Quiz #1 Flashcards
Origin of Laboratory Medicine:
-Hippocrates advocated a diagnostic protocol that included tasting the patient’s urine
20th century laboratory medicine highlights:
- Microbiology
- Clinical Chemistry
- Transfusion Medicine
CLIA:
- Clinical Laboratory Improvement Amendments: regulated testing by Centers for Medicare & Medicaid Services (CMS); CMS responsible for financial backing
- Passed in 1988 to ensure quality lab testing
- Carried out by CCSQ
- Waived and Non-Waived tests
Waived and Non-Waived tests:
- Categorization of in vitro diagnostic tests under CLIA; FDA responsible
- Based on potential for risk to public health
Waived Tests:
- Cleared for home use
- Low risk
Non-Waived Tests:
-Uses scoring system (scale of 1-3) based on 7 criteria
College of American Pathologists:
- Leader in lab quality assurance
- Inspects and accredits over 7600 labs globally
All work-related fatalities, amputations, inpatient hospitalizations, and all losses of an eye must be reported to OSHA within:
- Fatalities: 8 hours
- Everything else: 24 hours
HIPPA:
Health Insurance Portability and Accountability Act:
- Title I: protects insurance coverage
- Title II: Administrative Simplification
Anatomic Pathology:
- Focuses on the diagnosis of disease
- Histology, Cytology, Forensic Pathology
Clinical Pathology:
- Diagnosis based on lab analysis of bodily fluids, such as blood and urine
- Clinical Chemistry, Hematology, Blood Bank, Microbiology
American Society for Clinical Pathology (ASCP):
-Provides certification for pathologists and lab professionals
Reference/Normal Range:
- Found by testing thousands of samples from individuals without disease and on no medications
- 2 standard deviations in middle or represents 95% of results
Desirable Range:
- Groups of experts compare lab test results with clinical outcome and create new desirable or prognosis-related ranges
- ie: Cholesterol reference range
Therapeutic Range:
- Determined by the drug’s effect rather than its concentration in the blood
- ie: Target blood level for a medication
Critical Lab Value:
- Test that requires rapid clinical attention
- Prompt verbal notification must be given to member of healthcare team responsible for patient
Precision:
-Ability to repeatedly obtain results that are close to each other on the same sample
Accuracy:
-Relationship between the number obtained and the true result
False Positive:
-Lab suggests there is a disease but patient does not
False Negative:
-Lab suggests there is not a disease when there is not
Sensitivity:
- True positive rate
- Ability of a test to correctly identify individuals who have a given disease or condition
Specificity:
- True negative rate
- Ability of a test to correctly exclude individuals who do not have a given disease or condition
Prevalence:
-The number of existing cases in a population
Incidence:
-Number of new cases occurring within a period of time
Blood components:
- Plasma/Serum
- Buffy Coat : WBC, Plt -RBC
Plasma:
- Extracellular matrix of whole blood
- Contains: water, proteins, glucose, clotting factors, electrolytes, hormones, CO2
Serum:
- Portion of blood that does not contain blood cells or clotting factors
- Contains everything else
Hematocrit (Hct):
- Volume % of RBCs
- Anemia: abnormally low hematocrit
- Polycythemia: abnormally high % of Hct
Hemoglobin (Hgb or Hb):
-Contains Fe2+ and O2
Serum Vacutainers:
- Red Top
- Gold or Marble Top
- Light Blue Top
- Lavender Top
- Green Top
- Gray Top
- Orange or Gray/Yellow Top
- Light Yellow
- Tan
- Royal Blue
- Black
Red Top:
-No Additives (60 min clot)
Gold or Marble Top:
- 30 minute clot
- Special gel creates barrier between RBCs and serum
Light Blue Top:
- Contains Sodium Citrate anticoagulant
- Must be completely filled
- Used for routine and special coagulation tests
Lavender Top:
- Contains EDTA
- Hematology: CBC, Hgb, Hct, WBC differential, reticulocyte count
- Chemistry: Hgb A1C
Green Top:
- Contains Heparin anticoagulant
- Used for mainly for chemistry tests
Gray Top:
- Potassium oxalate anticoagulant
- Sodium fluoride: antiglycolytic stabilizer
- Used for glucose levels, BAC, lactate, HCO3-
Orange or Gray/Yellow:
- Contains thrombin
- Used for STAT serum testing (5 minute clot)
Light Yellow:
-Contains SPS for blood cultures or ACD for blood bank studies
Tan:
- Contains either heparin or EDTA
- Used for lead determinations
Royal Blue:
- Contains either northing or heparin
- Used for metal trace analysis
Black:
-Used for Erythrocyte Sedimentation Rate
Tube Draw Order:
1) Blood Culture Tube or Vial
2) Citrated Tube
3) Serum Tubes w/ or w/o Clot Activator, w/ or w/o Gel Separator
4) Heparin Tube
5) EDTA Tube
6) Glycolytic Inhibitor
Capillary Blood Collection:
- Puncturing dermis to access capillary beds
- Used for glucose, INR
Point-of-care-testing (POCT):
- Medical testing at or near the site of patient care
- Immediate Results
- Lack of quality control, training, infection control
Na+:
136-146 mEq/L
K+:
3.5-5.0 mEq/L
Cl-:
96-106 mEq/L
CO2 (HCO3-):
22-28 mEq/L
BUN:
10-20 mg/dL
Crt:
0.5-1.0 mg/dL
Glu:
70-100 mg/dL
CBC:
- WBC
- Hgb
- Hct
- Plt
WBC:
5,000-10,000/mm3
Hgb:
- Males: 14-18 g/dL
- Females: 12-16 g/dL
Hct:
- Males: 42-52%
- Females: 37-47%
Plt:
150,000-450,000/mm3
Common Lab Value Shorthand
Common Lab Value Shorthand
