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CLIN CHEM > CIULLA GEN LAB > Flashcards

CIULLA GEN LAB Flashcards

1
Q

used in most analytical
laboratory procedures; meet the specifications established
by the American Chemical Society (ACS)

A

Analytic Reagent grade chemicals

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2
Q

have undergone additional processing that makes them suitable for special procedures such as [3]

A

Ultrapure reagents

AAS
Chromotography
Molecular dx

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3
Q

Reagent grade water meets the specifications of ____________ the standards for which were established by the__________.

A

Clinical Laboratory Reagent Water
CLSI

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4
Q

_____________
the highest quality and is used in test methodologies where minimum interference and maximum precision and accuracy are needed. Resistivity of greater than or equal to ______ at ____°C is required.

A

Clinical Laboratory Reagent Water

1OM*cm
25C

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5
Q

Processes required in preparation of reagent grade water (CLRW):
[5]

A

Prefilters
Activated Carbon
Reverse osmosis
Ion exchange
Submicron filter

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6
Q

glass or cotton microfibers that remove 98% of the particulate matter.

A

Prefilters

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7
Q

removes organic matter and chlorine.

A

activated carbon

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8
Q

emoves all particles or microorganisms larger than the membrane pore size.

A

submicron filter

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9
Q

process that removes 95-99% of bacteria and organic and other particulate matter.

A

reverse osmosis

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10
Q

a system of resin cartridges or tanks connected in series that remove cations and anions to make deionized water.

A

ion exchange

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11
Q

May require different preparation than
CLRW according to intended use, such as sterility specification for tissue or organ culture, nucleic acid content for DNA testing, metal content for trace metal analysis, etc.

A

Special reagent water [SRW]

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12
Q

Special reagent water (SRW): May require different preparation than
CLRW according to intended use, such as sterility specification for [3]

A

tissue/organ culture
nucleic acid content for DNA testing
metal content for trace materials

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13
Q

Used for internal instrument rinsing, making dilutions, etc., and needs to meet manufacturer’s specifications.

A

Instrument feed water

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14
Q

Label states intended use;do not substitute for CLRW or SRW unless
label indicates it is of such quality.

A

water for use as a diluent or reagent supplied by manufacturer

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15
Q

Exercise care because some
plastic containers permit microorganism growth due to air permeability.

A

Purified water commercially bottled

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16
Q

With purified water commercially bottled, exercise care because some
___________ permit microorganism growth due to __________.

A

plastic containers
air permeability

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17
Q

Purified to contain only low levels of organics, inorganics, and particulate matter so it does not leave residue on glassware or contaminate solutions and media in autoclaves.

A

water for Lab dishwashers and autoclaves

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18
Q

highly purified chemicals that are weighed
or measured to produce a solution with an exact concentration.

A

primary standard

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19
Q

are solutions whose values are determined
by repeated analyses, using a reference method.

A

secondary standard

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20
Q

provides reference materials for purchase.

A

National Institute of Standards and Technology [NIST]

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21
Q

NIST provides these 2 reference materials:

A

Standard reference materials
Certified reference materials

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22
Q

Values of the materials are determined by high-quality analysis, and the chemical composition is certified.

A

standard reference materials
certified reference materials

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23
Q

Units of measure: _______________ is a system of measurement that is known as ________ may be classified as [3]

A

System Internationale d’Unites

SI units

Base
Derived
Supplemental

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24
Q

________ are drying agents that absorb water from air or other materials. ___________ is one of the most effective desiccants, and ________ is one of the least hygroscopic. ___________ provide a dry environment for chemical materials.

A

Dessicants

Magnesium perchlorate
Silica gel

Dessicators

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25
Q

Laboratory supplies such as pipettes, flasks, etc. used for analytical work must meet specific ____________ as designated by the NIST. ________ is the designation used when laboratory supplies meet NIST specifications.

A

tolerances of accuracy
Class A

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26
Q

is made from soda-lime glass. It is inexpensive and used in making some DISPOSABLE laboratory glassware.

