Clin lab test 1 Flashcards

(50 cards)

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
Hyperkalemia leads to ______?
Aldosterone secretion and K excretion
26
Hyperkalemia is associated with
Prim/Sec hypoaldosteronism
27
Hypokalemia is associated with
Diabetes mellitus, Cushings, Hyperaldosteronism.
28
Hyper and hypochloremia are generally tied to what?
Shifts in sodium and bicarb. Cl shifts to maintain electrical neutrality
29
Increased HCO3 is indicative of what disorder?
Metabolic alkalosis; Primary or secondary to Respiratory acidosis
30
Decreased Bicarb in BMP is associated with what disorder?
Metabolic acidosis
31
Increased blood urea nitrogen on a panel is indicitave of disorder with what organ? What could be happening?
Kidneys. Decreased GFR/Increased tubular reabsorption, inadequate excretion, or increased gut production from too much protein or blood.
32
Serum calcium is tied to changes in what?
Serum albumin
33
A Complete metabolic panel includes what tests?
All BMP plus albumin, alanine transaminase (ALT), Alkaline phosphatase (ALP), Aspartate aminotransferase (AST), Bilirubin, Total protein
34
Albumin comprises _______ percent of total extracellular blood protein. It is a measure of ______ function
60% | Hepatic
35
Increased ALT mainly signifies what? | Increased ALP signifies what?
Damage to the liver (though remember skeletal muscles too) liver or bone disorders
36
AST is most commonly a reflection of what? | If AST is >2 x the ALT, what should you suspect?
Liver injury Alcohol abuse w/ cirrhosis or alcoholic hepatitis
37
Total protein measures what 2 classes of protein?
Albumin and globulin
38
CBC contains what information? | Include critical values
``` 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
UA panel consists of what 10 tests?
``` 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
What are desirable and high levels for Total Cholesterol?
D: less than 200 mg/dl High: 240+
41
What are desirable and high levels for fasting triglycerides?
D: Less than 150 mg/dl High: 200-500 VH: 500+
42
What are desirable and high levels of LDL and HDL
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
Up to 70% of lab errors occur during what phase of testing?
Pre-analytical
44
A critical test value must be reported in what timeframe? What about a STAT test result?
Crit: 1 hour from completion STAT: 1 hour from receipt of order
45
What is a reflex test?
An automatic test conducted by the lab in the event of a specific positive first test.
46
Describe cortisol's diurnal variation
Peaks 4-6 AM Lowest @ 8PM-12AM 50% lower at 8 PM than AM
47
When is insulin lowest, night or daytime?
Night
48
Iron peaks when? How much does it decrease following its peak?
Early to late morning | Decrease by up to 30% during the day.
49
What are 10 common errors in specimen collection?
``` 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
What are 10 rejection criteria of drawn samples?
``` Improper collection and label Prolonged transport - degraded Leakage Incomplete request Clotted/hemolysis/insuff quantity Non-fasted Improper preservation Unprot from light Acidified Non-Frozen ```