Tri 5 Lab Dx Test 1

Front 1

CLIA stands for? What two words describes what the CLIA does?

Back 1

Clinical Laboratory Improvement Amendment (CLIA)

Quality Control

Front 2

OSHA stands for? Provides what service?

Back 2

Occupational Safety and Health Administration

provides Safety Measures for the workplace DUH!

Front 3

Four things to remember when "sticking a patient" are?

Back 3

1. Position tourniquet
2. Position bevel of needle up
3. Needle 15-30 degrees angled to forearm
4. Remove tourniquet before removing needle

Front 4

Sensitivity:

Low Sensitivity:

High Sensitivity:

Back 4

The ability to detect small abnormalities in the body.

Low = frequent false negatives

High = FEW false negatives

Front 5

Specificity:

Low Specificity:

High Specificity:

Back 5

The degree to which the results are exclusive for the condition.

Low = frequent false positives

High = Few false positives

Front 6

Prevalence:

Back 6

The number of persons with the disease in the population being tested.

Front 7

Gold Standard:

Back 7

A method of testing that has been proven to be accurate (sensitive & specific) to which other test can be compared.

Front 8

Reproducibility:

Back 8

Getting the same results when the test os repeated on the same specimen.

Front 9

Accuracy:

Back 9

The CORRECT answer!

Front 10

In a Gaussian distribution,__ of normal people will fall within __ standard deviations from the mean?

Back 10

95%, 2

This means 5% will be above or below 2 SD.

Front 11

Nonparametric calculation of normal ranges is/does?

Back 11

1. Not assume symmetry of distribution
2. More difficult to calculate
3. Require more samples

Front 12

Problems with normal ranges include:

Back 12

1. Some people being tested may have sub clinical disease
2. Calculated from too small a number of cases.
3. Population used may not be population being tested
ie. locality, race, sex, diet, specimen storage time

Front 13

Problems with normal ranges contd':

Back 13

4. Values obtained by one method are often applied to other methods.
5. Different reagents or equipment produce different results.
6. Population may not be random.

Front 14

On a 12-test profile there is a __% probability that at least one test value will be falsely abnormal.

Back 14

46%

Front 15

Comparison with ______ values can detect changes.

Back 15

Baseline

Front 16

Contamination by not using "___ ___" collections can result in additional RBC, WBC, protein, and bacteria in the urine.

Back 16

Clean Catch

Front 17

A small volume on a 24-hour urine collection could mean ____ or an incomplete collection.

Back 17

dehydration

This would be indicated by an elevated specific gravity.

Front 18

Eating cooked meat can elevate ____ excretion by __% - __% over 24 hours.

Back 18

creatine, 10%-20%

Front 19

Age, race, sex, time of day, meals, and ___ _____ can all influence lab values.

Back 19

body position

Front 20

What alters lab values by injuring tissue, competing with biochemicals, or interfering with the analysis method?

Back 20

Drugs

Front 21

What means emergency to a laboratory?

Back 21

STAT

Front 22

Hemoglobin:

Men = ___-___
Women = ___-___

Boys and girls have equal ranges until age ___?

Back 22

Men = 14-18

Women = 12-16

Age 11

Front 23

Factors Affecting Hb levels:
1. Race: African Americans average 0.5-1.0gm ___ than europeans.
2. Position: 1gm ____ b/w standing and recumbent.
3. Diurnal cycle: peaks around ___ and is lowest ___.

Back 23

Lower

Decrease

9:00am

8:00pm

Front 24

Smoking ___ levels of Hb.

Pregnancy ___ levels d/t dilution.

Back 24

Increases

Decreases

Front 25

In newborns, capillary Hb and Hct values are higher than in venous blood at about ___gm and can be as high as ___gm.

Back 25

3.5

10

Front 26

RBC counts:
Men: ___-___million
Women: ___-___ million

Back 26

4.5-6 million

4.0-5.5 million

Front 27

RBC's/ml is an indirect estimate of ___?

Back 27

Hb

Front 28

Manual RBC counting results in a ___%-___% error

Back 28

7%-14%

Front 29

Hct values:
Men: ___%-___%
Women ___%-___%

Back 29

Men: 40%-54%

Women: 37%-47%

Front 30

Hct is the ratio of ____ to ___?

Back 30

RBC's to Plasma

Note: Hct depends mostly on RBC's and slightly affected by size of the RBC.

Front 31

Hct is not measured directly but calculated from the ___ count and ___.

