Laboratory PT1 Flashcards
1
Q
What are laboratory policies aimed to provide?
A
a safe and healthful enviroment
2
Q
What is the first priority of laboratory rules when handling infectious materials?
A
Safety
3
Q
What is not allowed in a laboratory?
A
eating drinking smoking apply cosmetics handling contact lenses horseplay
4
Q
What actions must be taken if a mishap or near-miss occurs in the laboratory?
A
Inform chain of command
Submit A&I report
5
Q
What is an infection control strategy designed to reduce the risk of disease transmissions introduced by the CDC in response to the HIV epidemic in 1985?
A
Universal Precautions
6
Q
What are examples of blood borne pathogens that are infectious?
A
Hep B
Hep C
HIV
7
Q
Universal precautions apply to what specimens?
A
Blood
Tissue
Semen
8
Q
Universal precautions do not apply to what specimens?
A
Feces Nasal Secretions Sputum Sweat Tears Urine or vomit w/o blood
9
Q
Are general work clothes considered PPE?
A
No
10
Q
What does PPE include?
A
Gloves
Gown, apron, lab coat
eye pro or face shield
other equipment (Caps, Shoes, Covers, Masks)
11
Q
What action is taken with gloves that have been contaminated, torn, punctured or when the ability to function as a barrier is compromised?
A
Replace gloves
12
Q
Gloves shall be what?
A
Disposable
Hypoallergenic
Appropriate Size
13
Q
Gowns, aprons and lab coats should be worn when?
A
Worn if risk of splashes of infections or hazardous substances.
14
Q
Eye protection and face shields must be worn if splashes could occur and must have what features?
A
Face shields - chin length
Goggles- Solid side shields
15
Q
What are the levels of Governing Bodies for the Laboratory? (broad)
A
Federal
State
Navy
Other (SOFA)
16
Q
What agencies fall under the federal body for laboratories?
A
Occupational Safety and Health Administration (OSHA)
National Institute for Occupational Safety and Health (NIOSH)
Code of Federal Regulations (CFR)
17
Q
What federal agency was created in 1970 by the US Department of Labor and is responsible for developing and enforcing workplace safety and health regulations?
A
OSHA
18
Q
What federal agency was created in 1970 by the US Department of Health and Human Services and was established to assure safe and healthful working conditions for those working by providing research, education and training?
A
NIOSH
19
Q
What act established OSHA and NIOSH?
A
Occupational Safety and Health Act of 1970
20
Q
What is included in OSHA’s Mission?
A
- Assure safety by setting and enforcing standards.
- Provide training, outreach and education
- Establish partnerships
- Encourage continual improvement in safety and health
21
Q
What are NIOSH’s responsibilities?
A
- Focused program research of high priority or high risk sectors
- Implement/maintain system of surveillance of injury, illness or hazards
- Increase prevention via evaluations, interventions and recommendations
- Provide information and training
22
Q
How often is the CFR revised?
A
Annually
23
Q
The CFR is divided into how many titles?
A
50
24
Q
What federal agency has regulations pertaining to the transportation of hazardous waste and if violated there are fines and penalities?
A
CFR
25
Each state has what divisions and departments?
Division of Occupational Safety and Health
Public Health Department
-Department of Health Services and Medical Waste Management
Department of Health and Human Services and Medical Waste management
Occupational Safety and Health Regulations
26
The Navy's labs are governed by what?
Clinical Laboratory Improvement Program (CLIP)
NAVOSH
BUMED
SOFA
27
What is the instruction for CLIP?
DODI 6440.02
28
CLIP applies to what platforms?
Non-fixed medical treatment facilities (MD aboard ships)
29
CLIP inspections occur how often?
Every 2 years
30
Who can perform a CLIP inspection?
Lab Officer
| Appointed Lab Tech for hospital in AOR
31
CLIP records must be maintained are what?
QCs on samples, test kits and analyzers
Logs of refrigerator and freezers
Maintenance logs for equipment
32
When can a technical assist visit from AOR's hospital be requested?
Before MRI
| Whenever needed to be compliant
33
What is the Navy's version of OSHA?
NAVOSH
34
What are the BUMED references IRT Navy Laboratory?
BUMED 6280.1 Series of Management of Infectious Waste
| NAVEDTRA 14295, Ch 19
35
SOFA agreements are between who?
host nation and military forces
36
What are the different types of waste?
Non-infectious
Infectious
Sharps
37
Medical waste that does not contain enough pathogen to be harmful is considered what?
Non-infectious or general waste
38
A liquid or solid waste containing potential pathogens in sufficient numbers to cause disease in susceptible hosts is what?
Infectious waste
39
What are examples of regulated body fluids?
