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Clinical Chemistry > Module 1: Introduction to Clinical Chemistry > Flashcards

Module 1: Introduction to Clinical Chemistry Flashcards

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1
Q

Enables analysis which is not
otherwise possible, and enables it to be made faster, more accurately, on smaller
quantities, or more cheaply than by alternative methods.

A

Instrumentation

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2
Q

consists of efforts to establish and maintain a
climate of continued improvements in the laboratory in order to deliver high-quality services
to health care

A

Quality management

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3
Q

include appropriate facilities and equipment, adequate training,
PPE, chemical management, SOPs, waste handling, signage, proper laboratory practices and safe working conditions.

A

Laboratory safety

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4
Q

includes patient preparation,

specimen considerations and variables

A

Specimen collection and processing

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5
Q

Agreement between your test result value and the true value

A

Accuracy

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6
Q

The division of a sample into at least two smaller size vials.

A

Aliquot

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7
Q

The chemical substance being measured in an assay, usually contained in blood or other body fluids.

A

Analyte

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8
Q

A diagnostic test to measure the concentration or level of a particular analyte.

A

Assay

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9
Q

A liquid solution containing a combination of chemicals, which control and maintain the pH of any other solution it is added to.

A

Buffer

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10
Q

A material, generally serum based with an accurately assigned analytical value, used to calibrate diagnostic assays.

A

Calibrator

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11
Q

A serum based material with assigned target values and acceptable ranges to evaluate the accuracy and reproducibility of a diagnostic assay.

A

Control

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12
Q

It is used to describe the highest concentration, at which a reaction is still measurable.

A

Linearity

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13
Q

refers to a material that has been freeze-dried

A

Lyophilised

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14
Q

Any biochemical compound which plays a key role in the metabolism of the body.

A

Metabolite

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15
Q

The clear amber liquid which is derived from whole blood that has been collected in the presence of an anticoagulant

A

Plasma

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16
Q

Refers to the reproducibility of test results and is a measure of how disperse the values are

A

Precision

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17
Q

The process of detecting errors in any manufacturing or operational system.

A

Quality Control

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18
Q

A component of a kit used to carry out a chemical reaction to determine levels of different analytes

A

Reagent

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19
Q

The addition of water to a freeze-dried reagent or control material to return it to its former condition.

A

Reconstitution

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20
Q

The clear amber liquid that is derived from clotted blood by centrifuging and removing the red blood cells.

A

Serum

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21
Q

An aqueous solution containing a known level or concentration of analyte that will not change and can be used to calculate diagnostic results.

A

Standard

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22
Q

Earliest recorded accounts of observations on urine specimens

A

400 B.C.

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23
Q

made diagnoses by listening to internal body sounds and palpating areas of the body

A

physicians in Egypt and Mesopotamia

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24
Q

Father of Medicine who began attributing disease to abnormalities in the body fluids.

A

Hippocrates (Ancient Greece 300 BC)

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25
Q

Hippocrates’ methods of diagnosis

A

tasting urine, listening to lungs, and observing appearance

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26
Q

described blood in the urine

A

Ephesus (50 A.D.)

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27
Q

blood in the urine

A

hematuria

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28
Q

three development in 1600s

A

invention of microscope, description of blood circulation, protein precipitation in urine through heat and acid

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29
Q

two developments in 1700s

A

sugar in urine for diabetic patients, yeast used in sugar test

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30
Q

laboratory medicine became more accepted

A

1850s-1890s

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31
Q

required hospitals to have

an adequately equipped and staffed laboratory

A

American College of Surgeons in 1918

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32
Q

almost half of US hospitals had laboratories

A

1920s

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33
Q

developed several methods for determining urine analytes in the 1920s

A

Otto Folin

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34
Q

renal function associated with ____, ____ and ____

A

uric acid, NPN, and blood urea nitrogen (BUN)

