MediaLab, Inc. Course Preview Pages

• You Are At Risk!
• About This Course
• What Causes Hepatitis B?
• How is HBV Spread?
• Spread of HBV In The Community
• Body Fluids Most Likely To Transmit HBV
• Blood Needed For Transmission
• What happens after HBV infection?
• Serious adverse outcomes from HBV infection
• How long can HBV be spread?
• Who is infected?
• How common is HBV?
• How can HBV be prevented?
• What causes HIV Infection?
• How is HIV spread?
• What happens after HIV infection?
• How easily is HIV transmitted?
• How common is HIV?
• How can HIV be prevented?
• Hepatitis C Virus (HCV)
• HCV disease
• Hepatitis C treatments
• What happens after Hepatitis C infection
• How common is HCV
• Question
• Question
• Occupational Exposure Standard
• The Relevant Components
• The Exposure Control Plan
• Exposure category
• Preventative Measures
• The Hepatitis B Vaccination
• Standard Precautions!
• Methods of Control
• Engineering Controls
• Work Practice Controls
• Sharps
• Needles, safety needles, and needleless systems
• Sharps DOs and DON'Ts
• Handling Specimens
• Transporting Specimens
• Biohazard Labeled Container
• Housekeeping
• Small Surface Spills
• Broken Glassware
• Contaminated Wastes
• Contaminated Wastes (continued)
• Biohazard Labeled Bags
• Contaminated Laundry
• Labeling
• Labeling not Required
• PPE and the OSHA Standard
• Personal Protective Equipment
• Gloves Must be Worn
• Gloves
• Hypoallergenic Gloves
• Face and Eye Protection
• Garments worn as Personal Protective Equipment
• Question
• Question
• Importance of Hand Hygiene
• When to Wash Your Hands
• Handwashing Procedure
• Alcohol hand gel
• Exposure Incident
• If an Exposure Occurs
• Evaluation and Treatment
• Avoiding exposure
• Question
• Question
• Introduction
• Be Alert and Knowledgeable
• Classes of Fire
• Class A
• Class B
• Class C
• PASS
• RACE
• Know Your Work Area
• Good Housekeeping
• Be Alert
• Don't Panic
• Fire Plan & Fire Drills
• This Program
• Goals of this Program
• Respect!
• In the Past
• In the Present
• Haz-Com
• Chemical Hygiene
• Employer Responsibility
• Your Responsibility
• Format of the Label
• Identification
• Instructions
• Read the Label!
• Numerical Ranking
• Health Hazards
• Fire Hazards
• Reactivity
• Special Hazards
• Right to Know
• Before Working...
• To Request a MSDS
• Sections
• Identification
• Identification (continued)
• Hazardous Ingredients
• Physical and Chemical Data
• Fire and Explosion Hazard Data
• Reactivity Data
• Health Hazard Data
• Spill and Disposal Data
• Handling and Storage Data
• General Information
• Be Prepared!
• General Laboratory Precautions
• Ingestion Prevention
• Management of Spill & Disposal
• Wash Your Hands!
• Personal Protective Equipment
• Fire Extinguishers
• Monitoring
• Common Sense Rules
• Common Sense Rules (continued)
• Keep It Safe!
• What is Formaldehyde?
• Where is Formaldehyde Used?
• What Does Formaldehyde Do?
• Symptoms of Overexposure
• A Potential Carcinogen
• Relevant OSHA Standards
• Surveillance Questionnaire
• Manufacturer's Label
• Material Safety Data Sheet
• Environment Monitoring for Formaldehyde
• How is Exposure to Formaldehyde Monitored?
• Monitoring Results
• OSHA has set these Permissible Limits for Formaldehyde Exposure:
• Acceptable Results
• Unacceptable Results
• Corrective Action
• Warning Signs
• Fume Hoods and other Controls
• Transporting formalin containers
• Personal Protective Equipment
• Respirators
• Respirators (continued)
• If you become contaminated...
• In case of a spill...
• The Ongoing Problem
• Trends in Tuberculosis
• Elimination of Tuberculosis (TB)
• Question
• Tuberculosis infection
• Symptoms
• A Word of Caution
• How tuberculosis is spread
• Infection Control
• High Risk Infection Groups
• High Risk Progression Groups
• Vaccine for Tuberculosis
• Question
• LTBI Testing Introduction
• Tuberculin Skin Test (TST)
• Records and Results
• TST Interpretation and Classification
• False Positive TST reactions
• TST False Negative Reactions
• Two Step Skin Testing
• Blood Assay for Mycobacterium tuberculosis (BAMT)
• Question
• CDC Guidelines
• CDC Risk Categories
• Tuberculosis Exposure Control Plan
• Health Care Worker Tuberculosis Screening
• Procedures with Increased TB Risk
• Question
• Fundamentals of TB infection control
• Three levels of TB Infection Control
• TB Infection Control in the Laboratory
• Biosafety Levels
• Biosafety Level 3
• Question
• Respiratory Protective Equipment
• Airborne Infection Isolation Room Practices
• Transporting TB Patients
• Protect Yourself
• References
• Introduction
• The Heimlich Maneuver
• Before Performing Heimlich Maneuver
• How to Perform the Heimlich Maneuver
• Caution
• Bleeding Aid
• Applying Direct Pressure
• Elevate the Wound
• Pressure Bandage
• Call For Medical Help
• Fracture
• Fracture Diagnosis
• Fracture Treatment
• Classification of Thermal Burns
• First Degree Thermal Burns
• Second Degree Thermal Burns
• Third Degree Thermal Burns
• Treatment of First and Second Degree
• Treatment of Third Degree
• Chemical Burns of Skin
• Treatment of Chemical Burns of Skin
• Chemical Burns of Eye
• Treatment of Chemical Burns of Eye
• CPR
• Purpose of this Course
• What is a voluntary compliance program?
• Introduction
• Element 1
• Element 2
• Element 3
• Element 4
• Element 5
• Element 6
• Element 7
• Laws and regulations that govern laboratories
• Risk areas
• Billing and medical necessity
• Coding
• Medical coverage policies (LMRPs)
• Advance Beneficiary Notices (ABNs)
• Confidentiality
• Requisitions and ambiguous orders
• Tests performed and ordered correctly
• Written and verbal orders
• Physician notices and acknowledgements
• Documentation and test release
• Panels and profiles
• Marketing and record retention
• Inducements
• Phlebotomists and equipment in client offices
• Utilization and other regulations
• Couriers and referral tests
• Medical necessity
• Billing
• ICD-9CM coding
• Local medical review policies (LMRPs)
• HCPCS and CPT coding
• Communication with physicians and patients
• Advance Beneficiary Notices (ABNs)
• Documentation
• Managers must set example
• Special role for managers/supervisors
• Preventing whistleblowers
• Protecting the company
• Whistleblowers
• Excused charges and other inducements
• Client contracts
• Test pricing and antitrust
• Sales proposals and discounts
• Equipment and space
• Test orders
• Confidentiality and inducements
• ICD-9 codes and ABNs
• Communicating with patients in person
• Case Study 1
• Case Study 2
• Case Study 3
• Case Study 4
• Case Study 5
• Case Study 6
• Case Study 7
• Case Study 8
• Case Study 9
• Case Study 10
• Employee's Responsibility
• Company Responsibility
• Question
• Question
• The Superoxol Test
• Question
• Review 2
• Question
• Question
• Acute Onset Pneumonia
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Pneumococcal Resistance
• Review 2
• Question
• Question
• Question
• Clinical History
• Question
• Question
• Question
• ESBL Activity
• Extended Spectrum Beta Lactamases
• Review 1
• Question
• Question
• Clinical History
• Question
• PYR Differential
• Question
• Enterococcus ID
• Enterococcus faecium ID
• Vancomycin Resistance
• Question
• Review 1
• Review 2
• Question
• Case History
• Question
• Question
• Colony Morphology
• Clostridium Quad Plate
• Clostridium septicum RapID ANA
• Question
• Review 1
• Review 2
• Review 3
• Question
• Question
• Clinical History
• Question
• Staph on BA
• Question
• Question
• Staph aureus Mannitol
• MRSA Screen
• MRSA Disk Test
• Review 1
• Review 2
• Review 3
• Question
• Question
• Question
• Question
• Spleen Specimen
• Question
• Question
• S. milleri CO2
• S. milleri Biochemicals
• Review 1
• Review 2
• Question
• Question
• Question
• Cellulitis Skin
• Question
• Question
• Group A Strep A Disk/SXT
• Question
• Review 1
• Review 2
• Question
• Question
• Clinical History
• Histology of Brain Biopsy
• Question
• Colony Morphology
• Question
• Question
• Listeria gram stain
• Question
• Listeria motility
• Review 1
• Review 2
• Review 2
• Review 3
• Question
• Question
• Question
• Cellulitis Lesion
• Eikenella BAP
• Question
• Eikenella - catalase & oxidase
• Eikenella biochemicals
• Question
• Question
• Review 1
• Review 2
• Review 3
• Question
• Question
• Question
• What is phlebotomy?
