AMT basic Flashcards
Deca:
Deci:
Centi:
Milli:
Deca: 10^1
Deci: 10^-1
Centi: 10^-2
Milli: 10^-3
fastest turnaround time
WB
LDL calc
TC - (TG/5 + HDL)
TC= cholesterol
Centrifuge: head/rotor, carriers/shields
RCF: relative centrifugal force calc
centrifugar force depends on three factors…
recommended RCF and rpm/time
1.118 x 10^-5 x r x rpm^2
mass, speed, radius
1.118x10-5 is the angular velocity
AAB study guide says 1.18
RCF 1-1200 or 3500rpm 10-15min
Horizontal/Swinging:
fixed angle good to…
microcentrifuge for smaller than…
ultracentrifuge rpm, for….
Horizontal/Swinging:
horizontal when spinning
fixed angle good to…sediment small particles faster
microcentrifuge for smaller than…<2ml
ultracentrifuge rpm, for….150,000rpm, chylomicrons
Pipettes:
Semiautomatic: recalibrate…/yr with…
Most accurate pipette, has accuracy of…
Pipette that is rinsed after 1st liquid drains….
Pipette that drains by gravity, tip to side….
Pippette w/2 frosted bands……
Pipettes:
Semiautomatic: recalibrate…/yr with…
4x/yr, gravimetric(wt=vol, water) or volumetric(dye into water, spectropho)
Most accurate pipette, has accuracy of…
volumetric/transfer 1:1000
Pipette that is rinsed after 1st liquid drains….
TC to contain
Pipette that drains by gravity, tip to side….
TD to deliver
Pippette w/2 frosted bands……
blow out remaining drop
Inspected etc…
Centrifuges for time/speed w/NIST…
Calibrations:
automatic pipetters…..
BSA hoods, thermometers w/NIST….
CLIA lab inspections….
Inspected etc…
Centrifuges for time/speed w/NIST…6 mths
-use daily, need to do more often
Calibrations 6mths
automatic pipettes…quarterly, every 4 mths
BSA hoods, thermometers w/NIST….yearly
CLIA lab inspections….2yrs
Microscopes…best for
Brightfield…
Darkfield…
Electron…
Fluorescent…
Phase contrast…
Polarized…
Diff. interference contrast/DIC….
Microscopes…best for
Brightfield…white light, low contrast of bio
Darkfield…collect scattered light, spirochete
Electron…electrons,enlarged image, tumor markers, tissue
Fluorescent…high enery emits lower, ANA
Phase contrast…phase shifts, diff in refractive index/contrast, manual PLT cts
Polarized…transmitted polarized light, crystals
Diff. interference contrast/DIC….recominbation of light, 3D
2 electron microscopes for virology/cells
beam of electrons thru specimen, fluorescent screen/plate >100,000x
beam electrons strikes surface of specimen, photographic fil/cathode ray tube, 3D image >1000x
2 electron microscopes for virology/cells
tranmission
beam of electrons thru specimen, fluorescent screen/plate >100,000x
scanning
beam electrons strikes surface of specimen, photographic fil/cathode ray tube, 3D image >1000x
Temp calculations…
C to F:
F to C:
C to K:
95F=C
95C=F
C to F: 5/9 x (F-32)
F to C: (9/5xC) + 32
C to K: C+273
95F=35C
95C=203F
37C EQUALS…F
98.6F
M:E ratio
what is counted as myeloid, what isn’t
what is examples of erythroid
M:E
M=myeloid, blast count as myeloid
-not lymphs/monos
E=normo/erthroblast/rubricytes
The normal M:E ratio in adults varies from 1.2:1 to 5:1 myeloid cells to nucleated erythroid cells. An increased M:E ratio (6:1) may be seen in infection, chronic myelogenous leukemia or erythroid hypoplasia. A decreased M:E ratio (<1.2-1) may mean a decrease in granulocytes or an increase in erythroid cells. M:E ratios are somewhat higher in newborns and infancy than in later childhood and in adults. It is important to note that lymphocytes, monocytes and plasma cells are not included in the M:E ratio.
