Heme 1 -- Chapter 25 Fundamentals of Med. Lab FINAL Review
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| Medical laboratories perform vast array of tests that assist providers with what? | Diagnosing; treating; following progression of Pts with acute and/or chronic illness.
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| What are examples of conditions we follow progression of? | Diabetes; hypertension; cholesterol
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| Rationale for laboratory testing: | Determine baseline values; legal purposes; pathological conditions (screening); confirm clinical diagnosis; obtain differential diagnosis; assess Tx options and Pt progress
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| A Pt that is not presenting with any symptoms at all would be called? | Asymptomatic
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| What is CLIA '88? | Clinical Laboratory Improvement Amendment -- created to protect Pts by establishing safety policies and procedures.
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| What types of labs must register with CLIA? | Every single lab regardless of its size or the nature of testing performed.
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| Quality Control | Procedures designed to ensure the accuracy and precision of lab tests and to discover and eliminate human error.
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| 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
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| Testing Categories: | Waived Tests (low complexity); Moderate Complexity Tests; High Complexity Tests
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| Waived Tests/Low Complexity | Simple to perform; require minimum of QC, judgement, interpretation and documentation (i.e. pregnancy, sugar/glucose, cholesterol, ESR)
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| 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)
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| High Complexity | Usually performed in labs subject to federal regulations. Requires high level of education and experience. (i.e. pap smears/cytology, histology, cytogenetics)
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| Which tests are most MA's likely to be performing? | Waive Tests
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| Which tests make up approx. 75% of all testing? | Moderate Complexity
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| Which testing will an MA never perform? | High Complexity
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| What types of laboratories are there? | Reference; Procurement (aka Satellite); POL; POCT; Hospital
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| Reference labs | Independent lab provides service to large region and performs most routine lab testing.
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| Procurement/Satellite labs | Exists solely for specimen collection, usually by venipuncture
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| POL | Physician's Office Lab performs waived-moderate testing and can range in size from small to very large.
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| POCT | Point of Care Testing that is performed beside/near the Pt.
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| Hospital labs | Lab within hospital. The larger the hospital, the larger the lab.
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| Assay | Test
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| Laboratory Departments | Urinalysis; Hematology; Immunology; Clinical Chemistry; Microbiology; Cytology; Histology; Blood Bank
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| Urinalysis Dept. | Study of Urine
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| Hematology Dept. | Study of Blood
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| Immunology Dept. | AKA Serology is the study of the immune system
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| Clinical Chemistry Dept. | Study of assays on urine, serum and cerebrospinal fluid, testing for presence and amount of specific chemical substances
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| Microbiology Dept. | Grows and identifies microorganisms -- mycology, virology, parasitology are subdivisions
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| Medical specialist that studies tissues and body fluids? | Pathologist
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| Hazards in the laboratory (3) | Physical; Chemical; Biological
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| Physical hazards cautions | Not using extension cords, overloading electrical outlets, use surge protectors, follow manufacturer's directions, etc.
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| Chemical hazard precautions | Label all bottles, recap bottles, clean spills, utilize wash stations, etc.
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| Biological hazard precautions | Hand washing, follow universal precautions, never eat, drink, apply make up or contact lenses, etc.
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| What must accompany every test sent out to a laboratory? | Requisition forms
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| Base of microscope | Supports upper components of the microscope
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| Arm | Used to carry microscope
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| Stage | Large platform that holds specimen
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| Illuminator | Base with light bulb, has on/off switch
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| Condenser | Under the stage, focuses, directs and concentrates light
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| Diaphragm | Within or beneath the condenser, can be opened/closed to increase/decrease the intensity of light (iris)
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| Fine tune knobs | Located on either side of the arm, is a knob that can be adjusted to fine tune focus
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| Oculars | Eyepiece of the microscope
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| Objectives | Lenses (typically 3) attached to revolving nose piece
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| Low power objective | Magnifies by power of 10 (10x)
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| High power objective | Magnifies by power of 40 (40x)
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| 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
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| Draw order for tubes | Non additives, Yellow, Blue, Reds (3), Green, Lavender, Gray
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| Cultures | Always drawn first (prior to tubes if ordered)
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| Yellow | Contains ACD (acid citrate dextrose) used for drawing whole blood for special tests
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| 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)
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| Red is broken into 3 categories: | Red, Gold and Marble
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| Red (red, gold) | Plain Vacutainer with no anticoagulant for collection of serum chemistry tests as well as clotted blood for immunohematology. Invert 5 times
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| 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.
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| Green | Contains sodium heparin for collection of heparinized plasma or whole blood for special tests. Invert immediately several times to prevent coagulation
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| Lavender | Contains EDTA (ethylenediaminetstraacetic-acid) for most hematological procedures. Invert immediately several times to prevent coagulation. (CBC, ESR, Hgb A1C)
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| 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)
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| Color tubes most often drawn by MAs | Blue, Lavender, Gray
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