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Clin Chem Test 1 Rev

Test prep for first test in Clinical Chemistry at Del-Tech Owens Campus

Universal precautions are procedures designed to do what? Protect the healthcare worker from exposure to blood and body fluids containing visible blood.
What is the primary purpose of the blood-borne pathogens standard? To reduce or eliminate exposure to HIV, HCV and HBV for health care workers.
Name 4 things that could expose health care workers to blood-borne pathogens? 1. blood 2. all body fluids 3. open wounds 4. microbiological cultures.
Open wounds aren't always __. visible
Wash hands before and __ every patient contact. after
Standard precautions are designed to do what 3 things? 1. protect the patient 2. control nosocomial infections 3. protect the health care worker.
What are transmission based precautions? Additional practices with patients known or suspected to be infected with pathogens spread by air, droplets, or contact.
Procedures designed to protect others from patients with infections that could be suspended in the air are called ? airborne precautions
How far does a healthcare worker need to stay away from a patient when droplet precautions are in effect? 3 feet
If a healthcare worker needs to get closer than 3 feet to a patient under droplet precautions, he/she must do what? wear a mask
Personal protective equipment (PPE) includes what 5 items? 1. gloves 2. fluid-resistant gowns 3. face shields of masks 4. goggles 5. safety glasses
How do you mix acid and water? Slowly add the acid to the water (not the reverse).
Chemicals that have skull and crossbone symbols on their labels are ? toxic
Toxic chemicals should not be touched by anyone who isn't wearing protection because they can be absorbed through ? the skin
Name 5 toxic chemicals. Benzene, chloral hydrate, formaldehyde, methanol, picric acid.
Gram stains and many other dyes used in a lab are dangerous __. carcinogens
Flammable liquids should be poured out of one container to another __. slowly
Flammables and combustibles are classified according to their __ __. flash point (the temp where they ignite)
Flammable liquids can be ignited at what temperature? Below 100F or 37.8C
Combustible liquids can be ignited at what temperature? At or above 100F or 37.8C
Name 6 solvents that are flammable or combustible. acetone, benzene, ethanol, isopropyl alcohol, methanol, xylene
Reactive chemicals can spontaneously __ or __ under certain circumstances. explode or ignite
Reactive chemicals can give off __ or __ gases or even __ gases. heat or flammable gases or even explosive gases.
The National Fire Protection Association uses the color red to indicate what? Flammability hazard
The National Fire Protection Association uses the color yellow to indicate what? Reactivity hazard
The National Fire Protection Association uses the color blue to indicate what? Health hazard
The National Fire Protection Association uses the color white to indicate what? Special hazards
The National Fire Protection Association uses the number 0 to indicate what? No hazard
The National Fire Protection Association uses the number 4 to indicate what? Extreme hazard
The National Fire Protection Association uses a W with a line through it to indicate what? A substance that reacts with water.
Radiation hazards are regulated by what organization? Nuclear Regulatory Commission
Direct electrical hazards can result in what 3 things? Death, shock, burns
Indirect electrical hazards can result in what 2 things? Fire and/or explosions
OSHA stands for what? Occupational Safety and Health Act
EPA stands for what? Environmental Protection Agency
DOT stands for what? Dept of Transportation
NCR stands for what? Nuclear Regulatory Commission
NFPA stands for what? National Fire Protection Agency
CLSI stands for what? Clinical Laboratory Standards Institute
CDC (also CDCP) stands for what? Center for Disease Control and Prevention
What does the NRC regulate? Radioactive chemicals, tissues, and wastes.
What does the OSHA do? Safety regulations, inspections, fines, laws.
What does DOT regulate? Interstate transport of waste and human specimens.
What does the EPA do? Tracks medical waste.
What does the NFPA do? Has a labeling system to identify hazards in work environment.
What does CLSI do? Creates voluntary safety guidelines that are often adopted by regulatory agencies.
What does the CDC(P) do? Defines biohazard levels and degree of PPE needed for those levels.
What is a class A fire? Ordinary combustibles. Wood, paper, cloth, plastic
What is a class B fire? Flammable liquids, gases, and combustible petroleum products. Grease, gasoline, paints, oil
What is a class C fire? Energized electrical equipment. Motors, switches
What is a class D fire? Combustible, reactive metals. Sodium, potassium, magnesium.
Type A fire extinguishers contain what and are used for what kinds of fires? Contain pressurized water. Class A fires.
Type BC fire extinguishers contain what and are used for what kinds of fires? Contain carbon dioxide. Class B fires.
Type ABC fire extinguishers contain what and are used for what kinds of fires? Contain dry chemicals. Class A, B, or C fires.
Halon fire extinguishers contain what and are used for what kinds of fires? Contain halon (duh). Class C fires.
Special fire extinguishers use what kind of extinguishing agents? dry chemical
PASS tells you how to use a fire extinguisher. What does it stand for? Pull pin, Aim nozzle, Squeeze trigger, Sweep nozzle.
RACE tells you what to do if a fire breaks out. What does it stand for? Rescue Alarm Contain Evaluate
What is the most important role of an MLT? To give correct results.
