LAB OPERATIONS Flashcards
SI and derived units quantity: mass
-name
-symbol
-kilogram
-kg
SI and derived units quantity: Amount of substance
-name
-symbol
-mole
-mol
SI and derived units quantity: length
-name
-symbol
-meter
-m
SI and derived units quantity: luminous intensity
-name
-symbol
-candela
-cd
SI and derived units quantity: electric current
-name
-symbol
-ampere
-A
SI and derived units quantity: time
-name
-symbol
-second
-s
SI and derived units quantity: thermodynamic temperature
-name
-symbol
-kelvin
-K
SI and derived units
selected derived units: volume
-name
-symbol
-liter
-L
SI and derived units
selected derived units: substance concentration
-name
-symbol
-molarity
-M
SI and derived units
selected derived units: catalytic activity
-name
-symbol
-Katal
-Kat
SI and derived units
selected derived units: pressure
-name
-symbol
-pascal
-Pa
SI and derived units
selected derived units: Temperature
-name
-symbol
-degree celsius
-°C
SI unit factor: 10^-18
-prefix
-symbol
-atto
-a
SI unit factor: 10^-15
-prefix
-symbol
-femto
-f
SI unit factor: 10^-12
-prefix
-symbol
-pico
-p
SI unit factor: 10^-9
-prefix
-symbol
-nana
-n
SI unit factor: 10^-6
-prefix
-symbol
-micro
-µ
SI unit factor: 10^-2
-prefix
-symbol
-centi
-c
SI unit factor: 10^-3
-prefix
-symbol
-mili
-m
SI unit factor: 10^-1
-prefix
-symbol
-deci
-d
SI unit factor: 10^1
-prefix
-symbol
-deka
-d
SI unit factor: 10^2
-prefix
-symbol
-hecto
-h
SI unit factor: 10^3
-prefix
-symbol
-kilo
-k
SI unit factor: 10^6
-prefix
-symbol
-mega
-M
SI unit factor: 10^9
-prefix
-symbol
-giga
-G
Factor of the SI unit prefix: atto
10^-18
Factor of the SI unit prefix: femto
10^-15
Factor of the SI unit prefix: pico
10^-12
Factor of the SI unit prefix: Nana
10^-9
Factor of the SI unit prefix: micro
10^-6
Factor of the SI unit prefix: mili
10^-3
Factor of the SI unit prefix: centi
10^-2
Factor of the SI unit prefix: deci
10^-1
Factor of the SI unit prefix: deka
10^1
Factor of the SI unit prefix: hecto
10^2
Factor of the SI unit prefix: kilo
10^3
Factor of the SI unit prefix: mega
10^6
Factor of the SI unit prefix: giga
10^9
temperature conversion formula:
F - C
C= (F-32)/1.8
temperature conversion formula:
C - F
F= 1.8(C+32)
temperature conversion formula:
K - C
C = K-273.15
The number of mole of solute per liter of soution
molarity
number of moles of solute per kilogram solvent
molality
number of equivalent weights of solute per liter of solution
normality
amount of solute per 100 total units of solution
percent solution
how does percent solution is expressed
% w/v, w/w, v/v
done when the analyte concentration is too high and exceeds the detection limit of the method
dilution
done when a weaker reagent concentration is needed than the stock substance available
dilution of stock solution
amount of something relative to another, expressed as part per part or part per whole
ratio
what are the measure of center?