```
Blood and blood components
Pleural fluids
Amniotic fluid
Synovial fluid
Peritoneal fluid
Pericardial fluid
CSF
Semen
Dialysate
```
40
Where can regulated body fluids be disposed?
Toilet or the hopper
41
What are examples of sharps?
```
Hypodermic needle
Blade
Slide
Coverslips
Contaminated broken glass or plastic ware
```
42
Segregation of waste should be conducted when?
At point of origin
43
Red biohazard bags are used for?
Infectious or regulated waste
44
How often should bio bags be emptied?
Daily
45
How are regulated or infectious waste prepared for disposal in a red bio bag?
Double bagged, goose-necked with heavy tape
| Labeled with name address, phone number of originator and biohazard symbol
46
What is the intervals a sharps container must be replaced?
After 90 days
3/4 full
foul odor is detected
47
What are the requirements for infectious waste storage?
Marked room with bio and authorized personnel only signs
Near treatment or transport site and lockable
Kept clean and free of pests/rodents
Limits storage to 7 days
48
When disposing of infectious materials ashore you must comply with what?
local, state, federal and SOFA regulations
49
Monitoring system for disposal of infectious materials ashore must include?
```
Date
time
amount
type
disposition
```
50
What are examples for criteria for overboard discharge?
Endangers health or safety
unacceptable nuisance
Compromise of combat readiness
51
What conditions must be met to dispose of infectious material afloat?
CO approval
Great than 50 nautical miles from shore
Properly packaged and weighted for negative buoyancy
52
Entries into the ship's deck log and medical journal must include what?
Date
Time
Ship location
Number of bags
53
What are the two methods of blood collection?
Capillary Puncture
| Venipuncture method
54
What is capillary puncture the method of choice and useful in what patients?
Most useful-pediatric
| useful-extreme obesity, severe burns, thrombotic tendencies
55
Where can capillary punctures be performed?
heel
finger
earlobe
toe
56
What is the best method of blood collection?
Venipuncture
57
What is the primary source of specimen for clinical laboratory analyses?
Venipuncture
58
Why do you not draw from IV sites?
Diluted specimens
| Alters test results
59
Max depth of a capillary puncture device should not exceed what?
2mm
60
What distance do you apply a tourniquet for venipunctures?
2-3 inches above AC
61
If a blood pressure cuff is used for venipuncture how much do you inflate?
30mm/Hg
62
What is the angle and orientation of a needle during venipuncture?
15-30 degree
| bevel up
63
How long does a patient hold pressure to venipuncture site after blood draw?
3 mins
64
What are the blood anticoagulants used in blood tubes?
EDTA
Sodium Citrate
Heparin
Sodium fluoride
65
Which blood tubes have EDTA in them?
Purple tops
66
Purple tops are typically used for what labs?
Hematology studies
- CBC w/ or w/o Diff
- ESR
- A1C
67
What is the most widely used anticoagulant in blood tubes?
EDTA
68
EDTA binds to what element?
Calcium
69
What anticoagulant is found in light blue tops?
sodium citrate
70
Light blue tops are used for what labs?
coagulation studies
- PT
- PTT
- Fibrinogen
- D-dimer
71
How long after collection are light blue tops good for?
4 hours
72
What blood tubes is heparin used as an anticoagulant?
Green tops
73
What are green tops used for?
Plasma and Chemistry testing
- Ammonia
- ACTH
74
Heparin inhibits clotting in green tubes by what method??
Inhibits thrombin, creating antithrombin
75
What are examples of miscellaneous tubes that do not use anticoagulants?
Red top
SST/Gold Top
Tiger top
HIV tube
76
Red top tubes are used for what?
Chemistry
Serology
Other tests requiring serum
77
SST/Gold tops, Tiger tops and HIV tubs contain what and are used primarily for what testing?
Serum separator gel
| Chemistry
78
What tubes use sodium fluoride?
Grey top
79
Grey tops are used for what studies?
Glucose
| ETOH
80
What are typical phlebotomy procedural errors?
```
Using IV sites
Prolong TQ
Wrong tube
Wrong draw order
Short fill
Not mixing tube
```
81
What may result if a tourniquet is applied for too long?
Measurable increase in blood cell concentration (hemoconcentration)
82
What is the draw order?
Non additive tubes then tubes with additives:
Additive tube order:
Cultures, blue, red, SST, green, purple, gray
83
What happens when the wrong type is used for a blood draw?
unable to perform the test
84
What are some blood draw complications?
Syncope
Infection
Continue bleeding
85
What occurs when integrity of the vein is compromised and blood is leaking into the tissues?
Hematoma
86
What is included in a Complete Blood Count results?
