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MT 12 lec > POCT > Flashcards

POCT Flashcards

1
Q

Specimen analysis performed outside of the clinical laboratory setting

A

Point of care testing

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2
Q

immediate results can be delivered, allowing assessment and management to be given swiftly.

A

point of care testing

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3
Q

POCT can be done at ___
(the 3 places it is possible to conduct)
BPO

A
  1. bedside of the patient
  2. physician’s office
  3. or any alternative site
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4
Q

Other names for POCT

A

● near patient testing
● Bedside testing
● Remote testing
● Satellite testing
● Physician’s office testing
● Extra-laboratory
● Decentralized
● Ancillary
● Alternate site testing (AST)
● Rapid diagnostics

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5
Q

ways in conventional testing procedure

A
  1. patient arrival
  2. collect sample
  3. sample procedures
  4. perform test
  5. compile all results
  6. analyze result
  7. patient admitted or discharged
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6
Q

ways in poct

A
  1. patient arrival
  2. Collection of sample
  3. Load the sample
  4. Analyze result
  5. patient admitted or discharged
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7
Q

Advantages of POCT
(CURSER CAR)

A
  1. cheaper and quicker traditional diagnostic methods.
  2. Can be used in resource limited settings
  3. Reduced preanalytical and post analytical testing errors
  4. Easier to use and reduced the need of training
  5. Rapid data availability
  6. Reduced the patient’s length of stay and waiting time in the hospital
  7. Convenient for clinicians
  8. Ability to test many types of samples
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8
Q

Disadvantages of POCT
BCDNQ

A
  1. Concerns about inaccuracy, imprecission, and performance
  2. Quality in testing is operator-dependent
  3. Bedside laboratory testing is performed by poorly trained non-laboratorians
  4. Difficult in integrating the test results with HIS and LIS; lack of connectivity
  5. Narrower measuring range for some analysis
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9
Q

what is the ASSURED (REASSURED) criteria by WHO

A

R - real-time connectivity
E - ease in the collection of the specimens
A - affordable
S - sensitive
S - specific
U - user-friendly / simple to perform
R - robust and rapid
E - equipment free
D - deliverable to those who need the test

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10
Q

3 primary stages of POCT

A
  1. preanalytical
  2. analytical
  3. post-analytical
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11
Q

Occurs before running the POCT on a sample; this includes collection, transport, preparation, and loading

A

preanalytical

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12
Q

actual testing of POCT is conducted

A

analytical

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13
Q

it is the actual testing of a sample

A

analytical

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14
Q

begins when testing is complete,
and an obtained result is available

A

post-analytical

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15
Q

Two ways of communicating the results:

A
  1. Results can be communicated directly to the hospital’s database / HIS
  2. Results can be commu updated directly through written or verbal communication
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16
Q

What ate the specimen requirements and procedures:

A
  1. Adhering to personnel regulations
  2. Patient identification
  3. Patient preparation
  4. Preparation of specimen collection containers
  5. Patient compliance
  6. Accurate clinical documentation
  7. Proper specimen storage
  8. Proper technique in collecting the specimens
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17
Q

Pre-analytical errors
(7)

A

Lack of preparation of the patient
Lack of information about the patient’s condition
Inappropriate specimen technique
Wrong or missing additives to blood
Mislabelled/Mishandling of patient specimen
Specimen contamination
Degradation of specimen due to delays in specimen processing

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18
Q

Post-analytical errors

A

Misreporting the patient result
Recording the wrong patient test result
Lost Data
Delayed reporting of critical results

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19
Q

Factors influencing these errors and problems
include the

A
  1. setting and the
  2. extent to which the instrument is within a network
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20
Q

Things irrelevant for POCT.

A

1.Transport
2.storage
3.centrifugation

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21
Q

It is mostly unnecessary, as whole blood is used.

A

Evaluation of the test results

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22
Q

The greatest importance in the pre-analytical process.