-mean
-median
-mode
what is the other term for measures of center?
central tendency
it is the average of data
mean
midpoint of a data set after the values have been rank-ordered
median
most frequently occurring value in a data set
mode
what is/are the measures of spread
-standard deviation (s)
-coefficient or variation
-range
what is the most common measures of center?
mean
what is the most common measurement of spread
standard deviation
it is the distribution of data points around the mean
standard deviation
it is the best indicator of precision
coefficient of variation
relationship of coefficient of variation and precision
inversely proportional
it is the difference between the highest and lowest value
range
it is the best indicator of uncertainty
standard deviation
what is the normal shape of the curve produced by gaussian distribution
bell-shaped curve
delta points are distributed symmetrically around the mean with most values close to the center
gaussian distribution
what is the impirical rule of gaussian distribution
68-95-99.7% rule
95%confidence interval formula
x̄ ± 2SD
x̄ = mean
pair of medical decision points that span the limits of results expected for a defined healthy population
reference interval
it is done to confirm the validity of an existing or published reference interval for an analyte
verifying a reference interval
verifying a reference interval requires how many study individuals
120
reference interval is based on
95% confidence interval
what is the confidence interval of the formula
x̄± 2SD
95%
what are the steps of method evaluation
1 - precision study
2- recovery study
rule of precision study
run 2 control materials twice a day over a 10 day- period
precision study scheme
2 x 2 x 10 scheme
this involves spiking a sample with a known amount of analyte and determining how much of it can be detected by the method in the presence of other compound in the matrix
recovery study
examples of inferential statistics
-t test
-f test
-linear regression
it compares the means of two groups of data
t test
this test compares the standard deviations of two groups of data
F test
this test compares the accuracy of two methods
t test
this test compares the precision of 2 procedure
f test
this is used in comparison -of-methods test and bias studies
linear regressions
in linear regression, what does x axis contains
-independent variable
-standard/reference methods
in linear regression, what does y axis contains
-dependent variable
- test or new method
in linear regression, what is the change that represents the proportional error
slope
in linear regression, what is the change that represent constant error
y-intercept
in linear regression, this represents the strength of the relationship between the two methosd
correlation coefficient
this is the ability of a method to detect the smallest concentration of an analyte
analytical sensitivity
this is the ability of a method to detect only the analyte of interest
analytical specificity
it is the ability of a test to detect a given disease or condition
diagnostic sensitivity
it is the ability of a test to detect the absence of a given disease
diagnostic specificity
it is the proportion of individual with the disease who have a positive test result
diagnostic sensitivity
it is the proportion if individuals with no disease who have a negative test result
diagnostic specificity
it is the proportion of individuals with positive result who truly have the disease
positive predictive value
it is the proportion of individuals with a negative result who truly do not have the disease
negative predictive value
most widely used approach to quality management in the healthcare
PDCA cycle
PDCA cycle
plan - do - check - act
it provides both a management philosophy or organizational development and a management process for improvement of quality in all aspects of work
total quality management
what are the TQMs Q framework
- quality planning
-quality laboratory process
-quality control
-quality assessment
-quality improvement
in tqm, this is necessary to standardize the remedy, establish measures for performance monitoring, and ensure that the performance achieved satisfies quality requirements
quality planning
in tqm, this includes the processes, policies, practices, and procedures that define how all aspects ow work are done
quality laboratory process
in tqm, it involves the statistical control procedures as well as nonstatistical checks
quality control
in tqm, this. is concerned with broader measured of laboratory performance including TAT, patient identification, specimen collection, and test utility
