Introduction to Clinical Chem Flashcards

1
Q

Branch of laboratory medicine that is concerned with the quantitative measurement of analytes in body fluids to facilitate the diagnosis of diseases

A

Clinical Chemistry

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2
Q

They are biologically important substances. It includes ions, salts and minerals, small organic molecules, and large macromolecules. It also includes carbohydrates, proteins, lipids, enzymes, metabolites, vitamins, and drugs

A

Analytes

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3
Q

Purpose of testing for these analytes is to assist the clinicians in making a diagnosis, monitor disease progression and guide treatment decisions.

TRUE OR FALSE

A

TRUE

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4
Q

It is USUAL that results from a single laboratory assay will provide a diagnosis

TRUE OR FALSE

A

FALSE

UNUSUAL

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5
Q

Additional tests may be needed in order to take the decision making to the next step

TRUE OR FALSE

A

TRUE

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6
Q

When the results of this tests are used appropriately, in the context of the medical history and physical examination findings of the patient, the decision making of the doctor or clinician is improved

TRUE OR FALSE

A

TRUE

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7
Q

It can also be used to monitor the disease over time and to check if treatment is effective or working

TRUE OR FALSE

A

TRUE

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8
Q

Clinical Chemistry examines various analytes using different methodologies, and is fully-automated.

TRUE OR FALSE

A

FALSE

Methodologies are both manual and fully-automated. Technological advances in this field are intertwined with developments in automations and the clinical laboratory

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9
Q

The scope of clinical chemistry encompasses many scientific disciplines such as:

A

Analytical Chemistry
Biochemistry
Instrumentation and Computers
Endocrinology
Immunology
Pharmacology
Toxicology
Other

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10
Q

It is the science of obtaining, processing, and communicating information about the composition and structure of matter

A

Analytical Chemistry

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11
Q

It is the branch of science that explores the chemical processes within and related to living organisms

A

Biochemistry

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12
Q

In clinical chemistry, the analysis involves both manual and automated methods. The productivity of the chemistry laboratory depends heavily on instrumentation

What is being talked about here?

A

Instrumentation and Computers

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13
Q

Decades ago, DOCTORS usually prepared Protein Free Filtrate (PFF) in small glass jars before proceeding with the test. But now, it has been replaced with modern analytical devices

TRUE OR FALSE

A

FALSE

MEDICAL TECHNOLOGISTS

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14
Q

By using modern instruments, analysis becomes faster and more efficient. They are also COST-HEAVY in long term

TRUE OR FALSE

A

FALSE

THEY ARE COST-EFFECTIVE

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15
Q

Progress of the clinical chemistry has been influenced to a great extent by the development of instrumentation

TRUE OR FALSE

A

TRUE

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16
Q

There is no automated system today that can function without computers

TRUE OR FALSE

A

TRUE

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17
Q

Computers are not only responsible for giving instructions, but also control the operation of the entire system

TRUE OR FALSE

A

TRUE

Example. It gives warning when there is malfunction

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18
Q

This is concerned with the hormones, endocrine glands, and endocrine disorders

A

Endocrinology

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19
Q

The study of defense mechanisms that protect humans from foreign invaders

A

Immunology

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20
Q

The study of mechanism of drug action and therapeutic uses of drugs

A

Pharmacology

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21
Q

The science that helps us understand the harmful effects of chemicals and substances to humans

A

Toxicology

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22
Q

Important factor in toxicology is the dose of drugs or chemicals because ALL substances have the potential to be toxic in certain conditions and at certain doses

TRUE OR FALSE

A

TRUE

Example: Two aspirin tablets is okay for one patient, but is considered as toxic to others

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23
Q

The purpose of performing these tests is to confirm or to reject a diagnosis. They are used in conjunction with the medical history and the physical examination findings in order to make medical decisions

A

Chemistry Tests

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24
Q

Almost ONE-FOURTH of laboratory investigations are composed of chemistry tests

TRUE OR FALSE

A

FALSE
ITS ONLY ONE-THIRD

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25
Q

These are laboratory tests for evaluation of disorders of renal, water, electrolyte, and acid-base status.

A

Chemistry Tests

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26
Q

Screening tests are often grouped together in a basic metabolic panel.

TRUE OR FALSE

A

TRUE

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27
Q

is one of the major consequences of common disorders such as diabetes and hypertension.

A

Renal Disease

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28
Q

The blood sample is tested for the amount of _____ to diagnose Diabetes mellitus

A

GLUCOSE

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29
Q

is a metabolic disorder characterized by hyperglycemia

A

Diabetic mellitus

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30
Q

The blood sugar increases because there is a lack of secretion of insulin. This indicates?

