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INTRO TO CLINICAL LAB > TEST 1 > Flashcards

TEST 1 Flashcards

1
Q

are CLS non patient facing staff

A

yes

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2
Q

describe what CLS do in one sentance

A

provide clinicians with data to help diagnose the patient

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3
Q

where would you find a clinical lab

A

hospitals

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4
Q

where would you find a research lab

A

academic centers

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5
Q

who federally regulates a clinical lab

A

CMS (centers for medicare services), FDA, and TJC (joint commission)

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6
Q

who federally regulates a research lab

A

grant programs

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7
Q

describe the test that clinical lab can preform

A

FDA approved test

created test that are approved by their medical director

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8
Q

describe the test that research lab can preform

A

design their own test protocol

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9
Q

True or false: results obtained in a clinical lab can be used to diagnosis and treat a patient

A

true

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10
Q

True or false: results obtained in a research lab can be used to diagnosis and treat a patient

A

false

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11
Q

which kind of lab has the quickest results

A

clinical lab

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12
Q

what type of regulation is voluntary

A

accreditation

certification

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13
Q

what type of regulation is mandatory

A

licensure

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14
Q

what type of regulation is non governmental

A

accreditation

certification

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15
Q

what type of regulation is gov’t agency

A

licensure

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16
Q

name of legislation to establish quality standards for all lab testing

A

CLIA 1988

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17
Q

describe lab testing that is waived

A

anyone can do it

results are dummy proof and are not life or death

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18
Q

ex of waived testing

A

pregnancy or glucometer

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19
Q

moderate complexity test

A

run in a lab

no judgment call

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20
Q

high complexity test

A

manually reads data
requires judgment call
ran in lab

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21
Q

ex of high complexity test

A

ph test or dip stick

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22
Q

jobs of the CMS

A

oversight of CLIA ‘88 regulations
inspect lab requesting/recieving payments from medicare and Medicaid
approves accreditation programs
reimbursement

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23
Q

what regulatory agency is the most strict

A

college of American pathologist (CAP)

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24
Q

regulatory agency for hospital wide inspections including the lab

A

the joint commission (TJC)

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25
Q

regulatory agency for transfusion med and regulates market entry of instruments and reagents

A

FDA

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26
Q

what types of samples do clinical pathology look at

A

liquids

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27
Q

what types of samples do anatomical pathology look at

A

bits of human (cells)

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28
Q

what are the branches of clinical pathology

A

chem
hematology
microbio
blood bank

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29
Q

what are the branches of anatomical pathology

A

cytology

histology

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30
Q 
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
A

medical lab assistants

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31
Q

who would preform these tasks:
licensed personnel, patient facing
routine venipuncture

A

phlebotomist

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32
Q 
who would preform these tasks: 
licensed 
aa and 6 months of internship required 
perform waived and moderate testing
can not perform judgement calls
A

medical lab technician

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33
Q

who would preform these tasks:
can perform high complexity testing
bachelors

A

CLS

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34
Q 
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
A

pathologist

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35
Q

who would preform these tasks:
masters degree and internship
performs gross inspection of organs/tissues
autopsies
ID sections of interest and embeds into wax

A

pathologist assistant

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36
Q 
who would preform these tasks: 
certified in CA
receives tissue in wax
uses microtome 
preps and stains slides for pathologist
A

histology technician/ histotochnologist

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37
Q

who would preform these tasks:
BS and internship, licensed
report cellular abnormalities
looks at pap smears

A

cytotechnologist

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38
Q

what kind of license do you have if you can only work in 1 department with a BS and 1 year internship

A

limited license

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39
Q

who studies chromosomes and mostly tumor analysis

A

clinical cytogenetics scientist

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40
Q

histocompatibility

A

make sure organ transplant will be tolerated in the recipient

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41
Q

put these in order:

  1. label blood specimen tubes at the bedside
  2. ID patients correctly
  3. collect blood specimen into the correct containers/tubes
  4. assess patients prior to specimen collection procedures
  5. assess the degree of discomfort, pain, or bleeding
  6. prepare patients accordingly
  7. assess the patient after the specimen collection procedure
A

