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🩸Hema🎀 > Automation > Flashcards

Automation Flashcards

1
Q

marked the first clot detection instrument

A

Koagulovis-dosimeter

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2
Q

laid the foundation for PT and PTT assays.

A

Gram’s method

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3
Q

Initial testing involved manual methods like the

A

tilt-tube technique

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4
Q

Traditional Coagulation Testing

A

● Prothrombin Time (PT) with international ratio (INR)
● Partial thromboplastin time (PTT/APTT)
● Fibrinogen and thrombin assays

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5
Q

Assay end-point detection principles

A
  1. Observation-Based End-Point Detection
  2. Feel-Based End-Point Detection
  3. Technological Advancements
  4. Modern Instrumentation
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6
Q

Assay end-point detection principles

Optical and Nephelometric Devices

A

Observation-Based End-Point Detection

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7
Q

Assay end-point detection principles

Utilizes “Observation” of Clot Formation

A

Observation-Based End-Point Detection

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8
Q

Assay end-point detection principles

Commonly used in Traditional Coagulation Instruments

A

Observation-Based End-Point Detection

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9
Q

Assay end-point detection principles

Mechanical and Viscosity Based Devices

A

Feel-Based End-Point Detection

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10
Q

Assay end-point detection principles

Detects clot formation by “Feel”

A

Feel-Based End-Point Detection

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11
Q

Assay end-point detection principles

Early instruments primarily relied on mechanical principles

A

Feel-Based End-Point Detection

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12
Q

Assay end-point detection principles

Traditional to Photo-Optical Detection

A

Technological Advancements

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13
Q

Assay end-point detection principles

Traditional to Photo-Optical Detection

A

Technological Advancements

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14
Q

Assay end-point detection principles

Technological Advancements Fixed wavelength between

A

500 and 600 nm

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15
Q

Assay end-point detection principles

Integration of Viscoelastic End-Point Detection for Specialty Testing

A

Technological Advancements

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16
Q

Assay end-point detection principles

Integration of Multiple-End Point Mechanisms

A

Modern Instrumentation

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17
Q

Assay end-point detection principles

Incorporation of Chromogenic and Immunoassay-Based Testing

A

Modern Instrumentation

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18
Q

Assay end-point detection principles

Streamlining Laboratory Workflows for Routine and Specialized Testing Needs

A

Modern Instrumentation

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19
Q

Measure a change in conductivity between two metal electrodes in plasma

A

Mechanical Clot End-Point Detection

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20
Q

Mechanical Clot End-Point Detection

A
  1. BBL fibrometer
  2. Magnetic sensors
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21
Q

Mechanical Clot End-Point Detection

first semi-automated instrument to be used routinely in the coagulation laboratory

A

BBL fibrometer

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22
Q

Mechanical Clot End-Point Detection

Has one stationary and one moving electrode

A

BBL fibrometer

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23
Q

BBL fibrometer principle:

A

Moving electrode: enters and leaves (breaks the current between the electrodes) the plasma at regular intervals

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24
Q

When a clot forms, the fibrin strand conducts current between the electrodes even when the moving electrode exits the solution. (stops the timer

A

BBL fibrometer

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25
Q

Another method that uses magnetic sensors that monitors the movement of a steel ball within the test plasma

A

Magnetic sensors

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26
Q

An electromagnetic field detects the oscillation of a steel ball within the plasma-reagent solution (fibrin formation increases viscosity and slows the movement until the oscillation decreases to a predefined rate — timer stops)

A

Magnetic sensors

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27
Q

A steel ball is positioned in an inclined well. As the well rotates, the ball remains positioned on the incline and is only swept out as fibrin forms. The position is detected by a magnetic sensor. Timer stops as it moves away from the sensor.

A

Magnetic sensors

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28
Q

Detect changes in plasma optical density (OD) during the clotting process

A

Photo-Optical Clot End-Point Detection

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29
Q

Light of a specific wavelength passes through the sample, and its intensity (OD) is recorded by a photodetector

A

Photo-Optical Clot End-Point Detection

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30
Q

Photo-Optical Clot End-Point Detection OD depends on

A

specimen color and clarity

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31
Q

Photo-Optical Clot End-Point Detection principle

A

Formation of fibrin strands causes light to scatter → less light to fall on the photodetector → increase in OD

Timer stops when the OD rises to a predetermined variance from the baseline

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32
Q

Used to detect clot formation in the past and is still used today in particular instruments for whole blood clotting

A

Viscoelastic Clot Detection

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33
Q

Viscoelastic Clot Detection

Information can be obtained on:

A

○ The time of clot
○ Kinetics of whole blood clot formation
○ Clot strength
○ Fibrinolytic activity

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34
Q

Uses a synthetic small peptide substrate (three amino acids that matches the factor) conjugated to a chromophore (para–nitroaniline or pNA)

