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Module 3

Heme 1 -- Chapter 25 Fundamentals of Med. Lab FINAL Review

Medical laboratories perform vast array of tests that assist providers with what? Diagnosing; treating; following progression of Pts with acute and/or chronic illness.
What are examples of conditions we follow progression of? Diabetes; hypertension; cholesterol
Rationale for laboratory testing: Determine baseline values; legal purposes; pathological conditions (screening); confirm clinical diagnosis; obtain differential diagnosis; assess Tx options and Pt progress
A Pt that is not presenting with any symptoms at all would be called? Asymptomatic
What is CLIA '88? Clinical Laboratory Improvement Amendment -- created to protect Pts by establishing safety policies and procedures.
What types of labs must register with CLIA? Every single lab regardless of its size or the nature of testing performed.
Quality Control Procedures designed to ensure the accuracy and precision of lab tests and to discover and eliminate human error.
Quality Assurance Set of policies and procedures designed to ensure accuracy and reliability of lab tests and include: QC; Orientation; Documentation in QC Log; Maintenance and Temp Checks; Check Exp. Dates; Proficiency Tests
Testing Categories: Waived Tests (low complexity); Moderate Complexity Tests; High Complexity Tests
Waived Tests/Low Complexity Simple to perform; require minimum of QC, judgement, interpretation and documentation (i.e. pregnancy, sugar/glucose, cholesterol, ESR)
Moderate Complexity Requires formal training, an understanding of test methodology, QC, instrument calibration, proficiency testing, record keeping (i.e. urine sedimentation, fecal leukocytes, direct wet mounts, semen analysis)
High Complexity Usually performed in labs subject to federal regulations. Requires high level of education and experience. (i.e. pap smears/cytology, histology, cytogenetics)
Which tests are most MA's likely to be performing? Waive Tests
Which tests make up approx. 75% of all testing? Moderate Complexity
Which testing will an MA never perform? High Complexity
What types of laboratories are there? Reference; Procurement (aka Satellite); POL; POCT; Hospital
Reference labs Independent lab provides service to large region and performs most routine lab testing.
Procurement/Satellite labs Exists solely for specimen collection, usually by venipuncture
POL Physician's Office Lab performs waived-moderate testing and can range in size from small to very large.
POCT Point of Care Testing that is performed beside/near the Pt.
Hospital labs Lab within hospital. The larger the hospital, the larger the lab.
Assay Test
Laboratory Departments Urinalysis; Hematology; Immunology; Clinical Chemistry; Microbiology; Cytology; Histology; Blood Bank
Urinalysis Dept. Study of Urine
Hematology Dept. Study of Blood
Immunology Dept. AKA Serology is the study of the immune system
Clinical Chemistry Dept. Study of assays on urine, serum and cerebrospinal fluid, testing for presence and amount of specific chemical substances
Microbiology Dept. Grows and identifies microorganisms -- mycology, virology, parasitology are subdivisions
Medical specialist that studies tissues and body fluids? Pathologist
Hazards in the laboratory (3) Physical; Chemical; Biological
Physical hazards cautions Not using extension cords, overloading electrical outlets, use surge protectors, follow manufacturer's directions, etc.
Chemical hazard precautions Label all bottles, recap bottles, clean spills, utilize wash stations, etc.
Biological hazard precautions Hand washing, follow universal precautions, never eat, drink, apply make up or contact lenses, etc.
What must accompany every test sent out to a laboratory? Requisition forms
Base of microscope Supports upper components of the microscope
Arm Used to carry microscope
Stage Large platform that holds specimen
Illuminator Base with light bulb, has on/off switch
Condenser Under the stage, focuses, directs and concentrates light
Diaphragm Within or beneath the condenser, can be opened/closed to increase/decrease the intensity of light (iris)
Fine tune knobs Located on either side of the arm, is a knob that can be adjusted to fine tune focus
Oculars Eyepiece of the microscope
Objectives Lenses (typically 3) attached to revolving nose piece
Low power objective Magnifies by power of 10 (10x)
High power objective Magnifies by power of 40 (40x)
Oil immersion objective Magnifies buy power of 100 (100x) -- drop of immersion oil placed on slide to remove the air and redirect the light straight to the specimen
Draw order for tubes Non additives, Yellow, Blue, Reds (3), Green, Lavender, Gray
Cultures Always drawn first (prior to tubes if ordered)
Yellow Contains ACD (acid citrate dextrose) used for drawing whole blood for special tests
Blue tubes Contains Sodium Citrate as anticoagulant used for coagulation studies; tubes must be filled to maintain proper ratio of blood to anticoagulant for valid prothrombin time results. Invert 6-10 times to activate. (PT, PTT, INR)
Red is broken into 3 categories: Red, Gold and Marble
Red (red, gold) Plain Vacutainer with no anticoagulant for collection of serum chemistry tests as well as clotted blood for immunohematology. Invert 5 times
Red (marble) Serum Gel (marble) has clot activator and serum gel separator for various test. Invert and let stand 20-30 min, then centrifuge for 10 min.
Green Contains sodium heparin for collection of heparinized plasma or whole blood for special tests. Invert immediately several times to prevent coagulation
Lavender Contains EDTA (ethylenediaminetstraacetic-acid) for most hematological procedures. Invert immediately several times to prevent coagulation. (CBC, ESR, Hgb A1C)
Gray Contains potassium oxalate as anticoagulant and sodium fluoride as preservative used to preserve glucose in whole blood and for special chemistry tests. Invert immediately several times to prevent coagulation. (GTT -- glucose tolerance testing)
Color tubes most often drawn by MAs Blue, Lavender, Gray
Created by: monkmaroni