Quiz #7
The American Heart Association recommends that the concentration of cholesterol in the blood exceed 200 mg/dL.
False - American Heart Association
FBS (FBG) range
Fasting Blood Sugar (8 hours) 70 to 110 mg/dL
What is the name of the equipment Medical Assistants use in point-of-care testing to measure glucose levels in patients with diabetes mellitus:
Glucose meter
What disorder is linked to high uric acid level (3-7 mg/dL = WNL)
Gout; high uric acid result; painful swollen joint (toe, elbow) Hyperuricem
Phenylketonuria (PKU) is an inherited condition in which a baby does not have the enzyme that metabolizes the phenyalanine amino acid into tyrosine amino acid. What test screens for PKU in newborns:
Guthrie screening test
Blood test monitors blood glucose control over last 2-3 months
Hemoglobin A1c (Glycosylated hemoglobin) = glucose measurement for past two months (Goal less than 7 for diabetics) (1382)
What hormone causes pregnancy tests to become positive:
Human chorionic gonadotropin
Drugs, orchitis, testicular atrophy, obstruction of the vas deferens, cigarette smoking, coffee, fever and alcohol consumption can alter semen analysis results. Match the sperm levels with the correct term:
Infertile - < 15 milion sperm per mL - Aspermia - No sperm - Oligospermia - < 20 milliom sperm per mL
What blood type is a universal donor:
O
Agency requires employers to ensure safe working environment
Occupational Safety Health Administration
OSHA - care for chemical contact on skin (3)
Occupational Safety Health Administration - Chemical Contact Skin 1. Flush with water STAT- five minutes (Eye 15 mins) - Eye wash stations; showers 2. Follow MSDS directions 3. Clean up chemical spill - spill kit
What test is often used to diagnose gestational diabetes:
Oral glucose tolerance test
POL
Physician's office laboratory
POCT
Point of care testing
Oral Glucose Tolerance Test (OGTT
Pregnancy check for Gestational Diabetes - high sugar during pregnancy Fasting 8 hours; Glucose load 75mg Glucola; blood tested at 1 ,2, & 3-hour intervals
What is the most common urine specimen in the clinical back office:
Random Specimen
Colors chemical warning labels - Diamond (National Fire Protection Association
Red - Fire hazard - Blue - Health hazard - Yellow - Instability hazard - White - Specific personal protective equipment needed to manage hazard
What is the most common tool for determining the specific gravity of urine:
Refractometer
What test is performed on pregnant women to avoid problems with mother's blood being incompatible with baby's blood:
Rh blood typing
C-reactive protein (CRP) is a blood test that determines inflammation in the body which may correlate with cardiac risk, arthritis and infection.
True - C-reactive protein
The Clinical Laboratory Improvement Amendments (CLIA) safeguards the public by regulating all testing of specimens taken from the body and is enforced by the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health and Human Services (DHHS).
True - Clinical Laboratory Improvement
Desirable levels of triglyceride in the blood are less than 150 mg/dL.
True - Desirable levels
High levels of high-density lipoproteins are associated with increased risk for coronary artery disease.
True - High levels of high-density
Transmission-Based Precautions are designed to reduce the risk for airborne, droplet and contact transmission of pathogens. These are used in addition to Standard Precautions and are intended for specific categories of patients.
True - Transmission - Based
Universal Precautions are intended to assist health care providers to greatly reduce the risk for contracting or transmitting infectious diseases, particularly AIDS and Hepatitis B.
