Clinical Lab Values Week 1

Front 1

What are the major divisions of clinical lab medicine and what do they do?

Back 1

a) blood bank - type, screen, compatibility
b) microbiology- ID bacteria, parasites, fungi & susceptibility testing
b-2) virology (separate micro) - ID viruses
c) chemistry - basic tests + tox
d) hematology - cell counts, coag testing
e) urinalysis - UTI, etc
f) immunology- HIV, measles, etc, allergies
g) specialty - flow cytometry, molecular diagnostics, cytogenetics, research

Front 2

The patient with type ___ blood has (1)___ antibodies and (2)___ antigens:
a) Type A
b) Type B
c) Type AB
d) Type O

Back 2

a) anti-B antibodies, A antigens
b) anti-A antibodies, B antigens
c) no antibodies, A and B antigens
d) anti A and B antibodies, no antigens

Front 3

What is the governing aspect of clinical lab medicine?

Back 3

CLIA - 1988: DOHHS - requires certifications of registrations to govern lab practices, standards, QA and QC documentation, etc

Front 4

___ is a test result that correctly classifies individuals with disease.

Back 4

True positive

Front 5

___ is a test result that incorrectly classifies healthy people as having disease.

Back 5

False Positive

Front 6

___ is a test result that correctly classifies the healthy patient.

Back 6

True negative

Front 7

____ is a test result that incorrectly classifies the diseased individual as being healthy.

Back 7

False negative

Front 8

___ is a measure of a test's positivity in disease. A test with 100% ___ doesnt miss anyone (no false negatives - may have false pos).

Back 8

Sensitivity

Front 9

____ is a measure of a test's negativity in the absence of disease. A test with 100%__ does not misclassify healthy people as having disease (no false positives - may have false negs)

Back 9

Specificity

Front 10

___ is the probability that any given individual in a defined population has a disease based on a positive test result.

Back 10

Positive Predictive Value

Front 11

___ is the probability that a patient will not have the disease based on a negative test result/

Back 11

Negative predictive value

Front 12

What steps should you take if you have a needle exposure?

Back 12

1. wash immediately with soap and water
2. notify supervisor
3. complete paperwork required
4. go to ER or Employee health

Front 13

In order to reduce needlesticks, you should avoid ____, and realize that ____ system is the safest

Back 13

1. butterflies
2. vacuum tube and holder

Front 14

What is the Most important step in phlebotomy/ venipuncture?

Back 14

Patient Identification

Front 15

Why is it important not to use a tube that was dropped?

Back 15

It may lose the vacuum

Front 16

Plastic red-top tubes contain _____ (glass ones may not)... and produces ____

Back 16

1. clot activator (glass ones didn't need it)
2. serum

Front 17

All the tubes except the plain red top produce ____ and have what type of additive?

Back 17

1. plasma
2. anti-coagulants

Front 18

Describe the properties of the light blue test tube:
a) additive
b) tests used for
c) how to get correct ratio

Back 18

a) Sodium Citrate
b) Protime, PTT, INR, specific coagulation factor testing
c) fill completely to get correct ratio,

Front 19

The green stopper tube contains ____ and is used for ____.

Back 19

1. heparin
2. "stat" chemistries

Front 20

The lavender stopper tube contains ____ and is usually used for ____.

Back 20

1. EDTA
2. Hematology (blood counts)

Front 21

The gray stopper tube contains ____ and is used for ___

Back 21

1. NaF, Koxalate
2. Preserves glucose up to 3 days (important if can't spin down blood righ taway), also for ethanol levels

Front 22

How long should red-tops sit to clot before spinning down?

Back 22

30 mins

Front 23

What is the first choice for phlebotomy? Second? Where to avoid?

Back 23

1. median cubital
2. cephalic
3. Avoid basilic (artery below, nerve bundle)

Front 24

How many attempts at venipuncture should you make before trying to have someone else do it?

Back 24

2

Front 25

What type of system is most useful in children, elderly, or hand veins?

Back 25

butterfly

Front 26

Why do you need to throw the first tube away if you begin with a blue top?

Back 26

first part of draw is tissue thromboplastin so would mess up testing.

Front 27

___ can occur due to leaving the tourniquet on too long, and may cause false enzyme results, albumin, and RBC counts also off.

Back 27

Hemoconcentration

Front 28

____ occurs when RBCs are damaged and release hemoglobin. The serum or plasma will look red or pink.

Back 28

Hemolysis (affects K, LDH, etc)