• What is a phlebotomist?
• What is a phlebotomist? [continued]
• What is a phlebotomist’s role in a health care facility?
• What is a phlebotomist’s role in health care facility? [continued]
• Laboratory work-flow cycle
• Work-flow cycle: patient ID to specimen processing
• Work-flow cycle: test performance to treatment
• Laboratory work-flow cycle: phlebotomist role
• Professionalism: maintaining confidentiality
• Professionalism: attitude
• Professionalism: appearance
• Professionalism: appearance continued
• What are bloodborne pathogens?
• Important bloodborne pathogens
• OSHA bloodborne pathogens standard
• Standard precautions
• Standard precautions continued
• Personal protective equipment
• Hand washing
• Hazardous waste disposal
• Needlestick safety and prevention act
• Needlestick safety and prevention act continued
• Needlestick safety and prevention act continued
• Needlestick safety and prevention act continued
• Anatomy & physiology: definitions
• Anatomy & physiology: essential to phlebotomy
• Integumentary system: structure
• Integumentary system : function
• Cardiovascular system : structure & function
• Circulation: venous portion
• Circulation: arterial portion
• Circulation: capillary portion
• Whole blood: components
• Plasma
• Plasma components
• Plasma water
• Plasma water continued
• Plasma electrolytes
• Plasma sugars
• Plasma proteins
• Plasma lipids
• Plasma drugs and toxins
• Whole blood formed elements
• Red blood cells
• White blood cells
• Platelets
• Blood clots
• Serum
• Common lab tests
• Panels or profiles
• Hemogram (CBC)
• Electrolytes panel (Lytes)
• Basic metabolic panel (BMP)
• Comprehensive metabolic panel (CMP)
• Obstetric panel
• Lipid panel
• Acute hepatitis panel
• Hepatic function panel
• TORCH panel
• Introduction to phlebotomy equipment
• Phlebotomy trays
• Blood collection tubes: introduction
• Blood collection tubes: types
• Hemogard ™ blood collection tubes
• Blood collection tubes: inversion
• Blood collection tubes: sizes
• Blood collection tubes: expiration dates
• Blood collection tubes: common types
• Lavender top tubes
• Light blue top tubes
• Green top tubes
• Red top tubes
• Speckle top tubes
• Gray top tubes
• Yellow top tubes
• Royal blue top tubes
• Blood culture bottles
• Needles
• Needle components
• Blood transfer device
• Single draw needles
• Multiple draw needles
• Needles with built-in safety devices
• Multiple draw needles with built-in safety features.
• Butterfly needles
• Butterfly needles continued
• Butterflies with built-in safety features
• Butterfly needles with built-in safety features continued
• Lancets
• Plastic holders used with the evacuated tube system
• Needle holders with built-in protection devices
• Needle holders, built-in protection devices contd
• Syringes
• Syringes with built-in safety devices
• Syringes with built-in safety devices contd.
• Tourniquets
• Sterilization materials for phlebotomy
• Bandaging materials
• Gloves
• Sharps disposal containers
• Marking pen
• Greeting
• Greeting continued
• Patient Identification
• Importance of Patient ID
• Patient Identification continued
• Special Requests
• Venipuncture Standard precautions
• Wash hands and apply gloves
• Positioning the patient
• Applying the tourniquet
• Applying the tourniquet continued
• Patient clenches fist
• Choosing a site
• Choosing a site continued
• Alternate Sites
• Sites to avoid
• Routine venipuncture equipment
• Routine Venipuncture equipment continued
• Cleaning the site
• Cleaning the site continued
• Attach needle to holder
• Place tube into holder
• Hold vein in place
• Insert needle
• Push tube onto holder
• Blood won't flow
• Adjust needle
• Multiple tube collections
• Remove needle
• Apply pressure
• Apply adhesive pressure
• Activation of safety device
• Needle disposal
• Specimem labeling
• Specimem labeling continued
• Finger stick - Specimen collection
• Heelstick - Pediatric collection procedures: Introduction
• Heelstick - Neonatal Blood collection
• Heelstick - Site selection and preparation
• Heelstick - Puncture
• Heelstick - specimen collection
• Heelstick - Apply sterile gauze
• Butterfly needle - Butterfly needle collections
• Butterfly needle - Butterfly needle collections continued
• Butterfly needle - Butterfly needles and needle-stick injuries
• Butterfly needle - Butterfly needles with built-in safety features
• Butterfly needle - Angel WingTM safety butterfly
• Butterfly needle - Punctur-GuardTM safety butterfly
• Finger stick - Finger stick collections
• Finger stick - Site preparation
• Finger stick - puncture
• Finger stick - Wipe away the first drop
• Finger stick - Specimen collection continued
• Syringe - Syringe blood collections
• Syringe - Syringe blood collections continued
• Syringe - Transferring blood to collection tubes
• Syringe - Transferring blood to collection tubes contd
• Introduction
• Introduction continued
• Performance
• Bleeding time
• Apply blood pressure cuff
• Prepare the site
• Make the incision
• Wick the blood
• Record elapsed time
• Bandage the incision
• Introduction
• Avoid skin contamination
• Equipment
• Select the site
• Site preparation
• Site preparation continued
• Feel the vein
• Clean the bottle tops
• Collection methods
• Volume is important
• Activate needle safety device
• Remove iodine
• Additional tips
• Additional tips continued
• Introduction
• 12 hour fast
• Collection tubes
• Administration of glucose
• Specimen collection
• Patient observation
• One hour screening test for gestational diabetes
• Introduction
• Peak and trough levels
• Collection times
• Introduction
• Collection kits
• Urine
• Urine continued
• Blood
• Documentation
• Blood bank specimens
• Hollister and similar systems
• Concept of Hollister and similar systems
• Hollister system: specimen collection and labeling
• Hollister system: armbands
• Hollister system: armbands continued
• Uncooperative patients
• Patients refusing blood work
• Fainting
• Fainting continued
• Hematosis
• Blood should not be drawn from arms with IVs
• Signs
• Arms to avoid
• Allergies
• Unsatisfactory specimens
• Causes
• Hemolysis
• Causes of hemolysis
• Clots
• Causes of clotting
• Insufficient volume
• Partial collection tubes
• Labeling errors
• Causes of labeling errors
• What if no blood flows when the needle is in place?
• Case
• Question
• Discussion
• Case
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• Discussion
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• What is HIPAA?
• Who does HIPAA apply to?
• Question
• Privacy is Your Responsibility.