Molarity calc…
Normality calc…
Molary= gmv/L, want mol/L
Normality= 1 Eq(each H)/gmw
Osmality NV, calc
Osmolar gap…
Osmality 275-295, 1.86Na+Glu/18+BUN/2.8
Gap is measured-calculated
SD is the…
CV is a measure of…
calc…
acceptable CV…
QC is a measure of…
SD is the square root of variance
needs min 20 values
Square root of (sum of squared differences from the mean)/N-1
CV measures precision
SD/mean x100, <5% acceptable
QC measures reliability
Confidence intervals is probability of estimated range, degree of uncertainty
1SD=
2SD=
3SD=
acceptable SD for lab/ranges CTRLs are in….
Confidence intervals is probability of estimated range, degree of uncertainty
1SD= 68%
2SD= 95%
3SD= 99%
acceptable SD for lab/ranges CTRLs are in…2SD
-to find 1SD you find mean, diff on each side is 2SD/2
pH, Henderson equa…
normal pH…
bicarb:acid…
pH= pka + log (salt/acid) or (A/HA)
normal pH 7.4
bicard:acid 20:1
Beers law:
-concentration=energy absorbed A=abc
-transmitted in inverse=A=2-log%T
Concentration/absorbance calc…
Concen unk/Con Std = Abs unk/Abs std
Get Unknown on one side first
Who catergorizes/grades tests based on complexicity…
Who determines if test can be waived…
Most lab complexicity…
PPM is what complexcity…
High complexcity tests….
Who catergorizes/grades tests based on complexicity…FDA
Who determines if test can be waived…HHS
Most lab complexicity…moderate
PPM is what complexcity…moderate
High complexcity tests….
-modified FDA cleared
-LDT(lab developed)
-cytology
-serogrouping/gel immuno/electro/flow
-pap
Proficiency testing:
Required by…up to…/yr…
Not required for…
These two can inspect…
This dept approves PT program…
Keep copy of PT for…
Unsuccessful PT…
-common causes of failure….
Alternate PT testing….
Proficiency testing:
Required by CMS under CLIA, 3x/yr
Not required for…waived
These two can inspect…CMS, HHS
This dept approves PT program…HHS
Keep copy of PT for…2yrs (as most records)
Unsuccessful PT…
-SAME analyte in 2 CONSECUTIVE testing events or 2/3 testing events
-common causes of failure: clerical, instrument method/codes, calibration bias, late turn in
Alternate PT testing….
-SPLIT sample testing w/ref/other lab or established in house
-clin validation by chart review
-participate in ungraded/educational PT program
Most errors occur in …and….analytical areas
PRE: %, if oral need written w/in…
Analytical: %, most common error
POST: % most common error
Keep records for…BB for…Pathology for…
Most errors occur in pre and post phase
PRE: 46%, oral ok/written w/in 30 days
-Joint commision national PT safety std=need to PT ids
Analytical: 8%, specimen integrity
POST: 47%, clerical error
records 2yrs, BB 5yrs/products 6mths after expire/Pathology 10yrs
Warning error…what to do if 1CTRL is out…
Random errors due to…causes
Systemic erros due to these 3…
-name of gradual loss/drift from mean/causes
-name of abrupt change/causes
1st #=how many out consecutively
2nd #=SD
Warning error…what to do if 1CTRL is out…
-1-2S: repeat same CTRL
Random errors due to… 1-3SD, R-4S
-unpredictable, preventable
-pipetitng, electronics, HIL
-R4S= 2 concensutive outside 4SD
Systemic erros due to these 3…
-2-2S, 4-1S, 10x
-name of gradual loss/drift from mean/causes: deterioation, accumulation, aging
-name of abrupt change/causes: reagent/lot change, maintenance, temp
Steps in out of range CTRLS…
1.)if only 1-2S…
2)If still out…
3.)still out…
4.)
5.)
6.)
