Sunday, January 10, 2010

Medical Diagnostic Lab

In an effort to broaden the scope of clinical understanding, each student provided urine specimens for gross and microscopic urinalysis. I felt rather fortunate to only find calcium oxalate crystals, a sign of dehydration. Considering the alternatives, it could have been worse.

Lab Diagnostics

The new, and last classroom, semester has begun and we are starting with an all encompassing look at the endocrine and renal systems. The two converge when considering the hormones involved, or the lack thereof. Our laboratory diagnostics course is intended to provide exposure to the procedures that are routinely performed when samples are needed (e.g. phlebotomy) or obtained. Despite knowing there will be staff who commonly accomplish these tasks, it is important for us to have an understanding of the protocols involved. Besides, how often do you get to analyze your body chemistry anyway?

The results of collecting various samples from wounds, vessels and orifices will be the determining factor in the care we provide as clinicians. Having a solid understanding of the results could very literally mean the difference between life and death. I will admit that there are so many values and tests that it can become overwhelming for the beginner, but in due time it will be second nature. Until that time, I intend to take a drink from the fountain at every opportunity, at the very least to protect my kidneys.

Board Prep Question of the Week

A 45 year old male presents to the Emergency Department of his local hospital coughing up blood. He reports a history of a dry cough for the past couple of months, but this is the first time that he has coughed up any blood. He denies any smoking history. On further questioning he notes that he has had episodes of blood in his urine recently.

A metabolic panel shows:
Na: 140
K: 4.9
Cl: 105
HCO3: 25
BUN: 30
Cr: 1.9

Urinalysis shows blood 2+, protein 1+, neg leukesterase, neg nitrites
Urine microscopy shows red blood cell casts

A kidney biopsy is taken and is stained (above). What is being stained in the slide?

A. Anti-glomerular basement membrane Ab
B. c-ANCA
C. C3
D. IgA
E. p-ANCA


Answer & Explanation

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