Chapter 1: Clinical Lab Flashcards
1
Q
LABORATORY SAFETY
1)Safety diamond
2) Magnitude of hazard (health)
3) Waste segregation
4) Types of fire
5) Steps to do when fire is discovered
6) steps in using fire extinguisher
A
Health (LEFT)- BLUE
Stability/ Reactivity (RIGHT)- YELLOW
Flammability (TOP)- RED
Special/ specific info. (BOTTOM)- WHITE
0- NONE 1-SLIGHT 2-MODERATE
3-SERIOUS 4-EXTREME
BLACK- DRY,non-infectious RED- sharps
GREEN-WET,non-infectious
ORANGE-Radioactive wastes
YELLOW-WET,infectious
CLASS A- cloth,paper,wood CLASS B- FLAMMABLE LIQUIDS CLASS C- ELECTRICAL EQUIPMENT CLASS D- combustible metals CLASS E- ARSENAL FIRE(liable to detonation)
R- RESCUE
A- ALARM
C- CONTAIN
E- EXTINGUISH
P- ull the pin
A- im at the base of fire
S- queeze handle
S-weeping motion
2
Q
7) Types of Fire Extinguishers
A
BC- Halon
ABC- Dry Chemical,common use in the lab
3
Q
8) when contact with chemical occurs, the best first aid is to flush the area with large amounts of?
A
WATER for at least 15 minutes and seek for medical attention
4
Q
9) Hazard associated with breakage in centrifuge
A
AEROSOL HAZARD
5
Q
10) Components of chain of infection (6 components)
A
1) Source of infection (pathogen)
2) Reservoir
3) Portal of Exit
4) Mode of Transmission
5) Portal of Entry
6) Susceptible Host
6
Q
11) Singel most effective way of preventing transmission of disease
A
HANDWASHING
- Steps in handwashing: Wet,Lather, Scrub,Rinse,Dry
- Length of Scrubbing: 20 seconds (CDC)
- Position of hand: DOWNWARD
- Handwashing song: Happy B-day song (2x)/ Twinkle 2 little stars
7
Q
12) HEPA (High Efficiency Particulate Air) filter can remove particles of at least
A
0.3 microns in size
8
Q
SPECIMEN COLLECTION
1) Usually taken EARLY in the MORNING, before the patient has eaten or before patient becomes physically active
A
BASAL STATE
9
Q
2) Number of fasting hours is part of?
A
PATIENT PREPARATION/ Pxt interaction
10
Q
3) Puncture site is disinfected/ cleansed using
A
ISOPROPYL ALCOHOL
11
Q
4) Antiseptic used in ethanol testing
A
BENZALKONIUM CHLORIDE
12
Q
5) Photosensitive analytes
A
BILIRUBIN, CK
13
Q
6) Analytes that requires CHILLING of spxn with ICE?
A
AMMONIA, BLOOD GAS
14
Q
8) Sources of error in AMMONIA analysis
A
SMOKING and DETERGENT
15
Q
9) Analytes Affected by TOBACCO SMOKING
A
INCREASED: Hb concentration, Hct
DECREASE: Eosinophils
16
Q
10) Analytes Increased in ALCOHOLISM
•Analytes Decreased in ALCOHOLISM
A
⬆️ AST, Lipoproteins, Bilirubin, Ketone bodies, TRIGLYCERIDES
⬇️ Glucose, Albumin, Transferrin
17
Q
11) Effect of bilirubin and hemoglobin in ALP determinations
A
INCREASED
18
Q
12) Analyte detects to assess completeness of a 24- hour urine
A
CREATININE
19
Q
13) specimen used in Newborn Screening
A
CAPILLARY BLOOD (BLOOD SPOT)
20
Q
14) Preferred sample for electrolyte analysis
A
HEPARINED PLASMA
21
Q
15) Preferred spxn for AMMONIA analysis
A
EDTA PLASMA/ HEPARINIZED PLASMA
22
Q
16) Vacutainer tubes that contains EDTA
A
LAVENDER, PINK, WHITE, TAN
23
Q
17) Spxn for ACP determination
A
SERUM, VAGINAL WASHING
24
Q
18) Effect of using non-anticoagulanted tube for ACP
A
NONE
25
19) Effect of direct rectal exam for ACP levels
INCREASED
26
20) Effect of intramuscular injection in CK-MM levels
INCREASED
27
21) Effect of breast examination on PROLACTIN levels
INCREASED
28
22) Bilirubin level of ICTERIC sample
25 mg/ dl
29
23) Bilirubin level associated w/ JAUNDICE
2-3 mg/ dl
30
24) KERNICTERUS- accumulation of Bilirubin in the Brain; danger kernicterus is at certainty at levels
Exceeding 20mg/ dL
31
25) Bilirubin levels of 25mg/dL (430mmol/ L) can cause interference in?
