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Laboratory PT1 Flashcards

1
Q

What are laboratory policies aimed to provide?

A

a safe and healthful enviroment

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2
Q

What is the first priority of laboratory rules when handling infectious materials?

A

Safety

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3
Q

What is not allowed in a laboratory?

A 
eating
drinking
smoking
apply cosmetics
handling contact lenses
horseplay
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4
Q

What actions must be taken if a mishap or near-miss occurs in the laboratory?

A

Inform chain of command

Submit A&I report

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5
Q

What is an infection control strategy designed to reduce the risk of disease transmissions introduced by the CDC in response to the HIV epidemic in 1985?

A

Universal Precautions

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6
Q

What are examples of blood borne pathogens that are infectious?

A

Hep B
Hep C
HIV

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7
Q

Universal precautions apply to what specimens?

A

Blood
Tissue
Semen

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8
Q

Universal precautions do not apply to what specimens?

A 
Feces
Nasal Secretions
Sputum
Sweat
Tears
Urine or vomit w/o blood
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9
Q

Are general work clothes considered PPE?

A

No

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10
Q

What does PPE include?

A

Gloves
Gown, apron, lab coat
eye pro or face shield
other equipment (Caps, Shoes, Covers, Masks)

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11
Q

What action is taken with gloves that have been contaminated, torn, punctured or when the ability to function as a barrier is compromised?

A

Replace gloves

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12
Q

Gloves shall be what?

A

Disposable
Hypoallergenic
Appropriate Size

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13
Q

Gowns, aprons and lab coats should be worn when?

A

Worn if risk of splashes of infections or hazardous substances.

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14
Q

Eye protection and face shields must be worn if splashes could occur and must have what features?

A

Face shields - chin length

Goggles- Solid side shields

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15
Q

What are the levels of Governing Bodies for the Laboratory? (broad)

A

Federal
State
Navy
Other (SOFA)

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16
Q

What agencies fall under the federal body for laboratories?

A

Occupational Safety and Health Administration (OSHA)
National Institute for Occupational Safety and Health (NIOSH)
Code of Federal Regulations (CFR)

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17
Q

What federal agency was created in 1970 by the US Department of Labor and is responsible for developing and enforcing workplace safety and health regulations?

A

OSHA

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18
Q

What federal agency was created in 1970 by the US Department of Health and Human Services and was established to assure safe and healthful working conditions for those working by providing research, education and training?

A

NIOSH

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19
Q

What act established OSHA and NIOSH?

A

Occupational Safety and Health Act of 1970

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20
Q

What is included in OSHA’s Mission?

A
  • Assure safety by setting and enforcing standards.
  • Provide training, outreach and education
  • Establish partnerships
  • Encourage continual improvement in safety and health
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21
Q

What are NIOSH’s responsibilities?

A
  • Focused program research of high priority or high risk sectors
  • Implement/maintain system of surveillance of injury, illness or hazards
  • Increase prevention via evaluations, interventions and recommendations
  • Provide information and training
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22
Q

How often is the CFR revised?

A

Annually

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23
Q

The CFR is divided into how many titles?

A

50

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24
Q

What federal agency has regulations pertaining to the transportation of hazardous waste and if violated there are fines and penalities?

A

CFR

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25
Q

Each state has what divisions and departments?

A

Division of Occupational Safety and Health
Public Health Department
-Department of Health Services and Medical Waste Management
Department of Health and Human Services and Medical Waste management
Occupational Safety and Health Regulations

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26
Q

The Navy’s labs are governed by what?

A

Clinical Laboratory Improvement Program (CLIP)
NAVOSH
BUMED
SOFA

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27
Q

What is the instruction for CLIP?

A

DODI 6440.02

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28
Q

CLIP applies to what platforms?

A

Non-fixed medical treatment facilities (MD aboard ships)

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29
Q

CLIP inspections occur how often?

A

Every 2 years

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30
Q

Who can perform a CLIP inspection?

A

Lab Officer

Appointed Lab Tech for hospital in AOR

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31
Q

CLIP records must be maintained are what?

A

QCs on samples, test kits and analyzers
Logs of refrigerator and freezers
Maintenance logs for equipment

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32
Q

When can a technical assist visit from AOR’s hospital be requested?

A

Before MRI

Whenever needed to be compliant

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33
Q

What is the Navy’s version of OSHA?

A

NAVOSH

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34
Q

What are the BUMED references IRT Navy Laboratory?

A

BUMED 6280.1 Series of Management of Infectious Waste

NAVEDTRA 14295, Ch 19

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35
Q

SOFA agreements are between who?

A

host nation and military forces

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36
Q

What are the different types of waste?

A

Non-infectious
Infectious
Sharps

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37
Q

Medical waste that does not contain enough pathogen to be harmful is considered what?

A

Non-infectious or general waste

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38
Q

A liquid or solid waste containing potential pathogens in sufficient numbers to cause disease in susceptible hosts is what?

A

Infectious waste

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39
Q

What are examples of regulated body fluids?

