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Cc > Chapter 1: Clinical Lab > Flashcards

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

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2
Q

7) Types of Fire Extinguishers

A

BC- Halon

ABC- Dry Chemical,common use in the lab

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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

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4
Q

9) Hazard associated with breakage in centrifuge

A

AEROSOL HAZARD

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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

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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
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7
Q

12) HEPA (High Efficiency Particulate Air) filter can remove particles of at least

A

0.3 microns in size

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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

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9
Q

2) Number of fasting hours is part of?

A

PATIENT PREPARATION/ Pxt interaction

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10
Q

3) Puncture site is disinfected/ cleansed using

A

ISOPROPYL ALCOHOL

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11
Q

4) Antiseptic used in ethanol testing

A

BENZALKONIUM CHLORIDE

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12
Q

5) Photosensitive analytes

A

BILIRUBIN, CK

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13
Q

6) Analytes that requires CHILLING of spxn with ICE?

A

AMMONIA, BLOOD GAS

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14
Q

8) Sources of error in AMMONIA analysis

A

SMOKING and DETERGENT

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15
Q

9) Analytes Affected by TOBACCO SMOKING

A

INCREASED: Hb concentration, Hct

DECREASE: Eosinophils

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16
Q

10) Analytes Increased in ALCOHOLISM

•Analytes Decreased in ALCOHOLISM
A

⬆️ AST, Lipoproteins, Bilirubin, Ketone bodies, TRIGLYCERIDES

⬇️ Glucose, Albumin, Transferrin

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17
Q

11) Effect of bilirubin and hemoglobin in ALP determinations

A

INCREASED

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18
Q

12) Analyte detects to assess completeness of a 24- hour urine

A

CREATININE

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19
Q

13) specimen used in Newborn Screening

A

CAPILLARY BLOOD (BLOOD SPOT)

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20
Q

14) Preferred sample for electrolyte analysis

A

HEPARINED PLASMA

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21
Q

15) Preferred spxn for AMMONIA analysis

A

EDTA PLASMA/ HEPARINIZED PLASMA

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22
Q

16) Vacutainer tubes that contains EDTA

A

LAVENDER, PINK, WHITE, TAN

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23
Q

17) Spxn for ACP determination

A

SERUM, VAGINAL WASHING

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24
Q

18) Effect of using non-anticoagulanted tube for ACP

A

NONE

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25
Q

19) Effect of direct rectal exam for ACP levels

A

INCREASED

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26
Q

20) Effect of intramuscular injection in CK-MM levels

A

INCREASED

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27
Q

21) Effect of breast examination on PROLACTIN levels

A

INCREASED

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28
Q

22) Bilirubin level of ICTERIC sample

A

25 mg/ dl

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29
Q

23) Bilirubin level associated w/ JAUNDICE

A

2-3 mg/ dl

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30
Q

24) KERNICTERUS- accumulation of Bilirubin in the Brain; danger kernicterus is at certainty at levels

A

Exceeding 20mg/ dL

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31
Q

25) Bilirubin levels of 25mg/dL (430mmol/ L) can cause interference in?

A

1) Albumin (in HABA method)
2) Cholesterol (in assays using ferric chloride reagent
3) Total protein assays (using Biuret reaction)

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32
Q

26) Fasting requirement for Lipid analysis

A

AT LEAST 12 HOURS

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33
Q

27) Lipemia occurs when?

A
  • TAG level EXCEEDS 400mg/dL

* It causes interference for AMYLASE, URATES, UREA, CREATINE KINASE, BILIRUBIN and TOTAL PROTEIN

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34
Q

28) Blood volume of an average person

A
  • MALES: 5-7L

* FEMALES: 4-6L

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35
Q

29) Preferred vein for venipuncture

A

MEDIAN CUBITAL VEIN

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36
Q

30) Analytical Testing performed outside the laboratory is known as?

