JC_ENH 1 Flashcards
predominant protein
albumin
CF: Albumin
10
CF: Bilirubin
17.1
CF: BUN
0.357
CF: Na
1
CF: K
1
CF: Cl
1
CF: Chole
0.026
CF: Crea
88.4
CF: Glucose
0.0555
CF: Thyroxine
12.9
CF: T4
12.9
CF: Total Protein
10
CF: Trigly
0.0113
CF: Uric acid
0.0595
Conversion:
Conv. to SI
conv. x CF
Conversion:
SI to conv.
SI / CF
Convert 126 mg/dL glucose to SI unit
126 x 0.0555 = 7 mmol/L
chemical substance subject of chemical analysis
Analyte
compound or mixture added to a system to cause a chemical reaction or test if a reaction occurs
Reagent
Term reagent is often used in place of __________.
reactant
T/F:
A reagent may not necessarily be consumed in a reaction like a reactant.
TRUE
anything that speeds up the rate of a chemical reaction but is not being produced or consumed in the reaction
Catalyst
process of testing and adjusting analyzer’s readout to establish correlation between measured and actual conc.
Calibration
a material of known conc.
Standard/Calibrator
sample that is chemically and physically similar to unknown spx and is tested in exactly the same manner
Control
set of introduction for methods used in the laboratory
SOP
type of rgt water with maximum water purity
Type I
rgt water used for ultramicrochem analysis
Type I
rgt water used for nano/subnano analysis
Type I
rgt water used for analysis of trace metals
Type I
rgt water used for analysis of drugs
Type I
rgt water used for analysis of hormones
Type I
rgt water used for tissue culture
Type I
rgt water used in most lab tests and routine tests
Type II
rgt water used for CBC
Type II
rgt water used for gram staining
Type II
rgt water used for rgt prep and QC
Type II
rgt water used for most qualitative tests
Type III
rgt water used in histology
Type III
rgt water known as tap water
Type III
rgt water used for U/A and F/A
Type III
expressed as the “% solution”
Concentration
Concentration formula
% / 100 = x / vol/wt
mol/L
Molarity
Eq/L
Normality
mol = ?
gmw
Eq = ?
gmw/v
valence = # of ___
Hydrogen
Dilution formula
vol of spx / (vol of spx + vol of diluent)
Corrected dilution formula
value obtained for diluted spx x reciprocal of dilution
centrifuge that is vertical at rest, horizontal in motion
swinging bucket/horizontal rotor
swinging bucket
air friction:
speed:
sediment:
swinging bucket
air friction: inc
speed: dec
sediment: poor
centri faster than swinging bucket due to less air friction which allows more rapid sedimentation
fixed/angle
head rotor of fixed centri
25-40 deg
centri with high speed and is refrigerated to reduce heat
Ultracentrifuge
ultracentri rpm
100,000 rpm
ultracentri is mainly used for?
lipoprotein analysis, to remove trubidity
Don’t respin serum separator tubes. Serum in contact with RBCs under gel can be expressed and increase which analyte?
K
electrolytes inc. in hemolysis
K, LD
Calibration of centri is done _________.
monthly
Disinfection of centri is done __________.
weekly
Apparatus used for centri calibration
Tachometer
Strobe light
Timer
pipette used to hold a particular volume but not dispense the exact volume
TC
pipette used to dispense exact amount
TD
Automatic pipette that relies on piston for suction
Air disp.
automatic pipette that uses disposable tips and is not suitable for viscous fluids
air disp.
automatic pipette that operates by moving the piston in the pipette tip or barrel, much like hypodermic syringe
Positive disp.
Positive displacement characteristics:
- lack air cushion
- suitable for viscous fluids
- constant aspiration force
Inc or Dec during activity/exercise:
Protein
Inc.
Inc or Dec during activity/exercise:
LD
Inc.
Inc or Dec during activity/exercise:
Lactic acid
Inc.
Inc or Dec during activity/exercise:
Glucose
Dec.
Inc or Dec during activity/exercise:
TAG
Dec.
Inc or Dec during activity/exercise:
Cholesterol
Dec.
