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AMT Lab/Phleb basics > AMT Lab/Phleb basics > Flashcards

AMT Lab/Phleb basics Flashcards

1
Q

Centrifugal force depends on 3 variables…

and separates based on…

A

mass, speed, radius

density

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2
Q

speed expressed as…

force generated express as…or…

angular velocity value…

r=

A

revolutions/min(rpm)

relative centrifugal force/RCF or gravity (g)

1.118x10*-5

r=radius in cm from center of axis to bottom

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3
Q

Equation for speed of centrifuge related to RCF/RCF=

A

1.118x10*-5 x r x (rpm)’2

*10 to neg 5
*2=squared

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4
Q

CLSI

A

clinical and lab standards institute

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5
Q

CLSI recommend blood be centrifuged at an RCF of…or…for…min

A

1,000-1200xg

OR

3500 rpm

for 10-15 min

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6
Q

…or… centrifuge where tubes are horizontal position when spinning and in a vertical position when stopped

A

Horizontal head or swinging bucket

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7
Q

…or…centrifuge where tubes are at angle in sample bucket, allowing small particles to sediment faster

A

fixed angle or angle head

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8
Q

Centrifuges that separate small liquid samples of <=2mL in plastic conical shaped containers w/integral snap cap

A

microcentrifuges

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9
Q

High speed centrifuge up to 150,000rpm to separate chylomicrons from serum

A

ultracentrifuge

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10
Q

strobe light determines…

A

speed

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11
Q

Check speed of centrifuge with…or….
every…

A

tachometer or strobe light, every 6mths

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12
Q

NIST

A

national institute of standards and technology

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13
Q

Check time with…timer, every…

A

NIST traceable timer, 6mths

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14
Q

centrifuge used to sediment small particles faster

A

fixed angle/angle head

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15
Q

centrifuge used to separate chylomicrons from serum

A

ultra

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16
Q

Glassware/plasticware must fall into class…or….
Institute that recommends tolerance limits…

Preferred glassware class…
Usually made of… …

A

Class A, B
NIST recommended

Preferred is A and made of borosilicate glass

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17
Q

Pipette that is electronic, prepare multiple samples…

Pipette that are handheld, disposable tips w/air displacement or positive displacement

A

Automatic pipette

semi-automated pipette

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18
Q

Mechanism of action which relies on a piston for creating suction to draw the sample into a disposable tip that’s changed after use

A certain volume of air remains between the piston and the liquid.

A

air displacement

ie. pipettes used in lab

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19
Q

Mechanism of action which has a moving piston in pipepette tip or barrel much like a hypodermic syringe, doens’t require a different tip and is used as a dispenser.

The piston is in direct contact with the liquid.

A

Positive displacment

ie. osmo pipette

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20
Q

Which pipete requires recalibration…
how often per year…

Two methods used to calibrate…

A

automatic pipettes, 4x/yr
Semiautomatic also uses this method

gravimetric and volumetric

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21
Q

Calibration that verifies accuracy by the amt of water dispensed by pipette.
Weight of water is proportional to the volume dispensed.
Weight=volume

Accuracy of volume is dispensed and adjusted accordingly to the weight

A

Gravimetric

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22
Q

Calibration that verifies accuracy of amt of dye thats pipetted into a specific volume of water and is read spectrophotometrically.
absorbance=amount

A

volumetric

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23
Q

Which class of glassware doesn’t need to be recalibrated

A

A

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24
Q

Handheld that require bulb to apply suction

A

manual

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25
Q

…or… is glass pipette that has a bulb in the middle w/tapered delivery tip

accuracy is 1:….

A

transfer or volumetric

1:1000

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26
Q

..or…Pipette thats uniform in diameter w/tapered delivery tip

A

measuring or graduated

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27
Q

Pipettte with two frosted bands

A

Last drop blown outb after pipette drains

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28
Q

Pipete must be rinsed w/solvent after first liquid has drained

A

To contain, TC

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29
Q

Pipette filled and allowed to drain by gravity. Held vertically, tip placed against side of vessel

A

To deliver, TD

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30
Q

Pipette filled, drained and remaining fluid in tip blown out, has two frosted bands at top

A

blow out

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31
Q

Pipette held in vertical position w/tip against vessel and drained by gravity

A

self draining, ie. TD

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32
Q

Organization that maintains standards for temps

A

NIST
national institute of standards and tech

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33
Q

Thermistor probe is also called

A

an electronic probe

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34
Q

3 types of thermometers

A

mercury/liquid in glass
digital
electronic/themistor probes

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35
Q

Gold/platinum thermometer calibrated on international temp scale w/lead wires and sheath

A

NIST
Standard ref material
(SRM)

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36
Q

All NIST certified thermometers come with a…

NIST traceable thermometers come with

A

NIST cert of calibration

NIST cert of traceability.
certificate issued by manufacturer

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37
Q

Temp for incubators, heat blocks, water baths

A

36-38C

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38
Q

RT

A

20-24C

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39
Q

Lab fridge…
BB fridge…

A

lab 2-8C
BB 1-6C

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40
Q

Lab freezer…
BB freezer…

A

lab <= -20C
BB <=-65C

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41
Q

Sln can use as alternative to lens sln…

sln not to use…

A

can use methanol, not xylene

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42
Q

Absorbance can be calculated easily from percent transmission using which calculation?

A

2 – log10 %T

Absorbance can be calculated easily from percent transmission using 2 – log10 %T. If all the light passes through a solution without any absorption, absorbance is zero and the %T is 100%. If all the light is absorbed, %T is zero, and absorption is infinite.

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43
Q

Most common microscope, white light illuminates sample from below…

limitation…

A

brightfield

low contrast of biological samples

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44
Q

Which immunoassay methodology is the emission of light by molecules in an excited state with a limited amount of heat as the result of a chemical reaction?

A

Chemiluminescence is the emission of light by molecules in an excited state with a limited amount of heat (luminescence) as the result of a chemical reaction. Chemiluminescent assays are ultrasensitive and are widely used in automated immunoassays and DNA probe assay systems. Chemiluminescence has excellent sensitivity and dynamic range. Chemiluminescent labels can be attached to an antigen or an antibody. Most chemiluminescent reagents and conjugates are stable and relatively nontoxic.

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45
Q

Microscopy improves contrast of unstained, transparent. Quantity of unscatted light/directly transmitted is minimized collecting only light scattered by sample… the field around the specimen (i.e., where there is no specimen to scatter the beam) is generally dark.

Good to view…

A

Darkfield

spirochetes

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46
Q

Uses electrons to illuminate and creates enlarged image.
Creates higher resolving power and higher magnification.
Uses electrostatic and electromagnetic lenses.
Focuses on a specific plane…

Good to view…or… …

A

Electron

tissue or tumor markers

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47
Q

Uses fluorescense. High energy light illuminates, emits light of lower frequency.
Dyes used to stain structures…

Good to view…

A

Fluorescent

ANA

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48
Q

Small phase shifts in the light passing thru transparent specimen showing differences in refractive index as diff in contrast…

An optical microscopy technique that converts phase shifts in light passing through a transparent specimen to brightness changes in the image. Phase shifts themselves are invisible, but become visible when shown as brightness variations.

Good to view…

A

phase contrast

manual PLT cts

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49
Q

Only transmits polarized light

good to view…

A

polarized

crystals

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50
Q

Gives 3D image. brightfield can be modified into this. Two split beams of light are polarized and recombined by objective prism.
Recombination gives 3D

A

Differential interference contrast

Differential Interference Contrast (DIC) is a phase contrast technique that allows transparent structures to be visualized by exploiting changes in refractive index. In contrast to conventional phase contrast techniques, which are based on changes in optical path length, DIC is based on the gradient of the optical path length (rate of change in wavefront shear). Steep gradients produce the high contrast and 3-D relief effect that is characteristic of DIC.

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51
Q

Magnification of:

eyepiece..

low power objective…
high power objective…
oil immersion objective…

A

eyepiece: 10X

low: 10x
high:40x
oil: 100x

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52
Q

Knob to move slide right and left…

knob to move stage forward and backward…

A

slide right/left:
x axis motion knob

stage forward/backward:
y axis

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53
Q

Rotating disk under stage to vary intensity/size of cone of light

A

iris diaphram

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54
Q

Focuses light onto specimen

A

condenser lens

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55
Q

part that connects the eyepiece to the revolving nosepiece/lenses

A

tube

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56
Q

holds objective lenses

A

nosepiece

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57
Q

focuses light onto specimen, can move up and down

A

condenser lens

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58
Q

English units of measurement

3 for length..
1 mass..
4 for volume…

A

length: inch,foot, yard

mass: lb

volume: cup, pint, quart, gallon

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59
Q

Metric system is based on decimal system, multiples of ten

length…
mass..
volume…

A

length: meter
mass: gram
volume: liter

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60
Q

luminous intensity in SI

A

candela

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61
Q

International System of Units/SI worldwide standardized system, recommended by CLSI

Length:
Mass:
Time:

amt sub:
temp:
electric current:
luminous intensity:

A

Length: meter
Mass: kg
Time: sec

amt sub: mole
temp: Kelvin
electric current: ampere
luminous intensity: candela

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62
Q

Deka

A

Deka…10*1

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63
Q

Hecto

A

Hecto…10*2

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64
Q

Kilo….