A

hyperglycemia

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31
Q

▪ Waste products of metabolism
▪ When the blood levels of these substances increase, there
is a problem with the excretory function of the kidneys

A

Urea, Creatinine, Uric acid

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32
Q

The main function of kidney is to eliminate waste products from the blood and excrete this in the form of urine

TRUE OR FALSE (TAENA WAG NIYO MALIIN TOH)

A

TRUE

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33
Q

Body fluid that contains both organic and inorganic substances which are dissolved in water

A

Urine

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34
Q

Assess the excretion and retention capability of the kidneys

A

Renal Function Tests

Like: Urea, Creatinine, Uric acid

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35
Q

These tests evaluate the functions of the liver.

A

Liver profile/Hepatic panel

Which consist of: Bilirubin, Albumin, Total Protein, Alkaline Phosphatase (ALP), Aspartate Transferase (AST) , Alanine Transferase (ALT)

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36
Q

Functions of the liver:

A
  • Detoxification
  • Excretory function
  • Synthetic function
  • metabolism of proteins, fats, and carbohydrates
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37
Q

when an individual test is not sufficient to assess a medical condition, a combination of several tests may be used

A

Panel

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38
Q

The pattern of results from the combination of the tests may provide a better insight into the status of the patient as compared to the result of a single test result alone

TRUE OR FALSE

A

TRUE

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39
Q

This test is aimed at providing information about the state of the patient’s liver

A

Liver profile/Hepatic panel

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40
Q

It is used to measure the amount of fats or lipids in the blood, used to screen abnormalities in the lipids, and to assess the risk of the patient in developing heart diseases.

A

Lipid profile/panel

Triglycerides, Total cholesterol, HDL cholesterol, LDL cholesterol

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41
Q

Enzymes are proteins

TRUE OR FALSE

A

TRUE

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42
Q

Amylase, Lipase, Creatine Kinase

These are all examples of?

A

Enzymes

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43
Q

They are produced at a certain organ of the body. So, when there is a damage to that particular organ, then it will alert us to the possibility that it is the reason for the elevation of that particular enzyme in the blood

A

Enzymes

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44
Q

Responsible for regulating water content and osmotic pressure or osmolality

A

Electrolytes

45
Q

major extracellular cation

A

Sodium

46
Q

major intracellular cation

A

Potassium

47
Q

major extracellular anion

A

Chloride

48
Q

Hormones, specific proteins, trace elements, vitamins, drugs, lipoproteins are all?

A

Specialized Tests

49
Q

These are complex tests that are too expensive for the laboratory. Some laboratories send out samples to reference laboratories who can carry out these tests.

A

Specialized Tests

50
Q

They are not routinely performed and need special equipment for the test. Not all laboratories have the capability to perform these tests

A

Specialized Test

51
Q

The specimens which are submitted in the chemistry section include the blood which is the most common, followed by urine, CSF, and other bodily fluids.

A

Clinical Specimens

52
Q

Most common specimen that is received in the laboratory

A

Blood

53
Q

2 parts of blood

A

Plasma and Cellular portion

54
Q

fluid portion that contains dissolved ions and molecules

A

Plasma

55
Q

What is being described?

▪ This is where most chemistry analytes are found.
▪ Part of the preparation of blood for testing these analytes
involves removing the cells.
▪ This is done by the centrifugation of the sample in order to
pack the cells at the bottom of the collection tube and to
allow for the removal of the plasma or serum for testing.

A

Plasma

56
Q

Part of blood composed of RBC, WBC, and platelets

A

Cellular portion

57
Q

Blood specimens are collected through venipuncture or phlebotomy.

TRUE OR FALSE

A

TRUE

58
Q

Most common puncture site for blood collection

A

antecubital fossa

59
Q

TRUE OR FALSE

o Blood will go directly to an evacuated tube
o This tube will hold 10mL of blood which is just enough to
perform many tests since automated analyzers require
only small amounts for single test

A

FALSE

The evacuated tube tube should only hold 5mL of blood

60
Q

For obese patients or patients with poor veins, skin or capillary puncture is performed

TRUE OR FALSE

A

TRUE

61
Q

o In ______ _______, the fleshy part of the fingertip is pricked
with a lancet
o We use the 2nd, 3rd, or 4th finger
o The blood is collected in a capillary tube or in a
microtainer tube

A

Capillary puncture

62
Q

For infants, blood collection is through heel puncture.

