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CLINICAL CHEMISTRY > Basic Principles and Practices > Flashcards

Basic Principles and Practices Flashcards

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1
Q

Quantitative science that is concerned with measurement of amounts of biologically important substances (analytes) in body fluids

A

Clinical Chemistry

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2
Q

What is the primary purpose of a clinical chemistry laboratory

A

To facilitate the correct performance of analytic procedures that yield accurate and precise information, aiding patient diagnosis and treatment

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3
Q

It defines the physical quantity or dimension

A

Unit

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4
Q

A system preferred in scientific literature and clinical laboratories and is the only system employed in many countries

A

Système International d’Unités (SI)

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5
Q

Système International d’Unités (SI), adopted internationally in

A

1960

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6
Q

The SI system units are based on

A

Metric system

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7
Q

Subclassifications of SI system

A

Basic unit
Derived units
Non-SI units

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8
Q

This group develops standards of practice, definitions, and guidelines that can be adopted by everyone in a given field, providing for more uniform terminology and less confusion

A

International Organization for Standardization

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9
Q

Reporting of laboratory results is often expressed in terms of

A

Substance concentration or the mass of a substance

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10
Q

Varying grades of purity of analytic chemicals

A

Analytic reagent (AR)
Ultrapure
Chemically pure (CP)
United States Pharmacopeia (USP)
National Formulary (NF)
Technical or commercial grade

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11
Q

Purity grade of the chemical that is specified by American Chemical Society

A

Analytic reagent (AR) grade chemicals

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12
Q

Chemicals of this category are suitable for use in most analytic laboratory procedures

A

Analytic reagent (AR)

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13
Q

Chemicals that have been put through additional purification steps for use in specific procedures such as chromatography, atomic absorption, immunoassays, molecular diagnostics, standardization, or other techniques that require extremely pure chemicals

A

Ultrapure chemicals

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14
Q

These reagents may carry designations of HPLC (high-performance liquid chromatography) or chromatographic on their labels

A

Ultrapure chemicals

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15
Q

Chemicals used to manufacture drugs

A

United States Pharmacopeia (USP); National Formulary (NF) grade chemicals

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16
Q

The limitations established for this group of chemicals are based only on the criterion of not being injurious to individuals

A

United States Pharmacopeia (USP); National Formulary (NF) grade chemicals

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17
Q

Chemicals that are pure enough for use in most chemical procedures

A

United States Pharmacopeia (USP); National Formulary (NF) grade chemicals

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18
Q

Impurity limitations are not stated and that preparation of these chemicals is not uniform

A

Chemically pure (CP) or pure grade

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19
Q

Analysis often used to ascertain the acceptable purity range of chemically pure (CP) grade chemicals

A

Melting point analysis

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20
Q

These chemicals are not recommended for clinical laboratories use for reagent preparation unless further purification or a reagent blank is included

A

Chemically pure (CP) or pure grade

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21
Q

Chemicals used primarily in manufacturing and should never be used in the clinical laboratory

A

Technical or commercial grade reagents

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22
Q

Organic reagents with some impurities

A

Practical grade

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23
Q

Organic reagents which approaches the purity level of reagent grade chemicals

A

Chemical pure

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24
Q

Purity levels of these chemicals are attained by their respective procedures

A

Spectroscopic (spectrally pure) and chromatographic grade organic reagents

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25
Q

Chemicals certified to contain impurities below certain levels established by the ACS

A

Reagent grade (ACS)

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26
Q

It requires manufacturers to clearly indicate the lot number, plus any physical or biologic health hazard and precautions needed for the safe use and storage of any chemical

A

Occupational Safety and Health Administration (OSHA)

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27
Q

They are required to provide technical data sheets for each chemical manufactured on a document called a Material Safety Data Sheet (MSDS)

A

Chemical manufacturers

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28
Q

Highly purified chemical that can be measured directly to produce a substance of exact known concentration and purity

A

Primary standard

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29
Q

ACS purity tolerances for primary standards

A

100 ± 0.02%

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30
Q

Developed certified standard reference materials/ SRMs for use in clinical chemistry laboratories

A

National Institute of Standards and Technology (NIST)

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31
Q

Used when producing calibrator and standard materials

A

NIST SRM

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32
Q

Substance of lower purity, with its concentration determined by comparison with a primary standard

