; Transports oxygen from lungs to body cellscells
LeukocytesLeukocytes ( (White Blood Cells) White Blood Cells) large-sized blood large-sized blood cell; protects body from infectioncell; protects body from infection
ThrombocytesThrombocytes ( (PlateletsPlatelets) small-sized blood cell; ) small-sized blood cell; helps blood clot after cut or similar injuryhelps blood clot after cut or similar injury
Erythrocytes Leukocytes Thrombocytes
Types of Types of Blood CellsBlood Cells
Obtaining blood sample for testingObtaining blood sample for testing
Venous stickVenous stick: bluish blood vessels visible : bluish blood vessels visible through skin.through skin.
Finger stickFinger stick: pin prick to finger (which samples : pin prick to finger (which samples capillary capillary blood); example: diabetics testing their blood); example: diabetics testing their own blood sugar.own blood sugar.
Arterial stickArterial stick: to assess : to assess oxygenationoxygenation of blood of blood
Blood TubesVenous Accucheck
Arterial
Accu Check Accu Check MachineMachinefor for Blood Sugar Blood Sugar LevelsLevels
Red Blood Cell DisordersRed Blood Cell Disorders
AnemiaAnemia: lower than normal amounts of RBCs; : lower than normal amounts of RBCs; possible causes: possible causes: hemorrhagehemorrhage, low RBC , low RBC productionproduction, or RBC , or RBC destruction.destruction.
PolycythemiaPolycythemia:: higher than normal amounts of higher than normal amounts of RBCs; possible cause: RBCs; possible cause: chronically low oxygenchronically low oxygen in in blood.blood.
Anemia Sickle Cell Polycythemia
White Blood Cell DisordersWhite Blood Cell Disorders
LeukopeniaLeukopenia: : lower lower than normal amounts of than normal amounts of WBCsWBCs
CausesCauses: Cancer, radiation & chemotherapy, : Cancer, radiation & chemotherapy, antipsychotic medicinesantipsychotic medicines
LeukocytosisLeukocytosis: : higherhigher than normal amounts of than normal amounts of WBCs; possible causes: infection or leukemiaWBCs; possible causes: infection or leukemia
CausesCauses: Massive infection: Massive infection
Platelet DisordersPlatelet Disorders
ThrombocytopeniaThrombocytopenia: lower than normal number of : lower than normal number of platelets.platelets.
CausesCauses:: Vitamin Vitamin B12 B12 or or Folic Acid Folic Acid deficiency deficiency LeukemiaLeukemia SepsisSepsis (massive blood infection) (massive blood infection) Dengue feverDengue fever
Typical Dengue
Rash
Severe The Culprit
Centrifuged BloodCentrifuged Blood
Blood in tube spunBlood in tube spun to to separate cellsseparate cells from plasma from plasma Formed elementsFormed elements: heavier cells : heavier cells forced to forced to
bottombottom of tube. of tube. Dissolved substancesDissolved substances: upper level, lighter in : upper level, lighter in
weight & color, is weight & color, is plasma plasma or or liquid portionliquid portion of of blood.blood.
Centrifuged BloodCentrifuged Blood
Blood TestingBlood Testing
IncludesIncludes RBC RBC (red blood cell count) or (CBC)(red blood cell count) or (CBC) HctHct (hematocrit) “ (hematocrit) “judging bloodjudging blood” the proportion ” the proportion
of of blood volume that is occupied by RBCs volume that is occupied by RBCs HgbHgb (hemoglobin) “ (hemoglobin) “proteinprotein” ” 97% 97% of dry of dry
content of the RBC…content of the RBC… WBCWBC (white blood cell count) (white blood cell count) DiffDiff (differential white blood cell count) (differential white blood cell count) PlateletPlatelet count count
Red Blood Cell Count(RBCs)Red Blood Cell Count(RBCs)
Quantity of RBCsQuantity of RBCs in 1 cubic mm in 1 cubic mm
Normal valuesNormal values: men: 4.6-6.2; women: 4.2-5.4: men: 4.6-6.2; women: 4.2-5.4
Decreased numbers Caused byDecreased numbers Caused by
1.1. blood lossblood loss
2.2. dietary insufficiency (iron, folic acid, certain dietary insufficiency (iron, folic acid, certain vitamins)vitamins)
3.3. decreased RBC Productiondecreased RBC Production
4.4. increased RBC destructionincreased RBC destruction
Red Blood Cell CountRed Blood Cell Count
Polycythemia: Polycythemia: too many RBCs….too many RBCs….