TRUE OR FALSE

A

TRUE

63
Q

Blood can also be collected from the artery, this method is known as

A

Arterial Puncture

64
Q

Sites for arterial puncture include the

A

radial, brachial, and femoral arteries

65
Q

Analysis is performed using gas in arterial blood

A

Arterial Blood Gas (ABG)

66
Q

The parameters that are being measured for ABG(Arterial Blood Gas) are:

A

▪ partial pressure of oxygen
▪ partial pressure of carbon dioxide
▪ pH oxygen saturation
▪ pH carbon dioxide saturation

67
Q

Test that assess collateral blood circulation. To determine if the site of puncture has other blood supply aside from it

A

Allen’s Test

68
Q

collected in a tube CONTAINING an anticoagulant which is an additive that prevents blood clotting

A

Plasma

69
Q

collected in a tube WITHOUT an anticoagulant, the blood will form a clot

A

Serum

70
Q

▪ Contains fibrinogen
▪ Ex. When you extract and draw a blood with an
anticoagulant tube (citrated tube or lavender top tube)
and you centrifuge the sample, there will be a separation
of the solid and liquid portion

A

Plasma

Solid portion of unclotted blood is the plasma

71
Q

▪ Has no fibrinogen because it has been exhausted or
used up during the clotting or coagulation process
▪ Upon centrifugation of the clotted blood, the clot will go to
the bottom of the tube, along with the cells. The liquid
portion on the top is called?

A

Serum

72
Q

gelatinous of semi-solid mass that is composed of cross-linked protein in serum. The Cross-linked protein is formed through coagulation

A

Clot

73
Q

➢ Composed of water and dissolved in water are the
organic and inorganic substances
➢ It is specially suitable for tests that evaluate kidney
function, waste products excreted by the kidneys, and
metabolites that are cleared from the bloodstream and
accumulated in the urine (such as drugs of abuse)

A

Urine

74
Q

Urine is collected by midstream clean catch method

TRUE OR FALSE (WAG NIYO MALIIN TOH HAHAHA)

A

TRUE

75
Q

o You collect the middle portion of a single continued
urination. For adults, it is relatively easy.
o Special techniques must be used for pediatric patients

A

midstream clean catch method

76
Q

Urine can either be concentrated or dilute. The main factor affecting this is the hydration status of the PROFESSIONAL

TRUE OR FALSE

A

FALSE

IT SHOULD BE THE PATIENT

77
Q

A difference in the concentration of the urine can affect the amount of the substances that are found in the sample at different times.

TRUE OR FALSE

A

TRUE

78
Q

In chemistry, we usually perform a 24-hour urine collection to measure the amount of creatinine in the blood. For quantitative determination of serum or plasma creatinine

TRUE OR FALSE

A

TRUE

79
Q

➢ The fluid that surrounds the brain and spinal cord. Acts
as a cushion that protects these structures from trauma
➢ It is crystal clear in appearance. Looks like distilled water

A

CEREBROSPINAL FLUID (CSF)

80
Q

Specimen collection of CSF is through?

A

LUMBAR PUNCTURE

81
Q

It is collected for patients who are suffering from meningitis, multiple sclerosis, and other neurologic disorders.

A

CEREBROSPINAL FLUID (CSF)

82
Q

Since the manner of collecting the sample is delicate, CSF must be handled properly and must be processed as soon as possible

TRUE OR FALSE

A

TRUE

83
Q

CSF are collected in 3 tubes which are labeled 1, 2, 3 depending on the order in which they are drawn. Identify what the tubes are used for.

Tube 1

A

used for Chemistry and Serology

84
Q

CSF are collected in 3 tubes which are labeled 1, 2, 3 depending on the order in which they are drawn. Identify what the tubes are used for

Tube 2

A

used for Microbiology

85
Q

CSF are collected in 3 tubes which are labeled 1, 2, 3 depending on the order in which they are drawn. Identify what the tubes are used for

Tube 3

A

used for performing cell counts in Hematology

86
Q

CSF are collected in 3 tubes which are labeled 1, 2, 3 depending on the order in which they are drawn. Identify what the tubes are used for

Additional Tube

A

Cytology analysis

87
Q

_____ is an ultrafiltrate of plasma. So the components of the plasma is similar to that of the _____ but differs in the concentration of the substances

A

CSF

88
Q

In chemistry, the CSF is tested for the presence of glucose and protein

TRUE OR FALSE

A

TRUE

89
Q

Typically used to test for congenital diseases also for neural tube defects and to assess or determine fetal maturity. This is the fluid that cushions the fetus in the mother’s womb.

