Pre-analytical phase in chemistry assay

Question 1

determine and address the root cause problem identified by QC and QA.

Answer 1

Quality improvement (QI)

Question 2

The application of this in the clinical laboratory is identification of problem with a process that likely to cause error.

Answer 2

Quality improvement (QI)

Question 3

work to eliminate the waste, such as streamlining a process to reduce wait times or modifying a process to reduce cost

Answer 3

Lean principles

Question 3

These are business philosophy and methodologies focusing on improving quality of products or services.

Question 4

The Six Sigma business strategy was developed by

Answer 4

Motorola, Inc.

Question 5

Lean principles

Answer 5

Defects
overproduction
waiting
unused talent
transportation
inventory
motion
extra-processing

Question 5

It seeks to improve the performance of a process by identifying and eliminating causes of defects and errors, resulting in eliminating variation in the process.

Answer 5

Lean Six sigma ( σ )

Question 6

Simplification of the process to reduce cycle time (turn around time) and by eliminating non-value adding steps.
Eliminates waste.

Answer 6

Lean principles

Question 7

refers to the number of SDs from the mean.

Answer 7

6 sigma

Question 8

It is the capability of process to meet or exceed the process specification or requirements.
Identifies and eliminates error and defects to minimize variations in the process.

Answer 8

6 sigma

Question 9

Lean Six sigma ( σ ) problem-solving methodology

Answer 9

DMAIC- define, measure, analyze, improve and control

Question 10

identify who use the services and expectations, different persons responsible in generating the service and mapping the laboratory work flow.

Answer 10

Define

Question 11

creating solutions to prevent errors from reoccurring.

Answer 11

improve

Question 11

data collection. determining the turn around time and defects in a certain test. It also includes surveys using the process.

Answer 11

measure

Question 12

data collected examination to identify the root cause of errors

Answer 12

analyze

Question 13

Lean 6 sigma levels of training to denote expertise

Answer 13

master black belt
black belt
green belt
yellow belt

Question 13

long term monitoring of the process over time.

Answer 13

control

Question 14

with a minimum 2 years experience, able teach lean 6 sigma.

Answer 14

Master black belt-

Question 15

full time project leader

Answer 15

Black belt-

Question 16

focus on the use of DMAIC and lean principles.

Answer 16

Green belt-

Question 17

awareness of the lean 6 sigma

Answer 17

Yellow belt-

Question 18

Nothing to eat or drink except water for at least 8 hours.

Answer 18

Fasting

Question 19

Fasting hours for blood glucose

Answer 19

8-12 hours, should not exceed more than 16 hours

Question 20

Fasting hours for lipid profile

Answer 20

12-14 hours

Question 21

Fasting is preferred collected in the?

Answer 21

Early in the morning

Question 22

Patient preparation for fasting (chemistry tests)

Answer 22

Fasting blood sugar Oral glucose tolerance test Lipid profile test Gastrin Inulin Aldosterone/Renin

Question 23

Increase: lactate, fatty acid, ammonia, CK, LD, testosterone, LH, urine protein Decrease: Cholesterol, TAG, FSH and LH

Answer 23

Exercise

Question 24

Serotonin rich food

Answer 24

banana, pineapple, tomato and avocado

Question 25

Caffeine increases?

Answer 25

increases glucose and catecholamine

Question 26

Fatty food increases

Answer 26

potassium, ALT, TAG

Question 27

High protein, low carb diet increase?

Answer 27

ketone in urine (ketonuria)

Question 28

Increase Glucose, cholesterol, TAG, cortisol, growth hormone, catecholamine. Decrease Vitamin B12

Answer 28

Smoking

Question 29

Increase TAG and gamma glutamyl transferase Decrease Glucose

Answer 29

Alcohol

Question 30

Increase Glucose Cortisol Insulin Albumin Catecholamine Prolactin

Answer 30

Stress/Anxiety

Question 31

plasma volume reduction

Answer 31

From supine to sitting/standing

Question 32

causes hemoconcentration (increase lipids decrease K and Cl).

Answer 32

From sitting to supine

Question 33

causes hemodilution

Answer 33

Standing to supine

Question 34

Factors in physiologic variations

Answer 34

age gender diurnal variation posture activity stress race

Question 34

decrease plasma albumin

Answer 34

Prolong bed rest

Question 35

Diurnal variation-high in the morning

Answer 35

ACTH, cortisol, aldosterone

Question 36

Diurnal variation high in the evening

Answer 36

GH, PTH, TSH, ACP

Question 37

increase albumin, K and Ca when standing,

Answer 37

Posture

Question 38

Sites to be avoided

Answer 38

IV in both arms Burned or scarred areas Hematoma Thrombosed veins Edematous arm Area of mastectomy Arms with fistula Cast on arms

Question 39

Evacuated tube system additive red (glass) red (plastic) red/black gold green/gray orange or gray yellow tan (glass and plastic) lavender or pink Light blue Yellow

Answer 39

none clot activator clot activator and gel seperator lithium heparin and gel seperator thrombin Na heparin and EDTA EDTA Na citrate Sodium polyanethol sulfonate (SPS)

Question 40

Specimen collection things to consider/avoid

Answer 40

Hemolyzed sample pumping of fist during extraction IV fluid contamination Wrong evacuated tube exposure to light inadequate centriguation delay seperation of serum storage temperature

Question 41

mostly interfere with spectrophotometric analysis.

Answer 41

hemolyzed sample-

Question 42

decrease bilirubin.

Answer 42

Exposure to light-

Question 42

Types of specimen in CC

Answer 42

Whole blood Serum- most common Plasma Arterial blood Capillary blood Urine CSF Synovial, Pleural, pericardial and peritoneal fluid Amniotic fluid

Question 43

additive - enhances the clotting of blood, e.g., thrombin, silica particles and diatomite.

Answer 43

Clot activators

Question 44

additive - an inert particle found at the bottom of the tube. forms a physical barrier between packed cells and liquid portion after centrifugation.

Answer 44

gel separator

Question 45

Red or pink serum

Answer 45

Hemolysis

Question 46

Contain bilirubin (430 mmol/L)

Answer 46

Icteric sample

Question 47

Yellow to orange serum/plasma

Answer 47

Icteric sample

Question 48

Milky serum

Answer 48

Lipemic sample

Question 49

Contains serum TG exceeding 300 mg/dl.

Answer 49

Lipemic sample

Question 50

For serum collection allow clot formation for

Answer 50

10-30 minutes

Question 51

All assay should be performed within

Answer 51

1 hour after collection.

Question 52

Centrifugation: 3000 RCF for

Answer 52

10 minutes.

Question 53

Serum is separated from clot within

Answer 53

30 minutes.

Question 54

Serum or plasma must be stored at __.if test is to be delayed. Can be freeze at __ for longer storage

Answer 54

4°C – 6 °C −20°C