Steps in out of range CTRLS…
1.)if only 1-2S rerun same CTRL 1x
2)New vial CTRL/new lot
3.)reagents, maintenance, specimen
4.)recalibrate/redo ctrls
5.)assistance, document corrective action
Safety training/Blood borne training/Chenmical hygiene/TB plan done…
-safety records kept…
DOT training w/in…every….
Safety/blood borne/chemical hygiene 1yr
-safety records kept 3yrs
DOT w/in 90 days, 3 yrs
NFPA HAZMAT DIAMOND COLORS/MEANING
Health: blue
Flamability: red
Instability: yellow
Special: white
-W: water reactive
-OX: oxidizer
Hazard Communication Std requires….on labels to alert…
examples…8
requires pictograms on labels to alert chemical hazards
-Health
-Environment
-Skull crossbone
-gas cylinder
-flame over circle
-exploding bomb
-flame
-exclamation mark
Health pictogram/Human: takes time, toxicity(not acute), cancer causing…6
Health: toxicity
-carcinogen, mutangenicity
-reproductive/organ toxicity
-respiration/aspiraton toxicity
Corrosion/hand-item: 4
Corrosion:
-skin corrosion/burns
-eye damage
-metal corrosion
Flame over circle: 1
flame over circle=oxidizer
Skull crossbone: 1
Skull cross bone
-acute toxicity/fatal
exploding bomb: 3
exploding bomb
-explosives
-self reactive/organic peroxides
exclamation mark: 6
often irritants/sensitizer
exclamation mark:
-skin/eye/respiratory irritant
-skin sensitizer
-acute toxicity
-narcotic affect
-ozone layer
Environment/fish:1 optional
aquatic toxicity
Flame: heat/flame 6
Flame/heat:
-flammables, pyrophorics
-emits flammable gas
-self heating, self reactives
-organic peroxides
TB plan reviewed…Class…BSC…
Plan to protect employees from heath hazards with hazardous chemicals…
Std related to blood/BF and contaminated items…
Plan that lays out potential risks, measures taken if exposed to bloodborne pathogens….
Universal precautions:
-all PTs/blood/BF/tissues/needles potentially infectious and contaminated with these 3…
-examples of BF that can spread these…
Primary mode of infection throgh these 2..
Post exposure testing…save blood for…
TB plan review anually, Class 2 BSC
Plan to protect employees from heath hazards with hazardous chemicals…
-Chemical hygiene plan
Std related to blood/BF and contaminated items…Bloodborn pathogen std
Plan that lays out potential risks, measures taken if exposed to bloodborne pathogens….exposure plan
Universal precautions: HIV, HBV, HCV
-blood, semen/vaginal, CSF/synovial/serous, amniotic, salive in dental, unfixed tissue/organs
primary mode:
-puncture/broken skin, contact
-mucous membrane
Hep B vaccine: available 10 days employment
Post exposure testing:
-3,6,12mths
-save blood 90days
HIV:
-dominant one, grps;
-slower, grps:
-incubation average:
-AIDs CD4 <, TH/Tctyo, category:
-Bacteria:
-Fungal:
-Viral:
-Parasites:
-Testing:
-Treatment:
HIV:
-dominant one, grps: HIV1, M,N,O
-slower, grps: HIV2 A,B
-incubation average: 18mths
-AIDs CD4 <, TH/Tctyo: <200, 1:2, 0.5, cat3
-Bacteria: mycobacterium
-Fungal: crypto neo, canida
-Viral: HBV, EBV, CMV, HSV
-Parasites: Pneumocystis, Crytpsporidium, Toxcoplasma
-Testing: Qual/ELISA, Quant/RNA NAT
-Treatment: HAART, AZT
How many classes of Biosafety Cabinet(BSC)..