What is quality assurance? Ensuring that the final results reported by the lab are correct. In effect, making sure the customer's needs and expectations are met.
What do quality assurance programs monitor? 1. competence 2. quality of materials, reagents, instruments 3. reliable test result reporting
Using pretested specimens with known values to test the accuracy of equipment is an example of ? quality assurance
A good quality assurance program sees the lab as series of processes that can be divided into 3 categories. What are they? Preanalytical, analytical, postanalytical. (Checks results before, during, and after tests have been run.)
What are 6 factors of the preanalytical process? 1.fasting specimens 2. posture 3. prep of collection site 4. diurnal analytes 5. physical activity 6. meds
What are 4 things that can cause preanalytical errors with test requests? 1. inappropriate tests ordered 2. illegible handwriting on orders 3. incorrect ID of patient 4. special requirements not specified
What are 6 things that can cause preanalytical errors with specimen acquisition and handling? 1. incorrect tube use 2. incorrect patient ID 3. inadequate volume 4. hemolyzed specimen 5. specimen collected at wrong time 6. specimen transported improperly
Name 4 errors that can cause problems with the analytical process. 1. instruments imprecise/not calibrated correctly 2. mixing up specimens 3. specimen volume incorrect 4. interfering substances
What is the difference between internal quality controls and external quality controls? Internal QC is done in house, while external QC is done through surveys by CAP or others.
What 8 things are involved in analytical processes? 1. proper handling/use of reagents 2. calibrate pipettes 3. preventative instrument maintenance 4. balances and thermometers accurate 5. centrifuge speed accurate 6. review procedure manuals 7. obey safety procedures 8. use checklists and maintenance logs
What do postanalytical processes involve? Procedures and policies that affect test reporting and interpretation.
Name 4 errors in test reporting that can cause problems with the postanalytical process? 1. incorrect patient ID 2. illegible reports 3. delayed reports 4. transcription errors
Name 5 errors in test interpretation that can cause problems with the postanalytical process? 1. Miss presence of interfering substances 2. specificity of test misunderstood 3. precision limits not recognized 4. inappropriate analytic sensitivity 5. lack of previous values for comparison
Name 2 examples of random errors. 1. error while pipetting 2. changes in incubation period
How can random errors be minimized? Training, supervision, adherence to standard operating procedures (SOP)
What are random errors? Random errors cannot be predicted or corrected, even under identical conditions.
What are systematic errors? Errors that remain constant under the same conditions. They create a bias in the test results that can be corrected.
Give 4 examples of random errors. 1. variations in incubation temps 2. blockage of plate washer 3. change in the reagent batch 4. modifications in testing methods.
Techniques and procedures that monitor performance parameters are called? quality controls
Statistics are used on test results to see if the analytical run is __. This is an example of quality control. acceptable
Special specimens inserted into the testing process are called ? control samples
If tests run on quality controls yield similar results to those run on patients, then the controls are (good or bad). Good
If you are exposed to a pathogen while performing your duties, an evaluation of the incident must be made to ensure __ __. (HINT: PEP) postexposure prophylaxis
What kind of controls monitor the accuracy and precision of equipment? quality controls
What 3 things do quality controls check? 1. monitor systems for errors 2. estimate the magnitude of errors 3. show that quality has deteriorated
Monitoring results obtained with contro specimens is done by ? 1. visual methods using Levey-Jennings chart 2. multirule methods
How do multirule violations work? They rely on rule violations to indicate that an error has occurred.
The process of assaying unknown samples sent to the lab from an outside agency is called? external quality controls
When running external quality controls, the results are tested by who? the agency that supplies the samples
The most common __ __ __ surveys a 3 levels. CAP Survey Program
What 9 areas does the CAP Survey Program focus on? Chemistry, hematology, microbiology, blood banking, serology, nuclear medicine, pathology, cytology, histology
Unlike controls, calibrators and standards are to do what 2 things? 1. adjust or standardize instruments 2. defind a standard curve for analysis.
What is the formula for calculating the mean? _ X=Ex -- n The mean equals the sum of all values divided by the number of values.
If an error occurs when a series of controls values consistently increases of decreases for several consecutive days, then what kind of error is it? Trend
Trends signal that something has gone wrong in at least one of what 5 areas? 1. procedure 2. instrument 3. technique 4. reagents 5. control sera
If control results are distributed on one side of the mean for several days but remain at a constant level, this type of error is called ? A shift
Westgard Rules specify what 3 things? 1. You must list specific limits on how much var. is acceptable in control values b4 test results are rejected 2. The lab must analyze 2 different levels of control sera (normal and abnormal) 3. A run is out of control if its results violate the rules.
A 1-2s violation means that both controls are outside the ? +1-2s limit
A 2-2s violation means that the same control level is outside -+2s limit in ? 2 successive runs
A 4-1s violation means that __ __ __ have values greater than the +1s all in the __ __. four consecutive runs, same direction
A 10x violation means that __ __ __ __ fall on one side of the mean. 10 consecutive control values
A patient's test results cannot be reported until the method of testing has been shown to be ? in control
Created by: IsaacJ