A

Flint glass

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27
Q

commonly used for laboratory glassware because of its properties, including resistance to heat, corrosion, and thermal shock.

A

Borosilicate glass

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28
Q

are glasses that can withstand high temperatures. They are made of borosilicate, which has a low alkali content.

A

Pyrex
Kimax

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29
Q

is alumina-silicate glass that is six times stronger than borosilicate glass.

A

Corex

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30
Q

It is used to make high-temperature thermometers, graduated cylinders, and centrifuge tubes.

A

Corex

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31
Q

glass can be heated to 900°C and is used for extremely high temperatures and resists heat shock.

A

Vycor

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32
Q

Chemically inert resins; generally resistant to acids, alkalis, and salt solutions

A

Poly-olefins/ethylene/propylene

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33
Q

has a clear appearance and because of its strength may be used for centrifuge tubes. Chemical resistance is less than the polyolefins.

A

Polycarbonate

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34
Q

Chemically inert and used for temperatures from —270 to +255°C; provide non-wettable surface; used for stir bars and tubing.

A

Fluorocarbon resins [Teflon]

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35
Q

types that have the bulb closer to the center and accurately deliver a fixed volume of [viscous flluid/aqueous solution]. They drain by gravity and should not be blown out.

A

volumetric pipettes

aqueous solution

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36
Q

TD types that have the bulb closer to the delivery tip because they deliver [viscous fluid/aqueous solution]. These pipettes deliver an accurate volume by being “blown out” using a pipetting bulb. An __________ near the top of the pipette indicates the need to “blow out.”

A

ostwald-folin pipettes

viscous fluid

etched rings/pair of etched rings

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37
Q

transfer pipettes [2]

A

volumetric
ostwald-folin

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38
Q

are TD types of measuring pipettes that are calibrated to the tip and must be “blown out” to deliver entire volume.

A

serologic pipettes

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39
Q

are TD types of measuring pipettes that are calibrated between marks and cannot be “blown out.”

A

Mohr pipettes

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40
Q

Pipettes labeled “to contain” (TC) must be rinsed out to deliver the entire contents. _____ pipettes and some ______ pipettes are in this category.

A

Sahli
Capillary

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41
Q

are handheld pipettes that use disposable tips, and the laboratorian performs aspiration and dispensing.

A

semiautomatic pipettes

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42
Q

are electronic and may not require tips. Many use a glass syringe that aspirates and dispenses through the same tube.

A

automatic pipettes

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43
Q

This method verifies the amount of liquid dispensed by a pipette. All equipment and water must be at room temperature before beginning.

A

Gravimetric pipette calibration

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44
Q

A specific amount of water is pipetted into a weighed container and the weight of the water is determined. The weight of the water is proportional to the volume of water pipetted.

A

Gravimetric pipette calibration

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45
Q

: This method uses a dye of known concentration and water.

A

Volumetric pipette calibration

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46
Q

A specific amount of dye is pipetted into a specific volume of water. Depending on the volume of the pipette, the absorbance of the solution will read a predetermined number. The pipette can then be adjusted, and the calibration repeated.

A

Volumetric pipette calibration

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47
Q

________accelerate gravitational separation of substances differing in their masses. ___________ is dependent upon several parameters, including mass and the speed and radius of rotation.

A

Centrifuges

Centrifugal force

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48
Q

Centrifuges are used to separate blood cells from __________, separate particulate matter in __________, and separate two liquid phases of different __________.

A

plasma or serum

urine

densities

49
Q

Centrifuge speed should be checked periodically with a ___________ for accuracy.

A

tachometer

50
Q

________________
allow the tubes to attain a [vertical/ horizontal position] in the centrifuge when spinning and a [vertical/ horizontal position] when the head is not moving.

A

horizontal head/swinging bucket centrifuges

horizontal position

vertical position

51
Q

have angled compartments
for the tubes and allow small particles to sediment more rapidly.

