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Clinical Chemistry 1 > A - Chapter I: INTRODUCTION TO CLINICAL CHEMISTRY > Flashcards

A - Chapter I: INTRODUCTION TO CLINICAL CHEMISTRY Flashcards

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1
Q

– seeks to understand the physiologic and biochemical processes occurring in normal and abnormal states

A

Fundamental science

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2
Q

– analyses performed on body fluids or tissues to provide important information for the diagnosis and treatment of disease

A

Applied science

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3
Q

LABORATORY REAGENTS:
A. CHEMICALS

A

Analytical grade/Reagent grade chemicals
United States of Pharmacopoeia and National Formulary
Chemically pure/Pure grade chemicals
Technical/Commercial grade

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4
Q

LABORATORY REAGENTS:
B. STANDARDS

A

Primary Standards
Secondary Standards
Standard Reference Materials

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5
Q
  • meet specifications set by the American Chemical Society
A

Analytical Grade

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6
Q
  • of high purity and is suitable for most analytical laboratory procedures
A

Analytical Grade: Ultra-Pure Reagents

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7
Q
  • Includes spectograde, nanograde and HPLC
A

Analytical Grade

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8
Q

-used to manufacture drugs

A

United States Pharmacopeia (USP) and National Formulary (NF)

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9
Q
  • Less pure grade
A

Chemically pure (CP) / Pure Grade Chemicals

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10
Q
  • Impurity limitations and chemical preparation are not uniform
A

Chemically pure (CP) / Pure Grade Chemicals

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11
Q
  • lowest quality and should not be used for analytical work
A

Technical or Commercial grade

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12
Q
  • highly purified chemicals that can be measured directly to produce a substance of exact known concentration.
A

Primary Standard (PS)

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13
Q
  • used for standardization of solutions of unknown strength
A

Primary Standard (PS)

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14
Q
  • stable and can be dried, preferably at 104 - 110 ̊C, without a change in composition
A

Primary Standard (PS)

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15
Q
  • not hygroscopic
A

Primary Standard (PS)

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16
Q
  • of lower purity with concentration determined by comparison with a primary standard
A

Secondary Standard

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17
Q
  • certified by the National Bureau of Standards (NBS)
A

Standard Reference Materials (SRM)

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18
Q
  • Types of Reagent Grade Water:
A

Distilled water
Deionized water

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19
Q

Type I

Resistivity (megaohm/cm (@ 25OC)
Silicate (mg/L, as SiO2)
pH
Microbiologic content (CFU/mL)

A

10
2.0
0.1

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20
Q

Type II

Resistivity (megaohm/cm (@ 25OC)
Silicate (mg/L, as SiO2)
pH
Microbiologic content (CFU/mL)

A

0.05
0.1
1.0

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21
Q

Type III

Resistivity (megaohm/cm (@ 25OC)
Silicate (mg/L, as SiO2)
pH
Microbiologic content (CFU/mL)

A

NS
NS
5 - 8

<10
103
NS

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22
Q

➢ Used in test methods requiring minimum interference and maximum precision and accuracy

A

Type I

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23
Q

➢ acceptable for most analytic procedures

A

Type II

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24
Q

 trace metal , iron and enzyme analyses, electrolyte measurements

A

Type I

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25
Q

 tissue or cell culture

A

Type I

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26
Q

 ultramicro analysis; preparation of all standards

A

Type I

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27
Q

 stored in a manner that reduces any chemical or bacterial contaminations and for short periods.

A

Type II

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28
Q

 chemistry, hematology, immunology, reagent QC & standard preparation

A

Type II

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29
Q

 urinalysis, parasitology, histology acceptable for washing glasswares

A

Type III

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30
Q

5 PREPARATION OF REAGENT GRADE WATER

A

Distillation
Filtration
Deionization
Reverse Osmosis
Unltraviolet oxidaiton/Ozone treatment

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31
Q

➢ Water is boiled and vaporized; Each cycle removes impurities

A

Distillation

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32
Q

➢ Some impurities sodium, potassium, manganese, carbonates and sulfates.

A

Distillation

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33
Q

➢ remove 98% of the particulate matter.

A

Filtration

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34
Q

: removes organic materials and chlorine

A

➢ Activated carbon

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35
Q

➢ : depending on the type of water

A

Submicron fibers (<0.2 mm) or glass or cotton fiber

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36
Q

: Remove particulate matters, microorganisms, pyrogens & endotoxins

A

➢ Ultrafiltration and Nanofiltration

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37
Q

➢ Uses an anion or cation exchange resin followed by replacement of the removed ions with OH- or H+.

