AMT basic Flashcards by Leah McAleer

Deca:

Deci:

Centi:

Milli:

Deca: 10^1

Deci: 10^-1

Centi: 10^-2

Milli: 10^-3

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fastest turnaround time

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LDL calc

TC - (TG/5 + HDL)

TC= cholesterol

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Centrifuge: head/rotor, carriers/shields

RCF: relative centrifugal force calc

centrifugar force depends on three factors…

recommended RCF and rpm/time

1.118 x 10^-5 x r x rpm^2

mass, speed, radius

1.118x10-5 is the angular velocity
AAB study guide says 1.18

RCF 1-1200 or 3500rpm 10-15min

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Horizontal/Swinging:

fixed angle good to…

microcentrifuge for smaller than…

ultracentrifuge rpm, for….

Horizontal/Swinging:
horizontal when spinning

fixed angle good to…sediment small particles faster

microcentrifuge for smaller than…<2ml

ultracentrifuge rpm, for….150,000rpm, chylomicrons

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Pipettes:

Semiautomatic: recalibrate…/yr with…

Most accurate pipette, has accuracy of…

Pipette that is rinsed after 1st liquid drains….

Pipette that drains by gravity, tip to side….

Pippette w/2 frosted bands……

Pipettes:

Semiautomatic: recalibrate…/yr with…
4x/yr, gravimetric(wt=vol, water) or volumetric(dye into water, spectropho)

Most accurate pipette, has accuracy of…
volumetric/transfer 1:1000

Pipette that is rinsed after 1st liquid drains….
TC to contain

Pipette that drains by gravity, tip to side….
TD to deliver

Pippette w/2 frosted bands……
blow out remaining drop

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Inspected etc…

Centrifuges for time/speed w/NIST…

Calibrations:

automatic pipetters…..

BSA hoods, thermometers w/NIST….

CLIA lab inspections….

Inspected etc…

Centrifuges for time/speed w/NIST…6 mths
-use daily, need to do more often

Calibrations 6mths

automatic pipettes…quarterly, every 4 mths

BSA hoods, thermometers w/NIST….yearly

CLIA lab inspections….2yrs

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Microscopes…best for

Brightfield…

Darkfield…

Electron…

Fluorescent…

Phase contrast…

Polarized…

Diff. interference contrast/DIC….

Microscopes…best for

Brightfield…white light, low contrast of bio

Darkfield…collect scattered light, spirochete

Electron…electrons,enlarged image, tumor markers, tissue

Fluorescent…high enery emits lower, ANA

Phase contrast…phase shifts, diff in refractive index/contrast, manual PLT cts

Polarized…transmitted polarized light, crystals

Diff. interference contrast/DIC….recominbation of light, 3D

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2 electron microscopes for virology/cells

beam of electrons thru specimen, fluorescent screen/plate >100,000x

beam electrons strikes surface of specimen, photographic fil/cathode ray tube, 3D image >1000x

2 electron microscopes for virology/cells

tranmission
beam of electrons thru specimen, fluorescent screen/plate >100,000x

scanning
beam electrons strikes surface of specimen, photographic fil/cathode ray tube, 3D image >1000x

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Temp calculations…

C to F:

F to C:

C to K:

95F=C
95C=F

C to F: 5/9 x (F-32)

F to C: (9/5xC) + 32

C to K: C+273

95F=35C

95C=203F

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37C EQUALS…F

98.6F

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M:E ratio

what is counted as myeloid, what isn’t

what is examples of erythroid

M:E

M=myeloid, blast count as myeloid
-not lymphs/monos

E=normo/erthroblast/rubricytes

The normal M:E ratio in adults varies from 1.2:1 to 5:1 myeloid cells to nucleated erythroid cells. An increased M:E ratio (6:1) may be seen in infection, chronic myelogenous leukemia or erythroid hypoplasia. A decreased M:E ratio (<1.2-1) may mean a decrease in granulocytes or an increase in erythroid cells. M:E ratios are somewhat higher in newborns and infancy than in later childhood and in adults. It is important to note that lymphocytes, monocytes and plasma cells are not included in the M:E ratio.