A

Correct Collection of the Sample

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23
Q

POCT DEVICES

A
  1. Commercial Benchtop Devices
  2. uPADS
  3. Microfluidic Multifixed Devices
  4. Stand-alone POC Devices
  5. Smartphone-based Devices
  6. Commercial Handheld devices
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24
Q

Beta-hydroxybutyrate detection from whole blood sample

A

uPADS

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25
Q

Multianalyte antibiotic detection from plasma
sample

A

Microfluidic multiplexed devices

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26
Q

Nucleic acid amplification test from nose swab
samples with colorimetric readout

A

Stand-alone POC Devices

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27
Q

semen analyzer for male infertility

A

Smart-phone based devices

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28
Q

Drug abuse detection and Disposable cartridges
for saliva sample

A

Commercial Handheld Devices

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29
Q

POCT is accomplished using

A

portable devices

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30
Q

Many point-of-care test systems are in the form of and often enclosed in

A

easy-to-use membrane-based test strips, in plastic test cassette

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31
Q

Parameter: HCG(human chorionic
gonadotropin)
Sample: Urine, Serum

A

Pregnancy Test Kits

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32
Q

Parameter: Ascorbic acid, glucose, bilirubin, ketone, SG, blood, pH,protein, urobilinogen leukocytes, nitrite
Sample: Urine

A

Urine dipstick analysis

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33
Q

Paramter: Albumin
Sample: Urine

A

Microalbumin screening

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34
Q

Parameter: Group A Strep,
Influenza A, +B, HIV, Chlamydia trachomatis antigen, MRSA, Helicobacter pylori-specific IgG
antibody

Sample: Swab, Serum

A

Infectious Agents Detection

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35
Q

Parameter: Hemoglobin

Sample: Stool

A

FOBT
(fecal occult blood test)

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36
Q

A wide range of devices, including single pad urine tests (dipsticks) and test kits.

A

SINGLE-USE QUALITATIVE STRIP OR CARTRIDGE
AND/OR STRIP DEVICES

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37
Q

These are generally dried, porous matrices with impregnated carrier elements that
interact with the analyte(s) when exposed;
chemical reaction usually results in a color
change

A

Dipsticks/Urine Strips

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38
Q

This utilizes a layer of supporting
materials, such as porous paper of cellulose fiber
filters or woven meshes; example is the at-home
pregnancy test

A

Test kits

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39
Q

PARAMETERS REACTION TIME
1. Glucose, Bilirubin
2. Ketones
3. Specific Gravity
4. pH, Protein, Blood,
Urobilinogen, Nitrite
5. Leukocytes Esterase

A
  1. 30 seconds
  2. 40 seconds
  3. 45 seconds
  4. 60 seconds
  5. 120 seconds
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40
Q

This kit uses antibodies to detect human chorionic gonadotropin (hCG)

A

Pregnancy test kits

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41
Q

a hormone that can be
detected in the urine

A

hCG (human chorionic gonadotropin)

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42
Q

What is the specimen and principle for Pregnancy test kits?

A

Specimen: first morning urine ( concentrated sample)
Principle : Lateral flow technology

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43
Q

This line utilizes a combination of antibodies including a monoclonal hCG antibody to detect elevated levels of hCG

A

Test Line

44
Q

This line composed of goat polyclonal
antibodies and colloidal gold particles.

A

Control line

45
Q

This test kit detects hepatitis B surface antigen in human
serum or plasma

A

HBsAg Test Kit

46
Q

HBsAg sample and principle

A

Sample: Serum/Plasma

Principle: Sandwich immunoassay

47
Q

A lab test used to check stool samples for hidden
(occult) blood.