1.1. dehydration, diarrhea (severe)dehydration, diarrhea (severe)
2.2. high altitudehigh altitude
3.3. over production by bone marrowover production by bone marrow
4.4. SmokingSmoking
5.5. Adrenal gland illnessesAdrenal gland illnesses
Hematocrit (Hematocrit (HctHct))
Determines what percentDetermines what percent of the blood is composed of of the blood is composed of RBCs.RBCs. Normal valuesNormal values: : menmen: 40-54%; : 40-54%; womenwomen: 38-47%: 38-47% Higher than normal HctHigher than normal Hct 1. dehydration 2. shock1. dehydration 2. shock Lower than normal HctLower than normal Hct 1. 1. anemia anemia 2. 2. hemorrhagehemorrhage, 3. , 3. hemolytic reactionshemolytic reactions
(blood cell destruction – such as what occurs when (blood cell destruction – such as what occurs when incompatible blood is transfused)incompatible blood is transfused)
Hemolytic ReactionHemolytic Reaction
Hemoglobin(Hemoglobin(HgbHgb))
Measures protein in RBCsMeasures protein in RBCs that carries oxygen that carries oxygen Normal valuesNormal values: : menmen: 13.5 – 17.5 g/dl; : 13.5 – 17.5 g/dl; womenwomen: 12-: 12-
16 g/dl; 16 g/dl; newbornsnewborns: 14-16 g/dl: 14-16 g/dl Decreased hemoglobinDecreased hemoglobin: anemia, excessive fluid : anemia, excessive fluid
intake, hemorrhage, pregnancy intake, hemorrhage, pregnancy Increased hemoglobinIncreased hemoglobin: : COPD COPD (which may result (which may result
in chronically low blood oxygen), high altitude in chronically low blood oxygen), high altitude
White Blood Cell Count White Blood Cell Count ((WBCsWBCs))
Measures total number of white blood cells 103/mm3
Normal values: men: 4.5-11; women: 4.5-11 ((leukopenialeukopenia): Decreased WBCs diagnosed with ): Decreased WBCs diagnosed with
WBC < 4,000WBC < 4,000• May be caused byMay be caused by alcoholism, viral infections, alcoholism, viral infections,
any chronic infection where body is so “any chronic infection where body is so “worn worn outout” that it cannot continue to produce enough ” that it cannot continue to produce enough WBCsWBCs
• ““panic valuepanic value,” WBC<500 is requires “,” WBC<500 is requires “STATSTAT” ” attention.attention.
White Blood Cell Count White Blood Cell Count ((WBCsWBCs) con’t) con’t
((leukocytosisleukocytosis) ) Increased WBCsIncreased WBCs Diagnosed with WBC > 10,000Diagnosed with WBC > 10,000 Usually results from an increase in just one Usually results from an increase in just one
type of WBCtype of WBC May be caused byMay be caused by infection, infection,
malignancy/leukemia, steroid therapy, malignancy/leukemia, steroid therapy, hemorrhage, coma, stress (pain/excitement), hemorrhage, coma, stress (pain/excitement), menstruation.menstruation.