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35
Q

reagent developed in 1920s for protein determination which is still used today

A

FolinCiocalteau

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36
Q

In the 1920s, clinical

methods for measuring ___ and ____ in serum were introduced

A

phosphorus and magnesium

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37
Q

six analytes whose methods for clinical determinations were developed in the 1930s

A

alkaline phosphatase,

acid phosphatase, serum lipase, serum and urine amylase, and blood ammonia

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38
Q

first used for measuring protein in urine in the 1930s

A

refractometer

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39
Q

company that played a large part in laboratory science by introducing
the first pH meter to measure the acidity and alkalinity of fluids

A

Beckman Instruments

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40
Q

two development in 1940s

A

photoelectric colorimeters and blood vacuum collection tubes

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41
Q

used to to read color

reactions of chemistry analyses

A

photoelectric colorimeters

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42
Q

two organization important to clinical chemistry founded in the 1940s

A

College of American Pathologists (CAP) and American Association of Clinical Chemistry
(AACC)

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43
Q

made quality control easier in 1950

A

Levey and Jennings Shewhart QC

chart

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44
Q

three developments in the late 1950s

A

method to measure blood triglycerides, AutoAnalyzer by Technicon Corporation, flame photometry

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45
Q

introduced the atomic

absorption spectrophotometer for determination of calcium and magnesium

A

Perkin-Elmer

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46
Q

late 1950s

A

laser, mechanical pipetter, Auto Dilutor, disposable needle and syringe, disk storage (IBM), random-access analyzer (DuPont)

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47
Q

provides an actual number that represents the amount of a substance present in the body

A

Quantitative tests

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48
Q

indicates the presence or absence of specific chemicals

A

Qualitative tests

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49
Q

tests that are frequently ordered, such as a single test for glucose or a chemistry
profile

A

routine tests

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50
Q

group of tests performed simultaneously on a patient specimen to provide an assessment of the patient’s general condition

A

routine chemistry profile/ complete metabolic profile

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51
Q

Tests that are ordered less frequently and might be performed only on certain days even in larger laboratories

A

special tests

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52
Q

principal uses of biochemical investigations

A

Diagnosis
Prognosis
Monitoring
Screening

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53
Q

composition of Borosilicate glass

A

Silica + boron trioxide

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54
Q

Most common type of glass

A

Borosilicate glass

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55
Q

Thermal property of Borosilicate glass

A

low coefficient of thermal expansion, can withstand higher temperature gradients and sudden temperature changes

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56
Q

maximum temperature at which a glass can be used without it being damaged

A

Strain point

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57
Q

strain point of Borosilicate glass

A

450 to 500 degrees celsius

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58
Q

Optical property of Borosilicate glass

A

clear and colorless

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59
Q

Chemical property of borosilicate glass

A

strong chemical resistance (higher than metals)

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60
Q

chemicals that Borosilicate glass is not resistant to

A

hydrofluoric acid, very hot phosphoric acid, alkaline solutions

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61
Q

Borosilicate is highly resistant to

A

water, neutral and acid solutions, concentrated acids and chlorine, bromine, iodine and organic matters

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62
Q

composition of Alumina-silicate glass

A

Aluminum oxide + high silica content

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63
Q

has greater chemical stability

and higher maximum operating temperature than borosilicate glass

A

Alumina-silicate glass

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64
Q

use of Alumina-silicate glass

A

high precision analytical work

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65
Q

properties of Alumina-silicate glass is comparable to

A

fused quartz

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66
Q

Alumina-silicate glass is strengthened ____ rather than ___

A

chemically, thermally

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67
Q

composition of Vycor glass

A

96% silica (similar to fused quartz)

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68
Q

strain point of vycor glass

A

900 degrees celsius continuously, 1200 Intermittently

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69
Q

vycor glass is resistant to

A

drastic heat shock and extreme chemical treatments

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70
Q

Most inexpensive glass with excellent chemical and physical properties

A

soda-lime glass

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71
Q

most common use of soda-lime glass in the clinical lab

A

pipettes

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72
Q

glassware that protects light sensitive chemical compounds from alteration

A

Low actinic glass

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73
Q

glassware for one time use only

A

Disposable glassware

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74
Q

three advantages of plastic ware

A

less expensive, unbreakable, preferred for alkali solutions

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75
Q

four disadvantages of plastic ware

A

surface constituents can leach into solution, permeable to water vapor, can evaporate, can absorb dyes, stains and proteins