quality assessment
this is based on statistics and quantitive measurements that is applied in the laboratory to reduce the frequency of test error or the number of DPMOs
six sigma
in tqm, this provides a structured problem-solving process to help identify the root cause of a problem and a remedy for that problem
quality improvement
what are indicators of six sigma
-improved performance
-improved quality
-improved bottom line
-improved customer and employee satisfaction
what are the steps of six sigma
DMAIC
-define
-measure
-analyze
-improve
-control
it is designed to reduce waste, increase efficiency, improve customer satisfaction
Lan
lean is often used in clinical laboratory to improve _____
turn around time (TAT)
what are the categories of waste in lean
DOWNTIME
-defects
-overproduction
-waiting
-non-utilized talent
-transport
-inventory
-motion
-excess processing
lean-six sigma belt color:
understands the basics of Lean-Six sigma (with training)
yellow belt
lean-six sigma belt color:
team members who contribute approximately 20% of their time to QI projects
green belt
lean-six sigma belt color:
team leaders who dedicate as much as 100% of their time to QI projects
black belt
lean-six sigma belt color:
black belt with at least 2 years of experience, they are lean-six sigma advisers/coaches
master belt
the process by which the lab ensures quality results by closely monitoring preanalytical, analytical, and postanalytical phases of testing
quality assessment/ quality assurance
an algorithm in which a current laboratory result is compared with results obtained on a previous specimen from the same patient
delta check
this ensures reliability
quality control
reliability formula
accuracy + precision
it is the ability to maintain accuracy and precision over an extended period of time during which equipment, reagents, and personnel may change
reliability
it is the closeness of the result to the true or actual value
accuracy
this is the ability to produce a series of results that agree closely with each other
precision
precision is commonly expressed in the terms of ______
coefficient of variation
precision is also called as
reproducibility/repeatability
this is important for the daily monitoring of accuracy and precision of analytical methods
internal quality control
internal quality control involves at least __ levels of _____, every _____
2 controls
24 hours
internal quality control’s initial control limits are established by analyzing controls for at least ___ consecutive ________
20
days or runs
other name of internal quality control
intralab qc
this qc involves testing blind samples sent periodically by regulatory agencies to participating labs
external quality assessment
other name of external QA
interlab QA
what is being done in interlab QA
proficiency testing
this is important for maintaining the long term accuracy of analytical methods
external QA
NEQAS
National external quality assessment scheme
who gives NEQAS
NRLs
What is the NRL for CC
Lung center
Standard deviation index result that means poor performance during NEQAS
> 2.0
random error is
imprecision
systematic error is
bias / inaccuracy
this error is due to chance or unpredictable cause
random error
this is a recurring error inherent in test procedure
systematic error
this error is usually a one-time error
random error
this error affects all result which may be a constant or proportional
systematic error
this error is indicated by shift or trend
systematic error
it is the abrupt change in the distribution of control values
shift
it is the gradual change un the distribution if control values
trend
this pattern in qc that accumulate on one side of the mean for 6 consecutive days
shift
this qc pattern continue to increase or decrease over a period of 6 consecutive says passing through the mean
trend
main cause of shift
calibration error
main cause of trend
deterioration if reagent
these are highly deviating control values caused by random or systematic error
outliers
what is being plotted in CUSUM’s chart
- y-axis
- x-axis
- mean
- run numbers
this is an effective method for comparing both within-lab and between-lab variability
tonks-youden plot
other name of tonks-youden
twin plot
used for the interlaboratory comparison of monthly means by plotting the mean value for one sample on the y-axis and the mean value of another on the x-axis
tonks-youden plot
this is the most commonly used QC chart
shewhart levey-jennings chart