A

AMNIOTIC FLUID

90
Q

These are tested in the chemistry section in order to determine the origin of the fluid whether they are transudate or exudate.

A

PLEURAL FLUID, PERITONEAL FLUID, PERICARDIAL FLUID

91
Q

they leak out of the blood vessels because of differences in hydrostatic pressure.

A

Transudate Fluid

91
Q

they are the result of infection, inflammation, and malignancy.

A

Exudate Fluid

92
Q

The POST-analytic phase is the most vulnerable phase for error.

TRUE OR FALSE

A

FALSE

it must be the PRE-analytic phase

Medical technologists should be able to detect these pre-analytical errors because this may lead to misdiagnosis and mismanagement of the patient

93
Q

Specimens must contain 2 identifiers:

These identifiers must match the accompanying request form

A

o Patient’s name
o Date of birth

Note: For every specimen there must be a request form

94
Q

In most request forms, it contains:

A

o Patient’s name
o Age
o Sex
o Date of birth
o Physician’s name
o Diagnosis
o Test requested
o Site or origin of the specimen

95
Q

Microbiology and Histopathology are site specific and must be indicated in the request form

TRUE OR FALSE

A

TRUE

96
Q

Most automated systems does NOT make use of barcode technology

TRUE OR FALSE

A

FALSE

automated systems do make use of barcode technology

97
Q

serve as the label they are used for the positive identification of the patient and also for tracking the specimen. This is also one way of eliminating errors caused by poor handwriting or by misreading the information if the label is handwritten

A

Barcodes

98
Q

QNS means?

A

quantity not sufficient

99
Q

Commonly reported pre-analytical errors in the laboratory

A

QNS - quantity not sufficient

100
Q

The specimen volume that must be submitted in the laboratory must be sufficient enough to perform the test and to perform repeat determinations if necessary

TRUE OR FALSE

A

TRUE

101
Q

TRUE OR FALSE

➢ If you want to obtain plasma, use a tube with
anticoagulant
➢ If you want serum, there should be no additive (red top
or yellow top tube)

A

TRUE

102
Q

TRUE OR FALSE

➢ Use of underfilled tubes can lead to erroneous results
➢ Use of overfilled tubes can lead to clotting, there is a
specified ratio and anticoagulant.
➢ There are markings which will indicate the maximum and
minimum fill line
➢ If the filling of blood stops for any reason this will result
in a partially filled tube (short draw)

A

TRUE

o These tubes are designed with vacuum
o When you draw blood, you allow the blood to fill the tube
until the vacuum is exhausted

103
Q

It may result in increased K, Mg, P, Acid Phosphatase (ACP), Lactate Dehydrogenase (LDH), Aspartate Aminotransferase (AST)

o These chemicals are found in the plasma
o When the red blood cells rupture, these will also be
released into the blood causing its elevation

A

Hemolyzed sample

104
Q

refers to the rupture or bursting of red blood cells

o Release of hemoglobin and intracellular contents of RBC
into plasma the resulting serum or plasma will be red in
color.
o Possibly due to poor technique in venipuncture or
excessive trauma in the blood vessel during collection
o It could also be the result of rough handling during
transport, tubes being mixed vigorously, and prolonged
contact of the red blood cells with serum or the plasma

A

Hemolysis

105
Q

➢ It affects tests that use spectrophotometric methods
➢ Specimen has a milky white appearance due to the
presence of lipids or fats
➢ This is due to a fatty diet or the patient did not fast
enough before specimen collection.
➢ Increase absorption of light
➢ The turbid appearance of serum and plasma will interfere
with the passage of light into solution, which is known as
the Principle of spectrophotometry
➢ Removed by high speed centrifugation (10,000g) and
extraction with Trichlorofluoroethane

A

LIPEMIC SAMPLE

106
Q

the recommended method by CLSI for lipemic samples

A

Ultracentrifugation

but the equipment of ultracentrifugation is expensive so not all laboratory have the capability to perform this

107
Q

These are the consequences of specimen rejection
TRUE OR FALSE

➢ Repeated specimen collection
o Added cost on the part of the patient who will pay
for the assay
o Cause inconvenience
o Potential for complications
➢ Delay in analysis and reporting of results
o Increase in turnaround time
➢ Delay in treatment of patient

A

TRUE

108
Q

Order the Laboratory workflow start to finish

Test ordered by clinican
Sample collection
Sample Transport
Result Transmission
Sample Analysis
Sample Processing

A

Test ordered by clinican
Sample collection
Sample transport
Sample processing
Sample analysis
Result transmission