A 
Blood and blood components
Pleural fluids
Amniotic fluid
Synovial fluid
Peritoneal fluid
Pericardial fluid
CSF
Semen
Dialysate
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40
Q

Where can regulated body fluids be disposed?

A

Toilet or the hopper

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41
Q

What are examples of sharps?

A 
Hypodermic needle
Blade
Slide
Coverslips
Contaminated broken glass or plastic ware
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42
Q

Segregation of waste should be conducted when?

A

At point of origin

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43
Q

Red biohazard bags are used for?

A

Infectious or regulated waste

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44
Q

How often should bio bags be emptied?

A

Daily

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45
Q

How are regulated or infectious waste prepared for disposal in a red bio bag?

A

Double bagged, goose-necked with heavy tape

Labeled with name address, phone number of originator and biohazard symbol

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46
Q

What is the intervals a sharps container must be replaced?

A

After 90 days
3/4 full
foul odor is detected

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47
Q

What are the requirements for infectious waste storage?

A

Marked room with bio and authorized personnel only signs
Near treatment or transport site and lockable
Kept clean and free of pests/rodents
Limits storage to 7 days

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48
Q

When disposing of infectious materials ashore you must comply with what?

A

local, state, federal and SOFA regulations

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49
Q

Monitoring system for disposal of infectious materials ashore must include?

A 
Date
time
amount
type
disposition
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50
Q

What are examples for criteria for overboard discharge?

A

Endangers health or safety
unacceptable nuisance
Compromise of combat readiness

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51
Q

What conditions must be met to dispose of infectious material afloat?

A

CO approval
Great than 50 nautical miles from shore
Properly packaged and weighted for negative buoyancy

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52
Q

Entries into the ship’s deck log and medical journal must include what?

A

Date
Time
Ship location
Number of bags

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53
Q

What are the two methods of blood collection?

A

Capillary Puncture

Venipuncture method

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54
Q

What is capillary puncture the method of choice and useful in what patients?

A

Most useful-pediatric

useful-extreme obesity, severe burns, thrombotic tendencies

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55
Q

Where can capillary punctures be performed?

A

heel
finger
earlobe
toe

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56
Q

What is the best method of blood collection?

A

Venipuncture

57
Q

What is the primary source of specimen for clinical laboratory analyses?

A

Venipuncture

58
Q

Why do you not draw from IV sites?

A

Diluted specimens

Alters test results

59
Q

Max depth of a capillary puncture device should not exceed what?

60
Q

What distance do you apply a tourniquet for venipunctures?

A

2-3 inches above AC

61
Q

If a blood pressure cuff is used for venipuncture how much do you inflate?

62
Q

What is the angle and orientation of a needle during venipuncture?

A

15-30 degree

bevel up

63
Q

How long does a patient hold pressure to venipuncture site after blood draw?

64
Q

What are the blood anticoagulants used in blood tubes?

A

EDTA
Sodium Citrate
Heparin
Sodium fluoride

65
Q

Which blood tubes have EDTA in them?

A

Purple tops

66
Q

Purple tops are typically used for what labs?

A

Hematology studies

  • CBC w/ or w/o Diff
  • ESR
  • A1C
67
Q

What is the most widely used anticoagulant in blood tubes?

68
Q

EDTA binds to what element?

69
Q

What anticoagulant is found in light blue tops?

A

sodium citrate

70
Q

Light blue tops are used for what labs?

A

coagulation studies

  • PT
  • PTT
  • Fibrinogen
  • D-dimer
71
Q

How long after collection are light blue tops good for?

72
Q

What blood tubes is heparin used as an anticoagulant?

A

Green tops

73
Q

What are green tops used for?

A

Plasma and Chemistry testing

  • Ammonia
  • ACTH
74
Q

Heparin inhibits clotting in green tubes by what method??

A

Inhibits thrombin, creating antithrombin

75
Q

What are examples of miscellaneous tubes that do not use anticoagulants?

A

Red top
SST/Gold Top
Tiger top
HIV tube

76
Q

Red top tubes are used for what?

A

Chemistry
Serology
Other tests requiring serum

77
Q

SST/Gold tops, Tiger tops and HIV tubs contain what and are used primarily for what testing?

A

Serum separator gel

Chemistry

78
Q

What tubes use sodium fluoride?

79
Q

Grey tops are used for what studies?

A

Glucose

ETOH

80
Q

What are typical phlebotomy procedural errors?

A 
Using IV sites
Prolong TQ
Wrong tube
Wrong draw order
Short fill
Not mixing tube
81
Q

What may result if a tourniquet is applied for too long?

A

Measurable increase in blood cell concentration (hemoconcentration)

82
Q

What is the draw order?

A

Non additive tubes then tubes with additives:

Additive tube order:
Cultures, blue, red, SST, green, purple, gray

83
Q

What happens when the wrong type is used for a blood draw?

A

unable to perform the test

84
Q

What are some blood draw complications?

A

Syncope
Infection
Continue bleeding

85
Q

What occurs when integrity of the vein is compromised and blood is leaking into the tissues?

86
Q

What is included in a Complete Blood Count results?

A 
WBC leukocyte count
RBC Erythrocyte Count
Hemoglobin
Hematocrit
Platelets
87
Q

RBC count includes what?