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Molarity calc…

Normality calc…

Molary= gmv/L, want mol/L

Normality= 1 Eq(each H)/gmw

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Osmality NV, calc

Osmolar gap…

Osmality 275-295, 1.86Na+Glu/18+BUN/2.8

Gap is measured-calculated

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SD is the…

CV is a measure of…
calc…
acceptable CV…

QC is a measure of…

SD is the square root of variance
needs min 20 values

Square root of (sum of squared differences from the mean)/N-1

CV measures precision
SD/mean x100, <5% acceptable

QC measures reliability

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Confidence intervals is probability of estimated range, degree of uncertainty

1SD=

2SD=

3SD=

acceptable SD for lab/ranges CTRLs are in….

Confidence intervals is probability of estimated range, degree of uncertainty

1SD= 68%

2SD= 95%

3SD= 99%

acceptable SD for lab/ranges CTRLs are in…2SD
-to find 1SD you find mean, diff on each side is 2SD/2

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pH, Henderson equa…

normal pH…

bicarb:acid…

pH= pka + log (salt/acid) or (A/HA)

normal pH 7.4

bicard:acid 20:1

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Beers law:
-concentration=energy absorbed A=abc
-transmitted in inverse=A=2-log%T

Concentration/absorbance calc…

Concen unk/Con Std = Abs unk/Abs std

Get Unknown on one side first

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Who catergorizes/grades tests based on complexicity…

Who determines if test can be waived…

Most lab complexicity…

PPM is what complexcity…

High complexcity tests….

Who catergorizes/grades tests based on complexicity…FDA

Who determines if test can be waived…HHS

Most lab complexicity…moderate

PPM is what complexcity…moderate

High complexcity tests….
-modified FDA cleared
-LDT(lab developed)
-cytology
-serogrouping/gel immuno/electro/flow
-pap

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Proficiency testing:

Required by…up to…/yr…
Not required for…

These two can inspect…
This dept approves PT program…

Keep copy of PT for…

Unsuccessful PT…
-common causes of failure….

Alternate PT testing….

Proficiency testing:

Required by CMS under CLIA, 3x/yr
Not required for…waived

These two can inspect…CMS, HHS
This dept approves PT program…HHS

Keep copy of PT for…2yrs (as most records)

Unsuccessful PT…
-SAME analyte in 2 CONSECUTIVE testing events or 2/3 testing events
-common causes of failure: clerical, instrument method/codes, calibration bias, late turn in

Alternate PT testing….
-SPLIT sample testing w/ref/other lab or established in house
-clin validation by chart review
-participate in ungraded/educational PT program

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Most errors occur in …and….analytical areas

PRE: %, if oral need written w/in…

Analytical: %, most common error

POST: % most common error

Keep records for…BB for…Pathology for…

Most errors occur in pre and post phase

PRE: 46%, oral ok/written w/in 30 days
-Joint commision national PT safety std=need to PT ids

Analytical: 8%, specimen integrity

POST: 47%, clerical error

records 2yrs, BB 5yrs/products 6mths after expire/Pathology 10yrs

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Warning error…what to do if 1CTRL is out…

Random errors due to…causes

Systemic erros due to these 3…
-name of gradual loss/drift from mean/causes
-name of abrupt change/causes

1st #=how many out consecutively
2nd #=SD

Warning error…what to do if 1CTRL is out…
-1-2S: repeat same CTRL

Random errors due to… 1-3SD, R-4S
-unpredictable, preventable
-pipetitng, electronics, HIL
-R4S= 2 concensutive outside 4SD

Systemic erros due to these 3…
-2-2S, 4-1S, 10x
-name of gradual loss/drift from mean/causes: deterioation, accumulation, aging

-name of abrupt change/causes: reagent/lot change, maintenance, temp

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Steps in out of range CTRLS…

1.)if only 1-2S…
2)If still out…
3.)still out…
4.)
5.)
6.)

