Leeuwenhoek had stolen and peeped into the fantastic sub-visible world of little things, creatures that had lived, had bred, had battled, had died, completely hidden from and unknown to all men from the beginning of time. Beasts these were of a kind that ravaged and annihilated whole races of men ten million times larger than they were themselves. Beings these were, more terrible than fire-spitting dragons or hydra-headed monsters. They were silent assassins that murdered babies in warm cradles and kings in sheltered places. It was this invisible, insignificant, but implacable-and sometimes friendly- world Leeuwenhoek had looked into for the first time of all men of all countries. ~Microbe Hunters

Wednesday, 4 September 2013

New Year

Welcome Back! Well, at least that is what the sign says over the common grounds on campus. Yet, I don't see any enticing free stuff to make me feel like welcoming another year of long days and sleepless nights while paying exorbitant amounts of money for tuition. Sigh. The grass looks voluptuous and well fertilized, which was the highlight of my walk around campus yesterday.

Back in first year, I remember thinking that it was absurd to have activities offered to upper year students when they already made their friends and had their fun. Now that I am an upper year student, I wish there were more daytime festivities open to everyone. Or free lunch.

With a new year comes a fresh round of Med Lab students. All 30 of them who were selected for the program will be secluded in a room this afternoon, and taught about Medical Laboratory Science. The professors will make it sound super exciting, and make 4th year/5th year placement sound so far away. Time flies. I know so much about so much by studying so much (and procrastinating so much). I look back now, and I see how far I have come, but I still cant fathom holding someone's life in the test tube in my hands in exactly one year from now.


Darn good and sure of it,

adot

Friday, 2 August 2013

Black Lung in Kathmandu

Hey-O!

If you decide to change career paths and work in a coal mine, you will most likely develop a condition known as Black Lung, in which your lung, quite literally, turns black from inhaling coal dust. The same thing can happen if you live in an area full of smog and pollution, like Beijing, China or Kathmandu, Nepal. Instead of developing COPD or a serious health issue from working in a coal mine, city-living causes black deposits in the lung. My Pathophysiology professor told us last year that as a pathologist, he could tell the difference between a city dweller and country folk, just by examining their lungs. It doesn't cause any harm, unless you have severe asthma or other underlying health conditions. It is just simply a staple that you have experienced technology.

In some places in the world, particularly heavily-populated Asian cities, people like to wear masks to prevent exposure to the excessive amounts of smog and pollution in their air. If someone was to come in contact with such a city, they may develop a sore throat or cold-like symptoms due to the increased contamination of air. Kathmandu, for example, does not have any environmental laws against pollution, so their air is more contaminated, than a city like Toronto, Canada, where we have strict environmental laws to protect our city, our health and the overall global environment.

In the summer of 2014, I will be traveling to Kathmandu to volunteer in a hospital. The health concerns of the country do not include smog-filled air, so I am going to lend a hand and also gain experience in a clinical lab. I am going with my friend, Sean, who wants to be a doctor, so he will also receive great hands-on experience.

If you would like to find out more, or donate to help us volunteer, please visit this website we made for fundraising, we are extremely grateful for any and all contributions and good-will messages. We also have a linked FaceBook page if you are curious. Let me know what you think!


Darn good and sure of it,

adot


p.s. if you click the links and find out my real name, please don't become my stalker and stand outside my window at night. That's all.

Friday, 7 June 2013

Lactose Intolerance

I work with this incredibly boring person for 8.5 hours a day, who is strangely uninterested in health and science topics. I like to be chatty, but it is difficult for me to come up with conversations (more, things I can blabber about) which will not make her fall asleep. The other day, I brought up a lactose intolerance quote my Analytical Chemistry prof used in my lecture the night before. She made the mistake of asking what lactose intolerance was, and got a 4.5 hour response on all medical-related things I could come up with. Pounce on the chance, right??

The quote: “You don’t need to be tested for lactose intolerance, you can just ask your wife!” I think that’s hilarious.

Anyways, lactose intolerance is actually very interesting.

The body is very specific as to what it can use for energy and nutrients. That is why there are so many different enzymes and metabolic pathways food goes through to give us the energy we need to run the marathon, or sit at a computer for 8 hours. All carbohydrates (sugars), lactose included, must be broken down to the simplest carbohydrate from, glucose, to be used by the body. Lactose is actually made of 1 glucose and 1 galactose molecule. The galactose must undergo another enzymatic reaction by other isomerase enzymes to convert it into the usable glucose.

If someone becomes lactose intolerant, the digestive system doesn’t possess the lactase enzyme, or it doesn’t make sufficient amounts to break down the amount of lactose eaten into glucose and galactose. What happens is, the lactose travels through the digestive system, and into the large intestine, where there are species of bacteria, like E.coli, that use lactose as an energy source. Since there is no oxygen available in the intestine, the bacteria ferment the lactose anaerobically, causing a mixture of gas to be produced. This causes gas and bloating, etc. Also, because there are increased amounts of carbohydrate sugars not being absorbed by the body (increased osmolality), water from the cellular tissues moves into the intestinal cavity to try and balance the concentration with the body’s normal concentration. This causes diarrhea.


Well, I found this interesting. 


Darn good and sure of it,

adot

Monday, 3 June 2013

Leibster Award!

I would like to thank Just Ermie for the Leibster Award she just gave me. I have gotten a Leibster Award before, but I still haven’t learned much about them. I also don’t think I knew many people on the interwebs with a blog back then. I will try and do better this time!

I write some things on my blog so I can remember what I do during school and/or learn new things, and I am just glad that some people are also learning and enjoying my blog too!

In order to accept, I have to:
  • Post the award to your blog.
  • Thank the nominator and link back to their blog.
  • Write 11 random facts about yourself.
  • Answer the 11 questions that the nominator has asked.
  • Nominate 11 fellow bloggers who have fewer than 200 followers.
  • Make up 11 original questions for your nominees to answer.