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76
Q

____ cannot be used for plasticware

A

high performance liquid chromatography

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77
Q

properties of polystyrene

A

70 C temp limit, clear, non autoclavable, rigid

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78
Q

uses of polystyrene

A

Disposable plastic ware

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79
Q

Properties of Conventional/ High density Polyethylene

A

80 C, translucent, non autoclavable, flexible

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80
Q

used for all purposes like reagent bottles, droppers

A

Polyethylene

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81
Q

properties of Linear/ Low Density Polyethylene

A

130 C, opaque, autoclavable

with caution, rigid

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82
Q

most commonly used plastic ware in the lab

A

Polypropylene

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83
Q

properties of polypropylene

A

135 C, translucent, autoclavable, rigid

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84
Q

uses of polypropylene

A

Screw-cap closure bottles

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85
Q

properties of Tygon

A

95 C, translucent, autoclavable, flexible

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86
Q

use for tygon

A

tubings

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87
Q

properties of Teflon (Fluorinated Ethylene Propylene/ Polytetrafluoroethylene)

A

205 C, Clear to translucent, autoclavable, flexible but easily scratched/warped

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88
Q

used for stopcocks, wash bottles, and beakers for

cryogenic experiments

A

Teflon

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89
Q

properties of polycarbonate

A

135 C, very clear and shatter proof, autoclavable, rigid (sterilizing reduces mechanical strength)

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90
Q

used for all purposes like large reagent containers, graduated cylinders and centrifuge tubes

A

Polycarbonate

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91
Q

properties of Polyvinyl Chloride

A

70 C, clear, non autoclavable, rigid

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92
Q

used to make bottles

A

polyvinyl chloride

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93
Q

properties of PVC for tubing

A

120 C, clear, autoclavable, flexible

94
Q

properties of polyallomer

A

130 C, translucent, autoclavable, moderately flexible

95
Q

properties of polysulfone

A

165 C, clear, autoclavable, rigid

96
Q

plasticware to use for acids, aldehydes, ketones, ethers, hydrocarbons, essential oils

A

Polystyrene

97
Q

Plasticware to use for alcohols and bases

A

polystyrene but only within 24 hours

98
Q

plasticware NOT to use for aldehydes, amines, ethers, hydrocarbons, and essential oils

A

Polyethylene and polypropylene

99
Q

plasticware NOT to use for lubricating oil and silicone

A

Conventional Polyethylene

100
Q

Resin possessing chemical resistance to almost all chemicals in clinical lab

A

Teflon

101
Q

three advantages of Teflon

A

Anti-adhesive, non wet-table surface, suitable for cryogenic experiments

102
Q

temperature capacity of Teflon

A

-270℃ to 255℃

103
Q

Plasticware susceptible to damage by most chemicals

A

Polycarbonate

104
Q

Polycarbonate is resistant to (4) ___ for a long time

A

water, aqueous salts, food, and inorganic acids

105
Q

Five grades of reagent purity

A
  1. Analytic reagent (AR)
  2. Ultrapure/ chemically pure
  3. United States Pharmacopeia (USP) and National Formulary (NF)
  4. Chemically Pure (CP)
  5. Technical or commercial grade
106
Q

purity grades are established by

A

American Chemical Society (ACS)

107
Q

Very high purity that is suitable use in most analytical procedures

A

Analytic reagent (AR)

108
Q

AR should be labeled with: (4)

A
  • percentage of impurities
  • initials AR or ACS
  • “For laboratory use”
  • “Standard-Grade Reference Materials”
109
Q

Like AR but have additional purification steps (higher grade)