Steps in out of range CTRLS…

1.)if only 1-2S rerun same CTRL 1x
2)New vial CTRL/new lot
3.)reagents, maintenance, specimen
4.)recalibrate/redo ctrls
5.)assistance, document corrective action

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Safety training/Blood borne training/Chenmical hygiene/TB plan done…
-safety records kept…

DOT training w/in…every….

Safety/blood borne/chemical hygiene 1yr
-safety records kept 3yrs

DOT w/in 90 days, 3 yrs

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NFPA HAZMAT DIAMOND COLORS/MEANING

Health: blue Flamability: red Instability: yellow Special: white -W: water reactive -OX: oxidizer

Hazard Communication Std requires....on labels to alert... examples...8

requires pictograms on labels to alert chemical hazards -Health -Environment -Skull crossbone -gas cylinder -flame over circle -exploding bomb -flame -exclamation mark

Health pictogram/Human: takes time, toxicity(not acute), cancer causing...6

Health: toxicity -carcinogen, mutangenicity -reproductive/organ toxicity -respiration/aspiraton toxicity

Corrosion/hand-item: 4

Corrosion: -skin corrosion/burns -eye damage -metal corrosion

Flame over circle: 1

flame over circle=oxidizer

Skull crossbone: 1

Skull cross bone -acute toxicity/fatal

exploding bomb: 3

exploding bomb -explosives -self reactive/organic peroxides

exclamation mark: 6 often irritants/sensitizer

exclamation mark: -skin/eye/respiratory irritant -skin sensitizer -acute toxicity -narcotic affect -ozone layer

Environment/fish:1 optional

aquatic toxicity

Flame: heat/flame 6

Flame/heat: -flammables, pyrophorics -emits flammable gas -self heating, self reactives -organic peroxides

TB plan reviewed...Class...BSC... Plan to protect employees from heath hazards with hazardous chemicals... Std related to blood/BF and contaminated items... Plan that lays out potential risks, measures taken if exposed to bloodborne pathogens.... Universal precautions: -all PTs/blood/BF/tissues/needles potentially infectious and contaminated with these 3... -examples of BF that can spread these... Primary mode of infection throgh these 2.. Post exposure testing...save blood for...

TB plan review anually, Class 2 BSC Plan to protect employees from heath hazards with hazardous chemicals... -Chemical hygiene plan Std related to blood/BF and contaminated items...Bloodborn pathogen std Plan that lays out potential risks, measures taken if exposed to bloodborne pathogens....exposure plan Universal precautions: HIV, HBV, HCV -blood, semen/vaginal, CSF/synovial/serous, amniotic, salive in dental, unfixed tissue/organs primary mode: -puncture/broken skin, contact -mucous membrane Hep B vaccine: available 10 days employment Post exposure testing: -3,6,12mths -save blood 90days

HIV: -dominant one, grps; -slower, grps: -incubation average: -AIDs CD4 <, TH/Tctyo, category: -Bacteria: -Fungal: -Viral: -Parasites: -Testing: -Treatment:

HIV: -dominant one, grps: HIV1, M,N,O -slower, grps: HIV2 A,B -incubation average: 18mths -AIDs CD4 <, TH/Tctyo: <200, 1:2, 0.5, cat3 -Bacteria: mycobacterium -Fungal: crypto neo, canida -Viral: HBV, EBV, CMV, HSV -Parasites: Pneumocystis, Crytpsporidium, Toxcoplasma -Testing: Qual/ELISA, Quant/RNA NAT -Treatment: HAART, AZT

How many classes of Biosafety Cabinet(BSC).. One lab use... Certified...and then...