11 Random Facts About Me
  1. I have ran 4 cars in Demolition Derbies and won 4 trophies/cash prizes.
  2. I sometimes sit outside in my lawn chair and study with my pellet gun on my lap to shoot at the red squirrels. They annoy me. I have horrible aim though.
  3. I have seen every episode of Untold Stories of the ER.
  4. I don’t know how to burp (unless I am vomiting).
  5. I have a tattoo on my wrist that says “imagine”.
  6. I dream about living in a trailer on a large piece of land by myself.
  7. I have a birthmark on my upper thigh that my parents used to think was poop when I was a baby. Too much information?
  8. I really really really want to see Dolly Parton live in concert and go to Dollywood. Like, really. Like, top of bucket list, really.
  9. I am a clean freak. I got the gene from my mother.
  10. My name is not really adot. I made it my “gangsta” name for my blog.
  11. I have 10 fingers and 10 toes. Pretty normal person.


Answers to the 10 Questions Just Ermie Asked

1.  If you could travel back in time, where and when would you go?
I would go back in time when families were self-sufficient and caught and cooked their own food and built their own houses and children kept themselves entertained with their imagination and maybe a stick or some stones.

2. What is your greatest undiscovered talent?
It is currently undiscovered.

3. What is your biggest D.I.Y. failure?
I tried to back my dad’s truck and trailer back through our forest last week and ran into a tree. The tree was hurt, but not the trailer. That was a failure. Maybe not the biggest…

4. What is your favourite book of all time?
I’m not a huge reader, but I really liked Little Princes or Stones into Schools. I like non-fiction political science-y books about something with more than just political science in it… if that makes sense. There are few books in that specific genre I can find.

5. If you could be a famous literary character, who would you be?
Winston from 1984. But only for a few minutes, then I would probably become too paranoid I am being watched. I feel like it would help me deal with living with my parents for the rest of the summer.

6. What is your most extravagant purchase?
I’m a student. I would say the chocolate milk that I bought on sale last week at Shopper’s was extravagant. When I was 18 my friend and I decided to buy tickets to go to the Vancouver 2010 Olympics. That was the most expensive and extravagant thing I have bought in my entire life.

7. What is the kindest thing you have ever done?
Well… I thought giving my dad a car for Father’s Day last year to enter it into a derby was pretty kind, but then he took it to the scrap yard in return for $150. That doubles as the saddest thing my father has ever done.

8. If you could live anywhere in the world, where would you live?
Don’t know. I haven’t been enough places in the world to make an educated decision. I found a roommate for Burk’s Falls, Ontario, Canada, though.

9. If you could do any job you wanted, what would you do?
A MEDICAL LABORATORY TECHNOLOGIST, DUH!! I don’t do University for pleasure. Actually, I really want to work for Doctors Without Borders or another agency to be placed in Northern Canada as a Lab scientist. But I will have to pay back my student line of credit and OSAP back first…that may take 150 years…

10. What is the best thing about being you?
If I told yah, I’d have to kill yah.

11. If you could change one event in history, what would it be?
Hmmm…

People I Decided to Nominate (in no order of preference):
  1.  Medic2RN at Ramblings of an ER Nurse – because the stories are quite interesting
  2. Susan Barclay at Notes from Innisfree – because I learned a lot about historical Canadians during the A to Z Challenge
  3. Ron at Portable Sunshine – because I liked reading about medical schooling in another country (its been a while since the last post, though!)
  4. Sofia at Sofia’s Blog – also because it is interesting to read about life and schooling in other countries (also been a while since the last post!)
  5. Rylie Sandorf at The Life of Ry – because, honestly, your life sounds hilarious
  6. Colie at The Colie Chronicles – because she is so good at telling stories
  7. Allison at Time Out – because I found her during A to Z Challenge and lives far away and life far away sounds interesting
  8. ?
  9. ?
  10. ?
  11. ?

Yah, I don't know who else I could give this to... 

11 Questions They Have to Answer:
  1. Cat or Dog or Alpaca?
  2. Do you have any allergies?
  3. Say you won $10 000 000 dollars, what would you do with it? (it was going to be 1 000 000, but $1 000 000 doesn’t go very far anymore)
  4. Where is the furthest place you have traveled to?
  5. What is your favorite song?
  6. What do you spend the greatest percentage of your waking time doing: sitting, standing, or standing?
  7. Would you live a year without technology?
  8. Do you have any piercings or tattoos or rebel-marks?
  9. What direction does your bedroom window face? (that wasn’t supposed to be so creepy)
  10. Are you aware of your own health?
  11. Do you have a favorite phrase or word?

Darn good and sure of it,

adot

Wednesday, 29 May 2013

Soap

Soap is the most effective way to rid your hands of any disease-causing microorganisms. However, within 20 minutes of showering, your body is fully colonized with your normal flora. The normal flora is important to keep you healthy, not to mention essential in many metabolic activities inside your body. When you wash your hands before eating a meal, you are washing away any pathogenic (disease causing) bacteria, or bacteria that cause illnesses, as well as your normal flora. Although your normal flora will regrow to its normal state before you are done eating your sandwich, you will not get sick from the pathogenic ones you already washed off. 

Antimicrobial soap does the same thing: it rids your hands of the exact same bacteria. It has become more known that using antimicrobial soap is contributing to the antibiotic resistance in organisms, however, what many people don’t understand is how they can directly harm themselves or their family by purchasing and using antimicrobial household products (i.e. hand soap, tooth paste and deodorant).

Pseudomonas aeurginosa is a microorganism generally found in hot tubs, contact lens solutions, and contaminated medical devices. They have many mechanisms of resistance including multi-drug EFFLUX PUMPS. They are clinically resistant to penicillin, ampicillin, trimethoprime, sulfonamide, cephalosporin, chloramphenicol and some beta-lactams. That’s a long list. Pseudomonas can actually grow and thrive in antibacterial soaps, whereas other microorganisms cannot. In normal soap, other organisms may colonize the soap, which out-competes Pseudomonas, making it unable to grow. These other organisms are not (typically) harmful to our health.

The use of infected antimicrobial soap can replace the normal, harmless, microflora on your hands, with disease-causing, resistant microflora of Pseudomonas, especially if not completely rinsed off perfectly. It can cause bacteremia (blood infections), wound infections, pulmonary disease, UTIs and endocarditis. If you land yourself an infection with Pseudomonas, you will have to be admitted to the hospital for intravenous (IV) drugs. The multi-resistance of this organism leaves few antibiotics that can treat it. A combination of beta-lactams and aminoglycoside drugs are used to treat these infections. Pregnant women are not prescribed aminoglycosides because of known fetal birth defect including hearing loss and kidney problems, thus further limiting treatment, or putting the baby's development at risk.

Pseudomonas is very pretty in the lab, though. It produces pyocyanin which results in a blueish pigmentation, and also has a grape like smell.

