Clinical Lab Flashcards by CHLOE SPRADLING

The process by which specimens are logged in, labeled, and assigned a specimen identification code

Accessioning

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A voluntary process in which an independent agency grants recognition to institutions or programs that meet or exceed established stands of quality

Accreditation

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AABB, International association that sets blood bank standards, accredits blood banks, and promotes high standards or performance in the practice of transfusion medicine

American Association of Blood Banks

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A chemical or substance that prevents blood coagulation

Anticoagulant

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The study of bacteria

Bacteriology

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Clinical lab department where blood components are tested and stored until needed for transfusion; immunohematology department; transfusion services; also the refrigerated unit used for storing blood components

Blood bank

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CMS, agency within the DHHS responsible for implementing CLIA ‘88

Centers for Medicare and Medicaid Services

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Testing outside the traditional lab setting, also called bedside testing

Point-of-care testing

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Specifies minimum performance standards for all clinical labs

Clinical Laboratory Improvement Amendments of 1988

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Under CLIA ‘88, certified labs are classified as preforming what? (Each level of certification can only do what specific test?)

Waived tests, test of moderate and high complexity, and provider-preformed microscopy procedures

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Over half of registered CLIA labs are located where?

Physician office laboratories (POLs)

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Labs in small hospitals (Less than 100 beds) primarily do what? (Responsibilies)

Routine tests, they send more complicated or infrequent tests to a larger laboratory

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A lab in a medium hospital (Up to 300 beds) typically preforms what kind of tests?

Routine test as well as more complicated tests, only newly developed test, infrequent tests, and tests that require a high level of skill and special instrumentation need to be sent to a reference laboratory

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Large hospital (300+ beds) labs can preform what tests?

Complex tests at large volumes

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Tests that have a very low risk of error, includes hemoglobin, hematocrit, urine reagent strip, urine pregnancy tests, blood glucose, and occult blood tests

Waived Tests

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Name for labs located inside physician offices that typically preform waived tests, over half of CMS-registered labs are these kinds of clinical lab

POLs

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Privately owned, regional labs that preform high-volume tests, usually preform high complexity tests for hospital labs

Reference Laboratories

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Every state has one of these facilities, which is operated by the state’s department of public health. In these facilities, tests preformed include those mandated by state regulations, like premarital blood tests and PKU testing of newborns, as well as other tests not typically available at other labs, like fungi and mycobacteria cultures and infectious diseases such as HIV

State laboratories

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First level of CLIA certificate, can only preform WAIVED tests, which many of can be preformed at home like a urine pregnancy test

Certificate of Waiver (COW)

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Second level of CLIA certification, preform microscopy-based tests on specimens not easily transported, include urine microscopic examinations, abbreviation of Provider-Preformed Microscopy Procedures

PPMP Certificate

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3rd, 4th, and 5th levels of CLIA certification, preform moderate to high complexity tests

Registration Certificate, Certificate of Compliance, and Certificate of Accredation

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Title for the director of a hospital laboratory

Pathologist

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Title for a lab’s technical supervisor

Lab manager or chief technologist

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Lab title for a technical consultant or general supervisor

Department head, section head, section supervisor, or technical specialists

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Lab title for testing personnel

(In order of responsibilities) Medical/clinical lab scientist, medical/clinical lab technologist, medical/clinical lab technician, and lab assistant

Directly under lab director, would be educated in clinical lab science with additional management training or experience, also responsible for making the SOP available to all personnel

Technical supervisor

Department of the lab that preforms tests involving blood

Hematology

Tests preformed in the hematology department that diagnoses and monitors a patient with defects in their blood clotting system

Coagulation tests

Included in its own department or part of chemistry or hematology, where physical, chemical, or microscopic examinations and tests of urine are preformed

Urinalysis

The largest department in most labs, preforms tests on plasma, serum, urine, and other fluids

Clinical Chemistry

Specially trained personnel responsible for collecting specimens, sometimes this responsibility is shared with nursing personnel

Phlebotomist

In small labs, specimens are taken directly to the department where the test needs to be preformed. In larger labs, specimens are delivered to this area to be processed and logged into a computer to be given an identification code

Accessioning area

A voluntary process by which an independent agency grants recognition to institutions or programs that meet or exceed established standards or quality

Accreditation

In 1996, Congress passed this act, from which a privacy rule was issued, providing federal protections for personal health information

Health Insurance Portability and Accountability Act (HIPAA)

Educational requirements for a Medical Lab Scientist

Baccalaureate degree, completed specific on-site training, then after being certified they can preform analysis in all lab departments and work as a supervisor, have the title MLS

Educational requirements for a Medical Lab Technician

Associate's degree or certificate from an accredited MLT program, and after certification they have the title MLT

Treating every patient, body fluid, substance, and unfixed tissues as potentially infectious