A

Deionization

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38
Q

➢ Uses pressure to force water through a semipermeable membrane

A

Reverse Osmosis

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39
Q

➢ Does not remove dissolved gases; may be used as pre-treatment of water.

A

Reverse Osmosis

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40
Q

FACTORS DETERMINING THERMAL DURABILITY

A
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41
Q

– temperature resulting to deformation due to heat stress

A
  1. Strain Point
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42
Q
  • °T at w/c glass is heated in order to prevent brittleness
A
  1. Annealing Point
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43
Q

– refers to dimension change w/ °T (ideally, it should be low)

A
  1. Coefficient of Expansion
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44
Q

PROPERTIES OF GLASS

A
  1. Breakabiity
  2. Thermal Durability
  3. Transparency
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45
Q

: dependent on silicate anion content (greater amount – more durable)

A

a. Breakability

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46
Q

: dependent on boron oxide, nickel & ferric ion content

A

b. Thermal Durability

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47
Q

: dependent on ferric ion content

A

c. Transparency

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48
Q

▪ With high degree of thermal resistance ( 510 oC)

A

Borosilicate w/ Low Alkaline content

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49
Q

▪ This should not be heated beyond its strain point

A

Borosilicate w/ Low Alkaline content

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50
Q

▪ May cloud/etch when used with strong alkalis; may be scratched

A

Borosilicate w/ Low Alkaline content

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51
Q

▪ Most common type used in volume measurements

A

Borosilicate w/ Low Alkaline content

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52
Q

▪ Corex

A

Alumina-silicate glasswares

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53
Q

▪ Strengthened chemically rather than thermally; 6X stronger than borosilicate glass but less thermally resistant

A

Alumina-silicate glasswares: Corex

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54
Q

▪ Alkali resistant; Resists some clouding and scratching

A

Alumina-silicate glasswares

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55
Q

ashing & ignition techniques; can withstand very high temperature.

A

Alumina-silicate glasswares: Vycor

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56
Q
  • with good thermal endurance (900 - 1200OC), chemical stability and electrical characteristics
A

High Silica Glasswares (96% silica)

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57
Q
  • good optical and temperature characteristics
A

High Silica Glasswares (96% silica)

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58
Q
  • With poor heat resistance but has high resistance to alkali
A

Boron-free glass (“Soft Glasswares”)

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59
Q
  • Thermally resistant and with a red or amber color
A

Low-Actinic glass

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60
Q
  • soda lime glass composed of a mixture of oxides of Silicon, Calcium and Sodium
A

Flint glass

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61
Q
  • cheapest and with poor resistance to high temperatures
A

Flint glass

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62
Q

Class A tolerances according to NIST :

A

high thermal borosilicate or aluminosilicate glass

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63
Q

SPECIAL GLASSWARES

A
  1. Colored and Opal Glasses
  2. Coated Glasses
  3. Optical Glass
  4. Glass Ceramics
  5. Radiation
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64
Q
  • has metallic oxides; used for filters and light bulbs
A

Colored and Opal Glasses

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65
Q
  • has a thin, metallic oxide permanently fire-bonded to its surface; can conduct electricity
A

Coated Glass

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66
Q
  • made of soda lime, lead and borosilicate
A

Optical Glass

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67
Q
  • has a high optical activity; prisms, lenses and optical mirrors
A

Optical Glass

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68
Q
  • with high thermal resistance, chemical stability and corrosion resistance
A

Glass Ceramics

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69
Q
  • for hot plates, table tops and heat exchangers
A

Glass Ceramics

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70
Q
  • made of soda lime and lead
A

Radiation-Absorbing Glass

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71
Q

LABORATORY PLASTIC WARES

A
  1. Polystyrene (PS)
  2. Polyethylene
  3. Polypropylene (PP)
  4. Teflon
  5. Tygon
  6. Polycarbonate (PC)
  7. Polyvinyl chloride (PVC)
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72
Q
  • Clear and rigid; not autoclavable
A

Polystyrene (PS)

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73
Q
  • Used for disposable wares
A

Polystyrene (PS)

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74
Q
  • Not recommended for use with acids, aldehydes, ketones, ethers, hydrocarbons or essential oils
A

Polystyrene (PS)

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75
Q
  • Chemically resistant to most substances except for aldehydes, amines, ethers, hydrocarbons and essential oils
A

Polyethylene

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76
Q

: translucent and flexible; not autoclavable

A
  • Conventional Polyethylene (CPE)
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77
Q
  • Has the same chemical resistant as polyethylene
A

Polypropylene (PP)

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78
Q
  • Translucent and rigid; autoclavable
A

Polypropylene (PP)

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79
Q
  • Resin that has excellent chemical resistance to almost all chemicals in the lab.
A

Teflon

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80
Q
  • Clear, translucent and flexible; autoclavable
A

Teflon

81
Q
  • Used for stopcocks, wash bottles and tubings
A

Teflon

82
Q
  • Translucent and flexible; autoclavable
A

Tygon

83
Q
  • Very susceptible to damage by most chemicals.
A

Polycarbonate (PC)

84
Q

Resistant to water, aqueous salts and inorganic acids for a long period.