There are 3 but 2 has two subclasses Class 2a Certified upon installation, then annually

Class BSC completely closed, neg pressure, most protection -air coming in is filter sterlized, rubber gloves

Class 3

Class BSC that only sterilizes air being exhausted, ventilated outside, negative pressure

Class 1

Class BSC that most labs use: -self contained, laminar flow, sash -air exhausted and over material sterilized -air recirculated thru HEPA

Class 2a

Class BSC used for radioisotopes, toxic chemicals, carcinogens

Class 2b

BioSafety cabinets BSC 1 -exhaust air sterlized, neg pressure BSC 2 -exhause+material air sterlized -laminar flow, sash a. most labs use, HEPA filter b. radioisotopes, toxic chem, carcinogens BSC 3 -most protecting, closed with gloves -air coming in filtered

How many BSL biosafety level are there... One that most std micro labs use..

4 BSL 1

BSL due to dangerous, aerosol trasmitted, fetal, no vaccine/treatment -all precautions of other BSL plus clothing change/shower/decontamination -most organisms are...

BSL 4 ebola, lassa, marburg viruses

BSL for indigenous, serious/letal thru inhalation -controlled access, decontamination -example microbes

BSL 3 -TB, Brucella, Y.petis, antracis, C.immitis

BSL most used in std micro labs: -not usually cause of disease -2 examples of microbes

BSL 1 B.subtilis(dry heat QC), E.coli

BSL used when theres risk of sharp injury, ingesting, mucous membrane -biohazard signs, sharps precautions,manual -example microbes

BSL 2 -S.aurea, Ecoli H157, Kpneumo, HBV/HIV

Biosafety levels BSL 1: -most common in lab, not likey issue -B.subtilis, E.coli BSL 2: -sharp/ingest/mucous route -warning signs/sharps, manual -Common pathogens: S.aureus, EcoliH157, Kpneumo, HBV/HIV BSL 3: -indigenous, serious/lethal, inhale -controlled access, decontamination -TB, Brucella, Y.petis, anthracis, C.immitis BSL 4: -most letal, no vaccine/treatment, aerosol -virus: eboal, lassa, marburg

Chlorine, propane, nitrous oxide, CO2 all examples of...

liquified compressed gas

oxygen, nitrogen, helium, argon all examples of

nonliquified compressed gas

acetylene example of a colorless pungent-smelling hydrocarbon gas, which burns with a bright flame, used in welding and formerly in lighting

dissolved compressed gas

Flashpt F/C.. lowest temp a vapor of flammable liquid can be ignited into air examples... keep in...

<100F/37.8C acetone, ethanol, methanol, xylene flammable liquid safety cabinet

Environmental CTRLS: safety color coding... all usually color with black letters Red code for, examples... Yellow code, example... Orange code, examples....

Environmental CTRLS: safety color coding... Red code for, examples... -fire, danger, stop: fire pull, biomed) Yellow code, example... -caution: radiation Orange code, examples.... -warning: biohazard, infectious agent(fluoursecent orange)

NFPA color coded labels recommended by OSHA.. red diamond: yellow diamond: blue diamond: white diamond:

NFPA color coded labels recommended by OSHA.. red diamond: fire -0=won't burn, 4=flashpt <73F yellow diamond: reactivity -0=stable, 4=detonate blue diamond: health -0=normal, 4=death white diamond: specific -ACID, ALK, COR, OXY -radioactive, use no water

Class Fires/Extinguishers how many classes

4, A-D

Class fire/extinguisher with combustible metals... examples of metals..

Class D combustible metals Mg,Li,Na, K yellow decagon, no #

Class fire/extinguisher with energized electrical equipment... examples..

Class C energized electrical equip analyzers, wiring, outlets blue circlen no #

Class fire/extinguisher with ordinary combustible.. examples..

Class A paper,wood,cloth, some rubber plastic green triangle, # is amt of water

Class fire/extinguisher with flammable/combustible liquids.. examples..

