Clinical Lab Flashcards
The process by which specimens are logged in, labeled, and assigned a specimen identification code
Accessioning
A voluntary process in which an independent agency grants recognition to institutions or programs that meet or exceed established stands of quality
Accreditation
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
A chemical or substance that prevents blood coagulation
Anticoagulant
The study of bacteria
Bacteriology
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
CMS, agency within the DHHS responsible for implementing CLIA ‘88
Centers for Medicare and Medicaid Services
Testing outside the traditional lab setting, also called bedside testing
Point-of-care testing
Specifies minimum performance standards for all clinical labs
Clinical Laboratory Improvement Amendments of 1988
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
Over half of registered CLIA labs are located where?
Physician office laboratories (POLs)
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
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
Large hospital (300+ beds) labs can preform what tests?
Complex tests at large volumes
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
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
Privately owned, regional labs that preform high-volume tests, usually preform high complexity tests for hospital labs
Reference Laboratories
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
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)
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
3rd, 4th, and 5th levels of CLIA certification, preform moderate to high complexity tests
Registration Certificate, Certificate of Compliance, and Certificate of Accredation
Title for the director of a hospital laboratory
Pathologist
Title for a lab’s technical supervisor
Lab manager or chief technologist
Lab title for a technical consultant or general supervisor
Department head, section head, section supervisor, or technical specialists
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
