CLINICAL CHEMISTRY (MTLE - KLUBSY)

• SODIUM

• POTASSIUM

• CHLORIDE

• BICARBOANTE

• MAGNESIUM

Analytes with mmol/L as SI unit and 1 as conversion factor: SO-POT-C-BI-M

• BILIRUBIN

• AMMONIA

• LITHIUM

• IRON

• CREATININE

Analytes with umol/L as SI unit: B-A-L-I-C

• TOTAL PROTEIN

• ALBUMIN

• GLOBULIN

Analytes with 10 as conversion factor: T-P-A-G

ACS STANDARD GRADE

Which grade of purity is known as Analytical reagent that is suitable for laboratory use and considered as highest purity according to CLSI?

PRIMARY STANDARD

Which reference material is highly purified chemical?

STANDARD REFERENCE MATERIALS

Which reference material is developed by NIST and use for Clinical Chemistry Laboratory?

SECONDARY STANDARD

Which reference material is substance of lower purity?

WATER

What is the MOST frequently used reagent in the laboratory?

TYPE 1

Which type of water is the purest?

TYPE 3

Which type of water is the is used as wash water?

TAP WATER

Which type of water is unsuitable for laboratory applications?

SOLUTE

A substance dissolved in liquid ex: blood?

SOLVENT

A liquid in which solute is dissolved ex: plasma?

SOLUTION

Solute + Solvent =

1. CONCENTRATION

2. SATURATION

3. COLLIGATIVE PROPERTIES

What are the Basic Properties of Solution?

PERCENT SOLUTION

It is the parts per hundred or the amount of solute per 100 total units?

MOLARITY

It is the number of moles per 1L of solution?

MOLALITY

It is the moles of solute per 1kg of solvent?

NORMALITY

It is the number of gram equivalent weights per 1L of solution?

DILUTE

What type of saturation is relatively little solute?

CONCENTRATED

What type of saturation is large quantity of solute in solution?

SATURATED

What type of saturation is excess of undissolved solute particles?

SUPERSATURATED

What type of saturation is greater concentration of undissolved solute?

VAPOR PRESSURE

What type of colligative properties is pressure at which the liquid solvent is in equilibrium with the water vapor?

FREEZING POINT

What type of colligative properties is temperature at which the vapor pressures of the solid and liquid phases are the same; most commonly used & preferred?

BOILING POINT

What type of colligative properties is temperature at which the vapor pressure of the solvent reaches one atmosphere?

OSMOTIC PRESSURE

What type of colligative properties is pressure that opposes osmosis when a solvent flows through semipermeable membrane?

BOROSILICATE (PYREX / KIMAX)

What is the MOST common type of glassware?

LOW-ACTINIC GLASSWARE

Which type of glassware is used for protection to light-sensitive materials?

GLASS PIPETTE

What is the MOST basic pipette?

AUTOMATIC PIPETTE

What is the routinely used pipette?

T/C TO CONTAIN

Which classification of pipette do NOT deliver the same volume?

T/C TO DELIVER

Which classification of pipette delivers or dispenses the stated volume and should NOT be blown out?

BLOW OUT

Which classification of pipette has a continuous etched ring?

SELF-DRAINING

Which classification of pipette has NO etched ring or markings?

TRANSFER

Which classification of pipette dispenses one volume without further subdivisions?

GRADUATED / MEASURING

Which classification of pipette dispenses several different volumes?

VOLUMETRIC

Type of transfer pipette that has the highest accuracy & precision?

OSTWALD FOLIN

Type of transfer pipette with a bulb closer to the delivery tip; used for viscous fluids such as blood?

PASTEUR PIPET

Type of transfer pipette with NO calibration marks?

SEROLOGIC

Type of measuring pipette with graduation marks; blowout pipet?

MOHR

Type of measuring pipette NO graduation marks; self-draining pipet?

MICROPIPETTE

Type of measuring pipette has single calibration marks; used for volume ranging from 1-1000 uL?

AIR-DISPLACEMENT

Which automatic pipette that piston does NOT come in contact with the liquid?

POSITIVE DISPLACEMENT

Which automatic pipette that tips are reusable?

GRAVIMETRIC

Which calibration of pipette/s are the MOST accurate method?

CENTRIFUGATION

A process in which centrifugal force is used to separate solid matter from a liquid suspension?

EVERY 3 WEEKS

Calibration of Centrifuge happens:

TACHOMETER / STROBE LIGHT

Calibration of Centrifuge uses:

TOTAL QUALITY MANAGEMENT

Promotes a philosophy that everyone involved in the laboratory workflow has a responsibility for a quality product?

SIX SIGMA

Goal: reduce the number defects to near zero?

• DEFINE

• MEASURE

• ANALYZE

• IMPROVE

• CONTROL

What are the tool of Six Sigma? D-M-A-I-C

LEAN

Goal: Eliminate / reduce wastes (nonvalued activities) in the production or manufacturing processes?

1. SORT

2. SET IN ORDER

3. SHINE

4. STANDARDIZE

5. SUSTAIN

What are the tools of Lean? 5S

• PLAN

• DO

• CHECK

• ACT

What are the tools of Lean? P-D-C-A

QUALITY ASSURANCE

Systemic process that ensures a quality laboratory service; to provide most reliable patient lab result and minimize error?