Differential white blood cell count Differential white blood cell count (Diff)(Diff)
Measures each different type of WBCMeasures each different type of WBC Types of WBCsTypes of WBCs
• NeutrophilsNeutrophils: combat bacterial infection, : combat bacterial infection, inflammation and stressinflammation and stress
• LymphocytesLymphocytes: fight viral infections: fight viral infections• EosinophilsEosinophils: respond to allergic conditions and : respond to allergic conditions and
parasitic invasionsparasitic invasions• MonocytesMonocytes: respond to severe and chronic : respond to severe and chronic
infectionsinfections• BasophilsBasophils: respond to inflammation & blood : respond to inflammation & blood
disordersdisorders
Platelet countPlatelet count
Determines number of platelets in bloodDetermines number of platelets in blood Normal valuesNormal values: 150,000-350,000 / mm: 150,000-350,000 / mm33
ThrombocytopeniaThrombocytopenia: : decreased plateletsdecreased platelets may be may be caused by blood transfusions, bone marrow caused by blood transfusions, bone marrow lesions, cancer chemotherapy, lesions, cancer chemotherapy, infections/pneumonia, toxic drug effectsinfections/pneumonia, toxic drug effects
ThrombocytosisThrombocytosis: : Increased plateletsIncreased platelets may be may be caused by splenectomy, heart disease, high caused by splenectomy, heart disease, high altitude living, iron deficiency, trauma, altitude living, iron deficiency, trauma, tuberculosis, cancertuberculosis, cancer
PT (PT (Prothrombin Time, ProTimeProthrombin Time, ProTime))
Timed testTimed test that measures blood’s ability to clot that measures blood’s ability to clot through use of the through use of the proteinprotein prothrombinprothrombin produced produced by the liver.by the liver.
Prothrombin Prothrombin converts converts to to thrombinthrombin Body needs Body needs Vit K Vit K to produce to produce prothrombinprothrombin Normal values: 10-14 secNormal values: 10-14 sec
PT (PT (Prothrombin Time, ProTimeProthrombin Time, ProTime) con’t) con’t
Increased ProTimeIncreased ProTime: suggests blood will not clot : suggests blood will not clot as quickly as normal; ex: patients on as quickly as normal; ex: patients on anti-anti-coagulantcoagulant therapy such as therapy such as CoumadinCoumadin
Decreased ProTimeDecreased ProTime: suggests : suggests increaseincrease in in blood’s ability toblood’s ability to clot clot; may result from excessive ; may result from excessive consumption of green, leafy vegetables (which consumption of green, leafy vegetables (which alters alters vitamin K vitamin K levels, and therefore alters levels, and therefore alters prothrombin levels or too much prothrombin levels or too much Vit KVit K..
Decreased ProTime Decreased ProTime may result in may result in blood clotsblood clots
PTT (PTT (Partial Thromboplastin TimePartial Thromboplastin Time) )
Timed testTimed test that measures blood’s that measures blood’s ability to clotability to clot through intrinsic through intrinsic thromboplastinthromboplastin system system
Used to monitor administration of Used to monitor administration of HeparinHeparin Normal valuesNormal values: 30-45 sec: 30-45 sec Increased PTTIncreased PTT: suggests blood will not clot as : suggests blood will not clot as
quickly as normal; ex: pts on quickly as normal; ex: pts on anti-coagulant anti-coagulant therapytherapy such as such as heparinheparin..
Blood Testing ResultsBlood Testing ResultsDon’t copy this!!! I will discuss this slide.Don’t copy this!!! I will discuss this slide.