1) Albumin (in HABA method)
2) Cholesterol (in assays using ferric chloride reagent
3) Total protein assays (using Biuret reaction)
32
26) Fasting requirement for Lipid analysis
AT LEAST 12 HOURS
33
27) Lipemia occurs when?
* TAG level EXCEEDS 400mg/dL
| * It causes interference for AMYLASE, URATES, UREA, CREATINE KINASE, BILIRUBIN and TOTAL PROTEIN
34
28) Blood volume of an average person
* MALES: 5-7L
| * FEMALES: 4-6L
35
29) Preferred vein for venipuncture
MEDIAN CUBITAL VEIN
36
30) Analytical Testing performed outside the laboratory is known as?
POINT- of CARE TESTING (POCT)
37
INSTRUMENTATION AND AUTOMATION
1) Centrifuge
A) centrifuge type recommended for SERUM SEPARATOR TUBE (SST)?
B) DISINFECTION of centrifuge is done every?
C) Calibration for speed of centrifuge is done every
D) Device used to calibrate the speed of centrifuge
A) (a)HORIZONTAL HEAD / SWINGING BUCKET
• Horizontal position when spinning; Vertical position when the HEAD is NOT MOVING
• Speeds approx. : 3000 rpm; 1,650g
• >3000 rpm—> excessive heat buildup due to increased air friction
(b) FIXED- ANGLE or ANGLE- HEAD
• allow small particles to sediment more rapidly
• Angle is fixed at around 52^
• speeds: 9000g
B) WEEK
C) 3mons./QUARTERLY
D) TACHOMETER/ STROBE LIGHT
RPM- SPEED
38
2) Pipets
A) Pipet w/ the highest PRECISION and ACCURACY
B) Transfer pipet used for VISCOUS SOL’N
C) Pipets w/ etched rings or continuous rings
D) Pipets w/o graduations lines at the tip
E) Cleaning sol’n for glassware
F) Sterilization technique for glassware
G) A positive displacement Pipet operates by moving the PISTON in the PIPET TIP or BARREL, much like a hypodermic needle. It does not require a different tip for each use. Because of carry over concerns, rinsing and blotting between samples may be required.
A) VOLUMETRIC PIPET (TD-V)
B) OSTWALD FOLIN PIPET
C) BLOW OUT PIPET
D) MOHR PIPET
E) ACID DICHROMATE
F) DRY HEAT OVEN (160-180^C; 1.5-2hrs)
39
3) Analyzer characterized by continuous system of tubings
CONTINUOUS FLOW
40
A) 1’ source of error in continuous flow analyzer
B) Reactants in the continuous tubing are separated usiy
C) Purpose of COILED TUBINGS in continuous flow analyzer
D) Example of continuous flow analyzer
A) CARRY OVER
B) AIR-BUBBLES
C) FOR MIXING
D) AUTOANALYZER TECHNICOn
41
4) Analyzer characterized by SPINNING ROTOR
CENTRIFUGAL ANALYZER
42
5) Most popular type of Analyzer; analyzer type that CAN PERFORM RANDOM ACCESS, BATCH and SEQUENTIAL ANALYSIS
DISCRETE ANALYZER
43
6) Examples of DISCRETE ANALYZER
* ACA ( Dupont) ———>ASTRA/SYNCHRON (Beckman)
* CENTRIFICHEM (Baker) ———>COULTER CHEMISTRY (Coulter Electronics)
* KDA (American Monitor) ———>ARCHITECT and TDX (Abbott)
* PARAMAX ———> HITACHI (Boehringer Mannheim/ Roche)
* VITROS (Ortho-Clinical D) ———> ADVIA and DIMENSION (Siemens)
44
7) is the unit of measure for the wavelength of radiant energy (Light)
NANOMETER
45
8) WAVELENGTH is INVERSELY PROPORTIONAL TO THE AMOUNT OF ENERGY. The longer the wavelength, the lower the energy; the shorter the wavelength, the higher the energy.