I am happy to say that with this information, the next shipment of hand soaps my boss is ordering for the city's public washrooms, is general foaming hand cleanser, as opposed to antibacterial foaming hand cleanser. Baby steps. As people become aware, we can live in harmony with the microscopic world in which we live. 


Darn good and sure of it,

adot

Monday, 27 May 2013

Summer School

I am taking an online Analytical Chemistry course through a University in Utah, called Weber State University. If you didn't know, Utah is in the USA. I am in Canada. Google maps tells me that we are 3374 km and a border crossing apart, but yet, for some reason it is the closest school that offers the course outside of being enrolled in a school's Medical Laboratory Science program. 

Some things I have learned from this course so far:

-Americans do not call Canada "the Provinces", so I should not call the Unites States of America "the States".
-My professor uses examples of measuring blood levels using "Twinkies" thus, I stereotype Americans to eat too many Twinkies that it is detectable in their blood.
-The USA still uses the standard measuring system and I have done 3 years of University (and 21 years of my life) to perfect the metric system, and therefore, the USA needs to change to the Metric system because I need them to. Before the end of the summer.
-My public library ID'd me for a library card because you have to be over 18 to get a library card without your parents permission, and the librarian didn't believe me that I was 21. (That was a very tragic day.) 
-My public library doesn't like that Utah is making me write 6 proctored tests that they have to staff for me. 
-Wikipedia still hasn't taught me how marking works in the USA. 

Anyways, I am really happy with how the A to Z Challenge went. I couldn't really publish many  posts the last few days because of work and the fact that I moved back home with my parents and they do not permit me to sit on my computer for 20 hours a day. Or even 2 minutes to press "Publish" on my pre-written posts. For that, I apologize. I will try and post some interesting things throughout the summer, but my summer job is cleaning toilets and picking litter at the next city's downtown. That uses no brain power, so I feel like I am getting dumb. Perhaps I will have a revelation in the next week or so!


Darn good and sure of it,

adot

Monday, 29 April 2013

(Xylene and) Yersinia

I forgot to do an X for Saturday! X is for xylene which is a chemical used in histology for removing wax from embedded and cut tissue samples in the processing stage and before and after staining. 

The absolute only thing that starts with a Y in the lab that I could think of is Yersina. Yersinia pestis is the bacterial infection that is responsible for the plague. As opposed to the Middle Ages, in present day, we do not see many infections of Yersinia because of our fairly conscious health, hygiene and anti-rodent controlled conditions and our world-wide recognition systems to prevent such outbreaks. In the past, the rodent-bourne infection caused many devastating outbreaks, like the Bubonic Plague aka the black plague, and has since been manufactured into an antibiotic resistant potential bioweapon.

Diagnosis and treatment of Yersinia pestis, and other members of the Enterobacteriaceae family, are easily done by automatic testing machines, or manually by a series of inoculated tubes, with the resulting pattern of results of the tubes indicating the identity of an organism. The tubes contain ingredients such as carbohydrates, to find out what the organism metabolizes for energy and growth, and their corresponding indicators, or tubes for visualizing motility of the organism. After the known species of the organism is known, then antibiotic susceptibility testing can be done to determine the best course of action to treat the infection. Yersinia are not naturally a very resistant genus of bacteria, so treatment can be carried out easily.

If you try and save a cat choking on a rat and get bit by an accident, you may get Yersinia. I suggest you don your old scratchy linen tunic and walk to your closest medicine man for some herbal leaves. Because really, this illness that medieval (or you are in a part of the world where that is the only way of life). 


Darn good and sure of it,

adot

Friday, 26 April 2013

WHMIS

This is the first day of summer for me! I finished my last exam yesterday, so this is all I can contain myself to write for “W”. DONE YEAR 3 OF UNIVERSITY!!
If you are anything like me, and have had a lot of jobs in a short period of time, all of which requiring WHMIS training, you probably already closed out of my blog and deleted your browsing history. For that reason, i advise you to read the labels on chemicals, and stay out of trouble.


Darn good and sure of it,

adot

Thursday, 25 April 2013

Vitros

Finals. Finals. Finals. Finals. Finals. 6/7 finals done. 
The Vitros is an automated chemistry analyzer used for various measurements on various body fluids. Aaand you thought we were doing manual titrations..... In our lab at school, the Vitros is named "Darth Vitros". A cleaver spoof of "Darth Vader", I believe.


Darn good and sure of it,

adot

Wednesday, 24 April 2013

Urine


Since I posted about blood testing in the Order of Draw, I thought it would be interesting if I posted about pee. I did, you probably don’t. Urine is a very revealing thing. Microbiology can test it for the presence of Chlamydia, and biochem can test it for the presence of HCG. Those are just a few examples. Drugs can also be tested in urine. The following are a few examples
·         Ethanol (the stuff that is in alcoholic beverages): When you drink too much, what happens is you get a build-up of acetic acid. The acid can decrease the pH of your body, causing many proteins to become inactive, or denatured, causing damage to organs and organ systems.
·         Methanol (the stuff that is in antifreeze): a lot of homeless people will drink this to get admitted to the hospital for free food, warmth and shelter. The effects are less severe than on overdose of ethanol, but can still cause blindness so it must be treated. The reason it is common for homeless people to overdose on it is that it is super cheap at Canadian Tire or Walmart. Quick trip into the warmth of a hospital in the dead of the Canadian winter.
·         Isopropanol (the stuff that is in rubbing alcohol): This is twice as severe as ethanol poisoning and by-products are rapidly formed including acetone. This is very toxic, so I would not recommend ingesting. Also, I saw on 1000 Ways to Die that someone bathed in it. Don't do that either, because you will die.
·         Opiates (morphine, codeine, heroine): These drugs typically used for pain management are highly addictive. The urine test that is done in the lab detects false positives if the patient has eaten a poppy seed bagel. Experienced drug users will walk in to give their urine sample eating a poppy seed muffin. In which case, we cannot test their urine to see if they are staying “clean” while on parole.
·          Acetaminophen (Tylenol): If you overdose on Tylenol, the antidote, or cure, could be more toxic to your cells than the actual drug. Health care professionals have to decide if it is worth giving the antidote on a case-by-case basis. A build-up of the by-products leads to protein inactivation and liver failure and death.

