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AMT Lab/Phleb basics > AMT Lab/Phleb basics > Flashcards

AMT Lab/Phleb basics Flashcards

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1
Q

Centrifugal force depends on 3 variables…

and separates based on…

A

mass, speed, radius

density

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2
Q

speed expressed as…

force generated express as…or…

angular velocity value…

r=

A

revolutions/min(rpm)

relative centrifugal force/RCF or gravity (g)

1.118x10*-5

r=radius in cm from center of axis to bottom

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3
Q

Equation for speed of centrifuge related to RCF/RCF=

A

1.118x10*-5 x r x (rpm)’2

*10 to neg 5
*2=squared

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4
Q

CLSI

A

clinical and lab standards institute

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5
Q

CLSI recommend blood be centrifuged at an RCF of…or…for…min

A

1,000-1200xg

OR

3500 rpm

for 10-15 min

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6
Q

…or… centrifuge where tubes are horizontal position when spinning and in a vertical position when stopped

A

Horizontal head or swinging bucket

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7
Q

…or…centrifuge where tubes are at angle in sample bucket, allowing small particles to sediment faster

A

fixed angle or angle head

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8
Q

Centrifuges that separate small liquid samples of <=2mL in plastic conical shaped containers w/integral snap cap

A

microcentrifuges

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9
Q

High speed centrifuge up to 150,000rpm to separate chylomicrons from serum

A

ultracentrifuge

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10
Q

strobe light determines…

A

speed

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11
Q

Check speed of centrifuge with…or….
every…

A

tachometer or strobe light, every 6mths

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12
Q

NIST

A

national institute of standards and technology

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13
Q

Check time with…timer, every…

A

NIST traceable timer, 6mths

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14
Q

centrifuge used to sediment small particles faster

A

fixed angle/angle head

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15
Q

centrifuge used to separate chylomicrons from serum

A

ultra

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16
Q

Glassware/plasticware must fall into class…or….
Institute that recommends tolerance limits…

Preferred glassware class…
Usually made of… …

A

Class A, B
NIST recommended

Preferred is A and made of borosilicate glass

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17
Q

Pipette that is electronic, prepare multiple samples…

Pipette that are handheld, disposable tips w/air displacement or positive displacement

A

Automatic pipette

semi-automated pipette

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18
Q

Mechanism of action which relies on a piston for creating suction to draw the sample into a disposable tip that’s changed after use

A certain volume of air remains between the piston and the liquid.

A

air displacement

ie. pipettes used in lab

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19
Q

Mechanism of action which has a moving piston in pipepette tip or barrel much like a hypodermic syringe, doens’t require a different tip and is used as a dispenser.

The piston is in direct contact with the liquid.

A

Positive displacment

ie. osmo pipette

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20
Q

Which pipete requires recalibration…
how often per year…

Two methods used to calibrate…

A

automatic pipettes, 4x/yr
Semiautomatic also uses this method

gravimetric and volumetric

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21
Q

Calibration that verifies accuracy by the amt of water dispensed by pipette.
Weight of water is proportional to the volume dispensed.
Weight=volume

Accuracy of volume is dispensed and adjusted accordingly to the weight

A

Gravimetric

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22
Q

Calibration that verifies accuracy of amt of dye thats pipetted into a specific volume of water and is read spectrophotometrically.
absorbance=amount