Standard Precautions

Exposure control methods

Standard Precautions, use of PPE, engineering controls (devices that eliminate or minimize worker exposure) and work practices (the manner in which a task is preformed to minimize the likelihood of exposure)

Tool used in sterilization that works by using steam under pressure to kill bacteria, viruses, and fungi

Autoclave

Common disinfection methods

Dilute chlorine bleach (1:10 dilution), alcohols 70% to 90%, phenols, and quarternary ammonium compounds

Chemicals used on skin or tissue to inhibit growth of microbes

Antiseptics

A measurement of 1/1000, 0.001, or 10^-3

Milli

Measurement of 1/100, 0.01, or 10^-2

Centi

Measurement of 1/10, 0.1, or 10^-1

Deci

Measurement of 1/1000000, or 10^-6

Micro

Measurement of 10^-9

Nano

Measurement of 10^-12

Pico

Converting an inch to a centimeter

Multiply the number of inches by 2.54

Convert an ounce to a gram

28oz = g

Convert a quart to a liter

Q0.95 = L

Convert teaspoons to mililiters

Multiply the number of teaspoons by 5 for the number of milliliters

Formula of Fahrenheit to Celsius

C= 5/9 (F-32)

Formula of Celsius to Fahrenheit

F= 9/5 (C) + 32

Dilution Ratio

A / (A+B) = C

In the dilution ration "A / (A+B) = C", what substance is each variable?

A = Volume of substance being diluted, B = Parts of diluent being added, C = the dilution, the fraction that shows the proportions of substances

Branch of medicine concerning blood

Hematology

The process of stopping bleeding

Hemostasis

Blood vessel that carries oxygenated blood away from the heart

Arteries

Smallest blood vessels that connect the smallest of arterioles and veins, have thin walls so nutrients, waste, and other fluids can pass through tissues. Beds of these vessels are where O2 and CO2 exchange occur

Capillaries

Carry deoxygenated blood from capillaries to the heart

Veins

About 50% to 60% of blood is made up of this substance, which is more than 90% water, also carries proteins for blood coagulation

Plasma

Erythrocytes

Red blood cells

Leukocytes

White blood cells

Thrombocytes, fragments of megakaryocytes, help stop bleeding by forming plugs while also releasing chemicals and enzymes

Platelets

Five types of white blood cells

Neutrophils, basophils, eosinophils, lymphocytes, and monocytes

Formation and development of blood cells, occurs in bone marrow in adults

Hemopoiesis

Anticoagulant most frequently used in hematology lab

Ethylenediaminetetraacetic acid

Anticoagulant used most commonly in coagulation tests

Sodium Cirate

One of the most common procedures requested in a hematology lab, includes at minimum the RBCC, WBCC, hemoglobin, hematocrit, red blood cell indices, white blood cell differential count, platelet count or platelet estimate, and evaluation of cell morphology

Complete blood count

The primary component of red blood cells, the oxygen carrying molecule

Hemoglobin

The measurement of blood hemoglobin indirectly evaluates what other property of blood?

The blood's oxygen carrying capacity

A test for a patient's level of red cell volume, and thus the blood's oxygen-carrying capacity

Hemocrit

A special counting chamber used when blood cell counts are preformed manually, also used to count cells in cerebrospinal fluid or sperm

Hemacytometer

A condition in which there is a decrease below normal in the RBC count or hemoglobin level

Anemia

The body's ability to resist disease

Immunity

Disposable method of counting WBCs and platelets marketed by Biomedical Polymers Inc.

LeukoChek

System Bioanalytic GmbH offers for RBC counts

Ery-TIC

System Bioanalytic GmbH offers for WBC counts

Leuko-TIC

System Bioanalytic GmbH offers for platelet counts

Thrombo-TIC

Ery-TIC method for diluting for RBC counts

995 μL (microliters) of isotonic solution, 5 μL of blood, equaling a 1:200 dilution

Leuko-TIC method of diluting blood for WBC counts

380 μL of an acetate buffer containing gentian violet, and 20 μL of blood, equaling a 1:20 dilution

LeukoChek method of diluting blood for WBC counts

Sealed reservoir containing 1.98 mL of buffered ammonium oxalate solution and a 0.02 mL capillary pipet, equaling a dilution of 1:100

Method of loading a hemacytometer to count RBC and WBCs

The blood dilution is mixed, a micropipetter is used to remove 10 to 15 μL, the pipet tip is touched to the coverglass and one side is loaded, the same is done on the other side

Formula used to count RBC using the Ery-TIC method

RBC/µL = Average #cells X 10,000 (Add four zeros to the end of average cell count)

RBC reference counts

Adult Male: 4.5 to 6 X 10^6/μL Adult Female: 4 to 5.5 X 10^6/μL Newborn: 5 to 6.3 X 10^6/μL

A solution that resists a sudden, marked change in pH when acid or base (alkali) is added

Buffer

Red-orange stain or dye

Eosin

Blue stain or dye

Methylene blue

Name of the stain that's a combination of eosin and methylene blue in methanol

Wright's stain

The only anticoagulant that can be used for a blood smear

Ethylenediaminetetraacetic acid (ETDA)

All smears must be stained within how long of being prepared?