A

Kilo….10*3

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65
Q

Mega..

A

mega: 10 *6

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66
Q

giga

A

giga 10*9

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67
Q

Deci

A

Deci: 10*-1

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68
Q

centi..

A

Centi:10*-2

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69
Q

milli

A

milli: 10*-3

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70
Q

micro

A

micro: 10*-6

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71
Q

Nano:

A

Nano: 10*-9

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72
Q

pico

A

pico: 10*-12

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73
Q

femto

A

femto: 10*-15

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74
Q

Celcius from farenheit

A

5/9x (F-32)

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75
Q

Farenheit from Celcius

A

(9/5)C +32

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76
Q

Kelvin from Celsius

A

C+273

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77
Q

95F to C

A

5/9x(95-32)=35C

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78
Q

95C to F

A

(9/5x95)+32=203F

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79
Q

95C to Kelvin

A

95+273=368K

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80
Q

BUN/Creatinine ratio
BUN 24.0
Creatinine 2.4
Give ratio

A

10:1

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81
Q

CHOL/HDL ratio
TC 200
HDL 40

A

5:1

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82
Q

Which cell lines aren’t included in the Myeloid part of M:E calculation

Which cell line is included in Erythroid ratio

A

Lymphs and Monos

Normoblasts

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83
Q

Write fraction, 1 pt solute to 1 part diluent

A

1/2

2 is total volume

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84
Q

pt:pt is

A

pt analyze + total parts (including diluent)

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85
Q

1:1 dilution=

1:2
1:5

A

1 pt serum+0 pt diluent

1:2 1 pt serum + 1 pt diluent
1:5 1 pt serum + 4 pt diluent

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86
Q

1:2, 1:4, 1:8 etc is a

1:5, 1:25, 1:125 is a

1:10, 1:100 is a

A

two fold, x2

five fold, x5

ten fold x 10

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87
Q

5% w/w sln equals how much solute to total solution

How much diluent is added

A

5g solute per 100g total solution

95g diluent added to 5g making 100g sln

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88
Q

Make 100g of 5% w/w sln of NaCl

A

5g/100g is 5% w/w,

5/100x 100g wanted=need 5g NaCl to 95g diluent to make a total of 100g sln

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89
Q

10% w/v sln equals how much solute to total sln

A

10g of solute to 100mL of total sln

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90
Q

Make 1,000 ml of 10% w/v of NaOH

A

10% w/v = 10g/100ml
x 1000mL= 100g of NaOH to add to 900ml diluent to get 1000mL total

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91
Q

2% v/v equals how much solute to sln

A

2ml/100ml

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92
Q

Make 50mL of a 2% v/v of HCl

A

2% v/v = 2ml/100ml
x50ml=1ml of HCl added to 49ml diluent equals total of 50ml

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93
Q

Molarity/M

A

Have g/L, covert to mole/L by get gmw
g/L x mole/L= M

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94
Q

40g NaOH/L, what is molarity?

A

1 mole NaOH is 40 GMW,
40g/L x 1 mole/40 =1mol/L=1M

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95
Q

Nomality (N)

A

N=Equivalent/L

1 Equivalent=gmw/valence

Valence is # of H

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96
Q

Osmolality=mOsmol/kg of H2O

Normal range…

calculation…

A

Normal range 275-295 mOsm/kg

1.86(NA) + GLU/18 + BUN/2.8

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97
Q

Osmolality of
NA 150
Glu 180
BUN 14

A

294 mOsmol/kg H2)

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98
Q

Osmolar gap

A

measured-calculated

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99
Q

Concentrated Slns

C1V1=C2V2
1 is, 2 is

A

1 is known
2 is unknown

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100
Q

PT has 350 PLT ct, how many mL of it needed to get 7mL of with concentration of 250

A

350x?mL=250x7=5mL

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101
Q

Ratio of SD of a distribution to its arithmetic mean.
Used to express precision and reproducibility of an assay

A

Coefficient of Variation, CV

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102
Q

Coefficient of Variation, CV used to express…and…

Acceptable CV is…

A

Used to express precision and reproducibility of an assay

Less than 5% for most analytical systems

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103
Q

/X is

A

mean

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104
Q

CV formula

Mean is 200, SD is 5, calculate CV

A

SD/Mean x 100

5/200 x 100 =2.5%

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105
Q

Gives an estimated degree of uncertainty. Probability of estimated range…

expressed as..

A

Confidence interval

percentage

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106
Q

Mean +- 1 SD=
Mean +- 2 SD=
Mean +- 3 SD=

A

1SD 68%
2SD 95%
3SD 99%

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107
Q

Given mean (/X) is 9.8, 1 SD is 0.2, calculate 95% confidence limits for control run with mean +- 2SD

A

1SD= 9.8 +- 0.2
2SD=9.8 +- 0.4, 9.4-10.2

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108
Q

pH formula

A

pH=pKa +log (base)(acid)
(salt)(acid)
(HCO3)(H2CO3)

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109
Q

Diff between cations and anions…
cations..
anions…

calculation

A

anion gap

cations: Na, K
anions: Cl, CO2

Na+K - Cl+CO2

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110
Q

Law that states concentration of sub is directly proportional to amt of radiant energy absorbed or inversely proportional to the logarithm of the transmitted radiant energy

2 formulas:
proportional to absorbed
versus
indirectly proportional to transmitted…

A

Beers Law

A=abc

A=2-log%T

Con unk/Con std = Abs unk/Abs std

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111
Q

Formula for known/unknown absorbance…

A

Concentration of unknown=
AbsUn/AbsStd x ConcenStd

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112
Q

Abs of 6.0g std is 0.40, abs of unknown is 0.350, concentration of unknown?

A

0.350/0.40 x 6.0

5.25g

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113
Q

Chain of custody things needed…

A

PT consent, security seal, to addresee only
store in locked area

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114
Q

Examples of chain of custody

A

alcohol levels for DUI
DOT drug testing
paternity, DNA
Rape
Medical examiner

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115
Q

Digital version of patient medical history/date

A

EMR
electronic medical record

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116
Q

Series of computer network that interconnects computers in a limited area like hospital, using network media

A

LAN
local area network

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117
Q

A computer network that interconnects computers in a broad area such as international, using private or public network trainsports

A

WAN
wide area network

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118
Q

Comprehenstive integrated info system to manage medical, admin, financial, and legal aspects of a hospital/services

A

HIS
Hospital info system

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119
Q

Computer software providing services to software apps beyond those available to the operating system

Software that lies between an operating system and the applications running on it. Essentially functioning as hidden translation layer, enables communication and data management for distributed applications.

A

Middleware

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120
Q

Computerized process for healthcare providers to electronically enter and order medical procedures/lab tests based on predetermined logarithm

A

CPOE
computerized provider order entry

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121
Q

CLIA stands for

A

clinical laboratory improvement amendments

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122
Q

CDC stands for

A

centers for disease control

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123
Q

CMS stands for

A

centers for medicare/medicaid services

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124
Q

Program that establishes quality standards for all labs…

Published by…and…

A

CLIA

plublished by CDC and CMS

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125
Q

Organization that categorizes and grades testing based on the complexityof testing

A

FDA

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126
Q

Two criteria to be waived test

A

cleared by FDA for home use

simple/accurate as to pose no reasonable risk if performed incorrectly

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127
Q

Examples of waived

A

blood glucose/cholesterol
urine prego, dipstick/tablet urinalysis
ovulation

nonautomated ESR
spun HCT

Hmg copper sulfate
Hmg by single analyze instruments

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128
Q

Who determines if a test meets criteria for being a waived test

A

HHS
Dept of Health and Human Services

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129
Q

Complexity?

-manual procedures w/limited steps
-microscopy of urine sediment
-automated heme w/out diff
-primary culture set up
-urine culture/colony ct kits
-gram

A

moderate

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130
Q

To be categorized as PPM, provider performed microscopy, must meet criteria

A

-physician, supervised midlevel practioner, dentist
-moderately complex

-main instrument is a microscope
-control materials not available

-specimen is labile, delay would affect results
-need limited handling/processing

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131
Q

Examples of PPM tests

A

-direct wet mt preps, qualitative semen
-KOH preps
-pinworm, fern
-postcoital direct, qualitative
-urine sediment

-nasal smears wbc, fecal wbc

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132
Q

3 criteria for high complexicity

A

-any modified FDA cleared test
-lab developed test/LDT
-cytology

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133
Q

Complexity?