A

volumetric

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23
Q

Which class of glassware doesn’t need to be recalibrated

A

A

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24
Q

Handheld that require bulb to apply suction

A

manual

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25
...or... is glass pipette that has a bulb in the middle w/tapered delivery tip accuracy is 1:....
transfer or volumetric 1:1000
26
..or...Pipette thats uniform in diameter w/tapered delivery tip
measuring or graduated
27
Pipettte with two frosted bands
Last drop blown outb after pipette drains
28
Pipete must be rinsed w/solvent after first liquid has drained
To contain, TC
29
Pipette filled and allowed to drain by gravity. Held vertically, tip placed against side of vessel
To deliver, TD
30
Pipette filled, drained and remaining fluid in tip blown out, has two frosted bands at top
blow out
31
Pipette held in vertical position w/tip against vessel and drained by gravity
self draining, ie. TD
32
Organization that maintains standards for temps
NIST national institute of standards and tech
33
Thermistor probe is also called
an electronic probe
34
3 types of thermometers
mercury/liquid in glass digital electronic/themistor probes
35
Gold/platinum thermometer calibrated on international temp scale w/lead wires and sheath
NIST Standard ref material (SRM)
36
All NIST certified thermometers come with a... NIST traceable thermometers come with
NIST cert of calibration NIST cert of traceability. certificate issued by manufacturer
37
Temp for incubators, heat blocks, water baths
36-38C
38
RT
20-24C
39
Lab fridge... BB fridge...
lab 2-8C BB 1-6C
40
Lab freezer... BB freezer...
lab <= -20C BB <=-65C
41
Sln can use as alternative to lens sln... sln not to use...
can use methanol, not xylene
42
Absorbance can be calculated easily from percent transmission using which calculation?
2 – log10 %T Absorbance can be calculated easily from percent transmission using 2 – log10 %T. If all the light passes through a solution without any absorption, absorbance is zero and the %T is 100%. If all the light is absorbed, %T is zero, and absorption is infinite.
43
Most common microscope, white light illuminates sample from below... limitation...
brightfield low contrast of biological samples
44
Which immunoassay methodology is the emission of light by molecules in an excited state with a limited amount of heat as the result of a chemical reaction?
Chemiluminescence is the emission of light by molecules in an excited state with a limited amount of heat (luminescence) as the result of a chemical reaction. Chemiluminescent assays are ultrasensitive and are widely used in automated immunoassays and DNA probe assay systems. Chemiluminescence has excellent sensitivity and dynamic range. Chemiluminescent labels can be attached to an antigen or an antibody. Most chemiluminescent reagents and conjugates are stable and relatively nontoxic.
45
Microscopy improves contrast of unstained, transparent. Quantity of unscatted light/directly transmitted is minimized collecting only light scattered by sample... the field around the specimen (i.e., where there is no specimen to scatter the beam) is generally dark. Good to view...
Darkfield spirochetes
46
Uses electrons to illuminate and creates enlarged image. Creates higher resolving power and higher magnification. Uses electrostatic and electromagnetic lenses. Focuses on a specific plane... Good to view...or... ...
Electron tissue or tumor markers
47
Uses fluorescense. High energy light illuminates, emits light of lower frequency. Dyes used to stain structures... Good to view...
Fluorescent ANA
48
Small phase shifts in the light passing thru transparent specimen showing differences in refractive index as diff in contrast... An optical microscopy technique that converts phase shifts in light passing through a transparent specimen to brightness changes in the image. Phase shifts themselves are invisible, but become visible when shown as brightness variations. Good to view...
phase contrast manual PLT cts
49
Only transmits polarized light good to view...
polarized crystals
50
Gives 3D image. brightfield can be modified into this. Two split beams of light are polarized and recombined by objective prism. Recombination gives 3D
Differential interference contrast Differential Interference Contrast (DIC) is a phase contrast technique that allows transparent structures to be visualized by exploiting changes in refractive index. In contrast to conventional phase contrast techniques, which are based on changes in optical path length, DIC is based on the gradient of the optical path length (rate of change in wavefront shear). Steep gradients produce the high contrast and 3-D relief effect that is characteristic of DIC.
51
Magnification of: eyepiece.. low power objective... high power objective... oil immersion objective...
eyepiece: 10X low: 10x high:40x oil: 100x
52
Knob to move slide right and left... knob to move stage forward and backward...
slide right/left: x axis motion knob stage forward/backward: y axis
53
Rotating disk under stage to vary intensity/size of cone of light
iris diaphram
54
Focuses light onto specimen
condenser lens
55
part that connects the eyepiece to the revolving nosepiece/lenses
tube
56
holds objective lenses
nosepiece
57
focuses light onto specimen, can move up and down
condenser lens
58
English units of measurement 3 for length.. 1 mass.. 4 for volume...
length: inch,foot, yard mass: lb volume: cup, pint, quart, gallon
59
Metric system is based on decimal system, multiples of ten length... mass.. volume...
length: meter mass: gram volume: liter
60
luminous intensity in SI
candela
61
International System of Units/SI worldwide standardized system, recommended by CLSI Length: Mass: Time: amt sub: temp: electric current: luminous intensity:
Length: meter Mass: kg Time: sec amt sub: mole temp: Kelvin electric current: ampere luminous intensity: candela
62
Deka
Deka...10*1
63
Hecto
Hecto...10*2
64
Kilo....
Kilo....10*3
65
Mega..
mega: 10 *6
66
giga
giga 10*9
67
Deci
Deci: 10*-1
68
centi..
Centi:10*-2
69
milli
milli: 10*-3
70
micro
micro: 10*-6
71
Nano:
Nano: 10*-9
72
pico
pico: 10*-12
73
femto
femto: 10*-15
74
Celcius from farenheit
5/9x (F-32)
75
Farenheit from Celcius
(9/5)C +32
76
Kelvin from Celsius
C+273
77
95F to C
5/9x(95-32)=35C
78
95C to F
(9/5x95)+32=203F
79
95C to Kelvin
95+273=368K
80
BUN/Creatinine ratio BUN 24.0 Creatinine 2.4 Give ratio
10:1
81
CHOL/HDL ratio TC 200 HDL 40
5:1
82
Which cell lines aren't included in the Myeloid part of M:E calculation Which cell line is included in Erythroid ratio
Lymphs and Monos Normoblasts
83
Write fraction, 1 pt solute to 1 part diluent
1/2 2 is total volume
84
pt:pt is
pt analyze + total parts (including diluent)
85
1:1 dilution= 1:2 1:5
1 pt serum+0 pt diluent 1:2 1 pt serum + 1 pt diluent 1:5 1 pt serum + 4 pt diluent
86
1:2, 1:4, 1:8 etc is a 1:5, 1:25, 1:125 is a 1:10, 1:100 is a
two fold, x2 five fold, x5 ten fold x 10
87
5% w/w sln equals how much solute to total solution How much diluent is added
5g solute per 100g total solution 95g diluent added to 5g making 100g sln
88
Make 100g of 5% w/w sln of NaCl
5g/100g is 5% w/w, 5/100x 100g wanted=need 5g NaCl to 95g diluent to make a total of 100g sln
89
10% w/v sln equals how much solute to total sln
10g of solute to 100mL of total sln
90
Make 1,000 ml of 10% w/v of NaOH
10% w/v = 10g/100ml x 1000mL= 100g of NaOH to add to 900ml diluent to get 1000mL total
91
2% v/v equals how much solute to sln
2ml/100ml
92
Make 50mL of a 2% v/v of HCl
2% v/v = 2ml/100ml x50ml=1ml of HCl added to 49ml diluent equals total of 50ml
93
Molarity/M
Have g/L, covert to mole/L by get gmw g/L x mole/L= M
94
40g NaOH/L, what is molarity?
1 mole NaOH is 40 GMW, 40g/L x 1 mole/40 =1mol/L=1M
95
Nomality (N)
N=Equivalent/L 1 Equivalent=gmw/valence Valence is # of H
96
Osmolality=mOsmol/kg of H2O Normal range... calculation...
Normal range 275-295 mOsm/kg 1.86(NA) + GLU/18 + BUN/2.8
97
Osmolality of NA 150 Glu 180 BUN 14
294 mOsmol/kg H2)
98
Osmolar gap
measured-calculated
99
Concentrated Slns C1V1=C2V2 1 is, 2 is
1 is known 2 is unknown
100
PT has 350 PLT ct, how many mL of it needed to get 7mL of with concentration of 250
350x?mL=250x7=5mL
101
Ratio of SD of a distribution to its arithmetic mean. Used to express precision and reproducibility of an assay
Coefficient of Variation, CV
102
Coefficient of Variation, CV used to express...and... Acceptable CV is...
Used to express precision and reproducibility of an assay Less than 5% for most analytical systems
103
/X is
mean
104
CV formula Mean is 200, SD is 5, calculate CV
SD/Mean x 100 5/200 x 100 =2.5%
105
Gives an estimated degree of uncertainty. Probability of estimated range... expressed as..
Confidence interval percentage
106
Mean +- 1 SD= Mean +- 2 SD= Mean +- 3 SD=
1SD 68% 2SD 95% 3SD 99%
107
Given mean (/X) is 9.8, 1 SD is 0.2, calculate 95% confidence limits for control run with mean +- 2SD
1SD= 9.8 +- 0.2 2SD=9.8 +- 0.4, 9.4-10.2
108
pH formula
pH=pKa +log (base)(acid) (salt)(acid) (HCO3)(H2CO3)
109
Diff between cations and anions... cations.. anions... calculation
anion gap cations: Na, K anions: Cl, CO2 Na+K - Cl+CO2
110
