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BCLT Final
review for clinical laboratory procedures final exam
| Question | Answer |
|---|---|
| Why is the metric system used in laboratory procedures? | It is more reliable, accurate, precise, and easily standardized. |
| What are the 3 types of glass used in lab glassware? | Flint, Borosilicate and Quartz. |
| What are 3 common plastics used in lab glassware? | Polyethylene, polypropylene and polystyrene. |
| What are beakers used for? | Estimating the amount of liquid, mixing solutions or holding liquids. |
| What are the 2 common flasks used in the lab? | Erlenmeyer-used to hold liquids, mix solutions or measure noncritical volumes. Volumetric-used for making critical measurements. |
| What are test tubes used for? | Containers for holding blood, urine or serum. |
| What are graduated cylinders commonly used for in the lab? | To measure the volume of 24-hour urine specimens. |
| What are pipets? | Glass or plastic tubes used to measure and transfer precise volumes of liquid. |
| What are the different types of pipets? | To deliver, to contain, volumetric, serological or graduated, micropipets and micropipetters. |
| What is the routine process for cleaning labware? | 1. Wash by hand 2. Rinse with tap water 3. Rinse 2-3 times with reagent-grade water 4. Final rinse in Type 1 reagent water several times. (contaminated labware also soaked in disinfectant solution) |
| What are the different types of centrifuges? | Microfuge, microhematocrit, clinical, serological, high-speed refrigerated and ultracentrifuge. |
| What is an autoclave used for? | To sterilize items with steam under pressure. |
| What pH is considered alkaline? Acidic? | A pH below 7 is considered acidic, a pH above 7 is considered alkaline. |
| What are the 3 types of laboratory grade water? | Type 1, Type 2 and Type 3; Type 1 being the purest. |
| What type of microscope is a clinical microscope? | A light microscope. |
| What are the major parts of the microscope? | Oculars, objective lenses, light source, condenser, diaphragm, coarse and fine focus adjustments, stage. |
| What are the 3 common objectives used in the lab? | Low power, high power, oil immersion. |
| What are the 3 types of blood vessels? | Arteries, capillaries and veins. |
| What is the difference between an artery and a vein? | Veins carry deoxygenated blood back to the heart while arteries carry oxygenated blood away from the heart. The only exceptions being the pulmonary vein and artery. |
| What is the complex solution in which blood cells are suspended? | Plasma. |
| Where are all blood cells derived from? | A bone marrow cell called the hemopoietic or hematopoietic stem cell. |
| What is the most common procedure done in the hematology lab? | CBC or complete blood count. |
| After centrifuging a capillary tube for a hematocrit test, what is the layer that separates the red blood cells and the plasma called? | Buffy coat. |
| What type of capillary tube should you use for a hematocrit test using capillary blood? | A heparinized tube (has a red ring). |
| What is the primary constituent of red blood cells? | Hemoglobin |
| What is specific gravity? | The density of a solution. |
| What is a hemacytometer and what is it used for? | A heavy, precision-made glass slide with two counting areas. Used for manual blood cell counts. |
| What common test would you use a stained blood smear for? | A CBC. |
| What does morphology mean? | Structure |
| What is the only anticoagulant that should be used when making a blood smear? | EDTA |
| Blood smears should be made within __ hours of blood collection. | 2 |
| What is the preferred specimen for a blood smear? | Capillary blood. However, venous blood that has EDTA added to it can also be used. |
| What are the 2 most commonly used blood stains in the US? | Wright's stain and Giemsa stain. |
| Where should stained smears be stored? | In the dark in a dust-free slide box or container. |
| Which area of a blood smear is examined microscopically? | The feathered edge using the oil-immersion objective. |
| What is the average number of red blood cells per cc? | 4.5-5 million |
| What is the center of the red blood cell called? | The central area of pallor. |
| What are the different types of white blood cells? | Neutrophil, lymphocyte, monocyte, eosinophil, basophil. (Remember, Never Let Monkeys Eat Bananas!) |
| What are platelets fragments of? | A larger cell called the Megakaryocyte, which is found in the bone marrow. |
| What is the ESR or Sed Rate commonly used for? | An indicator of inflammation and malignancies. |
| What is the term for cells that are arranged like rolls or stacks of coins? | Rouleaux |
