1- BASIC PRINCIPLES AND PRACTICES

Question 1

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

Answer 1

CLINICAL CHEMISTRY

Question 2

Examples of analytes in CC

Answer 2

 Ions, salts and minerals
 Metabolites
 Therapeutic drugs
 Drugs of abuse
 Proteins
 Enzymes
 Lipoproteins
 Diabetes marker

Question 3

Specific samples of analytes that are Ions, salts and minerals

Answer 3

potassium, sodium, calcium, chloride, phosphorus, lead, iron

Question 4

Specific samples of analytes that are Metabolites

Answer 4

glucose, urea, bilirubin, creatinine, triglycerides, cholesterol

Question 5

Specific samples of analytes that are Therapeutic drugs

Answer 5

digoxin, vancomycin, theophylline, phenytoin, valproic acid

Question 6

Specific samples of analytes that are Drugs of abuse

Answer 6

cocaine, barbiturates, amphetamines, opiates, cannabinoids

Question 7

Specific samples of analytes that are Proteins

Answer 7

albumin, haptoglobin, transferrin,
ferritin

Question 8

Specific samples of analytes that are Lipoproteins

Answer 8

Lipoprotein (a), HDL, LDL

Question 9

Specific samples of analytes that are Enzymes

Answer 9

alanine aminotransferase, aspartate aminotransferase, amylase, lipase

Question 10

Specific samples of analytes that are Diabetes marker

Answer 10

Hemoglobin A1c

Question 11

It is to be remembered that ________ are analyzed in the laboratory while the __________ are measured and quantified

Answer 11

specimens or samples
analytes

Question 12

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

Answer 12

Panel or profile

Question 13

Panel or profile examples

Answer 13

Hepatic Panel (Liver Profile)
Lipid Profile

Question 14

These tests are used to determine hepatic
dysfunction or hepatic damage

Answer 14

Hepatic panel

Question 15

Which analytes are quantified in a Hepatic Panel (Liver Profile)

Answer 15

Albumin
Total Protein
Alkaline phosphatase
Alanine aminotransferase
Aspartate aminotransferase
Total Bilirubin
Direct Bilirubin

Question 16

Which analytes are quantified in a Lipid Profile

Answer 16

Total Cholesterol
LDL Cholesterol
HDL Cholesterol
Triglycerides

Question 17

Results of clinical chemistry tests are compared to what in order to determine if it is normal

Answer 17

reference intervals or a medical decision level (MDL)

Question 18

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

Answer 18

Impaired fasting glucose

Question 19

MDL that means the patient has
diabetes mellitus

Answer 19

Provisional diabetes diagnosis

Question 20

Normal Fasting Glucose range

Answer 20

FPG 70-99 mg/dl
3.9 - 5.5 mmol/L

Question 21

Impaired Fasting Glucose range

Answer 21

FPG 100-125 mg/dl
5.6-6.9 mmol/L

Question 22

Provisional Diabetes Diagnosis ranged

Answer 22

FPG >126 mg/dl
>7.0 mmol/L

Question 23

2 components of a quantitative laboratory result

Answer 23

Actual value
Unit of expression

Question 24

components of a quantitative laboratory result that describes the numeric value

Answer 24

Actual value

Question 25

components of a quantitative laboratory result that describes the physical quantity or dimension (e.g. mass, volume, length or time)

Answer 25

Unit of expression

Question 26

o Adopted internationally in 1960 o Preferred in scientific literature and clinical laboratories o Based on metric system o Only system used in many countries

Answer 26

Système Internationale d’Unités (SI)

Question 27

a compound or mixture added to a system to start or test a chemical reaction

Answer 27

reagent

Question 28

Type of chemicals that are best for lab use

Answer 28

Analytic reagent grade (AR) and ultrapure

Question 29

CHEMICALS USED FOR REAGENT PREPARATION

Answer 29

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

Question 30

o Must meet specifications set of the American Chemical Society (ACS) o Must have labels with the initials AR or ACS or the term For laboratory use or ACS Standard-Grade Reference Materials

Answer 30

Analytic Reagent (AR) Grade

Question 31

Analytic Reagent (AR) Grade are commonly used for?