BUN (BUN (Blood Urea NitrogenBlood Urea Nitrogen))
Measurement of kidney’s ability to eliminate ureaMeasurement of kidney’s ability to eliminate urea ((waste productwaste product) from blood) from blood
Normal valuesNormal values: 7-18ml/dl or 2.5-6.3mmol/L: 7-18ml/dl or 2.5-6.3mmol/L
BUN (BUN (Blood Urea NitrogenBlood Urea Nitrogen) (cont’d)) (cont’d)
Increased BUN Increased BUN May be caused by renal function impairment, May be caused by renal function impairment,
non-renal causes (acute MI, chronic gout, non-renal causes (acute MI, chronic gout, diabetes, excessive protein consumptiondiabetes, excessive protein consumption
Signs and symptomsSigns and symptoms of increased BUN: of increased BUN: confusion, convulsions, Hypertensionconfusion, convulsions, Hypertension
Decreased BUNDecreased BUN
May be caused byMay be caused by
1.1. low protein diet/malnutrition,low protein diet/malnutrition,
2.2. fluid overload, fluid overload,
3.3. liver failure, liver failure,
4.4. nephrotic syndromenephrotic syndrome S/S of edemaS/S of edema
BUN Testing ResultsBUN Testing Results
ElectrolytesElectrolytes
Crucial for proper cellular function Crucial for proper cellular function throughout throughout body; body must maintain normal concentrations body; body must maintain normal concentrations of various electrolytes of various electrolytes
Amount of water in body Amount of water in body (too much or too little) (too much or too little) can affect electrolyte concentrationscan affect electrolyte concentrations
Electrolyte Testing ResultsElectrolyte Testing Results
Calcium (Ca++)Calcium (Ca++)
Normal valuesNormal values: : 4.5-5.4 mEq/L4.5-5.4 mEq/L HypercalcimiaHypercalcimia: Increased Calcium: Increased Calcium Caused byCaused by hyperparathyroidism, malignant hyperparathyroidism, malignant
tumors, diuretic therapy, excessive calcium tumors, diuretic therapy, excessive calcium consumption (milk or antacids), vitamin D consumption (milk or antacids), vitamin D intoxication.intoxication.
S/SS/S: anorexia, constipation, lethargy & : anorexia, constipation, lethargy & weakness, hyporeflexia, mental deterioration, weakness, hyporeflexia, mental deterioration, kidney stoneskidney stones
Calcium (Ca++) con’tCalcium (Ca++) con’t
HypocalcimiaHypocalcimia: Decreased calcium: Decreased calcium Caused byCaused by hypoparathyroidism, vitamin D hypoparathyroidism, vitamin D
deficiency, diuretic therapy, pregnancydeficiency, diuretic therapy, pregnancy S/SS/S: muscle cramping, paresthesia, mental : muscle cramping, paresthesia, mental
disturbances, convulsionsdisturbances, convulsions
Chloride (ClChloride (Cl--))
Normal valuesNormal values: 95-103 mEq/L: 95-103 mEq/L Decreased ChlorideDecreased Chloride: caused by excessive : caused by excessive
vomiting, dehydration, burns.vomiting, dehydration, burns. S/SS/S: depressed breathing, muscle : depressed breathing, muscle
hypertonicity/hypertonicity/tetanustetanus
Potassium (KPotassium (K++))
Normal ValuesNormal Values: : 3.8-5.0 mEq/L3.8-5.0 mEq/L Hyperkalemia-High potassiumHyperkalemia-High potassium: caused by : caused by
muscle tissue damage, renal failure muscle tissue damage, renal failure S/SS/S: diarrhea/nausea, : diarrhea/nausea, ventricular fibrillation ventricular fibrillation
(heart dysrrhythmias), irritability, weakness(heart dysrrhythmias), irritability, weakness. . confusionconfusion..
