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
.