-serogrouping/typing
-manual procecures w/multiple steps/reagent prep
-concentration/diff staining

-antimicrobial testing

-gel immunochemical
-electrophoresis, flow

-pap smear

A

high

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134
Q

These two can conduct an inspection of any accredited lab that’s issued a certificate of accreditation…

How often CLIA requires…

A

CMS, dept of HHS

2yrs

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135
Q

External quality control to verify accuracy of lab test methods

A

PT
proficiency testing

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136
Q

Proficiency testing is required by… under…
Usually done …times per year

Not required for…

A

CMS, under CLIA

3 times per year

not required for waived tests

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137
Q

Approves the PT program that must be enrolled in

A

HHS

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138
Q

Must maintain copy of PT related forms for minimum of….from the date of PT event

A

2 yrs

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139
Q

Satisfactory performance on PT testing is…for each analyze

except with immunoheme, some are..

A

80%

100%

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140
Q

Unsatisfactory PT

A

same analyte in 2 consecutive
OR
2 out of 3 testing events

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141
Q

Alternate/Split sample testing can be done for PT if…

A

approved PT isn’t available

SPLIT SAMPLES w/other or ref lab, established in house method, clinical validation by chart review, participation in ungraded/educational PT program

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142
Q

Examples of pre analytical testing

A

lab req, id, collection, storage, transportation, specimen adequacy, aliquoting, centrifugation

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143
Q

Oral requests can be made if…
and within…

A

followed by written authorization
within 30 days

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144
Q

Standard that requires the use of at least 2 pt ids…

3 examples of ids

A

Joint Commision
National Patient Safety Standard

-name, bday, med rec

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145
Q

How long keep records of test reqs/authorizations (can be patients chart/medical record)…

Who may request records…

A

2 yrs

HHS

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146
Q

Examples of analytical testing

A

reagents, calibration, QC, temps
recording results
verify normal range
competency of personell

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147
Q

Process of testing and adjusting an instrument/kit to provide a known relationship between the measurement response and the value of the substance being measured by the test

Contains a known amount of analyte being tested

used to establish a correlation between the measurement response and the concentration or amount of the substance that is being measured by the test procedure.

A

calibration

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148
Q

Records of patient testing kept for at least…
BB records kept for…
Blood/products…
Pathology kept for..

A

-PT 2yrs
-BB 5yrs
-Blood/products: 5yrs or 6mths after exp which ever is later
-path 10yrs

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149
Q

How long must a copy of each procedure w/dates and initial use/discontinuance be kept

A

2 yrs after discontinuence

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150
Q

Post analytic examples

A

verifying calculations
reporting results
ID/notify panic
filing
data retrieval

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151
Q

Most errors occur in what two phases…

A

pre and post

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152
Q

percentage of error:

pre…
analytical..
post…

A

pre 46%
analytical 8%
post 47%

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153
Q

Term used to describe monitoring/evaluating all aspects of testing and all phases.
Uses the QC data and conducted over a period of time

A

QA

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154
Q

Term that is one component of QA, involves mostly the analytical phase, ensures accuracy, and performed daily

A

QC

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155
Q

standard that where concentration is determined by dissolving weighted amt of std in solvent and diluting to a stated volume/mass.

Accuracy based on purity of std/solvent not analytical method.

A

primary calibration std

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156
Q

Standard where concentration is determined by an analytical method of stated reliability.
Prepared from pure substances of known composition.

A

Secondary std

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157
Q

Process that sets the instrument to a specific parameter, also called standards

A

calibration

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158
Q

Substances that are patient like used to validate run after calibration and tests the accuracy and precision of the method

Can use sera/BF thats stable for at least…

A

controls

a year

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159
Q

Control reqs

A

should be pt like
run at lease 2 levels
stable
never used to calibrate

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160
Q

Term that is the agreement between the measured quanitity and its true value

How close the value is to the true value

A

accuracy

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161
Q

Material prepared/purchased w/stated or expected value

A

assay control

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162
Q

Material whose value is not known except when assayed w/in lab by repeated testing

A

unassayed control

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163
Q

Aggrement among replicate measurements. How close the single values are to one another. The repeatability or reproducibility

A

precision

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164
Q

The more precise the method, the…the SD among replicate results

A

smaller

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165
Q

Actual middle value

A

median

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166
Q

value that occurs the greatest frequency

A

mode

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167
Q

average of all values, included in control material, represented by /x

A

mean

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168
Q

dispersion of control values about the mean.

repeatability, reproducibility, precision

A

SD

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169
Q

If data have a normal distrubution,
the mean/mode/median are…

A

about the same

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170
Q

Difference between highest and lowest values

A

range

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171
Q

average squared distance of data points from the mean

A

variance

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172
Q

square root of the variance

A

SD

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173
Q

SD expressed as percentage of the mean

A

CV
coefficient of variation

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174
Q

CV formula….

acceptable CV is less than…% for most analytical systems

A

SD/mean x 100

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175
Q

1SD
…% will fall to the right and left of the mean, so…% of all data fall within 1SD

A

34.1% fall to right and left
68.2% of all data fall within 1SD

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176
Q

2SD
…% of all data will fall between 2 SD

A

95.5% of all data fall within 2SD

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177
Q

3SD

…% of all data will fall within 3SD

A

99.6% of all data fall within 3SD

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178
Q

The lab normally runs within …or…% confidence limit to be considered accurate and precise

A

2SD, 95%

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179
Q

A chart with a normal distrubution curve on its side. Used to determine if a run is acceptable/quality of run.

Values within…on each side are accepted as being accurate and precise

Accurate test results fall w/in acceptable limits of +/-…SDs….% of the time

A

Levey Jennings chart

2SD

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180
Q

Signal of errors

…consecutive results fall on…side of mean

…consecutive results fall outside…

…result falls outside….

A

5 consecutive results fall on 1 side of mean

2 consecutive results fall outside 2SD

1 result falls outside 3SD

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181
Q

6 steps in finding source of signal errors

A
  1. clerical
  2. reagent
  3. procedural/maintainence
  4. retest ctrl
  5. recalibrate instrument/new ctrl
  6. call tech
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182
Q

Error thats unpredicable, no obvious pattern and almost always preventable.

Large deviation from mean.

A

Random error

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183
Q

3 Random error causes…
Remedy…

A

operator error (pipetting etc)
electronic fluctuation in instrument
interfering substances

Remedy: repeat test with fresh reagents, good working pipettes

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184
Q

Error that happens over a period of time, data points are not evenly distributed about the mean.

This can be described as…or….

A

Systemetic error

shift or trends

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185
Q

Error where data pts gradually drift from the mean.

Gradual loss of reliability.

When seven points in a row in an upward or downward direction are seen on a quality control graph

A

trend

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186
Q

Error with abrubt change in data pts from mean.

A

Shift

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187
Q

2 causes of trend

A

-deterioration/aging of reagents, ctrl, light
-accumulation of debris cuvette window

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188
Q

4 causes of shift

A

-change in reagent lot/without calibration
-failure of calibration
-instrument maintence
-change in room temp

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189
Q

Set of rules/decision criteria to decided whether an analytical run is in control or out of control..

A

Westgard Multirules

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190
Q

A…is an interval w/in which the accuracy and precision of testing system are expected to be stable but cannot be greater than 24hrs or less the frequency stated by m2anufacturer.

A

run

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191
Q

Multirule where you accept the run/is a warning
1 ctrl exceeds mean by +/-2SD

A

1-2S

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192
Q

Multirule where you reject, 1 ctrl exceeds mean by +/-3SD

A

1-3S

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193
Q

Rule where you rejct, 2 consecutive exceeds mean by +-2SD.
May be beginning of systemic error

A

2-2S

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194
Q

Rule where you reject, two consecutive is greater than +/- 4SD
May be due to random error

A

R-4S

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195
Q

Rule where you reject, 4 consecutive exceed by +/-1SD in the same direction.
May be systematic error

A

4-1S

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196
Q

Rule where you reject, 10 consecutive exceed in same direction.
May be systematic

A

10x

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197
Q

Normal range, normal value, ref range also called…

Refer to a normal grp of individuals free from disease and represent…% of the population

A

reference interval

95%

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198
Q

If no existing analyze or methodology exists to do comparative studies, need ….to… people

If method already in place, ref interval is validated by using method comparision.