Darn good and sure of it,

adot

Tuesday, 23 April 2013

Troponin

A bit of a late post, but I just finished 2 back-to-back finals. 2 more and I am done year 3!!
Troponin is a cellular protein released from heart cells when you have a heart attack, aka Myocardial Infarction, MI.

Historically, myocardial infarctions have been diagnosed by fulfilling 2 of the 3 following criteria:

  • History of chest pain
  • Abnormal electrocardiogram (ECG)
  • Rise and fall of cardiac markers
Since the diagnosis was based on the fact that 2 of the 3 conditions had to be met, there were some people who were not properly diagnosed with having had an MI. We know now that some people do not have chest pain when experiencing a heart attack, nor may they have an abnormal ECG. The only indication some people have are characteristic cardiac marker fluctuations. 

The protein cardiac markers the lab tests for and monitors over a 24 hour period are troponin, CK-MB, and myoglobin. The first marker that is elevated is myoglobin. Since myoglobin is released from all muscle cells of the body when they die, it is nonspecific, but it helps to "rule out" or "fail to rule out" an MI. That means, the "chest pain" someone may be experiencing may be due to eating 10 kg of Gramma’s chilli causing acid reflux, or a potential heart attack. The next marker to be tested for is troponin which begins to rise after 2-8 hours after the onset of an MI and stays elevated for 5-10 days after. It is considered a "late marker" so it will still be positive if the patient doesn't come to the ER immediately, but can still receive effective treatment. And the final one is CK-MB and it's rise-fall pattern is in the middle of the 2 other enzymes so using the measurement of CK-MB and either of the other proteins, health care professionals can determine approximately the time someone has a heart attack.
Isn't this the CUTEST LITTLE HEART?!?!
It is the heart of the fetal pig my little sister dissected.

Darn good and sure of it,

adot

Monday, 22 April 2013

Staphylococcus aureus


Last summer my little sister and I met a newlywed couple from Malta (teeny country in Europe) who were travelling around Canada for their honeymoon. As useless of information that is to you, you have probably had bigger trips and bigger adventures and encountered even more people along the way. Why I bring this up, is because of the infection rates of Staphylococcus aureus in the world. Not only the infection rates, because generally, they can be treated with antibiotics and cured, but rather the resistant strains of Staph aureus. Have you ever heard of MRSA?

Normal flora, or bacteria that is always on our body, is essential to keep us healthy because it takes up the space where pathogens, or harmful bacteria, could potentially inhabit. Unless there is an imbalance between our normal flora, we will not get sick from these flora. For example, the use of antibiotics or chemo therapy can cause certain bacteria to be wiped out, which could cause other normal flora to cause infection. Or, if you take a knife and stab your neighbour, normal flora from their skin could be transferred into the deep wound of the knife. The bacteria that can do this are called opportunists. In the lab, we do not report when we find normal flora, unless they are suspected to have invaded and caused a problem.

Staph aureus is part of some people’s normal flora in their nose. When you go into a hospital, sometimes they will do a nasal and/ or rectal swab to find out if you are a carrier. If you are, that could lead to your own room for your hospital stay so that you don’t infect other people. Some of these carriers can have methicillin-resistant Staphylococcus aureus, MRSA, hiding in their nose. Methicillin is the antibiotic normally used to treat staph infections, so when it becomes resistant, it can cause problems, like necrotising fasciitis (normally strep pyrogens) which is also called FLESH-EATING DISEASE.

Malta actually has the highest incidence of MRSA in the world to date. Something like 90% of the Staph aureus infections are resistant to methicillin. Surprisingly (well not that alarming, but), the rates of resistance in Canada are substantially less than America. I wonder how long that will last. Probably until someone decides it is a good idea for them to test for MRSA and other diseases at the boarder and in airports. You think that's crazy now? Wait until the green party gets one more seat in the House of Commons, Canada! (Kidding) But still, the rate of global travel is increasing the spread of these resistant organisms.

Last week my prof shared something else that’s interesting: The people/things who you reside with, be it family, roommates, or animals, have a strong influence on your normal flora and immune system's resistance. Sometimes, when we get a new roommate, move into the library at exam time or join a really rowdy frat house, our normal flora doesn’t really mesh together. This could cause irregular sicknesses, for example, longer or more frequent minor illnesses because the immune system is altering itself to deal with the new microflora. It will take a while for your immune system to pick up on the change of normal flora, but eventually a healthy immune system will expand itself to allow you to live in sync with one another- as long as they leave the toilet seat down.


Darn good and sure of it,

adot

Saturday, 20 April 2013

Rouleaux Formation

For some reason, when someone says “rouleaux” I picture a hula-hoop. You know, in the Alvin and the ChipmunksChristmas Song, “I just want a hula-hoop”. It's irritating.
Well, it has absolutely nothing to do with that. Rouleaux formation is when blood cell pile on top of each other and you can see this under the microscope on a blood smear. The cells may look like: 
Doctors sometimes order a test called an ESR, or erythrocyte sedimentation rate, which shows how much your blood cells can settle by rouleaux in an hour of sitting in a thin vertical chamber. An increased sedimentation rate can non-specifically show multiple myeloma, inflammation, and even pregnancy. It is so non-specific, I don’t really understand the purpose or ordering the test anymore. Doctors are very particular when it comes to the way they want things tested. Just make sure, if you ever go to the doctors and he/she wants to test if you are pregnant and orders an ESR, that’s a litttttle unconventional. It is way too general to give any information away for itself. You should get tested for bHCG if you think you may be pregnant. As for multiple myeloma, I would want my doctor to be certain before telling me I have cancer.


Darn good and sure of it,

adot

Friday, 19 April 2013

QC

I felt the need to write about James O. Westgard because if I didn’t and my biochem prof found out, I would be dead. Westgard rules are the basis for quality control (QC) in the biochemistry/clinical chemistry lab. The founding father of these rules is none other than James O. Westgard himself. What seems like 99% of the work in clinical chemistry involves ensuring accurate and reproducible results. Some tests require the accuracy and precision to be tested with each test run, like ESRs in hematology, but most of chemistry tests require daily calibration using quality control charts, like troponin.

