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Unit 1 Flashcards

1
Q

A quantitative science that is concerned with measurement of amounts of biologically important substances (analytes) in body fluids.

A

CLINICAL CHEMISTRY

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2
Q

__________________ are analyzed in the laboratory while the substances in them (________) are measured and quantified

A

specimens or samples are analyzed in the laboratory while the substances in them (analytes) are measured and quantified

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3
Q

When an individual test is not sufficient to assess the medical condition of the patient, combination of several test may be used, which is known as

A

“Panel or profile”

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4
Q

CATEGORIES OF FASTING PLASMA GLUCOSE:

FPG 70-99 mg/dL (3.9-5.5 mmol/L)

A

Normal fasting glucose

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5
Q

CATEGORIES OF FASTING PLASMA GLUCOSE:

FPG 100-125 mg/dL (5.6-6.9 mmol/L)

A

Impaired fasting glucose

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6
Q

CATEGORIES OF FASTING PLASMA GLUCOSE:

FPG ≥ 126 mg/dL (≥ 7.0 mmol/L)

A

Provisional diabetes diagnosis

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7
Q

True or false

Impaired fasting glucose is not a clinical entity but an indication that the patient is at risk of having diabetes mellitus

A

True

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8
Q

True or false

Provisional diabetes diagnosis means the patient has diabetes mellitus

A

True

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9
Q

purpose of a Clinical Chemistry Laboratory

A

to facilitate the correct performance
of analytic procedures.

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10
Q

True or false

It is the role of the medical laboratory scientist/medical technologists to produce results with utmost accuracy and reliability

A

True

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11
Q

True or false

Achievement of accurate and reliable results is anchored into the idea that medical technologist is able to understand fundamental concepts critical to any analytic procedures

A

True

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12
Q

Two components of a quantitative laboratory result

A

Actual value
Unit of expression

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13
Q

describes the numeric value

A

Actual value

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14
Q

describes the physical quantity or dimension (e.g.
mass, volume, length or time)

A

Unit of expression

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15
Q

■ Adopted internationally in 1960
■ Preferred in scientific literature and
clinical laboratories
■ Based on metric system
■ The ONLY system used in many
countries

A

Système Internationale d’Unités (SI)

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16
Q

Seven basic SI units

A

Length
Mass
Time
Electric Current
Thermodynamic Temperature
Amount of substance
Luminous intensity

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17
Q

● from the mathematical derivation of one of basic units
● Katal is derived from SI units, mole and second
■ Expressed as mol/s

A

SELECTED DERIVED UNITS

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18
Q

SELECTED DERIVED UNITS

A

Frequency
Force
Celsius temperature
Catalytic activity

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19
Q

● Widely used and become acceptable for use with basic SI units and selected derived units
● Commonly used and also accepted as one of the SI units

A

SELECTED ACCEPTED NON-SI

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20
Q

SELECTED ACCEPTED NON-SI

A

Minute(time)
Hour
Day
Liter(volume)
Angstrom

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21
Q

PREFIXES USED WITH SI

A

atto
Femto
Pico
Nano
Micro
Milli
Centi
Deci
Liter/meter/gram
Deka
Hecto
Kilo
Mega
Giga
Tera
Peta
Exa

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22
Q

____________ in the containers are already prepackaged as a unit . These may require addition of water or buffer to the solid or powder prepackaged reagent

A

Reagents

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23
Q

Varying grades of purity
Analytic reagent grade (AR) and ultrapure
○ Best for lab use

A

Chemicals

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24
Q

CHEMICALS USED FOR REAGENT PREPARATION

A

Analytic Reagent (AR) Grade
Ultrapure Reagent
Chemically Pure (CP)/ Pure Grade
Technical/ Commercial Grade

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25
Q

● Important of quantitative and qualitative analysis
● For trace metal analysis and preparation of standard solution
○ Used for calibration of instruments
● Must meet specifications set of the American Chemical Society (ACS)
● Must have labels with the initials AR or ACS or the term For laboratory use or ACS Standard-Grade Reference Materials
○ If these labels are printed in the storage containers, it means that the chemical is analytic reagent

A

Analytic Reagent (AR) Grade

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26
Q

● Put through additional purification procedures
● For use in specific procedures such as chromatography, atomic absorption, immunoassays, and molecular diagnostics
● Labels – with designations of HPLC (high performance liquid chromatography) or chromatographic