Answer 31

calibration of instruments

Question 32

In which analysis do we use analytic reagent grade

Answer 32

For trace metal analysis and preparation of standard solution

Question 33

chemical grade that is put through additional purification procedures

Answer 33

Ultrapure Reagent

Question 34

Ultrapure Reagent for use in specific procedures such as

Answer 34

chromatography, atomic absorption, immunoassays, and molecular diagnostics

Question 35

Labels attached to ultrapure reagents

Answer 35

with designations of HPLC (high performance liquid chromatography) or chromatographic

Question 36

Impurity limitations are not stated and preparation is not uniform Not recommended for research & analytical chemistry

Answer 36

Chemically Pure (CP)/ Pure Grade

Question 37

Since impurity limitations of chemically pure/ pure grade reagents are not stated, Purity is assessed by measurement of

Answer 37

melting point or boiling point

Question 38

o Primarily used in manufacturing o Should never be used in the clinical laboratory

Answer 38

Technical/ Commercial Grade

Question 39

Technical/Commercial grade is handled by

Answer 39

United States Pharmacopoeia (USP) and National Formulary (NF)

Question 40

Technical/Commercial grade is primarily used for

Answer 40

Drug manufacturing

Question 41

A major source of safety information for employees OSHA Federal Hazard Communication Standard Requires that all employees have a right to know all about the chemical hazards present in their workplace

Answer 41

MATERIAL SAFETY DATA SHEET (MSDS)

Question 42

Information contained in an MSDS includes the following:

Answer 42

o Physical and chemical characteristics o Fire and explosion potential o Reactivity potential o Health hazards and emergency first aid procedures  When there will be splattering or splashing, what are the emergency first aid procedures o Methods for safe handling and disposal o Primary routes of entry o Exposure limits and carcinogenic potential

Question 43

Solution containing known concentration of a particular chemical or analyte

Answer 43

Standard solution/ Standards

Question 44

Highly purified chemical that can be measured directly to produce substance of exact known concentration & purity

Answer 44

Primary Standard

Question 45

Primary Standard American Chemical Society (ACS) purity tolerances

Answer 45

100±0.02%

Question 46

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

Answer 46

National Institute of Standards and Testing (NIST)

Question 47

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

Answer 47

SECONDARY STANDARD

Question 48

 Composed of the glucose reagent and the glucose standard  used when performing enzymatic method of glucose determination o Glucose oxidase method of glucose determination

Answer 48

Glucose (oxidase) liquid reagent

Question 49

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

Answer 49

o College of American Pathologists (CAP) o Clinical and Laboratory Standards Institute (CLSI)

Question 50

Clinical and Laboratory Standards Institute (CLSI) Formerly known as the

Answer 50

National Committee for Clinical Laboratory Standards (NCCLS)

Question 51

most frequently used reagent in clinical laboratory

Answer 51

Water

Question 52

Water is used

Answer 52

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)

Question 53

Labs use what grade of water

Answer 53

Reagent grade water

Question 54

6 types of reagent grade water (CLSI):

Answer 54

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

Question 55

Can be of use in place of Type 1 and Type 2 water

Answer 55

Clinical laboratory reagent water (CLRW)

Question 56

Satisfactory replacement for Type 3 water

Answer 56

Autoclave and wash water

Question 57

Water For test methods or analytical procedures requiring minimum interference

Answer 57

Type 1

Question 58

Type 1 water is used for test like

Answer 58

Flame photometry, AAS (Atomic Absorption Spectrometry) blood gases and pH (analysis) enzyme studies electrolyte testing HPLC (high performance liquid chromatography) trace metal and iron studies

Question 59

Water typed used for Reagent, quality control, and standard preparation

Answer 59

Type 2 water

Question 60

type 2 water is usually used in tests like

Answer 60

Hematology, Microbiology, Immunology, and Chemistry analysis

Question 61

Water type used for glassware washing

Answer 61

Type 3

Question 62

Type 3 water is commonly used in

Answer 62

UA (urinalysis), Parasitology, and Histology

Question 63

Indicator of ionic content of purified water

Answer 63

Resistivity

Question 64

Type 1 water must have a resistivity of

Answer 64

> 10 MΩ

Question 65

MONITORING WATER PURITY what factors

Answer 65

Resistivity Bacterial content (count) pH Silica content Organic contaminants

Question 66

Most commonly found organisms after purification process are

Answer 66

gram-negative gut (ex. E. coli)

