CM (SAFETY IN THE CLINICAL LAB and Renal Physio) Source: Sir Errol's handout and Strasinger 6th Ed.

Biologic Hazards

hazards resulting from living organisms that cause adverse effects on people

chain of infection

factors that lead to the transmission or spread of disease

IREMES - meaning??

IIDS ( ingestion, inhalation, direct contact and skin innoculation)

Common routes of infection

Hand contact

is the primary method of infection transmission.

Handwashing

Most important means of preventing the spread of infection

BEST WAY to prevent transmission of infection

Friction

important part of handwashing

1st is True, 2nd is True

In Handwashing, rinse your hands with water in downward position. Then after washing, turn off the faucet with paper towel to avoid contamination

Alcohol based Sanitizers

If hands are not visibly soiled, one must apply what?

Happy birthday song

the handwashing song, and it must be sing for atleast 2x while doing the handwashing

Urine containers

All are biological waste materials except?

Fluorescent orange

background color for biohazards

1 part of sodium hypochlorite and 9 parts of water

ratio between Sodium hypochlorite to water is?

daily

Disinfection of sink must be done??

Three circles overlapping with each other

symbol for biohazard

Sharp hazards

needles, lancets, and broken glassware

Red colored label with Syringe and no symbol with it

Puncture-proof container

Any disposable sharp objects coming into contact with blood shall be disposed of in a..?

Radioactive hazard

A hazard that uses radioisotopes that can cause birth defect.

By storing to a marked, closed room that uses a radioactive material, and wait until the background count is down to 10 half lives ionization

How to dispose radioactive material?

Chemical Hazards

harmful chemicals in the air, water, soil, and food

15 mins

Best first aid if chemical spills on your skin is to wash with large amount of water for atleast??

Same with the eyes that affected with acid or alkali burn

False

TRUE OR FALSE; neutralize the acidic chemical spill on your skin with basic chemicals

False

always add water to acid

NFPA

This system utilizes the four small diamonds arranged so they form one large diamond

health hazard

The blue color in the NFPA labeling system signifies what type of hazard?

specific hazard

The white circle in the diamond. It addresses hazardous properties not covered in the other three circles. for example radioactivity and acidity.

Reactivity

The yellow color in the diamond that represents the stability of a material

fire hazard

The red diamond, appearing at the top of the label that conveys information.

Electrical Hazards

Electrical connections not handled properly, may result in electric shock, burn, or other injury.

3 pronged plug

This is used to avoid electrical shock

1st statement is True, 2nd statement is false

TRUE or FALSE

If electrical shock occurs, never touch the person or the equipment involved. Instead, unplug the equipment using a steel rod.

PASS

This is how to operate a fire extinguisher

RACE

When fire is discovered, you should do

Dry Chemical

Extinguishing system that uses dry chemical as the primary extinguishing agent

Type ABC fire

paper, wood, cloth

Class A type of fire materials are?

water

main component of Type A fire extinguisher

CO2

main component of Type B and C fire extinguisher

Sand

it is use to extinguisher flammable metal such as sodium, mercury, lithium and magnesium

Aerosols

when centrifuging an uncapped specimen, it may produce a biologic hazard in the form of?

Kidneys

Filter blood from the renal arteries and produce urine as waste

consist of 12.5 cm in length, 6cm in width, and 2.5 cm in depth

150 grams

weight of kidney

25 cm long

How long is ureter?

150 mL

total volume of accumulated urine in bladder

4cm

length of female urethra

20cm

length of male urethra

Nephrons

Functional units of the kidneys

cortical nephrons

85% of nephrons and it is responsible for removal of wastes and reabsorbing nutrients in the kidney

juxtamedullary nephrons

15% of nephrons and responsible for osmotic gradient or concentration of urine in kidney

glomerulus, PCT, loop of henle, DCT, collecting duct, Calyx, and Renal pelvis

Order of urine formation

25% of blood

Approximately, how many (percent) blood is going to the kidney

1,200 mL

Total renal blood flow is

600-700 mL/min

Total renal plasma flow

renal artery

where the unfiltered blood flows

afferent arteriole

carries blood to the glomerulus

efferent arteriole

The small artery that carries blood away from the capillaries of the glomerulus.

