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CCMA > Module 11: Testing and Laboratory Procedures > Flashcards

Module 11: Testing and Laboratory Procedures Flashcards

1
Q

Urine testing - random urine

A

Patient urinates in a clean, nonsterile container. This specimen is used for screening purposes

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2
Q

Urine testing - First morning specimen

A

The patient collects the first specimen of the morning in a clean container. This specimen is more concentrated and used for pregnancy testing, or when other analytes (protein, nitrites) need to be evaluated

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3
Q

Urine testing - Clean-catch midstream

A

The patient performs perineal cleaning using moist wipes, begins to urinate, and then collects the specimen midstream in a sterile urine container. This specimen is used for cultures or when a noncontaminated specimen is desired

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4
Q

Urine testing - 24-hour

A

This method uses a container with preservatives. The patient discards the first morning specimen and collects all specimens for the next 24 hr, including the first void of the second day.

Important in quantitative analysis of components such as protein when analyzing kidney function

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5
Q

Urine testing - Catheterized collection

A

This method is used when a sterile urine sample is needed or if patients are unable to provide a specimen on their own. It involves insertion of a sterile tube through the urethra into the bladder. This procedure is performed by the provider or nurse, with the medical assistant prepping the patient and assisting.

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6
Q

Fecal occult blood test

A

Stool specimen screened for the presence of blood. Patient will avoid specific medications and foods to avoid for 3 days. Three separate specimens on filter paper.

Control strip turns blue
blue is positive for blood

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7
Q

Tape test

A

Parents are given a slide with a piece of tape on it. The tape is placed over the child’s anus before getting up in the morning and then back on the slide, which is brought in for analysis

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8
Q

Stool specimens infections

A

Specific containers are used for each of these tests. O&P testing detects the presence of parasites and their eggs, either of which require treatment

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9
Q

Sputum specimens

A

A deep, productive cough is necessary to produce a specimen from the lungs. Best collected in early morning

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10
Q

Precautions and requirements for specimen collections

A

Take precautions to avoid touching the insides of lids, swabs, or containers

Collect the specimen at right time, from site of suspected infection.
Minimize transport time to a reference lab, collect the appropriate quantity.
Use the appropriate containers and label them accordingly

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11
Q

What does CLIA-waived testing mean?

A

Simplest of laboratory procedures. Medical assistants may perform these tests per provider request

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12
Q

Point of care testing: Pregnancy testing

A

Urine is screened for the presence of human chorionic gonadotropin (hCG) antibodies

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13
Q

Point of care testing: Rapid strep

A

Throat swabs are obtained to screen for Group A streptococcus

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14
Q

Point of care testing: dipstick, tablet, or multi-stick urinalysis

A

Urinalysis is a screening tool for analytes that are excreted in the urine

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15
Q

Point of care testing: hemoglobin

A

A machine is used to screen for the oxygen-carrying protein in whole blood, performed using capillary blood from a fingerstick (capillary puncture)

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16
Q

Point of care testing: Spun hematocrit

A

Fingerstick collection of blood in microcapillary tubes is centrifuged and evaluated for the percentage of red blood cells

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17
Q

Point of care testing: blood glucose

A

Whole blood is analyzed in a glucometer for a quantitative glucose level and is a screening test for diabetes, performed using capillary blood from a finger stick (capillary puncture)

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18
Q

Point of care testing: Hemoglobin A1c

A

Capillary blood test shows diabetes control over an approximate 3 month period

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19
Q

Point of care testing: Cholesterol testing

A

Lipids are evaluated using capillary blood

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20
Q

Point of care testing: Helicobacter pylori

A

A blood sample screens for H pylori, the main cause of gastric ulcers

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21
Q

Point of care testing: Mononucleosis screening

A

Tests for the presence of the Epstein-Barr virus in capillary blood

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22
Q

Point of care testing: nasal smear for influenza types A and B

A

Qualitative test for influenza antigens using a swab that is inserted into the nostril

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23
Q

Point of care testing: drug testing

A

Substances can be detected in urine and blood samples

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24
Q

Point of care testing: fecal occult blood

A

Test performed to screen for hidden blood in the stool

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25
Q

CLIA regulations: moderate- and high-complexity

A

Nonwaived, labs must have a CLIA certificate and undergo inspections to ensure standards are being met

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26
Q

CLIA regulations: provider-performed microscopy procedures

A

Considered a form of moderate-complexity testing, but CLIA approved to allow the provider to develop a preliminary diagnosis and begin treatment as warranted

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27
Q

COLA

A

Commission on Office Laboratory Accreditation, an independent accreditor for laboratories, focuses on meeting CLIA regulations

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28
Q

Quality assurance vs quality control

A

Quality assurance is comprehensive, relates to policies and procedures that must be implemented for reliability of test results

Quality control is a more specific part of quality assurance, it attempts to uncover errors and eliminate them.