A

angle head/fixed angle

52
Q

_______________
are high-speed centrifuges used to separate layers of different specific gravities. They are commonly used to separate __________. The chamber is generally [action] to counter heat produced through friction.

A

Ultracentrifuges

lipoproteins

refrigerated

53
Q

_________ is a physical property of matter.

A

mass

54
Q

A ________ compares the mass of an unknown against a known mass.

A

balance

55
Q

NIST recognizes [#} types of calibration weights for assessing the accuracy of balances.

_________weights are use to check analytical balances for proper calibration.

__________ weights have the quality of a primary standard and are used to check the accuracy of other weights.

A

5

Class S

Class M

56
Q

_________: have greater tolerance than Class S weights; are used for routine analytic work
_________: have greater tolerance than Class S-1
_________: are intended for micro analytical work and range from 50 to 0.05 m

A

CLASS S-1 WEIGHTS

CLASS-P WEIGHTS

CLASS J WEIGHTS

57
Q

_____________has a single beam with arms of equal length. Standard weights are added manually to the pan on the [left/right] side
to counterbalance the weight of the object on the [left/right-side] pan.

A

Double-pan balances

right side

left-side

58
Q

has arms of unequal length. The object is placed on a pan attached to the shorter arm. A restoring _____ is applied
mechanically to the other arm until the indicator is balanced.

A

Single-pan balances

force

59
Q

utilizes ___________ force to replace the weights as the counterbalance, with the force being proportional to the weight on the pan.

A

Electromagnetic force

60
Q

There are three types of thermometers: ___________ (replaces mercury type), ___________, and __________ (1 example).

A

liquid-in-glass
digital
electronic

thermistor probe

61
Q

Thermometers should be calibrated using an ______-certified thermometer; It provides an _________ thermometer with several calibration points, such as _____°C and _____°C.

A

NIST

SRM

30
37

62
Q

Changes in analyte concentration occur at different times during the day, week, or month

A

Cyclic variation

63
Q

Variation according to sleeping and waking times

A

Diurnal variation

64
Q

Occurs during a 24-hour period

A

Circadian variation

65
Q

Occurs twice a year; related to seasonal changes in climate and diet (elevated in the summer, decreased in the winter)

A

Circannual variation

66
Q

3 Physical variables affecting laboratory determinations

A

Exercise
Eating
Stress

67
Q

Exercise may cause alteration of [8 analytes]

A

ACCPPPLL

AST
Creatinine
CK
Protein
Potassium
Phosphate
LDH
Lactic acid

68
Q

Eating causes increased in [ 8 analytes]

A

CGGIILTs

Creatinine
Gastrin
Glucose
Insulin
Iron
LD
TAGs
Sodium

69
Q

Stress: May cause increase in [4 analytes] and even decrease hormone production of [2]

A

ACTH
Cortisol
Cholesterol

Pituitary hormone
ALDO

70
Q

Short draws for _____________ are not acceptable.

A

coagulation studies

71
Q

____________
caused by tourniquet use and repeated fist clenching, as well as improper drawing techniques, can lead to increased serum potassium, proteins, and metabolic by-products, as well as _________ of red blood cells.

A

Stasis

hemolysis

72
Q

Increased analytes in prolonged tourniquet

A

K+
Na
Lactic acid
Potassium
Protein

73
Q

Increased analytes in fist clenching

A

Na
Lactic acid
Phosphate

74
Q

Hemolysis cauases an increased values in analytes [8]

A

Creatinine
K+
LD
AST
ALT
ALP
Aldolase
Magnesium
Phosphate

75
Q

interferes with assays for a number of analytes.

A

Lipemia

76
Q

Drawing from a vein receiving intravenous (IV) fluid dilutes blood analytes but increases the value of analytes present in the IV fluid [4]

A

NAKCLGlu [nak sali glue]
Na
K+
Chloride
Glucose

77
Q

[3] are major concerns in specimen collection. Proper protocol must always be followed.