2, 4, 6, 3, 1, 5, 7

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42
Q

put these in order:

  1. assist in lab testing procedures as needed
  2. select and use appropriate equipment
  3. transport specimens correctly
  4. manipulate small objects, tubes, needles
  5. preform quality control functions
  6. prepare/process the specimen for testing/analysis
A

4, 2, 5, 3, 6, 1

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43
Q

why are there different color tube tops

A

color coded according to the additive

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44
Q

serum

A

blood that clots

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45
Q

plasma

A

yellow liquid

doesn’t clot

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46
Q

what is added to blood so it doesn’t clot

A

anticoagulants

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47
Q

function of anticoagulants

A

extend metabolism and life span of the RBC after collection

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48
Q

what color top is the lowest anticoagulant

A

red

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49
Q

what color top is the highest anticoagulant

A

grey

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50
Q

what is the color order of draw

A 
yellow/red
light blue
gold/blue
light green/ dark green
lavender/ purple/ pink
grey
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51
Q

what color top contains sodium citrate

A

light blue

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52
Q

what kind of test is the light blue top used for

A

coagulation

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53
Q

what is important about the light blue top

A

it is important to get the ratio of blood right for accurate results

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54
Q

what kind of test is red top

A

anticoagulant

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55
Q

what kind of fluid is put in a gold top

A

serum

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56
Q

what color tube has a polymer barrier at the bottom

A

gold top

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57
Q

function of polymer barrier

A

forms a barrier between serum and blood cells

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58
Q

what kind of test are gold top used for

A

chem and immunology

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59
Q

what color top has anticoagulants sodium heparin, ammonium heparin, and lithium heparin

A

green top

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60
Q

what kind of liquid is put into green tops

A

plasma or whole blood

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61
Q

what kind of test should green tops not be used for

A

blood smear on microscope slides

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62
Q

what do purple top chelate

A

Ca

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63
Q

what kind of test are purple tops used for

A

hematological
blood bank
molecular diagnostic test

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64
Q

what does a purple test determine

A

complete blood count

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65
Q

what is in a pink top

A

EDTA

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66
Q

what kind of test is done on a pink top

A

blood bank

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67
Q

what color top contains potassium oxalate and sodium fluoride, or sodium fluoride and EDTA, or only sodium fluoride

A

gray top

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68
Q

what kind of test are done on a gray top

A

glucose test

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69
Q

multiple sample needles

A

vacuum collection tubes

multiple tube changes

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70
Q

true or false: the smaller the gauge of needle the bigger the needle is

A

true

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71
Q

how should the safety of needle be put on

A

against a hard surface

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72
Q

what is the most commonly used intravenous device

A

butterfly needle

73
Q

where would you discard used needles and broken glass

A

sharps container

74
Q

function of tourniquets

A

provide a barrier to slow down venous flow

75
Q

what kind of glove do phlebotomist use

A

non latex

76
Q

what would you use to collect baby blood

A

lancets

77
Q

put these in order:

  1. labeling sample and use of transport containers
  2. post draw patient assessment
  3. choosing a venipuncture method
  4. hand hygiene after the procedure
  5. sample collection and order of draw
  6. activating safety device and discarding contaminated supplies
A

3, 5, 6, 1, 2, 4

78
Q

true or false: you should not explain the procedure to the patient before you take their blood

A

false

79
Q

how many identifiers are used when ID a patient

A

2

80
Q

what are the most common sites for blood to be drawn

A

median cubital vein
cephalic vein
basilic vein

81
Q

where is the cephalic vein located

A

outer edge of arm/ thumb side

82
Q

where is the basilica vein located

A

inner edge of arm/ pinky side

83
Q

where would you take blood from if the veins in the arm are destroyed

A

hand

84
Q

what should you do if the veins are not palpable

A

warm the puncture site

85
Q

what is the most common/economical venipuncture method

A

evacuated tube method

86
Q

should you place the tourniquet below or above the puncture site

A

above

87
Q

true or false: you can leave a tourniquet on for more than a min

A

false

88
Q

what is 1 inversion

A

going upside down and then returning upright

89
Q

true or false: it is ok to prelabel tubes

A

false

90
Q

put these in order: end of venipuncture procedure

  1. sanitize hands again
  2. apply an adhesive bandage if the patient is agreeable
  3. thank the patient
  4. check the puncture site to make sure that the bleeding stopped
  5. remove or appropriately discard supplies and equipment that were brought in
  6. ensure that all tubes are appropriately labeled
A

