LONG LECTURE EXAM 2 ratio

Recollect the specimen due to false elevation

A hemolyzed potassium sample is reported as 6.5 mmol/L (critical high). The most appropriate laboratory action is to:

Short draw on sodium citrate tube

Which of the following pre-analytical errors would most affect coagulation test results?

May dilute specimen

with IV fluid

A patient on IV infusion has blood drawn from the same arm above the IV site. How may this affect test results?

Cortisol

Which analyte is MOST

affected by diurnal variation,

requiring standardized morning

collection.

To prevent cellular

metabolism altering

analytes

Which of the following is the main reason plasma is separated from cells within two hours for most chemistry tests?

Citrate - Serum - EDTA

Which blood collection order-of-draw prevents cross-contamination of additives that could interfere with coagulation testing?

All of the above

Which of the following is the most important factor in ensuring specimen integrity?

a. Proper labeling

b. Correct technique

c. Timely transport to the laboratory

d. All of the above

All of the above

Which of the following may cause hemolysis in blood specimens?

a. Vigorous shaking

b. Using a small bore needle

c. Prolonged tourniquet application

d. All of the above

Whole blood specimens

obtained from the

venous circulation are

most commonly used in

Clinical Chemistry.

Which of the following

statements is INCORRECT?

Volatile solvents

evaporate into the air

cushion, and viscous

solutions resist

aspiration.

A technician is pipetting ethanol (volatile) and glycerol (viscous) using an air-dispenser pipette but contains inconsistent results. Why is an air-displacement pipette unsuitable for these liquids?

Prevents aspiration of

incorrect volume.

When aspirating liquid, why should a pipette be held vertically rather than at an angle?

Too rapid plunger release during aspiration.

While pipetting serum, air bubbles consistently appear in the tip. What is the most likely cause?

To prevent splashing, aerosols, and volume inconsistencies.

Why should aspiration and

dispensing be done slowly and

smoothly?

To perform analytic

procedures that provide

accurate and precise

data for diagnosis and

treatment.

Which of the following best

captures the primary purpose

of clinical chemistry as a

quantitative science?

Any reagent prepared must be labeled with date/time of preparation and concentration.

Which statement correctly reflects best practice in reagent preparation for clinical chemistry laboratories?

Amniotic Fluid

Which body fluid would be

least likely chosen for

evaluating kidney function but

more likely for assessing

intrauterine fetal conditions?

Labor-intensive processes with limited precision and high variability between technologists.

Prior to the development of

automation, most tests in the

1960s were performed

manually. Which of the

following represents the

greatest disadvantage of such

manual testing?

Dry reagent strips require manual color comparison, while wet and dry chemistry systems utilize spectrophotometric measurement.

In differentiating wet and dry

chemistry systems, which of

the following is the most

accurate

Endocrinology

Which of the following areas of Clinical Chemistry is most directly concerned with the quantitative determination of hormone levels?

Low Coefficient of thermal expansion

Which property of borosilicate

glass test tubes make them

preferably for high temperature

applications such as dry-heat

sterilization?

Cumulative stress and

corrosion from repeated

use.

In terms of clinical centrifuge safety, the most common cause of rotor failure is

III and IV only

A serum sample for bilirubin

determination was initially tested undiluted, but the

analyzer flagged the result as

above the measuring range. To

resolve this, a first dilution was

performed by adding 0.1 mL of

serum to 1.9 mL of diluent.

However, the analyzer again

flagged the result as above the

measuring range. A second

dilution was then prepared by

mixing 2.0 mL of the first

diluted sample with 3.0 mL of

diluent. This final diluted

sample was measured and

showed a value of 4.8 mg/dL.

Which of the following

statements is CORRECT in

reporting the final bilirubin

concentration?

I. The final bilirubin

concentration is 82.08

umol/L.

II. The final bilirubin

concentration is 14.04

umol/L.

III. The final bilirubin

concentration is

240.00 mg/dL.

IV. The final bilirubin

concentration is

4104.00 pmol/L.

III and IV only

Which of the following Rules in

Rounding Off Numbers is/are

INCORRECT?

I. If the first figure

dropped is less than

5, the last figure kept

should be unchanged.

II. If the first figure

dropped is greater

than 5, the last figure

kept should be

increased by 1.

III. If the first figure

dropped is 5, then the

last figure kept should

be unchanged if that

last figure is odd.

IV. If the first figure

dropped is 5, then the

last figure kept should

be increased by 1 if

that last figure is

even.

Leading zeros (to the

left of the first nonzero

digit) are significant.

Which of the following Rules in

Identifying Significant Figures

is/are INCORRECT?

41.00 degrees

Fahrenheit

A medical technologist was assigned with the responsibility of monitoring and documenting the temperature of several refrigerators in the clinical laboratory to ensure proper storage of reagents and samples. During one of the routine checks, the temperature of the refrigerator used for storing blood samples was recorded at 50°C. What is the equivalent temperature in degrees Fahrenheit?