what is the hierarchy of controls from most effective to least effective
- elimination
- substitution
- engineering controls
- administrative controls
- PPE
it is the hierarchy of control that physically remove the hazard
elimination
it is the hierarchy of control that replace the hazard
substituion
it is the hierarchy of control that isolate people from the hazard
engineering control
it is the hierarchy of control that change the way people work
administrative control
it is the hierarchy of control that protects the worker with equipment
PPE
it is the most important means of preventing the spread of infection
handwashing
duration of hands rubbing during handwashing
15-20 seconds
it can be used when hands are not visibly contaminated
alcohol-based cleansers
bsc that sterilizes only the air to be exhausted
class 1
bsc that does not protect the work surface
class 1
bsc that is most commonly used in microbiology
class 2
other name for bsc class 2
vertical laminar flow
bsc that sterilize air that flows over the infectious material as well as air to be exhausted
class 2
bsc: 70% circulated air; 30% exhausted into the room
class 2 A1
difference of bsc a2 from a1
higher intake air velocity of 100 linear feet per meter (lfm)
bsc: 30% recirculated; 70% exhausted outside of the buillding
class 2 b1
bsc: 100% exhausted outside of the building
class 2 b2
bsc that is completely enclosed with glove ports
class 3
bsc that provides the highest level of personnel protection which is commonly used for extremely hazardous organisms
class 3
decontamination solution
5.2% NaOCl (sodium hypochlorite)
10% chlorine bleach
bleach to water ratio
1:9
wavelength of UV
<400 nm
wavelength of visible light
400-700 nm
wavelength of infrared
> 700
wavelength of microwaves
3µ - 3mm
wavelength of low frequency
> 3 cm
radiation type seen in germicidal lamps used in BSCs
UV
radiation type seen in general illumination
visible light spectrum
radiation type seen in heat lamps, lasers, and vein selectors
infrared
radiation type seen in microwave energy beam used to accelerate tissue staining
microwave
radiation type seen in radiofrequency coil in icp-ms
low frequency
a major source of information about chemicals written by manufacturers
safety data sheet (SDS)
how many sections SDS consist of
16
NFPA hazard diamond color: health hazard
blue
NFPA hazard diamond color: fire/flammable
red
NFPA hazard diamond color: reactivity/instability
yellow
NFPA hazard diamond color: specific
white
NFPA hazard diamond category: white
specific
NFPA hazard diamond category: yellow
reactivity/stability
NFPA hazard diamond category: blue
health hazard
NFPA hazard diamond category: red
flame/flammable hazard
nfpa flame hazard basis of rating the degree
flash point
fire hazard rating: 4
below 70 F
fire hazard rating: 3
below 100 F
fire hazard rating: 2
below 200 F
fire hazard rating: 1
above 200 F
fire hazard rating: 0
will not burn
NFPA health hazard rating: 4
deadly
NFPA health hazard rating: 3
extremely danger
NFPA health hazard rating: 2
hazardous
NFPA health hazard rating: 1
slightly hazardous
NFPA health hazard rating: 0
normal material
NFPA reactivity rating: 4
may detonate
NFPA reactivity rating: 3
shock and heat may detonate
NFPA reactivity rating: 2
violent chemical change
NFPA reactivity rating: s1
unstable if heated
NFPA reactivity rating: 0
stable
NFPA: ☢
radioactive
NFPA: OXY
oxidixer
NFPA: ALK
alkali
NFPA: COR
corrosive
this is used for materials that give off harmful vapors which provides personnel protection only
fume hood
duration of flushing the skin or eye with large amount of water when contact occurs
15 minutes
actions to take in the event of fire
RACE
rescue
alarm
contain
extinguis/evacuate
steps in operating a fire extinguisher
(PASS)
pull pin
Aim nozzle
Squeeze trigger
Sweep nozzle
fire hazard class: ordinary combustibles
A
fire hazard class: flammable liquids
b
fire hazard class: electrical equipments
c
fire hazard class: flammable metals
d
fire hazard class: arsenal or materials that are liable to result in detonation
E
fire hazard class: combustible cooking media in commercial cooking equipment
k
fire hazard class: wood, paper, cloth
a
fire hazard class: motors,, switches, computers
c
fire hazard class: grease gasoline, paints, oils
B
fire hazard class: magnesium, sodium, potassium, lithium
D
fire hazard class: vegetable/animal oils and fats
K
fire hazard class that use this extinguisher: pressurize water
A
fire hazard class that use this extinguisher: dry chemical
ABC
fire hazard class that use this extinguisher: carbon dioxide
BC