Most common ref interval study used in lab is as few as…test subjects

A

120-700

40

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199
Q

Parameters categorized as sensitivity, specificity and predicitive value are broadly defined as…

A

diagnostic efficiency

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200
Q

A predicitive value of a methods ability to detect patients with a disease is called the…

Probability of correctly classifying diseased patient as disease

A

sensitivity of a test

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201
Q

the test that has 100% sensitivity can detect the disease in question in every patient who has the disease is called

A

true positive

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202
Q

Diagnostic sensitivity formulas

A

diseased w/+ result/total diseased x100%

or

true pos/# true pos + # false neg x 100%

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203
Q

The abilty to predict the value of a method to exclude a patient without disease is called…

Correctly classifying a nondiseased person as nondiseased

A

specificity

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204
Q

The test that has 100% specificity will always be negative, and a patient who tests negative does not have the disease

A

true negative rate

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205
Q

Diagnositic specificity formulas

A

nondiseased w/neg result/

total #nondiseased x 100%

or

true neg/# true neg + # false pos x100%

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206
Q

positive predictive value formula…
% of the time a positive test will be true

A

true pos/#true pos +#false pos x100%

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207
Q

negative predictive value formula…
% of the time a negative test will be true

A

true neg/#true neg+#false neg x100%

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208
Q

Differences between repeated and successive test results…

A

delta check

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209
Q

Delta check can be usesd as a form of …

A

quality assurance

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210
Q

4 parameters delta checks can be based on…

A

-current result minus previous
-current-previousx100%/previous
-delta diff/delta time
-delta % change/delta time

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211
Q

Any test performed at the time a rapid decision can be made that leads to treatment w/immediate pt outcome

A

POCT
point of care testing

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211
Q

What category of testing involves microscopic evaluation (i.e., wet mount, Potassium hydroxide preparation, fern test, etc.) by a physician in the office for their own patient?

A

To meet the criteria for inclusion in the Provider-Performed Microscopy (PPM) category, procedures must follow these specifications: The examination must be personally performed by the practitioner (defined as a physician), a midlevel practitioner (defined as a physician, a midlevel practitioner under the supervision of a physician), or a dentist. The procedure must be categorized as moderately complex. The primary test instrument is the microscope (limited to brightfield or phase-contrast microscopy). The specimen is labile. Control materials are not available. Specimen handling is limited. Proficiency testing is not required; however, twice-yearly verification of accuracy is required. Those with a PPM certificate can also perform waived testing.

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212
Q

5 POCT classifications

A

-off site
-alternate sit
-physican office
-near patient
-beside

213
Q

POCT devices have these characteristics

A

-portable
-easy to use, mininal steps
-results w/in mins
-flexible test menus
-reagent at RT
-built in cal/QC

214
Q

Ensures the electronics of the device are performing as expected

A

internal QC

215
Q

Tests the system in the same manner as a patient sample

A

external QC

216
Q

Tests the system and its operators blindly by providing unknown samples

A

PT

217
Q

Examples of POC device principles

A

-reflectance
-electrochem/impedance
-spectrophotometry
-fluorescen
-PCR

218
Q

Most POCT classified as…
POCT is… …. than conventional lab testing

A

moderate complexicity tests

more expensive

219
Q

Testing personell req…

A

-On/B4 April 1995 highschool, clinical training
-Until Sep 1997 high school, clinical exp
-After 1997 AS

-AS or equivalent education/training
-licensed physician (doctor,master,bacherlor in chem/phy/bio, or CLS/MT accredited)

220
Q

CLIA reg to evaluate/document performance for high complexicity testing at least…during the first year, then at least….

A

semiannually the first year then annually

221
Q

Lab must document/assess problems during quality assurance reviews and take corrective action to prevent reoccurance

A

performance improvement projects

222
Q

Lab must keep docs of quality assurance activities for….

A

2 yrs

223
Q

Incidents which involves risk of injury or actual injury must be reported to risk management within

A

48hrs

224
Q

Event which facility personell could exercise control and which is associated in whole or in part with the facility’s intervention, rather than the condition for which such intervention occured.

An event in which care resulted in an undesirable clinical outcome-an outcome not caused by underlying disease-that prolonged the patient stay, caused permanent patient harm, required life-saving intervention, or contributed to death.

A

adverse incident

225
Q

Name of term where risk management must report serious adverse incidients to the state within 15 days

A

code 15

226
Q

an occurence that results in unanticipated death or major loss of functions not related to the natural course of patients illness or underlying condition.

A

sentinel event

A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. The phrase “or the risk thereof” includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome. Such events are called “sentinel” because they signal the need for immediate investigation and response. The terms “sentinel event” and “medical error” are not synonymous; not all sentinel events occur because of an error and not all errors result in sentinel events.

227
Q

Process variation for which a recurrence carries a significant chance of serious adverse event

A

near miss

A near miss is something that you instinctively recognize at the moment. It usually comes with a surge of adrenaline and relief. We also know it as a “close call,” a “narrow escape,” or a “near accident.”

In fact, “near accident” is probably the best general definition of “near miss.”

228
Q

In depth analysis of an occurence by a multidisciplinary team of involved employees.

It is a structured facilitated team process to identify root causes of an event that resulted in an undesired outcome and develop corrective actions.

A

root cause anaysis

229
Q

OSHA..

is part of…
and a…agency

A

occupational safety and health admin

the US dept of labor

federal agency

230
Q

Fed agency that issues regulations to ensure employee workplace safety with employers with 1+ employees

A

OSHA

231
Q

In addition to having id, severity of hazard, nature/degree, and recommended measures to minimize adverse effects,
label of hazardous materials should have these 3 things

A

-name
-address
-phone
of manufacterer

232
Q

Standard that requires pictograms on labels to alert users of chemical hazards

A

hazard communication standard

233
Q

6 chemical hazard classifications for pictogram labels

A

-carcinogen
-corrossive
-flammable
-irritant
-toxic

234
Q

Pictogram with skull and crossbones for what 1 hazard

A

acute toxicity

235
Q

Pictogram of environment for what 1 hazard

A

aquatic toxicity

236
Q

Pictogram of flame over circle for what 1 hazard

A

oxidizers

237
Q

Pictogram of exploding bomb for what 3 hazards

A

-explosives

-self reactives
Self reactive substances are thermally unstable liquids or solids liable to undergo a strongly exothermic thermal decomposition even without participation of oxygen (air).

-organic perioxides:
organic peroxides supply both the oxygen and the fuel source.

238
Q

Pictogram of corrosion (test tubes dripping on hand)
for what 3 hazards

A

-skin corrosion/burn
-corrosive to metals
-eye damage

239
Q

Pictogram of gas cylinder for what 1 hazard

A

gases under pressure

240
Q

Pictogram of exclamation mark for what 6 hazards

A

Skin, irritants:
-skin sensitizer
-irritant(skin, eye, respiratory tract)

-acute toxicity

-narcotic effects

-hazardous to ozone layer

241
Q

Pictogram of flame for what 6 hazards

A

-flammables
-pyrophorics: Pyrophoric materials are substances that ignite instantly upon exposure to oxygen.

-self heating
-emits flammable gas

-self reactives
-organic peroxides

242
Q

Pictogram of health hazard(person) of what 6 hazards

A

-carcinogen
-mutageniticity

-reproductive toxicity
-target organ toxicity

-aspiration toxicity
-respiratory sensitizer

243
Q

Safety training required by…every…
kept for…

A

OSHA, year
3yrs

244
Q

A written program to set forth procedures, equipment, PPE, and work practices to help protect employees from health hazards by hazardous chemicals

A

Chemical hygiene plan

245
Q

Plan required by OSHA concerning bloodborrne pathogens that describes potential risks and measures taken to protect/if exposed

A

exposure control plan

246
Q

Term that all samples are infectious and also contaminated w/HIV, HBV and all sharps are contaminated

A

Universal precautions/Standard Precautions

247
Q

Common sources of HIV, HepB,C include blood and body fluids such as these…

A

-semen, vaginal secretions
-CSF, snynovial, pleural, peritoneal, amniotic
-saliva in dental settings

-unfixed tissues/organs
-cell, tissue organ cultre

248
Q

Primary transmission modes for HIV, HBV, HCV are these 3

A

-puncture wound contaminated objects
-skin contact with infectious fluid/tissue thru broken skin
-mucous membrane contact (eye, nose, mouth)

249
Q

Hepatitis that is fecal oral,foodborne, vaccine available

A

Hep A

250
Q

Hep A lab
elevated…and…
two ab and correlation…
done with…

A

elevated ALT, bili
IgM=disease
IgG=immunity
done with EIA

251
Q

Hep B transmitted thru these 3

A

-sex
-needs/IV drug
-transfusion

252
Q

Hep B incubation period…
95% are…or…
5% are..