A

Secondary standard

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33
Q

The composition of this standard cannot be directly determined

A

Secondary standard

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34
Q

This standard depends on analytic reference method

A

Secondary standard

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35
Q

Most frequently used reagent in the laboratory

A

Water

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36
Q

Water solely purified by distillation results in

A

Distilled water

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37
Q

Water purified by ion exchange produces

A

Deionized water

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38
Q

Reverse osmosis, which pumps water across a semipermeable membrane, produces

A

RO water

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39
Q

Other methods for water purification

A

Ultrafiltration
Ultraviolet light
Sterilization
Ozone treatment

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40
Q

Clinical and Laboratory Standards Institute (CLSI), classified reagent grade water into six categories based on

A

Specifications needed for its use

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41
Q

Categories of reagent grade water

A

Clinical laboratory reagent water (CLRW)
Special reagent water (SRW)
Instrument feed water
Water supplied by method manufacturer
Autoclave and wash water
Commercially bottled purified water

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42
Q

Water monitoring parameters

A

Microbiological count
Resistivity
pH
Organics
Particulate matter
Silicate

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43
Q

Type of water with the most stringent requirements and generally suitable for routine laboratory use

A

Type I

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44
Q

Process that can remove particulate matter from municipal water supplies before any additional treatments

A

Prefiltration

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45
Q

Composition of filtration cartridges

A

Glass
Cotton
Activated charcoal
Submicron filters

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46
Q

Pore size of submicron filters

A

≤0.2 mm

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47
Q

Function of activated charcoal in filtration cartridge

A

Removes organic materials and chlorine

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48
Q

Function of submicron filter in filtration cartridge

A

Remove substances larger than the filter’s pores, including bacteria

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49
Q

Water that has been purified to remove almost all organic materials, using a technique of distillation

A

Distilled water

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50
Q

Water that has some or all ions removed, although organic material may still be present, so it is neither pure nor sterile

A

Deionized water

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51
Q

Water that is produced using either an anion or a cation exchange resin, followed by replacement of the removed ions with hydroxyl or hydrogen ions

A

Deionized water

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52
Q

Process that uses pressure to force water through a semipermeable membrane, producing water that reflects a filtered product of the original water

A

Reverse osmosis

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53
Q

Process that is excellent in removing particulate matter, microorganisms, and any pyrogens or endotoxins

A

Ultrafiltration and nanofiltration

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54
Q

Process that removes some trace organic material

A

Ultraviolet oxidation

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55
Q

Acceptable for glassware washing but not for analysis or reagent preparation

A

Type III/autoclave wash water

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56
Q

Type of water acceptable for most analytic requirements, including reagent, quality control, and standard preparation

A

Type II water

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57
Q

Type of water used to test methods requiring minimum interference, such as trace metal, iron, and enzyme analyses

A

Type I water

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58
Q

Why is it that storage for some reagent grade water is discouraged?

A

Because of the changes in resistivity

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59
Q

Storage requirement for Clinical Laboratory Reagent Water

A

CLRW should be stored in a manner that reduces any chemical or bacterial contamination and for short periods

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60
Q

Testing procedures to determine the quality of reagent grade water include measurements of

A

Resistance
pH
Colony counts
Chlorine
Ammonia
Nitrate or nitrite
Iron
Hardness
Phosphate
Sodium
Silica
Carbon dioxide
Chemical oxygen demand
Metal detection

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61
Q

The relationship of water purity to resistance

A

Linear, Generally, as purity increases, so does resistance

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62
Q

A substance that is dissolved in a liquid is called

A

Solute

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63
Q

In laboratory science, biologic solutes are also known as

A

Analytes

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64
Q

The liquid in which the solute is dissolved

A

Solvent

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65
Q

Solute and solvent together represent a

A

Solution

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66
Q

SI expression for the amount of a substance

A

Mole

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67
Q

Expressed as equal parts per hundred or the amount of solute per 100 total units of solution

A

Percent solution

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68
Q

Three expressions of percent solutions

A

Weight per weight (w/w)
Volume per volume (v/v)
Weight per volume (w/v)

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69
Q

Expressed as the number of moles per 1 L of solution

A

Molarity (M)

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70
Q

Represents the amount of solute per 1 kg of solvent

A

Molality (m)