PRE-ANALYTICAL PHASE

Which QA phase is prior to the actual testing, where most testing errors occur, such as testing orders, patient identification, specimen collection, etc.?

INCREASING PROCESS AUTOMATION

Which strategy is MOST effective at reducing pre-analytical laboratory errors?

ANALYTICAL PHASE

Which QA phase where errors happens in the actual laboratory testing such as internal / external QC?

POST-ANALYTICAL PHASE

Which QA phase where errors happens following the examination, authorizes accurate reporting and transmission of results such as delta check?

DELTA CHECK

An RMT performs a comparative analysis between a patient’s current glucose value (250 mg/dL) and their value from 4 hours prior (90 mg/dL). This quality monitoring procedure is known as a:

QUALITY CONTROL

A system ensuring accuracy and precision, detects analytical errors?

ANALYTICAL SENSITIVITY

Which parameters of quality control is the ability to measure the smallest concentration of the analyte of interest; prevent false negative?

ANALYTICAL SPECIFICITY

Which parameters of quality control is the ability to measure ONLY the analyte of interest; prevents false positive?

ACCURACY

Which parameters of quality control is the ability to measure the nearness or closeness of the assayed value to the true value?

PRECISION

Which parameters of quality control is the ability to give repeated results that agree with one another?

PRACTICABILITY

Which parameters of quality control is the degree by which a method is easily repeated?

RELIABILITY

Which parameters of quality control is the ability to maintain accuracy and precision over an extended period of time?

DIAGNOSTIC SENSITIVITY

Which parameters of quality control is the ability to detect the proportion of individuals with the disease?

DIAGNOSTIC SPECIFICITY

Which parameters of quality control is the ability to detect the proportion of individuals without the disease? individuals

CONTROL

Similar in composition with the specimen; with known analyte value?

STANDARD

Highly purified substances of known composition; with best way to measure accuracy?

INTERNAL QC (INTRALABORATORY)

Type of QC in which performed by the lab personnel using control materials; essential for daily monitoring?

EXTERNAL QC (INTERLABORATORY)

Type of QC that provides samples of unknown concentration; significant in maintaining long-term accuracy of the analytical method (NEQAS, NRL)?

CAP PROGRAM

What is the GOLD standard for clinical laboratory proficiency testing?

RANDOM ERROR

Type of error which detects/measure imprecision; it is due to change and varies from sample to sample?

SYSTEMATIC ERROR

Type of error which detects/measure inaccuracy; repeating error that is easily predicted, seen as trend on data?

CONSTANT SYSTEMATIC ERROR

Which type of systematic error is independent on sample concentration; occurs when y = 0 and test used is interference experiment?

PROPORTIONAL SYSTEMATIC ERROR

Which type of systematic error is dependent on sample concentration; occurs when y = 1 and test used is recovery experiment?

MEAN

It is the average of the individual values in the sample set?

MEDIAN

It is the midpoint of the distribution?

MODE

It is the MOST frequently found number(s) in a data set?

RANGE

It is the difference between the highest and lowest score in a data?

STANDARD DEVIATION

MOST frequently used measure of variation?

COEFFICIENT OF VARIATION

Also known as Relative Standard Deviation (RSD); an index of precision used to extensively summarize QC data?

VARIANCE

Measure of variability?

T-TEST

To check for accuracy using Mean?

F-TEST

To determine precision, must know SD?

ASSAYED CONTROL

A quality control material that has been analyzed by multiple reference methodologies to assign specific numerical concentration ranges is known as a(n):

LEVY JENNINGS (LJ CHART)

A representative of the data used to complete the normal or gaussian (bell-shaped) curved; most widely used chart?

20 RUNS

What is the minimum number of daily analytical measurements required to establish initial baseline mean and SD for a Levey-Jennings QC chart?

CUSUM CHART

A QC plot that plots the cumulative sum of deviations from the target mean and detects systematic errors early when the line slope exceeds 45 degrees is the:

TREAT 1_2S AS WARNING RULE

An RMT observes a single control result exceeding +2 SD on a Levey-Jennings chart. No other rules are violated. What is the correct action?

R4s RANDOM ERROR

On a single analytical run, Control Level 1 produces a value at +2.2 SD and Control Level 2 produces a value at -2.1 SD. Which Westgard rule is violated, and what type of error does it represent?

4_1S

For 4 consecutive days, both Level 1 and Level 2 controls fall between +1.0 (SD) and +1.8 (SD). Which rule is violated?

10_X SYSTEMATIC ERROR

Ten consecutive daily control runs for serum calcium fall on the positive side of the mean, ranging between + 0.2 SD and + 0.9 SD. This represents a:

• 1_2S

• 2_2S

• 4_1S

What are the Warning rules in LJ Chart?

• 13s

• R4s

• 10x

What are the Mandatory rules in LJ Chart?

± 2 SD

If controls are within ___ the run is “in control” (95% confidence interval) and should be accepted:

SHIFT

Abrupt, sudden change in one direction in control sample values?