A

asymptomatic or acute

chronic

253
Q

Order of apperance of HepB markers

A

-HBV DNA
-HBsAg
-HBeAg

-anti-HBc
-anti-HBe
-anti-HBs

254
Q

First detectable Hep B marker…
detected using…

A

HBV DNA
NAT

255
Q

Two Hep B antigens in acute phase, very infectious

A

HBsAg
HBeAg

256
Q

Hep B marker indicating viral replication and most infectious

A

HBeAg

257
Q

Marker that is marker for previous infection and is in recovery phase and remains throughout persons life

A

anti-HBc

258
Q

Marker where infection is resolving and patient is immune; is protective against future

A

Anti-HBs

259
Q

Marker due to immunity due to vaccination

A

anti-HBs

260
Q

Two Hepatitis with vaccines

A

Hep A and B

261
Q

Hep similar to Hep B, sex/iv use/trans;
7-8wk incubation;
elevated ALT

A

Hep C

262
Q

Hep C tests:
EIA for…
RT-PCR for…

A

EIA: antibody to HCV
RT PCR: HCV RNA

263
Q

Hep virus that needs HBV, IV drug/hemophiliacs

A

Hep D

264
Q

Hepatitis thats cause of epidemic and sporadic heptatis in developing countries;
resemebles Hep A, fecal oral

A

Hep E

265
Q

HIV spreads thru…or….
It infects…

A

sex, IV drug
CD4+ T cells

266
Q

Opportunisitc pathogens in HIV:
3 Parasites…
4 viruses…
2 fungi…
1 bacteria….

A

Opportunisitc pathogens in HIV:
Parasites
-crytosporidium
-pneumocystis
-toxoplasma

viral
-HBV, CMV, EBV, HSV

Fungal
-candida
-Cryptococcus

Bacteria
-mycobacterium

267
Q

Two types of HIV…
Dominant one worldwide…
which one is slower…

A

HIV1,2
Dominant HIV1
Slower HIV2

268
Q

Groups in HIV1

A

M,N,O

269
Q

Incubation period for HIV…
full blown AIDS when CD4 drows below…

A

18mths
200 cell/microL

270
Q

Reversal of T Helper to suppresor CD4:CD8,
what is normal ratio, ratio in HIV

A

normal >1.5
HIV <0.5

271
Q

Name of therapy that interferes with any aspect of HIV rep/spread

A

HAART
hightly active antiretroviral therapy

272
Q

Technique used for qualitative detection of antibodies and antigens to both HIV1,2

A

ELISA

273
Q

No further testing for HIV is required for…on the…immunoassay

A

nonreactive on initial

274
Q

Specimens with reactive ag/ab or repeatedly reactive should do a test that….from…

A

differentiates HIV1 ab from HIV2 ab

275
Q

Specimens reactive at initial and nonreactive on HIV1/2 ab differentiation should be tested using

A

HIV1 NAT

276
Q

High risk tasks

A

needles, shaprs usage
invasive procedures w/bleeding
large amount of blood
spill,splatter, splashes

277
Q

Plan name that establishes procedures and utilizes appropriate materials and equipment to minimize exposure to bloodborne pathogens

A

exposure control plan

278
Q

Enginerring controls

A

hand wash, sharps containers, leakproof containers, protective shields

279
Q

Work practice controls

A

-hand wash
-handle needles appropriatly, no double handed recap, not overfilled, no hands in sharp container
-leaking/puntured in second container
-closed b4 disposed of
-no mouth pipette
-no food etc in lab

280
Q

Labels not required if .. .. or … .. are used

A

red bags or red containers

281
Q

Hep B vaccine must be made available within…days of initial employment

A

10 days

282
Q

OSHA requires exposed person be tested after initial exposure then at…,…, and…months.

If person refuses testing, blood should be drawn and saved for…days

A

3, 6, 12 months

90 days

283
Q

How often does OSHA require blood borne pathogen training

A

yearly

284
Q

When there’s potential to generate aerosols of M.tb or large concentrations used BSC class…

A

2

285
Q

BSC class that allows unsterlized room air into cabinet and around area/material and only sterilizing the air that is exhausted outside by… …

A

BSC class 1

negative pressure

286
Q

BSC class with a sash that sterilizes the air that flows over the infectious material as well as the air that is exhausted.

A

BSC class 2

287
Q

BSC class 2 also called

A

laminar flow BSC

288
Q

Category/Subcategory of BSC… which is self contained and 70% of air is recirculated by passing thru HEPA filter

A

BSC 2A

289
Q

Category/Subcategory of BSC…used by radioisotopes, toxic chemicals, or carcinogens

A

BSC 2B

290
Q

BSC completely enclosed and has negative pressure. Most protection. Air is sterilized while infectious material is handled with gloves.

A

BSC 3

291
Q

Most clinical micro labs use class…BCSs

Certified once installed, then…..

A

BSC 2A

annually

292
Q

Code 15

A

Name of term where risk management must report serious adverse incidients to the state within 15 days

293
Q

Markers in convalescent/recovery phase of hepB

A

AntiHBc, antiHBe

294
Q

Marker for previous infection hepb

A

AntiHBc

295
Q

% of the time a positive test will be true

A

positive predictive value

296
Q

% of the time a negative test will be true

A

negative predictive value

297
Q

BSL not known to consistently cause disease in humans and used in standard micro practices

examples are nonpathogenic ie. Ecoli, B.subtilis

A

BSL 1

298
Q

BSL with agents associated with human disease aquired thru percutaneous injury,ingestion, or mucous membrane.

BSL 1 practice and limited access, biohazard warnings, sharps precausings

ie. S.aureus, E.coli 157, K.pneumo, HBV, HIV

A

BSL 2

299
Q

BSL with indigenous agents may cause serious or lethal disease thru inhalation.
BSL2 practice and controlled access, decontamination

M.tb, B.abortus, Y.pestis. B.antracis, C.immitis

A

BSL 3

300
Q

BSL with dangerous agents which cause individual risk of aerosol transmitted lab infections, fatal, no vaccines/treatment

BSL3 practice and clothing change, shower, decontamination

Ebola, Lassa, Marburg

A

BSL 4

301
Q

BSL used with most standard microbiological practices not known to cause issues

A

BSL 1

302
Q

BSL used thats most fatal, no vaccine/treatment, risk of aerosol

A

BSL 4

303
Q

BSL used with limited access, biohard signs, and sharps precaustions, most common pathological pathogens seen

A

BSL 2

304
Q

BSL used for agents that are generally inhaled and lethal, decontamination

A

BSL 3

305
Q

B.subtilis, E.coli used BSL

A

1

306
Q

ebola, lassa, marburg use BSL

A

4

307
Q

m.tb, B.aborus, Y.pestis, B.anthracis, C.immitis use BSL

A

3

308
Q

S.aureas, E.coli 157, K.pneumo, HBV, HIV use BSL

A

2

309
Q

How must a laboratory operate to handle TB sputum and TM materials?
Question 2Answer

A

Biosafety level of 2+ or 3

BSL-3 builds upon the requirements of BSL-2. Organisms that can cause serious or potentially lethal disease through respiratory transmission are typically worked with in a BSL-3 laboratory. Example: Mycobacterium tuberculosis.

310
Q

3 Categories for bioterrorism agents…

A

A, B,C

310
Q

What category are agents anthrax, botulism, plague, smallpox, tularemia, filoviruses, and arenaviruses classified as?

A

Category A are pathogens that are rarely seen in the United States. These agents have the highest priority; organisms in this category pose a risk to national security because they can be easily disseminated or transmitted from person to person and result in high mortality rates and have the potential for major public health impact.

311
Q

Category with emerging pathogens and could be used for mass dissemination due to ease of production/dissemination and high morbidity…

Two types…

A

C

Nipah virus, hanta virus

312
Q

Category moderately easy to dissemniate, moderate morbidity,

low mortality

and need specific enhancements of CDCs diagnostic capacity/enhanced surveillance

A

B

313
Q

Category B examples

A

Brucellosis, C.perf

Salmonella, Shigella, Ecoli

B.mallei, C.psittaci, Coxiella burnetii

Typhus fever/Rickettsia pro

vibrio cholerae, crypto parvum

313
Q

Category that pose risk to national security because they are easily disseminated,

high mortality rates, might disrupt public/panic

A

Category A

314
Q

category A agents

A

anthrax, plague, smallpox

tularermia
botulism

ebola, marburg, lassa

315
Q

3 types of gas stored in cylinders…and examples

A

liquefied: chlorine, propane, CO2
nonliquefied: helium, nitrogen

dissolved gases: acetylene

316
Q

…is lowest temp which vapor of a flammable liquid can be ignited in air

A

Flashpoint

317
Q

A flammable liquid is any liquid with a flashpoint below …F/C

Stored in…

A

100F/37C

flammable liquid safety cabinet

318
Q

Safety color coding:
red means 3 things…
yellow means…
orange means..
fluorescent orange…

Color is contrasted with…

A

red: fire, danger, stop
yellow: caution
orange: warning
fluorescent orange: bio hazard

black

319
Q

Fire pull alarms, bio med waste containers, and emergency stop are color…

A

red

320
Q

Radiation signs are

A

yellow

321
Q

Color biological hazard signs used to signify potential prescence of biohazardous infectious agent posing potential risk is color

A

fluorescent orange

322
Q

Organization that sets color coded scheme for hazards

A

NFPA
national fire protection agency

323
Q

Blue diamond…
0-4…

A

health hazard

normal to deadly

324
Q

Red diamond…
0-4…

A

fire hazard
won’t burn to flash pt below 73F

325
Q

White diamond…
6 specific hazards…

A

specific hazard

-ACID
-ALK (alkali)
-COR (corrosive)
-OXY (oxidizer)
-radioactive symbol
-W crossed out: don’t use water

