HST Testing and Labratory Procedures

Hematuria

Presense of blood in the urine

What organization accredits Reference Labs

COLA

FOBT stands for

Fecal Occult Blood Test

UTI

Urinary Tract Infection

UA

Urinalysis

Oliguria

Abnormally low urine output, typically less than 400 milliliters per day in adults.

How do you determine the if the patient has a condition from Liver disease

Finding elevated Bilirubin and urobilinogen levels

How do you determine the if the patient has a condition from Diabetes mellitus

High concentrations of glucose

How do you determine the if the patient has a condition from Inflammation

Abnormal amount of white blood cells in the urine

How do you determine the if the patient has a condition from elevated Alkaline or Acid

An elevated pH range above 8.0

Reasons for labratory analysis

• Regular monitoring to help identify specific diseases or problems

• Specific tests to help confirm or contradict a physician’s initial diagnosis

• Help determine & monitor proper dosage of a patient’s medications

Reference Labratory

Laboratory owned and operated outside of the medical practice

Physician’s Office Laboratory (POL)

Tests completed in a physician’s office (Usually CLIA waived tests)

Clinical Laboratory Improvement Amendments of 1988
(CLIA)

Attempt to assure the accuracy of laboratory tests

Certificate of Waiver Tests

Pose an small risk to the patient if performed or interpreted incorrectly
 Involve simple procedures so risk of obtaining incorrect
results is minimal
 Be approved by the FDA
 Office must apply for a certificate of waiver and are still
subject to random inspections

Moderate Complexity Test

75% of all tests performed inlaboratories
(Lab must be run by a pathologist with a MD or PhD)

High Complexity Test

Must be headed by a medical doctor or PHD trained scientist

Moderate Complexity Test Examples

Complete blood count, cholesterol screening

High Complexity Test Examples

Histology, cytology

When using a refractometer, make sure there is no visible contamination and no more than _____ has passed since collection

1 hour

If the refractometer has not yet been calibrated, calibrate it with _____

Distilled water

Read the specific gravity valve at the line where _____

Light and dark meet

Do NOT _____ the test pads during a Reagent strip test

Blot

Presence of the bile pigment bilirubin in the urine, called _____, is one of the first signs of liver disease or conditions that involve the liver.

Bilirubinuria

The hormone tested for in urine pregnancy tests is:

HCG

WBC

White blood cells

The ______urine specimen is the most common type of sample and may be obtained at any time of the day.

Random

When you obtain a urine specimen for drug or alcohol analysis, you must establish a proper _____  __  _____.

Chain of Custody

A(n) ___________ urine specimen is used to complete a quantitative and qualitative analysis of one or more substances such as chloride, sodium and calcium and is collected over s full day.

24-hour

A sample of a specimen that is placed in or on a substance that allows microorganisms to grow is a _______.

culture

When the practitioner suspects that a patient has a protozoal or parasitic infection, what is the minimum number of stool specimens that need to be examined?

3

An excess of protein in the urine is called ____________ and usually indicates renal disease. However, it may occur in pregnant patients or after heavy exercise.

Proteinuria

Renal or urethral obstruction and renal failure can cause absence of urine production known as:

Anuria

Patients that are dehydrated, have a decreased fluid intake, are in shock, or have renal disease may have an insufficient production or volume of urine. This is called:

Oliguria

The gelatin-like substance derived from seaweed that gives a culture medium its consistency is called:

Agar

SPG is an abbreviation for:

Specific Gravity

In cases of a suspected parasitic worm infestation, a(n) ____________ specimen may be ordered by the practitioner.

Ova and parasites

The evaluation of urine to obtain information about body health and disease is called a(n) __________.

Urinalysis

Urinary __________ is a measure of the degree of acidity or alkalinity of the urine and can provide information about a patient's metabolic status, diet, and medications being taken.

pH

A(n) _____________ mount is a type of mount used when a physician suspects that a patient has a fungal infection of the kin, nails, hair or vagina because it dissolves keratin and allows visualization of any fungus.

KOH

A(n) ___________ urine specimen contains greater concentrations of substances that collect overnight than do specimens taken during the day.

First morning

Occurring in patients with diabetes, ________ is the presence of significant glucose in the urine.

Glycosuria

Determination of the number of bacteria present in specimens is called:

Quantitative analysis

O&P stands for:

Ova and Parasites

A(n) __________ is a optical instrument that measures the refraction or bending of light as it passes through a liquid and is used to measure specific gravity of the liquid.

Refractometer

A measure of the concentration or amount of substances dissolved in urine is ____________.

