CC PART 1 Flashcards

1
Q

(2) WET CHEMISTRY

A

A. Liquid Reagent
B. Lyophilized Reagent

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2
Q

entails freezing a material at −40 °C or less and then subjecting it to a high vacuum. Very low temperatures cause the ice to sublimate to a vapor state. The solid non-sublimable material remains behind in a dried state.

A

Lyophilization

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3
Q
  1. In Jendrassik-Grof Method for bilirubin, caffeine and sodium benzoate serve as:

A. Color developer
B. Stopper of reaction
C. Dissociating reagent
D. Reducing agent

A

C. Dissociating reagent

Rationale:
● Technique for Multiple Choice Questions →
Elimination
○ Color developer (diazo reagent) ✖️
○ Stopper of the reaction (Ascorbic acid) ✖️
● Explanation: In Jendrassik Grof, B1 is attached to
the albumin. When you add a diazo, it will not
react. B1 and Albumin (Both are indirect method)
must be separated via Dissociating Reagent such
as
■ Caffeine
■ Sodium benzoate
■ Evelyn Malloy
● Reagent: 50% methanol

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3
Q

Storage and stability

Reagent storage:

A

2-80 C

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4
Q
  1. Performance indicator that refers to the dispersion of repeated measurements around the mean

a) Accuracy
b) Precision
c) Reliability
d) Linearity

A

B. Precision - magkakasama yung values pero wala sa gitna

Rationale:
● Accuracy: Nearness to the true value (If it hits the right target)
● Reliability: If the machine remains both accurate and precise for an extended period of time
● Linearity: It is the reportable range of an analyte

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4
Q
  1. Long acting barbiturate used in treating generalized grand-mal tonic-clonic seizures:

a) Ethosuximide
b) Acetaminophen
c) Tacrolimus
d) Phenobarbital

A

D. Phenobarbital

Rationale:
● 2 types of seizure:
○ Grand mal
○ Petit mal
● NOT tacrolimus since it is an immunosuppressant
● NOT acetaminophen since it is an antipyretic

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5
Q
  1. When the spread of data in the gaussian distribution falls between +/- 2 SD, the confidence
    interval is:

a) 68.3%
b) 95.8%
c) 99.7%
d) 100%

A

b. 95.8%

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6
Q
  1. Convert 5 dL to mL

A. 5 mL
B. 50 mL
C. 500 mL
D. 5000 mL

A

C. 500 mL

Rationale: 1 dL = 100 mL

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7
Q
  1. Process that guarantees that the laboratory results are accurate as possible and includes three phases of testing: Preanalytic, analytic, post-analytic

A. Quality Management
B. Quality assurance
C. Quality points
D. Quality Control

A

Quality Assurance

Rationale: The bigger umbrella is Quality Management. Under Quality Management is the Quality Assurance. Quality Assurance has three phases called pre-examination,
examination, and post examination. Quality Control is under the examination phase or analytical phase.

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8
Q
  1. Which of the following lipoproteins can be observed in the upper part of the evacuated tube?

A. Cholesterol
B. VLDL
C. Triglycerides
D. Chylomicrons

A

D. Chylomicrons

Rationale:
● If the patient does not fast, this can be observed in the upper portion of Chylomicrons
● If the sample is turbid? = VLDL
What type of triglyceride does chylomicron transport?
● Exogenous
○ For VLDL
● Endogenous
If the question would be “Which LIPID…” = The answer would be Triglycerides

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9
Q
  1. Instrument technique that measures the amount of light emitted by the excited atom

a) Atomic Absorption Spectrophotometry
b) Spectrometry
c) Flame Emission Photometry
d) Nephelometry

A

Flame Emission Photometry

Rationale:
● If the question would be “The amount of light…”
○ Emitted: Flame Emission Photometry
○ Absorbed by ground state: Atomic
Absorption Spectrometry
○ Transmitted: Spectrometry
○ Scattered: Nephelometry
○ Blocked: Turbidimetry

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10
Q
  1. If the quality improvment, the question “Does this process need to exist?” refers to:

A. Lean
B. Six Sigma
C. Lean Six Sigma
D. Quality Assessment

A

A. Lean

Rationale:
● Lean: Reduction of waste
● Six Sigma: Reduction of errors
● If combined (Lean Six Sigma): Reduction of waste
and errors

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11
Q
  1. Sa blood sample collected by the medical technologist was accidentally left at the nurse station of hours, what test can still be performed?