A

Polycarbonate (PC)

85
Q
  • Very clear and rigid; autoclavable
A

Polycarbonate (PC)

86
Q
  • Used for carboys, test tube racks
A

Polycarbonate (PC)

87
Q
  • Used for most bottles and tubings
A

Polyvinyl Chloride (PVC)

88
Q

STERILIZATION OF HIGH QUALITY PLASTICWARE:

  1. Autoclaving:
  2. Chemical sterilization:
  3. Gas sterilization:
A

121°C at 15 psi for 15-20 mins

Benzalkonium chloride

Ethylene oxide

89
Q

: 121°C at 15 psi for 15-20 mins

A

Autoclaving

90
Q

: Benzalkonium chloride

A

Chemical sterilization

91
Q

: Ethylene oxide

A

Gas sterilization

92
Q
  1. CLASSIFICATION ACCORDING TO GRADUATIONS:
A

A. TRANSFER PIPETS
B. GRADUATED OR MEASURING PIPETS
C. “Blow Out”
D. “Between Two Marks”

93
Q

A. TRANSFER PIPETS

A
  1. Volumetric or Transfer pipet
  2. Ostwald-Folin pipet
  3. Pasteur pipets
  4. Automatic (macro or micropipets)
94
Q

B. GRADUATED OR MEASURING PIPETS

A

Mohr
Serological

95
Q
  • used to transfer aqueous solutions & non-viscous samples
A

Volumetric or Transfer pipet

96
Q
  • self-draining
A

Volumetric or Transfer pipet

Mohr

97
Q
  • has the greatest degree of accuracy and precision
A

Volumetric or Transfer pipet

98
Q
  • read at the lower meniscus
  • with bulb at the center
A

Volumetric or Transfer pipet

99
Q

Should be used when diluting standards, calibrators, or QC material.

A

Volumetric or Transfer pipet

100
Q
  • used for biologic fluids having viscosity greater than water
A

Ostwald-Folin pipet

101
Q
  • blowout pipets
A

Ostwald-Folin pipet

102
Q
  • read on the upper meniscus

Indicated by two etched continuous rings at the top.

A

Ostwald-Folin pipet

103
Q
  • bulb is closer to the delivery tip
A

Ostwald-Folin pipet

104
Q
  • no calibration mark
A

Pasteur pipets

105
Q

used to transfer solutions or biologic fluids without consideration of a specific volume

A

Pasteur pipets

106
Q

capable of dispensing; used to deliver a pre- determined volume of liquid

A

GRADUATED OR MEASURING PIPETS

107
Q

➢ calibrated between two marks; deliver between their calibration marks

A

Mohr pipet

108
Q

➢ Tip should NOT touch the receiving vessel

A

Mohr pipet

109
Q

➢ self-draining; with smaller orifice

A

Mohr pipet

110
Q

➢ graduated down to the tip

A

Serological pipet

111
Q

➢ blow-out pipet; with larger orifice

A

Serological pipet

112
Q

– exact volume is calibrated to fill the volume between two calibration points on the pipet

A

“Between Two Marks”

113
Q

CLASSIFICATION ACCORDING TO USE:

A

“To-Contain” (TC)
“To-Deliver” (TD)

114
Q

➢ Holds the particular volume but does not dispense the exact volume

A

“To-Contain” (TC)

115
Q

➢ Requires rinsing

A

“To-Contain” (TC)

116
Q

➢ calibrated with mercury

A

“To-Contain” (TC)

117
Q

➢ usually a micropipette; Volumes are expressed in microliter

A

“To-Contain” (TC)

118
Q

Example: Sahli pipet

Example: Mohr, Serologic, Volumetric Transfer pipets

A

“To-Contain” (TC)

“To-Deliver” (TD)

119
Q

➢ Delivers the exact volume indicated; Calibrated for the volume delivered

A

“To-Deliver” (TD)

