Exam 1 Lecture 1 Flashcards
(85 cards)
1
Q
What is Hematology?
What division of the Lab is responsible for this?
A
Study of Blood and its disorders
-Clinical Pathology
2
Q
BMP stands for what and it is what type of lab panel?
A
Basic Metabolic Panel Type: Chemistry Panel
3
Q
What is included in a BMP?
A
Electrolytes and Kidney Function
- Sodium (Na+)
- Potassium (K+)
- Chloride (Cl-)
- Carbon Dioxide Content (CO2)
- Blood Urea Nitrogen (BUN)
- Serum Creatinine (Cr)
- Serum Glucose (Glu)
- Total Calcium (Calcium)
4
Q
BMP is collected in what color tube and has what availability to be conducted?
A
-Light Green PST
-Gold SST
-Red
Available: 24/7
5
Q
What does the BUN measure?
A
Amount of Urea Nitrogen in the blood
6
Q
Where and How is urea formed?
A
Liver as end product of protein metabolism and transported to kidneys for excretion
7
Q
What does an increase in BUN indicate?
A
- Decrease glomerular filtration
- Increase tubular reabsorption
- inadequate excretion
- Increased production in the gut from ingested protein or blood
8
Q
What is the BUN interpreted in conjunction with?
A
Creatinine
9
Q
The BUN and Creatinine tests are referred to as?
A
Renal Function Studies
10
Q
What role do clinical laboratory test play in patient care?
A
Detection, Diagnosis, Treatment of disease
11
Q
What do laboratory tests help determine?
A
Presence, Extent, or Absence of disease
Monitor Effectiveness of treatment
12
Q
What is the primary and secondary function of the Clinical Laboratory? (Role of)
A
Primary: Generate Information
Secondary: Educate Providers and other staff
13
Q
In the rationale for ordering laboratory tests what are some recommendations as to why a lab test should be ordered?
A
- Identify Changes in pt’s health
- Diagnose a disease or condition
- Plan treatment for disease or condition
- Evaluate response to treatment
- Monitor course of disease over time
14
Q
What affects lab results?
A
- Gender
- Age
- Race
- Medication/s
- Pt compliance w/preparatory instructions
- Variations in lab techniques
- Variation from one lab to another
15
Q
The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients, refers to what?
A
Evidence Based Medicine
16
Q
What are the aspects that make up Evidence Based Medicine?
A
- Individual Clinical Expertise
- Best External Evidence
- Patient Values and Expectations
17
Q
What does the practice of Evidence Based Medicine mean?
A
Integrating individual clinical expertise with the best available external clinical evidence from systematic research
18
Q
The overutilization of laboratory testing increases the likelihood of what? (inappropriate Lab Testing)
A
- Incorrect Diagnosis
- Increased Costs
- Adverse Outcomes
19
Q
A ‘Good’ Type of Lab Test will provide what information?
A
Useful information in patient management decisions
20
Q
A ‘Bad’ Type of Lab Test will provide what information?
A
Non Useful information in patient management decisions and uses valuable resources
21
Q
An ‘Ugly’ Type of Lab Test will provide what information?
A
Misleading or irrelevant information and uses valuable resources
22
Q
A ‘Good’ Screening Lab test has what type of Sensitivity and Predictive Value?
A
High Sensitivity
Negative Predictive Value
23
Q
A ‘Good’ Diagnosis’ Lab Test has what type of Specificity and Predictive Value?
A
High Specificity
Positive Predictive Value
24
Q
Describe the Basic Organizational Structure of the Laboratory?
A
- Medical Director/Laboratory Director (MD, DO, PhD)
- Laboratory Manager/Supervisor (MLS(ASCP)^CM)
- Anatomic Pathology, Support Services, Clinical Pathology
25
What is provided by Support Services in the Laboratory?
- Central Process/Client Services
- Phlebotomy
- Clerical Services
- Laboratory Information Systems
26
Anatomical Pathology is responsible for what type of services/testing?
Histology
Cytology
Autopsy
27
Clinical Pathology is responsible for what type of services/testing?
```
Microbiology
Hematology
Urinalysis
Serology
Chemistry
Immunohematology
```
28
Microbiology section is responsible for what lab tests?
```
Cultures/Sensitivity
Gram Stain
Parasitology
Mycology
Virology
```
29
Hematology section is Responsible for what lab tests?