fire hazard class that use this extinguisher: Halon
bc
extinguisher for: class D
Metal X or sand
which fire class that cannot be extinguished and is allowed to burn but nearby materials should be protected
E
serum and plasma preparation:
-centri
-duration
1000-2000 rcf
10 mins
it is the preferred specimen for most cc test
serum
analytes that has higher value in serum that plasma
glucose, K, PO4, HCO2, Albumin, CK, AST, ALP
analytes that has higher value in plasma than serum
TP, Ca, LD
separate the serum or plasma from cells with ______ of collection
2 hrs
samples should be analyzed within _____
4 hrs
what to do If sample was not analyzed within 4 hrs
refrigerate for 48 hrs or freeze at -20C for linger storage
analyte that has greater value in plasma that wb
glucose
percent of how high glucose value is at plasma that wh
10-15%
Aanalyte with higher value in capillary blood than venous blood
Glucose
veins that are in antecubital fossa which can be site for puncture ( most preferred to least)
median cubital > cephalic > Basilic
length of tourniquet from the puncture site
3-4 inches
reapplication of tourniquet should be after
2 minutes
if blood pressure cuff is used, instead of tourniquet, it should be inflate to ______
40-60 mmHg
commonly used routine antiseptics
70% isopropyl alcohol
antiseptic used during venipuncture for blood culture specimen
double antiseptic procedure
- 70% alcohol
2 iodophor / povidone iodine/ chlorhexidine
antiseptic used for veni specimen to be used in ethanol assay
benzalkonium chloride
angle between needle and vein for syringe and ets
15-30 degrees (if ranged)
15 degrees (if not ranges)
angle between needle and vein for butterfly infusion set
<15 degree
this venipuncture method is not not recommended by CLSI due to safety and specimen quality issue
needle and syringe
this venipuncture method is the most preferred by clsi
evacuted tube system
this venipuncture method is used for infants and children, hand veins, and difficult-draw situation
butterfly/ winged infusion set
this veni method consit of double headed-needle, adapter, and color coded-evacuated tubes
evacuated tube system
color code of needle gauge:
20
yellow
color code of needle gauge:
21
green
color code of needle gauge: 22
black
color code of needle gauge: 23
blue
color code of needle gauge: 25
orange
what is the needle gauge of hub/wing/needle cap that is color: black
22
what is the needle gauge of hub/wing/needle cap that is color: yellow
20
what is the needle gauge of hub/wing/needle cap that is color: blue
23
what is the needle gauge of hub/wing/needle cap that is color: green
21
what is the needle gauge of hub/wing/needle cap that is color: orange
25
what is the gauge that is used for large volume tubes or large volume syringes used in patients with normal size veins
20
what is the standard needle gauge for routine veni on patients with normal veins
21
what is the needle gauge used for older children and adult patients with small veins or for syringe draw on difficult vein
22
what is the needle gauge used for infants and children, difficult vein, or hand veins of adults
23
what is the needle gauge used to collect blood from scalp or tiny veins of permature infants
25
what needle gauge is the most prone to hemolysis
25
what is the preferred needle length that provides better control
1 inch
needle length for n/s and ets
1 - 1.5 inc
needle length for butterfly infusion set
0.5 - 0.75 inch
what are the anticoagulant additives
-edta
-citrate
-oxalate
-heparin
what is the mechanism of action: EDTA
chelation of calcium
what is the mechanism of action: Citrate
chelation of calcium
what is the mechanism of action: oxalate
precipitation of calcium
EDTA whole blood is used in what tests
-HbA1c
- therapeutic drug monitoring (TDM)
what is the mechanism of action: heparin
inhibition of thrombin
(heparin activates anti-thrombin 3 which is responsible for thrombin inhibition)
color of EDTA
lavander, pink, tan, pearl
EDTA plasma is use in what tests
lipids and lipid profiles
color of citrate tube
-light blue
-black
color of oxalate tube
black
color of heparin tube
green
test that uses heparinized arterial blood
-ABG
-ammonia
test that uses heparinized plasma
most cc test
special cc test
what are the additives of clot activator tubes
-silica
-thrombin
color and material of silica containing tube
red plastic
how long will is the clotting time of the specimen using silica tube
30 mins
how long is the clotting time when using thrombin tube
5 mins
what is the color of thrombin tube
orange