A

POINT- of CARE TESTING (POCT)

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37
Q

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) (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

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38
Q

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

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)

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39
Q

3) Analyzer characterized by continuous system of tubings

A

CONTINUOUS FLOW

40
Q

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

A) CARRY OVER

B) AIR-BUBBLES

C) FOR MIXING

D) AUTOANALYZER TECHNICOn

41
Q

4) Analyzer characterized by SPINNING ROTOR

A

CENTRIFUGAL ANALYZER

42
Q

5) Most popular type of Analyzer; analyzer type that CAN PERFORM RANDOM ACCESS, BATCH and SEQUENTIAL ANALYSIS

A

DISCRETE ANALYZER

43
Q

6) Examples of DISCRETE ANALYZER

A
  • 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
Q

7) is the unit of measure for the wavelength of radiant energy (Light)

A

NANOMETER

45
Q

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.

A

WL♾ 1/ ENERGY; ⬆️WL ♾ ⬇️ ENRGY ; ⬇️WL♾ ⬆️ENRGY

46
Q

9) Spectra of Light

A

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
Q

10) Color and Energy

A

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
Q

11) States that absorbance ( optical density) is DIRECTLY PROPORTIONAL to Concentration

A

BEER-LAMBER LAW

A= 2- log%T A= abc

49
Q

12) Graph of Beer’s Law will show a straight line if:

A

• Con’n vs Absorbance are plotted using
——> LINEAR PAPER

• Con’n vs Transmittance are plotted using
——> SEMILOG PAPER

50
Q

13) Used to correct for INTERFERENCES attributed from the sample

A

SAMPLE BLANK

51
Q

14) Part of the spectrophotometer that ISOLATES the specific wavelength of interest (desired wavelength):

A

MONOCHROMATOR

(Prisms, Diffraction Gratings, Interference filters, Colored glass filters)

52
Q

15) Part of spectrophotometer that converts light to electrical energy

A

PHOTODETECTOR

53
Q

16) Instrument w/ 2 photodetectors

A

DOUBLE BEAM IN SPACE SPECTROPHOTOMETRY

54
Q

17) 2 MONOCHROMATORS, positioned at 90deg

A

FLUOROMETRY

55
Q

A) Characteristics of EXCITATION LIGHT

B) Characteristics of FLUORESCENT LIGHT

C) Disadvantage of FLUOROMETRY

D) Effect of QUENCHING in fluorescence

A

A) HIGH ENERGY, SHORT WAVELENGTH

B) LOW ENERGY, LONGER WAVELENGTH

C) QUENCHING

D) DECREASED FLUORESCENCE

56
Q

18) Instrument that measures the light/ color emitted by the analyte; used for analytes that are easily excited by the flame

A

FLAME EMISSION PHOTOMETRY

57
Q

A) COLOR emitted by:

B) DILUTION of serum used in Na/K analysis in FEP

C) INTERNAL STANDARDS used in FEP

A

A) Na= YELLOW
K= VIOLET
Li= RED

B) 1:100/ 1:200

C) LITHIUM, CESIUM

58
Q

19) Instrument used for analytes that are NOT EASILY excited by the flame; servesas reference method for CALCIUM and MAGNESIUM

A

ATOMIC ABSORPTION SPECTROPHOTOMETRY

59
Q

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

A) HOLLOW CATHODE LAMP

B) ATOMIZER

60
Q

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

A

REFLECTANCE SPECTROPHOTOMETRY

61
Q

21)
A) Instrument that measures LIGHT SCATTERED

B) Instrument that measures LIGHT BLOCK by particles

A

A) NEPHELOMETRY

B) TURBIDIMETRY

62
Q

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

A

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
Q

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

A) AMPEROMETRY

B) POTENTIOMETRY

C) GLASS

D) CLARK

E) SEVERING HAUS

F) COATED w/ VALINOMYCIN (Ion-selective electrode (ISE)

G) ANION GAP

64
Q

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

A) HARDWARE

B) SOFTWARE

65
Q

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

A) INPUT

B) OUTPUT

66
Q

26) 1st step to be taken when attempting to TROUBLE-SHOOT ELECTRONIC EQUIPMENT is to __________. This is done in order to prevent electric hazard.