WL♾ 1/ ENERGY; ⬆️WL ♾ ⬇️ ENRGY ; ⬇️WL♾ ⬆️ENRGY
46
9) Spectra of Light
A) Visible Light Spectrum ( 400-700nm);
• 380-720nm (white Light—>most flexible)
B) Spectrum of UV light (4nm-400nm)
C) Spectrum of IR light (750nm-0.3cm)
47
10) Color and Energy
A) Color w/ the HIGHEST energy (VIOLET)
B) Color w/ the LONGEST wavelength (RED)
V I B G Y O R >700- IR
400———-700
48
11) States that absorbance ( optical density) is DIRECTLY PROPORTIONAL to Concentration
BEER-LAMBER LAW
A= 2- log%T A= abc
49
12) Graph of Beer’s Law will show a straight line if:
• Con’n vs Absorbance are plotted using
——> LINEAR PAPER
• Con’n vs Transmittance are plotted using
——> SEMILOG PAPER
50
13) Used to correct for INTERFERENCES attributed from the sample
SAMPLE BLANK
51
14) Part of the spectrophotometer that ISOLATES the specific wavelength of interest (desired wavelength):
MONOCHROMATOR
| (Prisms, Diffraction Gratings, Interference filters, Colored glass filters)
52
15) Part of spectrophotometer that converts light to electrical energy
PHOTODETECTOR
53
16) Instrument w/ 2 photodetectors
DOUBLE BEAM IN SPACE SPECTROPHOTOMETRY
54
17) 2 MONOCHROMATORS, positioned at 90deg
FLUOROMETRY
55
A) Characteristics of EXCITATION LIGHT
B) Characteristics of FLUORESCENT LIGHT
C) Disadvantage of FLUOROMETRY
D) Effect of QUENCHING in fluorescence
A) HIGH ENERGY, SHORT WAVELENGTH
B) LOW ENERGY, LONGER WAVELENGTH
C) QUENCHING
D) DECREASED FLUORESCENCE
56
18) Instrument that measures the light/ color emitted by the analyte; used for analytes that are easily excited by the flame
FLAME EMISSION PHOTOMETRY
57
A) COLOR emitted by:
B) DILUTION of serum used in Na/K analysis in FEP
C) INTERNAL STANDARDS used in FEP
A) Na= YELLOW
K= VIOLET
Li= RED
B) 1:100/ 1:200
C) LITHIUM, CESIUM
58
19) Instrument used for analytes that are NOT EASILY excited by the flame; servesas reference method for CALCIUM and MAGNESIUM
ATOMIC ABSORPTION SPECTROPHOTOMETRY
59
A) Light souroof AAS
B) Purpose of the flame in AAS
C) After Analyzing an analyte, the HOLLOW CATHODE LAMP MUST BE CHANGED FIRST, before proceeding w/ the analysis of the next analyte
A) HOLLOW CATHODE LAMP
B) ATOMIZER
60
20) Instrument that measures reflected light; serves as the principle behind Vitros, Kodak Ektachem and Automated Dipstick Readers:
• Dry Slide Technology (Layers; top- bottom)
SPREADER—> SCAVENGER—> REAGENT—> INDICATOR—> SUPPORT/ BASAL
REFLECTANCE SPECTROPHOTOMETRY
61
21)
A) Instrument that measures LIGHT SCATTERED
B) Instrument that measures LIGHT BLOCK by particles
A) NEPHELOMETRY
B) TURBIDIMETRY
62
22) Method that separates substances accdng. to their CHARGE.