Law that states concentration of sub is directly proportional to amt of radiant energy absorbed or inversely proportional to the logarithm of the transmitted radiant energy 2 formulas: proportional to absorbed versus indirectly proportional to transmitted...
Beers Law A=abc A=2-log%T Con unk/Con std = Abs unk/Abs std
111
Formula for known/unknown absorbance...
Concentration of unknown= AbsUn/AbsStd x ConcenStd
112
Abs of 6.0g std is 0.40, abs of unknown is 0.350, concentration of unknown?
0.350/0.40 x 6.0 5.25g
113
Chain of custody things needed...
PT consent, security seal, to addresee only store in locked area
114
Examples of chain of custody
alcohol levels for DUI DOT drug testing paternity, DNA Rape Medical examiner
115
Digital version of patient medical history/date
EMR electronic medical record
116
Series of computer network that interconnects computers in a limited area like hospital, using network media
LAN local area network
117
A computer network that interconnects computers in a broad area such as international, using private or public network trainsports
WAN wide area network
118
Comprehenstive integrated info system to manage medical, admin, financial, and legal aspects of a hospital/services
HIS Hospital info system
119
Computer software providing services to software apps beyond those available to the operating system Software that lies between an operating system and the applications running on it. Essentially functioning as hidden translation layer, enables communication and data management for distributed applications.
Middleware
120
Computerized process for healthcare providers to electronically enter and order medical procedures/lab tests based on predetermined logarithm
CPOE computerized provider order entry
121
CLIA stands for
clinical laboratory improvement amendments
122
CDC stands for
centers for disease control
123
CMS stands for
centers for medicare/medicaid services
124
Program that establishes quality standards for all labs... Published by...and...
CLIA plublished by CDC and CMS
125
Organization that categorizes and grades testing based on the complexityof testing
FDA
126
Two criteria to be waived test
cleared by FDA for home use simple/accurate as to pose no reasonable risk if performed incorrectly
127
Examples of waived
blood glucose/cholesterol urine prego, dipstick/tablet urinalysis ovulation nonautomated ESR spun HCT Hmg copper sulfate Hmg by single analyze instruments
128
Who determines if a test meets criteria for being a waived test
HHS Dept of Health and Human Services
129
Complexity? -manual procedures w/limited steps -microscopy of urine sediment -automated heme w/out diff -primary culture set up -urine culture/colony ct kits -gram
moderate
130
To be categorized as PPM, provider performed microscopy, must meet criteria
-physician, supervised midlevel practioner, dentist -moderately complex -main instrument is a microscope -control materials not available -specimen is labile, delay would affect results -need limited handling/processing
131
Examples of PPM tests
-direct wet mt preps, qualitative semen -KOH preps -pinworm, fern -postcoital direct, qualitative -urine sediment -nasal smears wbc, fecal wbc
132
3 criteria for high complexicity
-any modified FDA cleared test -lab developed test/LDT -cytology
133
Complexity? -serogrouping/typing -manual procecures w/multiple steps/reagent prep -concentration/diff staining -antimicrobial testing -gel immunochemical -electrophoresis, flow -pap smear
high
134
These two can conduct an inspection of any accredited lab that's issued a certificate of accreditation... How often CLIA requires...
CMS, dept of HHS 2yrs
135
External quality control to verify accuracy of lab test methods
PT proficiency testing
136
Proficiency testing is required by... under... Usually done ...times per year Not required for...
CMS, under CLIA 3 times per year not required for waived tests
137
Approves the PT program that must be enrolled in
HHS
138
Must maintain copy of PT related forms for minimum of....from the date of PT event
2 yrs
139
Satisfactory performance on PT testing is...for each analyze except with immunoheme, some are..
80% 100%
140
Unsatisfactory PT
same analyte in 2 consecutive OR 2 out of 3 testing events
141
Alternate/Split sample testing can be done for PT if...
approved PT isn't available SPLIT SAMPLES w/other or ref lab, established in house method, clinical validation by chart review, participation in ungraded/educational PT program
142
Examples of pre analytical testing
lab req, id, collection, storage, transportation, specimen adequacy, aliquoting, centrifugation
143
Oral requests can be made if... and within...
followed by written authorization within 30 days
144
Standard that requires the use of at least 2 pt ids... 3 examples of ids
Joint Commision National Patient Safety Standard -name, bday, med rec
145
How long keep records of test reqs/authorizations (can be patients chart/medical record)... Who may request records...
2 yrs HHS
146
Examples of analytical testing
reagents, calibration, QC, temps recording results verify normal range competency of personell
147
Process of testing and adjusting an instrument/kit to provide a known relationship between the measurement response and the value of the substance being measured by the test Contains a known amount of analyte being tested used to establish a correlation between the measurement response and the concentration or amount of the substance that is being measured by the test procedure.
calibration
148
Records of patient testing kept for at least... BB records kept for... Blood/products... Pathology kept for..
-PT 2yrs -BB 5yrs -Blood/products: 5yrs or 6mths after exp which ever is later -path 10yrs
149
How long must a copy of each procedure w/dates and initial use/discontinuance be kept
2 yrs after discontinuence
150
Post analytic examples
verifying calculations reporting results ID/notify panic filing data retrieval
151
Most errors occur in what two phases...
pre and post
152
percentage of error: pre... analytical.. post...
pre 46% analytical 8% post 47%
153
Term used to describe monitoring/evaluating all aspects of testing and all phases. Uses the QC data and conducted over a period of time
QA
154
Term that is one component of QA, involves mostly the analytical phase, ensures accuracy, and performed daily
QC
155
standard that where concentration is determined by dissolving weighted amt of std in solvent and diluting to a stated volume/mass. Accuracy based on purity of std/solvent not analytical method.
primary calibration std
156
Standard where concentration is determined by an analytical method of stated reliability. Prepared from pure substances of known composition.
Secondary std
157
Process that sets the instrument to a specific parameter, also called standards
calibration
158
Substances that are patient like used to validate run after calibration and tests the accuracy and precision of the method Can use sera/BF thats stable for at least...
controls a year
159
Control reqs
should be pt like run at lease 2 levels stable never used to calibrate
160
Term that is the agreement between the measured quanitity and its true value How close the value is to the true value
accuracy
161
Material prepared/purchased w/stated or expected value
assay control
162
Material whose value is not known except when assayed w/in lab by repeated testing
unassayed control
163
Aggrement among replicate measurements. How close the single values are to one another. The repeatability or reproducibility
precision
164
The more precise the method, the...the SD among replicate results
smaller
165
Actual middle value
median
166
value that occurs the greatest frequency
mode
167
average of all values, included in control material, represented by /x
mean
168
dispersion of control values about the mean. repeatability, reproducibility, precision
SD
169
If data have a normal distrubution, the mean/mode/median are...
about the same
170
Difference between highest and lowest values
range
171
average squared distance of data points from the mean
variance
172
square root of the variance
SD
173
SD expressed as percentage of the mean
CV coefficient of variation
174
CV formula.... acceptable CV is less than...% for most analytical systems
SD/mean x 100
175
1SD ...% will fall to the right and left of the mean, so...% of all data fall within 1SD
34.1% fall to right and left 68.2% of all data fall within 1SD
176
2SD ...% of all data will fall between 2 SD
95.5% of all data fall within 2SD
177
3SD ...% of all data will fall within 3SD
99.6% of all data fall within 3SD
178
The lab normally runs within ...or...% confidence limit to be considered accurate and precise
2SD, 95%
179
A chart with a normal distrubution curve on its side. Used to determine if a run is acceptable/quality of run. Values within...on each side are accepted as being accurate and precise Accurate test results fall w/in acceptable limits of +/-...SDs....% of the time
Levey Jennings chart 2SD
180
Signal of errors ...consecutive results fall on...side of mean ...consecutive results fall outside... ...result falls outside....
5 consecutive results fall on 1 side of mean 2 consecutive results fall outside 2SD 1 result falls outside 3SD
181
6 steps in finding source of signal errors
1. clerical 2. reagent 3. procedural/maintainence 4. retest ctrl 5. recalibrate instrument/new ctrl 6. call tech