The purpose of quality control is to ensure that our equipment and reagents involved in a test are running in tip top shape to ensure quality health care to the patients. Westgard rules involve using standard deviations (a statistics term) to determine whether or not the test is running accurately and the patient results produced are accurate and can be sent out for diagnosis. You may think, like na├»ve little me in the beginning, that preforming QC is a waste of time and money and you can spit out more patient results if you just skip that step. However, you would be doing just that: spitting out results. No one would know whether the results are accurate, and it is surprising what can go wrong in the lab. Improper storage of reagents, or expiration and degradation of reagents can greatly affect the results of the patient, so we as a lab, have to preform QC to make sure we are giving you the correct diagnosis. 

I have been looking for the animated picture that my prof put in her PowerPoint for Westgard rules. Here it is, but imaging the animated hearts falling down…


Each lab has to determine their own QC and the "normal" values for their population. In order to do this, they have to test x amount of people to determine the normal distribution. Where do they find these people? In the Emergency room! If you come in with a sore finger, and you get blood drawn on you, it might just be the lab preforming their quality control, and you drew the short stick. It rarely happens that the lab draws from a person who doesn't need blood to be drawn in the first place. Normally, if you have to get tested for something else, for example, iron studies, you might just get another tube drawn for the lab to QC their normal cardiac enzyme results. It is essential we do this. What if the next time you come into the hospital with chest pain and need a cardiac marker test. Well it is a good thing the the lab has up-to-date normal results to efficiently and accurately diagnose you with a heart attack!


Darn good and sure of it,

adot

Thursday, 18 April 2013

Pseudopseudoparahypothyroidism



Pseudopseudohypoparahypothyroidism is the medical condition that has the most letters in its name. It is actually the longest word in the English language if you exclude lame excuses for words of which no one would ever use in real life.

This hormonal disorder is quite uncommon. Typically with pseudohypoparathyroidism, a patient’s parathyroid hormone, PTH, is not being acted upon properly by the body. This causes low calcium and high phosphorus levels in the blood because the PTH is supposed to regulate these levels, but is failing to do so.

Pseudopseudohypoparahypothyroidism makes no sense to me because the PTH is being responded to by the body, but yet, the patient has is considered to be in a diseased state. They possess a genetic abnormality for a disease, but do not have any symptoms. Wouldn’t that just make them a carrier?

I browsed the interwebs for this topic, a bit. I got frustrated and stopped.

Anyways, a common hormonal disorder is thyroidism. The thyroid is the larger gland on which the 4 tiny parathyroid glands are located. In the lab, thyroid disorders are commonly diagnosed with the use of testing called “reflex testing”.  

By law, the lab is not allowed to run tests that are not ordered by physicians. That means, although your sister works in a lab, you can’t call her up and ask her to test your thyroid hormones or make sure your blood smear looks normal. There are exceptions to this rule, though, and they are called reflex tests. When the doctor orders a test and it comes out as positive, sometimes the lab runs further tests on the sample to determine a cause for the positive test, or for further diagnosis.

The normal physiological regulation response of the thyroid is stimulated by the hypothalamus and the pituitary glands. The hypothalamus releases thyrotropin-releasing hormone (TRH), which stimulates the release of thyroid stimulating hormone (TSH) from the pituitary, which, in turn, stimulates the production of T3 and T4 by the thyroid. Once T3 and T4 are produced and released into the blood, the hypothalamus detects them and stops producing TRH. This is called a negative feedback mechanism. The doctor orders a TSH test and if it is abnormal, the lab automatically runs a FT4/FT3 test to determine the cause.

After we get our results, we have to report back to the physician who ordered the test. The lab is not allowed to give out any test results to patients, so calling the lab over and over again would just be a waste of your cell phone minutes.


Darn good and sure of it,

adot

Wednesday, 17 April 2013

Order of Draw


In phlebotomy, or the practice of drawing blood on a patient, there is a certain order in which phlebotomists must fill the tubes required for testing. There are different additives in each tube, and there is a small, very small, chance that there will be cross-contamination of the tubes. The order of the tubes goes from most sterile or lease selective, to most selective. The order of draw goes as follows:
·         Yellow top tube: goes to microbiology (usually for testing of bacteria in the blood)
·         Blue top tube: contains sodium citrate as anticlotting agent
·         Red top tube: serum tube (clots blood so Lab can work with the serum)
·         Green top tube: contains heparin as an anticlotting agent
·         Purple top tube: contains EDTA as anticoagulant and goes to hematology
·         Grey top tube: fluoride tube for glucose testing
Sort of boring. If you need to get your blood taken, I have a few questions that you can ask your Lab professional. I found a little paper in my backpack randomly, and I will copy the questions onto here:
·         How is the test done?
·         How accurate is the test?
·         Will the test be uncomfortable?
·         What do I need to do to prepare for the test?
·         Can I drink before the test? What and how long prior?
·         Can I smoke before the test?
·         Can I eat before the test?
·         Can I exercise before the test?
·         Where will the test be done?
·         What time is best for collection?
·         How long does the test take?
·         How will I feel during the test?
·         Where do I have to go for the sample collection?
·         How long will the collection of sample take?
·         When will the results be sent to my doctor?
Some tests that are run on your blood sample are dependent on consistency. For example, if you are getting your blood tested for cholesterol and lipids, it is probably not an okay thing to eat 2 bacon and cheese sandwiches before the test. It would instantly increase your blood lipid volume. Also, if your doctor is ordering a test on muscle damage or finding out if you had a heart attack, it is probably not a good idea to exercise before the test. Or glucose levels, probably wasn’t wise to eat the bag of candy.

It is not always just “common sense” when it comes to what you can and cannot do before a blood test, because things happen at the molecular level, and I guarantee that you do not know your body as well as the Laboratory professionals running the tests will know. We are intelligent people. There is very few ways to trick us. For example, you tried to starve yourself and cut out sugar like crazy before getting tested for “diabetes”? We will see that, sure your current glucose level is low, but wait, your glycated hemoglobin is high? They tried to trick us! But guess what, we caught you. It is always a good idea to ask your health professional for advice on what to do for lab tests. If would really suck if we had to ask you to come in again for a re-draw because you were “being funny” the first time. 


Darn good and sure of it,

adot

Tuesday, 16 April 2013

Neisseria spp.