Class B gases, greases, some rubber/plastic acetone,ethanol,methanol, xylene red square, # is sq ft can extinguish

Fire/extinguisher acronyms... Fire acronym... Extinguisher acronym...

Fire: RACE to the fire -R: rescule -A: alarm, call operator -C: contain -E: extinguish or evacate Extinguisher: PASS the extinguisher -Pull the pin -Aim at base -Squeeze -Sweep side to side

Regulates disposal of waste... DOT HMR used in most labs...

EPA DOT HMR: cat B -not in form cause harm/fatal, triple packing

Federal law defines min wage, OT, how to be paid... -exempt versus nonexempt: Law prohibits discriimination, Title 7: Law that prohibits discriminatin w/disabilities: Law that allow for continued health insurance when retire/resign/laid off/chage to PT... Law that protects health insurance when changing jobs and protects health info...

Federal law defines min wage, OT, how to be paid...Fair Labor Std Act -exempt: salary, nonexempt hourly Law prohibit discriimination,Title 7: Civil right Law that prohibits discriminatin w/disabilities: Americeans Disabilities act Law that allow for continued health insurance when retire/resign/laid off/chage to PT...COBRA 18/36mths Law that protects health insurance when changing jobs and protects health info... -Health Insurance Portability and Accountablity Act

If get PLT ct and volume and want new concentration and volume use...

C1xV1=C2xV2

Competency for high complexity done

Initially, 6mths, 1yr, annually

2 accredidate healthcare organizations, 1 of them accrediates programs

JCAHO CAP

EDTA prevents clotting by chelating

Ca2

Heparin prevents clotting by neutralizing

thrombin prevents hemolysis

Sodium citrate prevents clotting by binding

Ca2

Order of draw for evacuated tubes/filling from syringe...6 tubes

blood culture blue red/gold green EDTA gray

Order of draw microcollection from capillary 4 tubes

blood gas pink other serum

increased specificity means decreased...

false positive good for confirmatory

Increased sensitivity means decreased ... ...

false negs good for screening

true pos false pos true neg false neg

true pos: pos who has disease false pos: pos who doesn't have true neg: neg who doesnt have false neg: neg who has

Total pos/Total pos+False neg x 100

diagnostic sensitivity w/disease test pos

total neg/total neg+false pos x100

diagnostic specificity w/out disease test neg

total pos/total pos+false pos x100

positive predictive value time that a pos is correct

total neg/total neg+false neg x100

negative predictive value time a neg is correct

Volumetric accuracy

1:1000

PT required by... Under... PT done.../yr % to pass in lab, % BB etc Fail PT Copy of PT kept ..

PT required by CMS Under CLIA PT done 3x/yr 80% to pass in lab, 100% BB etc Fail PT: 2 consec, same analyzer or 2/3 events Copy of PT kept ..

Inspection of accredited land by CMS, HHS every oSHA SAFETY EVERY...KEPT...

INSPECTION CMS/HHS 2 years OSHA SAFETY YEARLY,KEPT 3 YRS Blood borne path training yearly

Opportunisitc pathogens in HIV: Parasites

Opportunisitc pathogens in HIV: Parasites -crytosporidium -pneumocystis -toxoplasma viral -HBV, CMV, EBV, HSV Fungal -candida -Cryptococcus Bacteria -mycobacterium

Hep A: fecal/oral, vaccine HepB: sex/iv/trans, mostly asymptomatic, vaccine HepC: sex/iv/trans, ALT HepD: iv/hemophil, needs HBV Hep E: epidemic/sporadic developing countries, similiar to A fecal.oral

....