A

Ultrapure/ chemically pure

110
Q

uses of Ultrapure/ chemically pure grade reagents

A

Chromatography
Atomic absorption immunoassays
Molecular diagnostics
Standardization

111
Q

Ultrapure/ chemically pure are labeled with (2)

A

HPLC or Chromatographic

112
Q

Used to manufacture drugs and not for laboratory analysis

A

United States Pharmacopeia (USP) and National Formulary (NF)

113
Q

only limitation of USP and NF grades

A

should be non-injurious to individuals

114
Q

Less pure grade chemicals whose impurity limitations are not stated, and preparation is not uniformed

A

Chemically Pure (CP)

115
Q

Chemically Pure (CP) is not recommended for reagent preparation unless:

A

a) has further purification

b) has reagent blank

116
Q

Used primarily in manufacturing and should never be used in clinical laboratory

A

Technical or commercial grade

117
Q

four grades of organic reagents

A

Spectroscopic Grade
Chromatographic Grade
Reagent grade
Chemically Pure

118
Q

Purity levels attained by spectrophotometric procedures

A

Spectroscopic Grade organic reagents

119
Q

Minimum purity of 99% determined by gas chromatography

A

Chromatographic Grade

120
Q

Certified to contain impurities below certain levels established by ACS

A

Reagent grade (ACS)

121
Q

Approaches purity level of reagent grade chemicals

A

Chemically Pure

122
Q

Materials with a specific, defined characteristic that serves a comparative value for analyses for quality assurance scheme

A

Reference materials

123
Q

Three standards for reference materials

A
  1. Primary Standard
  2. Standard Reference Material
  3. Secondary Standard
124
Q

Highly purified chemical
which is used to produce a substance of EXACT known concentration. This is not used in the laboratory as biologic constituents are unavailable within these limits.

A

Primary standard

125
Q

ACS purity tolerance for Primary standard

A

100 ± 0.02%

126
Q

Primary standard in the clinical chemistry laboratory in place of ACS primary standard.

A

Standard Reference Material (SRM)

127
Q

developed and assigned a value to SRM after careful analysis

A

National Institute of Standards and Technology (NIST)

128
Q

Used to verify calibration or accuracy/bias assessments, to produce calibrator and standards and as reference for comparison of commercially obtained standards and reagents

A

Standard Reference Material (SRM)

129
Q

Label to be found in Standard Reference Material (SRM)

A

“Traceable to NIST”

130
Q

Lower level of purity

A

Secondary standard

131
Q

The concentration of a secondary standard is determined by comparison with

A

primary standard

132
Q

Secondary standard depends not only on composition which cannot be directly determined but also on

A

analytic reference method

133
Q

Secondary standard manufacturers are required to list

A

the SRM or primary standard used

134
Q

most frequently used reagent in the lab

A

water

135
Q

six processes in the purification of water

A
  1. prefiltration
  2. distillation
  3. deionization
  4. reverse osmosis
  5. ultrafiltration and nanofiltration
  6. UV oxidation and ozone treatment
136
Q

Remove particulate matter from municipal water supplies before any additional treatment

A

Prefiltration

137
Q

Four types of filtration cartridges

A

Glass
Cotton
Activated charcoal
Submicron filters

138
Q

preferable in filtration of hard water

A

glass or cotton

139
Q

contents of hard water

A

Ca, Fe, and other dissolved elements

140
Q

Use of activated charcoal filter

A

adsorption of organic material and Cl

141
Q

pore size of submicron filters

A

< 0.2 mm

142
Q

Better suited after distillation, deionization and reverse osmosis treatment

A

Submicron filters

143
Q

Removes any substances larger than pore, including bacteria

A

Submicron filters

144
Q

Removes microbiological organism and minerals iron, magnesium, and calcium

A

Distillation

145
Q

Distillation does not remove

A

volatile impurities (CO2, Cl, NH3)