One lab use…
Certified…and then…
There are 3 but 2 has two subclasses
Class 2a
Certified upon installation, then annually
Class BSC completely closed, neg pressure, most protection
-air coming in is filter sterlized, rubber gloves
Class 3
Class BSC that only sterilizes air being exhausted, ventilated outside, negative pressure
Class 1
Class BSC that most labs use:
-self contained, laminar flow, sash
-air exhausted and over material sterilized
-air recirculated thru HEPA
Class 2a
Class BSC used for radioisotopes, toxic chemicals, carcinogens
Class 2b
BioSafety cabinets
BSC 1
-exhaust air sterlized, neg pressure
BSC 2
-exhause+material air sterlized
-laminar flow, sash
a. most labs use, HEPA filter
b. radioisotopes, toxic chem, carcinogens
BSC 3
-most protecting, closed with gloves
-air coming in filtered
How many BSL biosafety level are there…
One that most std micro labs use..
4
BSL 1
BSL due to dangerous, aerosol trasmitted, fetal, no vaccine/treatment
-all precautions of other BSL plus clothing change/shower/decontamination
-most organisms are…
BSL 4
ebola, lassa, marburg viruses
BSL for indigenous, serious/letal thru inhalation
-controlled access, decontamination
-example microbes
BSL 3
-TB, Brucella, Y.petis, antracis, C.immitis
BSL most used in std micro labs:
-not usually cause of disease
-2 examples of microbes
BSL 1
B.subtilis(dry heat QC), E.coli
BSL used when theres risk of sharp injury, ingesting, mucous membrane
-biohazard signs, sharps precautions,manual
-example microbes
BSL 2
-S.aurea, Ecoli H157, Kpneumo, HBV/HIV
Biosafety levels
BSL 1:
-most common in lab, not likey issue
-B.subtilis, E.coli
BSL 2:
-sharp/ingest/mucous route
-warning signs/sharps, manual
-Common pathogens: S.aureus, EcoliH157, Kpneumo, HBV/HIV
BSL 3:
-indigenous, serious/lethal, inhale
-controlled access, decontamination
-TB, Brucella, Y.petis, anthracis, C.immitis
BSL 4:
-most letal, no vaccine/treatment, aerosol
-virus: eboal, lassa, marburg
.
Chlorine, propane, nitrous oxide, CO2 all examples of…
liquified compressed gas
oxygen, nitrogen, helium, argon all examples of
nonliquified compressed gas
acetylene example of
a colorless pungent-smelling hydrocarbon gas, which burns with a bright flame, used in welding and formerly in lighting
dissolved compressed gas
Flashpt F/C..
lowest temp a vapor of flammable liquid can be ignited into air
examples…
keep in…
<100F/37.8C
acetone, ethanol, methanol, xylene
flammable liquid safety cabinet
Environmental CTRLS:
safety color coding…
all usually color with black letters
Red code for, examples…
Yellow code, example…
Orange code, examples….
Environmental CTRLS:
safety color coding…
Red code for, examples…
-fire, danger, stop: fire pull, biomed)
Yellow code, example…
-caution: radiation
Orange code, examples….
-warning: biohazard, infectious agent(fluoursecent orange)
NFPA color coded labels recommended by OSHA..
red diamond:
yellow diamond:
blue diamond:
white diamond:
NFPA color coded labels recommended by OSHA..
red diamond: fire
-0=won’t burn, 4=flashpt <73F
yellow diamond: reactivity
-0=stable, 4=detonate
blue diamond: health
-0=normal, 4=death
white diamond: specific
-ACID, ALK, COR, OXY
-radioactive, use no water
Class Fires/Extinguishers how many classes
4, A-D
Class fire/extinguisher with combustible metals…
examples of metals..
Class D combustible metals
Mg,Li,Na, K
yellow decagon, no #
Class fire/extinguisher with energized electrical equipment…
examples..
Class C energized electrical equip
analyzers, wiring, outlets
blue circlen no #
Class fire/extinguisher with ordinary combustible..
examples..
Class A
paper,wood,cloth, some rubber plastic
green triangle, # is amt of water
Class fire/extinguisher with flammable/combustible liquids..
examples..