A

Fecal Occult Blood Test

48
Q

Occult blood may indicate

A

Colon cancer or polyps in the rectum or colon

49
Q

TRUE OR FALSE
Can detect the presence or absence of
blood – it can determine what’s causing the
bleeding

A

false

Can only detect the presence or absence of
blood – it cannot determine what’s causing the
bleeding

50
Q

They include a meter or monitoring device thereby enabling for the detection and quantification of
analytes.
○ EX. Glucometer

A

SINGLE-USE QUANTITATIVE CARTRIDGE AND
STRIP TEST WITH MONITORING DEVICES

51
Q

Done to evaluate warfarin (vitamin K antagonist)
and heparin therapy

A

Coagulation monitoring

52
Q

Common coagulation tests checked:

PIAPA

A

○ Prothrombin time (PT)
○ International normalized ratio (INR)
○ Activated partial thromboplastin time (APTT or
PTT)
○ Activated clotting time (ACT)
○ Platelet function

53
Q

Coagulation POCT Devices

A

Cascade cassette
CoaguCheck Xs Plus
GEM Premier 4000
iSTAT
Verify now

54
Q

For what kind of test:
Cascade cassette
CoaguCheck Xs Plus
GEM Premier 4000
iSTAT
Verify now

A

Cascade cassette - ACT, APTT, INR/PT
CoaguCheck Xs Plus - INR/PT
GEM Premier 4000 - ACT, APTT, INR/PT
iSTAT - ACT, INR/PT
Verify now - Platelet function

55
Q

A non-instrumented test ordered by the physician to evaluate capillaries for platelet plug formation.

A

Bleeding Time

56
Q

Used for pre-surgical screening and detection of
problems involving hemostasis.

A

Bleeding Time

57
Q

Methods in bleeding Time
(DICS)

A

○ Duke method (finger and earlobe)
○ Ivy method
○ Copley-Lalitch Immersion Test (uses sterile
Normal Saline Solution and 37 degrees Celsius
waterbath)
○ Surgicutt method

58
Q

The common methods in bleeding Time

A

Duke’s method and surgicutt

59
Q

Duke’s method:

A

● Patient pricked with special needle/lancet.
● Preferably on earlobe/fingertip.
● Swabbed with alcohol first.
● Prick depth: 3–4 mm.
● Patient wipes blood every 30 seconds with filter
paper.
● Test stops when bleeding stops.

60
Q

This analysis has a prospective influence on patient
care than any other laboratory determinants.

A

ABG - arterial blood gas

61
Q

are the most important factors in the
management of critically ill patients.

A

Tissue oxygenation
Ventilation
Acid base status

62
Q

Parameters of ABG

A

pH
pO2
pCO2

63
Q

refers to the concentration of hydrogen ions in
a solution.

A

pH

64
Q

is an indicator of how well air is
exchanged between the blood and lungs;
measure of the pressure exerted by dissolved
CO2 in the blood plasma in proportion to the PO2 in the alveoli.

A

pCO2

65
Q

pressure exerted by dissolved O2 and the
ability of the lungs to diffuse oxygen through the
alveoli.

A

pO2

66
Q

placed on ice and held at
0°C until analysis

A

arterial blood

67
Q

2 devices for blood gas analyzer

A

EPOC Critical Care Blood Gas Analyzer
OPTI Critical Care Analyzer

68
Q

cartridge-based analyzer with all the analytical
requirements for the performance of a test contained
within an individual cartridge.

A

iSTAT

69
Q

What are the tests offered by iSTAT?

A

Lactate
Hematology
Chemistries and Electrolytes
Cardiac Markers
Endocrinology
Blood Gases
Coagulation

70
Q

CG4+

A

Lactate

71
Q

CG8+, EG7+

A

Hematology

72
Q

CHEM8+, EG7+

A

Chemistries and Electrolytes

73
Q

cTnL, CK-MB, BNP

A

Cardiac Markers

74
Q

Beta - hCG

A

Endocrinology

75
Q

EG7+, CG8+

A

Blood Gases

76
Q

PT/INR, ACT kaolin, ACT Celite

A

Coagulation

77
Q

Most comprehensive device for POCT

A

iSTAT

78
Q

Connects to LIS then transmits to EMR

A

iSTAT

79
Q

transmitting nerve impulses
○ Hypernatremia (increased Na levels);
Hyponatremia (decreased Na levels)

A

Sodium

80
Q

helps in nerve conduction and muscle
function; regulates acid-base balance and osmotic
pressure (STAT).
○ Hyperkalemia and Hypokalemia

A

Potassium

81
Q

maintains the integrity of the cells by
helping in balancing osmotic pressure and acid-base
and water balance of the body.
○ Hyperchloremia and hypochloremia

A

Chloride

82
Q

helps transport CO2 from the
lungs resulting in the reduction of hydrogen ions and increase in blood pH.