Potassium (KPotassium (K++))
Hypokalemia: Hypokalemia: Decreased PotassiumDecreased Potassium Caused byCaused by diuretic therapy, diarrhea, endocrine diuretic therapy, diarrhea, endocrine
disorder, chronic stressdisorder, chronic stress S/SS/S: : cardiac arrhythmiascardiac arrhythmias, hypotension, muscle , hypotension, muscle
weakness, malaise weakness, malaise
Dangerous Cardiac Arrest
Sodium (NaSodium (Na++))
Normal valuesNormal values: 136-142 mEq/L: 136-142 mEq/L HypernatremiaHypernatremia: Increased sodium: : Increased sodium: Caused byCaused by dehydration dehydration S/SS/S: dry mucous membranes & tongue, intense : dry mucous membranes & tongue, intense
thirst, flushed skinthirst, flushed skin
Sodium (NaSodium (Na++) con’t) con’t
HyponatremiaHyponatremia: : Low Sodium LevelLow Sodium Level Etiology:Etiology: excessive water intake, loss of GI excessive water intake, loss of GI
secretions, excessive sweating, burnssecretions, excessive sweating, burns S/SS/S: abdominal cramps, muscle twitching, : abdominal cramps, muscle twitching,
confusion, seizures, vasomotor collapseconfusion, seizures, vasomotor collapse
EnzymesEnzymes
Complex proteinsComplex proteins that facilitate chemical that facilitate chemical changeschanges
Normally foundNormally found inside body cells inside body cells May be released into bloodstreamMay be released into bloodstream following cell following cell
injury or death; example: injury or death; example: cardiac enzymescardiac enzymes are are released into bloodstream when cardiac tissue released into bloodstream when cardiac tissue dies during dies during heart attackheart attack
Urine TestingUrine Testing
Body makesBody makes 1-1.5 liters of urine every day 1-1.5 liters of urine every day Kidneys produce urine in order toKidneys produce urine in order to: :
• Excrete wasteExcrete waste• Regulate concentration of various Regulate concentration of various
substances in bloodsubstances in blood Morning urineMorning urine is best for testing as it is the most is best for testing as it is the most
concentrated.concentrated.
Urine Testing (cont’d)Urine Testing (cont’d)
DipsticksDipsticks: have several different areas : have several different areas impregnated with different reactive chemicalsimpregnated with different reactive chemicals ProcedureProcedure: dipstick is dipped into urine and : dipstick is dipped into urine and
observed for color changes observed for color changes Urine properties measured by dipstickUrine properties measured by dipstick: pH, : pH,
bilirubin, ketones, glucose, leukocyte bilirubin, ketones, glucose, leukocyte esterase, protein, hemoglobin, nitrite, esterase, protein, hemoglobin, nitrite, urobilinogenurobilinogen
Urine TestingUrine Testing
Specific gravitySpecific gravity
Measurement ofMeasurement of: : 1.1. Kidney’s ability to concentrate urineKidney’s ability to concentrate urine
2.2. Hydration of a patientHydration of a patient
3.3. Amount of solids mixed in urine Amount of solids mixed in urine Normal valuesNormal values: : 1.010-1.0251.010-1.025
Concentrated urineConcentrated urine = 1.025-1.030+; suggests = 1.025-1.030+; suggests dehydrationdehydration
Diluted urineDiluted urine = 1.001-1.010; suggests = 1.001-1.010; suggests overhydrationoverhydration or or diureticdiuretic use use
Factors that can interfere with urine test resultsFactors that can interfere with urine test results
Use of diureticsUse of diuretics HypercalcemiaHypercalcemia Potassium deficiencyPotassium deficiency Liver, Bone & diseasesLiver, Bone & diseases
Urine ColorUrine Color
Normal valuesNormal values: straw-amber color: straw-amber color Abnormal urine colors and their significanceAbnormal urine colors and their significance
BlackBlack: Lysol poisoning; alkaptonuria: Lysol poisoning; alkaptonuria BrownBrown: Addison’s disease, drugs, melanotic tumor, : Addison’s disease, drugs, melanotic tumor,
bilirubin, rhubarb ingestionbilirubin, rhubarb ingestion Clear/nearly clearClear/nearly clear: ETOH or other diuretic substances, : ETOH or other diuretic substances,
large fluid intake, diabetes insipidus, chronic interstitial large fluid intake, diabetes insipidus, chronic interstitial nephritis, untreated diabetes mellitusnephritis, untreated diabetes mellitus
OrangeOrange: concentrated urine, decreased fluid intake, : concentrated urine, decreased fluid intake, excessive sweating, drugsexcessive sweating, drugs
RedRed: (: (hematuriahematuria) blood/hemoglobin, beets, drugs) blood/hemoglobin, beets, drugs
Urine….Urine….