A. Electrolytes
B. Cholesterol
C. Triglycerides
D. Glucose

A

C. Triglycerides

Rationale:
● Electrolytes: Increase
● Glucose: Decrease every hour

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12
Q

(2) CHEMISTRY APPROACH

A

1 WET CHEMISTRY
2 DRY CHEMISTRY

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13
Q

NO reconstitution needed

A

Liquid Reagent

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14
Q

Does Lyophilized Reagent Has Longer shelf life?

True or False

A

True

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15
Q

+ Diot H2oO -> Reconstituted

A

Lyophilized Reagent

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16
Q

Machine: Vitros

A

Dry Chemistry

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17
Q

Machine: Cobas

A

Wet Chemistry

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18
Q

(5) layers in Dry Chemistry

A
  1. Spreading
  2. Scavenger
  3. Reagent
  4. Indicator
  5. Support
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18
Q

Principle: Reflectance Photometry
- Lights are reflected

A

Dry Chemistry

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19
Q

Validation Studies

BUN STD = 10 mg/dL

a. 11 mg/dL
b. 10 mg/dL
c. 9 mg/dL
d. AOTA

A

b. 10 mg/dL (Accuracy)

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19
Q

Smaller volume requirement

A

Dry Chemistry

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20
Q

(5) Reagent Considerations

A
  1. Storage and stability
  2. Reagent Distribution
  3. Interfering Substances
  4. Expected Values
  5. Performance Characteristics
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20
Q

Change in the Reagent Lot number:

A

Perform Validation Study (Recalibration)

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21
Q

TREND or SHIFT

Using deteriorated reagent:

A

TREND

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22
Q

Trend and Shift is it Random or Systematic?

A

Systematic

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23
Q

(2) Reasons for using a calibrator/standard

A
  1. When performing method evaluation/technical validation
  2. Identification of errors in WG rule when the reagent is out of control
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24
Q

Must know of a medtech:

A

Knowledge of chemicals, standards solutions buffer and water requirements (MSDS/SDS)

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25
Q

(5) Reagent Deterioration

A
  1. Turbidity and precipitation
  2. Reagent fails to meet linearity claims
  3. Fails to recover control value in stated range
  4. Moisture has penetrated the vial and caking has occurred
  5. discrepancy in the first absorbance against water either greater or less than 0.8 depending on the set wavelength
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25
Q

Reportable range

A

linearity

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26
Q

(3) Interfering Substances

A
  1. Anticoagulants
  2. Drugs and other substances
  3. Pyridoxal Phosphate
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27
Q

(3) Common anticoagulants that cause interference:

A
  1. EDTA
  2. NaF
  3. Oxalate
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28
Q

(3) Blank

A
  1. Reagent blank
  2. Sample blank
  3. Water blank
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29
Q

If the sample is hemolyzed, lipemic, icteric what blank will you used?

A

Sample Black

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30
Q

To set spectrophotometer reading to zero

ABS -
% Transmission -

A

Water Blank

ABS - 0
% Transmission - 100

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31
Q

Before, During, After

Reagent

A

Before

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32
Q

Before, During, After

Sample

A

During

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33
Q

Before, During, After

Water Blank

A

Before

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34
Q

(4) Performance Characteristics

A
  • Linearity/Analytical Measurement Range (AMR)
  • Comparison of methods
  • Sensitivity and Specificity
  • Precision studies
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35
Q

Two commercial serum controls were assayed twenty times and the following ________________ precison was obtained.

A

Within Run

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36
Q

Two commercial serum controls were assayed for five consecutive days (triplicate for each level), the following ______________ precision was obtained

A

Run to Run Precision

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37
Q

Two means

A

T test

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38
Q

highly purified chemical than can be measured directly to produce a substance of exact known
concentration

A

Primary standard

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39
Q

substance of lower purity

A

Secondary standard

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40
Q

represents a specimen that is similar in composition to the patient’s whole blood or plasma. The value is known and measured the same way with the patient unknown sample.

A

Controls

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40
Q

Can you use Secondary standard alone?

