Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MOHDIII - Unit 2 > Laboratory Medicine > Flashcards

Laboratory Medicine Flashcards

1
Q

serum uses

A
  1. most tests that measure antibodies

2. serum protein electrophoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

whole blood uses

A
  1. heavy metals
  2. hematology
  3. transplant immunosuppressants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how to obtain plasma

A

centrifuge tube of blood, supernatant is plasma, tubes contain anticoagulants to prevent clotting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how to obtain serum

A

allow blood to clot, everything NOT clotted is serum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Use of red top tube (no additive-refers to no anticoagulant)

A

plastic tube w/ clot activators, sample usually clots w/in 30 min aided by tube inversion, uses-serology, protein electrophoresis, mailout tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

drawbacks of red top tube

A

time for clot to form, microclots can interfere w/ automated instruments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

use of serum separator tube

A

common for doctor’s offices that refer most tests to commercial labs - Gel prevents clotted cells from contaminating serum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

EDTA (lavender/pink tops) tube uses

A

EDTA chelates Ca & prevents blood clotting, uses - tests that require whole blood or plasma - hematology, molecular diagnostics, drug tests requiring whole blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

plasma separator tube (PST) uses

A

anticoagulant is lithium heparin, gel goes b/w plasma & cells after centrifugation - tube of choice for UIHC for most chemistry assays

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

plasma separator tube drawbacks

A

cannot use for lithium drug levels due to lithium heparin used as anticoagulant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

light blue top tube (sodium citrate)

A

tube of choice for coagulation tests - problem is inadequate filling of tubes leading to too much anticoagulant relative to blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

royal blue top tubes

A

required for certain trace metals analysis - DO NOT NEED FOR BLOOD LEAD ANALYSIS EDTA TUBE IS FINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

proper draw order for tubes

A
  1. blood cultures - yellow top
  2. citrate tube - light blue
  3. Serum tube - red top
  4. Heparin tube/PST - light green top
  5. EDTA tube - purple top
  6. Fluoride tube - gray top
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

common interferences & testing issues

A

hemolysis, lipemia, icterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

causes of hemolysis

A

can be due to disease or MORE OFTEN related to blood draw technique (narrow gauge needle, too rapid, contamination)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

problems caused by hemolysis

A
  1. false elevation b/c RBCs contain analyte being measured - AST,LDH,K+
  2. RBC lysis reduces what is being measured (proteases are released that degrade peptides) - insulin
17
Q

hemolytic index

A

300 = sever

18
Q

Cause & problems of lipemia

A

due to elevated lipids & mostly effected by high triglycerides, extreme lipemia (triglycerides > 1,000 md/dL) can interfere and also cause hemolysis

19
Q

cause of icterus

A

high bilirubin can lead to yellow or yellow-brown plasma, can lead to test cancellation if bilirubin is > 40mg/dL

20
Q

method of inpatient reimbursement

A

bundled payment arrangement such as diagnosis-related groups

i.e. fixed payment for inpatient stay

21
Q

outpatient reimbursement method

A

increasing trend for outpatient encounters toward bundled payments - applies to common lab tests INCLUDING Pap smears

22
Q

charges vs. cost of tests

A

charges are set by hospital financial - insurance only pays fraction & self pay patients can be responsible for full charge
-actual costs of tests usually lower than charges

23
Q

patient liability for tests

A

COMPLICATED

  • outpatient: major issue is pre authorization for expensive tests
  • inpatient: have to consider deductibles, co-insurance, & max caps
24
Q

Clinical Laboratory Improvement Act (CLIA)

A
  • passed in 1988, revised in 2003
  • established federal gov. oversight of clinical labs including small labs in doctor’s offices
  • enforced by center for medicare and medicaid services (CMS)
25
Q

CLIA waived tests

A

pregnancy test kits, fingerstick glucose

26
Q

CLIA moderate complexity

A

FDA approved automated chemistry & hematology tests

27
Q

CLIA high complexity tests

A
  • surgical pathology
28
Q

CLIA take home point

A
  • each site MUST have a CLIA certificate to perform ANY lab tests
  • CLIA certificate must cover HIGHEST complexity of testing in lab i.e. even if only one test in high complexity, then lab must meet high complexity requirements
29
Q

Plasma sample uses

A

most chemistry tests

30
Q

challenges in lab medicine

A
  • continually expanding number of test, especially mailout testing
  • high cost of genetic and other specialty tests
31
Q

number of mailout testing laboratories

A

130

32
Q

number of mailout tests available in Epic

A
  • 1,600 plus another 400 ordered sporadically
33
Q

impact of supreme court decision June 2013

A
  • association for molecular pathology vs. myriad genetics
  • naturally occurring DNA segment is product of nature not patent eligible
  • cDNA IS PATENT ELIGIBLE
  • should reduce testing costs
34
Q

scenarios due DNA patents & clinical testing

A
  1. no associated patents - competition possible
  2. gene patented - one provider then clears out all competition
  3. gene patented - other labs allowed to test if licensing fees are paid
35
Q

concerns with ‘diagnostic monopolies’ ex. BRCA1 & 2 testing

A
  • previously could not get second opinion or testing from another lab
  • pricing was higher than if there was competition
  • companies may not report data to public databases
36
Q

future of gene patenting

A
  • will net gen genome wide sequencing make patent issues irrelevant
  • companies have been aggressive in stating their patents still apply
37
Q

direct-to-consumer (DTC) genetic testing

A
  • rapidly growing
  • more and more patients requesting additional samples for analysis patients want done outside of hospital then come back to primary care to explain results

MOHDIII - Unit 2 (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions