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Clinical Lab > Clin lab test 1 > Flashcards

Clin lab test 1 Flashcards

1
Q

1998 CLIA (Clinical Laboratory improvement) did what to deficiencies? How?

A

Decreased deficiencies by 40%. Established standards related to accuracy, reliability and timeliness.

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2
Q

What are the three parts of the EBM triad?

A
  1. Individual clinical expertise
  2. Best external evidence
  3. Patient values and expectations
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3
Q

Gray top tube is used for what? What type of additives are in the tube?

A

Blood alcohol, glucose. Sodium flouride (glucose preservative) and Potassium oxylate

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4
Q

Green Top has an anticoagulant. True or false? What is it?

A

True, Heparin

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5
Q

Lab pathology is divided into two subsections, what are they?

A

Anatomic and clinical.

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6
Q

Clinical pathology is divided into what 6 sections

A

Microbiology, UA, hematology, chemistry, serology, immunohematology

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7
Q

Light blue top tube has what in it?

A

Sodium citrate (9:1)

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8
Q

Light blue top goes to what lab section?

A

Hemotology, coagulation

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9
Q

What is the primary and secondary function of the chemical laboratory

A

Generate info and educate providers/staff.

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10
Q

What is the second most common lab sample

A

capillary pull

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11
Q

What is the role of medical laboratory testing?

A

Detect, diagnose, treat

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12
Q

What are the 5 criteria for testing complexity under clia 98?

A
  1. Risk of harm to the patient. 2. Risk of erroneous result. 3. Type of testing method used. 4. Degree of independent judgment and interpretation. 5. availability for home use.
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13
Q

What are the four categories of test complexity?

A

Waived (minimal)
Moderate (includes PPM)
High

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14
Q

What are the three types of unacceptable blood specimens?

A

Icteric (jaundiced)
Lipemic
Hemolyzed (processing error)

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15
Q

What color tube is used for a CBC? What anticoagulant is in it?

A

Lavender, EDTA

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16
Q

What determines a good screening test? What about a good confirmatory test?

A

Screen: Sensitivity and NPV high
Confirm: Specificity and PPV high

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17
Q

Define PPV, Define NPV

A

TP/TP+FP positive result actually positive ratio

TN/TN+FN negative result actually neg ratio

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18
Q

What is the best site for venipuncture

A

Median cubital vein

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19
Q

What is the most common specimen submitted to the laboratory

A

Venous blood samples

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20
Q

What is the order of draw for tubes based on color? What are the associated inversions for each?

A
  1. Yellow 8-10
  2. light blue 3-4
  3. gold/red/grey 5, red (plastic) 5, red (glass) 0, Orange 5-6
  4. Light Green, Green 8-10 (For all following as well)
  5. lavender
  6. white
  7. gray
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21
Q

A BMP (basic metabolic panel) consists of what tests?

A

Sodium, Potassium, Chloride, CO2 (Bicarb)

Blood Urea Nitrogen, Serum Creatinine, Serum Glucose, Total Calcium

22
Q

A BMP is typically collected in what vial?

A

Red (slides say Light green, gold as well)

23
Q

Hypernatremia always indicates what in relation to body water?

A

Relative total body water deficit

24
Q

(Among other things…) Hyponatremia is found in what?

Hypernatremia is found in what?

A

Addison’s

Cushings

25
Q

Hyperkalemia leads to ______?

A

Aldosterone secretion and K excretion

26
Q

Hyperkalemia is associated with

A

Prim/Sec hypoaldosteronism

27
Q

Hypokalemia is associated with

A

Diabetes mellitus, Cushings, Hyperaldosteronism.

28
Q

Hyper and hypochloremia are generally tied to what?

A

Shifts in sodium and bicarb. Cl shifts to maintain electrical neutrality

29
Q

Increased HCO3 is indicative of what disorder?

A

Metabolic alkalosis; Primary or secondary to Respiratory acidosis

30
Q

Decreased Bicarb in BMP is associated with what disorder?

A

Metabolic acidosis

31
Q

Increased blood urea nitrogen on a panel is indicitave of disorder with what organ? What could be happening?

A

Kidneys. Decreased GFR/Increased tubular reabsorption, inadequate excretion, or increased gut production from too much protein or blood.

32
Q

Serum calcium is tied to changes in what?

A

Serum albumin

33
Q

A Complete metabolic panel includes what tests?

A

All BMP plus albumin, alanine transaminase (ALT), Alkaline phosphatase (ALP), Aspartate aminotransferase (AST), Bilirubin, Total protein

34
Q

Albumin comprises _______ percent of total extracellular blood protein. It is a measure of ______ function

A

60%

Hepatic

35
Q

Increased ALT mainly signifies what?

Increased ALP signifies what?

A

Damage to the liver (though remember skeletal muscles too)

liver or bone disorders

36
Q

AST is most commonly a reflection of what?

If AST is >2 x the ALT, what should you suspect?

A

Liver injury

Alcohol abuse w/ cirrhosis or alcoholic hepatitis

37
Q

Total protein measures what 2 classes of protein?

A

Albumin and globulin

38
Q

CBC contains what information?

Include critical values

A 
Total RBC
Hemoglobin
Hematocrit (RBC volume of total blood)
Mean Corpuscular value (avg size of RBC)
Mean Corpuscular Hemoglobin
MCHC (proportion of cell occupied by hemoglobin --color)
RBC distribution width (variation in RBC size)
WBC count (crit - <2k or >30k)
Platelets (crit - <20k)
39
Q

UA panel consists of what 10 tests?

A 
Specific gravity
pH
Protein (kidneys)
Glucose 
Ketones
Blood (ketones vs. trauma)
Leucocyte esterase (infection)
Nitrite (bacterial metabolism product)
Bilirubin 
Urobilinogen (formed from bilirubin in intestine)
40
Q

What are desirable and high levels for Total Cholesterol?

A

D: less than 200 mg/dl
High: 240+

41
Q

What are desirable and high levels for fasting triglycerides?

A

D: Less than 150 mg/dl
High: 200-500
VH: 500+

42
Q

What are desirable and high levels of LDL and HDL

A

LDL
Desirable: less than 100mg/dl
High 160-189

HDL:
Desirable:60mg/dl both men and women or MORE
Low: less than 40 for men and 50 for women.

43
Q

Up to 70% of lab errors occur during what phase of testing?

A

Pre-analytical

44
Q

A critical test value must be reported in what timeframe? What about a STAT test result?

A

Crit: 1 hour from completion
STAT: 1 hour from receipt of order

45
Q

What is a reflex test?

A

An automatic test conducted by the lab in the event of a specific positive first test.

46
Q

Describe cortisol’s diurnal variation

A

Peaks 4-6 AM
Lowest @ 8PM-12AM
50% lower at 8 PM than AM

47
Q

When is insulin lowest, night or daytime?

A

Night

48
Q

Iron peaks when? How much does it decrease following its peak?

A

Early to late morning

Decrease by up to 30% during the day.

49
Q

What are 10 common errors in specimen collection?

A 
Mis-ID of patient
Mislabel specimen
Bad draw/wrong ratio
Mixing problems/clots
wrong tubes
Hemolysis/Lipemia
Hemoconcentration from TQ
Exposure to light and high temps
improper timing
Processing errors
50
Q

What are 10 rejection criteria of drawn samples?

A 
Improper collection and label
Prolonged transport - degraded
Leakage
Incomplete request
Clotted/hemolysis/insuff quantity
Non-fasted
Improper preservation
Unprot from light
Acidified
Non-Frozen

Clinical Lab (2 decks)

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