4, 2, 6, 1, 5, 3

91
Q

what do mastectomy patient have in their blood

A

more lymph and waste products

92
Q

what kind of patients use dermal puncture

A

kids, burn, obese, cancer patients, at home testing

93
Q

true or false: you should use a dermal puncture when sites are swollen

A

false

94
Q

true or false: you shouldn’t use a dermal puncture when large amounts of blood are being drawn

A

true

95
Q

true or false: you should use a dermal puncture when a patient is dehydrated

A

false

96
Q

true or false: you shouldn’t use a dermal puncture when a patient has poor peripheral circulation

A

true

97
Q

what kind of test cannot be drawn by dermal puncture

A

coagulation studies
blood cultures
erythrocyte sedimentation rate (ESR)

98
Q

what kind of blood is composed of capillary, arteriole, venule blood and intracellular and interstitial fluid

A

capillary blood

99
Q

true or false: capillary blood is more like arterial blood than venous blood

A

true

100
Q

where should you puncture the skin for a dermal puncture (hand)

A

slightly off-center of the fleshy part of the middle or ring finger

101
Q

where should you puncture the skin for a dermal puncture (foot)

A

edges of the heel

102
Q

true or false: it is ok to test the first drop of blood in a dermal puncture

A

false

103
Q

is the conc of glucose higher in capillary or venous blood

A

capillary

104
Q

is the conc of potassium, total protein, and calcium lower in capillary or venous blood

A

capillary

105
Q

true or false: you can use heparinized tubes for dermal puncture

A

false

106
Q

if the paperwork and the specimen id don’t match up which one do you follow

A

the specimen id

107
Q

what are the 3 reasons why we transfuse

A
  • oxygen carrying capacity
  • blood volume
  • coagulation factors
108
Q

what kind of blood is not really used in the U.S. for transfusion

A

whole blood

109
Q

what kind of patient would need a whole blood transfusion

A

trauma

110
Q

whole blood needs to be stored at ____ C, ______ life, ___ effective coagulation factors

A

1-6
shortened
less

111
Q

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.

A

goes up

112
Q

what kind of blood is typically given to patients?

A

packed RBCs

113
Q

true or false: packed RBCs are not heavily monitored at 1-6 C

A

false

114
Q

Can whole blood or packed RBCs be stored the longest

A

packed RBCs

115
Q

what do packed RBCs do to the patient when they are transfused?

A

provides O2 carrying

116
Q

how long can plasma be stored

A

1 year frozen

117
Q

why would you transfuse plasma into a patient

A

blood volume

118
Q

what do platelets make in the body when there is a cut

A

scab

119
Q

how long can platelets be stored

A

5-7 days

120
Q

why do platelets need to constantly agitated

A

so they don’t make a plug

121
Q

why would a patient be given platelets

A

help with patient clotting due to low platelet count

122
Q

what is the criteria for blood donors

A

Healthy/ feeling well
at least 16/17 yrs old
weigh 110 lbs

123
Q

what are antibodies

A

immunoglobulins

124
Q

when are antibodies made

A

in response to foreign antigen exposure

125
Q

explain RBC antibodies

A

naturally-occurring

immune based on antigenic stimulus

126
Q

substance the immune system recognizes as foreign

can elicit an immune response

A

antigen

127
Q

examples of RBC antigens

A

proteins
glycoproteins
glycolipids

128
Q

where do antibodies bind to

A

specific portion of the target antigen (epitope)

129
Q

when an antibody and an antigen bind what is it called

A

antigen-antibody complex

130
Q

what kind of immune response: antibody develops after 1st exposure to antigen

A

primary

131
Q

what kind of immune response: latent period of few days – months before Ab detected

A

primary

132
Q

what kind of immune response: IgM Ab prod. first, then IgG

A

primary

133
Q

what kind of immune response: Lower titer of total Ab produced

A

primary

134
Q

what kind of immune response: Antibody response to 2nd/subsequent exposure to same Antigen

A

secondary

135
Q

what kind of immune response: IgM made first; rapidly replaced by IgG

A

secondary

136
Q

what kind of immune response: increased titer of IgG (& total Ab prod.)