what test does silica and thrombin tube used
stat serum test
component of serum separator tube (SST)
gel + silica
component of plasma separator tube
gel + heprin
what are the antiglycolytic agents used in evacuated tubes
-sodium fluoride
-ioadoacetate
what is the tube color of sst
gold with red black spot
what is the color of pst
light green / green with gray spots
what is the effect of sodium fluoride to BUN and Uric acid
falsely decrease
(due to inhibition of urea and uricase caused by NaF)
what is the color of sodium fluoride tube
gray
when (test) does antiglycolytic agent containing tube used
-glucose
-lactate
-ethnol
what to tube should be use when test includes urea and Uric acids
iosoacetate
what are the factors that affect evacuated tube quality
- ambient tempt
- altitude
- humidity
-light
ets venipuncture modification in high temperature
decrease the draw volume
ets venipuncture modification in low temperature
increase the draw volume
this factor affect CTAD tube
lgiht
ets venipuncture modification in high altitude
low or decrease draw volume
hight/altitude considered to be significant in doing venipuncture
> 5000 ft
that humidity level does make the migration of water vapor inside a tube
high humidoty
what test used capillary puncture
-newborn screening
-POCT
- DM monitoring
what are the site of capillary puncture
-lateral plantar of the heel
-3rd or 4th fingers
-big toe
-erlobe
recommended lenght of lancet blade for heel stick
1.75 mm
when does arterial puncture performed
-BGA
- absence of palpable vein
what is the order of site puncture (in order of preference_
Radial > Brachial > femoral
what should be done before doing radial artery puncture to ensure there is adequate blood flow from artery
modified allen test
what is the second most common venipuncture complication
infection
what are the types of glass materials
-borosilicate
-aluminosilicate
-high silica
-soft glass
-flint glass
-low actinic glass
this type of glass can tolerate heating and sterilization for lengthy periods
borosilicate
borosilicate is subject to
scratching and cloud with strong alkali
example of borosilicate glass
-pyrex
-kimax
this glass material can better resist scratching and alkali attack
alluminosilicate
aluminosilicate is ____ stronger than _____
-6X
-borosilicate
give an example of aluminosilicate
corex
this glass material has high heat, chemical, and electrical tolerance and excellent optical properties
high silica
give example of high silica glass
vycor
other term for soft glass
boron-free glass
this glass material has low thermal resistance but can still be used with strong acids and alkali
soft glass
other term for flint glass
soda-lime glass
this is the most inexpensive type of glass material
flint glass
this glass has low thermal resistance and releases alkali causing errors in certain determinations
flint glass
this glass reduces light transmission and used to contain photosensitive substances
low actinic glass
what is the other term for low actinic glass
amber-colored glass
what is the type of plastic material that is excellent in temperature tolerance and chemical resistance
teflon
what are the types of plastic materials that are autoclaveable and has high heat resistance
-teflon
-polypropylene
-polycarbonate
what is the type of plastic material that is resistant to most chemicals which can withstands high temperatures
polycarbonate
what type of plastic material is stronger than polypropylene
polycarbonate
what type of plastic material is being utilized in the making of pipet tips and plastic test tubes
polypropylene
what lab equipments utilizes polycarbonate
-centrifuge tubes
-graduated cyllinder
which is more chemical resistant (polycarbonate/polypropylene)
polypropylene
what type of substance/acid that polyethylene is not resistant to?
concentrated acids
this type of plastic material is used for the storage of alkaline solution
polyethylene
this type of plastic material is rigid, cleat, and is used for test tubes and graduated tubes
polystyrene
this type of plastic material is soft and flexible but porous, and is frequently used for tubing
polyvinyl chloride
what are the designs of glass pipettes
-to contain
-to deliver
this design of glass pipette holds but does not deliver the exact volume
to contain
QC parameter for centrifudge
-timer
-speed (tachometer)
temperture
QC frequency of centrifuge
quarterly
it has the highest degree of purity suitable for use in most analytical procedures
analytic reagent grade`
this chemical is for specific procedures such as chromotography, AASl