A

Ultrapure Reagent

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27
Q

● Impurity limitations are not stated and preparation is not uniform
● Not recommended for research & analytical chemistry
● Purity is assessed by measurement of melting point or boiling point
○ Since impurity limitations are not stated

A

Chemically Pure (CP)/ Pure Grade

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28
Q

● Primarily used in manufacturing
● Should never be used in the clinical laboratory
● United States Pharmacopoeia (USP) and National
Formulary (NF)
○ Drug manufacturing

A

Technical/ Commercial Grade

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29
Q

A major source of safety information for employees

A

MATERIAL SAFETY DATA SHEET (MSDS)

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30
Q

A major source of safety information for employees

A

MATERIAL SAFETY DATA SHEET (MSDS)

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31
Q

Requires that all employees have a right to know all about the chemical hazards present in their workplace

A

OSHA Federal Hazard Communication Standard

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32
Q

Information contained in an MSDS

A

● Physical and chemical characteristics
● Fire and explosion potential
● Reactivity potential
● Health hazards and emergency first aid procedures

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33
Q

Who is responsible in providing a copy of the MSDS to the purchasing laboratories or units

A

Chemical Manufacturer

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34
Q
  • Solution containing known concentration of a
    particular chemical or analyte
  • Used to calibrate instruments used for colorimetric, electrochemical, turbidimetric, & other analytical measurements
  • Used to calibrate instruments in any analytic procedure
A

STANDARD SOLUTION/ STANDARDS

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35
Q

● Highly purified chemical that can be measured directly to produce substance of exact known concentration & purity
● American Chemical Society (ACS) purity tolerances –100 ±0.02%

A

PRIMARY STANDARD

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36
Q

certified the use of standard reference materials (SRMs) instead of ACS primary standards

A

National Institute of Standards and Testing (NIST)

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37
Q

Substance of lower purity, with its concentration determined by comparison with primary standard

A

SECONDARY STANDARD

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38
Q

two (2) organizations providing guidelines for proper chemical selection and reagent preparation

A

○ College of American Pathologists (CAP)
○ Clinical and Laboratory Standards Institute (CLSI)
■ Formerly the National Committee for Clinical Laboratory Standards (NCCLS)

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39
Q

most frequently used reagent in clinical laboratory

A

Water

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40
Q

It is used:
- To prepare reagents
- As diluent for controls and standards
- To flush and clean the internal components of analyzers or of instruments in the Clinical Chemistry laboratory
- To wash and rinse laboratory glassware (cluster purity)
-For most of uses, water must be of highest purity
-The water required for rinsing laboratory glassware can be of lesser purity

A

Water

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41
Q

True or false

Labs use reagent grade water

A

True

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42
Q

6 types of reagent grade water (CLSI):

A

Clinical laboratory reagent water (CLRW)
Special reagent water (SRW)
Instrument feed water
Water supplied by method manufacturer
Autoclave and wash water
Commercially bottled purified water

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43
Q

Water specification:

○ For test methods or analytical procedures
requiring minimum interference

A

Type 1

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44
Q

Water specification:

■ Hematology, Microbiology, Immunology, and
Chemical analysis
■ Reagent, quality control, and standard
preparation

A

Type 2

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45
Q

Water specificqtion:

■ UA (urinalysis), Parasitology, and Histology
■ Glassware washing

A

Type 3

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46
Q

MONITORING WATER PURITY

A

Resistivity - > 10 MΩ (megaohms)
Bacterial content (count)
pH
Silica Content
Organic contaminants

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47
Q

uses activated charcoal to remove organic materials and a submicron filter or a filter that would remove substances larger than the filter’s pores

A

Prefiltration

48
Q

This method is the oldest method of water purification

A

Distillation

49
Q
  • Uses pressure (high pressure) to force water through a semi permeable membrane
  • Like distillation method, it does not produce type 1 water alone but if additional filter (ion exchange and carbon filters) are added to the system, a type 1 water may be produced
A

Reverse osmosis

50
Q

This method uses bead-like resin materials (ion
exchange resins (cation resin and anion resin))

A

Deionization

51
Q

True or false

A reagent grade water can be obtained by initially filtering it to remove particulate matter (prefiltration), followed by reverse osmosis, deionization, and a 0.2 mm filter or more restrictive filtration process

A

True

52
Q

True or false

Glasswares used in heating during experiments are more prone in breakage.

