Microorganisms, Orientation to the lab, Urine collection, Diagnostic imaging and physical therapy

week 8

Microbiology

study of small life forms only detected under a microscope

Microorganisms

every where in the environment and usually causes no problems (can beneficial) although some can cause disease

Normal flora

bacteria that lives in and on the body that assists systems to stay in homeostasis (normal flora can cause infection if they invade another body area or are overgrown)

Lactobacillus acidophilus

normal flora found in the gastrointestinal tract

Means of transmission

how tha pathogen spreads to a host

Droplets

carries 3-6ft

Vector-born

ticks, dog, mosquito

Fomites

indirect contact (doorknob)

Microorganisms cause disease by

• using nutrients needed by cells and tissues they invade

• damaging body cells by reproducing themselves within cells

• making body cells the target of the body’s defenses

Bacteria

small cell microorganisms that can survive without living tissue (have various classification and shapes)

Aerobic

bacteria that needs air to grow and multiply

Anaerobic

bacteria that can grow and multiply without air

Rickettsia

lives and grows only inside other living things like insects (vector-based)

Coccus

round shaped bacteria

Spirillum

spiral shaped bacteria

vibrio

comma shaped bacteria

Bacillus

rod shaped bacteria

Bordetella pertussis

whooping cough (airborne)

Escherichia coli

diarrhea, UTI (foodborne)

Viruses

smallest known infectious agents that require living tissues to survive and grow and attaches to host cells, takes control of cell, and destroys cell and nearby cells (some attack immediately while others lie dormant)(difficult to kill due to mutation during replication)

Fungus (fungi)

mold that grows on or in animals and plants (most do not normally cause disease)(athletes foot, vaginal yeast infection)

Protozoa

single cell parasite that can be microscopic or large enough to be seen with a microscope (they thrive in a damp environment and replicate rapidly inside host)

Multicellular parasites

cause infestation and infection (lice, worms)

Immunocompetent

normal functioning immune system

Immunodeficient, Immunocompromised, Immunosuppressed

non-normal functioning immune system (opportunistic infections)

Opportunistic infections

caused by normal organisms that would not cause an infection in a immunocompetent patient

CLIA-WAIVED testing

simple test that can be done inside practice

Reference laboratory

located outside of practice and has more technological resources for test

Physicians office laboratory (POL)

within the practice and has a quicker turnaround

Quantitative test

number value (glucose, hemoglobin)

qualitative test

either positive (+) or negative (-) value (urine, strep, influenza)

Centrifuge

spins and separates blood and urine specimens

autoclave

sterilizes instruments

Quality assurance

maximizes accuracy and patient safety

Quality control

procedures that are completed on testing equipment to ensure accuracy

Quality control log

validate the equipment is in good working order

Labeling specimens

patient name, DOB, date and time of collection, and initials of collection person

Acceptable label placement

align the label lengthwise of the top of the tube with the patient’s name reading from left to right (make sure labels are straight and wrinkle free so the bar code can be read)

Hemoglobin (Hgb)

(m) 13-18g/dl (f) 12-16g/dl

Hematocrit

(m) 42-52% (f) 36-48%

Erythrocyte sedimentation rate (ESR)

(m) 0-20mm/hr (f)0-30mm/hr

Fasting blood glucose (FBS)

60-110mg/dl

Total cholesterol

less than 200mg/dl

Low-density lipoprotein (LDL)

less than 130mg/dl

High-density lipoprotein (HDL)

greater than 40mg/dl

triglycerides

less than 150mg/dl

Prothrombin time (PT)

10.4-15.7 seconds

International normalized ratio (SNR)

0.8-1.2

pH

4.8-9

specific gravity

1.005-1.030

Urobilinogen

0.1-1

all other urine values

negative (-)

Chemistry lab

chemicals found in blood

Hematology

study of blood

Urinalysis

examines urine

Blood banks

deals with blood used for transfusion

Cytology/pathology

examination of human cells under the microscope

Biological safety

treat all specimens as if contaminated

types of urine testing

physical, chemical, and microscopic

Urine specimens must be

refrigerated after an hour of collecting and returned to room temperature before testing

Pale color urine

indicates diluted urine

Dark color urine

indicates concentrated urine

Turbidity

gage and report the urine as clear, slightily cloudy, cloudy, or very cloudy (swirl to reveal settlements)

Reagent strip testing

used to test urine for subsistence (color changes indicate the presence of a substance and its’s concentration)

Glucose strip

increase glucose indicates glycosuria (diabetes)(read first at 30 sec)

Protein strip

excess protein indicates proteinuria (kidney issues)

Specific gravity strip

indicates hydration status (normal 1.005-1.030)

Blood strip

present hematuria (could be due to menstruation)(can indicate UTI, cancer, nephritis, urolithiasis)

Bilirubin strip

breakdown of hemoglobin (early sign of liver disease)

Urobilinogen strip

abnormal levels seen with liver dysfunction

Ketones strip

normally not found in urine and may indicate patient following a low carbohydrate diet, starvation, excessive vomiting, diabetes (products of fat and protein metabolism on the body)

pH strip

monitoring may be helpful in preventing the formation of kidney stones (normal 4.5-8.0)(average 6.0)

Nitrites strip

most specific test for bacterial UTI

Leukocyte strip

seen with inflammation of UTI (read last at 120 sec)

Microscope examination

view elements only visible with microscope (this examination is outside of the scope of the MA)

Random urine specimen

(most common) single sample taken at anytime of the day (not specific collection requirements)(used for screening)

First morning speciment

collected after a night of sleep so it contains greater concentration of substances (advise patient to refrigerate sample until delivered to office)

Clean catch midstream

usually collected when reagent strip testing has abnormalities in leukocytes ( method require special cleansing of external genitalia to avoid contamination of bacteria)(only catch the midstream portion)

24 hour specimen

used to diagnose proteinuria, hypercalciuria, and creating clearance (renal function), or urinary output (collect all urine in 24 hour period except for the first morning on the first day)

Catheterized

catheter inserted into bladder (not in the MA scope of practice)

Nocturia

excessive urination at night

Oliguria

decrease in urination

Polyuria

overproduction of urine

Pyelonephritis

inflammation of kidney

Anuria

no urine production

Cystalgia

pain in bladder

cystitis

inflammation of the bladder

Dysuria

pain with urination

Hematuria

blood in the urine

X-ray

electromagnetic waves that travel at the speed of light and penetrate solid objects (requires shielding with lead apron)

KUB radiography

x-ray of the abdomen

Mammography

x-ray exam of internal breast tissues

Contrast medium

used for radiologic test to aid in making structures lighter and brighter (iodine, barium, air/gas, elements)

Oral contrast agents

can take a week to be exerted from the body and will interfere with visualization testing (endoscopy studies will need to be delayed until the dye clears the body)

IV contrast/ iodine

dye clears the body in 24 hours and is injected into the blood vessel (may cause those with existing kidney issues to worsen)(do not use on those with possible shellfish or iodine allergy)

Computed tomography (CT)

diagnostic imaging procedure that uses a combination of x-ray and computer technology to produce images of the inside of the body

Magnetic resonance imaging (MRI)

medical imaging technique that uses a magnetic field and computer generated radio waves to create detailed images of organs tissues

Fluoroscopy

x-ray with video that shows movements inside the body over time

Hysterosalpingography

examination of uterus and fallopian tube

Arthrography

(contrast medium) used to diagnose abnormalities or injuries in joint, cartilage, tendons, and ligaments