A) Support media include
B) POSITIVE POLE/ electrode
C) NEGATIVE POLE/ electrode
D) Most common pH used in protein electrophoresis
E) In ALKALINE pH, proteins become
F) pH at which substances will have NET ZERO CHARGE
ELECTROPHORESIS
A) PAPER, CELLULOSE ACETATE, AGAROSE GEL, POLYACRYLAMIDE GEL, STARCH GEL
B) ANODE
C) CATHODE
D) 8.6
E) NEGATIVELY CHARGED
F) ISOELECTRIC POINT
63
23) Electrodes
A) Principle used in O2 determ’n, GLUCOSE and PEROXIDASE
B) Principle used in pH and pCO2 determ’n
C) Electrode used in pH determ’n
D) Name of electrode used in pO2 determ’n
E) Name of electrode used in pCO2 determ’n
F) Electrode used in POTASSIUM determ’n
G) Parameter that can be used as QUALITY CONTROL for ISE
A) AMPEROMETRY
B) POTENTIOMETRY
C) GLASS
D) CLARK
E) SEVERING HAUS
F) COATED w/ VALINOMYCIN (Ion-selective electrode (ISE)
G) ANION GAP
64
24)
A) TANGIBLE/ PHYSICAL COMPONENT of computers; i.e. CPU, keyboard, mouse, printer, scanner, monitor
B) NON- TANGIBLE COMPONENT of computers; i.e. applications, programs, operating systems
A) HARDWARE
B) SOFTWARE
65
25)
A) Used to ENTER INFORMATION into the computer i.e. keyboard, scanner
B) Used to PRODUCE A RESULT from the computer i.e. monitor, printer
A) INPUT
B) OUTPUT
66
26) 1st step to be taken when attempting to TROUBLE-SHOOT ELECTRONIC EQUIPMENT is to __________. This is done in order to prevent electric hazard.
ENSURE THAT THE INSTRUMENT HAS BEEN TURNED OFF
67
27) In some electrical Instruments, there are 3 wires. The 3RD WIRE IS FOR ______. It reduces the RISK OF SERIOUS ELECTRIC SHOCK
GROUNDING
68
QUALITY ASSURANCE
1)
A) Ability to detect SMALL AMOUNTS of analyte.
B) Ability to detect ONLY THE ANALYTE of interest
A) ANALYTICAL SENSITIVITY
B) ANALYTICAL SPECIFICITY
69
2)
A) CLOSENESS of the value to the TARGET/ TRUE VALUE
B) CLOSENESS of the value to the REPEATED VALUE
A) ACCURACY
B) PRECISION
70
3)
A) Indicator of PRECISION
B) RELATIVE indicator of PRECISION
A) STANDARD DEVIATION
B) COEFFICIENT OF VARIATION
CV(%)= SD/MEAN x 100
71
4)
A) Measures the statistical differences between 2 MEANS.
B) Measures the statistical differences between 2SD or 2 VARIANCES.
A) T- test
M—ean
A—ccuracy
T—test
B) F- test
S—D
P—recision
F—test
72
5) LOWER COEFFICIENT of variation indicates.
GOOD PRECISION
73
6) BELL- SHAPED CURVE
MEAN= MEDIAN = MODE
A) MEAN- CENTRAL TENDENCY
B) MEDIAN- MIDPOINT
C) MODE- MOST FREQUENT
D) RANGE- difference between Highest and Lowest value
GAUSSIAN CURVE
74
7) BULL’S EYE in the quality control chart indicates :
GOOD ACCURACY = GOOD PRECISION
75
8) Type of Qc where analysis of control sample together with patient specimen.
INTRALAB/ INTERNAL QC
76
9) Control are materials of known value that is analyzed w/ pxn samples to determine acceptability of results. It is of knowin quality with several analytes present. It resembles the patient serum. Controls are usually made from
POOLED SERUM
77
10) Variation/ Error present in all measurements, due to chance
RANDOM ERROR
78
11) CAUSES
A) Mislabeling of sampy, PIPETTING ERRORS, improper mixing of sample and reagent, voltage fluctuations, temperature fluctuations
B) Improper calibration, DETERIORATION OF REAGENTS, sample instability, changes in standard materials, Instrument drift.
