TEST 1 Flashcards
are CLS non patient facing staff
yes
describe what CLS do in one sentance
provide clinicians with data to help diagnose the patient
where would you find a clinical lab
hospitals
where would you find a research lab
academic centers
who federally regulates a clinical lab
CMS (centers for medicare services), FDA, and TJC (joint commission)
who federally regulates a research lab
grant programs
describe the test that clinical lab can preform
FDA approved test
created test that are approved by their medical director
describe the test that research lab can preform
design their own test protocol
True or false: results obtained in a clinical lab can be used to diagnosis and treat a patient
true
True or false: results obtained in a research lab can be used to diagnosis and treat a patient
false
which kind of lab has the quickest results
clinical lab
what type of regulation is voluntary
accreditation
certification
what type of regulation is mandatory
licensure
what type of regulation is non governmental
accreditation
certification
what type of regulation is gov’t agency
licensure
name of legislation to establish quality standards for all lab testing
CLIA 1988
describe lab testing that is waived
anyone can do it
results are dummy proof and are not life or death
ex of waived testing
pregnancy or glucometer
moderate complexity test
run in a lab
no judgment call
high complexity test
manually reads data
requires judgment call
ran in lab
ex of high complexity test
ph test or dip stick
jobs of the CMS
oversight of CLIA ‘88 regulations
inspect lab requesting/recieving payments from medicare and Medicaid
approves accreditation programs
reimbursement
what regulatory agency is the most strict
college of American pathologist (CAP)
regulatory agency for hospital wide inspections including the lab
the joint commission (TJC)
regulatory agency for transfusion med and regulates market entry of instruments and reagents
FDA
what types of samples do clinical pathology look at
liquids
what types of samples do anatomical pathology look at
bits of human (cells)
what are the branches of clinical pathology
chem
hematology
microbio
blood bank
what are the branches of anatomical pathology
cytology
histology
who would preform these tasks: receives and delivers samples answer phones/ customer service do non analytical task no experience of license required help with maintenance
medical lab assistants
who would preform these tasks:
licensed personnel, patient facing
routine venipuncture
phlebotomist
who would preform these tasks: licensed aa and 6 months of internship required perform waived and moderate testing can not perform judgement calls
medical lab technician
who would preform these tasks:
can perform high complexity testing
bachelors
CLS
who would preform these tasks: medical doc medical school, 4 years of residency may be medical directors of clinical labs make interpretations based on lab data
pathologist
who would preform these tasks:
masters degree and internship
performs gross inspection of organs/tissues
autopsies
ID sections of interest and embeds into wax
pathologist assistant
who would preform these tasks: certified in CA receives tissue in wax uses microtome preps and stains slides for pathologist
histology technician/ histotochnologist
who would preform these tasks:
BS and internship, licensed
report cellular abnormalities
looks at pap smears
cytotechnologist
what kind of license do you have if you can only work in 1 department with a BS and 1 year internship
limited license
who studies chromosomes and mostly tumor analysis
clinical cytogenetics scientist
histocompatibility
make sure organ transplant will be tolerated in the recipient
put these in order:
- label blood specimen tubes at the bedside
- ID patients correctly
- collect blood specimen into the correct containers/tubes
- assess patients prior to specimen collection procedures
- assess the degree of discomfort, pain, or bleeding
- prepare patients accordingly
- assess the patient after the specimen collection procedure
2, 4, 6, 3, 1, 5, 7
put these in order:
- assist in lab testing procedures as needed
- select and use appropriate equipment
- transport specimens correctly
- manipulate small objects, tubes, needles
- preform quality control functions
- prepare/process the specimen for testing/analysis
4, 2, 5, 3, 6, 1
why are there different color tube tops
color coded according to the additive
serum
blood that clots
plasma
yellow liquid
doesn’t clot
what is added to blood so it doesn’t clot
anticoagulants
function of anticoagulants
extend metabolism and life span of the RBC after collection
what color top is the lowest anticoagulant
red
what color top is the highest anticoagulant
grey
what is the color order of draw
yellow/red light blue gold/blue light green/ dark green lavender/ purple/ pink grey
what color top contains sodium citrate
light blue
what kind of test is the light blue top used for
coagulation
what is important about the light blue top
it is important to get the ratio of blood right for accurate results
