Lab Practical

Question 1

Critical Value

Answer 1

test results that fall significantly outside the normal range & may represent life-threatening values & require urgent medical intervention

Question 2

reporting panic values

Answer 2

should be called within 30 minutes of verifying the test result

Question 3

STAT

Answer 3

emergency testing only

test will be performed as rapidly as possible, generally 60 minutes or less from the time of receipt

Question 4

TIMED

Answer 4

specimens which are require collection at a specific time (peak drug levels) are requested as ‘timed study’
treated as STAT

Question 5

ROUTINE

Answer 5

lab orders not specifically STAT or TIMED & will be processed with a routine priority
most are completed the same day

Question 6

examples of timed draws

Answer 6

cardiac panel- every 4-6 hours

peaks & troughs of drugs

Question 7

time for peak drug draw

Answer 7

1 hour after administration of drug

Question 8

time for trough drug draw

Answer 8

30 minutes prior to administration of drug

Question 9

BMP

Answer 9

glucose
calcium
electrolytes: Na, K, CO2, Cl
kidney tests: BUN, Creatinine

Question 10

CMP

Answer 10

glucose
calcium
proteins: albumin & total protein
electrolytes: Na, K, CO2, Cl
kidney tests: BUN & Creatinine
Liver tests: ALP, ALT, AST, & bilirubin

Question 11

Lipid panel

Answer 11

total cholesterol
HDL
LDL
Triglycerides

Question 12

Liver panel

Answer 12

total bilirubin
AST
ALT
ALP
Albumin
Total protein 
maybe: GGT, LDH, PT

Question 13

other panels

Answer 13

cardiac - CK, CK-MB, troponin, BNP
nutrition
thyroid
hepatitis

Question 14

Delta Checks

Answer 14

if a change in the value of an analyte exceeds an expected physiological range the result is flagged as a possible error

Question 15

goal of a delta check

Answer 15

1. ID changes in patient condition

2. ID sample quality issues/patient misID

Question 16

goal of a delta check

Answer 16

1. ID changes in patient condition

2. ID sample quality issues/patient misID

Question 17

causes of discrepant results

Answer 17

pre-analytical: patient ID, specimen collection, post- collection
analytical : instrument, method
biological: rhythmic changes, lifespan, treatment

Question 18

who investigates delta checks?

Answer 18

the lab to rule out any errors

Question 19

steps to start investigation

Answer 19

1. repeat analysis
2. investigate pre-analytical issues
3. investigate analytical issues
4. consider changes in the patient

Question 20

elevated potassium

Answer 20

almost always HEMOLYSIS

Question 21

Myoglobin cardiac marker

Answer 21

more sensitive than CK-MB
rise within 1-4 hours
returns to baseline within 18-24 hours
not used often

Question 22

CK-MB cardiac marker

Answer 22

rise within 4-6 hours

return to normal within 2-3 days

Question 23

Troponin T

Answer 23

rise within 3 hours
peak by day 2
return to baseline after 7 days

Question 24

Troponin I

Answer 24

rises 4-6 hours
peaks 12-18 hours
returns to baseline in 6 days

Question 25

CKMB index

Answer 25

CK-MB(ng/ml)
——————— x 100
total CK activity

Question 26

CM-MB is elevated & CKMB index >3

Answer 26

suggestive of MI

Question 27

CK-MB is elevated & CKMB is

Answer 27

suggestive of skeletal muscle damage

Question 28

hsCRP

Answer 28

indicator of risk of cardiovascular disease

Question 29

BNP

Answer 29

b natriuretic peptide

major marker of congestive heart failure