I wanted to thank those who wished me luck for yesterday having 3 finals in 1 day. I survived. Barely. With 4 more coming up next week, it looks like I will be setting up camp in the library. I really like this challenge so it will be my break in between studying. (FaceBook has been inactivated...). This is definitely the 5th or 6th microbiology post in a row... I didn't mean for that to happen since there are 5 disciplines of Medical Laboratory Science and plenty of information. Anyways, this is "N"!
First of all, “spp.” means “species” in short. There are many different species in the genus Neisseria, but the most commonly known one is (another) STI called Neisseria gonorrheae, which causes gonorrhea.
Following chlamydia, gonorrhea is the second most prevalent STI found in Canada (and I guess America, too since we do trade everything). If you are suspected to have gonhorrea, you will also be tested for, and probably have, chlamydia, “the clap”, as well.  I don’t have any derogatory or slang names for gonorrhea, but it getting a bit redundant typing it over and over, so if you have one, please share.

Neisseria spp. are very fastidious organisms, meaning they are difficult to culture in the lab. They live only within a host and that host must be human. That means that humans have kept this infectious bacteria around themselves, just by passing it from person-to-person for x amount of years. Ew. In order to culture the bacteria in the lab, a special agar plate is needed to give it the nutrients it needs that it would otherwise have an abundance of in the body. That plate it grows on is called a chocolate agar plate.

Chocolate agar contains no chocolate. It contains no chocolate, so you should not try to eat it. In high school, my insane heart-surgeon-resident biology teacher ate one. It was actually chocolate jell-o she made in a petri dish, but it was psycho either way. Anyways, this plate actually contains lysed blood cells, or red blood cells that have been physically popped open to release their nutrient-filled insides to be mixed into the agar. Neisseria, being so picky, can then use these "chocolatelynutrients called X and V factors, to grow. I dont know about you, but next time I want chocolate I will announce it by my need for X and V factors.

Anyways, that’s fastidious Neisseria.


Darn good and sure of it,

adot

Monday, 15 April 2013

MacConkey Agar

M is for MacConkey Agar. It is also for Monday Mornings, Mildly exhausted from last night`s studying, and Might die today in finals.  I also dont know what I wrote here, so I apologize for any Mistakes.
Agar is a solid jell-o like substance that comes solidified conveniently in little dishes called petri dishes. In order to grow bacteria in the lab, we add ingredients to the base agar to make certain bacteria inhibited, or enrich the agar to make it easier for certain (fastidious) bacteria to grow, and add things like carbohydrates and indicators to be able to differentiate between what is growing on the plate. MacConkey agar is used to selectively isolate gram negative bacteria (i.e. E. coli or salmonella infections) from samples known to yield mixed specimens (i.e. stool samples in which the majority is bacteria).

If we find just one salmonella or E. coli infection in the lab, we have to report it to the Public Health Agency of Canada (PHAC). WHY? It’s not like we are having an outbreak… Well, if you think about it, you ate a McDonalds hamburger coming home from Gramma’s house. Then, you get sick and go to the closest hospital back home. Someone else eats a hamburger from the same McDonalds and they head home after their hockey tournament and go to the hospital closest to them. Someone else sticks it out at home. Someone else flew out to Alberta for the Calgary Stampede. Someone else goes to the hospital beside the McDonalds which gave them the food poisoning. All of a sudden, there is an outbreak of E. coli spread across Canada. The purpose of the PHAC is to track down where all these people ate and what they ate to prevent further spreading.

Some strains of E.coli (O:157 H:7) are what’s known as hemorrhagic  E.coli. This is what caused the Walkerton, Ontario outbreak where lots of people got very sick, and some died. (Summary of what happened in Walkerton: raw sewage contaminated drinking water because a valve was broken in a treatment plant). The sad thing about E.coli infections are that you cannot kill the infection with antibiotics and get rid of the damage. The toxins produced by this bacteria cause ulceration in the intestines. Once you have the ulceration, or bleeding sores, in the large intestine, they don’t go away and people have to live with the infection all their lives. If you try and treat it with antibiotics, the E.coli will just release more toxins causing even more damage. A new innovation, that sounds disgusting, is having a fecal transplant. Yep, they take someone else’s poop (usually familial cross generations with the same gender i.e. mother-daughter, father-son) and shove it up there. Remember that poop mainly consists of bacteria which is healthy and actually helps to aid in digestion and normal body regulatory systems. By adding some healthy bacteria back to your system, they hope to restore a more normal atmosphere in your intestines for health and digestion. They also do this regularly for the nosocomial (hospital acquired) infection of C. difficile.  

E.coli is the cause of the infection known as Traveller’s Diarrhea. The tropical places we travel to do not have proper treatment plants and often have fecal (E.coli) contamination in their drinking water. To get sick, you would have to ingest a lot of the bacteria. This can be prevented with a simple vaccination or relying on bottled water. Eating a few of the fruits and vegetables washed in contaminated water should not get you sick because the high number of organisms required to make you sick. Especially if you spray them with Lysol before eating them. Kidding, don’t do that. I also don’t know the effects that pina colada has on the action of bacteria, but I like to say that alcohol disinfects :p 


Darn good and sure of it,

adot

Saturday, 13 April 2013

Leeuwenhoek

Whoaaa it's the end of week 2 for A-Z Challenge already! 3 finals Monday *sadface*. Anyways, here is Leeuwenhoek, my favorite scientist EVER.
Anton Van Leeuwenhoek was a man of many sorts who accidently discovered “animalcules” (which I think is the cutest word ever). He was not a microbiologist, but his (really strange) hobby of grinding up glass then putting it back together allowed him to see tiny bacteria, which he called animalcules. The very strange man, who invented the first microscope, took to the grave the art of making microscopes because he had not shared the skill with anyone. Although the link to disease was not made at this time, the presence of microbes allowed for many advancements in knowledge that are common practice for us today. Leeuwenhoek is one of my favorite people in history because of his uneducated revelations on science. I really love the quote from Paul de Kruif’s book, Microbe Hunters which is on the banner below the title on my blog. It reads:
Leeuwenhoek had stolen and peeped into the fantastic sub-visible world of little things, creatures that had lived, had bred, had battled, had died, completely hidden from and unknown to all men from the beginning of time. Beasts these were of a kind that ravaged and annihilated whole races of men ten million times larger than they were themselves. Beings these were, more terrible than fire-spitting dragons or hydra-headed monsters. They were silent assassins that murdered babies in warm cradles and kings in sheltered places. It was this invisible, insignificant, but implacable-and sometimes friendly- world Leeuwenhoek had looked into for the first time of all men of all countries.