Inc or Dec during activity/exercise:
K
Inc.
Inc or Dec during activity/exercise:
Crea
Inc
Inc or Dec during activity/exercise:
CK
Inc.
Inc or Dec during activity/exercise:
Phosphate
Inc.
Analytes increased in fist clenching
K, Lactic acid, Phosphate
Inc or Dec during recent food ingestion:
Glucose
Inc.
Inc or Dec during recent food ingestion:
Cl-
Dec.
Inc or Dec during recent food ingestion:
Insulin
Inc.
Inc or Dec during recent food ingestion:
TAG
Inc.
Inc or Dec during recent food ingestion:
K+
Dec.
Inc or Dec during recent food ingestion:
Amylase
Dec.
Inc or Dec during recent food ingestion:
Gastrin
Inc.
Inc or Dec during recent food ingestion:
HCO3-
Inc.
Final breakdown product of Protein
Urea
product of deamination of amino acids
ammonia
High protein and low glucose will harbor what product
ketones
Serotonin increase urinary secretion of _________
5-hydroxyindole acetic acid (5HIAA)
natural source of serotonin in the body
chromaffin cell
serotonin rich foods
banana, pineapple, coffee, tomato, avocado
a condition wherein a tumor secretes large amount of serotonin in the body
argentaffinoma
argetaffinoma px prep
avoid serotonin rich foods
relationship of Cl- and HCO3-
inversely prop.
hormone which stimulates parietal cell and increases HCl in the stomach
gastrin
after recent food ingestion, pH (inc/dec).
Inc (alkaline)
during alkaline tide, K+ (inc/dec)
dec
Urobilinogen favors (acidic/alkalinic) environment
alkalinic
Intracellular or Extracellular:
K+
Intra
Intracellular or Extracellular:
Na++
Extra
Severe liver disease
Urea:
Ammonia:
Severe liver disease
Urea: Dec.
Ammonia: Inc.
Increased ammonia may reach the brain and lower neurotransmitters such as GABA. this may result to which condition?
Hepatic coma
What analyte is tested in the CSF in cases when hepatic coma is suspected
Glutamine
Inc. ammonia = Dec. neurotransmitter = Hepatic coma
(Ammonia unstable in CSF)
TAG conc. which increases turbidity/lactescence:
400 mg/dL
analytes increased when standing:
CACA
Calcium
Albumin
Cholesterol
Aldosterone
Analytes increased when the posture changes from supine to sitting/standing:
Calcium
Albumin
Effects of prolonged tourniquet application
Hemoconcentration
Anaerobiosis
Duration of tourniquet application.
<1 min
INC or DEC when smoking:
glucose
INC
INC or DEC when smoking:
GH
INC
INC or DEC when smoking:
Cortisol
INC
INC or DEC when smoking:
Cholesterol
INC
INC or DEC when smoking:
TAG
INC
INC or DEC when smoking:
UREA
INC
INC or DEC in older age:
Albumin
INC
INC or DEC in older age:
ALP
INC
INC or DEC in older age:
Phosphorus
INC
(Dec. Ca = Inc. P)
INC or DEC in older age:
Chole
INC.
Due to slow metabolism
Analytes are increased AM/PM:
ACP
PM
Analytes are increased AM/PM:
ACTH
AM
Analytes are increased AM/PM:
Cortisol
AM
Analytes are increased AM/PM:
Fe
AM
Analytes are increased AM/PM:
GH
PM
Analytes are increased AM/PM:
PTH, TSH
PM
Analytes are increased AM/PM:
Aldosterone
AM
Analytes protected from light
Bilirubin
Carotene
Erythrocyte protoporphyrin
Niacin
CK
Analytes that require ice slurry
Lactic acid
Ammonia
Blood gas
Ionized Ca
Order of draw
BCRRHES
Blood culture
Citrate
Red glass
Red plastic
Heparin
EDTA
Sodium fluoride
*Oxalate
What will happen to Na, Fe, K, Ca when EDTA is used
Na, K = INC
Ca, Fe = DEC
Additives that distort RBC morph
Oxalate (main)
Fluoride
1st step in sample collection
Px ID
Uses of arterial puncture
Blood gas, pH
this test is done before arterial puncture to ensure proper blood flow
Modified Allen Test
degree of arterial puncture
45-60 deg
Femoral: 90 deg
Order of vein choice
Median
Cephalic
Basilic
Dorsal
Tubes with Gel must not be used for what tests
ISBT
ImmunoSero
Blood banking
TDM, Trace metals
Effect when tubes with gel are used for tests involving ImmunoSero, Blood Banking, TDM, and Trace metals
False (-), False dec.