182
Error thats unpredicable, no obvious pattern and almost always preventable. Large deviation from mean.
Random error
183
3 Random error causes... Remedy...
operator error (pipetting etc) electronic fluctuation in instrument interfering substances Remedy: repeat test with fresh reagents, good working pipettes
184
Error that happens over a period of time, data points are not evenly distributed about the mean. This can be described as...or....
Systemetic error shift or trends
185
Error where data pts gradually drift from the mean. Gradual loss of reliability. When seven points in a row in an upward or downward direction are seen on a quality control graph
trend
186
Error with abrubt change in data pts from mean.
Shift
187
2 causes of trend
-deterioration/aging of reagents, ctrl, light -accumulation of debris cuvette window
188
4 causes of shift
-change in reagent lot/without calibration -failure of calibration -instrument maintence -change in room temp
189
Set of rules/decision criteria to decided whether an analytical run is in control or out of control..
Westgard Multirules
190
A...is an interval w/in which the accuracy and precision of testing system are expected to be stable but cannot be greater than 24hrs or less the frequency stated by m2anufacturer.
run
191
Multirule where you accept the run/is a warning 1 ctrl exceeds mean by +/-2SD
1-2S
192
Multirule where you reject, 1 ctrl exceeds mean by +/-3SD
1-3S
193
Rule where you rejct, 2 consecutive exceeds mean by +-2SD. May be beginning of systemic error
2-2S
194
Rule where you reject, two consecutive is greater than +/- 4SD May be due to random error
R-4S
195
Rule where you reject, 4 consecutive exceed by +/-1SD in the same direction. May be systematic error
4-1S
196
Rule where you reject, 10 consecutive exceed in same direction. May be systematic
10x
197
Normal range, normal value, ref range also called... Refer to a normal grp of individuals free from disease and represent...% of the population
reference interval 95%
198
If no existing analyze or methodology exists to do comparative studies, need ....to... people If method already in place, ref interval is validated by using method comparision. Most common ref interval study used in lab is as few as...test subjects
120-700 40
199
Parameters categorized as sensitivity, specificity and predicitive value are broadly defined as...
diagnostic efficiency
200
A predicitive value of a methods ability to detect patients with a disease is called the... Probability of correctly classifying diseased patient as disease
sensitivity of a test
201
the test that has 100% sensitivity can detect the disease in question in every patient who has the disease is called
true positive
202
Diagnostic sensitivity formulas
diseased w/+ result/total diseased x100% or true pos/# true pos + # false neg x 100%
203
The abilty to predict the value of a method to exclude a patient without disease is called... Correctly classifying a nondiseased person as nondiseased
specificity
204
The test that has 100% specificity will always be negative, and a patient who tests negative does not have the disease
true negative rate
205
Diagnositic specificity formulas
#nondiseased w/neg result/ total #nondiseased x 100% or true neg/# true neg + # false pos x100%
206
positive predictive value formula... % of the time a positive test will be true
#true pos/#true pos +#false pos x100%
207
negative predictive value formula... % of the time a negative test will be true
#true neg/#true neg+#false neg x100%
208
Differences between repeated and successive test results...
delta check
209
Delta check can be usesd as a form of ...
quality assurance
210
4 parameters delta checks can be based on...
-current result minus previous -current-previousx100%/previous -delta diff/delta time -delta % change/delta time
211
Any test performed at the time a rapid decision can be made that leads to treatment w/immediate pt outcome
POCT point of care testing
211
What category of testing involves microscopic evaluation (i.e., wet mount, Potassium hydroxide preparation, fern test, etc.) by a physician in the office for their own patient?
To meet the criteria for inclusion in the Provider-Performed Microscopy (PPM) category, procedures must follow these specifications: The examination must be personally performed by the practitioner (defined as a physician), a midlevel practitioner (defined as a physician, a midlevel practitioner under the supervision of a physician), or a dentist. The procedure must be categorized as moderately complex. The primary test instrument is the microscope (limited to brightfield or phase-contrast microscopy). The specimen is labile. Control materials are not available. Specimen handling is limited. Proficiency testing is not required; however, twice-yearly verification of accuracy is required. Those with a PPM certificate can also perform waived testing.
212
5 POCT classifications
-off site -alternate sit -physican office -near patient -beside
213
POCT devices have these characteristics
-portable -easy to use, mininal steps -results w/in mins -flexible test menus -reagent at RT -built in cal/QC
214
Ensures the electronics of the device are performing as expected
internal QC
215
Tests the system in the same manner as a patient sample
external QC
216
Tests the system and its operators blindly by providing unknown samples
PT
217
Examples of POC device principles
-reflectance -electrochem/impedance -spectrophotometry -fluorescen -PCR
218
Most POCT classified as... POCT is... .... than conventional lab testing
moderate complexicity tests more expensive
219
Testing personell req...
-On/B4 April 1995 highschool, clinical training -Until Sep 1997 high school, clinical exp -After 1997 AS -AS or equivalent education/training -licensed physician (doctor,master,bacherlor in chem/phy/bio, or CLS/MT accredited)
220
CLIA reg to evaluate/document performance for high complexicity testing at least...during the first year, then at least....
semiannually the first year then annually
221
Lab must document/assess problems during quality assurance reviews and take corrective action to prevent reoccurance
performance improvement projects
222
Lab must keep docs of quality assurance activities for....
2 yrs
223
Incidents which involves risk of injury or actual injury must be reported to risk management within
48hrs
224
Event which facility personell could exercise control and which is associated in whole or in part with the facility's intervention, rather than the condition for which such intervention occured. An event in which care resulted in an undesirable clinical outcome-an outcome not caused by underlying disease-that prolonged the patient stay, caused permanent patient harm, required life-saving intervention, or contributed to death.
adverse incident
225
Name of term where risk management must report serious adverse incidients to the state within 15 days
code 15
226
an occurence that results in unanticipated death or major loss of functions not related to the natural course of patients illness or underlying condition.
sentinel event A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. The phrase "or the risk thereof" includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome. Such events are called "sentinel" because they signal the need for immediate investigation and response. The terms "sentinel event" and "medical error" are not synonymous; not all sentinel events occur because of an error and not all errors result in sentinel events.
227
Process variation for which a recurrence carries a significant chance of serious adverse event
near miss A near miss is something that you instinctively recognize at the moment. It usually comes with a surge of adrenaline and relief. We also know it as a "close call," a "narrow escape," or a "near accident." In fact, "near accident" is probably the best general definition of "near miss."
228
In depth analysis of an occurence by a multidisciplinary team of involved employees. It is a structured facilitated team process to identify root causes of an event that resulted in an undesired outcome and develop corrective actions.
root cause anaysis
229
OSHA.. is part of... and a...agency
occupational safety and health admin the US dept of labor federal agency
230
Fed agency that issues regulations to ensure employee workplace safety with employers with 1+ employees
OSHA
231
In addition to having id, severity of hazard, nature/degree, and recommended measures to minimize adverse effects, label of hazardous materials should have these 3 things
-name -address -phone of manufacterer
232
Standard that requires pictograms on labels to alert users of chemical hazards
hazard communication standard
233
6 chemical hazard classifications for pictogram labels
-carcinogen -corrossive -flammable -irritant -toxic
234
Pictogram with skull and crossbones for what 1 hazard
acute toxicity
235
Pictogram of environment for what 1 hazard
aquatic toxicity
236
Pictogram of flame over circle for what 1 hazard
oxidizers
237
Pictogram of exploding bomb for what 3 hazards
-explosives -self reactives Self reactive substances are thermally unstable liquids or solids liable to undergo a strongly exothermic thermal decomposition even without participation of oxygen (air). -organic perioxides: organic peroxides supply both the oxygen and the fuel source.