Darn good and sure of it,

adot

Friday, 12 April 2013

Kirby-Bauer Test

The Kirby-Bauer Test is a type of antibiotic susceptibility testing (AST). It is done by isolating the pathogen that is causing infection in a patient, and streaking an agar growth plate with the specimen using a standardized turbidity of bacteria (0.5% McFarland standard). There are 2 things that you have to keep in mind when setting up this test. 1. You can’t leave the bacteria on the agar longer than 15 minutes before placing the disk of antibiotics on it, and 2. Once you place the disks on the plate, you must place them in an incubator within 15 minutes. Why? The action of the antibiotic disks is to create a concentration gradient of antibiotic around itself to inhibit the bacteria. After 24 hours, the circles of inhibition around the antibiotics are read to see what antibiotic the doctor should prescribe for the patient’s infection. If you wait too long to put the disk on, the bacteria can begin to grow (slowly) and they would have an advantage over the antibiotic. If you don’t put the plate in the incubator, then the antibiotic can diffuse faster creating a larger zone of inhibition without the bacteria growing in its optimal environment.

It is important to do ASTs and use the antibiotic with greatest effectiveness to not make “superbugs” in which the organism becomes resistant to the antibiotic. The overuse of antibiotics in today’s high-demand society has caused many organisms to become resistant to drugs that were once used to treat them. It has become standard practice to test susceptibility in the lab to help doctors treat the patient effectively. 

Also, do not flush old antibiotics down the toilet. Instead, take them back to your doctor. That way, they can reuse them for the next patient that comes in with a sore finger. Totally kidding. Never reuse antibiotics. Doctors know how to dispose of them properly. 


Darn good and sure of it,

adot

Thursday, 11 April 2013

Cheese Predicament

This has nothing to do with the A to Z Challenge I have been working on, but cheese has just come to my attention. I have a huge problem which involves cheese. Before you get all flabbergasted on me, it has nothing to do with my abilities to tolerate cheese in my body. The "problem" does not involve me sitting here flatulent or whatever an overdose of cheese does to you. I have an extremely difficult decision coming up, and I just don't know what I will do!

You see, cheddar cheese, is all firm and easy to cut. It has a lovely taste when (and if ever) you cook with it. It really brings out a nice taste when paired with jam and thrown on some bread.

Marble cheese tastes much better on its own. By "own its own" I totally meant "with crackers". You don't really taste it in sandwiches nor does it bring out any exciting flavors when paired with apples as a snack.

Before anyone goes all "fancy-shmancy" on me, I am talking about CrackerBarrel blocked cheese, or its cheaper equivalent. I could never purchase the more expensive cheeses because that leads to more upgrades including the more expensive crackers, and lets face it, my plate is currently a paper towel.

I really don't know what cheese to choose. I have to wait until they come on sale, but when they do, I don't know what I will do. Perhaps I will stick to taking a block of whatever my mother has in her fridge. That's like, 100% off family discount!

Or I could just let my milk turn into cheese like it did the last time...


Darn good and sure of it,

adot

Joint fluid

Joint fluid, known to us (pre) medical specialists, is scientifically called synovial fluid. If you remember from the “C” post on Chlamydia, this normally sterile site can become infected by certain disease states.  Also, in other inflammatory disorders such as gout, you can have the formation of monosodium urate crystals or an increase in the white blood cell line that take up space in your synovial fluid. There typically isn’t very much fluid in these areas, just enough to add some lubrication so you can get out there and be active. Go be active right now, because that is all I can think of to write about for “J”.


Darn good and sure of it,

adot

Wednesday, 10 April 2013

Ileum

Before I start with "I", I wanted to say that I am really enjoying this A-Z Challenge. I like to go on the A-Z sign up page and click on, like, 100 random links every day until I find some that I am interested in, and perhaps even follow for more. I am enjoying the different themes that I am encountering and everything that I am learning about from around the world. I have been trying to comment on at least 5 posts for every letter (some of them may be on the day after, but nonetheless), however, I have finals starting in LESS THAN A WEEK so I have to get crackin' and I will not be able to read/ focus long enough to comment on many for a while. I have written (most) of my posts, but I'm sorry if I start slacking!

The final section of the small intestine before your partially digested food, called chyme, travels to your large intestine, or bowel, is the ileum. Food travels through your digestive system by the action of rhythmic, smooth muscle contractions. The inner part of the lumen where the food passes, is composed of a mucosa layer consisting of simple columnar cells with goblet cells and microvilli, which aid in the absorption of some nutrients, especially those needed for blood cell production (i.e. B12). The Auerbach Plexus is a nerve area between 2 layers of smooth muscle (muscularis mucosa) controlled by the autonomic nervous system (ANS) which allows for the coordination of the muscle contractions...  SNORE. The things we must know in Med Lab..

The only things of interest about the ileum is that it is 2-4 meters long and it works independently of your brain (hence, the ANS). You don’t have to tell your digestive system, “Okay, sandwich I just ate, I must now digest you”. Oh, another interesting tidbit is that once your food has been fully digested and about to be excreted as waste, it is actually mostly composed of bacteria from your gut. The majority of your poop is rotten food and bacteria that colonized that food. Mmm, eh? And have you ever wondered why your feces are brown? I bet you haven't but I digress. When your blood cells go to your liver (or spleen or lymph nodes) to die, a breakdown product of the hemoglobin is formed and secreted into the large intestine. The formed product is called urobilinogen and it has 2 interesting pathways. It can be reabsorbed into your bloodstream by your mucosal cells in the intestine and then filtered out of your blood by your kidneys and cause the yellow pigmentation of your urine. It can also be reduced to stercobilin in the intestines which causes the brown colour of your feces. Wanna blow some minds? Try bringing that up at the dinner table...


Darn good and sure of it,

adot

Tuesday, 9 April 2013

Hemoglobin

H is for Hemoglobin. 
You have approximately 5L of blood in your body at any given time. Blood circulates through your arteries and veins and back to your heart supplying oxygen to tissues and removing the carbon dioxide produced from cellular metabolism. A normal blood cell lasts approximately 120 days in circulation before it is taken out of circulation by the spleen (or lymph nodes or liver if you have had a splenectomy). Hemoglobin is the key protein in blood that allows the transport of oxygen to cells and carbon dioxide back to the lungs to be expelled.  There are a variety of different hemoglobins produced in your body at different times. For example, a fetus will possess an increase in hemoglobin F which has a higher affinity for oxygen than hemoglobin A found in adults.  The fetus’ higher affinity to oxygen means that the oxygen circulating in the mother’s blood joined to the hemoglobin A can be easily removed and transferred to the fetus without blood being transferred to oxygenate the fetus. As soon as the fetus is born, in normal circumstances, the baby will start to replace the hemoglobin F with A.