3.0 M

During preparation of buffer solution in the lab, a medical technologist started with 4.0 L of a concentrated stock solution. To achieve the desired working concentration, the technologist diluted the stock solution by adding 1.0 L distilled water, resulting in total volume of 5.0 L. After mixing, the concentration of diluted solution was measured to be 2.4 M. What was the concentration of the original stock solution?

Tube B = 7,

Tube C = 49,

Tube D = 343,

Tube E = 2401

A medical technologist prepared 5 tubes and labelled them Tubes A to E. Tube A contains 9 ml of pure/undiluted serum. Tube B to E contains 6 ml of diluent. 1 ml of sample from Tube A is added to Tube B and was mixed. 1 ml of mixture from Tube B was added to Tube C. The same procedure was done until Tube E. What is the dilution factor in Tubes B, C, D, and E?

5.50 mmol/L

A patient's glucose level was initially reported as "above measuring range" by the clinical chemistry analyzer, indicating the concentration was too high to measure accurately. To obtain a measurable result, the medical technologist on duty diluted the serum sample toy pipetting 20.00 uL of the original serum into 0.60 mi of diluent and thoroughly mixed the solution. The diluted sample was then reanalyzed, yielding a glucose concentration of 3.2 mg/cL. What should be the reported value in SI unit?

1/256

A medical technologist

prepared 5 tubes and labelled

them A to E. Tube A contains

4ml of pure/undiluted serum.

Tubes B to E contain 3ml of

diluent. 1ml of the sample from

Tube A is added to tube B and

was mixed. 1mL of the mixture

from Tube B was added to the

the same procedure was done

until Tube E. What is the final

dilution of Tube E?

0.83 M

What is the molarity of a

solution containing 52.6 g of

KCl dissolved in 854 ml of

water? Round off the final

answer to 2 decimal places.

(Atomic mass: Cl = 35.45, K =

39.0183)

Long tourniquet

application; remove the

tourniquet promptly

What is the primary cause of

"hemoconcentration" during

venipuncture, and how can it

be prevented?

Statements II and IV are correct

II. Establish specific guidelines

IV. Ensure newly hired personnel abide by policies as established by the institution

Which of the following is a part of maintaining quality laboratory processes?

Statements I, II, and III are correct

I. Training of laboratory personnel

II. Documentation of laboratory procedures

III. Keeping a log of known errors over time for each instrument

good quality program includes

Statements I, II, and III

are correct

I. They are stable &

homogenous

II. Level 1 control

contains low to

normal

concentration of

analyte

III. Level 2 control

contains normal to

high concentration

of analyte

Which of the following correctly

describes control solutions

being used for Quality Control?

Statements I and III are

correct

I. It is a solution that

contains a known

amount of an

analyte to be

assayed.

III. A single calibrator

run is good

for 28 days.

Which of the following are TRUE about a calibrator?

Statements I, II, and III are correct

I. Proper patient identification before initiating venipuncture.

II. Correct ordering of tests.

III. Proper specimen collection.

Pre-analytical Quality Assurance includes:

Statements III and IV are correct

III. Review of test results for possible transcription errors.

IV. Verification of correct interpretation of laboratory tests by physicians.

Post-analytical Quality Assurance includes:

Statements I, II, and III are correct

I. Identifying the root cause of the error in the laboratory workflow

II. Streamline a process so results can be released faster.

III. Eliminate variation in the procedure

Goals of lean six sigma

includes:

Statements I, II, and III are correct

I. This is caused by a random error.

II. There is westgard violation of R4s

III. Reject the run.

Given a cholesterol test where the level I control has a mean of 190 and SD OF 3 and the level 2 control material has a mean of 256 and SD of 4. What is the proper interpretation when the control values observed across a run on a sample day are 197 for L1 and 240 for L2.

Only statement IV is correct

IV. Entails error within defined limit

Which of the following are true

about TEa?

Statements II and IV are

correct

II. NEQAS proficiency

testing

IV. Lung center of the

philippines

Parts of external quality control:

Statements I and III are correct

I. Delta check

III. Internal quality control

Assess the patient’s most

recent result for a particular

test as compared to the

patient’s previous value refers

to:

Statement I, II, and III are correct

I. The reagents have deteriorated.

II. There is systematic error

III. Trend started on Day 11

Based on the Levey-Jennings Chart below, what can you observe?

Statement II and IV are correct

II. Bias = 3%

IV. Sigma Metric Scale is 2 sigma

Based on the Method Decision

Chart below, which data is/are

correct?

Statement II and IV are correct

II. Mislabeling of patient’s sample

IV. Voltage and temperature fluctuation

What is/are the possible causes of error for this type of westgard violation?

Statement IV only

V. Random Error

Identify the type of Error on

Day 15.

3.4

HSY Centrifuge Manufacturing

Company has a six-sigma

metric scale in its

manufacturing operations.

What is the total number of

defects if 1,000,000 centrifuges

are manufactured?

Green Belt

Which level of six sigma will

lead and manage when

implementing the DMAIC

strategy?