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71
Q

The least likely encountered concentration expression in clinical laboratories, but it is often used in chemical titrations and chemical reagent classification

A

Normality

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72
Q

It is defined as the number of gram equivalent weights per 1 L of solution

A

Normality

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73
Q

Routine terms in the clinical laboratory that describe the extent of saturation

A

Dilute
Concentrated
Saturated
Supersaturated

74
Q

A solution which there is relatively little solute or one which has been made to a lower solute concentration per volume of solvent as when making a dilution

A

Dilute solution

75
Q

Solution that has a large quantity of solute in solution

A

Concentrated solution

76
Q

A solution in which there is an excess of undissolved solute particles can be referred to as

A

Saturated solution

77
Q

A solution that has an even greater concentration of undissolved solute particles than a saturated solution of the same substance

A

Supersaturated solution

78
Q

The properties of osmotic pressure, vapor pressure, freezing point, and boiling point are called

A

Colligative properties

79
Q

The pressure at which the liquid solvent is in equilibrium with the water vapor

A

Vapor pressure

80
Q

The temperature at which the vapor pressures of the solid and liquid phases are the same

A

Freezing point

81
Q

The temperature at which the vapor pressure of the solvent reaches one atmosphere

A

Boiling point

82
Q

Predictable changes in the colligative properties when solute is dissolved in a solvent

A

Freezing point is lowered by -1.86°C
Boiling point is raised by 0.52°C
Vapor pressure is lowered by 0.3 mm Hg or torr
Osmotic pressure is increased by a factor of 1.7 × 10^4 mm Hg or torr

83
Q

A measure of the ability of a solution to accept or donate electrons

A

Redox potential, or oxidation-reduction potential

84
Q

Substances that donate electrons are called

A

Reducing agents

85
Q

Substances that accept electrons are called

A

Oxidizing agents

86
Q

A measure of how well electricity passes through a solution

A

Conductivity

87
Q

The reciprocal of conductivity, is a measure of a substance’s resistance to the passage of electrical current

A

Resistivity

88
Q

The primary application of resistivity in the clinical laboratory

A

For assessing the purity of water

89
Q

Unit of expression of resistivity

A

Ohms

90
Q

Unit of expression of conductivity

A

Ohms^-1 or mho

91
Q

Refers to weak acids or bases and their related salts that, as a result of their dissociation characteristics, minimize changes in the hydrogen ion concentration

A

Buffers

92
Q

Represents the negative or inverse log of the hydrogen ion concentration

A

pH

93
Q

Mathematically describes the dissociation characteristics of weak acids and bases and the effect on pH

A

Henderson-Hasselbalch equation

94
Q

The concentration or activity of ions in a solution or buffer

A

Ionic strength

95
Q

The SI designation for temperature

A

Kelvin

96
Q

Type of thermometer that uses a colored liquid (red or other colored material), or at one time mercury, encased in plastic or glass material with a bulb at one end and a graduated stem

A

Liquid-in-glass thermometers

97
Q

Thermometers used for measuring temperatures in units such as heating blocks and water baths and should be immersed to the proper height as indicated by the continuous line etched on the thermometer stem

A

Partial immersion thermometers

98
Q

Thermometer that requires the bulb and entire column of liquid be immerse into the medium measured, and are used for refrigeration applications

A

Total immersion thermometers

99
Q

Thermometer used to check temperatures on flat surfaces, such as in an incubator or heating oven

A

Surface thermometers

100
Q

Laboratory supplies consisted of some type of glass could be correctly termed

A

Glasswares

101
Q

Class of laboratory supplies that satisfy ASTM precision criteria and are preferred for laboratory applications

A

Class A

102
Q

Class of laboratory supplies that are identical to Class A, have twice the tolerance limits of Class A, and are often found in student laboratories where durability is needed

A

Class B

103
Q

Designation for vessels that do not deliver the same volume when the liquid is transferred into a container

A

To contain (TC) devices

104
Q

Designation for vessels that delivers exact amount of liquid

A

To deliver (TD) devices

105
Q

Categories of glasswares

A

Kimax/Pyrex (borosilicate)
Corex (aluminosilicate)
High silica
Vycor (acid and alkali resistant)
Low actinic (amber colored)
Flint (soda lime) glass used for disposable material

