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MTAP 1 MTLBE > SEM Errors and Remedy in Clinical Laboratory (Management Approach) > Flashcards

SEM Errors and Remedy in Clinical Laboratory (Management Approach) Flashcards

1
Q

Non-conforming results with “statistical meaning”. This category includes all the “wrong” laboratory measures due to non-human action

A

Errors

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2
Q

Non-conforming results with “no statistical meaning”. This category contains all the human errors e.g. mixing up samples

A

Mistakes

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3
Q

Test ordering, Specimen Collection, handling and Transport

a. Preanalytic
b. Analytic
c. Post-analytic

A

a

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4
Q

Reporting interpretation, Diagnosis and Treatment

a. Preanalytic
b. Analytic
c. Post-analytic

A

c

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5
Q

Specimen processing, Evaluation and Validation of Results
a. Preanalytic
b. Analytic
c. Post-analytic

A

b

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6
Q

Common errors in QA phases:

Incorrect test request or test
selection

a. Preanalytic
b. Analytic
c. Post-analytic

A

a

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7
Q

Common errors in QA phases:

Wrong Matching between sample and laboratory’s files

a. Preanalytic
b. Analytic
c. Post-analytic

A

c

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8
Q

Common errors in QA phases:

Failure in sampling system

Failure in aspiration system of
reagents

a. Preanalytic
b. Analytic
c. Post-analytic

A

b

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9
Q

Common errors in QA phases:

  • Incomplete laboratory request
    forms
  • Inappropriate specimen collection, labelling and transportation

a. Preanalytic
b. Analytic
c. Post-analytic

A

a

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10
Q

Common errors in QA phases:

  • Expired reagents, controls or
    calibrators
  • Changes in analyzers photometric unit / flow cell/ measuring unit

a. Preanalytic
b. Analytic
c. Post-analytic

A

b

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11
Q

Common errors in QA phases:

  • Wrong anticoagulant
  • Inappropriate patient’s preparation
  • Mistakes in patient’s identification

a. Preanalytic
b. Analytic
c. Post-analytic

A

a

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12
Q

Common errors in QA phases:

  • Delay in delivering the results to the physicians, clinics or patients

a. Preanalytic
b. Analytic
c. Post-analytic

A

c

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13
Q

Common errors in QA phases:

  • Environmental conditions
  • Matrix effects

a. Preanalytic
b. Analytic
c. Post-analytic

A

b

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14
Q

Common errors in QA phases:

  • Loss of the results
  • Incorrect interpretation of results

a. Preanalytic
b. Analytic
c. Post-analytic

A

c

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15
Q

Troubleshooting in Pre analytical:

Possible effect:
Treatment errors, possibility of transfusion fatality

a. Misidentification of patient
b. Drawing at incorrect time
c. Improper skin disinfection
d. Drawing from edematous site

A

a

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16
Q

Troubleshooting in Pre analytical:

Possible effect:
Treatment errors if samples for certain tests aren’tdrawn at appropriate time, e.g.

a. Misidentification of patient
b. Drawing at incorrect time
c. Improper skin disinfection
d. Drawing from edematous site

A

b

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17
Q

Troubleshooting in Pre analytical:

Possible effect:
Dilution of sample with tissue fluid

a. Misidentification of patient
b. Drawing at incorrect time
c. Improper skin disinfection
d. Drawing from edematous site

A

d

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18
Q

Troubleshooting in Pre analytical:

Possible effect:
Contamination of blood cultures & blood components.

a. Misidentification of patient
b. Drawing at incorrect time
c. Improper skin disinfection
d. Drawing from edematous site

A

c

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19
Q

Troubleshooting in Pre analytical:

Possible effect:
Increase in Potassium, lactic acid, Calcium, phosphorus

Decrease pH

a. Fist pumping during venipuncture
b. Tourniquet >1 min
c. IV fluid contamination

A

a

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20
Q

Troubleshooting in Pre analytical:

Possible effect:
Increase in Potassium, lactic acid

a. Fist pumping during venipuncture
b. Tourniquet >1 min
c. IV fluid contamination

A

b

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21
Q

Troubleshooting in Pre analytical:

Possible effect:
Increase in glucose, electrolytes

a. Fist pumping during venipuncture
b. Tourniquet >1 min
c. IV fluid contamination

A

c

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22
Q

Troubleshooting in Pre analytical:

Possible effect:
Hemoconcentration

a. Fist pumping during venipuncture
b. Tourniquet >1 min
c. IV fluid contamination

A

b

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23
Q

If taking on the site with IV, The ____ will remove the IV and collect after __ mins

A

nurse/physician, 2

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24
Q

Delivery time of Specimen is delivered to the lab within _______ mins of collection

A

45

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25
Q

Clot blood _______ centrifuge

A

before

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26
Q

Centrifuge clot blood for about ______ mins and maintain tube in ________ position

A

30-40 mins

Vertical

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27
Q

Centrifuge within 1 hour or up to 2 hours to minimize _________

A

glycolysis

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28
Q

Spin most tubes at 1000-1300 RCF for ________ mins

A

10-15

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29
Q

Specimen transmported with ice includes:

  • Ammonia
  • Lactate
  • TH
  • ACTH
  • Blood gas

Which of the following does not belong?

