Test 1 Flashcards
CLIA
clinical laboratory improvement amendments
laws and regulations governing how labs are operated
waived tests
tests often done in office that don’t require CLIA oversight
POCT
point of care testing
CLIA waived testing
quality control
testing run on control materials periodically to assure that an assay or test is reliable
quality assurance
programs within a lab to assure accurate and reliable results
proficiency testing
perioding testing required to assure that technical personnel are performing tests correctly and getting accurate results
incidence of disease
number of new cases of a disease during a specified period of time and population
prevalence
number of existing cases of disease during a specified period of time and population
predictive value
ability of a screening test result to correctly identify disease state
pretest probability
the probability of the target disorder before a diagnostic test result is known
critical/panic value
lab value that requires immediate notification to the provider for urgent action
normal range
range of value determined by the lab to encompass values within 2 standard deviations of the mean for a large population, 5% of normal values fall out of this range
specificity
- ability of a test to identify correctly those who do not have the disease
- identify the true negative
- highly specific test unlikely to give false positive
- used to confirm results of screening tests
sensitivity
- ability of a test to identify who truly has a disease
- identify the true positive
- acts as screening test
pretest or preanalytical issues
issues related to patient, proper test selection, consent, preparation, specimen collection, specimen storage and transport
intratest or analytical issues
may include issues related to testing procedures, interference, reagents, QC
posttest or postanalytical issues
includes issues related to calculating, reporting, and interpreting results, follow-up
tube draw order
blue, red, gold, green, purple, gray
lavender tube
- contains EDTA
- hematology, CBC, making blood smears
light blue tube
- contains sodium citrate
- coagulation studies like PT/INR
green tube
- contains heparin
- plasma chemistry studies
WBC panic value
<2000
>30000
Hb/Hgb Panic values
<5
>20
HCT panic values
<20%
>60%
neutrophils
- most numerous
- most important
- only ethnic difference
- pyogenic bacterial infection
neutrophilia
- acute bacterial infection
- inflammation
- myeloproliferative
neutropenia
- overwhelming infection
- viral infection
- aplastic anemia
eosinophil
- parasite defense
- allergic reaction
eosinophilia
- parasite infection
- allergy
- UC/crohns
eosinopenia
- stress
- cushings
- drugs
basophil
allergic reaction
basophilia
- myelocytic leukemia
- acute basophilic leukemia
- inflammation
- allergy
basopenia
- stress
- prolonged steroid use
monocyte
severe infection
monocytosis
- bacterial infection
- TB
- syphilis
monocytopenia
- prednisone
- overwhelming infection
- HIV
- aplastic anemia
Lymphocyte
viral infection
lymphocytosis
- mononucleosis
- pertussis
- CLL, ALL
shift to the left
-increase in number of immature granulocytes
-neutrophils
-increase bands to >80%
found in pregnancy, bacterial infection, hemorrhage, myeloproliferative disorder
leukocytosis
WBC > 10,000
- bacterial/viral infections
- dehydration
- leukemia
- inflammation
- prednisone
- hemorrhage/hemolysis
- demargination of cells
leukopenia
WBC < 4,000
- overwhelming bacterial infection
- viral infection
- bone marrow disorder
- over hydration
- medications
acute lymphocytic leukemia
- lymphoblasts present
- 1/3 of childhood cancers
chronic lymphocytic leukemia
- predominant small mature lymphocyte
- smudge cells
acute myeloid leukemia
-blasts present in peripheral blood
chronic myeloid leukemia
- philadephia chromosome
- basophilia and neutrophilia
reticulocytes
immature RBC
normal/decreased reticulocyte
- iron deficient anemia
- anemia of chronic disease
- lead poisoning
- B12/folate deficiency
- aplastic anemia
elevated reticulocyte
- hemolytic anemia
- hemorrhage
- early treatment nutritional deficiency
iron deficient anemia
- most common cause of anemia
- causes: malnutrition, chronic blood loss, pregnancy
- microcytic
- hypochromic
- decreased RBC
- high RDW
- decreased ferritin is earliest finding and persists
sideroblastic anemia
- bone marrow produces ringed sideroblast rather than normal RBC
- body has iron but can’t incorporate it into hemoglobin
Why separate serum from RBC
blood glucose will decrease
what is drawn first
blood cultures for sterility
primary polycythemia
- RBC high
- EPO low
- caused by abnormality of cells in marrow
secondary polycythemia
- RBC high
- EPO high
- caused by disorder originating outside of marrow
microcytic anemia
TAILS Thalassemia Anemia of Chronic Disease Iron Deficiency anemia Lead toxicity Sideroblastic
Thalassemia lab finding
- Low MCV
- Normal RDW
- Increased iron
- Decreased TIBC
- Abnormal Hemoglobin electrophoresis (Hb A2)
Normocytic anemia
- Hemorrhagic/Hemolytic
- aplastic
macrocytic anemia
B12/folate deficiency