Back 31

RBC

MCV

Front 32

Factors affecting Hct:
1. Decreases when ____
2. Increases when ____

Back 32

1. Recumbent

2. Smoking

Front 33

HB x 3 = ___

RBC x 3 = ___

RBC x 9 = ___

Hct x 10/RBC = ___

Back 33

Hct

Hb

Hct

MCV

Front 34

Wintrobe Indices:
MCV: ________
MCH: _______
MCHC: _______
RDW: _______

Back 34

MCV: Mean Corpuscular Volume
MCH: Mean Corpuscular Hb
MCHC: Mean Corpuscular Hb Concentration
RDW: RBC Distribution Width

Note: These indices only significant if RBC, Hb, Hct is abnormal.

Front 35

Smoking _____ MCV

Back 35

Increases

Front 36

Increased MCV = _____

Decreased MCV = _____

Back 36

Macrocytosis

Microcytosis

Front 37

Many Macrocytic pts. will NOT have elevated MCV True or False

Back 37

True

Front 38

Causes of Macrocytosis:
1. Folic Acid or B12 def.
2. Chronic liver disease
3. Chronic alcoholism
4. Cardiorespiratory abnormality
5. Cytotoxic Chemotherapy
6. Reticulocytosis
7. Myelodysplastic syndromes

Back 38

Just know the causes of each....Could be which of the following is not Macro?

ie Chronic iron deficiency

Front 39

Causes of Microcytosis
(3)

Back 39

1. Chronic Iron Deficiency
2. Alpha or Beta Thalassemia
3. Anemia of chronic disease

Front 40

MCH influenced by:
1. Size of the ___
2. Amount of ___ relative to size

Back 40

1. RBC

2. Hb

Front 41

MCH increases with _____
and decreases with _____?

Back 41

Macrocytosis
Microcytosis

Front 42

MCHC increased by: (5)

Back 42

1. Spherocytosis
2. Free plasma Hb
3. High titer cold agglutinins
4. Severe plasma lipemia
5. Heavy Smoking

Front 43

MCHC decreased by:

Back 43

1. Chronic Iron Deficiency
2. Sideroblastic anemia
3. Anemia of chronic disease

Front 44

Definition: Anisocytosis

Back 44

Different sizes of cells

Front 45

RDW elevated by:

Back 45

1. Factor deficiency (Iron, Folate, B12)
2. RBC fragmentation
3. Homozygous hemoglobinopathies
4. Normal Thalassemia minor
5. Anemia of Chronic Disease

Front 46

RDW decreases:

Back 46

NEVER

Front 47

Peripheral Blood Smear uses what type of stain to allow examination of RBC abnormality?

Back 47

Wright Stain

Front 48

Hypochromia = ?

Back 48

Iron Deficiency

Front 49

What do Oval Macrocytes represent?

Back 49

1. Folic Acid and/or B12 deficiency
2. Myelodysplasia or Myeloid metaplasia

Front 50

Round Macrocytes represent?

Back 50

1. Alcoholism
2. Cirrhosis
3. Hypothyroidism
4. Reticulocytosis
5. Aplastic Anemia

Front 51

Hypochromic Microcytes are indicative of?

Back 51

Iron Deficiency

Front 52

Normochromic Microcytes are indicative of?

Back 52

1. Thalassemia minor
2. Anemia of Chronic Disease

Front 53

Spherocytes are?

Back 53

Round cells without the central clear area

Front 54

Spherocytes are congenital or form autoimmune hemolytic anemia, some toxins including ____.

Back 54

Snake Venom

Front 55

Polychromatophilic RBC's are?

Back 55

Reticulocytes

Front 56

Reticulocytes are caused by an increased RBC production from? (4)

Back 56

1. Acute Bleed
2. Hemolysis
3. Hematopoietic
4. Factor Dependent Anemia Therapy

Front 57

Schistocytes are?

Back 57

Broken cells that have one or more sharp points.

Front 58

Acanthocytes are sub-groups of ?

Back 58

Schistocytes that have small spherical finger-like projections

Front 59

Acanthocytes are seen in patients with?

Back 59

1. Liver Disease
2. Anorexia Nervosa
3. Abetliproteinemia

Front 60

Echinocytes are?

Back 60

Crenated RBC's

Front 61

Echinocytes are seen in patients with?

Back 61

1. Liver Disease
2. Renal Disease
3. Hyperlipidemia
4. RBC enzymopathies

Front 62

Bite Cells or Degmacytes are seen with?