120
Q

➢ fluid is allowed to flow freely with the pipet tip touching the inner wall of receiving vessel

Designed to be drained by gravity

A

“To-Deliver” (TD)

121
Q

 Safer, less time consuming, precise & convenient

A

Automatic macropipets or micropipets

122
Q

➢ mechanism draws up and dispenses the liquid

A

Automatic macropipets or micropipets

123
Q

Automatic macropipets or micropipets types

A
124
Q

: relies on a piston for suction creation to draw the sample into a disposable tip

A

Air-displacement

125
Q

: operates by moving the piston in the tip or barrel

A

Positive displacement

126
Q
  • Sample enters directly upon contact without air interference
A

Positive displacement

127
Q
  • No need to replace delivery tip
A

Positive displacement

128
Q

: obtain the liquid from a common reservoir and dispense it repeatedly

A

Dilutor/Dispenser pipets

129
Q

combines sampling & dispensing functions

A

Dilutor/Dispenser pipets

130
Q

process in which centrifugal force is used to separate solid matter from a liquid suspension; also separate two liquid phases of different densities

A

Centrifugation

131
Q

 RCF in grams=

A

1.118 x 10-5 x r x (rpm)2 ; or use nomogram

132
Q

 RPM =

A

tachometer or strobe light

133
Q

CENTRIFUGE TYPES

A
  1. Horizontal-head or swinging-bucket centrifuge
  2. Angle-head or fixed angle centrifuge
  3. Ultracentrifuge
134
Q

➢ tubes placed in the cups of the rotor assume a horizontal plane when the rotor is in motion and vertical position when at rest

A

Horizontal-head or swinging-bucket centrifuge

135
Q

➢ Tubes are held at a fixed angle from 25-40 degrees to the vertical axis of rotation

A

Angle-head or fixed angle centrifuge

136
Q

➢ Particles are driven outside and bottom of the tube and the surface of the sediment packs against the side and bottom of the tube and the surface of the sediment is parallel to the shaft of the centrifuge

A

Angle-head or fixed angle centrifuge

137
Q

➢ High-speed centrifuge ( its rotor can spin as high as 1000000 x g)

mainly fixed angle rotors

For the separation of lipoproteins

A

Ultracentrifuge

138
Q

➢ requires a refrigerated chamber

A

Ultracentrifuge

139
Q

5% HCl or 5% HNO3

A

New pipets

140
Q

10% NaOH (12 - 24 hours)

A

Blood clots

141
Q

20% HNO3

A

Metal ion determinations

142
Q

50% KOH

A

Grease

143
Q

50% HCl; Mixture of 1% FeSO4 in 25% H2SO4

A

Permanganate stains

144
Q

2 - 4% cresol autoclaving

A

Bacteriologic glasswares

145
Q

HCL solution (1:2); HNO3 solution (1:3)

A

Iron determination

146
Q

General washing procedures:

A
147
Q
  • each individual lot is analyzed and the actual amount of impurity is reported.
A

A. Lot-Analyzed Reagents

148
Q
  • the maximum impurities are listed.
A

B. Maximum Impurities Reagents

149
Q

not pure enough for use in most chemical procedures

A

United States Pharmacopoeia (USP) and National Formulary (NF)

150
Q

Primarily used in manufacturing

A

Technical or Commercial grade

151
Q

IUPAC requires PS to be at least 99.98% pure; working standard be 99.95%

A

Primary Standard (PS)

152
Q

concentrations cannot be exactly known by direct measurement

A

Secondary Standard

153
Q

Is often used to verify calibration or accuracy/bias assessments.

A

Standard Reference Materials (SRM)

154
Q

: Is a water suitable for reagent and standard preparation.

A

REAGENT GRADE WATER

155
Q

: is purified to remove almost all organic materials.

A
  1. Distilled Water
156
Q

: is produced from distilled water using either an anion or cation exchange resin followed by replacement of the removed particles with hydroxyl or hydrogen ions respectively.

A
  1. Deionized Water
157
Q

For trace metal analyses , iron and enzyme analyses, electrolyte measurements, tissue or
cell culture , Ultra-micro chemical analysis, and preparation of all standards

A

Type I

158
Q

not requiring Type I or Type I water.

A

Type III

159
Q

Used for most qualitative measurements/examinations.

A

Type III

160
Q

Oldest method of water purification.

A

Distillation

161
Q

are composed of glass, cotton, activated charcoal which removes organic materials and chlorine

A

Filtration cartridges

162
Q

➢ The use of UV radiation at the biocidal wavelength of 254nm eliminates many bacteria and cleaves many ionizing organics that are then removed by deionization.

