Lab management -Statistic Flashcards

1
Q

What is the Coefficient of Variation (CV)?

A

CV =SD/Mean x 100 Llower the CV, the better the precision for the measurement.

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2
Q

Standard error of mean

A

= SD/ Square root of n

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3
Q

1 2s violation?

A

1 control value is outside of the ±2 SD limit; but the other control within ±2 SD limit Accept run Random Error

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4
Q

1 3s

A

One control exceeds ±3 SD Reject run Random

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5
Q

2 2s

A

Both controls outside ±2 SD limit; or two consecutive controls outside the limit Reject run Systematic

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6
Q

R 4s

A

One control +2 SD and another -2SD Reject Run Random

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7
Q

4 1s

A

4 consecutive controls exceeding +1 SD or -1SD Reject run Systematic

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8
Q

10X

A

10 consecutive control values falling on one side of the mean Reject run Systematic

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9
Q

What is the Delta Check?

A

When a patient’s values deviates more than a predetermined limit from the previous value

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10
Q

What is seen on this Levey Jennings graph?

A

Shift

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11
Q

What is seen on this Levey Jennings graph?

A

Trend

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12
Q

Sensitiviy =

A

TP/TP + FN X100

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13
Q

Specificity =

A

TN/TN + FP X 100

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14
Q

Positive Predictive value

A

TP/TP+FP X 100

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15
Q

In six sigma, the goal of the lab is to reduce the error rate to at least __% or ____ sigma , but preferably ___% or ____sigma

A

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

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16
Q

The equation for the percent of results falling outside of the reference range

A

(1-0.95n) X 100

or just multiple the n by 5, and choose the closest lower number

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17
Q

NADH is absorbed at ___ nm

A

NADH is absorbed at 340 nm

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18
Q

What is incorporated into the potassium-selective electrode?

A

Valinomycin

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19
Q

What does FPIA stand for?

A

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.

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20
Q

What does EMIT stand for?

A

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.

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21
Q

What does CEDIA stand for?

A

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.

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22
Q

What does LOCI stand for?

A

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.

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23
Q

Before measuring the cholesterol levels, what must be done first?

A

Convert the Cholesteral ester into Cholesterol

85% of the body’s cholesterol is in the cholesteral ester form (not measured).

24
Q

Total Cholesterol

Desirable

Borderline High

High

A

Desirable <200

Borderline High 200-239

High >240

25
Q

LDL

Desirable

Near Optimal

Borderline High

Highly Elevated

A

Desirable <100

Near Optimal 100-129

Borderline High 130-159

Highly Elevated >160

26
Q

HDL

Low

High

A

Low

< 40 (males)

< 45 (females)

High (desirable) >= 60

27
Q

Triglycerides

Desirable

Borderline high

High

Very high

A

Desirable <150

Borderline high 150-199

High 200-499

Very high >500

28
Q

In LDL, which is desriable ApoB48 or ApoB100?

A

ApoB100, ApoB48 increases risk of CVD

29
Q

LDL=

A

LDL= Total cholesterol - HDL - Triglyceride/5

30
Q

Triglycerid/5 is also known as

A

VLDL

31
Q

Which type has the most phospholid?

A

HDL

32
Q

In lipid electrophoresis

Type 1

Type 2a

Type 4

Type 5

A

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

33
Q

Which type of DM has autoantidoies?

A

Type 1

34
Q

Which type of DM has family history of DM?

A

Type 2, MODY

35
Q

Fasting blood glucose level

Normal

Impaired

Diabetes

A

Normal: 70-99

Impaired: 100-125

Diabetes: >126 determined in at least 2 occasions

36
Q

Random blood glucose indicative of diabetes

A

>200

37
Q

Hemoglobin A1C level indicated of diabetes

A

>6.5%

38
Q

What is the refence method for measuring glucose?

A

Hexokinase method ( measures NADH which absorbs at 340nm)

39
Q

Proinsulin is cleaved to form what?

A

Insulin and C-peptide

40
Q

In a glucose tolerance test (75g) what is considered indicative of diabetes?

If pregnant

A

After 75g oral glucose load, a glucose level of >200 at 2 hours

If preg then;

Fasting >92

1hour >180

2hours >153

41
Q

How long does PCP remain in urine?

A

8 days

42
Q

How long does most drug remain in urine?

A

2-3 days

43
Q

How long does marijuan stay in urine?

A

2-3 weeks

44
Q

Name the target metabolite used in Immunoassays

Amphetamine/Methamphetamine

Cocaine

Opiate

Oxycodone

Heroin

Marijuana

PCP

Barbiurates

A

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

45
Q

BE + Alcohol –>

A

Cocaethylene

46
Q

Opiate Immunoassay can not detect which drugs?

A

Oxycodone, Oxymorphone, Propoxyphene, Fentanyl and its autologues

47
Q

Can THC immunoassay detect spices?

A

No

48
Q

Plasma osmolality =

A

Plasma osmolality = 2Na + Glucose + urea mmol/L

OR

Plasma osmolality = 2Na + Glucose mg/dl / 18 + BUNmg/dl / 2.8

49
Q

Osmolar gap=

A

Osmolar gap= observed osmolality - calculated osmolality

Increased if >10

50
Q

Causes of inccreased osmolar gap (>10)?

A

Ethanol, methanol, ethylene glycol

or

reduced fractional water content ( due to hyperlipidemia or paraproteinemia)

51
Q

Normal

pH=

PCO2 =

HCO3- =

Cl- =

A

pH= 7.35 -7.45

PCO2 = 35-45

HCO3- = 23-25

Cl- = 95-105

52
Q

Anion gap =

A

Anion gap = Na - (Cl + HCO3-)

53
Q

Normal value of Anion gap?

A

8-12

54
Q

Causes of normal anion gap metabolic acidosis

A

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

55
Q

Cause of increased anion gap metabolic acidosis

A

MUDPILES

Methanol

Uremia

Diabetic ketoacidosis

Paraldehyde

Isopropanol

Lactic acidosis

Salicylate

56
Q

Winters formula

A

pCO2= [(1.5 x HCO3-) + 8] +- 2

Is there adequate respiratory compensation?

If pCO2 is low: Resp alk

If pCO2 is high: Resp acidosis