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Lung Information and Courses from MediaLab, Inc.

These are the MediaLab courses that cover Lung and links to relevant pages within the course.

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Laboratories Individuals

CLIA Chemistry / Urinalysis Review
The lecethin to sphingomyelin ratio (L/S) is used to assess:View Page
Respiratory acidosis is associated with:View Page
Match the tissues on the left with the corresponding LDH isoenzyme peak on the right.View Page
The following LDH Isoenzyme pattern would be seen in:View Page
The following LDH Isoenzyme pattern would be seen in:View Page
The following LDH Isoenzyme pattern would be seen in:View Page

CLIA Hematology / Hemostasis Review
What is the primary function of hemoglobin :View Page

CLIA Microbiology / Serology Review
Adult Ascaris lumbricoides worms live in the:View Page

Current Topics in Clinical Microbiology
Clinical History

A 67 year-old man entered the hospital with cough, right lower chest pain accentuated by deep breathing, and fever. He had a history of chronic obstructive pulmonary disease secondary to a long history of smoking. The temperature on admission was 39.2C, and auscultation of the chest revealed rales in the right lower lung field. The admission white blood count was 13,500/ml with 80% segmented neutrophils and a shift to the left. A blood culture was obtained.

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Review 1

Spencer RC.: Invasive streptococcEuropean Journal of Clinical Microbiology & Infectious Diseases. 14 Suppl. 1:S26-32, 1995.Before the introduction of antibiotics, serious infections caused by Streptococcus pyogenes (Lancefield Group A streptococci) were common. Before World War II, this bacterium was responsible for as many as 50% of postpartum deaths and was the major cause of death in patients with burns. Also common were the sequelae of streptococcal infections-rheumatic fever and post-streptococcal glomerulonephritis.With the use of penicillin, however, Streptococcus pyogenes was believed to be virtually eliminated as a pathogen. The organism was consigned to the history books, but not for long.In the mid-1980s, focal resurgences of rheumatic fever began to be reported from different areas in the USA, such as Salt Lake City, Utah. In such communities, where increases in cases of rheumatic fever had been reported, the serotypes M-1, 3, 5, 6 and 18 were isolated which, on culture, produced characteristic mucoid colonies. At the same time, reports of increases in invasive streptococcal disease began to surface in both the USA and Europe.Two syndromes were described; invasive streptococcal infection, occurring in previously healthy children and adults, commonly associated with septicaemia resulting from a deep focus of infection such as bone or lung; and streptococcal toxic shock syndrome, involving a cutaneous focus, accompanied by necrotizing or bullous soft tissue changes. Septicaemia is rare in streptococcal toxic shock syndrome, but the most characteristic feature is one of rapidly progressing multi-organ failure. A high proportion of the strains of Streptococcus pyogenes associated with this condition are serotype M-1, and fatality rates approaching 50% have been reported.

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First Aid
The Heimlich Maneuver

The Heimlich Maneuver is used to clear food or other material obstructing a conscious victim's airway.An airway obstruction is most likely to occur during a meal.The victim will appear to be choking, often grabbing her throat with her hands, and cannot speak.The Heimlich maneuver can dislodge the obstructing object by forcing air from the lungs through the airway.

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Introduction to Bioterrorism
Lung-damaging or Choking Agents

 Example: Phosgene Physical Properties: Heavy gas, smells like fresh cut hay. General Signs and Symptoms: Coughing and choking, followed by tightness in chess, nausea, vomiting and headache. Death is due to the accumulation of fluid in the lungs. Relative Rate of Action: Immediate in high concentrations to several hours in low concentrations.

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Laws and Rules of the Florida Board of Clinical Laboratory Personnel
Description of Specialties (2)

Specialists in immunohematology perform all testing prior to blood transfusions and work to prevent transfusion infections. They also investigate any post-transfusion reactions. This specialty includes all lab procedures performed in the specialty of histocompatibility. Specialists in clinical chemistry analyze body fluids such as blood, urine, and spinal fluid to determine the chemical makeup, including the amount of carbohydrates, proteins, enzymes, and trace elements. The special covers urine microscopics and chemical evaluation of the liver, kidneys, lungs, heart, and other vital organ systems. This specialty also covers all testing performed in the specialties of radioassay and blood gas analysis. Specialists in blood banking can perform all immunohematology testing as well as testing from the specialties of clinical chemistry, hematology and serology/immunology that relates to donor blood. Specialists in immunohematology, clinical chemistry, hematology, and serology / immunology may perform all tests in the blood banking specialty.

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Description of Specialties (3)

Specialists in radioassay use radionuclides to determine the chemical makeup of body fluids such as blood and urine. Specialists in blood gas analysis evaluate lung and breathing function by levels of oxygen, carbon dioxide, pH, and hemoglobin with automated tests. Specialists in histology examine cellular and tissue samples using fixation, dehydration, embedding, microtomy, frozen sectioning, staining, and other similar techniques. Histology specialists licensed as technicians can perform specimen processing, embedding, cutting, staining, and frozen sectioning only under the general supervision of a director, supervisor, or technologist. Specialists in cytology process and interpret samples relating cytopathological disease. Non-gynecological cytology preparations can be screen by a specialist in cytology but final review and interpretation must be done by a physician.