Ex:
Reviewing expiration date, documenting temperature of laboratory refrigerator is quality control
Rotating stock to put newest containers in back of storage, maintaining proper temperature of laboratory refrigerator is quality assurance.

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29
Q

Quality control logs

A

Responsibility of medical assistant to monitor function of equipment within facility. Logbooks need to be maintained to validate the test was conducted under optimal conditions, control samples were accurate prior to testing patient samples.

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30
Q

Correct specimen labeling

A

Labeled with patient information at the time of collection. Labels should be verified against the patient chart and the lab order before sending the specimen to the lab for processing.

Label on side of container and not top.

31
Q

Parts of a laboratory requisition form

A

Patient information, provider authentication, specific tests are marked (panel is a variety of tests), source of specimen along with date and time of specimen collection

ICD-10 code diagnosis

32
Q

Precautions for handling collected lab specimens

A

Hand-washing is most effective means of preventing spread of infection. PPE should be used based on specimen being handled.

Nonblood specimens need appropriate packaging - wrapping the container in protective material, biohazard identification on outside of package if transported via mail

33
Q

Chain of custody

A

Required to ensure that specimen tampering does not occur with urine drug screens. A kit is usually provided, along with a signature of everyone who has contact with the specimen.

34
Q

Special handling bilirubin testing

A

Specimen needs to be protected from light, which would affect the accuracy of the testing - dark container is required

35
Q

Processing of nonblood specimens

A

Sometimes necessary to maintain integrity of specimen

Ex: making sure a swabbed specimen is moist by breaking the fluid chamber within the specimen container. Urine specimens for microscopic analysis can sometimes require centrifuging prior to transport. Proper storage is another component

36
Q

Storage of nonblood specimens: urine, STD swabs

A

Urine might require refrigeration if testing is not immediately performed to avoid chemical changes or biological breakdown of the specimen - if left at room temperature for more than TWO HOURS pH changes will start to occur and sample is unfit for testing

Swabs for STDs might need to be maintained at body temperature so the organisms do not die

37
Q

Disposal of nonblood specimens

A

Red biohazard waste bags or sharps containers if anything could break or splinter. Designated sink for disposal of urine specimens

38
Q

Hgb reference range

A

Hemoglobin: 13-18 g/dL males, 12-16 g/dL females

39
Q

Hct reference range

A

Hematocrit: 42-52% males, 36-48% females

40
Q

FBS reference range

A

Fasting blood glucose: 60 to 110 mg/dL

41
Q

Total cholesterol reference range

A

<200 mg/dL

42
Q

LDL reference range

A

Bad cholesterol: <130 mg/dL

43
Q

HDL reference range

A

Good cholesterol: >40mg/dL

44
Q

Triglycerides reference range

A

<150 mg/dL

45
Q

ESR reference range

A

Erythrocyte sedimentation rate: 0 to 20 mm/hr males, 0 to 30 mm/hr females

46
Q

INR reference range

A

International normalized ratio: 0.8 to 1.2

blood coagulation test commonly performed on patients taking anticoagulants

47
Q

PT reference range

A

10.4 to 15.7 s

a measure of the blood’s coagulation abilities; how long it takes for a clot to form

48
Q

Urine pH reference range

A

4.5 to 8

49
Q

Urine specific gravity reference range

A

1.005 - 1.030

measures concentration of particles in urine

50
Q

Urine urobilinogen reference range

A

.1 to 1

Absent = biliary obstruction
Increased = liver or hemolytic disease
Reduced = reaction to antibiotic or medication

51
Q

Potassium reference range

A

3.5 - 5 mEq/L

52
Q

Platelet concentration reference range

A

130 - 400/mm^3

53
Q

RBC concentration reference range

A

4.7 to 6.1/mm^3 for males

4.2 to 5.4/mm^3 for females

54
Q

Sodium level reference range

A

135 - 145 mEq/L

55
Q

BUN reference range

A

Blood urea nitrogen: 7 - 25 mEq/L

56
Q

Calcium reference range

A

8.5 - 10.5 mg/dL

57
Q

Procedures for normal lab values

A

If necessary, scan or upload results into patient portal.

Note date of provider review and action to be taken. If possible, make results accessible to patients for viewing in EMR.

Verify identity of patient when communicating information over the phone to maintain HIPAA compliance. Only release lab results to patients if provider reviewed and signed off information. Avoid miscommunication!