Hep markers order 6

-HBV DNA -HBsAg -HBeAg -anti-HBc -anti-HBe -anti-HBs

Hep B first detected..using...HBV DNA,NAT acute/infectious...HBsAg,HBeAg viral rep/most infectious....HBeAg previous infection/recovery..anti-HBc infection resolving,immunity...anti-HBs vaccination...anti-HBs

Two types HIV... 3 groups... incubation period...mths aids ct.... cd4:cd8 normal... HIV... test ELISA HIV1/2, if neg no need test further, if reactive diff between two with NAT

Two types HIV...1 dominant, 2 slower 3 groups...M,N,O incubation period...mths aids ct....18ths, 200cell/microL cd4:cd8 normal...>1.5 HIV...<0.5

BSC: 1,2,3 Bioterrrism: A,B,C BSL: 1,2,3,4

BSC: 1,2,3 1 least protective 2A labs use, certified yearly 3 most protective Bioterrrism: A,B,C A: highest priority, rare, easily diss -smallpox,plague, botulism B: moderate, salmonella,typhus,vibrio C: emerging, nipah,hanta There is no D! BSL: 1,2,3,4 1: cause least disease (e.coli, subtiliis) 2: disease thru cut etc, HIV 3: inhalation (tb), immitis, anthracis 4: aerosol, fatal, no vacccine (ebola)

centrifuge speed: 6mths thermometers checked: yearly BSA hoods: yearly automated pippetes: 4x year/quarterly

What is the order of draw for multiple evacuated tubes?

Blood culture (aerobic) blood culture (anaerobic), blue red, green stopper lavender, gray When collecting multiple tubes of blood, a specified “order of draw” protocol needs to be followed to diminish the possibility of cross contamination between tubes caused by the presence of different additives. Errors in the order of draw can affect laboratory test results.

Order of draw for BD microtainer

Lavendar green/mint green grey gold red

Capillary order of draw: 4

Blood gases EDTA other additive mini serum

3 LAYERS of anticoagulated blood and they're components/% Top: 55% plasma -90% water -10% solutes middle: 1% buffy coat -WBC,PLT bottom: 45% rbc

BLUE: 3.2% citrate, 1:9, anticoag/blood RED: plastic/none, glass/silicone GREEN: heparin, inhibits thrombin, Xa chem,ph,gasca LAVENDAR/PINK K2EDTA: dry K3EDTA: liquid -chelates Ca, helps prevent RBC shrinkage GRAY: flouride,inhibits glycolysis

standard gauge for syringe, tubes...21gauge 1. ID patient 2.assemble at beside 3.gloves 4.select, prepare site with alcohol,dry 5. one hand hold tube, arm downward, need 1-2in below site, 20degrees, tourniquet ,1

3 veins; cephalic, basilic, median cubital

Capillary blood collection: puncture perpendicular once, wipe 1st drop fingertip, 3rd/4th finger heel big toe earlobe adults last resort

infants: medial/lateral plantar/sole heel or big toe

managment philosophy focuses on satisfying customers thru empowering employees to be an active part of continuous quality improvement systematic

TQM total quality management

system of internal and external reviews and audits of all aspects of an EMS system continuous, incremental

CQI continuous quality improvements

is an activity designed to id and resolve work task-related problems that yield poor quality

PI performance improvement

universal precautions; blood/BF of all people infectious until proven otherwise standard: Updated version of universal, Include Universal precautions and body substance isolation and assume that all blood, BF, secretions may be infectious and apply to all patients

centrifugation for blood RCF, rpm, min

1-2,000 rcf 3500rpm 10-15min

calibrate ocular micrometer: 1. put stage micrometer on stage 2. focus micrometer 3. line up left edge of micrometer with left edge of stage micrometer 4. adjust field so 0 line of ocular micrometer is superimposed on 0.0 line of scale 5. find furthest point to right where a line on ocular micrometer lines up with a line on stage micrometer 6. count # divisions on ocular micrometer per mm or micrometer on stage

Linearity

Linearity is the ability to provide laboratory test results that are directly proportional to the concentration of the measurand (quantity to be measured) in a test sample.