Urine odorUrine odor
Normal urineNormal urine has distinct, but non-offensive has distinct, but non-offensive aromaaroma
Unusual odorsUnusual odors can suggest specific problems can suggest specific problems• Ammonia scentAmmonia scent: stale urine with bacterial activity: stale urine with bacterial activity• General sweet smellGeneral sweet smell: diabetic : diabetic ketosisketosis• Maple syrup scentMaple syrup scent: particular metabolic disorder: particular metabolic disorder
Urine pH (Urine pH (acidityacidity))
Controlled by kidneysControlled by kidneys to maintain homeostatic pH in body to maintain homeostatic pH in body Normal valuesNormal values: pH of 4.6-8 (with : pH of 4.6-8 (with average pH of 6average pH of 6)) Excessively acidic urineExcessively acidic urine may be due to may be due to respiratory acidosis respiratory acidosis
(retention of CO(retention of CO22 in lungs causes extra acid in blood, which in lungs causes extra acid in blood, which
kidneys try to eliminate), diarrhea/dehydration, high protein kidneys try to eliminate), diarrhea/dehydration, high protein diets, starvationdiets, starvation
Excessively alkaline urineExcessively alkaline urine may be due to may be due to hyperventilation hyperventilation (body blows off too much CO(body blows off too much CO22 causing deficient acid in causing deficient acid in
blood; kidneys try to correct blood pH by eliminating less blood; kidneys try to correct blood pH by eliminating less acid into urine), acid into urine), chronic renal failurechronic renal failure, , renal tubular acidosisrenal tubular acidosis, , urinary tract infectionurinary tract infection (UTI), (UTI), salicylatesalicylate ( (aspirin) aspirin) intoxicationintoxication
Urine turbidityUrine turbidity
Measure ofMeasure of how “ how “cloudycloudy” urine appears” urine appears Normal valuesNormal values: clear to slightly hazy: clear to slightly hazy Cloudy urine may be caused byCloudy urine may be caused by
• Bacteria Bacteria (infection)(infection)• PusPus (lots of WBCs) (lots of WBCs)• Red Red blood cells (blood cells (hematuriahematuria))• Ingestion of certain foods (especially greasy/fatty Ingestion of certain foods (especially greasy/fatty
foods)foods)• Vaginal contamination Vaginal contamination (common occurrence (common occurrence • when women give urine samples)when women give urine samples)
Urine SugarUrine Sugar
GlycosuriaGlycosuria or or GlucosuriaGlucosuria
Caused byCaused by::
1. un-treated or inadequately treated DM1. un-treated or inadequately treated DM
2. emotional stress2. emotional stress
3. early Renal Failure3. early Renal Failure
Urine protein (Urine protein (proteinuriaproteinuria))
Normal ValuesNormal Values: 50-80mg /24 hours: 50-80mg /24 hours Causes of ProteinuriaCauses of Proteinuria: :
• activitiesactivities: bathing or swimming in : bathing or swimming in cold watercold water, , eating large amounts of eating large amounts of proteinprotein, violent/intense , violent/intense exerciseexercise, severe emotional , severe emotional stressstress
• Renal diseaseRenal disease: kidney stones, nephritis, : kidney stones, nephritis, nephrosis, polycystic kidney, tuberculosis or nephrosis, polycystic kidney, tuberculosis or cancer of the kidneycancer of the kidney
Urine ketone bodies (Urine ketone bodies (acetoneacetone))
Ketones released as result ofKetones released as result of metabolism of fatty metabolism of fatty acids; takes place when body runs out of acids; takes place when body runs out of carbohydrates to burncarbohydrates to burn
Normal valuesNormal values: negative: negative Causes of KetonuriaCauses of Ketonuria: DM, anorexia/starvation/ : DM, anorexia/starvation/
fasting, diarrhea/prolonged vomiting, fever, fasting, diarrhea/prolonged vomiting, fever, drugs (i.e. insulin)drugs (i.e. insulin)
Urine Bacteria Urine Bacteria
