CC PART 1 Flashcards
(2) WET CHEMISTRY
A. Liquid Reagent
B. Lyophilized Reagent
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.
Lyophilization
- 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
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
Storage and stability
Reagent storage:
2-80 C
- Performance indicator that refers to the dispersion of repeated measurements around the mean
a) Accuracy
b) Precision
c) Reliability
d) Linearity
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
- Long acting barbiturate used in treating generalized grand-mal tonic-clonic seizures:
a) Ethosuximide
b) Acetaminophen
c) Tacrolimus
d) Phenobarbital
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
- 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%
b. 95.8%
- Convert 5 dL to mL
A. 5 mL
B. 50 mL
C. 500 mL
D. 5000 mL
C. 500 mL
Rationale: 1 dL = 100 mL
- 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
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.
- Which of the following lipoproteins can be observed in the upper part of the evacuated tube?
A. Cholesterol
B. VLDL
C. Triglycerides
D. Chylomicrons
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
- 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
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
- 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. Lean
Rationale:
● Lean: Reduction of waste
● Six Sigma: Reduction of errors
● If combined (Lean Six Sigma): Reduction of waste
and errors
- 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
C. Triglycerides
Rationale:
● Electrolytes: Increase
● Glucose: Decrease every hour
(2) CHEMISTRY APPROACH
1 WET CHEMISTRY
2 DRY CHEMISTRY
NO reconstitution needed
Liquid Reagent
Does Lyophilized Reagent Has Longer shelf life?
True or False
True
+ Diot H2oO -> Reconstituted
Lyophilized Reagent
Machine: Vitros
Dry Chemistry
Machine: Cobas
Wet Chemistry
(5) layers in Dry Chemistry
- Spreading
- Scavenger
- Reagent
- Indicator
- Support
Principle: Reflectance Photometry
- Lights are reflected
Dry Chemistry
Validation Studies
BUN STD = 10 mg/dL
a. 11 mg/dL
b. 10 mg/dL
c. 9 mg/dL
d. AOTA
b. 10 mg/dL (Accuracy)
Smaller volume requirement
Dry Chemistry
(5) Reagent Considerations
- Storage and stability
- Reagent Distribution
- Interfering Substances
- Expected Values
- Performance Characteristics
Change in the Reagent Lot number:
Perform Validation Study (Recalibration)
TREND or SHIFT
Using deteriorated reagent:
TREND
Trend and Shift is it Random or Systematic?
Systematic
(2) Reasons for using a calibrator/standard
- When performing method evaluation/technical validation
- Identification of errors in WG rule when the reagent is out of control
Must know of a medtech:
Knowledge of chemicals, standards solutions buffer and water requirements (MSDS/SDS)
(5) Reagent Deterioration
- Turbidity and precipitation
- Reagent fails to meet linearity claims
- Fails to recover control value in stated range
- Moisture has penetrated the vial and caking has occurred
- discrepancy in the first absorbance against water either greater or less than 0.8 depending on the set wavelength
Reportable range
linearity
(3) Interfering Substances
- Anticoagulants
- Drugs and other substances
- Pyridoxal Phosphate
(3) Common anticoagulants that cause interference:
- EDTA
- NaF
- Oxalate
(3) Blank
- Reagent blank
- Sample blank
- Water blank
If the sample is hemolyzed, lipemic, icteric what blank will you used?
Sample Black
To set spectrophotometer reading to zero
ABS -
% Transmission -
Water Blank
ABS - 0
% Transmission - 100
Before, During, After
Reagent
Before
Before, During, After
Sample
During
Before, During, After
Water Blank
Before
(4) Performance Characteristics
- Linearity/Analytical Measurement Range (AMR)
- Comparison of methods
- Sensitivity and Specificity
- Precision studies
Two commercial serum controls were assayed twenty times and the following ________________ precison was obtained.
Within Run
Two commercial serum controls were assayed for five consecutive days (triplicate for each level), the following ______________ precision was obtained
Run to Run Precision
Two means
T test
highly purified chemical than can be measured directly to produce a substance of exact known
concentration
Primary standard
substance of lower purity
Secondary standard
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.
Controls
Can you use Secondary standard alone?
No
(2) Controls
- Assayed
- Unassayed
High, Normal, Low
3 levels
Pathologic and nonpathologic
2 levels
All CC tests except Blood gases, therapeutic drugs, hormones
2 Levels
WG note:
1:2s
1:3s
R:4S
2:2S
4:1S
10:X
2 Levels
● Additional Westgard rules:
- 3:15
- 2 of 3:2S
- 7T
- 9X
3 Levels
Once in 24 hours
2 levels
Every 8 hours
3 levels
monitors overall reliability of laboratory results
means of accuracy and precision
Quality Controls
Two Divisions of Quality Control:
- Internal
- External
Proficiency testing
External quality control
- Analysis of control samples
- Instrument maintenance
- Statistical analysis
Internal quality control
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.
Distilled Water
-process of removing dissolved gases by nonvolatile substances carried over steam in the distillation process or by dissolved substances from storage containers
Double Distillation
Water that is always used in Molecular biology
Double Distillation
used for tests that require Nh3 free water
Double Distillation
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
Deionized Water
water purified by reverse osmosis
Reverse-Osmosis
Uses pressure to pump water across a semipermeable membrane, thereby producing filtered product of the original water. Use also for pretreatment of water
Reverse-Osmosis
(4) Water Purification
- Activated charcoal
- Glass
- cotton
- submicron filter (0.2 mm)
Removes organic materials
Activated charcoal