326
Q

Yellow diamond
0-4

A

reactivity

stable, may detonate

327
Q

Fire with ordinary combustible material…
Such as…

A

Class A
paper, wood, cloth
some rubber, plastic

328
Q

Fire w/flammable or combustible liquid….
Such as…

A

Class B
gasses, greases
some rubber, plastic

329
Q

Fire w/energized electric equipment

A

Class C

330
Q

Fire w/combustible metal…
such as…

A

Class D
mag,sodium,lithium, potassium

331
Q

Class extinguisher ordinary combustible materials such as wood, paper, cloth

A

Class A

332
Q

Class extinguisher flammable or combustible liquid such as acetone, ethanol etc

A

Class B

333
Q

Class extinguisher w/energized electrical

A

Class C

334
Q

Class extinguisher w/combustible metal

A

Class D

335
Q

Fire acrynom

A

Remove people from danger
Activate alarm, call
Confine fire
Extinguish or evacuate

336
Q

Extinguisher acroynym

A

Pull pin
Aim at base
Squeeze handle
Sweep side to side

337
Q

Electrical safety checked… … and then…

A

upon install, annually

338
Q

Requirements for radiation safety 4 reqs

A

-employee gets motoring equiment to monitor exposure
-records and checkins annually

-post sign radition caution symbol, caution, radiation area
-keep radiation as low as reasonably achievable (ALARA) per NRC

339
Q

NRC, ALARA

A

Nuclear regulatory commision
as low as reasonably achievable

340
Q

Federal agency regulates disposal of toxic/bio hazardous waste

A

EPA
environmental protection agency

341
Q

Act that gives EPA authority to control hazardous waste such as generation, trans, treatment, storage, disposal

A

RCRA
resouce conservation and recovery act

342
Q

Hazardous waste def…
RCRA def…

A

any waste w/properties that make it dangerous or potentially harmful to environment or public health

RCRA: waste that appears on one of the four hazardous waste lists or exhibits at least 1 of 4 characteristics (ignitablity,corrosivity,reactivity,toxicity)

343
Q

Fed agency regulates packing, labeling, trans of hazardous.
National safety by air/rail/highway/water

A

DOT
dept of trans

344
Q

IATA..
purpose…

A

international air transport association

regulate packing,shipping by air

345
Q

DOT training req within… and every…

A

90 days
3yrs

346
Q

DOT requires markings on hazardous with these 4

A

-shipping name
-UN id #
-inhalation hazard if necessary
-name/address cosignee

347
Q

DOT Hazard has how many classes

A

9 stupid classes I won’t remember

348
Q

ICAO:
international civil aviation organization
instructions for safe transport by air

IMO:
international maritime organization
by water

A

…

349
Q

DOTs HMR has two categories… and …

…capable of causing permanent disability/fatal
…not in a form to generally be capable of permanent disability or fatal

…which category does clinical lab specimens fall

A

Category A, B

A: harm
B: not generally harmful, most lab specimens

350
Q

Not subject to packing and shipping reqs…

A

-blood/plasma from uninfected
-dried blood spots, fecal occult blood on material
-PT samples for research,diag,investigational

351
Q

Category B is triple packaged

….,…., and …

A

primary receptacle
secondary packaging
outer packaging

352
Q

LAW that prohibits discrimination of disabilities either presently,past, perceived to, or associated with someone

A

ADA
american disablities act

353
Q

Def of ADA disability…
Def of qualified employee…

A

physical or mental
limits major life activity

can perform the essential functions of the job or without a reasonable accommodaiton

354
Q

FEDREAL AGENCY enforces employment , discrimination laws, protects from discrimination such as age, disability, equal pay, race, religion,sex,etc

A

EEOC
equal employment opportunity
commission

355
Q

EEOC

A

equal employment opportunity
commission

356
Q

Federal law that defines min wage, overtime, how to be paid…

classfied into…and…

A

FLSA
fair labor standards act

nonexempt: hourly
exempt: salaried

357
Q

FLSA

A

fair labor standards act

358
Q

ACT of 1963 prohibiting discrimnation on race,color,creed,religion,sex etc which now includes disabilities, veterans, 40-70

A

title 7 civil rights act

359
Q

Form of insurance providing compensation medical care who are injured on job in exchange for mandatory relinquishment of right to sue, also called compensation bargain

A

workmans comp

360
Q

Payments made by goverment to unemployed; proportional to their previous earned salary

A

unemployment comp

361
Q

Requires employers with more than 50 employees up to …weeks of unpaid job proteced leave in any…mth period to care for baby,kid,spouse,parent or serious health

can also leave intermittently or reduced schedule when medically necessary without employee permission, can still get benefits and right to return

A

FMLA
12 weeks unpaid job leave in 12mth period

362
Q

FMLA

A

family and medical leave act

363
Q

Act that provide health insurance for…or…mths after retiring,resigning,laid off, full time to part time, or discharged except for… ….

A

COBRA
consolidated omnibus budget reconcilation act

18 or 36mths

expect for gross misconduct

364
Q

Act that
-enables workers to keep health insurance protection when changing jobs
-establishes electronic healthcare trans standards for HHS
-maintain privacy etc health info

A

HIPAA

365
Q

HIPAA

A

health insurance
portability and accountability act

366
Q

PHI
examples

A

protected health info

med rec
appt schedule
billing
med list

367
Q

eval of tecnicial skills..
done…

A

competency eval
annually

368
Q

eval of knowledge, skills, attitudes and beliefs…
done…

A

performance eval
anually

369
Q

voluntary process non government grants recognition to an individual who has met certain education reqs and has entry level competency by examination

A

certification

370
Q

mandatory process some states grant permission to engage in an occupaiton

A

licensure

371
Q

voluntary process non government agency grants recognition to an organization that achieved a set predetermined standards

A

accreditation

372
Q

Budget items such as salaries and benefits changed based on previous years budget, based on # of tests

A

forecast budget

373
Q

Budget with fixed amount of money granted for fixed period of time, 1-2yrs.
Usually government bodies

A

Appropriation budget

374
Q

Budget with fixed(overhead) and variable expenses(reagents) are itemilzed.
Usefull when test volume subject to change, thus able to adjust variable portion

A

Flexible budget

375
Q

Budget used for continuous managment of ogranization used by lab managers

A

operational budget

376
Q

Budget designed for purchase of equipment, expansion of program or remodeling

A

capital budget

377
Q

Budget where historical budget is disregarded and new costs/items are made.
Eliminates dead wood

A

Zero based budget

378
Q

Budget prepared quarterly and more accurate than annual

A

Rolling quarter budget

379
Q

Budget made monthly to anticipate cash flow, received/spent. Predicts timing/amt of cash flow

A

Cash budget

380
Q

Cost directly assigned to production of product, billable test, consumables, labor

A

direct

381
Q

costs not directly involved in production, personell costs, supervisor,phleb

A

indirect costs

382
Q

costs that change with production volume, ie reagents

A

variable costs

383
Q

costs that don’t change with production volume, lease on equipement, techs needed

A

fixed

384
Q

Fringe benefits can be …% to …%

examples

A

20-25% of salary

SS tax,FICA
unemployment, workmans comp
health/life/disability insurance
retirement,vacation
sick,maternity

385
Q

Standardized descriptions of 5 character, alpha numeric codes w/text descripter

coders/billers use to report healthcare services/procedures for reimbursement

A

CPT

current procedural terminology

386
Q

CPT

A

current procedural terminology

387
Q

Category of CPT describes procedure/service with 5 digits

A

Category 1 CPT

388
Q

Category of CPT supplemental tracking for performance measurement

A

Category II CPT

389
Q

Category of CPT that is temporary tracking for new and emerging technologies

A

Category III CPT

390
Q

Term when procedure was modified but code/def was not changed

examples

A

CPT code modifier

serum electropho
PLT agg
BF crystals

ie. 91 repeat clinical diag lab test

391
Q

ICD

ICD-10-CM

A

international classificaition of diseases

clinical modifications

392
Q

Oldest method of tracking diseases and mortality in the world. Tabular list with disease code #s, index of disease entries, classification system for procedures

ie. R31.0 asymptomatic hematuria

A

ICD, International Classification of Diseases

ICD-10-CM

393
Q

HCPCS codes

A

healthcare common procedure coding system

394
Q

Standard HIPAA code set for reporting supplies, orthotic/prostetic devices, durable med equip.
Report healthcare provider and services.

ie.G0001 routine venipuncture for collection of blood

A

HCPCS

healthcare common procedure
coding system

395
Q

Acquisition or improvement of work related skills by people already in the workforce. Keeps people up to date on skills etc.