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Mycology: Yeasts and Dimorphic Pathogens
Shown in this photomicrograph is a Gomori methenamine silver stain of a lung biopsy obtained from a patient with X-ray evidence of multi-focal pneumonitis. The yeast most likely to be recovered in culture of this tissue is:View Page
The colonies illustrated in this photograph were recovered from a blood culture after 48 hour incubation at 30°C. The most likely source for the septicemia is:View Page

Normal Peripheral Blood Cells
Function and Kinetics

Erythrocytes are produced in the bone marrow and released into the peripheral blood where they may remain for approximately 120 days before senescence.Their main function is the transport of the respiratory gases (oxygen and carbon dioxide) between the lungs and body tissues.Each erythrocyte can be thought of as an "envelope" containing hemoglobin.Each hemoglobin molecule contains iron which has a high affinity for oxygen.As a result, when an erythrocyte passes through one of the capillaries of the lungs, it picks up oxygen.The oxygen is transported through the blood to the tissues where it is released.Carbon dioxide from the tissues then diffuses into the RBC where it undergoes chemical changes.About 70% of the altered carbon dioxide diffuses into the plasma, 25% binds to the hemoglobin molecule, and 5% goes into simple solution within the red cell.In each of these three ways carbon dioxide is transported from the body tissues back to the lungs, where it is released.

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All of the following methods can be used to transport carbon dioxide to the lungs EXCEPT:View Page
Erythrocytes or Red Blood Cells (RBC's)

The first group is composed of erythrocytes or red blood cells (RBC's). The main function of the erythrocytes is the transport of oxygen from the lungs to the body tissues. Most of the cells in this Wright's stained peripheral blood smear are red cells. On is shown at the arrowhead.

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Life Span and function of Eosinophils

Eosinophils have a circulating half-life of approximately 18 hours and a tissue life span of at least 6 days.They are capable of locomotion and phagocytosis and can enter inflammatory sites, but do so less readily than neutrophils.In tissues the primary location for eosinophils is in the epithelial barriers to the outside world such as, lungs, skin and GI tract.They are capable of returning to the circulating blood and bone marrow after they enter the tissues.

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Phlebotomy
Cardiovascular system : structure & function

The cardiovascular system consists of the Heart, and Blood Vessels. Its main function is circulate oxygenated blood from the lungs to various organs, and return blood depleted of oxygen to the lungs, where it is reoxygenated. Illustration this screen from LifeArt Collection 2000, with permission. © Lippincott Williams & Wilkins.

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Circulation: arterial portion

Blood is then pumped from the right side of the heart to the lungs, where it takes up oxygen. Oxygenated blood is then pumped through the left side of the heart via arteries to tiny blood vessels called capillaries.Illustration this screen from LifeArt Collection 2000, with permission. © Lippincott Williams & Wilkins.

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Red blood cells

Red blood cells contain hemoglobin, which carries oxygen from the lungs to the tissues of the body. Hemoglobin gives blood its red color. Red blood cells are shown in the photomicrograph of a stained blood smear to the right.

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Reading Gram Stained Direct Smears
Significance of Specific Findings:

Epithelial cells in large numbers within sputum smears means that the specimen is predominantly oral saliva, rather than true sputum from the lung. Epithelial cells in urine smears indicate that the sample has been contaminated by organisms found on the vulva or distal urethra. Bacteria found near or on epithelial cells are usually normal contaminating bacterial flora.White blood cells indicate inflammation and possible infection. The direct smear examination should focus within and around these cells.Red blood cells in a direct smear are not usually significant.Yeast may be present as normal flora in upper respiratory tract or genital tract. They may be significant if they predominate, or if budding yeast forms are seen.Hyphae are more likely to indicate the presence of fungal infection, but this determination requires correlation with clinical findings.Bacteria found in spinal fluid, blood, tissue and specimens from other sterile sites are always significant.Body fluids which are normally sterile must be examined carefully. If only one organism per oil immersion field is identified, then there are about 105 organisms per mL present in the sample! Bacteria observed in specimens from the throat, genital tract and other areas containing normal flora suggest infection only if their composition and type varies significantly from the norm.

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Tuberculosis Awareness for Healthcare Workers
Tuberculosis infection

The natural history of TB infection is usually followed by an immune response and latency after exposure. In about 5-10% of cases, the latent period progresses to an active infection.The organism that causes TB infection is Mycobacterium tuberculosis. This organism is pictured in the photograph to the right as observed when stained with acridine orange stain. Infection occurs when a susceptible person inhales droplet nuclei containing Mycobacterium tuberculosis and the organism reaches the alveoli of the lungs.About 2-12 weeks after infection, the immune system limits multiplication of additional bacteria and the immunological test becomes positive.Latent tuberculosis infection (LTBI) is the stage when the viable organism remains in the body, and the patient has no symptoms and is non-infectious.Most infected persons do not experience clinical illness and are noninfectious. About 5-10% of persons infected with Mycobacterium tuberculosis who are not treated will develop TB during their lifetime. The risk for progression is highest during the first several years after infection.TB infects the lungs most often; however, it can infect almost any organ in the body, including bones and joints.

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High Risk Progression Groups

The following persons are at high risk for progression from LTBI to TB disease: Persons infected with HIV Persons infected with Mycobacterium tuberculosis within the past two years Persons with untreated or inadequately treated TB disease Infants and children <4 years of age Persons with chronic medical conditions or immunocompromising conditions

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