A

None

30
Q

Cold temp:
Increase Alkapose?
Decrease LDH

T or F

A

T

31
Q

Bilirubin is decrease by 50% after 1 hour light exposure

T or F

A

T

32
Q

The following increase in hemolysis:

  • Potassium
  • LDH
  • ACP
  • Mg
  • PO4
  • Creatinine

Which of the following does not belong?

A

Creatinine

33
Q

Best practices to prevent hemolysis:

Use the correct needle size which is?

A

20-22

34
Q

Best practices to prevent hemolysis:

Standard needle?

A

21 gauge

35
Q

Best practices to prevent hemolysis:

Allow disinfectant on venipuncture site to dry completely

T or F

A

T

36
Q

Serum samples containing more than _______ mg/dL of hemoglobin can cause non-specific binding in serologic test

A

100

37
Q

(+) Cloudy
(+) lipid

a. Lipemic
b. Hemolyzed
c. Icteric

A

a

38
Q

(+) Yellow

a. Lipemic
b. Hemolyzed
c. Icteric

A

c

39
Q

(+) Red
(+) RBC destruction

a. Lipemic
b. Hemolyzed
c. Icteric

A

b

40
Q

Increase Bili content

a. Lipemic
b. Hemolyzed
c. Icteric

A

c

41
Q

Affects K and enzyme testing

a. Lipemic
b. Hemolyzed
c. Icteric

A

b

42
Q

Interferes with colorimetric analysis

a. Lipemic
b. Hemolyzed
c. Icteric

A

a

43
Q

Due to non fasting patients

a. Lipemic
b. Hemolyzed
c. Icteric

A

a

44
Q

Order of Draw?

A

Blood culture, Light blue, Red (SST, PST), Green, Lavender, Grey

45
Q

Analytical:

How close measurement is to true value

a. Accuracy
b. Precision

A

a

46
Q

Analytical:

How close results are when same sample is tested multiple times

a. Accuracy
b. Precision

A

b

47
Q

Involves systematic monitoring of analytic processes in order to detect analytic errors that occur during analysis

A

Quality control

48
Q

performed by laboratory personnel using control materials of known values and comparing it to the established, acceptable ranges

a. Internal Control
b. External Control

A

a

49
Q

Checks primarily the precision of the method

a. Internal Control
b. External Control

A

a

50
Q

Performed by laboratory personnel when analysing specimens sent to the laboratory by an external agency, and the results generated are submitted to the agency for assessment

a. Internal Control
b. External Control

A

b

51
Q

known as proficiency testing

a. Internal Control
b. External Control

A

b

52
Q

A set of operations which, under special conditions, establishes the relationship between the values indicated by measuring instruments and standards.

A

Calibrations

53
Q

The schedules of calibration or
performance checks should be based on:

  • Manufacturers’ recommendations
  • Reference standards
  • Recalibration of the measuring devices based on recommended time intervals.

T or F

A

T

54
Q

Typical Steps Taken When a Control Is Outside Acceptable Range:

If control is still out, run a new vial of
control or another lot #

Rationale:
Control might have been _______, improperly stored, contaminated

A

Outdated

55
Q

Typical Steps Taken When a Control Is Outside Acceptable Range:

If control is still out, look for & correct
any problems, then run control.

Rationale:
Consider reagents, preventive
maintenance (overdue), mechanical
problems, clots, etc

T or F

A

T

56
Q

The schedules of doing QC includes:

  • At the end of each shift
  • After and instrument is serviced
  • When Reagent lots are changed
  • After calibration
  • When results of the analytes seem inappropriate

Which of the following is wrong

A

At the end of each shift

Should be at the beginning

57
Q

Comparison of patient data with previous results

A

Delta checks

58
Q

External control checks for Precision

T or F

A

F

Accuracy

59
Q

____________ has been established by the Department of Health–Philippines (DOH) to provide DOH-approved external quality assessment programs, including the Proficiency
Picture: NEQAS Test (PT) for Bacteriology to clinical laboratories

A

National External Quality Assessment
Scheme (NEQAS)

60
Q

The central Governmental agency authorized to regulate the operation and maintenance lab

A

DOH

61
Q

A monitoring approach that evaluates various aspects of the laboratory process or services to determine if the minimum standards of quality are being attained by the production process

A

Quality assurance monitoring

62
Q

defines QA as a part of Quality Management focused on providing confidence that quality requirements will be fulfilled

a. DOH
b. ISO
c. PSA

A

b

International Organization fo Standards

63
Q

the act of continually looking to improve upon a process, product, or service through small incremental steps

a. Quality determination
b. Continuous improvement

A

b

64
Q

Quality is determined by the product users, clients, or customers.
It’s not the same as ‘expensive’ or ‘high quality.

a. Quality determination
b. Continuous improvement

A

a

65
Q

Plan, Do, Act, Study and repeat

What cycle is this?

A

Shewhart cycle

66
Q

Post analytical Phase:

LAb results should be sign by?

A

Pathologist and Medtech

67
Q

Defined as an analytic result that suggests a clinical condition that may be life-threatening and may require immediate clinical intervention

A

Critical values

68
Q

Resolving Post analytical error

  • Report STAT results and critical values promptly

T or F

A

T

69
Q

Resolving Post analytical error

  • have a written quality assurance program
  • generate Levy-Jennings or trend plots of QC results to identify
    changes in test performance.

T or F

A

T

70
Q

Resolving Post analytical error

  • accurately transmit test results
  • reduce human error through root-cause analysis, process control, and
    education/communication

T or F

A

T

MTAP 1 MTLBE (23 decks)

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