A

Mean Corpuscular Volume (MCV)
Mean Corpuscular Hemoglobin (MCH)
Mean Corpuscular Hgb Concentration (MCHC)
RBC distribution width (RDW)

88
Q

WBC w/ Diff is a test used to determine what?

A

Infection or leukemia

89
Q

What is the normal WBC range?

A

4.5-11.0 x10^3/mm^3

90
Q

What is the low critical value for WBC w/ Diff?

91
Q

What is the high critical value of WBC w/ diff?

92
Q

In relative percentages of each cell must add up to 100% in WBC count. If one increases the other cells must?

93
Q

What are the WBC percentages?

A 
Neutrophils 50-70%
Eosinophils 1-5%
Basophils 0-1%
Lymphocytes 20-40%
Monocytes 1-6%
94
Q

What are the normal adult ranges of RBC?

A

M-4.5-5.9 x 10^6 cells/uL

F-4.5-5.1 x 10^6 cells/uL

95
Q

MCV is what?

A

an estimate of the average volume (size) of RBCs

96
Q

An increase in MCV is associated with?

A

B12 or folate deficiency

97
Q

A decrease in MCV implies?

A

abnormality in Hgb synthesis

98
Q

What is the normal range of MCV?

A

76-96 fL/cell

99
Q

MCH is the amount of what?>

A

hemoglobin per RBC

100
Q

Decrease of MCH implies?

A

iron deficiency

101
Q

What is the normal range of MCH?

A

27-32 pg/cell

102
Q

MCHC is what?

A

average concentration of Hgb in a given volume of packed RBCs

103
Q

How is MCHC calculated?

A

Hgb/Hct x100

104
Q

What is the normal range of MCHC?

A

30-35 g/dL

105
Q

What is a protein that serves as the vehicle for the transportation of oxygen and carbon dioxide in a RBC?

A

hemoglobin (Hgb)

106
Q

What does the Hgb molecule consist of?

A

two pairs of polypeptide chains

four prosthetic heme groups, each containing one atom of ferrous iron

107
Q

What are the normal adult ranges for Hgb?

A

M-14-17.5 g/dL

F-12.3-15.3 g/dL

108
Q

What is the critical low value of Hgb?

109
Q

What is the ratio of the volume of erythrocytes to that of the whole blood?

A

Hematocrit (Hct)

110
Q

Hct is usually what amount higher than Hgb?

A

3 times the amount

111
Q

Hct is usually what amount higher than Hgb?

A

3 times the amount

112
Q

What are the normal ranges of Hct?

A

M 42-52%

F 37-47%

113
Q

What is the normal value of Platelet count?

A

150k to 400k

114
Q

What is the critical values for Plt?

A

Low <20k

High >1m

115
Q

What results will a QBC STAR give?

A 
Hct
Hgb
MCHC
WBC
-Granulocytes
-% Granulocytes
-Lymph/Mono
-% Lymph/Mono
Platelets
116
Q

What results does the QBC star not give?

117
Q

The special coating on the QBC star tube stains the two WBC populations and the platelet layer what colors?

A

Granulocytes -orange-yellow
Lymph/mono -green
Platelets -yellow-orange

118
Q

The ability to quantify the cells is enhanced by what?

A

precision plastic float

119
Q

What is directly measured from the cell layers?

A

Hct
WBC count
Platelet count

120
Q

What instrument is intended for in vitro diagnostic use?

121
Q

How many times must you mix the blood before filling the QBC star tube?

A

12-15 times

122
Q

What is the blood volume in a QBC star tube?

A

65-75 microliters

123
Q

How many times will you rock the QBC Star tube to ensure proper mixing with the orange coating?

A

at least 4

124
Q

What time must the QBC star tube be inserted into the machine for testing?

A

within 15 min after capping.

125
Q

When are electronic QC values printed from the QBC star?

A

every 8 hrs and start up

126
Q

The LCD screen will display what for values out of range?

A

dashes only

127
Q

What will the printout read for values outside the normal range?

A

out of operating range

128
Q

What is used for cleaning the QBC star?

A

damp cloth and mild detergent

129
Q

What is used to disinfect the QBC star?

A

10% solution of household bleach, stand for 10 mins

flush with water

130
Q

Fecal blood is a frequent and early symptom of what?

A

Colorectal cancer

131
Q

Early detection of fecal blood can decrease mortality of colon cancer by what?

132
Q

Patient education before Occult testing should include what?

A

Meat-free diet x 3 days

High fiber diet

133
Q

What is the time frame samples are collected for Occult testing?

A

3 specimens from 3 separate days

134
Q

Where is the sample taken from for occult testing?

A

center of stool sample

135
Q

HCG stands for?

A

Human Chorionic Gonadotropin

136
Q

When and where is HCG produced?

A

from the earliest stages of fetus development

from the placenta

137
Q

What other conditions might you find HCG?

A

Trophoblastic tumors in men
Beginning of menopause
Cyst-like moles

138
Q

Quantitative HCG measures what?

A

Amount of HCG, used for estimation of gestational age and dx early pregnancy

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