the transfer of one additive/specimen to another thru needle contact
Carryover
additive most common cause of carryover
EDTA
tourniquet must be applied ______ inches above site
3-4
device that is used to inspect an organ by passing light through its wall
Transillumination
Lights used in transillumination
LED
Infrared
Std needle gauge
21’
Needle gauge for pediatric px
23’
Relationship of needle gauge and bore size
Inv. prop
Length of needle that is believed to give better control and is less frightening to the px
1 inch
Angle of venipuncture
15-30 deg
swelling around the puncture site due to leakage of large amount of blood
Hematoma
most common complication in blood collection
Ecchymosis
leakage of small amount of blood causes
Ecchymosis
When IV site is present, what to do?
Use the opposite arm or perform fingerstick.
If both arms with IV;
- ask the nurse to turn off IV for 2 mins
- apply tourniquet and collect under IV site
- discard first 5 mL (clear top or red top)
10% contam. with 5% dextrose increase glucose by
500 mg/dL
Pressure applied when blood pressure cuffs are used for venipuncture
60 mmHg
Antiseptic used for ethanol testing
Benzalkonium Cl (Zephiram Cl)
Length of lancet for skin punc.
1.75 mm
Depth of incision during skin pnc.
Infants: <2 mm
Adult: <2.5 mm
Skin punc. preferred site
Infant: Lateral plantar heel
Adult: 3rd and 4th fingers (Middle and ring)
Least preferred: Earlobe
Order of draw during skin puncture
BSEON
Blood gas
Slide
EDTA
Other additives
Non-additives
Arterialized Capillary blood is used for measurement of:
pCO2, pH
NOT pO2
Preferred site for collection of arterialized capillary blood
Earlobe
Don’t perform arterialized capillary blood test when arterial BP is below _________
95 mmHg
any test used as evidence in legal proceedings (blood alcohol, DNA analysis, tox screen)
chain of custody
a management philosophy and approach that focuses on processes and their improvement as the means to satisfy customer needs and reqs
TQM
include analytical processes and the general policies, practices, and procedures that define how all aspects of the work are done
QLP
emphasizes statistical control procedures, but also include nonstatistical check procedures, such as linearity checks, rgt, and standard checks, and temperature monitors
QC
concerned primarily with broader measures and monitors of lab performance including TAT, spx ID, px ID, test utility
QA
branch of TQM which provides a structured problem-solving process to help identify the root cause of a problem and a solution to that problem
QI
branch of TQM which is necessary to standardize the remedy, establish measures for performance monitoring, ensure that the performance achieved satisfies quality reqs, and document the new QLP
QP
a comprehensive program in an institution in which all areas of operation are monitored to ensure quality with the aim of providing the highest quality px care
Quality Assurance
ability to measure the smallest conc.
Sensitivity
ability to measure only the analyte of interest
Specificity
closeness of the assayed value to the true value
Accuracy
ability to give the same results on the same sample that agree with one another
Precision/Reproducibility
area of QC concerned with instrument and method
Sensitivity and Specificity
area of QC concerned about the laboratory itself
Accuracy
Precision
characteristic required of confirmatory tests
Specificity
characteristic associated with screening tests
Sensitivity
ability to detect proportion of individuals with that disease who test positive for the disease
Dx Sensitivity
ability to detect the proportion of individuals w/o the disease who test negatively for the disease
Dx Specificity
Dx Sensitivity formula
TP / (TP + FN) x 100
Dx Specificity formula
TN / (TN + FP) x 100