238
Pictogram of corrosion (test tubes dripping on hand) for what 3 hazards
-skin corrosion/burn -corrosive to metals -eye damage
239
Pictogram of gas cylinder for what 1 hazard
gases under pressure
240
Pictogram of exclamation mark for what 6 hazards
Skin, irritants: -skin sensitizer -irritant(skin, eye, respiratory tract) -acute toxicity -narcotic effects -hazardous to ozone layer
241
Pictogram of flame for what 6 hazards
-flammables -pyrophorics: Pyrophoric materials are substances that ignite instantly upon exposure to oxygen. -self heating -emits flammable gas -self reactives -organic peroxides
242
Pictogram of health hazard(person) of what 6 hazards
-carcinogen -mutageniticity -reproductive toxicity -target organ toxicity -aspiration toxicity -respiratory sensitizer
243
Safety training required by...every... kept for...
OSHA, year 3yrs
244
A written program to set forth procedures, equipment, PPE, and work practices to help protect employees from health hazards by hazardous chemicals
Chemical hygiene plan
245
Plan required by OSHA concerning bloodborrne pathogens that describes potential risks and measures taken to protect/if exposed
exposure control plan
246
Term that all samples are infectious and also contaminated w/HIV, HBV and all sharps are contaminated
Universal precautions/Standard Precautions
247
Common sources of HIV, HepB,C include blood and body fluids such as these...
-semen, vaginal secretions -CSF, snynovial, pleural, peritoneal, amniotic -saliva in dental settings -unfixed tissues/organs -cell, tissue organ cultre
248
Primary transmission modes for HIV, HBV, HCV are these 3
-puncture wound contaminated objects -skin contact with infectious fluid/tissue thru broken skin -mucous membrane contact (eye, nose, mouth)
249
Hepatitis that is fecal oral,foodborne, vaccine available
Hep A
250
Hep A lab elevated...and... two ab and correlation... done with...
elevated ALT, bili IgM=disease IgG=immunity done with EIA
251
Hep B transmitted thru these 3
-sex -needs/IV drug -transfusion
252
Hep B incubation period... 95% are...or... 5% are..
asymptomatic or acute chronic
253
Order of apperance of HepB markers
-HBV DNA -HBsAg -HBeAg -anti-HBc -anti-HBe -anti-HBs
254
First detectable Hep B marker... detected using...
HBV DNA NAT
255
Two Hep B antigens in acute phase, very infectious
HBsAg HBeAg
256
Hep B marker indicating viral replication and most infectious
HBeAg
257
Marker that is marker for previous infection and is in recovery phase and remains throughout persons life
anti-HBc
258
Marker where infection is resolving and patient is immune; is protective against future
Anti-HBs
259
Marker due to immunity due to vaccination
anti-HBs
260
Two Hepatitis with vaccines
Hep A and B
261
Hep similar to Hep B, sex/iv use/trans; 7-8wk incubation; elevated ALT
Hep C
262
Hep C tests: EIA for... RT-PCR for...
EIA: antibody to HCV RT PCR: HCV RNA
263
Hep virus that needs HBV, IV drug/hemophiliacs
Hep D
264
Hepatitis thats cause of epidemic and sporadic heptatis in developing countries; resemebles Hep A, fecal oral
Hep E
265
HIV spreads thru...or.... It infects...
sex, IV drug CD4+ T cells
266
Opportunisitc pathogens in HIV: 3 Parasites... 4 viruses... 2 fungi... 1 bacteria....
Opportunisitc pathogens in HIV: Parasites -crytosporidium -pneumocystis -toxoplasma viral -HBV, CMV, EBV, HSV Fungal -candida -Cryptococcus Bacteria -mycobacterium
267
Two types of HIV... Dominant one worldwide... which one is slower...
HIV1,2 Dominant HIV1 Slower HIV2
268
Groups in HIV1
M,N,O
269
Incubation period for HIV... full blown AIDS when CD4 drows below...
18mths 200 cell/microL
270
Reversal of T Helper to suppresor CD4:CD8, what is normal ratio, ratio in HIV
normal >1.5 HIV <0.5
271
Name of therapy that interferes with any aspect of HIV rep/spread
HAART hightly active antiretroviral therapy
272
Technique used for qualitative detection of antibodies and antigens to both HIV1,2
ELISA
273
No further testing for HIV is required for...on the...immunoassay
nonreactive on initial
274
Specimens with reactive ag/ab or repeatedly reactive should do a test that....from...
differentiates HIV1 ab from HIV2 ab
275
Specimens reactive at initial and nonreactive on HIV1/2 ab differentiation should be tested using
HIV1 NAT
276
High risk tasks
needles, shaprs usage invasive procedures w/bleeding large amount of blood spill,splatter, splashes
277
Plan name that establishes procedures and utilizes appropriate materials and equipment to minimize exposure to bloodborne pathogens
exposure control plan
278
Enginerring controls
hand wash, sharps containers, leakproof containers, protective shields
279
Work practice controls
-hand wash -handle needles appropriatly, no double handed recap, not overfilled, no hands in sharp container -leaking/puntured in second container -closed b4 disposed of -no mouth pipette -no food etc in lab
280
Labels not required if .. .. or ... .. are used
red bags or red containers
281
Hep B vaccine must be made available within...days of initial employment
10 days
282
OSHA requires exposed person be tested after initial exposure then at...,..., and...months. If person refuses testing, blood should be drawn and saved for...days
3, 6, 12 months 90 days
283
How often does OSHA require blood borne pathogen training
yearly
284
When there's potential to generate aerosols of M.tb or large concentrations used BSC class...
2
285
BSC class that allows unsterlized room air into cabinet and around area/material and only sterilizing the air that is exhausted outside by... ...
BSC class 1 negative pressure
286
BSC class with a sash that sterilizes the air that flows over the infectious material as well as the air that is exhausted.
BSC class 2
287
BSC class 2 also called
laminar flow BSC
288
Category/Subcategory of BSC... which is self contained and 70% of air is recirculated by passing thru HEPA filter
BSC 2A
289
Category/Subcategory of BSC...used by radioisotopes, toxic chemicals, or carcinogens
BSC 2B
290
BSC completely enclosed and has negative pressure. Most protection. Air is sterilized while infectious material is handled with gloves.
BSC 3
291
Most clinical micro labs use class...BCSs Certified once installed, then.....
BSC 2A annually
292
Code 15
Name of term where risk management must report serious adverse incidients to the state within 15 days
293
Markers in convalescent/recovery phase of hepB
AntiHBc, antiHBe
294
Marker for previous infection hepb
AntiHBc
295
% of the time a positive test will be true
positive predictive value
296
% of the time a negative test will be true
negative predictive value
297
BSL not known to consistently cause disease in humans and used in standard micro practices examples are nonpathogenic ie. Ecoli, B.subtilis
BSL 1
298
BSL with agents associated with human disease aquired thru percutaneous injury,ingestion, or mucous membrane. BSL 1 practice and limited access, biohazard warnings, sharps precausings ie. S.aureus, E.coli 157, K.pneumo, HBV, HIV
BSL 2
299
BSL with indigenous agents may cause serious or lethal disease thru inhalation. BSL2 practice and controlled access, decontamination M.tb, B.abortus, Y.pestis. B.antracis, C.immitis
BSL 3
300
BSL with dangerous agents which cause individual risk of aerosol transmitted lab infections, fatal, no vaccines/treatment BSL3 practice and clothing change, shower, decontamination Ebola, Lassa, Marburg
BSL 4
301
BSL used with most standard microbiological practices not known to cause issues
BSL 1
302
BSL used thats most fatal, no vaccine/treatment, risk of aerosol
BSL 4
303
BSL used with limited access, biohard signs, and sharps precaustions, most common pathological pathogens seen
BSL 2
304
BSL used for agents that are generally inhaled and lethal, decontamination
BSL 3
305
B.subtilis, E.coli used BSL
1
306
ebola, lassa, marburg use BSL
4
307
m.tb, B.aborus, Y.pestis, B.anthracis, C.immitis use BSL
3
308
S.aureas, E.coli 157, K.pneumo, HBV, HIV use BSL
2
309
How must a laboratory operate to handle TB sputum and TM materials? Question 2Answer
Biosafety level of 2+ or 3 BSL-3 builds upon the requirements of BSL-2. Organisms that can cause serious or potentially lethal disease through respiratory transmission are typically worked with in a BSL-3 laboratory. Example: Mycobacterium tuberculosis.
310
3 Categories for bioterrorism agents...
A, B,C
310
What category are agents anthrax, botulism, plague, smallpox, tularemia, filoviruses, and arenaviruses classified as?
Category A are pathogens that are rarely seen in the United States. These agents have the highest priority; organisms in this category pose a risk to national security because they can be easily disseminated or transmitted from person to person and result in high mortality rates and have the potential for major public health impact.
311
Category with emerging pathogens and could be used for mass dissemination due to ease of production/dissemination and high morbidity... Two types...
C Nipah virus, hanta virus
312
Category moderately easy to dissemniate, moderate morbidity, low mortality and need specific enhancements of CDCs diagnostic capacity/enhanced surveillance
B
313
Category B examples
Brucellosis, C.perf Salmonella, Shigella, Ecoli B.mallei, C.psittaci, Coxiella burnetii Typhus fever/Rickettsia pro vibrio cholerae, crypto parvum