A

Chromogenic End-Point Detection

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35
Q

Measures the activity of a specific coagulation factor (exploits the factor’s enzymatic properties

A

Chromogenic End-Point Detection

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36
Q

In Chromogenic End-Point Detection, The OD of the solution is proportional to protease activity and is measured by a photodetector at

A

405 nm

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37
Q

Chromogenic End-Point Detection:

OD is proportional to the activity of the analyte being measured

A

Direct Chromogenic Assay

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38
Q

Example of Direct Chromogenic Assay

A

Protein C activity

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39
Q

Chromogenic End-Point Detection:

Protein or analyte being measured inhibits a target enzyme (has the activity toward the chromogenic substrate)

A

Indirect Chromogenic Assay

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40
Q

Chromogenic End-Point Detection:

OD is inversely proportional to the concentration or activity of the substance being measured

A

Indirect Chromogenic Assay

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41
Q

Example of Indirect Chromogenic Assay

A

anti-factor Xa assay

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42
Q

Is a modification of photo-optical end-point detection in which 90-degree or forward-angle light scatter rather than OD is measured

A

Nephelometric End–Point Detection

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43
Q

A light-emitting diode produces incident light at approx. 600 nm, and a photodetector detects variations in light scatter at 90 degrees (side) and 180 degrees (forward)

A

Nephelometric End–Point Detection

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44
Q

Formation of fibrin polymers causes side and forward-angle scatter to rise. Timer stops as it reaches a predetermined intensity

A

Nephelometric End–Point Detection

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45
Q

In Nephelometric End–Point Detection, Continuous readings throughout the clotting period produce a

A

clot curve or signature

46
Q

Provides a quantitative assay of coagulation factors

A

Nephelometric End–Point Detection

47
Q

Are based on antigen–antibody coagulation testing

A

Immunologic Light Absorbance End-Point Detection

48
Q

Uses light absorbance to detect an end-point

A

Immunologic Light Absorbance End-Point Detection

49
Q

Latex microparticles are coated with antibodies directed against the selected antigen, forming agglutinates that absorb light that is proportional to the antigen levels

A

Immunologic Light Absorbance End-Point Detection

50
Q

Immunologic Light Absorbance End-Point Detection principle:

A

The increased in light absorbance is proportional to the size of the agglutinates, which in turn is proportional to the antigen level.

51
Q

Are useful to evaluate specimens from patients who have circulating inhibitors or who are on treatment

A

Chromogenic end-point

52
Q

Is isolated to the specific chemical (enzymatic) reaction in question rather than the entire coagulation cascade

A

Chromogenic end-point

53
Q

More specific than clot–based assays

A

Chromogenic end-point

54
Q

Not affected by icterus or lipemia

A

Mechanical clot end–based methods

55
Q

Able to detect weak clots (low fibrinogen or factor XIII deficiency)

A

Mechanical clot end–based methods

56
Q

May be confounded by icterus or lipemia

A

Photo-optical clot end-point detection

57
Q

The ability to select reagents independently of the analyzer is a high priority

A

Open reagent systems

58
Q

Keep records of reagent lot numbers and expiration dates, on–board monitoring of reagent volumes with flagging systems, and reagent barcoding

A

Reagent tracking

59
Q

Eliminates the need to separate the plasma into the secondary tube

A

Primary Tube Sampling

60
Q

Instruments often accommodate multiple tube sizes

A

Primary Tube Sampling

61
Q

Placement of the primary blood collection tube without removing the blue stopper (the cap is pierced by a needle in the instrument that aspirates plasma)

A

Closed–Tube Sampling

62
Q

Eliminates cross-over between specimens

A

Closed–Tube Sampling

63
Q

Reduces the risk to the staff of specimen exposure

A

Closed–Tube Sampling

64
Q

Eliminates the need for the operator to perform tasks manually

A

Automatic Dilutions

65
Q

Examples of Common POC Tests:

A

○ Whole Blood Activated Clotting Time (ACT)
○ Prothrombin Time/International Normalized Ratio (PT/INR)

66
Q

Used the viscoelastic property of blood clotting

A

Thromboelastography

67
Q

Provides information on the entire kinetic process of whole blood clot formation

A

Thromboelastography

68
Q

Thromboelastography specimen

A

whole blood

69
Q

Allows evaluation of interactions of platelets, erythrocytes, leukocytes, plasma coagulation factors, and plasma proteins

A

Thromboelastography

70
Q

Assesses both bleeding and thrombosis risk

A

Thromboelastography

71
Q

Provides an evaluation of fibrinolysis and a hypercoagulable state

A

Thromboelastography

72
Q

TEG Thrombelastograph Hemostasis analyzer system from haemonetics

Specimen
Reagent

A

Specimen: Nonanticoagulated or citrated WB
Reagent: Kaolin

73
Q

As the blood clots, the resulting pin torque generates an electrical signal from the torsion wire