A

No

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41
Q

(2) Controls

A
  1. Assayed
  2. Unassayed
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42
Q

High, Normal, Low

A

3 levels

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43
Q

Pathologic and nonpathologic

A

2 levels

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44
Q

All CC tests except Blood gases, therapeutic drugs, hormones

A

2 Levels

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45
Q

WG note:
1:2s
1:3s
R:4S
2:2S
4:1S
10:X

A

2 Levels

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46
Q

● Additional Westgard rules:
- 3:15
- 2 of 3:2S
- 7T
- 9X

A

3 Levels

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47
Q

Once in 24 hours

A

2 levels

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48
Q

Every 8 hours

A

3 levels

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49
Q

monitors overall reliability of laboratory results

means of accuracy and precision

A

Quality Controls

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50
Q

Two Divisions of Quality Control:

A
  1. Internal
  2. External
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51
Q

Proficiency testing

A

External quality control

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52
Q
  1. Analysis of control samples
  2. Instrument maintenance
  3. Statistical analysis
A

Internal quality control

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53
Q

Water purified by distillation, purified to remove almost all organic materials. Water is boiled, vaporized and condensed, distillation of water can be more than once.

A

Distilled Water

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54
Q

-process of removing dissolved gases by nonvolatile substances carried over steam in the distillation process or by dissolved substances from storage containers

A

Double Distillation

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55
Q

Water that is always used in Molecular biology

A

Double Distillation

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56
Q

used for tests that require Nh3 free water

A

Double Distillation

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57
Q

water purified by ion exchange ; removes some or almost all ions ;organic materials may still be present it is neither pure nor sterile ;deionized water is purified from previously pre-filtered or distilled water; produced using either an ANION or a CATION exchange resin

A

Deionized Water

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58
Q

water purified by reverse osmosis

A

Reverse-Osmosis

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59
Q

Uses pressure to pump water across a semipermeable membrane, thereby producing filtered product of the original water. Use also for pretreatment of water

A

Reverse-Osmosis

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60
Q

(4) Water Purification

A
  1. Activated charcoal
  2. Glass
  3. cotton
  4. submicron filter (0.2 mm)
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61
Q

Removes organic materials

A

Activated charcoal

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62
Q

Higher the water resistance/resistivity

_______ the water purity

A

Higher

63
Q

used in clinical chemistry (highest purity)

A

Type 1

64
Q

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

A

Type 1

65
Q

acceptable for most analytic requirements

A

Type 2

66
Q

autoclave wash water- acceptable for glassware washing but not for analysis or reagent preparation

A

Type 3

67
Q
  • utensils made of glass or plastic that are used to transfer liquids. They may be reusable or disposable
A

Pipets

68
Q

the tip should be immersed in the liquid to be transferred to a level that will allow it to remain in the solution after the volume of liquid has entered the pipet

A

Design

68
Q
  • lean by soaking to a soapy water with the pipet tips up; -used for volumes of 20 ml or less.
A

Pipets

69
Q
  • with different tolerances depending on the volume(mL).
A

Pipets

70
Q

Holds a particular volume but does not dispense that exact volume; delivers the
amount by washing it and emptying

A

To contain (TC)

71
Q
  • Calibrated by: Mercury
  • Drainage characteristic: Blow-out
  • For viscous sample
A

To Contain

72
Q

● Calibrated by: Water
● Drainage characteristic: Self-draining
● For non-viscous samples

A

To Contain

73
Q

will dispense the volume indicated; transfer exact amount- do not blow the last drop; rate of flow is gravity

A

To deliver (TD)

74
Q

(2) Drainage Characteristics

A

a. Blow-out
b. Self-draining

75
Q
  • Self draining
  • Non viscous
A

To deliver (TD)

76
Q

Markings are absent

A

Self-draining

76
Q

Calibrated by: Distilled Water

A

To deliver (TD)

77
Q

● Contains two etched rings with
colored rings near the top where
you place the rubber aspirator.
● Before, mouth pipetting was used but was discontinued a few years ago.