what kind of test is red top
anticoagulant
what kind of fluid is put in a gold top
serum
what color tube has a polymer barrier at the bottom
gold top
function of polymer barrier
forms a barrier between serum and blood cells
what kind of test are gold top used for
chem and immunology
what color top has anticoagulants sodium heparin, ammonium heparin, and lithium heparin
green top
what kind of liquid is put into green tops
plasma or whole blood
what kind of test should green tops not be used for
blood smear on microscope slides
what do purple top chelate
Ca
what kind of test are purple tops used for
hematological
blood bank
molecular diagnostic test
what does a purple test determine
complete blood count
what is in a pink top
EDTA
what kind of test is done on a pink top
blood bank
what color top contains potassium oxalate and sodium fluoride, or sodium fluoride and EDTA, or only sodium fluoride
gray top
what kind of test are done on a gray top
glucose test
multiple sample needles
vacuum collection tubes
multiple tube changes
true or false: the smaller the gauge of needle the bigger the needle is
true
how should the safety of needle be put on
against a hard surface
what is the most commonly used intravenous device
butterfly needle
where would you discard used needles and broken glass
sharps container
function of tourniquets
provide a barrier to slow down venous flow
what kind of glove do phlebotomist use
non latex
what would you use to collect baby blood
lancets
put these in order:
- labeling sample and use of transport containers
- post draw patient assessment
- choosing a venipuncture method
- hand hygiene after the procedure
- sample collection and order of draw
- activating safety device and discarding contaminated supplies
3, 5, 6, 1, 2, 4
true or false: you should not explain the procedure to the patient before you take their blood
false
how many identifiers are used when ID a patient
2
what are the most common sites for blood to be drawn
median cubital vein
cephalic vein
basilic vein
where is the cephalic vein located
outer edge of arm/ thumb side
where is the basilica vein located
inner edge of arm/ pinky side
where would you take blood from if the veins in the arm are destroyed
hand
what should you do if the veins are not palpable
warm the puncture site
what is the most common/economical venipuncture method
evacuated tube method
should you place the tourniquet below or above the puncture site
above
true or false: you can leave a tourniquet on for more than a min
false
what is 1 inversion
going upside down and then returning upright
true or false: it is ok to prelabel tubes
false
put these in order: end of venipuncture procedure
- sanitize hands again
- apply an adhesive bandage if the patient is agreeable
- thank the patient
- check the puncture site to make sure that the bleeding stopped
- remove or appropriately discard supplies and equipment that were brought in
- ensure that all tubes are appropriately labeled
4, 2, 6, 1, 5, 3
what do mastectomy patient have in their blood
more lymph and waste products
what kind of patients use dermal puncture
kids, burn, obese, cancer patients, at home testing
true or false: you should use a dermal puncture when sites are swollen
false
true or false: you shouldn’t use a dermal puncture when large amounts of blood are being drawn
true
true or false: you should use a dermal puncture when a patient is dehydrated
false
true or false: you shouldn’t use a dermal puncture when a patient has poor peripheral circulation
true
what kind of test cannot be drawn by dermal puncture
coagulation studies
blood cultures
erythrocyte sedimentation rate (ESR)
what kind of blood is composed of capillary, arteriole, venule blood and intracellular and interstitial fluid
capillary blood
true or false: capillary blood is more like arterial blood than venous blood
true
where should you puncture the skin for a dermal puncture (hand)
slightly off-center of the fleshy part of the middle or ring finger
where should you puncture the skin for a dermal puncture (foot)
edges of the heel
true or false: it is ok to test the first drop of blood in a dermal puncture
false
is the conc of glucose higher in capillary or venous blood
capillary
is the conc of potassium, total protein, and calcium lower in capillary or venous blood
capillary
true or false: you can use heparinized tubes for dermal puncture
false
if the paperwork and the specimen id don’t match up which one do you follow
the specimen id
what are the 3 reasons why we transfuse
- oxygen carrying capacity
- blood volume
- coagulation factors
what kind of blood is not really used in the U.S. for transfusion
whole blood
what kind of patient would need a whole blood transfusion
trauma
whole blood needs to be stored at ____ C, ______ life, ___ effective coagulation factors
1-6
shortened
less
when whole blood is separated and a patient is given the separated parts from all different people instead of 1. What happens to the risk for the patient.
goes up
what kind of blood is typically given to patients?