Class B
gases, greases, some rubber/plastic
acetone,ethanol,methanol, xylene
red square, # is sq ft can extinguish
Fire/extinguisher acronyms…
Fire acronym…
Extinguisher acronym…
Fire: RACE to the fire
-R: rescule
-A: alarm, call operator
-C: contain
-E: extinguish or evacate
Extinguisher: PASS the extinguisher
-Pull the pin
-Aim at base
-Squeeze
-Sweep side to side
Regulates disposal of waste…
DOT HMR used in most labs…
EPA
DOT HMR: cat B
-not in form cause harm/fatal, triple packing
Federal law defines min wage, OT, how to be paid…
-exempt versus nonexempt:
Law prohibits discriimination, Title 7:
Law that prohibits discriminatin w/disabilities:
Law that allow for continued health insurance when retire/resign/laid off/chage to PT…
Law that protects health insurance when changing jobs and protects health info…
Federal law defines min wage, OT, how to be paid…Fair Labor Std Act
-exempt: salary, nonexempt hourly
Law prohibit discriimination,Title 7:
Civil right
Law that prohibits discriminatin w/disabilities: Americeans Disabilities act
Law that allow for continued health insurance when retire/resign/laid off/chage to PT…COBRA 18/36mths
Law that protects health insurance when changing jobs and protects health info…
-Health Insurance Portability and Accountablity Act
If get PLT ct and volume and want new concentration and volume use…
C1xV1=C2xV2
Competency for high complexity done
Initially, 6mths, 1yr, annually
2 accredidate healthcare organizations, 1 of them accrediates programs
JCAHO
CAP
EDTA prevents clotting by chelating
Ca2
Heparin prevents clotting by neutralizing
thrombin
prevents hemolysis
Sodium citrate prevents clotting by binding
Ca2
Order of draw for evacuated tubes/filling from syringe…6 tubes
blood culture
blue
red/gold
green
EDTA
gray
Order of draw microcollection from capillary 4 tubes
blood gas
pink
other
serum
increased specificity means decreased…
false positive
good for confirmatory
Increased sensitivity means decreased … …
false negs
good for screening
true pos
false pos
true neg
false neg
true pos: pos who has disease
false pos: pos who doesn’t have
true neg: neg who doesnt have
false neg: neg who has
Total pos/Total pos+False neg x 100
diagnostic sensitivity
w/disease test pos
total neg/total neg+false pos x100
diagnostic specificity
w/out disease test neg
total pos/total pos+false pos x100
positive predictive value
time that a pos is correct
total neg/total neg+false neg x100
negative predictive value
time a neg is correct
Volumetric accuracy
1:1000
PT required by… Under…
PT done…/yr
% to pass in lab, % BB etc
Fail PT
Copy of PT kept ..
PT required by CMS Under CLIA
PT done 3x/yr
80% to pass in lab, 100% BB etc
Fail PT:
2 consec, same analyzer or
2/3 events
Copy of PT kept ..
Inspection of accredited land by CMS, HHS every
oSHA SAFETY EVERY…KEPT…
INSPECTION CMS/HHS 2 years
OSHA SAFETY YEARLY,KEPT 3 YRS
Blood borne path training yearly
Opportunisitc pathogens in HIV:
Parasites
Opportunisitc pathogens in HIV:
Parasites
-crytosporidium
-pneumocystis
-toxoplasma
viral
-HBV, CMV, EBV, HSV
Fungal
-candida
-Cryptococcus
Bacteria
-mycobacterium
Hep A: fecal/oral, vaccine
HepB: sex/iv/trans, mostly
asymptomatic, vaccine
HepC: sex/iv/trans, ALT
HepD: iv/hemophil, needs HBV
Hep E: epidemic/sporadic developing countries, similiar to A fecal.oral
….