A

Blow-out

78
Q

capable of dispensing several different volumes

A

Measuring or graduated

79
Q

designed to dispense one volume without further subdivisions

A

Transfer

80
Q

Serologic (graduated up to the tip)

A

Blow-out pipet

81
Q

-self draining
- full volume should be used
-has dead space

A

Mohr (has dead space)

82
Q

Pipets: According to function

  1. Measuring Pipets
A
  • Mohr
  • Serologic

a. Sahli-Hellige
b. Lang-Levy
c. RBC/WBC pipet

83
Q

-do not have _____________
-transfer solution or biologic fluids without consideration of ________
-maybe disposable

A

-do not have CALIBRATION MARKS
-transfer solution or biologic fluids withOUT consideration of SPECIFIC VOLUME
-maybe disposable

83
Q

-do not have _____________
-transfer solution or biologic fluids without consideration of ________
-maybe disposable

A

Pasteur Pipet

84
Q

– for preparation of ____________________________
-always ______________.
- with greatest degree of accuracy and precision
- most accurate pipet

A

Volumetric pipet (bulb is in the middle)

85
Q

– for preparation of ____________________________
-always ______________.
- with greatest degree of accuracy and precision
- most accurate pipet
- Non-viscous

A

– for preparation of STANDARDS/CALIBRATORS, CONTROLS AND REAGENT.
-always SELF-DRAINING.
- with greatest degree of accuracy and precision
- most accurate pipet

86
Q

-with an etched marked near the delivery tip
-classified as blow-out pipette
- Viscous Samples

A

Ostwald Folin (bulb is nearer the mouthpiece)

87
Q

-with an etched marked near the _______________
-classified as ___________________

A

-with an etched marked near the DELIVERY TIP
-classified as BLOW OUT PIPETTE
- Viscous Samples

88
Q
  1. Single-Channel -
  2. Multi-Channel -
A
  1. Single-Channel - 1 Tip
  2. Multi-Channel - Multiple Tip
89
Q

Fixed Volume and ___

A

Variable volume

90
Q

for volumes less than 1 ml
-automatic implies that the mechanism that draws up liquid and dispenses it

A

Micropipet /Automatic pipet

91
Q
  1. with total holding of less than 1ml
  2. may serologic or Mohr
A

Micropipet

92
Q

QUESTION 1: Pipet with the greatest degree of accuracy and precision:

A. Serologic Pipet
B. Mohr Pipet
C. Ostwald-Folin pipet
D. Volumetric pipet

A

D. Volumetric pipet

93
Q

§ Uses a suction aspirate & dispense sample through polypropylene tip. 1 or 2 stop. 2nd stop button is depressed to 2nd stop to “blow out”. tips can only be used once. Seals require periodic lubrication

A

Air Displacement

94
Q

§ piston-mechanism; air movement; relies on a piston for suction creation to draw the sample into
a disposable tip.

A

Air Displacement

95
Q

§ Uses a glass capillary tip fitted with Teflon -tipped plunger. No carryover. Tips are reusable. Plunger setting must be checked & teflon tip replaced periodically

A

Positive Displacement

96
Q

§ Piston mechanism; syringe like; operates by moving the piston in the pipet tip or barrel; much like a hypodermic syringe.; piston comes in contact with the liquid; no air-interface

A

Positive Displacement

97
Q

QUESTION 2: Positive displacement pipet:

A. With no air cushion
B. Can pipet high density samples
C. Aspiration force remains constant
D. A, B and C

A

D. A, B and C

98
Q
  1. bottle-top
  2. motorized
  3. band-held
  4. attached to dilutor
A

Dispenser pipets

99
Q

Obtain from a common reservoir and dispense it repeatedly

A

Dispenser pipets

100
Q

for automatic pipetting devices

a. spectrophotometer – molar extinction coefficient of a compound is obtained or comparison of different dilution of potassium dichromate and its absorbance

b. Use potassium dichromate (K2CR207), a primary standard that is readily available and has a sharp absorption peak at 350 nm.

A

Photometric method

100
Q

done by delivering and weighing a solution of known specific gravity; such as water; most desirable method-most desirable for pipet calibration.