Normal valuesNormal values: negative : negative Presence of bacteria in urine can suggest Presence of bacteria in urine can suggest
urinary tract infection (urinary tract infection (UTIUTI))
Fecal MatterFecal Matter Normal stoolNormal stool: 100-200 g/day, dark brown: 100-200 g/day, dark brown Color AbnormalitiesColor Abnormalities::
• Yellow/yellow-Yellow/yellow-greengreen: breast fed infant, bowel : breast fed infant, bowel sterilization due to antibiotics, severe diarrheasterilization due to antibiotics, severe diarrhea
• GreenGreen: severe diarrhea, antibiotic therapy, : severe diarrhea, antibiotic therapy, ingestion of chlorophyll-rich vegetablesingestion of chlorophyll-rich vegetables
• Tan/clayTan/clay: common bile duct blockage, pancreatic : common bile duct blockage, pancreatic insufficiency, excessive fat intakeinsufficiency, excessive fat intake
• Black: Black: upper GI bleeding, ingestion of iron, high upper GI bleeding, ingestion of iron, high meat diet, ingestion of charcoal or bismuthmeat diet, ingestion of charcoal or bismuth
• RedRed: bleeding from lower GI tract; if red streaking : bleeding from lower GI tract; if red streaking on outer surface of stool, consider hemorrhoids or on outer surface of stool, consider hemorrhoids or anal pathology; if blood mixed through stool, anal pathology; if blood mixed through stool, consider problem higher up GI tractconsider problem higher up GI tract
Blood in stoolBlood in stool
CausesCauses: gastritis, gastric ulcers, diverticulitis, : gastritis, gastric ulcers, diverticulitis, ulcerative colitis, colon or gastric cancer, ulcerative colitis, colon or gastric cancer, trauma.trauma.
Conditions that cause false-positiveConditions that cause false-positive occult blood occult blood tests: ingestion of tests: ingestion of red meat,red meat, large amounts of large amounts of inorganic ironinorganic iron, and large doses of , and large doses of vitamin Cvitamin C
Pathology Conncection:Pathology Conncection:Colon PolypsColon Polyps
Cerebral Spinal Fluid (Cerebral Spinal Fluid (CSFCSF))
Clear and colorless fluidClear and colorless fluid found in ventricles of found in ventricles of the brain and central canal of the spinal cordthe brain and central canal of the spinal cord
FunctionsFunctions: acts as a : acts as a shock absorbershock absorber, helps , helps regulate regulate intracranial pressureintracranial pressure, cranial glucose , cranial glucose levels, leading to hunger sensations & eating levels, leading to hunger sensations & eating behaviors.behaviors.
CSF AnalysisCSF Analysis
Normal valuesNormal values Normal daily production Normal daily production = 500ml= 500ml Normal circulation Normal circulation around brain and spinal around brain and spinal
cord = 150-200mlcord = 150-200ml Normal color Normal color = clear, colorless= clear, colorless Normal cell count Normal cell count = 0-5/microliters= 0-5/microliters
Adult Spinal TapAdult Spinal Tap
CSF AbnormalitiesCSF Abnormalities
Abnormalities due toAbnormalities due to:: HemorrhageHemorrhage Micro-organismsMicro-organisms TumorsTumors Infections (like Infections (like meningitismeningitis)) TraumaTrauma
Culture and Sensitivity Culture and Sensitivity (C&S) Testing(C&S) Testing
PurposePurpose: to identify pathogen causing infection : to identify pathogen causing infection ((cultureculture) and which drug will most effectively kill ) and which drug will most effectively kill pathogen (pathogen (sensitivitysensitivity))
Important considerationsImportant considerations Culture may grow Culture may grow normal floranormal flora as well as as well as
pathogenspathogens C&S results may be C&S results may be alteredaltered if patient is already if patient is already
on some kind of on some kind of antibioticantibiotic
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