Back 62

1. Hemolytic Anemia d/t an oxidizing agent
2. Heinz body anemia

Front 63

1. Sickle Cells are ___shaped?

2. Hb-__ = anemia

3. Hb-__ = trait

Back 63

1. Crescent
2. SS
3. SC

Front 64

Elliptocytes or Ovalocytes have what shape?

Back 64

Short Rod

Front 65

Target Cells are the peripheral ___ and central ___ of ___?

Back 65

Ring
Disk
Hb

Front 66

Target Cells are seen in what diseases?

Back 66

Hb C disease, Thalassemia, Chronic Liver Disease

Front 67

Tear Drop cells are seen in?

Back 67

Myeloid metaplasia & Myeloproliferative syndromes

Front 68

Stomatocytes have a particular configuration known as?

Back 68

Rectangular or slit like

Note: Drug induced seen in hereditary stomatocytosis

Front 69

Rouleaux AKA ___? Suggesting that ___ stick together, seen in ___?

Back 69

"Stack of Coins"
RBC's
Multiple Myeloma

Front 70

Basophilic Stippling suggest a condition known as?

Back 70

Lead Poisoning

Front 71

Howell-Jolly bodies are produced in a patient with?

Back 71

Sever anemia or a pt. with hemolytic anemia following a splenectomy.

Front 72

Pappenheimer bodies are small dark hemosiderin granules found after?

Back 72

Splenectomy

Front 73

Inclusions not seen with Wright-Stain include?

Back 73

1. Reticulocytes-Retics
2. Hemoglobin H
3. Heinz Bodies

Front 74

Reticulocytes-Retics are Immature ___?

Back 74

RBC's

Front 75

Reticulocytes increased = increased RBC's and increased ___ ___ activity?

Back 75

Bone Marrow

Front 76

Heinz bodies are derived from ____ ____ _____?

This indicates an RBC ___ defect.

Back 76

unstable denatured hemoglobin

enyme

Front 77

White Blood Cell Counts are within the ____ range?

Back 77

4,500-11,000/mm3

Front 78

Platelet Counts reference range?

Back 78

150,000-400,000/mm3

Front 79

Bone Marrow aspirations are used to diagnose ____, ___, ___?

Back 79

1. megaloblastic anemia
2. leukemia
3. multiple myeloma

Note: Used to document insufficient iron stores

Front 80

Neutrophils are AKA?

Back 80

Segs or Polys at 50%-70%

Front 81

Lymphocytes' differential values are?

Back 81

20%-40%

Front 82

Differential values:
Monocytes = ?
Eosinophils = ?
Basophils = ?

Back 82

Mono = 7%

Eosin = 5%

Baso = 1%

Front 83

What is the most important WBC abnormality?

Back 83

Pelger-Huet

Note: Many will hyposegment into a dumbbell or eyeglass shape.

Front 84

Neonatal Leukocytosis:
1-3 days:
3-4 days:
6 months:
4-5 years:

Back 84

1-3 = 18,000-22,000

3-4 = 8,000-16,000

6 months = close to adult levels, but lymphocytes predominate

4-5 years = Adult levels

Front 85

The most m/c/c of Neutrophilic Leukocytosis?

Back 85

M/C/C = Inflammation

secondary effects = Bacterial Infection, Viral Infection

Front 86

ECHO stands for?

Back 86

Enteric Cytopathic Human Orphan

Front 87

Most viral infection will show_______of WBC's?
A: an elevated level
B: depressed level

Back 87

B: depressed (may even be normal)

Front 88

Patients who present with a Lymphocytosis secondary to a viral infection or Addison's Disease will have a ___ to ___ WBC count.

Back 88

low to normal

Front 89

In a patient with atypical lymphocytes, we would suspect?

Back 89

1. Infectious Mononucleosis
2. Adult Cytomegalovirus
3. Viral Hepatitis

Front 90

Monocytosis may occur without ___ caused by a variety of conditions.

Back 90

Leukocytosis

Front 91

Eosinophilia are seen in patients with? (5)

Back 91

1. Parasite Infections
2. Acute Allergic attacks
3. Chronic skin disease
4. Scarlet Fever
5. Cancer or Hodgkin's Disease

Front 92

Basophilia are seen in patients with?

Back 92

1. Chronic myelogenous leukemia
2. Myeloproliferative diseases
3. Some non-malignant conditions

Front 93

Neutropenia or Granulocytopenia

Back 93

< 4,000/mm3

Front 94

Patient presents with Leukoerythroblastosis. The presents of ___ and ___ are noted in the peripheral blood smears.

Back 94

1. Immature WBC's

2. Nucleated RBC's