A

ENSURE THAT THE INSTRUMENT HAS BEEN TURNED OFF

67
Q

27) In some electrical Instruments, there are 3 wires. The 3RD WIRE IS FOR ______. It reduces the RISK OF SERIOUS ELECTRIC SHOCK

A

GROUNDING

68
Q

QUALITY ASSURANCE
1)
A) Ability to detect SMALL AMOUNTS of analyte.

B) Ability to detect ONLY THE ANALYTE of interest

A

A) ANALYTICAL SENSITIVITY

B) ANALYTICAL SPECIFICITY

69
Q

2)
A) CLOSENESS of the value to the TARGET/ TRUE VALUE

B) CLOSENESS of the value to the REPEATED VALUE

A

A) ACCURACY

B) PRECISION

70
Q

3)
A) Indicator of PRECISION

B) RELATIVE indicator of PRECISION

A

A) STANDARD DEVIATION

B) COEFFICIENT OF VARIATION

       CV(%)= SD/MEAN x 100
71
Q

4)
A) Measures the statistical differences between 2 MEANS.

B) Measures the statistical differences between 2SD or 2 VARIANCES.

A

A) T- test

M—ean
A—ccuracy
T—test

B) F- test

S—D
P—recision
F—test

72
Q

5) LOWER COEFFICIENT of variation indicates.

A

GOOD PRECISION

73
Q

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

A

GAUSSIAN CURVE

74
Q

7) BULL’S EYE in the quality control chart indicates :

A

GOOD ACCURACY = GOOD PRECISION

75
Q

8) Type of Qc where analysis of control sample together with patient specimen.

A

INTRALAB/ INTERNAL QC

76
Q

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

A

POOLED SERUM

77
Q

10) Variation/ Error present in all measurements, due to chance

A

RANDOM ERROR

78
Q

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

A) RANDOM ERROR

B) SYSTEMATIC ERROR

79
Q

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

A

LEVEY- JENNINGS CHART ( SHEWHART PLOT)

80
Q

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

A) TREND

B) SHIFT

81
Q

14) Control values that are FAR FROM THE MAIN SET of values

• Highly deviating values; control result OUTSIDE established limits

A

OUTLIERS

82
Q 
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

A) RANDOM ERRORs

B) SYSTEMATIC ERRORs

83
Q

16) WARNING or SCREENING RULE for REJECTION

A

1️⃣2s

84
Q

17) Westgard multirule for RANDOM ERROR

A

1️⃣2s, 1️⃣3s, R4s

85
Q

18) SYSTEMATIC ERROR

A

2️⃣2s, 4️⃣1s, 🔟x

86
Q

19) Comparison of PREVIOUS RESULTS with the CURRENT RESULT

A

DELTA CHECK

87
Q

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).

A

INTERFACE PORTION

88
Q

21)

A) ASAP

B) STAT

A

A) (“AS SOON AS POSSIBLE“)

B) ( “IMMEDIATELY “)—from the latin “STATIM”

89
Q

REAGENT PREPARATION and LABORATORY MATHEMATICS

1) CONVERSION FACTORS

A 
———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
Q

2) Panic/ Alert/ Critical Values

A

• GLUCOSE: <40mg/dL
>500mg/dL

• BILIRUBIN: >18mg/dL (newborn)

91
Q

3) ANION GAP

A

( Na + k ) - ( Cl + HCO3) /

Na - ( Cl + HCO3)

92
Q

4) CARBONIC ACID

[ H2CO3 / dissolved CO2 ]

A

pCO2 x 0.031

93
Q

5) FREE T4 INDEX = TOTAL T4 x THBR

A

THBR = T3U of Patient / T3U of serum pool (Control)

94
Q

6) g of NaCl combined with 100mL of water to make NSS

A

• 0.85g / 100 mL

~ 0.85g / 100 mL
NaCl H2O

~ 8.5g / 1L / 1000 mL
NaCl H20

95
Q

7) Amount of NaOCl needed to make 10L of disinfectant

A

• 1L

~ NaOCl = (SODIUM HYPOCHLORITE)
Dilution = 1:10

96
Q

8) Amount of NaOCl needed to make 7L of disinfectant

A

• 700 mL

~ Dilution = S / TV
= 1L / 10L
= 0.7L/7L / 700mL

Cc (3 decks)

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