peritubular capillaries

The network of tiny blood vessels that surrounds the proximal and distal tubules in the kidne

vasa recta

the capillary system in the kidney that serves the loop of Henle

responsible for exchanging nutrients and water

renal vein

blood vessel that carries blood away from the kidney and toward the heart

glomerulus

A ball of capillaries surrounded by Bowman's capsule in the nephron and serving as the site of filtration in the vertebrate kidney.

working portion of kidneys

sieve

this resembles glomerulus

podocytes

cells in the Bowman's capsule in the kidneys that wrap around capillaries of the glomerulus

<70,000 daltons

In order to pass through into the filtrate, substances must have a molecular weight less than what?

capillary endothelium

Known as simple squamous endothelium and forms the wall of the capillary

trilayer basement membrane

consist of lamina rara interna, densa, and rara externa

filtration diaphragm

it is found between the podocytes and Bowman's space

Shield of negativity

A term describing the impediment produced by negatively charged components of the glomerular filtration barrier. Present on both sides of and throughout the filtration barrier, these negatively charged components effectively limit the filtration of negatively charged substances from the blood (e.g. albumin) into the urinary space.

tubular reabsorption

selectively returns 99% of substances from filtrate to blood in renal tubules and collecting ducts

1st function to be affected in renal disease

160-180 mg/dL

renal threshold for glucose

PCT, LH, DCT, CD

Part/s which alter urine conc.

PCT

The majority of tubular reabsorption takes place in the

ascending LH

Part of nephron which is highly permeable to water and renal conc. begins

absorbs salts

descending LH

No active transport of Na+ Cl- but collects water only

Reabsorb

if Aldosterone is High, salt will?

The Aldosterone is low

what happened if salt is excreted in urine

ADH (vasopressin)

a hormone that regulates water reabsorption

if increased, then water will reabsorb and if decreases, water will be excreted.

amino acids

a organic compound that a 100% reabsorbs in our system

Glucose

this compound will be reabsorb if renal threshold is <160 mg/dL, but will increased in urine output if the renal threshold exceeds

Urea

major nitrogenous waste excreted in urine

60% is excreted through urine and 40% is reabsorbed

active transport

the movement of materials through a cell membrane using electrochemical energy

passive transport

transport of a substance across a cell membrane by diffusion

Glucose, Amino acids and salts

active transport is responsible for reabsorption of these in the PCT

Chloride

active transport is responsible for reabsorption of this in Ascending LH

Sodium

active transport is responsible for reabsorption of this in PCT and DCT

Water

passive transport is responsible for this in PCT, descending LH and CD

urea

it is reabsorb in PCT and ascending LH

Sodium

absorbs in ascending LH in passive transport

ADH

regulates water reabsorption in DCT and CD

Decrease ADH

if the Body hydration is high, and urine volume is high, what is the ADH level?

SIADH

charactorized by inappropriate, excessive secretion of ADH in the absecense of hypovolemia stimulus. Hyponatremia occurs secondary to hemodilutuion. Clinical s/s are secondary to hemodilution and increased blood volume.

diabetes insipidus

antidiuretic hormone is not secreted adequately, or the kidney is resistant to its effect

Aldosterone

Hormone that stimulates the kidney to retain sodium ions and water

RAAS

this mechanism helps maintain a balance of sodium and water and a healthy blood volume and pressure.

Renin

hormone secreted by the kidney that raises blood pressure

Angiotensinogen

Converted to angiotensin I by renin

Angiotensin I

an inactive precursor that is converted by an enzyme to yield active angiotensin II

ACE

a mechanism that converts Angiotensin I to Angiotensin II in the Alveoli of lungs

Angiotensin II

increases blood pressure by stimulating kidneys to reabsorb more water and by releasing aldosterone

active form.of Angiotensin I

dilates afferent renal arterioles, constricts efferent arterioles, promotes reabsorption of Sodium in PCT, stimulates Adrenal cortex to release Aldosterone (sodium reabsorption in DCT and CD, and Potassium excretion), and releases ADH to promote water reabsorption in CD

What are the effects of Angiotensin II

PCT

Major site of removal of non filtered substances, and it is also where H+ ions are secreted in exchange of Na+ ions in which reabsorbed together with HCO3 in the plasma

tubular secretion

Moves substances from the blood in the peritubular capillary into the renal tubule.

it regulates acid base balance and eliminates waste products

Renal tubular acidosis

A metabolic acidosis resulting from impaired renal reabsorption of bicarbonate and impaired secretion of H+ ions; the urine is alkaline.