A

Px ID
Spx ID
Chain of custody

78
Q

Although sample transport is always important, it is of special concern for accurate analysis of some analytes. Specimens for [2] analysis should be placed on ICE for transport to the laboratory. [1] specimens drawn in plastic syringes should be transported immediately to the laboratory for analysis.

A

Ammonia
Lactic acid

Blood gases [pH]

79
Q

Sample processing involves logging the specimen into a ___________ and assigning the sample an ___________, sorting and delivering specimens to various departments for testing, centrifuging to separate/remove serum or plasma from red blood cells(if not in a gel separator tube),

A

Laboratory Information System [LIS]

ID number

80
Q

______________ involves logging the specimen into a laboratory information system (LIS) and assigning the sample an identification number, sorting and delivering specimens to various departments for testing, centrifuging to separate serum or plasma from red blood cells, and removing serum or plasma from red blood cells (if not in a gel separator tube),

A

Sample processing

81
Q

Separate serum or plasma from __________ as soon as possible, and preferably within [#] hours of blood draw (may need to be sooner for some analytes).

_____________ are commonly used in hospital situations, and they provide a good alternative for off-site collection provided a centrifuge is available (physician offices, clinics).

A

RBC

2hrs

Gel separator tubes

82
Q

Serum/plasma can generally be stored at _____°C for 2-3 days; for long periods, storage at ___°C is recommended for many analytes.

A

2-8C

-2OC

83
Q

2) For an inpatient, compare the patient’s name and identification number
on the patient’s ________ to the laboratory requisition. _________ may be used to scan patient identification band for confirmation.

A

ID band

Electronic scanners

84
Q

3) If the patient is an inpatient and an identification band is not present, the px’s [2 subjects] must be asked to identify the patient. Their name must be recorded on the laboratory requisition.

A

nurse
physician

85
Q

If the patient is an out patient without an identification band, the patient must provide ___________` for proper identification.

A

2 unique identifiers

86
Q

Select the venipuncture site: The preferred collection site includes the [2] as a last resort, the _________ can be used but caution must be taken because of its close proximity to the median nerve and the brachial artery.

A

median cubital vein
cephalic vein

basilic vein

87
Q

Gloves, alcohol swabs [__________ for blood cultures and alcohol levels], gauze, tape or band aids, evacuated blood collection tubes, needles, needle holders with safety, and tourniquets [Velcro or latex band; alternative non-latex, _________: should be used because of latex allergies].

____________ are used for finger sticks.

A

betadine

nitrile materials

lancets

88
Q

When selecting blood collection tubes, use tubes with the smallest volume necessary for testing to prevent _____________

A

iatrogenic anemia

89
Q

Apply the tourniquet and palpate using two fingers to select the most appropriate collection site. The phlebotomist should never leave the tourniquet on the patient more than 1-2 minutes. Patient results will be affected; blood may become more [diluted/concentrated] because of blood flow _______. If the tourniquet is left on the arm for a prolonged time period, it could also increase the chance of pain and discomfort to the patient and the possible formation of a ___________.

A

concentrated

stasis

hematoma

90
Q

Needles are usually ________ gauge. A higher number means a smaller needle diameter.

A

20 or 21

91
Q

Assemble the needle and needle holder with the evacuated tube, or needle and ______ for blood cultures or collection from fragile veins. Because of small-diameter needles (23 gauge), some phlebotomists prefer using the ________ for difficult draws. It is, however, more difficult to collect large quantities of blood using this.

A

syringe

butterfly method

92
Q

1) Needle should enter the site at a _________-degree angle, with the bevel of the needle facing [up/down].
2) Advance the evacuated tube onto the needle; change tubes carefully without moving the needle. If the collection tube has an anticoagulant, invert [#] times before progressing to the next tube.
3) Once good blood flow is established or the last tube has been advanced onto the needle, the tourniquet should be removed.

A

15- to 30
up

2-3 times

93
Q

Remove the needle and then immediately apply [action] to the site using a gauze pad.

