Clinical Chem part 1

通報

問題一覧

Luminous intensity

Candela

Electric current

Ampere

Thermodynamic temperature

Kelvin

Electrical potential

Volt

Temperature

Degree Celcius

Arrange ascending order

zepto, atto, femto, pico, nano, micro, milli, centi, deci, deka, hecto, kilo, mega, giga, giga, tera, peta, exa

Number of moles of solute per liter of solution

molarity

Number of moles of solute per kilogram solvent

molality

Number of equivalent weights of solute per liter of solution

normality

What is a valence?

Either

Percent solution can be expressed as the following, except;

% v/w

Expression of relative concentration

dilution

Done when the analyte concentration is too high and exceeds the detection limit of the method

dilution of sample

Done when a weaker reagent concentration is needed than the stock substance available

Dilution of stock solution

Amount of something relative to another; expressed as part per part or part per whole

ratio

Average or arithmetic mean

mean

Midpoint of a data set after the values have been ranked-ordered

median

Most frequently occurring value in a data set

mode

It is the difference between the highest and lowest values; greatly affected by outlier.

range

The distribution of data points around the mean

standard deviation

The best indicator of precision

coefficient of variation

What is the usual confidence interval of a guassian/normal distribution?

95%

Verifying a reference interval requires how many study? individuals

atleast 20

RI is adopted if ____ of the subjects fall outside the range

<10%

Establishing a reference interval requires how many study individuals?

atleast 120

What CI is the RI based?

95%

Compares the means of two groups of data or the accuracy of two methods

t-test

Compares the standard deviations of two groups of data or the precision of two procedures

f test

It is used to compare two methods using the best fit line through the data points

linear regression

The x-axis is the dependent variable/new method. The Y-axis is the independent/reference method.

Both statements are false

Ability of a method to detect the smallest concentration of an analyte

analytical sensitivity

Ability of a method to detect only the analyte of interest

analytical specificity

Ability of a test to detect a given disease or condition; proportion of individuals with the disease who have a positive test result

diagnostic sensitivity

Ability of a test to detect the absence of a given disease or condition; proportion of individuals with no disease who have a negative test result

diagnostic specificity

Used to compare results obtain on a high and low control serum from different laboratories

Youden Twin plot

Precision study is usually done by running

two control materials twice a day over a 10 day period

It is the most widely used approach to quality improvement in the healthcare

PDCA cycle

Provides both a management philosophy or organizational development and a management process for improvement of quality in all aspects of work

TQM (Total Quality Management)

Based on statistics and quantitative measurements applied in the clinical laboratory to reduce the frequency of test errors or the number of DPMOs

Six Sigma

It is designed to reduce waste, increase efficiency and improve customer satisfaction; often used in clinical laboratories to improve TAT.

Lean

Categories of wastes:

Defects, Overproduction, Wasting, Non-utilised talent, Transport, Inventory, Motion, Excess processing

Understands the basics of lean six sigma

yellow belt

Team members who contribute approximately 20% of their time to QI projects while delivering their normal job functions

green belt

Team leaders who dedicate as much as 100% of their time to QI projects

black belt

Black belt with at least two years of experience; lean six sigma advisors/coaches

master

Pre-analytical includes;

Test requisition, Patient preparation, Patient identification, Specimen collection, Labeling, Specimen transport, Specimen reception, Handling, Preparation

Analytical includes;

Reagents, Preventive maintenance of equipment, Calinration, Analysis of samples, Quality control

Post-analytical includes;

Verification of calculations and reference ranges, Flagging and notification of panic/critical values, Delta checks, Reporting of results, Interpretation

Inappropriate test requested

Pre-analytical

Handwriting not legible

Pre-analytical

Special requirements not specified

Pre-analytical

Delayed order

Pre-analytical

Incorrect tube or container

Pre-analytical

Incorrect patient identification

Pre-analytical

Inadequate specimen volume

Pre-analytical

Invalid specimen

Pre-analytical

Wrong collection time

Pre-analytical

Improper transport conditions

Pre-analytical

Instrument not calibrated correctly

Analytical

Instrument precision problem

Analytical

Specimen mix up

Analytical

Incorrect sample volume

Analytical

Interfering substance present

Analytical

Poorly written procedure

Analytical

Deteriorating reagent

Analytical

Contaminated control solutions

Analytical

Calibration error

Analytical

Report not posted in chart, not legible, or delayed

Post-analytical

Transcription error

Post-analytical

Interfering substances not recognized

Post-analytical

Specificity of test not understood

Post-analytical

Precision limitations not recognized

Post-analytical

Analytical sensitivity not appropriate

Post-analytical

Previous values not available for comparison

Post-analytical

Ability to maintain accuracy and precision over an extended period of time during which equipment, reagents, and personnel may change

Reliability

Closeness of the result to the true or actual value

accuracy

Ability to produce a series of results that agree closely with each other; commonly expressed in terms of coefficient of variation; also called repeatability or reproducibility

Precision

Internal Quality Control involves the analysis of at least __ levels of control every ___

2; 24 hours

In internal quality control, initial control limits are established by analyzing controls for at least ___ consecutive days or runs

Involves testing blind samples sent periodically by regulatory agencies to participating laboratories

external quality assessment

Due to chance or an unpredictable cause; does not recur in regular pattern

Random error

Usually a one time error and represents imprecision

Random error

All of the choices

Warning!!!

1 2s

Causes random errors

instrument instability such as temperature and voltage fluctuations, dirty glasswares, sampling error, improper mixing of sample and reagent, operator variability such as pipeting error, anticoagulant or drug interference

Causes systematic errors

deterioration of reagents, change in reagent lot, unstable reagent blanks, calibration error, changes in standard concentration, contaminated control solutions, diminishing lamp power, dirty photo meter, faulty ISE, pipettor maintenance error

A recurring error inherent in test procedure; influences observations in one direction

Systematic error

Maybe constant or proportional

Systematic error

2 2s, 4 1s, 8 1s, 10 x

It is an abrupt change in the distribution of controlled values such that they accumulate on one side of the mean for six consecutive days

Shift

Major cause of shift

calibration error or error in standard preparation

Major cause of trend

deterioration of reagents

Gradual change in the distribution of control values such that they continue to increase or decrease over a period of six consecutive days passing through the mean

trend

Highly deviating control values

outliers

Prepared by plotting the algebraic sum of the difference between each quality control result and the mean on the y-axis and the run number on the x-axis

CUSUM chart

Used for interlaboratory comparison of monthly means by plotting the mean value for one sample on the y-axis and the mean value for another on the x-axis

Tonks-Youden plot

It is an effective method for comparing both within-laboratory and between-laboratory variability

Tonks-Youden plot

Most common used quality control chart

Shewhart Levey-Jennings chart

What is the molarity of a 1 liter solution containing 10g of NaOH? Na=23 O=16 H=1

0.25 M

100

Convert 0.4 um to m

0.0000004 m

Microbiology

Microbiology

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