Blood culture collection 2-3 sets w/in 24hrs, can be separate sites or time intervals, aerobic 1st then anaerobic 10-20ml per bottle clean with alcohol then povidine iodine 6-18hr incubate at 35C checked daily for 7 days

range in which 95% of pop falls, random samples from normal pop fall within 2S range

ref range, normal range

Calculation that doesn't change concetration: unit wt 1/unit vol 1 =unit wt 2/unit vol 2 make 500ml of 0.5% NaOH -0.5/100= x/500

N=Mx valence (H) 0.4 N H3PO4 is 0.4/3=.13M

measures total number of dissolved particles in sln; size/density/type doesn't matter freezing point depression alcohol can increase

separates mixture into individual components based on physical characteristics 5 types

Chromatography 1.) liquid-liquid (aqueus,organic) 2.)ion exchange (wt,size,charge) 3.)gas-liquid (volatility, rate diffusion) -blood alcohol, drugs abuse use w/MS 4.)Thin layer(Rf sub/solvent) 5.)high performance liquid(pumped thru columns under high pressure)

Method to separate proteins on charge and size direction on isoelectric point and pH of buffer cellulose acetate most common

can separate aminos, serum proteins, lipo,glyco,nuclei,hmg, isoenzymes

3 types of electrochemistry methods

potentiometry: voltage, diff between ref and indicator, pH/glass, K valinomycin amperometry: current flowing, O2 electrode, platinum coulometry: titration, Ag+ ions cause tiration to stop; Cloride

Method/name of cell passing thru current creating pulse=cell size MCV meausred directly=cell size RBCs/PLTs counted in RBC bath WBC/nRBC counted in WBC bath

electronic impedance/Coulter

Optical scatter, 5pt diff light scatter... forward/side...

Flow cytometry forward cell size side interior

RBC left shift.. right shift...

leftshift microcytes right shift macrocytes

Method that uses light in a fluid medium to measure cells laser excites fluorochrome forward scatter is diffraction/refractions=size side scatter is reflection=granularity

air displacement: air remains between the piston and the liquid. Positive displacment:piston is in direct contact

Osmolality=mOsmol/kg of H2O Normal range 275-295 mOsm/kg 1.86(NA) + GLU/18 + BUN/2.8. -NA, GLU, BUN , 1.86, 18, 2.8 Osmolality of NA 150 Glu 180 BUN 14 294 mOsmol/kg

Proficiency testing is required by CMS under CLIA, approved by HHS Usually done 3 times per year, keep 2yrs 80% lab/100% BB 2/3 fail or 2 consec same analyte

EEOC equal employment opportunity commission FLSA fair labor standards act title 7 civil rights act ACT of 1963 prohibiting discrimnation, FMLA 12 weeks unpaid job leave in 12mth period COBRA consolidated omnibus budget reconcilation act Act that provide health insurance 18 or 36mths expect for gross misconduct HIPAA health insurance portability and accountability act

Race: rescue, alarm/call, contain, extinguish Pass: pull, aim, squeeze, sweep base

Nongausian skewed pos or neg, skews alter these two, but not this

Alter mean and median, not mode

Immunoassay/immunochemical use ab to bind ag of intereste visa/versa Immunoprecipitation/agg: clumping of ab particles to which specific antigenic labels are attached Immunoelectrophoresis: immunoprecipitation in which ag are separated by migration in electric field, followed by ab reaction by immunodiffusion Immunodiffusion: spreading movement of ab and/or ag in suport medium Immunofixation: western blot Heterogeneous IA: liquid/solid phases to separate Homogenous IA: labeled analyte does not require separation of bound free ag Radioimmunoassay: RIA Enyzme mulitiplied immunoabsorbent assay: ELISA Immunofluoresence/fluroimmoassay Immunohistochemistry Nephelometry: light scattering ag/ab aggregation

Anion gap: cations-anions Na+K minus Cl+CO2 =10-20

...

Anion gap: cations-anions Na+K minus Cl+CO2 =10-20

...