A

Bicarbonate ion

83
Q

helps in muscular function,
cardiac function, blood clotting, nerve transmission function of the body.
○ Hypercalcemia and Hypocalcemia

A

Ionised ion

84
Q

What are the steps to operate iSTAT?

A
  1. Insert 2 to 3 drops of blood into the cartridge
  2. Close the cartridge and insert it into the iSTAT handheld
  3. View the results on the handheld screen within minutes
  4. Upload information automatically to the HIS/LIS
85
Q

iSTAT System Integration with LIS/EMR

A

iSTAT (if wireless transfer) > POC Data Manager > LIS > EMR

iSTAT > iSTAT Downloader > POC Data Manager > LIS > EMR

86
Q

What are the 4 non-invasive POCT?

A
  1. Pulse oximetry
  2. Transcutaneous Measurement of Bilirubin
  3. Non-invasive hemoglobin monitors
  4. GlucoWatch BIOGRAPHER
87
Q

For monitoring a patient’s oxygen saturation.

A

Pulse oximetry

88
Q

Most common used sites for application for pulse oximetry

A

Fingernail and toenail beds

89
Q

Principle for pulse oximetry

A

based on the red and infrared light
absorption characteristics of oxygenated and
deoxygenated hemoglobin

90
Q

What is the particular wavelength for deoxygenated and oxygenated hemoglobin for pulse oximetry

A

Oxygenated- 940 nm
Deoxygenated- 660 nm

91
Q

This meter measures the yellowness of the
subcutaneous tissue by measuring the difference in the optical density of two wavelengths through the skin

A

Transcutaneous Measurement of Bilirubin

92
Q

What are the sites used in measuring transcutaneous Measurement of Bilirubin?

A

Baby’s forehead or sternum

93
Q

A pulse co-oximeter that uses a multi-wavelength
sensor for spot check and continuous measurement

A

Non-invasive hemoglobin monitors

94
Q

The technology emits multiple wavelengths of light and then calculates the hemoglobin concentration based on the adsorption of light in the blood.

A

Non-invasive hemoglobin monitors

95
Q

The device that extracts glucose through intact skin via reverse iontophoresis where it is detected by an amperometric biosensor.

A

GlucoWatch BIOGRAPHER

96
Q

GlucoWatch BIOGRAPHER can provide glucose readings every ?

A

20 minutes for 12 hours

97
Q

Gauge the effectiveness of
the thrombolytic therapy
being administered to
patients who have suffered
from heart attacks

A

Cardiac Troponin T
and Troponin I
(cardiac markers)

98
Q

Measures the alanine
transferase (ALT) of patients
under lipid-lowering
medication.

A

Lipid Testing

99
Q

Differentiates chronic
obstructive pulmonary
disease (COPD) and
congestive heart failure
(CHF)

A

B-Type Natriuretic
Peptide (BNP)

100
Q

Detects and evaluates
infection, tissue injury, and
other inflammation disorders
(usually non-specific).

A

C-Reactive Protein
(CRP)

101
Q

Diagnostic tool for diabetes
therapy monitoring.

A

Glycosylated hemoglobin

102
Q

shows what a person’s
average blood glucose level was for
3 months before the test

A

Glycosylated Hemoglobin

103
Q

Measures the volume of the
red blood cells.

A

Hematocrit
(or PCV - Packed
Cell Volume)

104
Q

Checks the hemoglobin level
to manage patients suffering
from anemia (either due to
low RBC count or low Hgb).

A

Hemoglobin

105
Q

Evaluates the severity of
lactic acid disorder and
stress response of the
patient.

A

Lactate

106
Q

Checks contact with
allergens and determines if
the body has developed
antibodies.

A

Skin test

107
Q

Detects the presence of
group A streptococci (S.
pyogenes for pharyngitis).

A

Strep testing

MT 12 lec (5 decks)

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