A

Ultraviolet oxidation; Ozone treatment

163
Q

Highly protective for handling heat-labile substances in the 300-500 nm range

A

LOW-ACTINIC GLASS

164
Q

Alcohols and bases can be used but not to be stored longer than 24 hours.

A

Polystyrene (PS)

165
Q

: unique group of resins with relatively inert chemical properties.

A

Polyolefins (polyethylene & polypropylene)

166
Q

Unaffected by acids

A

Polyethylene

167
Q

Used for screw-cap closures

A

Polypropylene (PP)

168
Q

Twice as strong as polypropylene ( from -100⁰C to 160⁰C)

A

Polycarbonate (PC)

169
Q

DISADVANTAGES OF PLASTICWARES:
1.[?] – increase in concentration
2.[?] – decreased reaction accuracy
3.[?] is difficult to describe

A

Evaporation of solutions

Absorb dyes/pigments

Color

170
Q
  1. Routine washing:
A

dilute bleach followed by drying in an oven, soaking in 20% Nitric Acid solution for 1224 hours and soak in Acid dichromate solution.

171
Q
  1. For blood clots:
A

soak in 10% NaOH

172
Q
  1. For new pipets:
A

soak in 5% HCl or 5% HNO3

173
Q
  1. For metal ion determination,
A

soak in 20% HNO3

174
Q
  1. For grease,
A

soak in any organic solvent or 50% KOH

175
Q
  1. For permanganate stains,
A

soak in 50% HCl or a mixture of 1% Fe2SO4 in 25% H2SO4

176
Q
  1. For bacteriologic glassware:
A

soak in 2-4% cresol solution followed by autoclaving and thorough washing.

177
Q
  1. For iron determination,
A

soak in 1:2 dilution of Conc. HCl solution or 1:3 dilution of Conc. HNO3.

178
Q

GENERAL WASHING PROCEDURES:
1. Soak glassware in soapy water or dilute bleach detergent Rinse with tap H2O 3X Rinse with dist. H2O oven dry @ > 140OC
2. Soak glassware in acid dichromate overnight rinse with dilute ammnonia rewash according to the procedure. Acid Dichromate preparation: Dissolve 50g sodium dichromate in 50 mL dist. H2O; Add to 500 mL conc. H2SO4
3. Soak glassware in 20% HNO3 for 12 – 24 hrs rewash according to the first procedure.

A
179
Q

: ✓ they are usually used to transfer volumes of 20 mL or less

A

PIPETS

180
Q

: is designed to transfer a KNOWN volume of liquid.

A

TRANSFER PIPETS

181
Q

✓ Is the most routinely used pipet in today’s Clinical Chemistry Laboratory.

A

Automatic (macro or micropipets)

182
Q

✓ Automated/self-automated

A

Automatic (macro or micropipets)

183
Q

✓ Advantages: safe to use, stable, ease of use, increased precision,

A

Automatic (macro or micropipets)

184
Q

✓ time-saveing, less cleaning required.

A

Automatic (macro or micropipets)

185
Q

✓ time-saveing, less cleaning required.

A

Automatic (macro or micropipets)

186
Q

= constant( determined from the angular velocity)

A

1.118 x 10-5

187
Q

= in cm ( measured from the center of the centrifuge axis to the bottom of the test tube shield or bucket)

A

r

188
Q

✓ The rotor looks like CROSS with bucket

A

Horizontal-head or swinging-bucket centrifuge

189
Q

✓ The surface of the sediment is flat

A

Horizontal-head or swinging-bucket centrifuge

190
Q

PIPET CLASSIFICATION ACCORDING TO DRAINAGE CHARACTERISTICS:

A
  1. BLOW-OUT
  2. SELF-DRAINING
191
Q

✓ Has a continuous etched ring or two small, close, continuous rings located near the top of the pipet.

A
  1. BLOW-OUT
192
Q

✓ No markings, the pipet is drained by gravity.

A
  1. SELF-DRAINING
193
Q

used as primary standard materials in the clinical laboratory.

A

Standard Reference Materials

194
Q

Should not be used in any quantitative analytic technique.

A

Pasteur pipet

195
Q

Has an etched-ring ( or pair of rings) near the bulb end of the pipet

A

Serological pipet

196
Q

used for tubings

A

Tygon

197
Q

Does not have graduations to the tip.

A

Mohr

198
Q

Does not have graduations to the tip.

A

Mohr

199
Q

Used for screw-cap closures

A

Polypropylene

Clinical Chemistry 1 (10 decks)

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