Quiz #1

Question 1

Origin of Laboratory Medicine:

Answer 1

-Hippocrates advocated a diagnostic protocol that included tasting the patient’s urine

Question 2

20th century laboratory medicine highlights:

Answer 2

• Microbiology
• Clinical Chemistry
• Transfusion Medicine

Question 3

CLIA:

Answer 3

• Clinical Laboratory Improvement Amendments: regulated testing by Centers for Medicare & Medicaid Services (CMS); CMS responsible for financial backing
• Passed in 1988 to ensure quality lab testing
• Carried out by CCSQ
• Waived and Non-Waived tests

Question 4

Waived and Non-Waived tests:

Answer 4

• Categorization of in vitro diagnostic tests under CLIA; FDA responsible
• Based on potential for risk to public health

Question 5

Waived Tests:

Answer 5

• Cleared for home use
• Low risk

Question 6

Non-Waived Tests:

Answer 6

-Uses scoring system (scale of 1-3) based on 7 criteria

Question 7

College of American Pathologists:

Answer 7

• Leader in lab quality assurance
• Inspects and accredits over 7600 labs globally

Question 8

All work-related fatalities, amputations, inpatient hospitalizations, and all losses of an eye must be reported to OSHA within:

Answer 8

• Fatalities: 8 hours
• Everything else: 24 hours

Question 9

HIPPA:

Answer 9

Health Insurance Portability and Accountability Act:

• Title I: protects insurance coverage
• Title II: Administrative Simplification

Question 10

Anatomic Pathology:

Answer 10

• Focuses on the diagnosis of disease
• Histology, Cytology, Forensic Pathology

Question 11

Clinical Pathology:

Answer 11

• Diagnosis based on lab analysis of bodily fluids, such as blood and urine
• Clinical Chemistry, Hematology, Blood Bank, Microbiology

Question 12

American Society for Clinical Pathology (ASCP):

Answer 12

-Provides certification for pathologists and lab professionals

Question 13

Reference/Normal Range:

Answer 13

• Found by testing thousands of samples from individuals without disease and on no medications
• 2 standard deviations in middle or represents 95% of results

Question 14

Desirable Range:

Answer 14

• Groups of experts compare lab test results with clinical outcome and create new desirable or prognosis-related ranges
• ie: Cholesterol reference range

Question 15

Therapeutic Range:

Answer 15

• Determined by the drug’s effect rather than its concentration in the blood
• ie: Target blood level for a medication

Question 16

Critical Lab Value:

Answer 16

• Test that requires rapid clinical attention
• Prompt verbal notification must be given to member of healthcare team responsible for patient

Question 17

Precision:

Answer 17

-Ability to repeatedly obtain results that are close to each other on the same sample

Question 18

Accuracy:

Answer 18

-Relationship between the number obtained and the true result

Question 19

False Positive:

Answer 19

-Lab suggests there is a disease but patient does not

Question 20

False Negative:

Answer 20

-Lab suggests there is not a disease when there is not

Question 21

Sensitivity:

Answer 21

• True positive rate
• Ability of a test to correctly identify individuals who have a given disease or condition

Question 22

Specificity:

Answer 22

• True negative rate
• Ability of a test to correctly exclude individuals who do not have a given disease or condition

Question 23

Prevalence:

Answer 23

-The number of existing cases in a population

Question 24

Incidence:

Answer 24

-Number of new cases occurring within a period of time

Question 25

Blood components:

Answer 25

- Plasma/Serum - Buffy Coat : WBC, Plt -RBC

Question 26

Plasma:

Answer 26

- Extracellular matrix of whole blood - Contains: water, proteins, glucose, clotting factors, electrolytes, hormones, CO2

Question 27

Serum:

Answer 27

- Portion of blood that does not contain blood cells or clotting factors - Contains everything else

Question 28

Hematocrit (Hct):

Answer 28

- Volume % of RBCs - Anemia: abnormally low hematocrit - Polycythemia: abnormally high % of Hct

Question 29

Hemoglobin (Hgb or Hb):

Answer 29

-Contains Fe2+ and O2

Question 30

Serum Vacutainers:

Answer 30

- Red Top - Gold or Marble Top - Light Blue Top - Lavender Top - Green Top - Gray Top - Orange or Gray/Yellow Top - Light Yellow - Tan - Royal Blue - Black

Question 31

Red Top:

Answer 31

-No Additives (60 min clot)

Question 32

Gold or Marble Top:

Answer 32

- 30 minute clot - Special gel creates barrier between RBCs and serum

Question 33

Light Blue Top:

Answer 33

- Contains Sodium Citrate anticoagulant - Must be completely filled - Used for routine and special coagulation tests

Question 34

Lavender Top:

Answer 34

- Contains EDTA - Hematology: CBC, Hgb, Hct, WBC differential, reticulocyte count - Chemistry: Hgb A1C

Question 35

Green Top:

Answer 35

- Contains Heparin anticoagulant - Used for mainly for chemistry tests

Question 36

Gray Top:

Answer 36

- Potassium oxalate anticoagulant - Sodium fluoride: antiglycolytic stabilizer - Used for glucose levels, BAC, lactate, HCO3-

Question 37

Orange or Gray/Yellow:

Answer 37

- Contains thrombin - Used for STAT serum testing (5 minute clot)

Question 38

Light Yellow:

Answer 38

-Contains SPS for blood cultures or ACD for blood bank studies

Question 39

Tan:

Answer 39

- Contains either heparin or EDTA - Used for lead determinations

Question 40

Royal Blue:

Answer 40

- Contains either northing or heparin - Used for metal trace analysis

Question 41

Black:

Answer 41

-Used for Erythrocyte Sedimentation Rate

Question 42

Tube Draw Order:

Answer 42

1) Blood Culture Tube or Vial 2) Citrated Tube 3) Serum Tubes w/ or w/o Clot Activator, w/ or w/o Gel Separator 4) Heparin Tube 5) EDTA Tube 6) Glycolytic Inhibitor

Question 43

Capillary Blood Collection:

Answer 43

- Puncturing dermis to access capillary beds - Used for glucose, INR

Question 44

Point-of-care-testing (POCT):

Answer 44

- Medical testing at or near the site of patient care - Immediate Results - Lack of quality control, training, infection control

Question 45

Na+:

Answer 45

136-146 mEq/L

Question 46

K+:

Answer 46

3.5-5.0 mEq/L

Question 47

Cl-:

Answer 47

96-106 mEq/L

Question 48

CO2 (HCO3-):

Answer 48

22-28 mEq/L

Question 49

BUN:

Answer 49

10-20 mg/dL

Question 50

Crt:

Answer 50

0.5-1.0 mg/dL

Question 51

Glu:

Answer 51

70-100 mg/dL

Question 52

CBC:

Answer 52

- WBC - Hgb - Hct - Plt

Question 53

WBC:

Answer 53

5,000-10,000/mm3

Question 54

Hgb:

Answer 54

- Males: 14-18 g/dL - Females: 12-16 g/dL

Question 55

Hct:

Answer 55

- Males: 42-52% - Females: 37-47%

Question 56

Plt:

Answer 56

150,000-450,000/mm3

Question 57

Common Lab Value Shorthand

Answer 57

Question 58

Common Lab Value Shorthand

Answer 58