146
Q

Distilled water meets specification for

A

type II and III water

147
Q

Removes substances that can ionize

A

Deionization

148
Q

deionization does not remove

A

organic substances and substances that do not ionize

149
Q

Deionization passes water through

A

cation-exchange or an anion-exchange resin

150
Q

Deionization replaces removed ions with

A

OH- and H+ ions

151
Q

Uses anion resin followed by cation resin

A

Two-bed system

152
Q

Uses pressure to force water through a semipermeable membrane

A

Reverse osmosis

153
Q

example of semipermeable membrane

A

cellulose acetate

154
Q

Reverse osmosis removes

A

Approximately 90% dissolved solids
98% organic impurities, insoluble matter, microbiological organisms
10% ionized particles

155
Q

Reverse osmosis does not remove:

A

Dissolved gases

156
Q

Excellent in removing particulate matter, microorganisms (pyrogens or endotoxin)

A

Ultrafiltration and Nanofiltration

157
Q

cleaves many ionizing organics, destroys bacteria but may leave residual products

A

Ultraviolet oxidation and ozone treatment

158
Q

UV radiation wavelength

A

biocidal wavelength 254 nm

159
Q

Two classifications of water purity

A 
Conventional Classification (National Committee for Clinical Laboratory Standards)
CLSI (Clinical and Laboratory Standards Institute)
160
Q

Grades of water based on Conventional Classification (National Committee for Clinical Laboratory Standards)

A

Type I, Type II, and Type III

161
Q

Purest type of water used for procedures that require maximum water purity

A

Type I reagent water

162
Q

Five uses of Type I reagent water

A 
Preparation of standard solutions, buffers and controls
Quantitative analytical procedures
Electrophoresis
Toxicology screening tests
HPLC
163
Q

Use immediately after produced, should not be stored

A

Type I reagent water

164
Q

Used for general lab test that do not require type I water

A

Type II reagent water

165
Q

Uses of Type II reagent water

A

Qualitative chemistry procedures
hematology
immunology
microbiology

166
Q

Also known as sutoclave wash water

A

Type III reagent water

167
Q

Can be used as water source for preparation of type I and type II

A

type III

168
Q

uses of Type III reagent water

A

washing and rinsing labware

169
Q

Maximum colony count (CFU/mL) for Type I water

A

10

170
Q

Maximum colony count (CFU/mL) for Type II water

A

1000

171
Q

Maximum colony count (CFU/mL) for Type III water

A

not specified

172
Q

pH of type I and type II water

A

not specified

173
Q

pH of type III water

A

5.0-8.0

174
Q

Maximum silicate (mg/L SiO2) content for Type I

A

0.05

175
Q

Maximum silicate (mg/L SiO2) content for Type II

A

0.1

176
Q

Maximum silicate (mg/L SiO2) content for Type III

A

1.0

177
Q

Minimum resistivity

MΩ/cm at 25℃ of Type I water

A

10

178
Q

Minimum resistivity

MΩ/cm at 25℃ of Type II water

A

1.0

179
Q

Minimum resistivity

MΩ/cm at 25℃ of Type III water

A

0.1

180
Q

6 grades of water according to CLSI classification

A 
Clinical Laboratory Reagent water (CLRW)
Special Reagent Water (SRW)
Instrument Feed water
Water supplied by method manufacturer
Autoclave and Wash water
Commercially bottled purified water
181
Q

Maximum Microbiological content of CLRW

A

10 CFU/ mL

182
Q

Minimum Resistivity at 25 C of CLRW

A

> 10 MΩ/ cm

183
Q

Maximum Silicate of CLRW

A

0.05 mg SiO2/L

184
Q

Particulate matter of CLRW

A

passed through 0.2 μm filter

185
Q

organic content of CLRW

A

< 500 ppb, through activated carbon

186
Q

used for HPLC

A

Special Reagent Water

187
Q

Intended for internal rinsing, dilution, and water bath functions of automated instruments

A

Instrument Feed water

188
Q

Supplied for use as diluent or reagent as described by for product labeling

A

Water supplied by method manufacturer

189
Q

Feed water for autoclaves and automatic lab dishwashers with heat drying cycles, previously referred to as type III water