• Importance of Privacy - An Example
• HIPAA Enforcement
• Relevant Components of HIPAA
• What is the HIPAA Privacy Regulation:
• What Information is Protected?
• The HIPAA Privacy Regulation:
• Administrative Requirements include the following:
• Safeguards
• Physical Safeguards
• Administrative Safeguards
• Technical Safeguards
• Question
• HIPAA Provides for the Following Rights:
• Question
• Notification
• Authorization
• Question
• Limiting Use and Disclosure of PHI
• Question
• Question
• Minimum Necessary Use and Disclosure
• Question
• Question
• Business Associate Agreement
• Question
• De-Identified Health Information
• Question
• Fax Machines
• What is the HIPAA Security Regulation?
• What is Electronic PHI (ePHI)?
• Security Officer
• Safeguards
• Administrative Safeguards
• Question
• Physical Safeguards: Access Controls
• Physical Safeguards: Storage and Disposal of Media
• Question
• Technical Safeguards: System Access Control
• Technical Safeguards: Passwords
• Protection Against Viruses and Malicious Software.
• email Security
• Question
• Follow your own Facilities' Policies and Procedures.
• Intent of this program
• Types of collections
• Standard collection
• Monitored collection
• Monitored collection
• Observed collection
• Prosthetic devices
• Observed collection
• Observed collection
• Question
• Federal drug testing custody and control form (CCF)
• Non-federally regulated custody and control form
• Custody and Control Form
• Exceptions
• Question
• Five areas having prerequisites for proper collection
• Collection site security requirements
• Other collection site requirements
• Collection supplies
• Collection Supplies
• Rules for collectors
• Completing the federally regulated custody and control form
• Completing the federally regulated custody and control form
• Completing the federally regulated custody and control form
• Acceptable forms of identification
• What if a self employed donor cannot produce photo identification?
• Unacceptable forms of identification
• Positive identification must be obtained before collection
• Steps for Typical Urine Collection
• Donor Preparation
• Donor washes hands
• The collection kit
• Donor provides the specimen
• Specimen integrity
• Specimen integrity
• Collector documents specimen temperature
• Donor gives specimen to collector
• Collector disperses specimen to bottle(s)
• Collector applies tamper-evidence seals
• Collector dates seals, donor initials seals
• Donor completes certification statement
• Collector packages specimen
• Distribution of custody and control form
• Question
• When problems occur
• Medications
• Refusal to test
• Refusal to test
• Situations not considered as refusal
• Donor refuses to complete paperwork
• Shy bladder
• Shy bladder
• Shy bladder
• Observed collection procedure (1)
• Observed collection procedure (2)
• Observed collection procedure (3)
• Observed collection procedure (4)
• Observed collection scenarios
• Observed collection scenarios
• Observed collection scenarios
• Observed collection scenarios
• Broken Security Seal
• Accidental Spills
• Fatal Flaws and Correctable Flaws
• Responsibilities and requirements for collectors
• What is Blood Composed of?
• Erythrocytes or Red Blood Cells (RBC's)
• Leukocytes or White Blood Cells (WBC's)
• Thrombocytes (Platelets)
• Overview
• Segmented and Band Nuclei
• Band Neutrophil
• Appearance of a Band Neutrophil
• Nucleus of the Band Neutrophil
• Maturing into Segmented Neutrophil
• Segmented Neutrophil
• Appearance of the Segmented Neutrophil
• Nucleus of the Segmented Neutrophil
• Definition of a Band Cell
• Definition of a Segmented Cell continued.
• Differentiating Bands from Segs
• Eosinophils
• Appearance of Cytoplasm
• Difference Between Neutrophilic Granules and Eosinophilic Granules
• The Nucleus of a Eosinophil
• Basophil
• Appearance of Cytoplasm
• Basophil Granules
• The Chromatin Pattern of the Basophil Nucleus
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Primary Function of Neutrophils
• Phagocytosis in a Neutrophil
• The Process of Phagocytosis
• Life Span and function of Eosinophils
• Eosinophils in Parasitic Infections and Allergic Reactions
• Basophils as Mediators of Inflammatory Responses
• Basophils in the Blood
• Mast Cells
• Question
• Question
• Question
• Question
• Mononuclear Cells: Lymphocytes and Monocytes.
• Lymphocyte or Lymph
• Small Lymphocytes
• Nucleus of Lymphocyte
• Large Lymphocytes
• Large Lymphocytes are Fragile Cells
• Large Lymphocyte Nuclei
• "Stretching" of Large Lymphocyte Nuclei
• Chromatin Pattern of Large Lymphocytes
• Monocyte
• Apprearance of Cytoplasm
• Opaque vs. Transparent
• Cytoplasmic Vacuoles
• Monocytes are Extremely Motile Cells
• Monocytes Nucleus compared to other Leukocytes
• Characteristics of the Monocyte Nucleus
• Overall Appearance of the Nucleus
• Differentiating Monocytes from Large Lymphocytes
• Differentiating Large Lymphocytes from Monocytes; A Table.
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• What is the Function of Lymphocytes?
• Humoral Immunity
• Cellular Immunity
• Null Cells
• When Lymphocytes Transform
• Monocytes
• Monocytes Defense
• Question
• Question
• Question
• Question
• Question
• Platelets
• Shape of a Platelet
• Platelet Clumps
• Platelet Color
• Platelet Cytoplasm
• Platelet Cytoplasm
• Platelet Kinetics
• Platelet Function
• Question
• Question
• Appearance of the Erythrocyte
• Erythrocyte Shape
• Cell Diameter
• Function and Kinetics
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Glossary of Terms A through M.
• Glossary of Terms N through Z.
• What is Cerebrospinal Fluid?
• Amount of CSF
• Location of CSF
• Three Main Functions of CSF
• Normal CSF Protein Level
• Chemical Substances Present in CSF
• Cells Present in Normal CSF
• CSF Evaluation and Diagnosis
• Question
• Question
• Question
• Question
• CSF Specimen Collection Process
• Specimen Collection (continued)
• Purposes of Collection Tubes
• Collection Tubes (continued)
• Which Tests May Be Ordered?
• Specimen Labeling and Transport
• Initial Specimen Examination
• Specimen Handling and Storage
• Safety Precautions
• Question
• Question
• Question
• Question
• Normal Characteristics
• Abnormalities
• Turbidity
• Clot/Pellicle
• Bloody Specimen
• Xanthochromia
• An Example of Xanthochromia
• Other Causes of Xanthochromia
• Causes of Xanthochromia in Premature Infants
• Important Aspects of Xanthochromia
• Question
• Question
• Question
• Question
• Question
• Question
• Normal Cell Counts
• Examining CSF with the Hemacytometer
• Examining CSF with the Hemacytometer (continued)
• Calculation of CSF Cell Count
• More on Undiluted Specimens
• Diluted Specimens
• Examining a Diluted Specimen
• Diluting Fluids
• WBC Correction for Traumatic Tap
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Stained Cytospin Preparations of CSF
• Cytospin Technique
• Cells Seen in CSF
• Mature Peripheral Blood Cells
• Immature Hematopoietic Cells
• Tissue Cells
• Malignant Cells
• Table of Normal CSF Properties
• Table of Conditions
• Mature Lymphocytes
• Neutrophil and Lymphocyte
• More Neutrophils and Lymphocytes
• Red Cells and Lymphocytes
• Monocytes
• Monocytes (continued)
• Lymphocytes
• Cells
• Neutrophils
• Blast Cells
• Spinal Fluid Sample
• Malignant Cells
• Another Malignant Cell
• Pia Arachnoid Mesothelial Cells
• Pia Arachnoid Mesothelial Cells (continued)
• Pia Arachnoid Mesothelial Cells (continued)
• Macrophage
• More Blast Cells
• More Malignant Cells
• Two Monocytes
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• What is Erythrocyte inclusion?
