Lab management -Statistic Flashcards
What is the Coefficient of Variation (CV)?
CV =SD/Mean x 100 Llower the CV, the better the precision for the measurement.
Standard error of mean
= SD/ Square root of n
1 2s violation?
1 control value is outside of the ±2 SD limit; but the other control within ±2 SD limit Accept run Random Error
1 3s
One control exceeds ±3 SD Reject run Random
2 2s
Both controls outside ±2 SD limit; or two consecutive controls outside the limit Reject run Systematic
R 4s
One control +2 SD and another -2SD Reject Run Random
4 1s
4 consecutive controls exceeding +1 SD or -1SD Reject run Systematic
10X
10 consecutive control values falling on one side of the mean Reject run Systematic
What is the Delta Check?
When a patient’s values deviates more than a predetermined limit from the previous value
What is seen on this Levey Jennings graph?
Shift
What is seen on this Levey Jennings graph?
Trend
Sensitiviy =
TP/TP + FN X100
Specificity =
TN/TN + FP X 100
Positive Predictive value
TP/TP+FP X 100
In six sigma, the goal of the lab is to reduce the error rate to at least __% or ____ sigma , but preferably ___% or ____sigma
In six sigma, the goal of the lab is to reduce the error rate to at least _0.1_% or __4.6__ sigma , but preferably _0.01__% or _5.2_sigma
The equation for the percent of results falling outside of the reference range
(1-0.95n) X 100
or just multiple the n by 5, and choose the closest lower number
NADH is absorbed at ___ nm
NADH is absorbed at 340 nm
What is incorporated into the potassium-selective electrode?
Valinomycin
What does FPIA stand for?
Fluorescent polarization immunoassay
FPIA is a homogenous competitive assay where after incubation the fluorescence polarization signal is measured; this signal is only produced if the labeled antigen is bound to the antibody molecule.
Therefore, intensity of the signal is inversely proportional to the analyte concentration.
What does EMIT stand for?
Enzyme multiplied immunoassay technique is a homogenous competitive immunoassay where the antigen is labeled with glucose 6-phosphate dehydrogenase, an enzyme that reduces nicotinamide adenine dinucleotide (NAD, no signal at 340 nm) to NADH (absorbs at 340 nm), and the absorbance is monitored at 340 nm. When a labeled antigen binds with the antibody molecule, the enzyme label becomes inactive and no signal is generated. Therefore, signal intensity is proportional to analyte concentration.
What does CEDIA stand for?
Cloned Enzyme Donor Immunoassay (CEDIA) method is based on recombinant DNA technology where bacterial enzyme beta-galactosidase is genetically engineered into two inactive fragments. When both fragments combine, a signal is produced that is proportional to the analyte concentration.
What does LOCI stand for?
Luminescent oxygen channeling immunoassays (LOCI): The immunoassay reaction is irradiated with light to generate singlet oxygen molecules in microbeads (“Sensibead”) coupled to the analyte. When bound to the respective antibody molecule, also coupled to another type of bead, it reacts with singlet oxygen and chemiluminescence signals are generated that are proportional to the concentration of the analyteantibody complex.
Before measuring the cholesterol levels, what must be done first?
Convert the Cholesteral ester into Cholesterol
85% of the body’s cholesterol is in the cholesteral ester form (not measured).
Total Cholesterol
Desirable
Borderline High
High
Desirable <200
Borderline High 200-239
High >240
LDL
Desirable
Near Optimal
Borderline High
Highly Elevated
Desirable <100
Near Optimal 100-129
Borderline High 130-159
Highly Elevated >160
HDL
Low
High
Low
< 40 (males)
< 45 (females)
High (desirable) >= 60
Triglycerides
Desirable
Borderline high
High
Very high
Desirable <150
Borderline high 150-199
High 200-499
Very high >500
In LDL, which is desriable ApoB48 or ApoB100?
ApoB100, ApoB48 increases risk of CVD
LDL=
LDL= Total cholesterol - HDL - Triglyceride/5
Triglycerid/5 is also known as
VLDL
Which type has the most phospholid?
HDL
In lipid electrophoresis
Type 1
Type 2a
Type 4
Type 5
Type 1: Elevated Chylomicron
Type 2a: Elevated LDL and Total cholesterol (due to LDL receptor defect)
Type 4: Elevated VLDL
Type 5: Elevated VLDL and Chylomicroms
Which type of DM has autoantidoies?
Type 1
Which type of DM has family history of DM?
Type 2, MODY
Fasting blood glucose level
Normal
Impaired
Diabetes
Normal: 70-99
Impaired: 100-125
Diabetes: >126 determined in at least 2 occasions
Random blood glucose indicative of diabetes
>200
Hemoglobin A1C level indicated of diabetes
>6.5%
What is the refence method for measuring glucose?
Hexokinase method ( measures NADH which absorbs at 340nm)
Proinsulin is cleaved to form what?
Insulin and C-peptide
In a glucose tolerance test (75g) what is considered indicative of diabetes?
If pregnant
After 75g oral glucose load, a glucose level of >200 at 2 hours
If preg then;
Fasting >92
1hour >180
2hours >153
How long does PCP remain in urine?
8 days
How long does most drug remain in urine?
2-3 days
How long does marijuan stay in urine?
2-3 weeks
Name the target metabolite used in Immunoassays
Amphetamine/Methamphetamine
Cocaine
Opiate
Oxycodone
Heroin
Marijuana
PCP
Barbiurates
Amphetamine/Methamphetamine: Methamphetamine or amphetamine
Cocaine: Benzoylecgonine (metabolite)
Opiate: Morphine
Oxycodone: Oxycodone
Heroin: 6-Acetylmorphine
Marijuana: 11-Nor-9-carboxy Δ9-tetrahydrocannabinol (THCCOOH,
metabolite)
PCP: Phencyclidine
Barbiurates: Commonly secobarbital
BE + Alcohol –>
Cocaethylene
Opiate Immunoassay can not detect which drugs?
Oxycodone, Oxymorphone, Propoxyphene, Fentanyl and its autologues
Can THC immunoassay detect spices?
No
Plasma osmolality =
Plasma osmolality = 2Na + Glucose + urea mmol/L
OR
Plasma osmolality = 2Na + Glucose mg/dl / 18 + BUNmg/dl / 2.8
Osmolar gap=
Osmolar gap= observed osmolality - calculated osmolality
Increased if >10
Causes of inccreased osmolar gap (>10)?
Ethanol, methanol, ethylene glycol
or
reduced fractional water content ( due to hyperlipidemia or paraproteinemia)
Normal
pH=
PCO2 =
HCO3- =
Cl- =
pH= 7.35 -7.45
PCO2 = 35-45
HCO3- = 23-25
Cl- = 95-105
Anion gap =
Anion gap = Na - (Cl + HCO3-)
Normal value of Anion gap?
8-12
Causes of normal anion gap metabolic acidosis
Loss of bicarbonate buffer from the GI tract ( chornic diarrhea, pancreatic fistula and sigmoidostomy) or
loss of bicarbonate due to kidney disroder such as renal tubular acidosis and renal failure
Cause of increased anion gap metabolic acidosis
MUDPILES
Methanol
Uremia
Diabetic ketoacidosis
Paraldehyde
Isopropanol
Lactic acidosis
Salicylate
Winters formula
pCO2= [(1.5 x HCO3-) + 8] +- 2
Is there adequate respiratory compensation?
If pCO2 is low: Resp alk
If pCO2 is high: Resp acidosis
