[1S] UNIT 2: Quality Assurance for Diagnostic Laboratories Flashcards

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1
Q

It is defined as accuracy, reliability and timeliness of reported test results.

A

Quality Assurance (QA)

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2
Q

The set of planned and systematic activities focused on providing confidence that quality requirements will be fulfilled.

A

Quality Assurance (QA)

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3
Q

Can be defined as “coordinated activities to direct and control an organization with regard to quality”. This definition is used by the International Organization for Standardization (ISO) and by the Clinical and Laboratory Standards Institute (CLSI).

A

Quality Management System

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4
Q

A widely used quality management system model organizes all of the laboratory activities into twelve quality system essentials, which are a set of coordinated activities that serve as building blocks for quality management.

A

Quality Management System (QMS) Model

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5
Q

GENERAL ADMINISTRATIVE GUIDELINES

It monitors and regulates all procedures for continuous measurement and improvement of laboratory performance by ensuring all laboratory processes follow Standard Operating Procedures (SOPs) validated at predefined parameters.

A

Internal Quality Assurance (IQA) system

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6
Q

GENERAL ADMINISTRATIVE GUIDELINES

known as proficiency testing (PT), are inevitable for monitoring of performance. It is necessary to periodically assess the analytical performance of molecular tests by inter-laboratory comparison.

A

External Quality Assurance (EQA) programs

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7
Q

SPECIMEN HANDLING

is the consequence of erroneous or misleading results caused by events that occur prior to sample analysis. The Clinical and Laboratory Standards Institute (CLSI) provides recommendations for the collection of specimens under standardized conditions.

A

Preanalytical error

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8
Q

SPECIMEN HANDLING

T/F: Specimen collection, transport and handling in the laboratory require careful attention, whereas the age, type and condition of the specimens are vital to the success of a clinical laboratory experiment.

A

T

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9
Q

SPECIMEN HANDLING GUIDELINES CLSI

T/F: 1. A requisition or electronic order should accompany the specimen.

A

T

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10
Q

SPECIMEN HANDLING GUIDELINES CLSI

T/F: The condition of the specimen, and the chain of custody (if necessary) isn’t reviewed on receipt of the laboratory.

A

F; is reviewed

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11
Q

SPECIMEN HANDLING GUIDELINES CLSI

T/F: 3. No specimen is accepted without proper labeling and identification on the specimen tube or container.

A

T

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12
Q

SPECIMEN HANDLING GUIDELINES CLSI

T/F: 4. The test requisition includes the type of specimen material (blood or bone marrow), ordered test, date and time of collection, reason for testing and the contact information of the ordering physician.

A

T

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13
Q

SPECIMEN HANDLING GUIDELINES CLSI

T/F: 5. The laboratory should have written procedures for documentation of specimen handling and accession.

A

T

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14
Q

SPECIMEN HANDLING GUIDELINES CLSI

T/F: 6. If a specimen is unacceptable, the disposal or retention of the specimen is not recorded in the patient report or laboratory quality assurance records.

A

F; is recorded

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15
Q

SPECIMEN HANDLING GUIDELINES CLSI

T/F: 7. If not processed immediately, specimens are maintained in secure areas with limited access under the appropriate conditions for the analyte being tested.

A

T

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16
Q

SPECIMEN HANDLING GUIDELINES CLSI

T/F: Biohazard stickers are required for cabinets, freezers that contain potentially hazardous specimens.

A

T

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17
Q

EXAMPLES OF SPECIMEN HANDLING TECHNIQUES

  • Nucleic acid-based testing on specimens on buccal cell suspensions and cerebrospinal fluids (CSF) must be performed.
  • The entire specimen is not used during isolation of nucleic acid to avoid cross-contamination during pipetting.
A

Routine Molecular Amplification lab setup

18
Q

EXAMPLES OF SPECIMEN HANDLING TECHNIQUES

Specimens received in the lab should be inspected for visual signs of hemolysis. Buffers and resins have been designed to sequester anticoagulants or hemoglobin for more rapid nucleic acid isolation.

A

DNA and RNA isolation procedures

19
Q

EXAMPLES OF SPECIMEN HANDLING TECHNIQUES

T/F: Solid tissues are best analyzed from heated samples. Highly recommended protocol before performing southern blot or polymerase chain reactions (PCR) methodologies that require high quality DNA.