Engage the safety on the needle immediately and discard needle into shaips container. Phlebotomists should [recap/never] contaminated needles.

If bar coding is not used, label all tubes completely. Although labeling
requirements vary among facilities, most require date and time of collection, name or initials of phlebotomist, and patient’s name and ____________.

A

pressure

NEVER RECAP

94
Q

tubes used when serum is required for the test

A

Red stopper
SST

95
Q

May be used for routine chemistries, therapeutic drug levels,
immunohematology, and serology

A

Red stopper tubes

96
Q

tubes contain ethylenediaminetetraacetate (K3 EDTA),
an anticoagulant.

tubes contain ethylenediaminetetraacetate (K2 EDTA),
an anticoagulant.

A

Lavender

Pink

97
Q

EDTA ratio is [#] mL of whole blood. Coagulation is prevented by [Action], which forms an _____________+.

A

1mL

chelation

insoluble calcium salt

98
Q

Used in hematology for complete blood count, slide preparation, and other routine hematology procedures; also used in immunohematology and for some special chemistry assays

A

Lavender tube

99
Q

Alternative formulation of Lavender tube ___________ may be used in immunohematology.

A

Pink stopper [K2 EDTA]

100
Q

____________ tubes contain sodium citrate, an anticoagulant

A

Blue

101
Q

Sodium citrate (3.2%) in a _____ ratio, [#] part sodium citrate to [#] parts
whole blood

A

1:10

1

9

102
Q

Prevents coagulation by removing ionized calcium (chelation)
[3 tubes]

A

Lavender
PInk
Royal Blue

103
Q

Used for coagulation studies (e.g., prothrombin time and activated
partial thromboplastin time)

A

Blue

104
Q

_________ tubes contain heparin, an anticoagulant.

A

Green

105
Q

Several forms of heparin are available [2]

A

Sodium
Lithium

106
Q

ratio is 0.2 inL/1 mL of whole blood.

A

Heparin- Green

107
Q

Prevents coagulation by inactivating thrombin

A

Green

108
Q

Used for routine and special chemistry and cytogenetic testing

A

Green

109
Q

contain a gel separator and often contain clot activators.

A

Speckled, tiger, or marbled top serum separator tubes [SSTs]

110
Q

They are used frequently
in clinical chemistry for a number of assays. ______________ are
not recommended for immunohematology or drug levels.

A

Serum-separator tubes

111
Q

contain a gel separator and an anticoagulant. In some cases, the PST stopper color is ________, which indicates that _____________ is the anticoagulant.

A

Speckled, tiger, marbled top plasma separator tube [PSTs]

green

lithium heparin

112
Q

For PSTs/SSTs,
The separator is a ____________ that forms a barrier between the cells and the serum during centrifugation.

A

thixotropic gel

113
Q

PST or SST
These tubes are useful when serum is needed

These tubes are useful when plasma is needed.

A

SSTs

PSTs

114
Q

_______________
reduce the time needed for clot formation and thus speed up the assay process. They are used frequently in clinical chemistry for a number of assays but are not recommended for immunohematology.

A

PSTs

115
Q

RED no additive
RED SSTs

Which of which is not recommended for immunohematology and drug levels

A

RED SSTs

116
Q

To prevent anticoagulant carryover and contamination when using a
needle and needle holder for blood collection, the following order of draw should be used:
1. sterile specimen [_________]
2.
3.
4.
5.

A

Blood culture
Light blue/Na Citrate - Coagulation
Plain RED/SST
Green/PST
Lavender/EDTA

117
Q

When using the butterfly (winged collection set) to collect a sodium citrate tube, if it is the first tube to be collected, then a _________ [2 options] must be collected first to remove the _____ from the tubing.

Sodium citrate tubes must be [partially/completely] filled to ensure the correct plasma: anticoagulant ratio, or the test results could be compromised.

A

Discard tubes

Plain red
Another Na citrate

air

completely

118
Q
A

CLIN CHEM (12 decks)

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