One hour

Electrolytes tested in clinical chemistry

Sodium, potassium, chloride, and bicarbonate

Disease that cause the immune system to react against the body's own tissue

Autoimmune disease

B cells, type of immunity that is the primary protection against bacteria, toxins, and circulating antigens, most vaccines use this kind of immunity, it allows lymphocytes to "learn" what antibodies to produce to combat a disease

Humoral Immunity

T cells, type of immunity that is protection against viruses, fungi, tumors, and intracellular organisms, secrete molecules called lymphokines or cytokines to commute with other cells to regulate the immune system

Cell-Mediated Immunity

Immunoglobulin type that's the most common antibody in blood, protects against bacterial and viral infections

IgG

First immunoglobulin activated in immune regulation

IgM

Immunoglobulin that functions in mucosal tissues (tissues lined with mucous [mucosA])

IgA

Immunoglobulin that functions as a antigen receptor for B cells (b=d)

IgD

The allergic reaction immunoglobulin

IgE

Primary antibody response: Which antibody is the first detectable, found 3 to 4 days after exposure?

IgM

Primary antibody response: Which antibody is detectable in serum for 1 to 2 weeks after exposure?

IgG

Term for when an antibody becomes detectable in the serum or plasma, like you're exposed on Day 1, you have NO antibodies on Day 2, but you have IgG concentration on Day 4 to 7

Seroconversion

When does the anamnestic immune response, or secondary immune response, occur?

Rapid immune response after re-exposure to the antigen

Antibody production during a secondary immune response (Pg 440 in the textbook has an AMAZING graph demonstrating this)

IgM and IgG increase rapidly in 2 to 3 days, IgG levels increase much higher than in a primary response, and IgG is detectable for months to years

Immune response that makes booster vaccines highly effective

Anamnestic/Secondary Immune Response

Term for an individual who is more susceptible to disease because of a deficiency or damage to the immune system

Immunocompromised

Term for the scientific study or examination of blood serum, common term used in the testing of the immune system

Serology

What does it mean when an immunity test is qualitative?

The test only give positive-negative results

What does it mean when an immunity test is semi-quantitative?

The test gives an estimate of the antibody concentration

What does it mean when an immunity test is quantitative?

It tests for a count of antibodies

Pregnancy tests are based on the detection of what hormone?

Human chorionic gonadotropin (hCG)

What is immunohematology?

The study of human blood groups

Advantages of Point-Of-Care testing

Rapid results, less traumatic for patients, many different workers in health-care can preform the tests, errors are reduced, and communication between the lab staff, nursing staff, and patients is improved

Disadvantages of Point-Of-Care testing

Increased costs, increased personnel means increased need for training, poor coordination between testing personnel and central lab can result in poor quality assessment, and the POCT coordinator must be highly skilled in communication, management, and the instruments used for the operation to run smoothly

The three types of bacteria morphology

coccus (round), bacillus (rod), and spiral

What is a gram stain?

Procedure that stains bacteria differently depending on their composition of their cell wall

Term for when mircoorganisms are growing in blood

Septicemia

Term for the method that removes all living organisms in an area, commonly preformed by autoclaving

Sterilization

Parts of the body that are primary lymphoid organs

Bone marrow and the thymus

Parts of the body that are secondary lymphoid organs

Lymph nodes and spleen

Humoral immunity protects against bacteria and toxins using antibodies and what kind of lymphocytes?

B cells

Humoral immunity protects against what using antibodies and B cells?

Bacteria and toxins

Cell-mediated immunity protects against viruses, fungi, and tumors using lymphokines and what kind of lymphocytes?

T cells

Cell-mediated immunity protects against what using lymphokines and T cells?

Viruses, fungi, and tumors

The process of stopping the loss of blood from blood vessels

Hemostasis

Substance that stops blood from clotting

Inhibitors

Term for first step in homeostasis; the blood vessel constricts to reduce blood flow to the damaged area

Vasoconstriction

Cytoplasmic fragments of megakaryocytes, have granules used in coagulation

Platelet

Second step of homeostasis; platelets come into contact with collagen in the wall of damaged blood vessel and change shape to...

Form a plug over the damage in the blood vessel

Plasma substances that are produced in the liver and that participate in the formation of the fibrin clot during homeostasis

Coagulation factors

Vitamin K-dependent coagulation factors

II, VII, IX, and X

Purpose of B Cells

Produce antibodies to fight infections, humoral immunity

Purpose of T Cells

Prevent infection, cell-mediated immunity