• More on Erythrocyte inclusions
• Question
• Question
• Reticulocytes
• More on Reticulocytes
• Erythrocyte Production
• Stress Reticulocytes
• Normal Red Cells
• Polychromatophilic Cells
• Another Polychromatophilic Cell
• Polychromatophilic Cell Absence
• Question
• Question
• Question
• Question
• What is Basophilic Stippling?
• More on Basophilic Stippling
• Fine and Coarse Basophilic Stippling
• Basophilic Stippling
• Polychromatophilic Cell
• Coarse Basophilic Stippling
• Another Coarse Basophilic Stippling
• Question
• Question
• Question
• Question
• Question
• Question
• What are Howell-Jolly Bodies?
• More on Howell-Jolly Bodies
• Howell-Jolly Body
• Another Howell-Jolly Body
• Howell-Jolly Bodies in Cytoplasm
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• What are Pappenheimer bodies?
• More on Pappenheimer bodies
• Howell-Jolly body and Pappenheimer bodies
• Cells Containing Pappenheimer Bodies
• Basophilic Stippling contrasted with Pappenheimer Bodies
• Howell-Jolly bodies and Pappenheimer bodies
• Three Way Comparison
• Siderotic Granules
• Siderocytes and Ring Sideroblasts.
• Siderocytes
• Sideroblast
• Another Sideroblast
• Ring Sideroblast
• Siderotic Granules
• Ring Sideroblast
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• What are Cabot rings?
• Cabot Rings
• More Cabot Rings
• Cabot Ring Impersonation
• Question
• Question
• Evaluation of Bone Marrow
• Examples of Conditions
• After Marrow Evaluation
• Question
• Question
• Basic Structure and Function of Bone Marrow
• Basic Structure and Function of Bone Marrow Cont'd
• Sinuses/Blood Vessels
• Cellular Componenets of Hematopoietic Cords
• Supporting Cells
• Fat Cells
• Location of Cells within Cord
• Location of Cells within Cord continued
• Lymphocytes
• Changes in Cell Distribution
• Summary
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Bone Marrow Samples
• Collection Sites
• Sample Collection
• Prepare the Patient
• Collection of the Aspirate
• Preparation of Direct Smears
• Preparation of Particle Smears
• Preparation of Concentrated Smears
• Flow Cytometry and Cytogenetics
• Collection of Bone Marrow Biopsy
• Biopsy Touch Preparation
• Fixation and Processing of the Biopsy Specimen
• Advantages of a Biopsy Specimen
• Question
• Question
• Question
• Question
• Microscopic Evaluation of Marrow Smears
• Evaluating Cellularity
• Low Power View of Biopsy
• Medium Power View of Biopsy
• Hypocellular Bone Marrow Biopsy
• Hypercellular Bone Marrow Biopsy
• Hypercellular Bone Marrow Biopsy
• Hypoplasia and Hyperplasia
• Question
• Question
• Question
• Question
• Question
• Question
• Example
• Biopsy Section and Bone Marrow Smear
• Perl's Prussian Blue Stain
• Iron Storage Site
• Low Power View of Prussian Blue Stained Biopsy
• Another Biopsy Showing Normal Iron Stores
• Absence of Stainable Iron
• Increase Marrow Iron Stores
• Ring Sideroblasts
• Romanowsky Stain
• Examination of Wright-Giemsa Stained Bone Marrow
• Low Power Magnification
• High Power Magnification
• Megakaryocyte Morphology
• Megakaryoblast
• Promegakaryocyte
• Nuclear Division in Megakaryocytes
• Megakaryocyte
• Meta Megakaryocyte Stage
• Another Meta-Megakaryocyte
• Bare Nucleus Megakaryocyte.
• Other Large Cells
• Osteoclasts
• Osteoblast
• More Osteoblasts
• Tumor Cells
• Another Example of Tumor Cells
• Question
• Question
• Question
• Question
• High Power Examination
• Normal M:E Ratio
• Percentages of Myeloid and Erythroid Precursors
• Normal M:E Ratio
• Differentiating Myeloid from Erythroid Cells
• Estimating Myeloid to Erythroid Ratio
• Normal M:E Ratio
• Increased M:E Ratio
• Another Example of Increased M:E Ratio
• Decreased M:E Ratio
• Another Example of Decreased M:E Ratio
• Evaluating M:E Ratio in a Patient with Chronic Lymphocytic Leukemia.
• Question
• Question
• Question
• Representative Counting Field
• Oil Immersion Field
• Macrophage
• Plasma Cells
• Mast Cells
• Increased Plasma Cells
• Flame Cells
• Mott Cell
• Gaucher Cell
• Sea Blue Histocyte
• Question
• Question
• Question
• What is the value of a Direct Smear?
• Question
• Question
• Question
• How to Choose a Microscopic Field
• Quality Control Smears
• Macroscopic Smear Appearance
• Thick Smears
• Thin Smears
• Properly Decolorized Smears
• Precipitated Stain
• Under-decolorized smear
• Question
• Question
• Question
• Question
• Question
• Question
• Cellular elements
• Epithelial cells
• White blood cells
• Red blood cells
• Yeast cells
• Fungal hyphae
• Question
• Question
• Question
• Question
• Question
• Identification of bacteria
• Gram positive cocci (GPC)
• Gram positive diplococci
• Gram negative cocci (GNC)
• Gram positive rods(GPR)
• Gram negative rods (GNR)
• Intracellular bacteria.
• Gram negative diplococci
• Epithelial cell
• Question
• Question
• Question
• Question
• Question
• Principle
• Overall Procedure
• Evaluation of Controls
• Size and Appearance of Cellular Elements
• Recording Bacterial Characteristics
• Reporting Direct Smear Results
• Significance of Specific Findings:
• Contaminated Gram Stain Solution
• Special Considerations for Genital Smears
• Question
• Question
• Question
• Question
• Question
• Culture, Isolation, and Identification of Microorganisms
• Question
• Question
• Gram Stain
• Macroscopic Appearance of Control Slides
• Microscopic Appearance of Control Slides
• Focus Power
• Cocci and Rods
• Variations in the Shape of Cocci
• Gram Negative Bacilli
• Variation in the shape of bacilli
• Variations in the Ends of Rods
• Cellular Arrangement
• Single Cell Arrangement
• Pair Cell Arrangement
• Chain Cell Arrangement
• Tetrad Cell Arrangement
• Clusters of Gram Positive Bacteria
• Yeast Cells
• Summary
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Culture Smears: Importance and Reporting
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Red Cell Morphology
• Assessing Red Cell Morphology Procedure
• Normal Red Cells
• Abnormal Red Cells
• Area of Evaluation
• Area of Evaluation
• Artifactual Morphology
• Question
• Question
• Size Variation
• Normal RBC Size
• Microcyte Diameter
• Microcyte with Normal Hemoglobin Content
• Summary of Microcytes
• Macrocytes
• Another Example of Macrocytosis
• Pseudomacrocytes
• Summary of Macrocytes
• Anisocytosis
• Summary of Anisocytosis
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Erythrocytes
• Color of Erythrocytes
• Hypochromia and Hyperchromia defined
• Normochromic Red Cells
• Polychromasia
• Hypochromia
• More Hypochromic Cells
• Hyperchromia
• Another Example of Hyperchromia
• Question
• Question
• Question
• Question
• Question
• Poikilocytosis
• Notes about Poikolocytosis
• Red Cell Variations in Shape
• Acanthocytes
• More Acanthocytes
• Codocyte
• Synonyms for Codocytes
• Another Target Cell
• Teardrop Cells
• Conditions Causing Teardrop Cells
• Sickle Cell (Drepanocyte)
• Sickle Cell Anemia
• Echinocytes (Burr Cells)
• Elliptocytes
• Elliptocytes
• More Elliptocytes
• Schistocytes
• Prekeratocyte or Blister Cells
• Keratocytes
• Another Keratocyte
• Spherocytes
• Conditions Associated with Spherocytes
• Stomatocyte
• Examples of Stomatocytes
• Summary
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Rouleaux and Autoagglutinaton
• True Rouleaux
• Artifactual Rouleaux
• Artifactual Rouleaux
• Autoagglutination
• Another Example of Autoagglutination
• Question
• Question
• Question
• Variations in Morphology
• Importance of Recognition
• Question
• Question
• Section Overview
• Hypersegmentation
• Conditions Associated with Hypersegmented Neutrophils
• Hypersegmented Neutrophil
• Another Example of a Hypersegmented Neutrophil
• A Normally Segmented Neutrophil
• Hyposegmentation of Neutrophils
• Conditions Associated with Hyposegmented Neutrophils
• Pelger-Huet Anomaly
• Pelger-Huet Anomaly Does Not Affect Phagocytosis.