True - Universal Precautions
The purpose of Standard Precautions is to enhance Universal Precautions and techniques known as body substance isolation (BSI). Standard Precautions contains measures intended to protect all health care providers, patients, and visitors from infectious diseases. (Very true)
True - purpose of Standard
Which blood test relates to a patient with gout:
Uric acid
The Mantoux Test requires the Medical Assistant to inject 5 Tuberculin units of purified protein derivative intradermally with the bevel up into the patient being screened for Tuberculosis. What is the name of the bubble (whitish raised bump) after the injection on the patient's skin:
Wheal
Timed urine specimen collection that requires preservatives in contain
- 24-Hour Urine Collection - Brown container - kept on ice - Start clock 0800; finish next day at 0800 after fist void - Bag & tag with patient identification information - transport to la
Lab test with the coordinating organ / function / substance:
- ALT / AST - Liver - BUN - Kidney - Calcium - Bones - Glucose -Pancreas - Sodium / Potassium -Electrolytes
Which test are included in a hepatic function panel
- AST / SGOT - Albumin - Bilirubin - ALT / SGPT
The normal blood levels for the liver function tests:
- Alanine Aminotransferase (ALT) 45 units/L - Albumin 3.4 to 5.4 mg / dL - Alkaline Phosphatase (ALP) 44 to 147 I/L - Aspartate Aminotransferase (AST) 10 to 34 IU/L
What chemical testing do urine reagent test strips indicate
- Bilirubin - Nitrates - Urobilinogen - Leukocytes - Blood - pH - Protein - Glucose - Ketones - Specific gravity
Examines diseases & recommends guidelines for CLIA studies?
- CDC; Center for Disease Control - CLIA: Clinical Laboratory Improvement Act
Specimen collection guideline
- Check MD order; Follow lab collection instructions; Patient instructions; - Obtain specimen; Follow OSHA Bloodborne Pathogens Guidelines; - Specimen Transport bag (double bag with MD order in outside pouch); - Document HER / Requisition
Which blood tests are included in a basic metabolic panel (BMP)
- Chloride - Glucose - Creatinine - Potassium - Calcium, total - CO2 - BUN
How can the transparency of urine be recorded
- Cloudy - Clear - Hazy - Turbid
Factors for accuracy of lab test resul
- Control tests - Proficiency testing - Preventative - Maintenance - Instrument - Validation
Chain of custod
- Court-ordered drug testing; Guards against tampering / guarantee integrity of specimen: 1. Photo ID 2. Patient signs; consents and completes questionnaire 3. Special collection device for temperature 4. Bathroom is inspected 5. Specimen is witnesses while collected 6. Signatures and documentation sealed with specimen 7. Transported to lab or POL
Quality Controls in the Lab (3)
- Daily temperature checks for refrigerators, freezers - Check expiration dates on supplies - Daily check Centrifuge Log
Triglycerides testing & results (mg/dL)
- Desirable = < 150 - Borderline high = 150-199 - High = 200-499 - Very high = > 500
Rationale for C&S (culture & sensitivity)
- Determine pathogen - MD can choose best medication to treat pathogen
Patient teaching for clean-catch midstream urine specimen to avoid contamination
- Directions: Clean urethra well. - Start urinate - Stop urinate - Place UA cup under urethra - Start urinate Fill cup - Stop - pull UA cup out - Finish draining bladder
What is correct in obtaining a blood specimen from a newborn
- Dispose of materials in biohazard container - Do not apply a bandage - Wash hands - Wipe away the first drop of blood with a gauze pad - Apply gentle pressure with a cotton ball after puncture until bleeding stops - Puncture the infant's lateral portion of the heel pad - Use alcohol swabs to clean heel and allow to dry before puncture
How is urine formed
- Filtration - Reabsorption - Secretion
Preferred sample for urine pregnancy testing
- First morning void - Sleep 8 hours - urine is concentrated - detects HCG - Human Chorionic - Gonadotropin (hormone release when placenta is develop
Equipment /supplies for performing a complete UA Physical, chemical and microscopic examination of urine
- Gloves - Urinalysis cup - Centrifuge - Requisition - Reagent test strips microscope - Refractometer, - Urinanalyzer
What substances are filtered out the body by the kidneys
- Glucose - Amino acids - Ammonia - Creatinine - Electrolytes - Water - Urea
What is considered an abnormal substance in urine
- Glucose - WBCs - Protein - Blood - Microorganisms - Urobilinogen - Fat - Bile
Department of typical medical laboratory