106
Q

Characteristics of laboratory plasticwares 

A

Resistance to corrosion and breakage
Flexible
Relatively inexpensive

107
Q

The major types of resins frequently used in the clinical chemistry laboratory

A

Polystyrene
Polyethylene
Polypropylene
Tygon
Teflon
Polycarbonate
Polyvinyl chloride

108
Q

Successful cleaning solutions for glasswares and plasticwares

A

Acid dichromate
Nitric acid

109
Q

Type of cleaner used in the clinical laboratory that can help remove debris coating the surfaces of glass

A

Ultrasonic cleaners

110
Q

The flask has a round, lower portion with a flat bottom and a long, thin neck with an etched calibration line

A

Volumetric flask

111
Q

The flask that has a wide bottom that gradually evolves into a smaller, short neck

A

Erlenmeyer flask

112
Q

Container that has a flat bottom, straight sides, and an opening as wide as the flat base, with a small spout in the lip

A

Griffin beaker

113
Q

Laboratory vessel with long, cylindrical tubes usually held upright by an octagonal or circular base

A

Graduated cylinders

114
Q

Glass or plastic utensils used to transfer liquids; they may be reusable or disposable

A

Pipets

115
Q

Pipet that holds or contains a particular volume but does not dispense that exact volume

A

TC pipets

116
Q

Pipet that will dispense the volume indicated

A

TD pipets

117
Q

Pipet that has a continuous etched ring or two small, close, continuous rings located near the top of the pipet

A

Blowout pipet

118
Q

Pipet that allows the contents of the pipet to drain by gravity

A

Self-draining pipet

119
Q

A self-draining pipet without graduations to the tip. And the tip should not be allowed to touch the vessel while the pipet is draining

A

Mohr pipet

120
Q

Pipet with graduation marks to the tip and is generally a blowout pipet

A

Serologic pipet

121
Q

A pipet with a total holding volume of less than 1 mL; it may be designed as either a Mohr or a serologic pipet

A

Micropipet

122
Q

The subgroups of measuring or graduated pipets

A

Mohr
Serologic
Micropipets

123
Q

These pipets are designed to dispense one volume without further subdivisions

A

Transfer pipets

124
Q

Pipet used with biologic fluids having a viscosity greater than that of water

A

Ostwald-Folin pipets

125
Q

Pipet designed to dispense or transfer aqueous solutions and is always self-draining

A

Volumetric pipet

126
Q

This type of pipet usually has the greatest degree of accuracy and precision and should be used when diluting standards, calibrators, or quality-control material

A

Volumetric pipet

127
Q

Pipet without calibration marks and are used to transfer solutions or biologic fluids without consideration of a specific volume

A

Pasteur pipets

128
Q

These pipets should not be used in any quantitative analytic techniques

A

Pasteur pipets

129
Q

The most routinely used pipet in today’s clinical chemistry laboratory

A

Automatic pipet

130
Q

A pipet associated with only one volume is termed

A

Fixed volume pipet

131
Q

A pipet associated with different volume is termed

A

Variable pipet

132
Q

Pipet that relies on a piston for creating suction to draw the sample into a disposable tip that must be changed after each use

A

Air-displacement pipet

133
Q

Pipet that operates by moving the piston in the pipet tip or barrel, much like a hypodermic syringe

A

Positive-displacement pipet

134
Q

Automatic pipets that obtain the liquid from a common reservoir and dispense it repeatedly

A

Dispensers and dilutor/dispenser pipets

135
Q

The most desirable method for pipet calibration

A

Gravimetric Pipet Calibration

136
Q

How often do we need to perform pipet calibration

A

Three or four times per year, or as dictated by the laboratory’s accrediting agency

137
Q

Labware that looks like a wide, long, graduated pipet with a stopcock at one end

A

Buret

138
Q

Function of buret

A

It is used to dispense a particular volume of liquid during a titration

139
Q

Many compounds combine with water molecules to form loose chemical crystals. The compound and the associated water are called a

A

Hydrate

140
Q

When the water of crystallization is removed from the compound, it is said to be

A

Anhydrous

141
Q

Substances that take up water on exposure to atmospheric conditions are called

A

Hygroscopic

142
Q

These compounds absorb enough water from the atmosphere to cause dissolution

A

Deliquescent substances

143
Q

Closed and sealed containers that contain desiccant material may be used to store more hygroscopic substances