A) RANDOM ERROR
B) SYSTEMATIC ERROR
79
12) Most widely used QUALITY CONTROL CHART
a) X- axis—->INDEPENDENT VARIABLE; HORIZONTAL LINE; date or time
A—bscissa
X—axis
I—ndependent
b) Y- axis —-> DEPENDENT VARIABLE; vertical line; Analyte concentration
D—ependent
O—rdinate
Y—axis
LEVEY- JENNINGS CHART ( SHEWHART PLOT)
80
13)
A) Control values INCREASING or DECREASING for 6 consecutive runs
• Main cause: DETERIORATION OF REAGENTS; gradual deviations/ changes
B) 6 consecutive control values on the SAME SIDE of the mean
• Main cause: IMPROPER CALIBRATION OF INSTRUMENT; sudden/ abrupt changes
A) TREND
B) SHIFT
81
14) Control values that are FAR FROM THE MAIN SET of values
• Highly deviating values; control result OUTSIDE established limits
OUTLIERS
82
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15) WESTGARD CONTROL RULES
A)
• 1 Control value exceeds the 2SD
—————>1️⃣2s
• 1 CONTROL VALUE EXCEEDS 3SD
—————>1️⃣3s
• 1 Control value exceeds 2s and another value exceeds -2s
—————>R4s
```
B)
• 2 CONSECUTIVE CONTROL VALUES EXCEED THE SAME MEAN +2s or -2s
—————->2️⃣2s
• 4 consecutive control values exceed +_1s
—————->4️⃣1s
• 10 consecutive control values fall on 1 side or other side of the mean
—————->🔟x
A) RANDOM ERRORs
B) SYSTEMATIC ERRORs
83
16) WARNING or SCREENING RULE for REJECTION
1️⃣2s
84
17) Westgard multirule for RANDOM ERROR
1️⃣2s, 1️⃣3s, R4s
85
18) SYSTEMATIC ERROR
2️⃣2s, 4️⃣1s, 🔟x
86
19) Comparison of PREVIOUS RESULTS with the CURRENT RESULT
DELTA CHECK
87
20) The next step in the connectivity process is TRANSMITTED OF TEST RESULTS FROM THE DATA MANAGER TO THE LIS and/ or HOSPITAL INFORMATION SYSTEM (HIS).
INTERFACE PORTION
88
21)
A) ASAP
B) STAT
A) (“AS SOON AS POSSIBLE“)
B) ( “IMMEDIATELY “)—from the latin “STATIM”
89
REAGENT PREPARATION and LABORATORY MATHEMATICS
1) CONVERSION FACTORS
```
———1️⃣———
• SODIUM
• POTASSIUM (mmol/L)
•CHLORIDE
• BICARBONATE
• LITHIUM ——>(umol/L
```
```
———🔟———TPAG (g/dL to g/L)
•TOTAL PROTEIN
•ALBUMIN
•GLOBULIN
•IgA
```
———-0️⃣.1️⃣1️⃣3️⃣——(mm/Hg to kPa)
•pCO2
•pO2
——-0️⃣.0️⃣5️⃣5️⃣5️⃣——(mg/dL to mmol/L)
•GLUCOSE
——-0️⃣.3️⃣5️⃣7️⃣——(mg/dL to mmol/L)
•BUN
——8️⃣8️⃣.4️⃣——(mg/dL to umol/L)
•CREATININE
—-0️⃣.0️⃣5️⃣9️⃣5️⃣—-(mg/dL to mmol/L)
•URIC ACID
——0️⃣.0️⃣1️⃣1️⃣3️⃣——(mg/dL to mmol/L)
•TRIGLYCERIDES
——1️⃣7️⃣.1️⃣——(mg/dL to umol/L)
•BILIRUBIN
——1️⃣2️⃣.9️⃣——(ug/dL to NMOL/L)
•THYROXINE
90
2) Panic/ Alert/ Critical Values
• GLUCOSE: <40mg/dL
>500mg/dL
• BILIRUBIN: >18mg/dL (newborn)
91
3) ANION GAP
( Na + k ) - ( Cl + HCO3) /
| Na - ( Cl + HCO3)
92
4) CARBONIC ACID
| [ H2CO3 / dissolved CO2 ]
pCO2 x 0.031
93
5) FREE T4 INDEX = TOTAL T4 x THBR
THBR = T3U of Patient / T3U of serum pool (Control)
94
6) g of NaCl combined with 100mL of water to make NSS
• 0.85g / 100 mL
~ 0.85g / 100 mL
NaCl H2O
~ 8.5g / 1L / 1000 mL
NaCl H20
95
7) Amount of NaOCl needed to make 10L of disinfectant
• 1L
~ NaOCl = (SODIUM HYPOCHLORITE)
Dilution = 1:10
96
8) Amount of NaOCl needed to make 7L of disinfectant
• 700 mL
~ Dilution = S / TV
= 1L / 10L
= 0.7L/7L / 700mL