• Normal Band Forms vs. Pelger-Huet Bands
• Bilobed Neutrophil
• Single-Lobed Pelger-Huet Cells
• Degenerate Neutrophils in EDTA blood
• Pelger-Huet Cells
• Barr Body
• Barr Bodies may be Normal or Pathological
• Barr Body
• Another Barr Body
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Cytoplasmic Variations
• Dohle Bodies
• More on Dohle Bodies
• May-Hegglin Bodies
• More on May-Hegglin
• Dohle Body
• Unusually Darkly Staining Dohle Bodies
• May-Hegglin Anomaly
• Auer Rods
• Auer Rod
• Auer Rods
• Cytoplasmic Vacuolation
• Cytoplasmic Vacuolation
• Smaller Vacuoles
• Toxic Granulation
• Neutrophil with Normal Granulation
• Band Neutrophil Showing Toxic Granulation
• Another Example of Toxic Granulation
• Dohle Bodies and Toxic Granulation
• Classification
• Inherited Anomalies
• Chediak-Higashi
• Albinism
• Granules in Chediak-Higashi Syndrome versus Toxic Granulation
• Neutrophil with Chediak-Higashi
• Neutrophil with Chediak-Higashi
• Toxic Granulation
• Lymphocyte with Chediak-Higashi
• Alder-Reilly Anomaly (Alder's Anomaly)
• Alder-Reilly Neutrophil
• Alder-Reilly Anomaly
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Microscopic Examination
• The Urine Microscopic Exam
• Question
• Question
• Urine Specimen Collection
• Specimen Collection and Storage
• Steps in Preparing a Concentrated Urine Sediment
• Microscopic Examination of Urine Sediment
• Phase-Contrast Microscopy
• Question
• Question
• Formation and Significance of Casts
• Factors Promoting Cast Formation
• Hyaline Casts
• Hyaline Casts Under High Power
• Hyaline Casts
• Cellular Casts
• White Cell Casts
• Red Cell Casts
• Red Cell Cast Under High Power
• Renal Tubular Epithelial Cell Casts
• Renal Tubular Epithelial Cast Under High Power
• Granular Casts
• Coarse Granular Casts
• Fine Granular Casts
• Waxy Casts
• Fatty Cast
• Broad Cast
• Cylindroids
• Squamous Epithelial Cell
• Recognition and Identification
• Question
• Question
• Question
• Cells Types Observed in Urine Sediment
• Squamous Epithelial Cells
• Squamous Cells Under High Power
• Squamous Cells Under Phase Contrast
• Renal Tubular Epithelial Cell
• Renal Epithelial Cells of Collecting Duct Origin
• Cuboidal Cells
• Renal Epithelial Fragments
• Transitional Epithelial Cells
• Epithelial Cell Groups
• Urine Sediment
• White Blood Cells Under Phase Contrast and High Power Magnification
• Large Clumps of White Cells
• Red Blood Cells
• Red Cells Under Brightfield Microscopy and High Power Magnification
• Red and White Cells
• Crenated Red Cells
• Swollen RBCs
• Ghost Cells
• Ghost Cells under Phase Contrast
• Yeast
• Bacteria
• Bacteria Under Phase Contrast
• Characteristics of Cellular Elements
• Question
• Question
• Question
• Question
• Crystals
• Identification of Crystals
• Normal Crystals
• Crystals in Normal Acid Urine
• Uric Acid Crystal Morphology
• Calcium Oxalate Crystals
• Amorphous Urates
• Crystals in Normal Alkaline Urine
• Calcium Carbonate Crystals
• Ammonium Biurate Crystals
• Review of Common Crystals
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Abnormal Crystals
• Crystals of Clinical Significance
• Leucine Crystals
• Tyrosine Crystals
• Cystine Crystals
• Cholesterol Crystals
• Bilirubin Crystals
• Summary of Abnormal Crystals
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Introduction
• Parasites
• Trichomonas under Phase-Contrast
• Trichomonas versus White Cells
• Enterobius Vermicularis Pinworm Ova
• High Power of Enterobius vermicularis Ova
• Phase-Contrast of Enterobius vermicularis
• Schistosoma Haematobium Ova
• Sperm
• Sperm Under Phase-Contrast
• Oval Fat Bodies
• Oil or Fat Droplets
• Mucous Threads
• Mucous Threads Under Phase Contrast
• Contaminants and Artifacts
• Air Bubbles
• Coverslip Defects
• Coverslip Scratches
• Starch Granules
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Introduction
• Red Blood Cells versus Yeast
• Lysis of Red Blood Cells with Acetic Acid
• White Blood Cells versus Cuboidal Epithelium
• White Blood Cells versus Cuboidal Epithelium
• Bacteria and Amorphous Material
• Amorphous Urates
• Fat Droplets
• Starch Materials
• Supravital Stains
• Sternheimer-Malbin Stain
• Staining Eosinophils
• Question
• Question
• Question
• Question
• An Introduction to Quantitating the Urine Microscopic
• Looking for Casts
• Counting Elements
• Estimating Elements
• Question
• Question
• Question
• Correlation of Results
• Urinalysis Reports
• Specimen #1 - Adult Female
• Specimen #2 - Adult Male
• Specimen #3 - Adult Female
• Specimen #4 - Adult Male
• Specimen #5 - Female Child
• Purpose
• Prerequisites
• Safety Precautions
• Semen
• Composition of Semen
• Importance of Semen Analysis
• Evaluating Male Infertility
• Limits of Semen Analysis
• Materials Needed
• In summary the procedure will involve the following:
• Question
• Question
• Question
• Identity of patient
• Collection
• Collection (continued)
• Testing collection containers
• Information to be obtained from patient
• Question
• Question
• Macroscopic examination of semen
• Liquefaction
• Appearance of semen
• Volume
• Viscosity
• pH
• Viability
• Fructose
• Summary of macroscopic evaluation
• Question
• Question
• Question
• Question
• Microscopic Examination of Semen
• Requirements for the microscopic examination of semen
• Sperm count: Normal values
• Sperm counting methods
• Neubauer hemacytometer
• Diluting a specimen for counting on a hemacytometer
• High viscosity
• Loading and counting using a hemacytometer
• Appearance of sperm
• Calculating sperm count on a hemacytometer
• Other counting chambers
• Motility
• Assessing motility
• Wet mount assessment of sperm motility
• Assessing sperm motion parameters
• Assessment of post vasectomy specimens
• Question
• Question
• Question
• Other cells in semen: Epithelial cells
• Other cells in semen: Round cells and red cells
• Other cells in semen: Round cells and red cells (continued)
• White cells in semen
• Question
• Question
• Question
• Morphology of sperm
• Morphology: What this presentation will teach you.