CBC
ESR
Coagulation
Body Fluid
30
Urinalysis section is Responsible for what lab tests?
Routine UA
| HCG
31
Serology section is Responsible for what lab tests?
Ab titer
Immune function
Autoimmune disorders
32
Chemistry section is Responsible for what lab tests?
Clinical Chemistry
- Routine Profiles
- Urine Chemistry
- CSF Chemistry
- TDM
- Toxicology
33
Immunohematology section is Responsible for what lab tests?
Blood Bank
Blood Donation
Therapeutic Phlebotomy
34
Define Histology.
| What division of the Lab is responsible for this?
Study of the microscopic anatomy (examination of) cells and tissues
-Anatomic Pathology
35
Define Cytology.
| What division of the Lab is responsible for this?
Study of cells in terms of Structure, Function, and Chemistry
-Anatomic Pathology
36
What does Hematology specifically look at in the lab sample?
-Blood Components (Cell counts, Blood Cells, Bone Marrow Cells)
37
Hematology aids in the diagnosis of what disorders/diseases?
Anemia
Hemophilia
Blood-Clotting Disorders
Leukemia
38
What division of the lab conducts routine urine screening tests and these tests aid in detection of what?
Clinical Pathology: Urinalysis section
| -Detection: Disease related to Kidneys and Urinary Tract
39
The Clinical Pathology Division, Chemistry section uses what type of process to measure what of the blood?
Uses Chemical Processes to measure levels of chemical components of the blood
40
What are the most common specimen tested by the Chemistry section of the Clinical Pathology division?
Blood and Urine
41
What Section of the Clinical Pathology division of the is able to conduct tests for the hormones, Cortisol, Thyroxine (T4), TSH, FSH, ACTH, Growth Hormones? Which Endocrine glands produce each of these?
Chemistry section
- Cortisol: Adrenal Glands
- Thyroxine (T4), TSH: Thyroid or Parathyroid Gland
- FSH, ACTH, Growth Hormones: Pituitary Gland
42
What can raised or lowered levels of certain hormones indicate?
Over-or-under activity of those glands
43
What section of the Clinical Pathology section conducts tests for levels of lipids?
Chemistry
44
What are lipids and what can they signal?
Fatty substances that can help signal coronary heart disease and liver disease with increased levels
- Triglycerides (Body Fat)
- Phospholipids (Part of Cell Membrane)
- Sterols (Cholesterol)
45
Cholesterol tests can signal what?
HDL; LDL, can estimate risk for what?
Triglycerides together w/what can help indicate risk for what?
Cholesterol: Coronary Heart Disease
HDL;LDL: Coronary Heart Disease
Triglycerides w/levels of cholesterol, indicate risk for Coronary Heart Disease
46
The chemistry section of the clinical pathology division can measure metabolic substances to evaluate organ function; BUN (Blood Urea Nitrogen) and Uric Acid are used to evaluate what organs?
BUN: Kidney or Liver Function
| Uric Acid: Can Signal Gout; Kidney Disease, other tissue damage
47
What can Proteins in lab tests indicate? Chemistry Section
Metabolic Disorders
Nutritional Disorders
Certain Cancers
48
What protein can signal Liver or Kidney disease, or Malnutrition?
Albumin
49
What protein can signal infection or inflammation and certain blood cancers?
Globulins
50
Enzymes are released into the blood by what and the level and type of enzyme released can indicate what?
Released by: Organs
| Indicate: Organ Affected
51
The Enzyme Creatine Kinase can signal what?
Heart Damage from Heart Attack
52
The Enzyme Alanine Aminotransferase (ALT), Aspartate or Aminotransferase (AST) can signal what?
Liver Disorders
53
The Enzyme Amylase and Lipase can signal what?
Inflammation or Cancer of the Pancreas
54
What section of the Clinical Pathology Division ensures donated blood or blood products are safe?
Transfusion Services
55
What is included to ensure the blood products are safe for transfusion?
Blood Type and cross
| Testing for infectious diseases
56
What Ag's and Ab's are present on the blood types, A, B, AB, and O? Which is considered a universal recipient and which is considered a universal donor?