A

secondary

137
Q

what kind of immune response: Antibodies have higher avidity for the Ag; elicited by lower dose of Ag

A

secondary

138
Q

what kind of immune response: Appears rapidly (1-3 d) after Ag exposure; persists longer due to amplification of T & B memory cells

A

secondary

139
Q

what are the 3 characteristics of IgG and IgM

A

complement fixation
agglutinating antibody
optimum reaction temp

140
Q

term? antibody- mediated clumping of particles that express surface antigens

A

agglutination

141
Q

when does RBC agglutination occur

A

when antibodies bind to antigens on adjacent RBC forming visible aggregates

142
Q

what are the 2 stages of agglutination

A 
sensitization
lattice formation (agglutination)
143
Q

what happens in the sensitization stage of agglutination

A

antibody attaches to antigen on RBC mmb

Ag-ab complex forms (no visible agglutination)

144
Q

what happens in the lattice formation stage of agglutination

A

multiple Ag- Ab bridges form between sensitized RBCs (visible agglutination)

145
Q

true or false: if you have the antigen you don’t have the antibody

A

true

146
Q

what are the 2 ways to test ABO grouping

A

tube or gel test

147
Q

during a gel test for ABO grouping if the blood is neg what happens

A

goes to the bottom

148
Q

which blood group is recessive

A

O

149
Q

where are antigens located

A

on the cell

150
Q

where are antibodies located

A

in serum

151
Q

when forward ABO testing is used what is being found

A

antigens

152
Q

when reverse ABO testing is used what is being found

A

antibody

153
Q

what kind of media enhances the growth of most

A

non-selective

154
Q

what kind of media enhances growth of some, suppresses growth of others

A

selective

155
Q

what kind of media different organisms appear differently on this type of media, generally through color

A

differential

156
Q

what kind of plate is no-selective, trypiticase soy agar, snf blood

A

blood agar plate

157
Q

what kind of plate is non-selective, enriched, and heated rbcs

A

chocolate agar

158
Q

what kind of plate test lactose

A

macConkey agar

159
Q

on a macConkey agar plate if bacteria is lactose positive what color will it turn?

A

pink

160
Q

on a macConkey agar plate if bacteria is lactose negative what color will it turn?

A

clear

161
Q

what is the basic equipment for growing bacteria

A
  • loop
  • incinerator
  • media
162
Q

what does aseptic mean

A

absence of germs

163
Q

true or false: you should flame the loop between each streaking

A

true

164
Q

what is the most common temp for bacteria growth

A

35-37 C

165
Q

what is the most common ph for bacteria growth

A

6.5-7.5

166
Q

what color do gram positive cells remain

A

purple/blue

167
Q

what color do gram negative cells remain

A

pink/red

168
Q

what does staph look like under a microscope

A

clusters

169
Q

what does strep look like under a microscope

A

chains

170
Q

true or false: late id of micro will guild therapy

A

false

171
Q

what is empiric therapy

A

antibiotics

172
Q

what does it mean if there is a clear zone around disc with antibiotic in the plate

A

bacteria is sensitive to that antibiotic

173
Q

what does it mean if there is a growth around disc with antibiotic in the plate

A

bacteria is resistant to that antibiotic

174
Q

true or false: new antibiotics are being made much more today

A

false

175
Q

what does overuse of an antibiotic lead to

A

resistance

176
Q

what do antibiotics work on

A

viruses

177
Q

what kind of media is bacteria grown on

A

agar

178
Q

what is gram stain based on

A

cell wall

INTRO TO CLINICAL LAB (3 decks)

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