A

Gravimetric method

100
Q

molar extinction coefficient of a compound is obtained or comparison of different dilution of potassium dichromate and its absorbance

A

Spectrophotometer

101
Q

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

A

Centrifugation

102
Q

Bottle: Low actinic

A

Positive Displacement

103
Q

supernatant –
sediment –

A

supernatant – liquid
sediment – solid

104
Q

Pipet Calibration

A

Quarterly or Every 3 months

105
Q

parts include: head/rotor, carriers, shields, motor, chamber, control panel

A

Centrifugation

106
Q

placing the tube by exact positioning or by the exact opposite

A

Rule of Thumb

107
Q

PURPOSE OF THE HOLE IN centrifuge machine:________________________

A

For speed centrifugation

108
Q

Relative Centrifugal Force (RCF): ________________
Revolutions Per Minute (RPM):________________

A

RCF: Force Acting in the Sample
RPM: Actual Speed

108
Q

TWO MODELS OF CENTRIFUGE:

A
  1. Floor-standing centrifuges
  2. Bench-top centrifuges
109
Q

Tube w/ gel separator:
Tube w/o gel separator:

A

**Tube w/ gel separator: 10-15 minutes @1000-3000g RCF
**Tube w/o gel separator: 10-15 minutes @1000

110
Q

(2) How to obtain better separation of sample:

A
  1. Increase Speed
  2. Increase Time
111
Q

(2) Influences the speed

A
  1. Motor
  2. Rotor
112
Q

You can convert RPM to RCH

true or false

A

true

113
Q

**Bouyant force
**Frictional force

A

Relative Centrifugal Force (RCF)

113
Q

= 1.12X10^-5 x r x rpm2

A

RCF

114
Q

(4) Types of Centrifuge

A
  1. REFRIGERATED CENTRIFUGE/ULTRACENTRIFUGE
  2. FIXED ANGLE
  3. SWINGING BUCKET
  4. CYTOCENTRIFUGE
115
Q

OPERATION VERIFICATION:

A
  1. For critical applications, RPM is checked and recorded at least monthly
  2. For routine applications, RPM is checked and recorded at least quarterly.
115
Q

The function of the refrigerated centrifuge is to protect the biological specimens from damaged caused by heating when centrifuge

Temperature ranges down to -10 C or -20 C (-50 F or -68 F)

A

Refrigerator

116
Q

The cups are held in a rigid position at a fixed angle.

● This position makes the process of centrifuging more rapid than
horizontal-head centrifuge
● Less chance that the sediment will be disturbed when the centrifuge stop

A

Fixed Angle or Vertical Centrifuge

117
Q

● Swinging bucket rotors have holders that swing outward in response to centrifugal force, so that the tube is held vertically when placed into or taken out of the holder, but held horizontally during centrifugation

A

SWINGING BUCKET / HORIZONTAL CENTRIFUGE

118
Q

Characteristics of a Horizontal Centrifuge:

A
  1. When a rest, the tubes are in VERTICAL POSITION
  2. During centrifugation the tubes are in horizontal position
  3. Not capable of higher speed
119
Q

QUESTION 3: Which of the following is not a characteristic of a Horizontal centrifuge?

A. Specimen cups are in vertical position when at rest
B. The cups move to a horizontal position during centrifugation
C. Capable of higher speed
D. As the sample is centrifuged, the particles being sedimented travel down through the liquid to the bottom of the tube

A

C. Capable of higher speed

120
Q

QUESTION 4:
Which centrifuge is used when rapid centrifugation of solution is needed?

A. Horizontal-head.
B. Fixed-Angle
C. Cytocentrifuge
D. None of the items

A

B. Fixed-Angle

121
Q

● Not used in clinical chemistry
● Used in histopathology
● Uses a very high-torque and low inertia motor to spread the
monolayers of cells rapidly across a special slide for clinical morphologic studies.

A

Cytocentrifuge

122
Q

depending on usage: Clean interior components with soap and water followed by freshly made 10% v/v bleach solution, including sample buckets. Wearing protective gloves, wipe interior sides and bottom, taking care when removing broken pieces of glass

A

Weekly or biweekly

123
Q

Place two equally balanced containers into the centrifuge, cover, and operate at the most commonly used speed, listening for unusual vibrations. Check the braking mechanism to ensure a smooth, gradual stop. Check the timer of the centrifuge at 15 minutes, 10 minutes, 5 minutes, and 1 minute for the time the centrifuge motor is spinning (reaches the desired rpm until the motor shuts off) using a stopwatch

A

Monthly

124
Q

Inspect gasket and check for wear and defects, and inspect cover latch for appropriate seal. Inspect head, head shaft, and coupling for evidence of wear, cracks in fitting, corrosion, uneven wear, and signs of fatigue. Inspect brushes for wear and replace according to manufacturer’s
instructions.