There are over 400 different abnormal hemoglobin things, called hemoglobinopathies. A commonly known one is sickle cell disease, in which blood cells are abnormally shaped like sickles as opposed to biconcave disks. An advantage of sickle cell disease and sickle cell carriers is that it prevents the infection of malaria in a person.  The mechanism behind this is not really well explained yet, but it describes the reason sickle cell inheritance is predominantly in areas in which the exposure to malaria is also high. It is beneficial if a person inherits one gene from one parent (heterozygous) for sickle cells, causing no clinical impact to the patient, except the benefit of evading malaria. If someone inherits 2 genes, one from both parent (homozygous) for the hemoglobinopathy, then the clinical impact is greater, and the risks involved with living with such an illness in a country with scarce health care could outweigh the benefits of malaria resistance. 

Anyways, that's H.


Darn good and sure of it,

adot

Monday, 8 April 2013

Genome


The genome and genetic typing & marking are interesting subjects. By mapping ones genome, you can find out lots of information about the genes that you possess and what they may encode for. For example, you can be the carrier of a disease, but not present with clinical symptoms. This could be because you are recessive for that disease and only inherited the gene from one parent, thus, only carry it as a “trait”. If two people with recessive traits conceive a child, that child has a chance to inherit that disease or true clinical illness. For example, my roommate, Jillian, has the recessive-linked disease of glycogen storage disease type 1a because both her parents were carriers of the disease, and she was the “25% unlucky” offspring that possess the disease.

Other uses of mapping ones genome include cancer precursor markers, obesity/diabetes genes, psychological illnesses such as addictions, heart disease, etc. Some people can be genetically predisposed to a cancer, such as breast cancer. I still remember from a genetic update conference I attended in Grade 11, Sam Rhine saying genetic mapping was the latest “thing”. Since then, I think it really skyrocketed. I haven’t exactly researched it since, and I am just writing these posts from memory (and occasionally re-looking at some lecture notes). Anyways, if you get your genome mapped, and the doctor says you have the gene for a cancer (i.e. breast), that doesn’t mean you will get said cancer. There has to be an activator to kick-start the gene before you actually have cancer. An activator would turn on the gene which would cause cancer. There are ways to keep healthy by monitoring the activation of that gene, or suppressing that activator all together. Another example is diabetes. If you are genetically predisposed to diabetes and you watch your caloric intake and exercise, you will not develop diabetes just because you have the genetic precursor.

In my opinion, the "zombie apocalypse" will happen when there is a drive-thru genetic typing lab, and everyone knows their genome. I would imaging the mass panic to be equal to a "zombie apocalypse" when people find out "how they are going to die". 


Darn good and sure of it,

adot

Saturday, 6 April 2013

Fixation


In the discipline of histology, fixation is the first thing done to human tissues once they are removed for the body. Whether it is from a biopsy, autopsy, some sort of –ectomy or amputated arm, the tissue must be fixed, usually in 10% formalin, to stop the autolysis (cell death) and putrefaction (bad smell). In fixation, the water in the tissue is replaced by the fixing agent. Have you ever dissected a frog in school? Someone probably has. The frog was placed in formalin to kill all infectious agents and make it safe for 30 rowdy grade 9's to dissect under the supervision of one teacher. You can tell it was fixed by formalin because of the distinct smell of “dissection” when you are walking down a public school hallway.

In the lab, we dissect all sorts of specimen types and make them into slides to look at them under the microscope. We look for cancer, abnormal cells, enlarged cells, and bacteria. There is an entire process which the tissue has to go through in order to make it visible under a microscope, so I don’t advise shoving a chunk of frog under a microscope to see it at a cellular level. Unless it’s an electron microscope...


Darn good and sure of it,

adot

Friday, 5 April 2013

Efflux Pumps

Day 'E' in A-Z Challenge! E is for efflux pumps.

Efflux pumps are a method of antibiotic resistance in certain organisms. There are proteins that carry the antibiotic into the cell then, the antibiotic acts on its target cell structure/function (i.e. transcription, translation, cell membrane, etc) causing the bacterial cell to die. When bacteria take over the cellular function, sometimes they can make an efflux pump (also made of proteins), which causes the antibiotic to be pumped right back out of the target cell before it can kill the cell.

One of my professors is conducting research on these protein structures, because if they find a way to inhibit the outflow of the antibiotics, we can use the antibiotics already available to treat the infection. To develop a new antibiotic it is estimated to take decades and millions of dollars in research. To come up with ways to combat the resistance mechanisms is a much more realistic use of resources.


Darn good and sure of it,

adot 


Thursday, 4 April 2013

DNP

This is day D!! Unfortunately, DNP doesn't have much to do with lab work, except maybe testing for levels in the body. I could have picked a more relevant topic, but I wanted to talk about Dr. Oz. *muahaha*

DNP stands for 2,4- dinitrophenol which is an inhibitor of cellular energy. In the 30s, people took 2,4- DNP as diet pills. They could eat as much as they wanted, but they would not gain weight because their cells would not convert the food into energy, and thus would not be stored as fats or circulate in the body as sugars. This is actually very dangerous, so don’t try this at home. It increases the temperature of your body because the energy produced is just being lost as heat because, if you remember from Grade 11 thermodynamics, energy cannot be created or destroyed so if you intake energy, it has to go somewhere. That heat created can fry other proteins in the body and cause serious harm, especially to the brain. Ain’t nobody got time for that!

Word of advice: be weary of anything that sounds too good to be true. Take, for example, Dr. Oz's Green Coffee Bean Extract "breakthrough". Do you wonder why no credible sources have published any articles on his "magic pill"? You really don't need diet pills to lose weight. You need someone to take over your job, do all your housework, and pay your bills so you have time to exercise. A pill will not get rid of excuses. A pill will put it in your head that it's okay to watch TV and eat all the leftover Easter candy.  Don't go all googly-eyed on the fact that he is a "doctor". He said it himself that it's a "made for TV" study. Like, what does that even mean? TV experiments make bad science.


Darn good and sure of it,

adot