313
Category that pose risk to national security because they are easily disseminated, high mortality rates, might disrupt public/panic
Category A
314
category A agents
anthrax, plague, smallpox tularermia botulism ebola, marburg, lassa
315
3 types of gas stored in cylinders...and examples
liquefied: chlorine, propane, CO2 nonliquefied: helium, nitrogen dissolved gases: acetylene
316
...is lowest temp which vapor of a flammable liquid can be ignited in air
Flashpoint
317
A flammable liquid is any liquid with a flashpoint below ...F/C Stored in...
100F/37C flammable liquid safety cabinet
318
Safety color coding: red means 3 things... yellow means... orange means.. fluorescent orange... Color is contrasted with...
red: fire, danger, stop yellow: caution orange: warning fluorescent orange: bio hazard black
319
Fire pull alarms, bio med waste containers, and emergency stop are color...
red
320
Radiation signs are
yellow
321
Color biological hazard signs used to signify potential prescence of biohazardous infectious agent posing potential risk is color
fluorescent orange
322
Organization that sets color coded scheme for hazards
NFPA national fire protection agency
323
Blue diamond... 0-4...
health hazard normal to deadly
324
Red diamond... 0-4...
fire hazard won't burn to flash pt below 73F
325
White diamond... 6 specific hazards...
specific hazard -ACID -ALK (alkali) -COR (corrosive) -OXY (oxidizer) -radioactive symbol -W crossed out: don't use water
326
Yellow diamond 0-4
reactivity stable, may detonate
327
Fire with ordinary combustible material... Such as...
Class A paper, wood, cloth some rubber, plastic
328
Fire w/flammable or combustible liquid.... Such as...
Class B gasses, greases some rubber, plastic
329
Fire w/energized electric equipment
Class C
330
Fire w/combustible metal... such as...
Class D mag,sodium,lithium, potassium
331
Class extinguisher ordinary combustible materials such as wood, paper, cloth
Class A
332
Class extinguisher flammable or combustible liquid such as acetone, ethanol etc
Class B
333
Class extinguisher w/energized electrical
Class C
334
Class extinguisher w/combustible metal
Class D
335
Fire acrynom
Remove people from danger Activate alarm, call Confine fire Extinguish or evacuate
336
Extinguisher acroynym
Pull pin Aim at base Squeeze handle Sweep side to side
337
Electrical safety checked... ... and then...
upon install, annually
338
Requirements for radiation safety 4 reqs
-employee gets motoring equiment to monitor exposure -records and checkins annually -post sign radition caution symbol, caution, radiation area -keep radiation as low as reasonably achievable (ALARA) per NRC
339
NRC, ALARA
Nuclear regulatory commision as low as reasonably achievable
340
Federal agency regulates disposal of toxic/bio hazardous waste
EPA environmental protection agency
341
Act that gives EPA authority to control hazardous waste such as generation, trans, treatment, storage, disposal
RCRA resouce conservation and recovery act
342
Hazardous waste def... RCRA def...
any waste w/properties that make it dangerous or potentially harmful to environment or public health RCRA: waste that appears on one of the four hazardous waste lists or exhibits at least 1 of 4 characteristics (ignitablity,corrosivity,reactivity,toxicity)
343
Fed agency regulates packing, labeling, trans of hazardous. National safety by air/rail/highway/water
DOT dept of trans
344
IATA.. purpose...
international air transport association regulate packing,shipping by air
345
DOT training req within... and every...
90 days 3yrs
346
DOT requires markings on hazardous with these 4
-shipping name -UN id # -inhalation hazard if necessary -name/address cosignee
347
DOT Hazard has how many classes
9 stupid classes I won't remember
348
ICAO: international civil aviation organization instructions for safe transport by air IMO: international maritime organization by water
...
349
DOTs HMR has two categories... and ... ...capable of causing permanent disability/fatal ...not in a form to generally be capable of permanent disability or fatal ...which category does clinical lab specimens fall
Category A, B A: harm B: not generally harmful, most lab specimens
350
Not subject to packing and shipping reqs...
-blood/plasma from uninfected -dried blood spots, fecal occult blood on material -PT samples for research,diag,investigational
351
Category B is triple packaged ....,...., and ...
primary receptacle secondary packaging outer packaging
352
LAW that prohibits discrimination of disabilities either presently,past, perceived to, or associated with someone
ADA american disablities act
353
Def of ADA disability... Def of qualified employee...
physical or mental limits major life activity can perform the essential functions of the job or without a reasonable accommodaiton
354
FEDREAL AGENCY enforces employment , discrimination laws, protects from discrimination such as age, disability, equal pay, race, religion,sex,etc
EEOC equal employment opportunity commission
355
EEOC
equal employment opportunity commission
356
Federal law that defines min wage, overtime, how to be paid... classfied into...and...
FLSA fair labor standards act nonexempt: hourly exempt: salaried
357
FLSA
fair labor standards act
358
ACT of 1963 prohibiting discrimnation on race,color,creed,religion,sex etc which now includes disabilities, veterans, 40-70
title 7 civil rights act
359
Form of insurance providing compensation medical care who are injured on job in exchange for mandatory relinquishment of right to sue, also called compensation bargain
workmans comp
360
Payments made by goverment to unemployed; proportional to their previous earned salary
unemployment comp
361
Requires employers with more than 50 employees up to ...weeks of unpaid job proteced leave in any...mth period to care for baby,kid,spouse,parent or serious health can also leave intermittently or reduced schedule when medically necessary without employee permission, can still get benefits and right to return
FMLA 12 weeks unpaid job leave in 12mth period
362
FMLA
family and medical leave act
363
Act that provide health insurance for...or...mths after retiring,resigning,laid off, full time to part time, or discharged except for... ....
COBRA consolidated omnibus budget reconcilation act 18 or 36mths expect for gross misconduct
364
Act that -enables workers to keep health insurance protection when changing jobs -establishes electronic healthcare trans standards for HHS -maintain privacy etc health info
HIPAA
365
HIPAA
health insurance portability and accountability act
366
PHI examples
protected health info med rec appt schedule billing med list
367
eval of tecnicial skills.. done...
competency eval annually
368
eval of knowledge, skills, attitudes and beliefs... done...
performance eval anually
369
voluntary process non government grants recognition to an individual who has met certain education reqs and has entry level competency by examination
certification
370
mandatory process some states grant permission to engage in an occupaiton
licensure
371
voluntary process non government agency grants recognition to an organization that achieved a set predetermined standards
accreditation
372
Budget items such as salaries and benefits changed based on previous years budget, based on # of tests
forecast budget
373
Budget with fixed amount of money granted for fixed period of time, 1-2yrs. Usually government bodies
Appropriation budget
374
Budget with fixed(overhead) and variable expenses(reagents) are itemilzed. Usefull when test volume subject to change, thus able to adjust variable portion
Flexible budget
375
Budget used for continuous managment of ogranization used by lab managers
operational budget
376
Budget designed for purchase of equipment, expansion of program or remodeling
capital budget
377
Budget where historical budget is disregarded and new costs/items are made. Eliminates dead wood
Zero based budget
378
Budget prepared quarterly and more accurate than annual
Rolling quarter budget
379
Budget made monthly to anticipate cash flow, received/spent. Predicts timing/amt of cash flow
Cash budget
380
Cost directly assigned to production of product, billable test, consumables, labor
direct
381
costs not directly involved in production, personell costs, supervisor,phleb
indirect costs
382
costs that change with production volume, ie reagents
variable costs
383
costs that don't change with production volume, lease on equipement, techs needed
fixed
384
Fringe benefits can be ...% to ...% examples
20-25% of salary SS tax,FICA unemployment, workmans comp health/life/disability insurance retirement,vacation sick,maternity
385
Standardized descriptions of 5 character, alpha numeric codes w/text descripter coders/billers use to report healthcare services/procedures for reimbursement
CPT current procedural terminology
386
CPT
current procedural terminology
387
Category of CPT describes procedure/service with 5 digits
Category 1 CPT
388
Category of CPT supplemental tracking for performance measurement
Category II CPT
389
Category of CPT that is temporary tracking for new and emerging technologies
Category III CPT
390
Term when procedure was modified but code/def was not changed examples