A

TEG Thrombelastograph Hemostasis
analyzer system from haemonetics

74
Q

A new version of thromboelastography

A

Rotational Thromboelastometry (ROTEM)

75
Q

Upon clot formation, the increased tension from fibrin binding the cup to the pin is detected by sensors

A

Rotational Thromboelastometry (ROTEM)

76
Q

Platelet Function Testing:

A
  1. Classic Platelet Aggregometry
  2. Whole Blood Aggregation by Impedance
77
Q

Platelet Function Testing:

Uses the light transmittance principle by Born

A

Classic Platelet Aggregometry

78
Q

Platelet Function Testing:

Measure the increase light transmission that occurs in direct proportion to platelet aggregation

A

Classic Platelet Aggregometry

79
Q

Platelet Function Testing:

Induced by various agonists

A

Classic Platelet Aggregometry

80
Q

Platelet Function Testing:

Upon activation, platelets become sticky and adhere to metal sensor wires (electrodes)

A

Whole Blood Aggregation by Impedance

81
Q

Platelet Aggregometers

Three calculated parameters:

A

○ Maximum percentage aggregation
○ Area under the curve
○ Velocity

82
Q

Platelet Aggregometers:

A

A. PAP–8E from BioData
B. Chrono-Log
C. Multiplate Analyzer from Diapharma
D. AggRAM from Helena

83
Q

Is an eight-channel platelet aggregometer with a touch screen and on-screen procedure templates

A

PAP–8E from BioData

84
Q

Uses LTA and a low sample volume

A

PAP–8E from BioData

85
Q

PAP–8E from BioData sample

86
Q

Has a whole blood/optical lumi–aggregation system

A

Chrono-Log

87
Q

Chrono-Log sample:

88
Q

Provides for platelet aggregation (impedance) and measures platelet secretion (optical density) response

A

Chrono-Log

89
Q

Also called Whole–Blood Multiple Electrode Platelet Aggregometer (MEA)

A

Multiplate Analyzer from Diapharma

90
Q

Monitors platelet function by impedance

A

Multiplate Analyzer from Diapharma

91
Q

Correlate well with LTA in testing therapeutic efficacy

A

Multiplate Analyzer from Diapharma

92
Q

A modular system for platelet aggregation and ristocetin cofactor testing

A

AggRAM from Helena

93
Q

AggRAM from Helena Use laser diode measuring at a wavelength of

94
Q

Platelet Function Analyzers

A
  1. Siemens PFA-100 Platelet Function Analyzer
  2. Verify Now from Accriva Diagnostics
  3. Plateletworks Platelet Function Assay (Helena)
95
Q

Automated instrument that provides rapid results on quanti- and qualitative platelet abnormalities

A

Siemens PFA-100 Platelet Function Analyzer

96
Q

Test cartridges stimulate platelet aggregation using collagen/epinephrine or collagen/ADP

A

Siemens PFA-100 Platelet Function Analyzer

97
Q

Measures the time for a platelet plug to occlude a microscopic aperture

A

Siemens PFA-100 Platelet Function Analyzer

98
Q

Successful in detecting von Willebrand disease and assessing aspirin therapy efficacy

A

Siemens PFA-100 Platelet Function Analyzer

99
Q

Optical detection system measuring platelet aggregation by microbead agglutination.

A

Verify Now from Accriva Diagnostics

100
Q

Uses disposable cartridges with fibrinogen-coated beads and platelet agonists.

A

Verify Now from Accriva Diagnostics

101
Q

Provides aspirin assay, glycoprotein IIb/IIIa inhibitor assay, and P2Y12 inhibitor assay

A

Verify Now from Accriva Diagnostics

102
Q

Results available in about 10 minutes, suitable for near-patient testing

A

Verify Now from Accriva Diagnostics

103
Q

Can be run on any standard impedance cell counter.

A

Plateletworks Platelet Function Assay (Helena)

104
Q

Aggregation results based on platelet count before and after activation

A

Plateletworks Platelet Function Assay (Helena)

105
Q

Results obtainable in 2 minutes, ideal for presurgical screening and antiplatelet therapy monitoring

A

Plateletworks Platelet Function Assay (Helena)

106
Q

Requires minimal specimen volumes, suitable for pediatric and difficult-to-draw patients.

A

Flow Cytometry

107
Q

Able to measure multiple cellular activation-dependent changes related to platelet function

A

Flow Cytometry

108
Q

Available for the diagnosis of heparin-induced thrombocytopenia (HIT), but currently laboratory developed tests (LDTs)

A

Flow Cytometry

109
Q

are widely used for their accuracy in detecting point mutations and single-nucleotide polymorphisms.

A

Polymerase chain reaction (PCR)-based assays

110
Q

while less common, is another method for analyzing PCR products

A

Restriction fragment-length polymorphism (RFLP) analysis

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