packed RBCs
true or false: packed RBCs are not heavily monitored at 1-6 C
false
Can whole blood or packed RBCs be stored the longest
packed RBCs
what do packed RBCs do to the patient when they are transfused?
provides O2 carrying
how long can plasma be stored
1 year frozen
why would you transfuse plasma into a patient
blood volume
what do platelets make in the body when there is a cut
scab
how long can platelets be stored
5-7 days
why do platelets need to constantly agitated
so they don’t make a plug
why would a patient be given platelets
help with patient clotting due to low platelet count
what is the criteria for blood donors
Healthy/ feeling well
at least 16/17 yrs old
weigh 110 lbs
what are antibodies
immunoglobulins
when are antibodies made
in response to foreign antigen exposure
explain RBC antibodies
naturally-occurring
immune based on antigenic stimulus
substance the immune system recognizes as foreign
can elicit an immune response
antigen
examples of RBC antigens
proteins
glycoproteins
glycolipids
where do antibodies bind to
specific portion of the target antigen (epitope)
when an antibody and an antigen bind what is it called
antigen-antibody complex
what kind of immune response: antibody develops after 1st exposure to antigen
primary
what kind of immune response: latent period of few days – months before Ab detected
primary
what kind of immune response: IgM Ab prod. first, then IgG
primary
what kind of immune response: Lower titer of total Ab produced
primary
what kind of immune response: Antibody response to 2nd/subsequent exposure to same Antigen
secondary
what kind of immune response: IgM made first; rapidly replaced by IgG
secondary
what kind of immune response: increased titer of IgG (& total Ab prod.)
secondary
what kind of immune response: Antibodies have higher avidity for the Ag; elicited by lower dose of Ag
secondary
what kind of immune response: Appears rapidly (1-3 d) after Ag exposure; persists longer due to amplification of T & B memory cells
secondary
what are the 3 characteristics of IgG and IgM
complement fixation
agglutinating antibody
optimum reaction temp
term? antibody- mediated clumping of particles that express surface antigens
agglutination
when does RBC agglutination occur
when antibodies bind to antigens on adjacent RBC forming visible aggregates
what are the 2 stages of agglutination
sensitization lattice formation (agglutination)
what happens in the sensitization stage of agglutination
antibody attaches to antigen on RBC mmb
Ag-ab complex forms (no visible agglutination)
what happens in the lattice formation stage of agglutination
multiple Ag- Ab bridges form between sensitized RBCs (visible agglutination)
true or false: if you have the antigen you don’t have the antibody
true
what are the 2 ways to test ABO grouping
tube or gel test
during a gel test for ABO grouping if the blood is neg what happens
goes to the bottom
which blood group is recessive
O
where are antigens located
on the cell
where are antibodies located
in serum
when forward ABO testing is used what is being found
antigens
when reverse ABO testing is used what is being found
antibody
what kind of media enhances the growth of most
non-selective
what kind of media enhances growth of some, suppresses growth of others
selective
what kind of media different organisms appear differently on this type of media, generally through color
differential
what kind of plate is no-selective, trypiticase soy agar, snf blood
blood agar plate
what kind of plate is non-selective, enriched, and heated rbcs
chocolate agar
what kind of plate test lactose
macConkey agar
on a macConkey agar plate if bacteria is lactose positive what color will it turn?
pink
on a macConkey agar plate if bacteria is lactose negative what color will it turn?
clear
what is the basic equipment for growing bacteria
- loop
- incinerator
- media
what does aseptic mean
absence of germs
true or false: you should flame the loop between each streaking
true
what is the most common temp for bacteria growth
35-37 C
what is the most common ph for bacteria growth
6.5-7.5
what color do gram positive cells remain
purple/blue
what color do gram negative cells remain
pink/red
what does staph look like under a microscope
clusters
what does strep look like under a microscope
chains
true or false: late id of micro will guild therapy
false
what is empiric therapy
antibiotics
what does it mean if there is a clear zone around disc with antibiotic in the plate
bacteria is sensitive to that antibiotic
what does it mean if there is a growth around disc with antibiotic in the plate
bacteria is resistant to that antibiotic
true or false: new antibiotics are being made much more today
false
what does overuse of an antibiotic lead to
resistance
what do antibiotics work on
viruses
what kind of media is bacteria grown on
agar
what is gram stain based on
cell wall