A

Autoclave and Wash water

190
Q

Must be validated for acceptable performance in test procedure to be used in

A

Commercially bottled purified water

191
Q

Help in getting perfect measurement of fluids

A

pipette

192
Q

three types of classifications of pipettes

A

according to design
according to drainage characteristic
according to type

193
Q

two types of pipettes according to design

A 
To contain (TC)
To deliver (TD)
194
Q

Holds particular volume but does not dispense that exact volume

A

To Contain (TC)

195
Q

Dispenses the exact volume indicated

A

To Deliver (TD)

196
Q

Two types of pipette according to drainage characteristic

A

Blowout

Self-draining

197
Q

The last drop of liquid should be expelled into the receiving vessel using rubber stopper/ rubber bulb or pipettol

A

Blowout

198
Q

indicates that a pipette is blowout

A

etched ring or two small, close close continuous rings

199
Q

Content of pipet drained by gravity

A

Self-draining

200
Q

pipettes according to type

A

Measuring graduated pipet
Transfer pipet
Automatic pipet

201
Q

Has many uniform graduations and can dispense different volumes

A

Measuring graduated pipet

202
Q

two types of measuring graduated pipet

A

Mohr pipette and Serological pipette

203
Q

Graduation ends BEFORE the tip

A

Mohr pipette

204
Q

qualities of a Mohr pipette

A

Self draining

Smaller orifice

205
Q

Has graduation marks until the tip

A

Serological pipette

206
Q

qualities of a Serological pipette

A

Blowout

Have larger orifice and thus drain faster

207
Q

Transfers a known volume of liquid and have no subdivisions

A

Transfer pipet

208
Q

two types of transfer pipet

A

Ostwald Folin

Volumetric

209
Q

the bulb closer to the tip to use for viscous fluids like blood

A

OSTWALD-FOLIN

210
Q

Ostwald Folin drainage characteristic

A

Blowout

211
Q

Cylindrical bulb at the center joined at both ends to the narrow glass tubing which is used for dilute aqueous solutions.

A

VOLUMETRIC

212
Q

Volumetric pipette drainage characteristic

A

self-draining

213
Q

used to transfer small quantities of liquids without calibration marks and consideration for volume

A

Pasteur Pipet

214
Q

Most routinely used pipet

A

automatic pipet

215
Q

three types of classification of automatic pipettes

A

Based on delivery volume amount, total volume capacity, mechanism

216
Q

Two types of pipettes based on delivery volume amount

A

Fixed volume

Variable volume

217
Q

Two types of pipettes based on total volume capacity

A

Micropipette: <1mL

Macropipette >1mL

218
Q

three types of pipettes based on mechanism

A

Air-displacement
Positive displacement
Dilutors/dispensers

219
Q

Relies on piston for creating suction to draw the sample into disposable tip where but it does not come in contact with the solution

A

Air-displacement

220
Q

has plastic disposable tip

A

Air-displacement

221
Q

Operates by moving the piston in the pipet tip or barrel, much like a hypodermic syringe

A

Positive displacement

222
Q

disadvantage of positive displacement

A

carryover or contamination due to tips not being removable

223
Q

obtain the liquid from a common reservoir and dispense it repeatedly

A

Dilutors/dispensers

224
Q

two ways to calibrate a pipette

A

Gravimetric method

Photometric method

225
Q

materials in gravimetric method calibration

A

deionized, distilled water
calibrated analytical balance
class 2 weights

226
Q

allowable percentage error of gravimetric method

A

0.5%

227
Q

materials in photometric method

A

spectrophotometer

Potassium dichromate

228
Q

Two components of a quantitative lab result

A

number & unit

229
Q

two systems of measurement

A

conventional system (metric and US standard) and Systeme Internatiol d’ Unites

230
Q

what type of unit: m, kg, s

A

basic units

231
Q

what type of unit: m/s2, m3

A

derived unit

232
Q

what type of unit: grams, liters, hours

A

supplemental unit

Clinical Chemistry (14 decks)

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