Block A

Question 1

What is clinical biochemistry?

Answer 1

This is pathology used to test and advice clinicians on next steps

Question 2

What is involved in Clinical Biochemistry

Answer 2

MLAs, BMS, Clinical Scientists, Doctors

Question 3

How can we use this?

Answer 3

Screening and Diagnostics

Question 4

Examples of clinical biochemistry in Scotland?

Answer 4

Bowel Screening Program

Question 5

What are the three main steps of the process?

Answer 5

Pre-Analytical, Analytical, Post-Analytical

Question 6

Who interprets results?

Answer 6

Clinical Biochemists

Question 7

How do Clincial Biochemists train?

Answer 7

STP with integrated MSc in Clinical Biochemists

Question 8

What is the day-to-day job of trainees

Answer 8

Doctors
Clinical advice
Research and teaching (literature)
Develop new tests
Analyseeeee

Question 9

Why implement a new test?

Answer 9

When it is appropraite for diagnosis and treatment of disease

Question 10

What questions should be asked before developing a new test?

Answer 10

Is it important?
Is it sutiable?
Is there already a comercially available test?
How can we validate this?

Question 11

What stats should be used?

Answer 11

Accurate
Precise
Specific
Sensitive

Question 12

What do we need when interpreting results?

Answer 12

Reference ranges
Whole picture

Question 13

What are some new test examples implemented by the NHS recently?

Answer 13

Troponin for MI
Anti-Mullerian Hormone for oocyte yield in IVF and success rate, however was use inappropriately for testing fertility - too many people requesting this. This is an example of an unnecessary use of a test.

Question 14

What are the areas of healthcare scientists in the NHS?

Answer 14

Life Sciences
Medical Physics
Ecological
Clinical Bioinformatics

Question 15

What are the purposes of testing?

Answer 15

Diagnosis
Progression
Treatment efficacy
Screening
Treatment complications
Predicting survival
Accuracy
Response to drugs
Malpractice
Assess health of the person
Uncertainty of diagnosis

Question 16

Testing can be done on….

Answer 16

Urine, Blood, Kidney and Gall stones, Stool, Saliva, Synovial Fluid, Cerebrispial fluid, Amnetotic fluid, Tissue, Gastric fluid

Question 17

Steps in a Lab Test

Answer 17

Requested
Collected - into a tube specific to the sample type e.g. EDTA for a blood sample
Transported
Logged into the lab
Processed
Analysed
Verified by CBC
Results sent to patient records
Assessed by a clinician

Question 18

Methods for analysis of certain things

Answer 18

Blood - flow cytometry
Steroid - Liquid chromatography tandem mass spectormety
Specialised - not automated
Trace metals - intergrated coupled plasma mass spectormetry
Vitamins - high pressure mass spectometry

Question 19

Three sections of lab

Answer 19

Core Lab
Specialised testing
Point of care tests

Question 20

Quality assurance

Answer 20

HLA - 2004 - tissue testing and storage and 2006 - authorisation
ABCLA
NEQUAS
Global quality assurance

Question 21

Why is there less than normal quality assurance>

Answer 21

Less liely to be errors because this is all automated and maintained

Question 22

What is a point of care test

Answer 22

Diagnostic test

Question 23

What is a point of care device

Answer 23

Allows for the test to be done anywhere

Question 24

Examples of point of care tests

Answer 24

Glycated haemoglobin
Blood glucose
Pregnancy hormones
Drugs of abuse
Rapid viral lateral flow
Cardiac biomerkers

Question 25

Quality assurance of POCT

Answer 25

Manufacturing devices standards and evalutation of the devices

Question 25

Future of point of care testing

Answer 25

HbA1c in Japan
Cardiac biomarkers
Lab on a chip
Blood glucose testing

Question 26

Device errors

Answer 26

Contamination
Bad programming
Out of date
Correct coding
Temperature of the device