| The sed rate can be affected by.. | The size, shape and number of RBC's. |
| The technical factors that can affect a sed rate are.. | Must be kept vertical, on a counter free from vibration, correct temperature (20-25 degrees C), should be set up within 2 hours, length and diameter of sed tube, anticoagulated blood samples must be well mixed, and careful pipeting technique used. |
| What are 4 methods used for sed rate? | Westergren Method, Sediplast ESR system, Wintrobe Method and Automated. |
| What is the process of stopping the loss of blood from blood vessels? | Hemostasis |
| Hemostasis involves 4 systems. What are they? | The blood vessels, platelets, coagulation factors and fibrinolysis. |
| The narrowing of a vessel is called.. | Vasoconstriction |
| When the endothelium lining of the blood vessels is damaged, what is exposed? | Collagen. |
| What happens to platelets when they are exposed to collagen? | They undergo a shape change and this contact initiates platelet adhesion, or the act of the platelets sticking to the damaged edge of a vessel. |
| Of all the coagulation factors, all are plasma proteins except for.. | Factor 4, Ionized Calcium. |
| What does the term D-dimer mean? | Fragments left over from a clot. |
| What are the coagulation pathways? | Extrinsic, intrinsic and common. |
| What is the major difference between Heparin and Coumadin? | Heparin can only be given by needle. Coumadin is given orally. |
| What is the difference between a thrombus and an embolus? | A thrombus is a blood clot attached to a vessel wall. An embolus is a blood clot that travels through the circulatory system. |
| Which anticoagulants are used for prothrombin time (PT)? | Warafin/coumadin. |
| Which anticoagulant is used for the activated partial thromboplastin time (APTT) and fibrin assays? | Heparin. |
| What is the PT test used for? | Evaluating the function of the extrinsic and common pathways of hemostasis and to monitor coumadin therapy. |
| Where is prothrombin produced? | The liver |
| Which tube is used to collect blood for a PT/APTT? | Light Blue (Sodium Citrate) |
| What reagent is used when performing the APTT? | Partial thromboplastin. |
| What medical situations require rapid hemostasis test results? | Patient is receiving heparin therapy, or conditions such as Disseminated intravascular coagulation (DIC) and deep vein thrombosis (DVT) are suspected. |
| Hemostasis tests include.. | Activated clotting time (ACT) and APTT. |
| What is Heparin? | An anticoagulant that inhibits forms of factors IX, X, and XII as well as platelet release factor. |
| A complication of deep vein thrombisis (DVT) can be.. | Pulmonary embolism. |
| Tests for D-dimer are useful in diagnosing.. | DIC, DVT, and pulmonary embolism. |
| The immune system can be involved in the initiation of disease. True or False? | True. |
| What is specific immunity and how is it characterized? | The type of immune response that recognizes and remembers different antigens. It is characterized by recognition, specificity and memory. This memory can also be called the anamnestic response. |
| The two major types of lymphocytes are.. | T cells and B cells. |
| What are the primary lymphoid organs in mammals? | The bone marrow and the thymus. |
| What are B cells responsible for? | Humoral immunity and providing primary protection against bacteria, toxins and circulating antigens. B cells produce antibodies. |
| What are T cells responsible for? | Bringing about cell-mediated immunity, providing protection against viruses, fungi, tumor cells and intracellular organisms. |
| What are the classes of immunoglobulins? | GMADE. |
| Immune deficiencies can be acquired or congenital. Most abnormalities of the immune system are.. | Acquired. |
| What does assay mean? | Measurement of immunoglobins. |
| What is agglutination? | the visible clumping or aggregation of cells or particles due to reaction with specific antibody. |
| Approximately how much blood is collected when donating? | 1 pint or 0.5 L |
| What is the average amount of blood circulating in the adult human body? | 10 pints |
| What is the major blood group system? | ABO |
| ABO grouping is based on the presence or absence of what? | Two blood group antigens- A and B, which are found on the cell membranes of RBC's. |
| The lack of both A and B antigens means a person is what blood type? | Type O. |
| Where are Rh antigens present? | On the surface of RBC's. |
| Antibodies to Rh antigens do not occur naturally in serum. True or False? | True. |
| What is the most important antigen in the Rh system? | The D antigen. |