A

Quarterly

125
Q

Check the revolutions per minute at several commonly used speeds, including 3000 and 1500 rpm, while centrifuging a balanced load (after it has reached stable speed) using a tachometer aimed at the reflective strip viewed through the top of the centrifuge. If the revolutions per minute vary by more than 5%, consult the manufacturer’s instructions for solving the problem.

A

Quarterly

126
Q

If an analog scale is provided for speed, the scale can be relabeled to match the actual speed. Lubricate the centrifuge shaft according to manufacturer’s instructions, if applicable.

A

Quarterly

127
Q
  • Used to separate serum from a blood clot-used in place of centrifugation
  • Filter material is made of paper cellulose and its derivatives, polyester fibers, glass and a variety of resin column material
A

Filtration

128
Q
  • filter paper differs in terms of pore size and should be collected according to separation needs
  • filter paper should not be used when using strong acids or bases
A

Filtration

128
Q
  • Filtrate : liquid that passes through the filter paper
A

Filtration

129
Q

COLLIGATIVE PROPERTIES

4 properties based on the relative number of each kind of molecule present

A
  1. Vapor Pressure
  2. Freezing point
  3. Boiling point
  4. Osmotic pressure
130
Q

(F and V)
(B and O)

A

Decrease (F and V)
Increase (B and O)

● As the freezing point decreases, the vapor pressure also decreases
● As the boiling point increases, the osmotic pressure also increases

131
Q

Optically measures the level of color density corresponding to the amount of substance being tested for in the sample

A

Spectrophotometer

132
Q

Sample is distributed evenly

A

Spreading Layer

133
Q

Filters out substances that interfere with results

A

Scavenger Layer

134
Q

Reagent reacts with sample

A

Reagent Layer

135
Q

Reacted sample collects for spectral analysis

A

Indicator Layer

136
Q

Optical interface

A

Support Layer

137
Q

Pressure at which the liquid solvent is in equilibrium with the water vapor

A

Vapor pressure

138
Q

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

A

Freezing point

139
Q

Temperature at which the vapor
pressure of the solvent reaches 1 atm.

A

Boiling point

140
Q

What are the three methods of separation?

A

Centrifugation, Filtration, and
Dialysis

140
Q

Pressure that allows solvent flow
through a semipermeable membrane to establish equilibrium between
compartments of different
concentrations.

A

Osmotic pressure

141
Q

method for separating macromolecules from a solvent or smaller substances

A

Dialysis

142
Q

For critical applications, RPM is checked and recorded

a. weekly or biweekly
b. at least monthly
c. at least quarterly

A

: at least monthly

142
Q

What are the two operational verification activities for centrifuge set by CLSI?

A
  1. Check timer against standardized time source (stopwatch)
  2. Verification of speed
143
Q

For routine applications, RPM is checked and recorded

a. weekly or biweekly
b. at least monthly
d. at least quarterly

A

d. at least quarterly

144
Q

Verification of centrifuge’s speed is done using

A

using a tachometer or strobe
light

145
Q

Weekly or biweekly cleaning uses soap and water followed by

A

: freshly made 10% v/v bleach
solution

146
Q

Inspection of gasket and checking for wear and defects, and inspecting cover latch for appropriate seal is done

a. weekly
b. monthly
c. quarterly

A

c. quarterly

147
Q

Checking the braking mechanism to ensure a smooth, gradual stop is done

a. weekly
b. monthly
c. quarterly

A

monthly

147
Q

Checking the revolutions per minute is done

a. weekly
b. monthly
c. quarterly

A

c. quarterly

147
Q

What do you call the product of filtration?

A

Filtrate

148
Q

Checking the timer of centrifuge is done

a. weekly
b. monthly
c. quarterly

A

b. monthly

148
Q

Used when rapid centrifugation of solutions containing small particle is needed up to 7000 rpm (slower than ultracentrifuge)

A

FIXED ANGLE / VERTICAL CENTRIFUGED

149
Q

FIXED ANGLE / VERTICAL CENTRIFUGED

Angle:

A

25-40