A

True

53
Q

True or false

Knowing the usage of the different glasswares helps in preventing breakage.

A

True

54
Q

TYPES OF GLASSWARE

A

Borosilicate Glass
Corex
Vycor
Low Actinic Glass
Standard Flint Glass

55
Q

Types of glassware:

● Most common type of glassware in volume measurement.
● High degree of thermal resistance, has a low alkali content, and free from the magnesium-lime zinc group of elements, heavy metals, arsenic, and antimony.
o Example: Pyrex and Kimax

A

Borosilicate Glass

56
Q

Types of glassware:

● A special alumina-silicate glass that has been strengthened chemically rather than thermally.
● Characterized by a high degree of chemical resistance.
● 6 times stronger than borosilicate.

A

Corex

57
Q

Types of glassware:

● Recommended use for applications involving high temperature, drastic heat shock, and extreme chemical treatment with acid and alkali.
● Acid and alkali resistant.

A

Vycor

58
Q

Types of glassware:

● High thermal resistance
● Amber or red color added as an integral part of the glass.
● Gives maximum protection to light sensitive material (bilirubin)
o Reagent bilirubin can be placed in a low actinic glass.
o Commonly used to store control material and
reagents

A

Low Actinic Glass

59
Q

Types of glassware:

● Made up of soda-lime glass and a mixture of calcium, silicon, and sodium oxides.
● Poor resistance to high temperatures.

A

Standard Flint Glass

60
Q

TYPES OF PLASTICWARE

A

Polypropylene
Polyethylene
Polystyrene
Teflon

61
Q

Types of plasticware:

● Flexible or rigid, is chemically resistant, and can be autoclaved.
● Used in the manufacturing of plastic pipet tips, specimen tubes, and test tubes.
o Usually used in the Clinical Microscopy.
● Can withstand temperatures down to -190 degree
Celcius.

A

Polypropylene

62
Q

Types of plasticware:

● Used in the manufacturing of test tubes, bottles, graduated ubes, stoppers, disposable transfer pipette, volumetric pipette, and test tube racks.

A

Polyethylene

63
Q

Types of plasticware:

● Used to manufacture capped graduated tubes and test tubes.
● Rigid, clear type of plastic which should not be autoclaved
● WIll crack and splinter when crushed
● Not resistant to hydrocarbons, ketones, and alcohols

A

Polystyrene

64
Q

Types of plasticware:

● For manufacturing stirring bars, tubing, cryogenic vials, and bottle cap liners
● -270 degree Celcius to +255 degree Celcius
● Resistant to a wide range of chemical classes

A

Teflon

65
Q

Most commonly used in measuring or graduated pipette in Clinical Chemistry

A

Serologic and Mohr Pipette

66
Q

VOLUMETRIC LABORATORYWARE

TYPES ACCORDING TO DESIGN:

A

To Contain (TC)
To Deliver (TD)

67
Q

● Contains necessary volume but do not deliver exact volume, due to tendency of fluids to cling to glass surface
o Holds/contains particular volume but does not
● dispense the exact volume
● Often referred to as rinse-out pipet
● Sahli hemoglobin and Lang-Levy pipette

A

To Contain (TC)

68
Q

● Will deliver the exact volume
o Dispenses exact volume into the receiving
vessel o Small amount left in the tip should
not be blown out
● Mohr, serologic and volumetric pipets

A

To Deliver (TD)

69
Q

VOLUMETRIC LABORATORYWARE

TYPES ACCORDING TO DRAINAGE
CHARACTERISTICS

A

Blowout Pipette
Self-draining Pipette

70
Q

● Has a continuous etch ring or two small, close, continuous rings located near the top of the pipette.
● Last drop of liquid should be expelled into the receiving vessel

A

Blowout Pipette

71
Q

● No etched rings or markings.
● Allow the content of the pipette to drain gravity.