| Rh Typing is important for.. | Correct blood transfusion type, identifying females at risk of giving birth to infants with hemolytic disease of the newborn (HDN), family genetic studies and to establish paternity. |
| What are the major functions of the kidneys? | Elimination of waste products, regulation of pH, regulation of body fluids, production of hormones. |
| The concave region of the kidney is called the.. | Renal hilus. |
| What is the outermost layer of the kidneys? What lies just beneath it? | The cortex. The medulla lies beneath it. |
| What is the functional unit in the kidneys called? | The Nephron. |
| What is the filtering unit of the kidney? | the glomerulus. |
| How much urine is produced in a healthy adult daily? | 2L or 800cc. |
| What hormones affect kidney function? | PTH, calcintonin, aldosterone, ADH, ANP. |
| What hormones are produced by the kidneys? | Erythropoietin, renin, active vitamin D3. |
| What is the preferred urine specimen? | First morning clean-catch. |
| What are 24 hour urine specimens primarily used to assess? | Kidney function. |
| Urine specimens should be examined within __ hour of collection, with the exception of the 24 hour tests. | 1 |
| Urine can be stored for up to how many hours at 4-6 degrees C? | 4 |
| What are the physical characteristics of urine that should be observed? | Color, Clarity, Odor, Specific Gravity. |
| Glucose present in urine can indicate what? | Diabetes. |
| Bilirubin present in urine can indicate what? | Liver disease, bile duct obstruction or hepatitis. |
| Ketones present in the urine can indicate what? | Diabetes, starvation or prolonged dieting or fasting. |
| Blood present in the urine can indicate what? | Infection, trauma to the urinary tract, bleeding in the kidneys, glomerular damage or tumor. |
| Protein present in the urine can indicate what? | Vigorous exercise, UTI or the presence of albumin. |
| Urobilinogen present in the urine can indicate what? | Hepatic disease or hemolytic disease. |
| Nitrate present in the urine can indicate what? | Possible bacterial UTI. |
| Leukocyte Esterase present in the urine can indicate what? | Presence of leukocytes in urine, usually due to infection or inflammation in the urinary tract. |
| What are the common components present in urine sediment? | Cells, casts, crystals and amorphous deposits. Fibers, hair etc. can also be found. |
| What is hCG? | Human chorionic gonadotropin. Produced by the placenta shortly after fertilization. |
| What is a chemistry profile, also called a complete metabolic profile? | A group of tests performed simultaneously on a patient specimen to provide an assessment of the patient's general condition. |
| Blood chemistry tests can be organized in to what categories? | Routine and special. |
| What specimens can be used for chemical analysis? | Blood, urine, cerebrospinal fluid, synovial, pleural or pericardial fluids. |
| Reference or normal ranges of a substance are determined by what? | Measuring the level of the substance in a portion of the general population and applying statistical methods to the data. |
| What are some analytes commonly tested in a chemistry profile? | Protein, Electrolytes, mineral metabolism, kidney function, liver function, cardiac function, lipid metabolism, carbohydrate metabolism and thyroid function. |
| What are the 2 major types of serum proteins? | Albumins and globulins. |
| When measuring electrolytes, what ions are measured? | Sodium, potassium, chloride, bicarbonate. |
| Minerals measured in mineral metabolism for a chem profile are.. | Calcium, phosphorous, iron. |
| In a chemistry profile, measurement of creatine, BUN and uric acid levels are used to test for what? | Kidney function. |
| What specimen is used for most clinical chemistry tests? | Serum. |
| What is serum? | The fluid portion that remains after blood has been allowed to clot. |
| What are the benefits of point of care testing or POCT? | Rapid results, less trauma-more patient participation, multiskilled personnel, reduced errors. |
| What are the components included in a point of care testing program? | Compliance with regulatory agencies, safety program, quality assurance program, personnel training and assessment, technical support, data management. |
| What is Glucagon? | The pancreatic hormone that increases blood glucose concentration by promoting the conversion of glycogen to glucose. |
| What is Glycogen? | The storage form of glucose found in high concentration in the liver. |
| What does insulin do? | Lowers blood glucose. |
| What increases blood glucose? | Growth hormone, epinephrine, cortisol, glucagon. |
| What is diabetes? | A chronic disease in which the body either produces insufficient insulin or is unable to use insulin properly. |