Question 67

Crystalline compound that is common constituent in rocks, minerals & sand

Answer 67

Silica

Question 68

Organic contaminants

Answer 68

Phenolic compounds, petroleum, pesticides

Question 69

METHODS OF WATER PURIFICATION

Answer 69

Prefiltration Distillation Reverse osmosis Deionization

Question 70

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

Answer 70

Prefiltration

Question 74

Under this method, water is first heated to the boiling point and the water vapor rises to the condenser (glass tube with glass coils) and the vapor is converted to liquid state and then is collected and stored in the storage tank

Answer 74

Distillation

Question 74

This method is the oldest method of water purification’

Answer 74

Distillation

Question 75

Distillation and Reverse osmosis can produce what type of water when additional filtration is added

Answer 75

Type 1

Question 75

Uses pressure (high pressure) to force water through a semi permeable membrane This filter removes 95% to 99% of organic compounds, bacteria and other particulate matter and about 95% of all ionized and dissolved materials

Answer 75

Reverse osmosis

Question 76

This method uses bead-like resin materials (ion exchange resins (cation resin and anion resin))  Ion present in the water sample are exchanged for other ions which are fixed to the beads

Answer 76

Deionization

Question 77

Cation resin: Anion resin:

Answer 77

Cation resin: hydrogen ion (attached to the resin) Anion resin: hydroxyl ion (fixed to the resin)

Question 78

A reagent grade water can be obtained by what specific order of filtration

Answer 78

Prefiltration Reverse osmosis Deionization 0.2mm filter or more restrictive filtration process

Question 79

TYPES OF GLASSWARE

Answer 79

Borosilicate glass Corex Vycor Low actinic glass Standard Flint Glass

Question 80

Most common type of glassware in volume measurement

Answer 80

Borosilicate glass

Question 81

Borosilicate glass is free from which group of elements

Answer 81

magnesium-lime zinc group of elements, heavy metals, arsenic, and antimony

Question 82

Borosilicate glass commercial types

Answer 82

Pyrex and Kimax

Question 83

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

Answer 83

corex

Question 84

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

Answer 84

Vycor

Question 85

o Amber or red color added as integral part of the glass o Gives maximum protection to light sensitive materials (bilirubin)

Answer 85

Low actinic glass

Question 86

Which types of glass has high thermal resistance

Answer 86

Borosilicate glass and Low actinic glass

Question 87

o Made up of soda-lime glass and a mixture of calcium, silicon, and sodium oxides o Poor resistance to high temperature

Answer 87

Standard Flint Glass

Question 88

TYPES OF PLASTICWARE

Answer 88

Polypropylene Polyethylene Polycarbonate Polystyrene Teflon

Question 89

o Flexible or rigid, is chemically resistant, and can be autoclaved o Used in the manufacturing of plastic pipet tips, specimen tubes, and test tubes o Can withstand temperatures down to - 190ᵒC

Answer 89

Polypropylene

Question 90

Type of plastic that is Used in the manufacturing of test tubes, bottles, graduated tubes, stoppers, disposable transfer pipets, volumetric pipets, and test tube racks

Answer 90

Polyethylene

Question 91

Type of plastic that is o Used to manufacture tubes for centrifugation, graduated cylinders, and flasks o Useable temp range is - 100ᵒC to +160ᵒC

Answer 91

Polycarbonate

Question 92

Type of plastic that is o Used to manufacture capped graduated tubes and test tubes o Rigid, clear type of plastic which should not be autoclaved o Will crack and splinter when crushed o Not resistant to hydrocarbons, ketones, and alcohols

Answer 92

Polystyrene

Question 93

Type of plastic used o For manufacturing stirring bars, tubing, cryogenic vials, and bottle cap liners o -270ᵒC to +255ᵒC o Resistant to a wide range of chemical classes

Answer 93

Teflon

Question 94

Most commonly used measuring or graduated pipet in CC

Answer 94

Serologic and Mohr pipet