• Staining and fixation for sperm morphology
• Morphology of normal sperm
• Abnormal forms
• Abnormal heads
• Abnormal tails
• Normal head shape
• Sperm with enlarged rounded head
• Sperm with enlarged head and split tail
• Double headed sperm
• Pinhead sperm
• Two abnormalities
• Tapered head
• Constricted head sperm
• Question
• Question
• Question
• Summary: Reference values
• Sample semen analysis report
• Reasons for Performing Confirmatory or Secondary Macroscopic Urine Tests
• Confirmatory and Secondary Tests
• The Presence of Glucose in the Urine
• Other Reducing Substances
• Alternate Tests for Sugars
• Specimen Processing for Urine Sugar Testing
• Testing for Reducing Substances Other Than Glucose
• Question
• Question
• Diseases Associated with Proteinuria
• Diseases Associated with Proteinuria
• Screening and Secondary Tests for Protein
• Sulfosalicylic Acid Test (Exton's Modification)
• Interpreting SSA Results
• Credibility of Results
• Heat and Acid Test for Urinary Protein
• Microalbumin Test
• Question
• Question
• Question
• Question
• Question
• Urinary Ketones
• Causes of Ketonuria
• Other Causes of Ketonuria
• Detection of Ketone Bodies
• Correlation of Urine Glucose and Ketones
• The Acetest®
• Urine Bilirubin
• Urine Bilirubin
• Causes for Bilirubinuria
• The Ictotest®
• The Ictotest® Procedure
• Quality of Supplies
• Procedure
• Principle of the Ictotest®
• Reporting Ictotest® Results
• Limitations of the Procedure
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Qualitative reports: Follow-up
• Ways out of the dilemma
• Question
• Criteria for peripheral blood smear review
• Guidelines for standard reports
• Reporting of laboratory data in regard to blood cell abnormalities
• References
• Question
• Question
• Spherocytes and reticulocytes
• Warm antibody hemolytic disease
• Hemolytic disease of the newborn
• Question
• Question
• Question
• Question
• Leukoerythroblastosis
• Question
• Pappenheimer bodies
• G6PD deficiency
• Intracellular RBC Inclusions-G6PD (continued)
• Heinz body formation
• Reticulocyte identification
• Question
• Dimorphic RBC population
• Question
• Question
• Sickle cells
• Question
• Atypical smear: Case follow-up
• Question
• Hb E disease (continued)
• Question
• Hemoglobin H disease
• Leptocytes and target cells
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Smear with teardrop cells
• Schistocytes vs. bite cells
• Question
• DIC: graft vs. host disease
• Cardiac hemolysis (Waring Blender Effect)
• Question
• Hereditary ovalocytosis and elliptocytosis
• Stomatocytes
• Question
• Rouleaux
• Question
• Case History
• Howell -Jolly bodies/ other erythrocyte environmental alterations
• Normoblasts
• Poikylocytosis and Basophilic Stippling
• Hypersegmented Neutrophils
• Iron Deficiency
• Peripheral blood smear preparation
• Criteria for evaluation of white blood cells and platelets
• Criteria for requesting a hematologist's review of the smear.
• Question
• Atypical Cells: Quantitative Estimate
• Question
• Platelet Estimate
• Question
• Additional comments on this exercise
• Question
• Question
• Question
• Question
• Leukemoid reaction revisited
• Question
• Question
• Case Follow-up
• Question
• Pelger-Huet Anomaly
• Question
• Chediac-Higashi anomaly
• Alder- Reilly Anomaly
• Question
• WBC inclusions: summary
• Familial disorders: summary
• Question
• Case History
• Doehle Bodies: Review
• The May -Hegglin anomaly
• Question
• Auer Rod
• Question
• Question
• Eosinophilia Follow-Up
• Eosinophil description
• Question
• Question
• Basophils
• Question
• Case history
• Case History 2
• Question
• Multiple myeloma
• Question
• Question
• More about lymphocytes, their impostors and varied faces
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Erythrophagocytosis
• Basic Structural Components
• HIV Envelope
• HIV Capsid
• Proteins Involved in Adsorption
• Adsorption (1)
• Adsorption (2)
• Penetration and Infection
• DNA Replication from RNA
• HIV is a Retrovirus
• Infection of the Host Cell (1)
• Infection of the Host Cell (2)
• Spread of Infection (1)
• Spread of Infection (2)
• Spread of the Infection (3)
• Destruction of the Host Cell
• Function of HIV Genes
• Mutations
• What is Quality Control?
• What is a Control?
• Safety and Handling of Controls
• Appearance of Controls
• Why Run Controls?
• Assayed and Unassayed Controls
• Question
• Question
• Aiming for the Target
• Closer, but not Quite
• Bull's-eye!
• Question
• Calculating Specificity
• Specificity Example
• Specificity Example: Test Results
• Specificity Example: Calculations (1)
• Specificity Example: Calculations (2)
• Specificity Example: Comparison
• Question
• Question
• Calculating Sensitivity
• Sensitivity Example: Calculations (1)
• Sensitivity Example: Calculations (2)
• Sensitivity Example: Comparison
• Specificity vs. Sensitivity
• Question
• Question
• What are Standards and Calibrators?
• Calibration Curve
• Linearity
• Linearity Example
• Non-linear Calibration Curves
• Question
• Types of Error
• Random Error
• Systematic Error
• Causes of Error
• Question
• Internal Quality Control
• External Quality Control (1)
• External Quality Control (2)
• External Quality Control (3)
• Comparing Types of Quality Control
• Question
• Reference Ranges
• Overview of Statistics
• Mean
• Histograms
• Standard Deviation
• Acceptable Standard Deviation
• Question
• The Levey-Jennings Chart's Inventors
• What is a Levey-Jennings Chart?
• Question
• Using Westgard Rules
• Westgard Rule 13S
• Westgard Rule 22S
• Westgard Rule 41s (1)
• Question
• Question
• Trends
• Shifts
• What is a Cumulative Summation Limit?
• CUSUM Example: Plotting Control Data
• CUSUM Example: Calculating CUSUM
• CUSUM Example: Exceeding the CUSUM Limit
• CUSUM and Westgard Rules
• What is a Youden Plot?
• Using a Youden Plot
• Question
• Troubleshooting
• Possible Corrective Action (1)
• Possible Corrective Action (2)
• Possible Corrective Action (3)
• Possible Corrective Action (4)
• Possible Corrective Action (5)
• Question
• Verification of Performance Specifications for Nonwaived Testing
• Verification for Nonwaived Testing
• Laws and Rules of the Florida Board
• Your Role
• The Board of Clinical Laboratory Personnel
• Question
• Clinical laboratory personnel license
• Types of licenses
• Director Responsibilities
• Director Qualifications
• Supervisor Responsibilities
• Supervisor Qualifications
• Technologist Responsibilities
• Technologist Qualifications
• Technician Responsibilities
• Technician Qualifications
• Summary of Qualifications
• Public health laboratory scientists
• Question
• Question
• Categories for Specialties
• Description of Specialties (1)
• Description of Specialties (2)
• Description of Specialties (3)
• Description of Specialties (4)
• Question
• Question
• Applying for a new license
• Renewal of clinical laboratory personnel license
• Inactive status
• Current Address
• Delinquent licenses
• Question
• Question
• License Fees
• Continuing Education Requirements for Renewal
• CEBroker
• Question
• Rules Violations
• Competency and Licensing Violations
• Advertisement and Report Violations
• Personal Conduct Violations
• Question
• Capability Violations
• Kickback and Inducement Violations
• Question
• Disciplinary Violations
• Question
• Failing to Report a Violation
• Penalties for violations
• License on probation
• More Information and Web Links
• Medical Errors in the United States
• Medical Errors
• Errors as a Cause Death
• Errors of Commission
• Errors of Omission
• Preanalytic Medical Errors
• Analytic Medical Errors
• Postanalytic Medical Errors
• Question
• Question
• Near Misses
• Medical Negligence
• Where Errors Occur
• Adverse Events
• Preventable and Unpreventable Adverse Events
• Bleeding After a Venipuncture Can Be an Adverse Event
• Question
• Question
• Question
• Sentinel Events
• Sentinel Event Categories
• The Joint Commission and Sentinel Events
• Root Cause Analysis and Sentinel Events
• Sentinel Event Reporting
• Question
• Root Cause Analysis
• RCA Description
• Question
• RCA Value
• RCA Limitations
• Question
• Question
• Reporting Reluctance
• Culture of Secrecy
• Systems Problems
• Systems Design
• Systems Failure
• Avoiding Systems Failure
• Question
• Follow-Up Error Detection
• Observation and Review
• Analyzing Medical Events
• Root Cause Analysis Reports
• RCA Information
• Relevant Human Factors
• Question
• Vigilance
• Awareness
• Study
• Discussion
• Question
• Failure Mode and Effect Analysis
• FMECA Steps
• Advantages of FMECA
• FMECA and RCA
• New Joint Commission Standards
• Question
• Question
• Question
• Question
• Public Responsibility for Safety
• Question
• Question
• Human Nature and Error Prevention
• Resources for Medical Error Prevention
• Terrorism Defined
• What Constitutes Terrorism?
