Study Guide for CLLS 308-Final exam

Total is 60 MCQs = 40 marks, 10 questions of the chapters covered in Midterm, 50 questions on

the chapters after the midterm
1. What does quality mean
- lab quality ensures lab results are reliable, accurate and in timely manner.
2. Recognize errors that might occur in pre-analytical, analytical or post
analytical stage
3. What does PPE mean?
- Personal Protective Equipment: gloves, lab coat
4. The correct procedure to handle needles in the lab
- Do not recap, needles should be disposed in sharp container
5. Benefit of equipment management (check handouts)
- Helps to maintain a high level of laboratory performance
- Reduces variation in test results = Reliable
- Reduces interruption of services due to breakdowns and failures; Lowers repair costs
- Increase instrument life
- Increases safety for workers
- Produces greater customer satisfaction
6. What is the correct action to be taken if we encounter problem with
equipment?
- Troubleshooting
- call manufacturer
- backup machine
- send sample to reference lab
7. Benefit of inventory management
- reagents and supplies are available all the time
8. What does Quantification mean? a process for calculating how much is required of any
particular item for a given period of time.
9. Methods of quantification:
- morbidity based: based on actual usage (health supplies actually used wastage–expired
or spoiled supplies)
- consumption based: based on the actual number of episodes (population size disease
incidence)
10. Advantage and drawbacks of computerized stock management
- Advantages:
Exact current state of stock, product classification
Management of expiration dates
Statistics
planning purchase orders
Management of possible distribution
Makes inventory tasks easier
- Drawbacks:
An on-site computer is needed
Requires trained staff
11. Reagents orders according to the life span
- if the life span is short 3 weeks, we do not place order for six months)
12. Patient identification and patient info should be included in the sample label
- Name
- Age
- Physician
- Test requested
- Time
13. Components of lab handbook (policies and procedures) for good sample management
- Instrument type, model number, serial number
- Location in lab
- Date purchased
- Vendor contact information
 - Warranty
- Spare parts
14. Sample requirements fasting or not, sampling timing
- glucose and cholesterol test require fasting
15. Some analyte is affected by light and require to be transported in a dark container:
- Bilirubin
16. Order of blood draw and anticoagulant
1. Blood Culture Bottles (Aerobic-Anaerobic)
2. Coagulation Tube
3. Serum Tube with or without clot activator, with or without gel separator
4. Heparin Tube with or without gel plasma separator
5. EDTA
6. Fluoride (Glycolytic Inhibitor)
17. Quality control is used to monitor accuracy and precision of the analytical stage
18. Examples of qualitative, semi-quantitative and quantitative test
- Qualitative: growth or no growth, positive or negative, reactive or non-reactive, color
change = Pregnancy test
- Semi-quantitative: “trace amount”, “moderate amount,” or “1+, 2+, or 3+” = urine
dipstick
- Quantitative test: specific number
19. Causes of hemolysis:
- Cooling down the sample below 0
- Vigorous shaking
- Insufficient amount
- Traumatic venipuncture
20. What do you expect to see in ABG sample with delayed analysis?
- Low pH, low O2, high CO2, low Glu, and high Lac.
21. The storage recommendation for ABG sample from a patient with leukocytosis:
- ABG samples should be analyzed within 30 minutes.
 - If delayed expected, use glass syringe and put it in slurry ice
- If the patient has high WBC and platelets, analyze sample within 5 mins.
22. ABG samples should be analyzed immediately for patient with leukocytosis and
thrombocytosis because WBCs and platelets are metabolically active and the parameters
will change quickly.

23. Which Information should be included in the test request form?

- Name
- Time of requested test
- Physician
24. Levey-Jennings charts is QC chart
25. Definition of accuracy and precision
- Accuracy: The closeness of measurements to the true value
- Precision: The amount of agreement in the repeated measurements
26. Control: is used to ensure the procedure is working properly (green light)
27. Calibrator: is used to set the measuring points on a scale
28. When should calibration be performed?
- Using new reagent with different and new lot number
- New equipment
- If QC value is out of the range
29. Definition of sensitivity and specificity
- Sensitivity: The ability to detect small quantities of a measured component
- Specificity: The ability of a method to measure only the component of interest
30. Standard deviation: measure of variation
31. Shift: control values are on one side of the mean for 6 consecutive days.
32. Trend: control moving in one direction– heading toward an “out of control” value
33. The correct action If QC is out of the range: stop analyzing the patient sample until the
problem resolved
34. West guard rules: to evaluate the QC values and help in taking decision.
35. Review the west guard rules you might get chart and asked to identify the violation of which
rules.

36. Causes of out-of-control range:

- Degradation of reagents or kits
- Control material degradation
- Operator error
- Calibration error
37. Internal audit for the hematology lab at AGH hospital is conducted by a group from the
same organization
38. Steps of auditing process (order)
1. Gather information
2. compare findings with documented management system
3. identify breakdown in system or departure from procedures
4. do something with audit results (audit outcomes report)
39. Correct order of corrective action process
- Using problem-solving team:
- Investigate root causes (root cause analysis)
- Develop appropriate corrective action
- Implement corrective action
- Examine effectiveness
- Record all actions and findings
- Monitor
40. Internal audit is more flexible and cost less money
41. Lab director is responsible for Setting overall policies for internal audit program
42. Quality manager is responsible for Managing the internal audit program
 - Outcome of internal and external audit is to Identify root causes of problems and
take corrective actions
- Corrective and remedial actions are Steps taken to improve a process or to correct
a problem
43. Definition of proficiency testing: A program in which multiple samples are periodically sent
to members of a group of laboratories for analysis and/or identification
44. How to handle the proficiency testing sample: analyzed in similar manner to the patient
sample using the same procedure and the same lab staff
45. Limitation of proficiency testing: it detects errors in the analytical stage only
46. On-site visit: evaluate the entire performance of the lab
47. What is Rechecking / retesting
- Rechecking: samples must be collected randomly; blinded
- Retesting: tested by reference laboratory; not blinded