58
Q

Procedures for abnormal/critical lab values

A

Rapid communication required, notify provider immediately. Accurately document communication and actions taken in the medical record

59
Q

Hyperopia, myopia, astigmatism and presbyopia

A

Nearsightedness (myopia) makes far-away objects look blurry.
Farsightedness (hyperopia) makes nearby objects look blurry.
Astigmatism can make far-away and nearby objects look blurry or distorted.
Presbyopia is a type of farsightedness that makes it hard for middle-aged and older adults to see things up close

60
Q

Near vision testing technique

A

For presbyopia or hyperopia; ask the patient to read printed material of various sizes 14 to 16 in away from eyes without corrective lenses. Test eyes separately and then both together.

The level at which the patient can read the smallest printing clearly is the result.

61
Q

Distance vision testing technique

A

For myopia; patients stand 20 feet from a chart, they can wear corrective lenses. Test eyes separately and then both together.
The line at which the patient can clearly see the letters or pictures is the result. The patient can miss one item and still pass that line.

Vision is recorded as a fraction, with 20/20 representing normal vision.

62
Q

Color vision testing; most common population and type of color blindness

A

Males are more commonly affected by color blindness, most common type is red-green deficiency.

Screening is done by testing the patient on 11 plates within an Ishihara book. If the patient misses 4 or more, further testing is warranted as there might be a color deficiency

63
Q

Perimetry testing purpose and technique

A

AKA visual field testing. Detects eye diseases such as glaucoma.

Patient looks straight ahead and responds to instructions. In an automated test patients respond to seeing lights flash. In a manual test patients identify when they can see hands or fingers in their peripheral vision

64
Q

Tympanometry (purpose, technique, normal result)

A

Records movement of the tympanic membrane, which can be affected by increased pressure in the middle ear

Eardrum movement is measured by changing the amount of air pressure
Valuable for determining presence of fluid and potential infections in the middle ear.

Normal result: peak in graph; Abnormal result: flat line

65
Q

Audiometry (purpose, technique, normal result)

A

Medical assistants can perform if patients (children) can respond to directions; patients acknowledge when various tones are heard through headphones.

Hearing level is documented in decibels, hearing frequency is documented in hertz. Normal hearing can hear tones above 25 decibels (adult) or 15 (child)

66
Q

Use of a tuning fork in audiometry

A

Used to determine the patient’s ability to hear tones transmitted through air and bone conduction. The vibrating tuning fork is placed on top of the head or on the mastoid process

67
Q

Allergy testing - skin testing

A

Delivers rapid results, minimally invasive. Typically performed on forearm or back. Needs to be conducted with provider supervision in case of allergic reactions.

68
Q

Allergy testing - scratch testing

A

Diluted allergen is applied to a scratch/prick on surface of skin. If a wheal occurs in first 15 minutes, the substance is a possible allergen - the larger the wheal the more significant the allergy

69
Q

Allergy testing - intradermal testing

A

A diluted allergen is injected intradermally, the patient is observed.

An initial wheal is expected, if the wheal becomes inflamed with induration (raised + hard) the substance can be identified as an allergen - larger the wheal the more significant the allergy

70
Q

RAST testing

A

Checks blood for specific antibodies that could indicate an allergy.

More invasive because it requires a blood draw, but safer as it avoids a potential allergic reaction

71
Q

Challenge testing

A

Can only be prescribed if scratch or intradermal tests are positive and patient has significant food allergies.

Patient receives increasing amounts of food suspected of causing an allergy, must be in controlled environment with available medication/treatment for allergic reactions

72
Q

Peak flow testing, instructions

A

Measures the “forced expiratory volume” - indicates the effectiveness of airflow out of the lungs
Esp for those with chronic diseases like asthma

Instructions:
Wear nonrestrictive clothing, begin with the marker at the bottom of the scale on the meter. In an upright position, take a deep breathe and forcefully blow out of the mouth, record the number where the marker is located at the end of the test
Repeat the test two to three times and record the results (pt allowed to practice)

73
Q

Spirometry testing, instructions and preparation

A

An automated test that produces a graphic result. Conducted similar to the peak flow meter.
(loose clothing, upright, breathe through mouth)

Patient should life the chin and extend the neck slightly to reduce breathing resistance. A clip may be applied to the patient’s nose to avoid nose-breathing.

Additional pretest preparation: no large meals 2 hours before test, no smoking 1 hour before test, no bronchodilators/breathing therapies (inhalers, nebulizers) 6 hours before the test

CCMA (18 decks)

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