A

F; fresh or frozen samples

20
Q

COLLECTION TUBES FOR MOLECULAR TESTING

Chemistry, serum, viral antibody studies

A

Red top

21
Q

COLLECTION TUBES FOR MOLECULAR TESTING

Immunology, virology studies

A

Sodium heparin (Freeze-dried) (Green)

22
Q

COLLECTION TUBES FOR MOLECULAR TESTING

Cytogenetic & molecular studies

A

Sodium Heparin (Brown)
- Lithium is toxic to the cell

23
Q

COLLECTION TUBES FOR MOLECULAR TESTING

Virology, molecular biology studies

A

Tripotassium EDTA (7.5-15%) (Lavender)

24
Q

COLLECTION TUBES FOR MOLECULAR TESTING

Molecular biology studies

A

Acid Citrate Dextrose Solution (Yellow)

25
Q

COLLECTION TUBES FOR MOLECULAR TESTING

T/F: Blood or bone-marrow specimens collected in EDTA or ACD tubes are preferred.

A

T

26
Q

PRECAUTIONS IN SPECIMEN HANDLING

According to Centers for Disease Control and Prevention, ALL specimens must be handled by _______ ______________ using Personal Protective Equipment (PPE).

A

standard precautions

27
Q

PRECAUTIONS IN SPECIMEN HANDLING

Include respirators that are used with airborne or contact-transmissible agents.

A

Transmission-based precautions

28
Q

PRECAUTIONS IN SPECIMEN HANDLING

These are designed for direct patient care where there is a potential for direct exposure to infectious agents on or from the patients.

A

Contact precautions

29
Q

T/F: In general, gloves, face masks, eye protection and gowns are standard precautions (PPE) used by molecular biologists and medical technologists when in direct contact with patients. These are necessary when performing nucleic acid isolation procedures to prevent contamination with nucleases

A

T

30
Q

EQUIPMENT MAINTENANCE

must exist to demonstrate and provide evidence that all instrumentation and equipment are validated, operated, inspected, maintained, tested and standardized to ensure optimal quality of assay results.

A

SOPs and supporting documentations

31
Q

EQUIPMENT MAINTENANCE

documents and reviews the equipment performance and maintenance consistently and on a routine basis.

A

Laboratory personnel

32
Q

EQUIPMENT MAINTENANCE

must review, sign, and date all documentation of equipment maintenance at least monthly. All laboratory equipment should be listed on the inventory.

A

Supervisory staff member

33
Q

SPECIFIC SERVICE GUIDELINES PER EQUIPMENT

Check for volumetric accuracy and reproducibility, and recalibrate as necessary at specific defined intervals, at least once every 6 months.

A

Adjustable and fixed-volume automatic pipettors

34
Q

SPECIFIC SERVICE GUIDELINES PER EQUIPMENT

Test against a standardized thermometric device annually.

A

Thermometers

35
Q

SPECIFIC SERVICE GUIDELINES PER EQUIPMENT

Establish tolerance limits for temperatures which must reflect the most stringent needs of all reagents, supplies and specimens stored within it.

A

Refrigerators and freezers

36
Q

SPECIFIC SERVICE GUIDELINES PER EQUIPMENT

Establish tolerance limits for temperatures, carbon dioxide levels and humidity as applicable.

A

Incubators and water bath

37
Q

SPECIFIC SERVICE GUIDELINES PER EQUIPMENT

Measure operating speeds periodically with a tachometer.

A

Centrifuges

38
Q

SPECIFIC SERVICE GUIDELINES PER EQUIPMENT

Verify content processing using heat sensitive tape with each autoclave batch. Verify effective sterilization with an appropriate biological indicator weekly.

A

Autoclave

39
Q

SPECIFIC SERVICE GUIDELINES PER EQUIPMENT

Check accuracy with standard weights and class at a predetermined frequency.

A

Analytical balances

40
Q

SPECIFIC SERVICE GUIDELINES PER EQUIPMENT

Verify air intake grills are not obstructed. Certify cabinets/hoods annually by a trained service
technician, certified maintenance department or company.

A

Biosafety cabinets/laminar flow hoods

41
Q

SPECIFIC SERVICE GUIDELINES PER EQUIPMENT

Any equipment that is out of service for any reason should be clearly identified and removed from the laboratory.

A

Out of service equipment