| What are the major functions of cholesterol? | A major constituent of cell membranes, protecting the skin from absorption of water-soluble substances, and to serve as a precursor to bile salts and steroid hormones. |
| What are the sources of cholesterol? | Body tissues (endogenous), Consumption (Exogenous). |
| What are the two fractions of cholesterol that are commonly measured? | HDL (high density lipoprotein) cholesterol and LDL (low density lipoprotein) cholesterol. |
| Which type of cholesterol is considered "bad"? "Good"? | HDL = good, LDL = bad. |
| Clinical microbiology encompasses the study of what? | Viruses, fungi, bacteria and parasites. |
| Bacteria usually multiply by what process? | Fission. |
| What are the three types of bacteria? | Coccus (round), Bacillus (rod), Spiral. |
| What is a gram stain? | A procedure that stains bacteria differentially according to the composition of their cell walls. |
| What are the characteristics of Gram positive and Gram negative bacteria? | Gram positive bacteria appear blue-purple, Gram negative bacteria appear pink-red. |
| What type of microorganisms invade the body and cause illness only when the body's immune defenses are impaired or absent? | Opportunistic pathogens. |
| Where can parasites be present in the body? | Blood, bone marrow, intestinal tract, liver, spleen, skin, hair or any organ system. |
| What is the most common blood parasite worldwide? | The malarial parasite, Plasmodium. |
| What is the difference between bacteria and a virus? | Bacteria-treated w/ antibiotics, viruses-anti-virals. Bacteria- RNA + DNA, viruses-EITHER DNA or RNA. Bacteria-seen using a clinical microscope, viruses-using electron microscope. Bacteria-grown on lab culture media, viruses-on living cells. |
| What is mycology? | The study of fungi (molds or yeasts) |
| What are the characteristics of molds? Yeasts? | Molds have branching filaments called hyphae. Yeasts are one celled and oval, and reproduce by budding. |
| What does the term aerobic mean? Anaerobic? | Aerobic- requires oxygen. Anaerobic- growing in the absence of oxygen. |
| What is normal flora? | Natural microorganisms inhabiting the human body. |
| What is agar? | A derivative of seaweed used to solidify liquid media. |
| What is primary medium? | The media on which the specimen collected from the patient is first inoculated. |
| What is selective medium? | A media containing ingredients that inhibit the growth of certain microorganisms while allowing the growth of others. |
| What can a bacterial smear be prepared from? | A swab from a wound or lesion, or from a culture such as an agar slant or petri dish. |
| What are the stains that are used in a gram stain? | Primary stain (crystal violet), Gram's Iodine (mordant), Decolorizer (alcohol/acetone), Counterstain (safranin). |
| What media will gram negative organisms grow on? Gram positive? | Gram negative- BA, EMB, MAC. Gram positive will only grow on BA. |
| What are two fecal occult blood tests? | Guaiac test, Immunochemical Test for fecal occult blood. |
| What is an ectoparasite? | A parasite on the exterior of the host. |
| The main host for an adult parasite is called.. | Definitive host. |
| An organism required to complete a parasite's life cycle in addition to the definitive host is called.. | Intermediate host. |
| An organism other than the main host that can harbor a parasite and serve as a source of infection is called.. | Reservoir host. |
| A living carrier that transmits a parasite to an uninfected host is called.. | Vector. |
| Where are the majority of parasites found? | Temperate to tropical climates. |
| What types of damage can a parasite cause to its host? | Mechanical (obstruction of an organ or vessel), irritative or toxic, allergic. |
| How do you prevent parasitic infection? | Block transmission, health education, improving sanitation, identifying and treating infected individuals to prevent spread of infection, vaccines. |
| What are the 3 major groups of parasites? | Protozoa (single celled), Helminths (worms), Arthropods (insects). |
| What types of specimens can be used for parasite examination? | Fecal, blood, specimens for immunological tests, sputum, vaginal secretions, CSF, and tissue. |
| What rules should you follow when collecting specimens for parasite examination? | 1. specimen must not be contaminated with urine or water 2. wait 1 week after ingesting antidiarrheal meds, barium or oily laxatives 3. label container w/date and time 4. 3 separate specimens over 3-5 days 5. deliver within 2 hours. |
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