CPT code modifier serum electropho PLT agg BF crystals ie. 91 repeat clinical diag lab test
391
ICD ICD-10-CM
international classificaition of diseases clinical modifications
392
Oldest method of tracking diseases and mortality in the world. Tabular list with disease code #s, index of disease entries, classification system for procedures ie. R31.0 asymptomatic hematuria
ICD, International Classification of Diseases ICD-10-CM
393
HCPCS codes
healthcare common procedure coding system
394
Standard HIPAA code set for reporting supplies, orthotic/prostetic devices, durable med equip. Report healthcare provider and services. ie.G0001 routine venipuncture for collection of blood
HCPCS healthcare common procedure coding system
395
Acquisition or improvement of work related skills by people already in the workforce. Keeps people up to date on skills etc.
CE continuing education
396
Old name for CLSI that develop accredited consensus clin lab standards
NCCLS national committee for clinical lab standards
397
Accredits labs under CMS, proficiency testing, and is member based physician organization
CAP college of american pathologists
398
Agency that approves new test methodologies/instruments/reagents before consumers can use
FDA
399
Biosafety hoods inspected...
annually
400
Federal legislation that regulates most labs
CLIA
401
Nonprofit that accredits healthcare organizations and programs in the US
JCAHO joint commision on accreditation of healthcare organization
402
Labs must have inspections every... Required by..
2yrs CLIA
403
Proficiency testing that doesn't meet CLIA is
failed SAME analyze in two consecutive PT events or 2 out of 3 testing events
404
4 examples of alternate PT testing
-split samples sent to other lab or ref lab -split sample w/established in house method, assayed material or regional pool -clinical validation by chart review -participation in ungraded/educational PT program
405
Split sample
Split sample comparison is performed by splitting a single sample into two aliquots. One aliquot is tested using the primary test method while the second aliquot is tested on by the same or an alternate test method at another acceptable laboratory.
406
transcription error entering manual result is an example of
post analytical
407
Most common analytical error
not checking specimen integrity, HIL
408
Most common post analytical error
clerical error
409
review procedure...and...
upon implementation and substantial revisians
410
thermometers must be check against NIST ...
annually
411
Centrifuge speed, timers checked
every 6 mths
412
Check quarterly
automatic pippetes 4x/yr
413
CTRL outside 3SD due to
random error
414
CTRL with 2 consecutive outside 4SD due to
random error
415
If only one CTRL is out of 2SD/95% what do you do
repeat same CTRL
416
4 docs req to keep in employee file
-job competency training checklist -annual peformance appraise -CE docs -remedial action docs
417
CEUs are...by CAP
not mandated
418
CEUs 3 facts
-required by some states/organizations -help learn about new stuff -help with networking
419
-customer complaints -monitoring trends for corrected reports are part of
QA
420
Federal law that requires competency of lab to be documented
CLIA
421
OSHA reqs safety training at...and then...
orientation, annually
422
3 OSHA TB plan req
-must get PPD skin tests -pos PPD must have annual chest xray -any PT contact must get fit for respirators
423
fire protocol
Rescue Alarm, call operator Contain Extinguish/evacuate
424
agency regulate disposal of biohazard waste
EPA
425
Fed agency regulates facilities that use radioisotopes
NRC nuclear regulatory commisson
426
Federal law defines min wage and OT
FLSA fair labor standards act
427
Agency enforces equal pay for equal work
EEOC equal employment opportunity commision
428
Title VII, prohibits discrimination in this labor law
civil rights act
429
HIPAA law requires....to establish standards for PHI
dept of HHS
430
molecules in solution=undissolved molecules A homogeneous mixture in which the dissolved substance (solute) is in dynamic equilibrium with its undissolved form. A...solution contains the maximum concentration of its solute. This maximum concentration is the solute's solubility limit.
saturated
431
Another term for analytical precision and repeatability
Coefficiant of variation
432
QC is a measure of...
reliability
433
Random due to these two
CTRL outside 3SD CTRL with 2 consecutive outside 4SD
434
99.95% purified chemical that can be measured directly
primary standard
435
derived from the primary and is less pure
Secondary standard
436
NCCLS
NCCLS national committee for clinical lab standards
437
COBRA
COBRA consolidated omnibus budget reconcilation act
438
laminar flow BSC is BSC #
2
439
What hazard communication pictogram defines a skin/eye and respiratory irritant?
Exclamation mark
440
Semi automated calibration method...
Gravimetric
441
OSHA safety training... Records kept..
Training annually Records kept 3yrs
442
Water ph
7.0
443
Coefficient of variation tests for... QC tests for...
CV: analytical precision QC: reliability
444
60g NaOH in 1L, normality? 1 Equivalent=40gmw for every 1 valence
60g/L x 1 Equivalent/40g =1.5N
445
Used as external QC, test accuracy of test methods
Proficiency testing
446
Under CLIA these two monitor proficiency testing, one requires
CMS requires Joint commission monitors also
447
4 Common causes of failed proficiency testing
-Clerical errors -instrument/method codes -calibration bias -not returning on time
448
An alternative performance assessment to determine reliability of analytical testing.
Split sample testing, alternate proficiency testing
449
What hazard communication pictogram defines oxidizers
Flame over circle
450
What hazard communication pictogram defines aquatic toxicity
Environment
451
What 2 hazard communication pictograms defines acute toxicity
Skull and cross bones Exclamation mark
452
What hazard communication pictogram defines explosives, self reactives, organic peroxides
Exploding bomb
453
What hazard communication pictogram defines eye damage
Corrosion
454
What hazard communication pictogram defines gases under pressure
Gas cylinder
455
What hazard communication pictogram defines narcotic effects and hazardous to ozone layer
Exclamation mark
456
What 2 hazard communication pictogram defines self reactives and organic peroxides
Flame Exploding bomb
457
What hazard communication pictogram defines aspiration/target organ/reproductive toxicity
Health hazard
458
BSL, how many levels
Biosafety levels, 4
459
BSL1: doesn't cause disease, most micro practices BSL 2: disease thru cut, ingest, mucous mem BSL 3: lethal, serious thru inhalation BSL 4: risk of aerosol, fatal, no vaccines
BSL 1: standard micro practices BSL2: standard plus signs, precautions, manual BSL 3: BSL 2 plus controled access and decontamination BSL 4: BSL 3 plus change clothes, shower, decontamination
460
A: paper, wood, cloth B: combustible liquid C: energized electrical D: combustible metals
...
461
Category of CPT codes: I: procedure or service II: supplemental tracking performance measurement III: temp set of tracking new and emerging technology
ICD codes: tracking diseases, mortality, R##.# HCPCS: reporting supplies, orthotic/prosthetic medical equipment G####
462
The GHS pictogram with an exclamation mark is used on substances that are harmful or irritating. The health effects are acute (set in quickly), but they're less severe than something marked with the toxic symbol. Chemical classes include:
-Skin, eye, or respiratory tract irritants -Skin sensitizers, which cause an allergic response -The lowest level of acutely toxic chemicals -Materials with narcotic effects (drowsiness, lack of coordination, and dizziness) -ozone
463
The health hazard pictogram is used for substances that present a health hazard over time. Chemical classes include:
-Carcinogens, which cause cancer -Mutagenic chemicals that cause genetic defects -Agents with reproductive toxicity that affects fertility or in utero development -Chemicals with target organ toxicity -Respiratory sensitizers -Substances with aspiration toxicity
464
Primary standard is what percent of a purified chemical that can be measured directly
99.95% purified chemical
465
Oversees FDA, CMS, CDC
Dept HHS
466
Major bacteria in HIV infection
Mycobacterium
467
3 parasites with HIV
Pneumocystis Toxoplasma Cryptosporidium
468
2 fungi in HIV
Cryptococcus Candida
469
4 viruses in HIV
CMV EBV HBV HSV
470
Min # standards needed for standard curve
3
471
Inspections for lab every... Required by..
2 yrs CLIA
472
Molarity calc
gmw/L
473
Normality calc
1 equ (Each H is 1)/gmw
474
Centrifuge inspection: time, speed every
6mths
475
BSA hoods, thermometer every
Year
476
Lab inspection every
2yrs
477
Pipettes every
Quarter
478
QA competency done... Then...
Twice a year then annually
479
Rule to report to state serious incident
Code 15
480
Report injury within
48hrs
481
Passing PT for main lab... Passing PT for BB... Fail...
Lab: 80% BB: 100% Fail: 2 consecutive PT events for one analyte
482
QA Records kept
2 years
483
RCF calc
1.118x 10^-5 x r x rpm^2
484
RCF NV Rpm NV Time
RCF 1-1200 Rpm 3500 10-15 min
485
Most accurate pipette for Ctrl... Concentration...
Transfer, volumetric 1:1000
486
C to F
5/9 x (F-32)
487
F to C
(9/5 x C) +32
488
Normal osmolality
275-295
489
Osmal gap calc