- Hematology -Quantitative tests of WBC, RBC and platelets - Urinalysis -Physical, chemical and microscopic analysis of urine - Chemistry - Analyzes CSF, joint fluid, assay enzymes, serum glucose and electrolytes - Serology / Immunology - Evaluates body's immune response and production of antibodies against viruses and bacteria and autoimmune responses - Toxicology - Tests for toxic substances, drug usage, therapeutic drug levels - DNA - Tests to prove paternity and maternity - Microbiology - Identifying viruses and bacteria - Parasitology - Study of parasites
Rejected specimens in the lab
- Insufficient amount of specimen - No patient identification - No MD order Delay in delivery - time - Improper collection method or equipment
What are the three primary goals that an employer must accomplish to be in compliance with the OSHA standard for chemical exposure
- Inventory and list of all chemicals considered hazardous - Educational program for new employees - Safety Data Sheets (MSDS)
Which test are included in a lipid panel
- LDL - Cholesterol - Triglycerides - HDL
How do Medical Assistants play an important in laboratory testing
- Obtaining specimens - Sending specimens to larger outside laboratories - Performing CLIA-waived tests - Preparing patients for tests
Steps for Mantoux Test
- PPD = Purified Protein Derivative - Mantoux Test = 0.1 mL of 5 TU (toxin unit) ID (intradermally) using a 1 - mL tuberculin syringe to create a Whaleys
A chain of custody guards against tampering and guarantees the integrity of the urine specimen. What is involved in the process of chain of custody that the Medical Assistant must follow
- Patient consents and answers a questionnaire - Patient belongings are not in the bathroom - Urine collection is monitored for court-ordered drug test - Urine collection cup has a thermometer to ensure urine is fresh and at body temperature - Bathroom and patient are inspected for samples that do not belong to the patient - Patient signs to verify the sample is his or hers - Patient presents photo identification - After the sample is collected the temperature is recorded and sample is sealed and secured for transport to testing facility
What does a routine urinalysis procedure consist of
- Physical or visual examination of urine - Chemical examination of urine - Microscopic examination of urine sediment
What is a test of blood's clotting ability and is often used for people who are taking anticoagulant medications such as Coumadin (warfarin)
- Pro-time (PT) - Prothrombin time - International normalized ratio (INR)
Clinical Laboratory Improvement Ammendments have established regulations regarding laboratory tests which are categoriezed as
- Provider-performed microscopy procedures (PPMP) - Moderate complexity - Waived tests - High-complexity tests
Follow up for positive TB/Mantoux test
- Return to read TB result 48 - 72 hours; check for induration - Positive reaction = 10 mm induration Positive PPD Screen is referred to radiology for CXR (Chest x-ray
Urine color with the caused
- Straw to yellow - Normal - Orange to amber - Concentrated urine - Colorless - Dilute urine - Deep yellow - Vitamin intake - Bright orange - Pyridium (Drug) - Greenish orange - Bilirubin - Smokey - Red blood cells - Green or blue - Methylene blue
What test screens for healthy thyroid function
- Thyroid stimulating hornone (TSH) - Thyroxine (T4) - Triiodothyronine (T3)
What are the purposes of laboratory testing
- To satisfy employment, insurance or legal requirements - To determine effectiveness of treatment - To differentiate between two or more diseases - To confirm clinical diagnosis - To detect asymptomatic conditions or diseases - To record a patient's state of health
Approximately 180 liters of filtrate is produced daily by the body. How much urine is typically eliminated by a normally functioning human body in 24 hours:
1 - 2 Liters
Categories of lab testing (5)
1. Waived 2. Low complexity 3. Moderate 4. Complexity 5. High Complexity
Amount of urine required for U
10 - 20 mL
What is considered a positive reaction for a Mantoux test:
10 mm induration
How much semen is needed to run a semen analysis
2.5 mL
Fasting blood glucose screens for diabetes mellitus. What is the normal fasting range value of glucose:
70 to 110 mg / dL
Test for healthy kidney function
BUN = blood urea nitrogen WNL= Adults (8-21)
Abnormal substances in urine
Blood, protein, bacteria, WBC, casts, mucous, pus, nitrat
What pathogen causes infectious mononucleosis:
Epstein-Barr Virus