A

Self-draining Pipette

72
Q

VOLUMETRIC LABORATORYWARE

TYPES ACCORDING TO PURPOSE:

A

Measuring or Graduated pipette
Transfer Pipette

73
Q

(Measuring or Graduated pipette)

does not have graduation to the tip; self-draining pipette, but tip should not be allowed to touch vessel while piper is draining.

A

Mohr Pipette

74
Q

(Measuring or Graduated pipette)

has graduation marks to the tip; a blowout pipette.

A

Serologic Pipette

75
Q

(Measuring or Graduated pipette)

total holding volume of less than 1 ml; may be designed as either Mohr or Serologic Pipette.

A

Micropipette:

76
Q

Designed to dispense one volume without further subdivision

A

Transfer Pipette

77
Q

(Transfer Pipette)

▪ Bub-like enlargement near the tip of pipette stem.
▪ for biologic fluids having a viscosity greater than water.
▪ a blowout pipette

A

Oswald-Folin

78
Q

(Tranfer Pipette)

▪ Has bulb enlargement midway In stem of pipette, near upper tip.
▪ To dispense or transfer aqueous solutions.
▪ A self-draining; used when diluting standards, calibrator, or quality control material.

A

Volumetric Pipette

79
Q

(Transfer Pipette)

▪ Does not have calibration marks
▪ Used to transfer solution or biologic fluids without consideration of a specific volume.

A

Pasteur Pipette

80
Q

(Transfer Pipette)

▪ Fixed volume: pipette associated with only one volume
▪ Variable: able to select different volume

A

Automatic Pipette

81
Q

Type of automatic pipette that relies on piston for suction draw to draw the sample into the disposable tip and must be changed after use.

A

Air-displacement

82
Q

Type of automatic pipette that operate like a hypodermic syringe, does not require a different tip for each use unlike for air- displacement pipette.

A

Positive-displacement

83
Q

automatic pipette that collects liquid from a common reservoir, and dispenses it to the receiving vessel.

A

Dispenser and diluter

84
Q

(TYPES OF THERMOMETER)

use a colored liquid (red etc.) or mercury in plastic or glass material with a bulb and a graduation scale.

A

Liquid-in glass thermometers

85
Q

(Types of Liquid-in glass thermometer)

immersed to the proper height or defined depth indicated in the thermometer.
■ Use to heating blocks and water baths

A

Partial immersion

86
Q

(Types of Liquid-in glass thermometer)

they have a bulb and the entire column of the liquid should be immersed to the medium being measured.
■ Use to: Refrigerators and freezers.

A

Total immersion

87
Q

(Types of thermometer)

It converts changes in temperature into resistance (transducer)

A

Electronic thermometer/thermistor probe

88
Q

(Types of thermometer)

a fast and easy thermometer that is used today. Used in clinical laboratories today

A

Digital thermometer

89
Q

● Most commonly used method of separating solid matter from a liquid suspension
● Uses centrifugal force
● A process in which centrifugal force is used to
separate solid matter from a liquid suspension.
● Most commonly used separation technique in
laboratory

A

Centrifugation

90
Q

Refers to the centrifugal force generated
○ Depends on the three important variables (mass, speed, and radius)

A

Relative Centrifugal Force (RCF) or Gravity (g)

91
Q

(Types of centrifuge)

  • Also known as Swinging Bucket Type
  • Centrifuge tubes are held in a vertical position when not moving but horizontal when the centrifuge is fully in motion.
  • Recommended for Serum Separator Tubes (SSTs)
A

Horizontal Head Centrifuge

92
Q

(Types of centrifuge)

Has a fixed 25-52° angle at which tubes are held during centrifugation

A

Angle-Head Centrifuge

93
Q

(Types of centrifuge)

○ Generates the highest speeds among all types
○ Useful for lipoprotein analysis tests
■ High Density Lipoprotein (HDL)
■ Low Density Lipoprotein (LDL)
■ Chylomicrons
■ Very Low Density Lipoprotein Fraction
○ Usually refrigerated centrifuge

A

Ultracentrifuge

94
Q

UNBALANCED CENTRIFUGE can cause ____________

A

UNBALANCED CENTRIFUGE can cause VIBRATION

95
Q

Tubes are placed in the centrifuge in a
_____________ position

A

Tubes are placed in the centrifuge in a
counterbalanced position.

96
Q

True of false

The tubes must be equal in volume and weight.