• Terrorism Targets
• Types of Terrorism
• Biological Agents
• Categories of Biological Agents
• Category A
• Category A Agents
• Category B
• Category B Agents
• Category B Agents in Food and Water
• Category C
• Category C Agents
• Question
• Question
• Recognizing Biological Agents as WMDs
• Agent: Smallpox (Virus)
• Agent: Anthrax (Bacterium)
• Agent: Pneumonic plague (Bacterium)
• Agent: Botulism (bacterium)
• Agent: Tularemia (bacterium)
• Agent: Viral hemorrhagic fevers (Ebola, Marburg, Lassa and Argentine)
• Advantages of using Biological Agents as WMDs
• Advantages of using Biological Agents (cont.)
• Disadvantages of using Biological Agents
• Question
• Question
• Chemical Agents
• Types of Chemical Agents
• Lung-damaging or Choking Agents
• Blood Agents
• Blister Agents
• Nerve Agents
• Advantages of Using Chemical Agents as WMDs
• Disadvantages of Using Chemical Agents as WMDs
• Question
• Laboratory Response
• The LRN Pyramid
• Sentinel Labs
• Reference Labs
• National Labs
• Laboratory Response - Chemical
• Laboratory Response - Chemical, Level 3
• Laboratory Response - Chemical, Level 2
• Laboratory Response - Chemical, Level 1
• Question
• Question
• Your Response
• Your Response – At Work
• Physical Security
• Electronic Security
• Suspicious Packages or Envelopes
• Suspicious Packages or Envelopes (cont.)
• What do I do if I find a suspicious package?
• Responding to an Alarm
• Be Prepared
• The Fear Factor in Bioterrorism
• What You Can Do to Prevent Panic
• Question
• Your Response - Beyond the Workplace
• Be Aware
• General Preparedness in Your Home
• General Preparedness in Your Community
• Homeland Security Advisory System Overview
• Question
• What if...?
• What if: Dirty Bomb Attack
• In Case of a Dirty Bomb Attack
• What if: Chemical Attack
• In Case of a Chemical Attack
• What if: Biological Attack
• In Case of a Biological Attack
• In the End
• Additional Information
• Introduction
• Retrovirus
• Basic Structural Components
• HIV capsid
• HIV Envelope
• Proteins Involved in Adsorption
• Function of HIV Genes
• Mutations
• Question
• Occupational Exposures
• Potentially infectious body fluids
• Risk factors associated with increased HIV infection
• Question
• Overview
• Work practice controls
• Sharps
• Face and Eye Protection
• Gloves
• Handwashing
• Question
• If an Exposure Occurs
• Evaluation and Treatment
• Postexposure prophlaxis
• Exposure Follow-up
• Question
• Legislative Intent
• Informed Consent
• Confidentiality
• Reporting results
• Preliminary and Confirmatory Testing
• Question
• References
• What is Quality Control?
• Quality Control Procedures
• Federal Regulations
• Question
• Question
• Internal Quality Control
• Control Materials
• Assayed and Unassayed Controls
• Use of Controls
• Control Testing Order
• Additional Variables
• Instrument Maintenance
• Record Keeping
• External Quality Control
• Question
• Question
• Question
• Question
• Mean and Standard Deviation
• Calculating Acceptable Ranges
• Question
• Question
• Levey-Jennings Quality Control Charts
• Random and Systematic Error
• Westgard Multi-Rules
• Tips on Using the Westgard Rules
• Question
• Question
• The History of the ABO System
• The History of the ABO System (cont.)
• Table 1: ABO Blood Group System
• Table 2: Testing the Patient Red Cells with Known Antisera (Forward Typing)
• Table 3: Testing the Serum with Known Red Cells (Reverse Typing)
• Question
• Question
• Question
• ABO Antibodies
• Anti-A and Anti-B Development
• ABO Antibodies and Aging
• "Immune" ABO Antibodies
• Immunoglobulin
• Question
• Question
• Question
• Strength of the A Antigen
• A1 and A2
• Rare Subgroups of A
• Inherited Antigens
• Why Knowledge of A Subgroups Is Important For Laboratorians
• Reaction of Red Cell Subgroups With Known Antisera
• Question
• Question
• Question
• Agglutination Reactions
• Forward Typing
• Testing the Red Cells With Known Antisera
• Reverse Typing
• Testing Patient Serum With Known Reagent Red Cells (Reverse Grouping)
• Interpretation of ABO Group
• Example of an ABO discrepancy
• Automated Systems
• Question
• Question
• Question
• Importance of Understanding the ABO System
• Epitopes
• Galactose and ABO Antigen Precursor Substance
• Fucose
• "A" Antigenic Activity
• "B" Antigenic Activity
• The H gene
• The Bombay Blood Group
• A, B, and O Genes
• A, B, and O Genes - Diagram
• Bombay Blood Group Genes
• Inherited Genes
• Deducing the Gene
• Genotyping Through Genetics
• Determining Possible Offspring
• Punnett Squares
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Chemical Reagent Strip
• Precautions
• Specimen Collection, Processing and Disposal
• Manual Urine Reagent Strip Procedure
• Procedure Caution
• Question
• Question
• Question
• Question
• Basis of the Urine pH Test
• pH Value
• Acid and alkaline urine pH
• Urine Specimen
• Question
• Question
• Question
• Question
• Protein Error of Indicators
• False Positive Protein Results
• Confirmatory Testing for Protein
• Clinical Significance
• Clinical Significance cont'd
• Clinical Significance cont'd
• Clinical Significance cont'd
• Follow-up Testing of Urine Dipstick Protein Results
• Question
• Question
• Question
• Question
• Glucose Test
• False Positive Results
• False Negative Results
• Timing
• Test for Reducing Substances Other than Glucose
• Clinical Significance
• Clinical Significance cont'd
• Question
• Question
• Question
• Three Kinds of Ketones
• Testing for Ketone Bodies
• Ketone Bodies
• False Positive Ketone Results
• False Negative Results
• Clinical Significance of Positive Urine Ketone Result
• Question
• Question
• Question
• Question
• Bilirubin Characterization
• Test for Bilirubin
• False Positive Results
• False Negative Results
• Confirmatory Testing
• Clinical Significance
• Question
• Question
• Question
• Question
• Hematuria
• The Test for Blood
• False Positive Results
• False Negative Results
• Clinical Significance
• Question
• Question
• Question
• Question
• Nitrite Test
• Bladder Infections
• Test Sensitivity
• False Positive Results
• False Negative Results
• Clinical Significance
• Question
• Question
• Question
• Urobilinogen
• The Test for Urobilinogen
• False Positive Urobilinogen Results
• False Negative Urobilinogen Result
• Confirmatory Test
• Clinical Significance
• Question
• Question
• Question
• Question
• Question
• Granulocytic white blood cells
• Leukocyte Esterase Dipstick Test
• False Positive Leukocyte Esterase Test
• False Negative
• Clinical Significance
• Question
• Question
• Question
• Measuring Specific Gravity
• Advantages and Limitations of the Reagent Strip Method for Specific Gravity
• Clinical Significance
• Question
• Question
• Semi-Automated Instruments
• Quality Control
• Question
• Question
• Question
• Introduction to Statistics
• Why Statistics?