A

Dessicators

144
Q

Type of balances that are currently the most popular in the clinical laboratory

A

Analytic and electronic balances

145
Q

Balance required for the preparation of any primary standard

A

Analytic balances

146
Q

A process in which centrifugal force is used to separate solid matter from a liquid suspension

A

Centrifugation

147
Q

Centrifugal force depends on three variables:

A

Mass
Speed
Radius

148
Q

The centrifugal force generated is expressed in terms of

A

Relative centrifugal force (RCF) or gravities (g)

149
Q

A process in which uses porous material to separate solid matter from a liquid suspension

A

Filtration

150
Q

The liquid that passes through the filter paper is called

A

Filtrate

151
Q

The solid material trapped on the filter paper is called

A

Residue

152
Q

Method for separating macromolecules from a solvent or smaller substances

A

Dialysis

153
Q

Expressed as mass per unit volume of a substance

A

Density

154
Q

Ratio of the density of a material when compared with the density of pure water at a given temperature

A

Specific gravity

155
Q

Represents the ratio of concentrated or stock material to the total final volume of a solution and consists of the volume or weight of the concentrate plus the volume of the diluent, with the concentration units remaining the same

A

Dilution

156
Q

Type of dilution when the laboratory scientist must decide on the total volume desired and the amount of stock to be used

A

Simple dilution

157
Q

It is defined as multiple progressive dilutions ranging from more concentrated solutions to less concentrated solutions

A

Serial dilution

158
Q

Dilution method used to obtain titer

A

Serial Dilutions

159
Q

Mathematically establishes the relationship between concentration and absorbance in many photometric determinations

A

Beer-Lambert law (Beer’s law)

160
Q

The act of obtaining a blood sample from a vein using a needle attached to a syringe or a stoppered evacuated tube

A

Phlebotomy, or venipuncture

161
Q

The most frequent site for venipuncture

A

Antecubital vein of the arm

162
Q

Relation of needle gauge and needle size

A

Inversely related; the larger the number, the smaller the needle bore and length

163
Q

How to properly collect blood samples to patients with IV infusions?

A

Sites adjacent to IV therapy should be avoided; however, if both arms are involved in IV therapy and the IV cannot be discontinued for a short time, a site below the IV site should be sought. The initial sample drawn (5 mL) should be discarded because it is most likely contaminated with IV fluid and only subsequent sample tubes should be used for analytic purposes

164
Q

The major difference between plasma and serum

A

Serum does not contain fibrinogen

165
Q

What to do before centrifuging serum samples?

A

It is important that serum samples be allowed to completely clot (≈20 minutes) before being centrifuged

166
Q

Does plasma samples require time to clot before centrifugation?

A

No

167
Q

Destruction of red cells that can result in hemoglobin release

A

Hemolysis

168
Q

First step in sample collection

A

Proper patient identification

169
Q

Effects of prolonged tourniquet application

A

Causes a stasis of blood flow and an increase in hemoconcentration and anything bound to proteins or the cells

170
Q

Why do we prohibit our patients to open and close their fist during phlebotomy?

A

It may cause an increase in potassium

171
Q

Proper antiseptic for disinfecting the site when drawing blood alcohol levels

A

Non-alcohol antiseptics

172
Q

Laboratory test often used to assess the completeness of a 24-hour urine sample

A

Creatinine analysis

173
Q

The average adult excretes _____ of creatinine per ___ hours

A

1-2grams; 24hours

174
Q

Is CSF an ultrafiltrate of the plasma?

A

Yes

175
Q

Sample used to assess fetal lung maturity (L/S ratio), congenital diseases, hemolytic diseases, genetic defects, and gestational age

A

Amniotic fluid

176
Q

Increased bilirubin pigment in blood samples

A

Icterus

177
Q

Increased lipids in blood sample

A

Lipemia

178
Q

Plasma or serum samples should be analyzed within

A

4 hours

179
Q

What to do when testing of plasma or serum samples is not possible within 4 hours?

A

Refrigerate at 4°C for 8 hours

180
Q

Temperature requirements when storing plasma or serum samples for a longer period

A

-20°C

CLINICAL CHEMISTRY (10 decks)

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