A

CE
continuing education

396
Q

Old name for CLSI that develop accredited consensus clin lab standards

A

NCCLS
national committee for clinical lab standards

397
Q

Accredits labs under CMS, proficiency testing, and is member based physician organization

A

CAP
college of american pathologists

398
Q

Agency that approves new test methodologies/instruments/reagents before consumers can use

A

FDA

399
Q

Biosafety hoods inspected…

A

annually

400
Q

Federal legislation that regulates most labs

A

CLIA

401
Q

Nonprofit that accredits healthcare organizations and programs in the US

A

JCAHO
joint commision on accreditation of healthcare organization

402
Q

Labs must have inspections every…
Required by..

A

2yrs
CLIA

403
Q

Proficiency testing that doesn’t meet CLIA is

A

failed SAME analyze in two consecutive PT events or 2 out of 3 testing events

404
Q

4 examples of alternate PT testing

A

-split samples sent to other lab or ref lab
-split sample w/established in house method, assayed material or regional pool
-clinical validation by chart review
-participation in ungraded/educational PT program

405
Q

Split sample

A

Split sample comparison is performed by splitting a single sample into two aliquots. One aliquot is tested using the primary test method while the second aliquot is tested on by the same or an alternate test method at another acceptable laboratory.

406
Q

transcription error entering manual result is an example of

A

post analytical

407
Q

Most common analytical error

A

not checking specimen integrity, HIL

408
Q

Most common post analytical error

A

clerical error

409
Q

review procedure…and…

A

upon implementation and substantial revisians

410
Q

thermometers must be check against NIST …

A

annually

411
Q

Centrifuge speed, timers checked

A

every 6 mths

412
Q

Check quarterly

A

automatic pippetes 4x/yr

413
Q

CTRL outside 3SD due to

A

random error

414
Q

CTRL with 2 consecutive outside 4SD due to

A

random error

415
Q

If only one CTRL is out of 2SD/95% what do you do

A

repeat same CTRL

416
Q

4 docs req to keep in employee file

A

-job competency training checklist
-annual peformance appraise
-CE docs
-remedial action docs

417
Q

CEUs are…by CAP

A

not mandated

418
Q

CEUs 3 facts

A

-required by some states/organizations
-help learn about new stuff
-help with networking

419
Q

-customer complaints
-monitoring trends for corrected reports are part of

A

QA

420
Q

Federal law that requires competency of lab to be documented

A

CLIA

421
Q

OSHA reqs safety training at…and then…

A

orientation, annually

422
Q

3 OSHA TB plan req

A

-must get PPD skin tests
-pos PPD must have annual chest xray
-any PT contact must get fit for respirators

423
Q

fire protocol

A

Rescue
Alarm, call operator
Contain
Extinguish/evacuate

424
Q

agency regulate disposal of biohazard waste

A

EPA

425
Q

Fed agency regulates facilities that use radioisotopes

A

NRC
nuclear regulatory commisson

426
Q

Federal law defines min wage and OT

A

FLSA
fair labor standards act

427
Q

Agency enforces equal pay for equal work

A

EEOC
equal employment
opportunity commision

428
Q

Title VII, prohibits discrimination in this labor law

A

civil rights act

429
Q

HIPAA law requires….to establish standards for PHI

A

dept of HHS

430
Q

molecules in solution=undissolved molecules

A homogeneous mixture in which the dissolved substance (solute) is in dynamic equilibrium with its undissolved form.
A…solution contains the maximum concentration of its solute. This maximum concentration is the solute’s solubility limit.

A

saturated

431
Q

Another term for analytical precision and repeatability

A

Coefficiant of variation

432
Q

QC is a measure of…

A

reliability

433
Q

Random due to these two

A

CTRL outside 3SD

CTRL with 2 consecutive outside 4SD

434
Q

99.95% purified chemical that can be measured directly

A

primary standard

435
Q

derived from the primary and is less pure

A

Secondary standard

436
Q

NCCLS

A

NCCLS
national committee
for clinical lab standards

437
Q

COBRA

A

COBRA
consolidated omnibus
budget reconcilation act

438
Q

laminar flow BSC is BSC #

A

2

439
Q

What hazard communication pictogram defines a skin/eye and respiratory irritant?

A

Exclamation mark

440
Q

Semi automated calibration method…

A

Gravimetric

441
Q

OSHA safety training…
Records kept..

A

Training annually
Records kept 3yrs

442
Q

Water ph

A

7.0

443
Q

Coefficient of variation tests for…
QC tests for…

A

CV: analytical precision
QC: reliability

444
Q

60g NaOH in 1L, normality?
1 Equivalent=40gmw for every 1 valence

A

60g/L x 1 Equivalent/40g =1.5N

445
Q

Used as external QC, test accuracy of test methods

A

Proficiency testing

446
Q

Under CLIA these two monitor proficiency testing, one requires

A

CMS requires
Joint commission monitors also

447
Q

4 Common causes of failed proficiency testing

A

-Clerical errors
-instrument/method codes
-calibration bias
-not returning on time

448
Q

An alternative performance assessment to determine reliability of analytical testing.

A

Split sample testing, alternate proficiency testing

449
Q

What hazard communication pictogram defines oxidizers

A

Flame over circle

450
Q

What hazard communication pictogram defines aquatic toxicity

A

Environment

451
Q

What 2 hazard communication pictograms defines acute toxicity

A

Skull and cross bones
Exclamation mark

452
Q

What hazard communication pictogram defines explosives, self reactives, organic peroxides

A

Exploding bomb

453
Q

What hazard communication pictogram defines eye damage

A

Corrosion

454
Q

What hazard communication pictogram defines gases under pressure

A

Gas cylinder

455
Q

What hazard communication pictogram defines narcotic effects and hazardous to ozone layer

A

Exclamation mark

456
Q

What 2 hazard communication pictogram defines self reactives and organic peroxides

A

Flame
Exploding bomb

457
Q

What hazard communication pictogram defines aspiration/target organ/reproductive toxicity

A

Health hazard

458
Q

BSL, how many levels

A

Biosafety levels, 4

459
Q

BSL1: doesn’t cause disease, most micro practices

BSL 2: disease thru cut, ingest, mucous mem

BSL 3: lethal, serious thru inhalation

BSL 4: risk of aerosol, fatal, no vaccines

A

BSL 1: standard micro practices

BSL2: standard plus signs, precautions, manual

BSL 3: BSL 2 plus controled access and decontamination

BSL 4: BSL 3 plus change clothes, shower, decontamination

460
Q

A: paper, wood, cloth

B: combustible liquid

C: energized electrical

D: combustible metals

A

…

461
Q

Category of CPT codes:

I: procedure or service

II: supplemental tracking performance measurement

III: temp set of tracking new and emerging technology

A

ICD codes: tracking diseases, mortality, R##.#

HCPCS: reporting supplies, orthotic/prosthetic medical equipment
G####

462
Q

The GHS pictogram with an exclamation mark is used on substances that are harmful or irritating.
The health effects are acute (set in quickly), but they’re less severe than something marked with the toxic symbol.

Chemical classes include:

A

-Skin, eye, or respiratory tract irritants
-Skin sensitizers, which cause an allergic response
-The lowest level of acutely toxic chemicals
-Materials with narcotic effects (drowsiness, lack of coordination, and dizziness)
-ozone

463
Q

The health hazard pictogram is used for substances that present a health hazard over time.

Chemical classes include:

A

-Carcinogens, which cause cancer
-Mutagenic chemicals that cause genetic defects
-Agents with reproductive toxicity that affects fertility or in utero development
-Chemicals with target organ toxicity

-Respiratory sensitizers
-Substances with aspiration toxicity

464
Q

Primary standard is what percent of a purified chemical that can be measured directly

A

99.95% purified chemical

465
Q

Oversees FDA, CMS, CDC

A

Dept HHS

466
Q

Major bacteria in HIV infection

A

Mycobacterium

467
Q

3 parasites with HIV

A

Pneumocystis
Toxoplasma
Cryptosporidium

468
Q

2 fungi in HIV

A

Cryptococcus
Candida

469
Q

4 viruses in HIV

A

CMV
EBV
HBV
HSV

470
Q

Min # standards needed for standard curve

A

3

471
Q

Inspections for lab every…
Required by..