A: Ag-A, Ab-B
B: Ag-B, Ab-A
AB: Ag-AB, Ab-None, Universal Recipient
O: Ag-None, Ab-AB, Universal Donor
57
Defined: The Study of disease-causing microorganisms (bacteria, fungi, parasites, viruses)
Microbiology
58
What section of the Clinical Pathology division of the lab is responsible for identifying infectious agents in blood, urine, sputum, feces, CSF and other body fluids?
Microbiology
59
What are the various techniques used by the microbiology section to identify infectious agents?
Cultures
Chemical, Immunological, and genetic tests
Examination under a microscope
Staining
60
What test is used to diagnose bacterial infections of the blood?
Blood Culture
61
What test is used to identify disease-causing organisms and test for effectiveness of antibiotics?
Culture and Sensitivity of burns and wounds
62
What test can be used to identify lower respiratory tract infections such as pneumonia?
Sputum Culture
63
What test can be used to identify bacteria causing GI upset or parasites that cause disease (i.e. pinworms)?
Stool Culture
64
A urine culture test can be used to identify what?
Disease-causing organisms in the kidney and urinary tract
65
Defined: The study of the body's immune system and its functions and disorders.
Immunology
66
Defined: The study of blood serum.
Serology
67
Immunology and Serology section of the lab are part of what lab division?
Clinical Pathology
68
What do Immunology and serology tests focus on?
- Identifying Ab's
- Investigating problems w/the immune system
- Determine organ compatibility
69
What test conducted by the Immunology and Serology section of the lab can determine the state of an immunodeficiency and certain cancers?
Immunoglobins
70
Rheumatoid Factor test is used for what?
To Classify arthritis and diagnose rheumatoid arthritis
71
Infectious diseases test for what?
Ab response
72
What is used to diagnose syphilis, which then must be confirmed with a more specific test?
Venereal Disease Research Laboratory (VDRL)
73
What is used to determine compatibility in organ transplantation, to determine paternity and to diagnose HLA-related disorders?
HLA Typing (Human Leukocyte Antigens)
74
What are the different sites of conducting lab tests?
```
Central Lab
Satellite Lab
Point of Care Testing
Reference Laboratory
Provider Office
```
75
What defined the educational requirements, training, and competency requirements for personnel in the clinical laboratory?
Clinical Laboratory Improvement Amendments (CLIA)
76
Who is considered to have ownership of the lab?
Pathologist or PhD
77
Name the Primary Laboratory Accrediting Organizations?
Commission on Office Lab Accreditation (COLA)
College of American Pathologists (CAP)
The Joint Commission (JTC)
American Association of Blood Banks (AABB)
Clinical And Laboratory Standard Institute (CLSI)
78
What established quality standards for laboratories to ensure the accuracy, reliability, and timeliness of patient test results regardless of where the test is performed? By how much did deficiencies decrease?
1988 Clinical Laboratory Improvement Amendments (CLIA)
| -40%
79
What are the Three phases of testing as part of the CLIA in the quality standards for laboratory testing?
1. Before Testing (Test Ordering and Specimen Collection)
2. During Testing (Control testing, test performance, and results interpretation and recording)
3. After Testing (Result reporting, Documentation, Confirmatory Testing, and Biohazard Waste Disposal)
80
From the CLIA '88 four categories of test complexity were established, what are the four categories and who determined them?
Determined by: FDA
- Minimal Complexity (AKA Waived Testing)
- Provider Performed Microscopy (Subcategory of Moderate Complexity Testing)
- Moderate Complexity
- High Complexity
81
Name the criteria used for the classification of testing complexity? (From CLIA '88)
1. Risk of Harm to Patient
2. Risk of an Erroneous Result
3. Type of Testing Method Used
4. Degree of Independent Judgment and Interpretation
5. Availability of the Test for Home Use
82
What tests are cleared by the FDA for Home use?
Waived Tests (Minimal Complexity)
83
What tests employ methodologies that are so simple and accurate as to render the likelihood of erroneous results negligible?
Waived Tests (Minimal Complexity)
84
What test complexity level poses no reasonable risk of harm to the patient if the test is performed incorrectly?
Waived Tests (Minimal Complexity)
85
Give some examples of Waived Testing?
- Dipstick or Tablet Reagent Urinalysis
- Fecal Occult Blood
- Ovulation Tests
- Urine Pregnancy Tests
- Erythrocyte Sedimentation Rate
- Hemoglobin
- Most "Bed Side" Testing