Measured- calculated
490
CV calc, how much ok
SD/mean x 100 5%
491
1SD.. 2SD... 3SD...
1: 68 2: 95 3: 99
492
pH calc... Normal pH... bicarb/acid...
pH= pKa + log (salt/A)(acid/HA) 7.4 20:1
493
Beers law con/abs calc
Concen unk/Concen std = Abs unk/Abs std
494
Copy of Proficiency testing and patient records kept... BB records kept... BB products kept.. Pathology kept...
Copy of Proficiency testing and patient records kept...2yrs BB records kept...5yrs BB products kept..6mths after expire or whatever is later Pathology kept...10yrs
495
QC tests
Reliability
496
Two rules that indicate random error, no pattern, due to pipetting, electronics, HIL
1-3SD and R4S
497
2-2S, 4-1S, and 10x indicate...errors that happen...
Systematic happen over time
498
Gradual loss, accumulation and aging can lead to this systematic error leads to drift from mean on one side
Trend
499
This is a systematic error that is an abrupt change due to reagent change without Cal, new lot, maintenance or room temp
Shift
500
Error that's a warning
1-2S
501
Deka: Deci:
Deka: 10*1 Deci: 10^-1
502
95F is what C
35C
503
95C is what F
203F
504
Post exposure, how often tested... Save blood..
Initial, 3, 6, 12 Blood 90 days
505
How many BSC... Which one most micro...
1,2,3 2A
506
How many BSL
1,2,3,4
507
Pictogram of exclamation mark for what 6 hazards
Skin, irritants: -skin sensitizer -irritant(skin, eye, respiratory tract) -acute toxicity -narcotic effects -hazardous to ozone layer
508
Pictogram of health hazard(person) of what 6 hazards
-carcinogen -mutageniticity -reproductive toxicity -target organ toxicity -aspiration toxicity -respiratory sensitizer
509
TLA
Total laboratory automation The move toward total laboratory automation is being driven by forces outside the clinical laboratory, such as healthcare reform and managed care. Developments in automation within the three phases of laboratory testing, robotics, data management, and workflow integration are making the move toward TLA possible.
510
How must a laboratory operate to handle TB sputum and TM materials?
Biosafety level of 2+ or 3 BSL-3 builds upon the requirements of BSL-2. Organisms that can cause serious or potentially lethal disease through respiratory transmission are typically worked with in a BSL-3 laboratory. Example: Mycobacterium tuberculosis
511
Absorbance can be calculated easily from percent transmission using which calculation?
2 – log10 %T Absorbance can be calculated easily from percent transmission using 2 – log10 %T. If all the light passes through a solution without any absorption, absorbance is zero and the %T is 100%. If all the light is absorbed, %T is zero, and absorption is infinite.
512
What category are agents anthrax, botulism, plague, smallpox, tularemia, filoviruses, and arenaviruses classified as?
Category A are pathogens that are rarely seen in the United States. These agents have the highest priority; organisms in this category pose a risk to national security because they can be easily disseminated or transmitted from person to person and result in high mortality rates and have the potential for major public health impact.
513
How many points up or down in a row is a trend
A trend is seven points in a row in an upward direction or seven points in a row in a downward direction. With a trend, it doesn’t matter if the centerline is crossed.
514
Which category of bioterrorism agents include emerging pathogens that could be engineered for mass dissemination in the future because of availability, ease of production and dissemination?
Category C Bioterrorism agents are a concern to laboratories. These agents are divided into categories A, B and C. The agents that have the third-highest priority are in the Category C and include emerging pathogens. Category C bioterrorism agents have the potential to be engineered for mess dissemination.
515
What category of testing involves microscopic evaluation (i.e., wet mount, Potassium hydroxide preparation, fern test, etc.) by a physician in the office for their own patient?
Provider-Performed Microscopy (PPM) To meet the criteria for inclusion in the Provider-Performed Microscopy (PPM) category, procedures must follow these specifications: The examination must be personally performed by the practitioner (defined as a physician), a midlevel practitioner (defined as a physician, a midlevel practitioner under the supervision of a physician), or a dentist. The procedure must be categorized as moderately complex. The primary test instrument is the microscope (limited to brightfield or phase-contrast microscopy). The specimen is labile. Control materials are not available. Specimen handling is limited. Proficiency testing is not required; however, twice-yearly verification of accuracy is required. Those with a PPM certificate can also perform waived testing.
516
Which three veins are most frequently used for a venipuncture?
Cephalic, basilic, and median cubital In the arm, the three veins that are typically used for venipuncture are the cephalic, basilic, and median cubital.
517
In the more common spectrophotometer, the electronic measuring device consists of a ____________ and a galvanometer.
photoelectric cell The amount of light transmitted by the solution in the cuvette is measured by a photoelectric cell, a sensitive instrument producing electrons in proportion to the amount of light hitting it. The electrons are passed on to a galvanometer, where they are measured.
518
What is the order of draw for multiple evacuated tubes?
Blood culture (aerobic), blood culture (anaerobic), blue, red, green stopper, lavender, and 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.
519
What category of bioterrorism agents have the highest priority and pose a risk to national security because they can be easily disseminated or transmitted from person to person, result in high mortality rates and have the potential for major public health impact?
Category A Bioterrorism agents are a concern to laboratories. These agents are divided into categories A, B and C. Category A agents have the highest priority. Anthrax and Smallpox are examples of Category A agents
520
Which term is defined as blood and blood products, contaminated sharps, pathology waste products, and microbiological waste?
Infectious waste Infectious waste is to be packaged for disposal in color-coded containers and should be labeled as such with the universal symbol for biohazards.
521
What category of bioterrorism agents include pathogens that are moderately easy to disseminate, result in moderate and low morbidity rates, and require specific enhancements of the CDC’s diagnostic capacity and enhanced disease surveillance?
Category B Bioterrorism agents are a concern to laboratories. These agents are divided into categories A, B and C; and Category B agents have the second highest priority. Category B agents have moderate morbidity (suffering from the disease) with low mortality (death) rates. Ricin toxin is an example of Category B agent.
522
Which category of bioterrorism agents include emerging pathogens that could be engineered for mass dissemination in the future because of availability, ease of production and dissemination?
Category C Bioterrorism agents are a concern to laboratories. These agents are divided into categories A, B and C. The agents that have the third-highest priority are in the Category C and include emerging pathogens. Category C bioterrorism agents have the potential to be engineered for mess dissemination.
523
What category are agents anthrax, botulism, plague, smallpox, tularemia, filoviruses, and arenaviruses classified as?
Category A Category A are pathogens that are rarely seen in the United States. These agents have the highest priority; organisms in this category pose a risk to national security because they can be easily disseminated or transmitted from person to person and result in high mortality rates and have the potential for major public health impact.
524
In the calculation of MCV = HCT x 10/___?
RBC MCV is calculated manually by dividing the volume of packed red cells (hematocrit) by the number of red cells, using the formula: MCV= HCT X 10/RBC.
525
A 200-mg/dL solution was diluted 1:10. This diluted solution was then additionally diluted 1:5. What is the concentration of the final solution?
4 mg/dL 200 mg/dL x 1/10 x1/5 = 200/50 = 4 mg/dL
526
What demonstrates an abrupt change from the established average value of the control for three days in a row?
Shift Assaying control specimens and standards along with patient specimens serves several major functions. A shift is defined as a sudden and sustained change in one direction in control sample values. A common cause of a shift is the failure to calibrate reagent when changing lot numbers.
527
Which substance is employed to produce a chemical reaction?
A reagent is defined as any substance employed to produce a chemical reaction. In highly automated clinical laboratories, very few reagents are prepared by laboratory staff. In many cases, only water or buffer needs to be added to a prepackaged reagent.
528
3 LAYERS of anticoagulated blood and they're components/% Top: middle: bottom:
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

AMT Lab/Phleb basics (1 decks)

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