A

2 yrs
CLIA

472
Q

Molarity calc

A

gmw/L

473
Q

Normality calc

A

1 equ (Each H is 1)/gmw

474
Q

Centrifuge inspection: time, speed every

A

6mths

475
Q

BSA hoods, thermometer every

A

Year

476
Q

Lab inspection every

A

2yrs

477
Q

Pipettes every

A

Quarter

478
Q

QA competency done… Then…

A

Twice a year then annually

479
Q

Rule to report to state serious incident

A

Code 15

480
Q

Report injury within

A

48hrs

481
Q

Passing PT for main lab…
Passing PT for BB…

Fail…

A

Lab: 80%
BB: 100%

Fail: 2 consecutive PT events for one analyte

482
Q

QA Records kept

A

2 years

483
Q

RCF calc

A

1.118x 10^-5 x r x rpm^2

484
Q

RCF NV
Rpm NV
Time

A

RCF 1-1200
Rpm 3500
10-15 min

485
Q

Most accurate pipette for Ctrl…
Concentration…

A

Transfer, volumetric
1:1000

486
Q

C to F

A

5/9 x (F-32)

487
Q

F to C

A

(9/5 x C) +32

488
Q

Normal osmolality

A

275-295

489
Q

Osmal gap calc

A

Measured- calculated

490
Q

CV calc, how much ok

A

SD/mean x 100
5%

491
Q

1SD..
2SD…
3SD…

A

1: 68
2: 95
3: 99

492
Q

pH calc…
Normal pH…
bicarb/acid…

A

pH= pKa + log (salt/A)(acid/HA)

7.4
20:1

493
Q

Beers law con/abs calc

A

Concen unk/Concen std

Abs unk/Abs std

494
Q

Copy of Proficiency testing and patient records kept…

BB records kept…
BB products kept..

Pathology kept…

A

Copy of Proficiency testing and patient records kept…2yrs

BB records kept…5yrs
BB products kept..6mths after expire or whatever is later

Pathology kept…10yrs

495
Q

QC tests

A

Reliability

496
Q

Two rules that indicate random error, no pattern, due to pipetting, electronics, HIL

A

1-3SD and R4S

497
Q

2-2S, 4-1S, and 10x indicate…errors that happen…

A

Systematic happen over time

498
Q

Gradual loss, accumulation and aging can lead to this systematic error leads to drift from mean on one side

A

Trend

499
Q

This is a systematic error that is an abrupt change due to reagent change without Cal, new lot, maintenance or room temp

A

Shift

500
Q

Error that’s a warning

A

1-2S

501
Q

Deka:
Deci:

A

Deka: 10*1

Deci: 10^-1

502
Q

95F is what C

A

35C

503
Q

95C is what F

A

203F

504
Q

Post exposure, how often tested…
Save blood..

A

Initial, 3, 6, 12

Blood 90 days

505
Q

How many BSC…
Which one most micro…

A

1,2,3

2A

506
Q

How many BSL

A

1,2,3,4

507
Q

Pictogram of exclamation mark for what 6 hazards

A

Skin, irritants:
-skin sensitizer
-irritant(skin, eye, respiratory tract)

-acute toxicity

-narcotic effects

-hazardous to ozone layer

508
Q

Pictogram of health hazard(person) of what 6 hazards

A

-carcinogen
-mutageniticity

-reproductive toxicity
-target organ toxicity

-aspiration toxicity
-respiratory sensitizer

509
Q

TLA

A

Total laboratory automation

The move toward total laboratory automation is being driven by forces outside the clinical laboratory, such as healthcare reform and managed care. Developments in automation within the three phases of laboratory testing, robotics, data management, and workflow integration are making the move toward TLA possible.

510
Q

How must a laboratory operate to handle TB sputum and TM materials?

A

Biosafety level of 2+ or 3

BSL-3 builds upon the requirements of BSL-2. Organisms that can cause serious or potentially lethal disease through respiratory transmission are typically worked with in a BSL-3 laboratory. Example: Mycobacterium tuberculosis

511
Q

Absorbance can be calculated easily from percent transmission using which calculation?

A

2 – log10 %T

Absorbance can be calculated easily from percent transmission using 2 – log10 %T. If all the light passes through a solution without any absorption, absorbance is zero and the %T is 100%. If all the light is absorbed, %T is zero, and absorption is infinite.

512
Q

What category are agents anthrax, botulism, plague, smallpox, tularemia, filoviruses, and arenaviruses classified as?

A

Category A are pathogens that are rarely seen in the United States. These agents have the highest priority; organisms in this category pose a risk to national security because they can be easily disseminated or transmitted from person to person and result in high mortality rates and have the potential for major public health impact.

513
Q

How many points up or down in a row is a trend

A

A trend is seven points in a row in an upward direction or seven points in a row in a downward direction. With a trend, it doesn’t matter if the centerline is crossed.

514
Q

Which category of bioterrorism agents include emerging pathogens that could be engineered for mass dissemination in the future because of availability, ease of production and dissemination?

A

Category C

Bioterrorism agents are a concern to laboratories. These agents are divided into categories A, B and C. The agents that have the third-highest priority are in the Category C and include emerging pathogens. Category C bioterrorism agents have the potential to be engineered for mess dissemination.

515
Q

What category of testing involves microscopic evaluation (i.e., wet mount, Potassium hydroxide preparation, fern test, etc.) by a physician in the office for their own patient?

A

Provider-Performed Microscopy (PPM)

To meet the criteria for inclusion in the Provider-Performed Microscopy (PPM) category, procedures must follow these specifications: The examination must be personally performed by the practitioner (defined as a physician), a midlevel practitioner (defined as a physician, a midlevel practitioner under the supervision of a physician), or a dentist. The procedure must be categorized as moderately complex. The primary test instrument is the microscope (limited to brightfield or phase-contrast microscopy). The specimen is labile. Control materials are not available. Specimen handling is limited. Proficiency testing is not required; however, twice-yearly verification of accuracy is required. Those with a PPM certificate can also perform waived testing.

516
Q

Which three veins are most frequently used for a venipuncture?

A

Cephalic, basilic, and median cubital

In the arm, the three veins that are typically used for venipuncture are the cephalic, basilic, and median cubital.

517
Q

In the more common spectrophotometer, the electronic measuring device consists of a ____________ and a galvanometer.

A

photoelectric cell

The amount of light transmitted by the solution in the cuvette is measured by a photoelectric cell, a sensitive instrument producing electrons in proportion to the amount of light hitting it. The electrons are passed on to a galvanometer, where they are measured.

518
Q

What is the order of draw for multiple evacuated tubes?

A

Blood culture (aerobic), blood culture (anaerobic), blue, red, green stopper, lavender, and 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.

519
Q

What category of bioterrorism agents have the highest priority and pose a risk to national security because they can be easily disseminated or transmitted from person to person, result in high mortality rates and have the potential for major public health impact?

A

Category A

Bioterrorism agents are a concern to laboratories. These agents are divided into categories A, B and C. Category A agents have the highest priority. Anthrax and Smallpox are examples of Category A agents

520
Q

Which term is defined as blood and blood products, contaminated sharps, pathology waste products, and microbiological waste?

A

Infectious waste

Infectious waste is to be packaged for disposal in color-coded containers and should be labeled as such with the universal symbol for biohazards.

521
Q

What category of bioterrorism agents include pathogens that are moderately easy to disseminate, result in moderate and low morbidity rates, and require specific enhancements of the CDC’s diagnostic capacity and enhanced disease surveillance?

A

Category B

Bioterrorism agents are a concern to laboratories. These agents are divided into categories A, B and C; and Category B agents have the second highest priority. Category B agents have moderate morbidity (suffering from the disease) with low mortality (death) rates. Ricin toxin is an example of Category B agent.

522
Q

Which category of bioterrorism agents include emerging pathogens that could be engineered for mass dissemination in the future because of availability, ease of production and dissemination?

A

Category C

Bioterrorism agents are a concern to laboratories. These agents are divided into categories A, B and C. The agents that have the third-highest priority are in the Category C and include emerging pathogens. Category C bioterrorism agents have the potential to be engineered for mess dissemination.

523
Q

What category are agents anthrax, botulism, plague, smallpox, tularemia, filoviruses, and arenaviruses classified as?

A

Category A

Category A are pathogens that are rarely seen in the United States. These agents have the highest priority; organisms in this category pose a risk to national security because they can be easily disseminated or transmitted from person to person and result in high mortality rates and have the potential for major public health impact.

524
Q

In the calculation of MCV = HCT x 10/___?

A

RBC

MCV is calculated manually by dividing the volume of packed red cells (hematocrit) by the number of red cells, using the formula: MCV= HCT X 10/RBC.

525
Q

A 200-mg/dL solution was diluted 1:10. This diluted solution was then additionally diluted 1:5. What is the concentration of the final solution?

A

4 mg/dL

200 mg/dL x 1/10 x1/5 = 200/50 = 4 mg/dL

526
Q

What demonstrates an abrupt change from the established average value of the control for three days in a row?

A

Shift

Assaying control specimens and standards along with patient specimens serves several major functions. A shift is defined as a sudden and sustained change in one direction in control sample values. A common cause of a shift is the failure to calibrate reagent when changing lot numbers.

527
Q

Which substance is employed to produce a chemical reaction?

A

A reagent is defined as any substance employed to produce a chemical reaction. In highly automated clinical laboratories, very few reagents are prepared by laboratory staff. In many cases, only water or buffer needs to be added to a prepackaged reagent.

528
Q

3 LAYERS of anticoagulated blood and they’re components/%

Top:

middle:

bottom:

A

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

AMT Lab/Phleb basics (1 decks)

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