Urine specific gravity

Normal result when analyzing urine for Ketones

.2

Normal result when analyzing urine for Urinary pH

5.0

Normal result when analyzing urine for Blood

Negative

Normal result when analyzing urine for Bilirubin

Negative

Normal result when analyzing urine for Glucose

Negative

Normal result when analyzing urine for Protein

Negative

Normal result when analyzing urine for Nitrites

Negative

Normal result when analyzing urine for Leukocytes

Negative

Normal result when analyzing urine for SPG

1.000

Possible diseases or disorders consistent with excess Ketones

Diabetic ketoacidosis, starvation, alchoholic ketoacidosis

Possible diseases or disorders consistent with excess Urinary Blood

Kidney stones, menstruation

Possible diseases or disorders consistent with excess Bilirubin

Hepatitis, cirrhosis, hemolyticanemia, obstruction of bile ducts

Possible diseases or disorders consistent with excess Glucose

Diabetes mellitus, renal glycosuria

Possible diseases or disorders consistent with excess Protein

Kidney disease/damage, dibetes hypertension, inflammation

Possible diseases or disorders consistent with excess Nitrites

UTI, bacterial infections

Possible diseases or disorders consistent with excess Leukocytes

UTI, Kidney infection, Inflammation

Possible diseases or disorders consistent with excess SPG

Dehydration, Diabetes insipidus, kidney dysfunction

C&S

Cesarean section (C-section)

Describe the process of a C&S (C-section)

Surgical delivery method where a horizontal incision is made in the lower abdomen and uterus to remove the baby. Done under anesthesia, Performed when vaginal birth poses risks to the mother or baby.

Describe a KOH mount

A slide preparation technique used in microbiology. It involves mixing a sample with potassium hydroxide (KOH) to dissolve non-fungal material and make fungal elements more visible under a microscope.

A KOH mount is utilized to look for what type of organism?

Fungis

The microscopic examination of tissues to make a diagnosis is _____

Histopathology/Histology

The test that cultures a microorganism and test the isolated bacteria’s susceptability to various antibotics is

Microbial culture and antibiotic susceptibility testing

When obtaining a throat culture, have the patient in a _____ position

Sitting

When obtaining a throat culture, avoid touching the:

Uvula, cheeks, & tongue

An O&P specimen is short for ________ and is examined  to check for the presence of: 

Ova & Parasites; Ova (eggs) of parasites, parasite larvae, Adult parasites, or Protozoan cysts or trophozoites

List 6 accepted ways you can instruct a patient on collecting a stool sample

1. Use a clean, dry container with a tight-fitting lid.

2. Avoid urine contamination by urinating before collecting the sample.

3. Collect a small amount of stool from different parts using a spoon or tongue depressor.

4. Ensure the sample is free of toilet paper, water, or other contaminants.

5. Place the sample in the container, filling it about halfway.

6. Label the container with patient information and deliver it to the lab promptly.

What is normal adult urine volume for a 24-hour period

800-2000 mL

Why would a chain of custody need to be established for a urine specimen?

Ensures integrity by documenting collection, handling, and analysis process. Guards against tampering, maintains legal admissibility, and preserves accuracy of results

Urochrome

A pigment responsible for the yellow color of urine.

Summarize procedures for mailing culture specimens

1. Use leak-proof containers.

2. Double bag the specimen.

3. Label the container with necessary information.

4. Include a completed requisition form.

5. Place the container in a biohazard bag.

6. Pack in a sturdy box with absorbent material.

7. Seal the box with tape.

8. Complete necessary shipping documents.

9. Use a reliable courier service.

10. Follow all local and international regulations.

Why are goggles and masks necessary protective equipment while obtaining a throat culture  specimen? 

To protect against splashes and respiratory droplets

What are most culture swabs made of now and why?

Synthetic materials like polyester or rayon due to their performance in collecting and releasing samples compared to traditional cotton swabs. Synthetic swabs have better absorption, release fewer fibers, and are less likely to interfere with test results.

Sputum

Thick mucus coughed up from the respiratory tract. It can contain bacteria, viruses, or other substances that can help diagnose respiratory conditions.

Culture medium

A substance used to support the growth and reproduction of microorganisms in a laboratory setting.

Responsibilities of a medical assistant in the POL

Collecting the sample, preparing the patient, reporting results to the physician

Routine tests most oftenly performed at the physician's office laboratory:

Chemistry and hematology

Generally positive and negative control samples are used with tests that yield a ________ test response to show the substance being tested for is either present or absent.

Qualitative

What is not needed on a specimen label

Physician's name, address and phone number

The instrument used to measure the amount of blood sugar in a fluid sample is a _____________.

Glucometer

The device used for spinning specimens at a high speed to separate the specimen into its component parts is a _________.

Centrifuge

Certificate of waiver tests are classified as such if they ______.

Pose an insignificant risk to the patient if they are performed incorrectly

All of the following information should be included on a laboratory requisition form except:

Prognosis

What test would NOT be performed in a POL

Histologic test

An instrument used in a medical laboratory to measure light intensity is called a_________.

Photometer

A slide calibrated to count sperm or blood cells is a ___________.

Hemocytometer

High-complexity tests

Cytogenetics, histopathology, histocompatibility and cytology

Workforce drug testing is a type of __________ tests.

Toxicology

Chemicals or chemically treated substances used in test procedures are known as ___________.

Reagents

What are the duties of a medical assistant in a POL?

Perform quality assurance and control procedures

Each time a test on a patient sample is processed, a ________ sample is used that serves as a check on the accuracy of the test.

Control

Explain the difference between a standard and a control sample

Standard sample: A sample with a known concentration or value used to calibrate instruments or validate test results. It establishes a reference point for accurate measurements.

Control sample: A sample with a known concentration or value used to monitor the performance of a test or instrument. It ensures the accuracy and precision of results by comparing them to expected values.