```
WBC leukocyte count
RBC Erythrocyte Count
Hemoglobin
Hematocrit
Platelets
```
87
RBC count includes what?
Mean Corpuscular Volume (MCV)
Mean Corpuscular Hemoglobin (MCH)
Mean Corpuscular Hgb Concentration (MCHC)
RBC distribution width (RDW)
88
WBC w/ Diff is a test used to determine what?
Infection or leukemia
89
What is the normal WBC range?
4.5-11.0 x10^3/mm^3
90
What is the low critical value for WBC w/ Diff?
<2k/mm^3
91
What is the high critical value of WBC w/ diff?
30k/mm^3
92
In relative percentages of each cell must add up to 100% in WBC count. If one increases the other cells must?
decrease
93
What are the WBC percentages?
```
Neutrophils 50-70%
Eosinophils 1-5%
Basophils 0-1%
Lymphocytes 20-40%
Monocytes 1-6%
```
94
What are the normal adult ranges of RBC?
M-4.5-5.9 x 10^6 cells/uL
| F-4.5-5.1 x 10^6 cells/uL
95
MCV is what?
an estimate of the average volume (size) of RBCs
96
An increase in MCV is associated with?
B12 or folate deficiency
97
A decrease in MCV implies?
abnormality in Hgb synthesis
98
What is the normal range of MCV?
76-96 fL/cell
99
MCH is the amount of what?>
hemoglobin per RBC
100
Decrease of MCH implies?
iron deficiency
101
What is the normal range of MCH?
27-32 pg/cell
102
MCHC is what?
average concentration of Hgb in a given volume of packed RBCs
103
How is MCHC calculated?
Hgb/Hct x100
104
What is the normal range of MCHC?
30-35 g/dL
105
What is a protein that serves as the vehicle for the transportation of oxygen and carbon dioxide in a RBC?
hemoglobin (Hgb)
106
What does the Hgb molecule consist of?
two pairs of polypeptide chains
| four prosthetic heme groups, each containing one atom of ferrous iron
107
What are the normal adult ranges for Hgb?
M-14-17.5 g/dL
| F-12.3-15.3 g/dL
108
What is the critical low value of Hgb?
<8 g/dL
109
What is the ratio of the volume of erythrocytes to that of the whole blood?
Hematocrit (Hct)
110
Hct is usually what amount higher than Hgb?
3 times the amount
111
Hct is usually what amount higher than Hgb?
3 times the amount
112
What are the normal ranges of Hct?
M 42-52%
| F 37-47%
113
What is the normal value of Platelet count?
150k to 400k
114
What is the critical values for Plt?
Low <20k
| High >1m
115
What results will a QBC STAR give?
```
Hct
Hgb
MCHC
WBC
-Granulocytes
-% Granulocytes
-Lymph/Mono
-% Lymph/Mono
Platelets
```
116
What results does the QBC star not give?
RBC
117
The special coating on the QBC star tube stains the two WBC populations and the platelet layer what colors?
Granulocytes -orange-yellow
Lymph/mono -green
Platelets -yellow-orange
118
The ability to quantify the cells is enhanced by what?
precision plastic float
119
What is directly measured from the cell layers?
Hct
WBC count
Platelet count
120
What instrument is intended for in vitro diagnostic use?
QBC Star
121
How many times must you mix the blood before filling the QBC star tube?
12-15 times
122
What is the blood volume in a QBC star tube?
65-75 microliters
123
How many times will you rock the QBC Star tube to ensure proper mixing with the orange coating?
at least 4
124
What time must the QBC star tube be inserted into the machine for testing?
within 15 min after capping.
125
When are electronic QC values printed from the QBC star?
every 8 hrs and start up
126
The LCD screen will display what for values out of range?
dashes only
127
What will the printout read for values outside the normal range?
out of operating range
128
What is used for cleaning the QBC star?
damp cloth and mild detergent
129
What is used to disinfect the QBC star?
10% solution of household bleach, stand for 10 mins
| flush with water
130
Fecal blood is a frequent and early symptom of what?
Colorectal cancer
131
Early detection of fecal blood can decrease mortality of colon cancer by what?
15-35%
132
Patient education before Occult testing should include what?
Meat-free diet x 3 days
| High fiber diet
133
What is the time frame samples are collected for Occult testing?
3 specimens from 3 separate days
134
Where is the sample taken from for occult testing?
center of stool sample
135
HCG stands for?
Human Chorionic Gonadotropin
136
When and where is HCG produced?
from the earliest stages of fetus development
| from the placenta
137
What other conditions might you find HCG?
Trophoblastic tumors in men
Beginning of menopause
Cyst-like moles
138
Quantitative HCG measures what?
Amount of HCG, used for estimation of gestational age and dx early pregnancy