Hep markers order 6
-HBV DNA
-HBsAg
-HBeAg
-anti-HBc
-anti-HBe
-anti-HBs
Hep B
first detected..using…HBV DNA,NAT
acute/infectious…HBsAg,HBeAg
viral rep/most infectious….HBeAg
previous infection/recovery..anti-HBc
infection resolving,immunity…anti-HBs
vaccination…anti-HBs
Two types HIV…
3 groups…
incubation period…mths
aids ct….
cd4:cd8 normal… HIV…
test ELISA HIV1/2, if neg no need test further, if reactive diff between two with NAT
Two types HIV…1 dominant, 2 slower
3 groups…M,N,O
incubation period…mths
aids ct….18ths, 200cell/microL
cd4:cd8
normal…>1.5
HIV…<0.5
BSC: 1,2,3
Bioterrrism: A,B,C
BSL: 1,2,3,4
BSC: 1,2,3
1 least protective
2A labs use, certified yearly
3 most protective
Bioterrrism: A,B,C
A: highest priority, rare, easily diss
-smallpox,plague, botulism
B: moderate, salmonella,typhus,vibrio
C: emerging, nipah,hanta
There is no D!
BSL: 1,2,3,4
1: cause least disease (e.coli, subtiliis)
2: disease thru cut etc, HIV
3: inhalation (tb), immitis, anthracis
4: aerosol, fatal, no vacccine (ebola)
centrifuge speed: 6mths
thermometers checked: yearly
BSA hoods: yearly
automated pippetes: 4x year/quarterly
What is the order of draw for multiple evacuated tubes?
Blood culture (aerobic)
blood culture (anaerobic),
blue
red,
green stopper
lavender,
gray
When collecting multiple tubes of blood, a specified “order of draw” protocol needs to be followed to diminish the possibility of cross contamination between tubes caused by the presence of different additives. Errors in the order of draw can affect laboratory test results.
Order of draw for BD microtainer
Lavendar
green/mint green
grey
gold
red
Capillary order of draw: 4
Blood gases
EDTA
other additive mini
serum
3 LAYERS of anticoagulated blood and they’re components/%
Top: 55%
plasma
-90% water
-10% solutes
middle: 1%
buffy coat
-WBC,PLT
bottom: 45%
rbc
BLUE: 3.2% citrate, 1:9, anticoag/blood
RED: plastic/none, glass/silicone
GREEN: heparin, inhibits thrombin, Xa
chem,ph,gasca
LAVENDAR/PINK
K2EDTA: dry
K3EDTA: liquid
-chelates Ca, helps prevent RBC shrinkage
GRAY: flouride,inhibits glycolysis
standard gauge for syringe, tubes…21gauge
- ID patient
2.assemble at beside
3.gloves
4.select, prepare site with alcohol,dry - one hand hold tube, arm downward, need 1-2in below site, 20degrees, tourniquet ,1
3 veins;
cephalic, basilic, median cubital
Capillary blood collection:
puncture perpendicular once, wipe 1st drop
fingertip, 3rd/4th finger
heel
big toe
earlobe adults last resort
infants:
medial/lateral plantar/sole heel
or big toe
managment philosophy focuses on satisfying customers thru empowering employees to be an active part of continuous quality improvement
systematic
TQM
total quality management
system of internal and external reviews and audits of all aspects of an EMS system
continuous, incremental
CQI
continuous quality improvements
is an activity designed to id and resolve work task-related problems that yield poor quality
PI
performance improvement
universal precautions;
blood/BF of all people infectious until proven otherwise
standard:
Updated version of universal, Include Universal precautions and body substance isolation and assume that all blood, BF, secretions may be infectious and apply to all patients
centrifugation for blood RCF, rpm, min
1-2,000 rcf
3500rpm
10-15min
calibrate ocular micrometer:
- put stage micrometer on stage
- focus micrometer
- line up left edge of micrometer with left edge of stage micrometer
- adjust field so 0 line of ocular micrometer is superimposed on 0.0 line of scale
- find furthest point to right where a line on ocular micrometer lines up with a line on stage micrometer
- count # divisions on ocular micrometer per mm or micrometer on stage
Linearity
Linearity is the ability to provide laboratory test results that are directly proportional to the concentration of the measurand (quantity to be measured) in a test sample.