A

True

97
Q

● Used only occasionally in labs today
● Paper is folded and fitted into funnel; solution (filtrate) drains through filter into receiving vessel.

A

Filtration

98
Q

● Popularized in the 1970s
● The process of _________:
○ Solution is put in bag or on one side of semipermeable membrane
○ Larger molecules remain in bag or on one side of membrane; smaller molecules and solvents are diffused out
● A time-consuming technique
● Occasionally performed in labs today

A

Dialysis

99
Q

Both liquid portion (plasma) and cellular components (red and white blood cells, platelets)

A

Whole Blood

100
Q

Clear yellow supernatant present in anticoagulated tubes; liquid called fibrinogen (used for clot formation).

A

Plasma

101
Q

● Remaining liquid after clotting.
● If you utilize a tube without
anticoagulant, yellow fluid that settles on top after centrifugation

A

Serum

102
Q

To measure or determine blood gasses and pH.

A

Arterial blood

103
Q

Urine creatinine: example of test utilizing urine sample.

A

Urine

104
Q

● Collected by lumbar puncture or spinal tap
● CSF Protein and CSF Glucose

A

CSF

105
Q

Pleural test/s: fluid example
● Pleural fluid cholesterol
● Pleural fluid triglycerides
● Pleural fluid glucose

Pericardial fluid example test/s:
● Detection of the enzyme adenosine deaminase

Peritoneal fluid example test/s:
● Peritoneal fluid glucose
● Peritoneal fluid alkaline phosphatase
● Peritoneal fluid amylase

Amniotic fluid example test/s:
● Amniotic fluid bilirubin

A

Serous fluids

106
Q

Factors to be checked before processing samples

A

○ Volume considerations
○ Use of appropriate anticoagulants or preservatives
○ Timing
○ Properly transported

107
Q

(3 distinct phases of centrifugation)

● Ideally, all measurements should be performed within 45 minutes to 1 hour.
● Plasma or serum is preferred for most biochemical determinations.
○ Serum: most common specimen of choice
● Plasma: centrifuge blood within 1 hour after collection for 10 minutes at a RCF of 850-1000x gravity.
● Serum or plasma must be stored at 4oC to 6oC
● If analysis is to be delayed for longer than 4 hours.
● Refrigeration is temporary

A

Pre-centrifugation

108
Q

(3 distinct phases of centrifugation)

● Utilizes centrifuge
● A centrifuge uses centrifugal force to separate phases of suspensions by different densities.
● Centrifuge is most frequently used in processing blood to derive plasma or serum fractions.
● Re-centrifugation of gel separator tubes has been associated with pseudo hyperkalemia.
○ False increase in serum or plasma potassium concentrations
○ One study demonstrated that after initial centrifugation, a new serum will develop under the gel within the cellular layer

A

Centrifugation

109
Q

(3 distinct phases of centrifugation)

● Serum or plasma should be separated from the cells immediately.
● If analysis is to be delayed, you have to store the sample at If analysis is to be delayed, you have to store the sample at 4oC to 6oC.

A

Post-centrifugation

110
Q

It is a legal document that describes how evidence is handled from the time it is acquired and through all subsequent examinations and storage.

A

Chain of custody

111
Q

According to the chain of custody, any individual in contact with the sample must document:

A

○ Receipt of the sample
○ Condition of the sample at the time of receipt
○ Date and time it was received

112
Q

Minimum Elements of Paper or Electronic Patient Reports:

A

○ Name and address of laboratory performing the analysis including any reference laboratories used.
○ Patient name and identification number or unique identifier.
○ Name of physician or person ordering the test.
○ Date and time of specimen collection.
○ Date and time of release of results (or available if needed).
○ Specimen source or type.
○ Test results and units of measure if applicable.
○ Reference ranges, when available.
○ Comments relating to any sample or testing
interferences that may alter interpretation.

113
Q

Physiological factors affecting chemistry analytes

A

Diet
Medication or herbal supplements
Circadian rhythm
Timing of collection

114
Q

Patient preparation factors affecting chemistry analytes

A

Patient posture
Fasting
24-hour urine collection

115
Q

Collection and sample processing factors affecting chemistry analytes

A

Venipuncture technique
Tube selection
Tourniquet use
Specimen transport and storage

CC1 (1 decks)

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