Blood culture collection
2-3 sets w/in 24hrs, can be separate sites or time intervals, aerobic 1st then anaerobic
10-20ml per bottle
clean with alcohol then povidine iodine
6-18hr incubate at 35C
checked daily for 7 days
range in which 95% of pop falls, random samples from normal pop fall within 2S range
ref range, normal range
Calculation that doesn’t change concetration:
unit wt 1/unit vol 1 =unit wt 2/unit vol 2
make 500ml of 0.5% NaOH
-0.5/100= x/500
N=Mx valence (H)
0.4 N H3PO4 is 0.4/3=.13M
measures total number of dissolved particles in sln; size/density/type doesn’t matter
freezing point depression
alcohol can increase
separates mixture into individual components based on physical characteristics
5 types
Chromatography
1.) liquid-liquid (aqueus,organic)
2.)ion exchange (wt,size,charge)
3.)gas-liquid (volatility, rate diffusion)
-blood alcohol, drugs abuse use w/MS
4.)Thin layer(Rf sub/solvent)
5.)high performance liquid(pumped thru columns under high pressure)
Method to separate proteins on charge and size
direction on isoelectric point and pH of buffer
cellulose acetate most common
can separate
aminos, serum proteins, lipo,glyco,nuclei,hmg, isoenzymes
3 types of electrochemistry methods
potentiometry: voltage, diff between ref and indicator, pH/glass, K valinomycin
amperometry: current flowing, O2 electrode, platinum
coulometry: titration, Ag+ ions cause tiration to stop; Cloride
Method/name of cell passing thru current creating pulse=cell size
MCV meausred directly=cell size
RBCs/PLTs counted in RBC bath
WBC/nRBC counted in WBC bath
electronic impedance/Coulter
Optical scatter, 5pt diff light scatter…
forward/side…
Flow cytometry
forward cell size
side interior
RBC
left shift..
right shift…
leftshift microcytes
right shift macrocytes
Method that uses light in a fluid medium to measure cells
laser excites fluorochrome
forward scatter is diffraction/refractions=size
side scatter is reflection=granularity
air displacement: air remains between the piston and the liquid.
Positive displacment:piston is in direct contact
Osmolality=mOsmol/kg of H2O
Normal range 275-295 mOsm/kg
1.86(NA) + GLU/18 + BUN/2.8.
-NA, GLU, BUN , 1.86, 18, 2.8
Osmolality of
NA 150
Glu 180
BUN 14 294 mOsmol/kg
Proficiency testing is required by CMS under CLIA, approved by HHS
Usually done 3 times per year, keep 2yrs
80% lab/100% BB
2/3 fail or 2 consec same analyte
EEOC equal employment opportunity
commission
FLSA fair labor standards act
title 7 civil rights act ACT of 1963 prohibiting discrimnation,
FMLA
12 weeks unpaid job leave in 12mth period
COBRA
consolidated omnibus budget reconcilation act Act that provide health insurance
18 or 36mths
expect for gross misconduct
HIPAA health insurance
portability and accountability act
Race: rescue, alarm/call, contain, extinguish
Pass: pull, aim, squeeze, sweep base
Nongausian skewed pos or neg, skews alter these two, but not this
Alter mean and median, not mode
Immunoassay/immunochemical use ab to bind ag of intereste visa/versa
Immunoprecipitation/agg: clumping of ab particles to which specific antigenic labels are attached
Immunoelectrophoresis:
immunoprecipitation in which ag are separated by migration in electric field, followed by ab reaction by immunodiffusion
Immunodiffusion:
spreading movement of ab and/or ag in suport medium
Immunofixation:
western blot
Heterogeneous IA: liquid/solid phases to separate
Homogenous IA: labeled analyte does not require separation of bound free ag
Radioimmunoassay: RIA
Enyzme mulitiplied immunoabsorbent assay: ELISA
Immunofluoresence/fluroimmoassay
Immunohistochemistry
Nephelometry:
light scattering ag/ab aggregation
Anion gap: cations-anions
Na+K minus Cl+CO2 =10-20
…
Anion gap: cations-anions
Na+K minus Cl+CO2 =10-20
…