• Descriptive Statistics
• Question
• Samples and Populations
• Statistics and Parameters
• Independent and Dependent Variables
• Discrete and Continuous Data
• Question
• Question
• Question
• Question
• Importance of Professional Tables and Graphs
• Table Specifications
• Figures Specification
• Question
• Question
• Data and Data Pairs
• Using Frequency Distributions
• Reading Frequency Distributions
• Constructing Frequency Distributions
• A Frequency Distribution Example
• Step 1: Select Size and Number of Class Intervals
• Step 2: List the Class Intervals
• Step 3: Sort the Data
• Step 4: Determine Frequencies
• Step 5: Determine Relative Frequencies
• Graphing Frequency Distributions
• Bar Chart
• Histogram
• Frequency Polygon
• Absolute vs. Relative Frequency
• Question
• Question
• Question
• Question
• Mean, Median, and Mode
• Mean
• Median
• Mode
• Question
• Question
• Question
• Standard Deviation
• Standard Deviation (continued)
• Standard Deviation Example
• Standard Deviation Example (continued)
• Question
• Introduction to the Normal Distribution
• Normal Distribution
• 68-95-99 Rule Illustrated
• Inferences from Sample Data
• Question
• Question
• A Measure of Relative Variability
• Using the Coefficient of Variation
• Monitoring Methods
• Question
• An Introduction to the Fundamentals of Coagulation
• An Introduction to the Fundamentals of Coagulation
• An Introduction to the Fundamentals of Coagulation
• An Introduction to the Fundamentals of Coagulation
• An Introduction to the Fundamentals of Coagulation
• Question
• Introduction to Hemostatic Mechanisms
• Introduction to Primary Hemostasis
• Primary Hemostasis – The Vascular System
• Primary Hemostasis – The Vascular System
• Primary Hemostasis – The Vascular System
• Primary Hemostasis – The Vascular System & Platelet Involvement
• Primary Hemostasis – The Vascular System & Platelet Involvement
• Question
• Primary Hemostasis – Characteristics of the Platelet
• Primary Hemostasis – Characteristics of the Platelet
• Primary Hemostasis – Platelet Function
• Primary Hemostasis – Platelet Kinetics
• Question
• Summary of Primary Hemostasis
• Overview of Secondary Hemostasis
• Secondary Hemostasis – Fibrin Formation via the Coagulation Cascade
• Secondary Hemostasis – The Coagulation Cascade
• Question
• A Snapshot of the Entire Coagulation Cascade
• Secondary Hemostasis – The Extrinsic Pathway
• Secondary Hemostasis – The Extrinsic Pathway
• Secondary Hemostasis – The Extrinsic Pathway
• Secondary Hemostasis – The Intrinsic Pathway
• Secondary Hemostasis – The Intrinsic Pathway
• Secondary Hemostasis – The Intrinsic Pathway
• Secondary Hemostasis – The Intrinsic Pathway
• Secondary Hemostasis – The Intrinsic Pathway
• Question
• Secondary Hemostasis – The Common Pathway
• Secondary Hemostasis – The Common Pathway
• Secondary Hemostasis – The Common Pathway
• Secondary Hemostasis - Factor Characteristics
• The Fibrinolytic System
• The Fibrinolytic System
• Laboratory Tests of Hemostatic Function
• Collecting Blood Specimens for Coagulation Testing
• Laboratory Tests of Hemostatic Function
• Laboratory Tests of Hemostatic Function – Prothrombin Time
• Laboratory Tests of Hemostatic Function – Prothrombin Time
• Laboratory Tests of Hemostatic Function - APTT
• Question
• Tests of Hemostatic Function – Fibrinogen Assay
• Fibrin/Fibrinogen Degradation Products and D-dimers
• Tests of Hemostatic Function - Platelet Function Assay
• Tests of Hemostatic Function - Mixing Studies
• Tests of Hemostatic Function - Factor Assays
• Question
• Coagulation Disorders
• Coagulation Disorders - Inherited
• Coagulation Disorders - Inherited
• Coagulation Disorders - Inherited
• Coagulation Disorders - Acquired
• Coagulation Disorders - Acquired
• Coagulation Disorders - Platelet Disorders
• Coagulation Disorders and Liver Disease
• Question
• Anticoagulation Therapy
• Anticoagulation Therapy - Heparin Therapy
• Anticoagulation Therapy - Oral Anticoagulant Therapy
• Predicting a Value
• A Regression Analysis Example
• A Regression Analysis Example (continued)
• Calculating the Y-Intercept
• Prediction Using the Resulting Equation
• Question
• Question
• Question
• Question
• Introduction to Least Squares Method
• The Least Squares Line
• Standard Error of Estimate
• Question
• Question
• Determining the Least Squares Line
• Formulae for Determining the Slope and Intercept
• Calculating the Standard Error of Estimate
• Correlation Coefficient
• Example Regression Line Calculation
• Using the Least Squares Formulae
• Determining Se and r2
• Data for Questions
• Question
• Question
• Question
• Question
• Confidence Intervals for Slope and Intercept Parameters
• Calculating Confidence Intervals
• Formulae for Confidence Intervals
• Question
• Question
• Introduction
• The Hazards of Electricity
• Electricity-induced Injury
• Factors that Determine the Degree of Electricity-induced Injury
• Alternating Current vs. Direct Current
• Electrical Resistance and Current Pathway in the Body
• Extension Cords
• Adapters
• Unplugging an Electrical Cord
• Ground
• Space heaters
• Space Heater Requirements
• Checks and Inspections
• Electrical Hazard Awareness
• Electrical Fires
• Electrical Fires
• Electrical Shock
• Electrical Burns
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Introduction
• Therapeutic Drug Monitoring Definition
• Pharmacogenomics Definition
• Basic Pharmacokinetics
• Drug Concentration Over Time
• Drug Metabolism
• Drug Elimination
• Half-life
• Bioavailability
• Protein Binding
• Protein Availability and Drug Dosing
• Other Factors Affecting Drug Absorption and Distribution
• Question
• Steady State
• Steady State Example
• Sampling
• Peak and Trough Sampling Times
• Why TDM?
• Why TDM?
• Why TDM?
• Unexpected Concentrations
• Question
• TDM for all drugs?
• When is TDM Not Useful?
• Alternative to TDM
• Examples of Drugs That are Monitored by TDM
• TDM for Antibiotics
• TDM for Anticonvulsants
• TDM for Immunosuppressants
• TDM for Cardiac Medications
• TDM for Theophylline
• Question
• Laboratory Methods
• PETINIA
• FPIA
• Chemiluminescence
• Individualized Medicine
• Polymorphism and CYP450
• CYP450s
• CYP2D6
• Metabolizers
• Enzyme Abnormalities and Drugs
• Clinical Utility
• Warfarin Metabolism
• Warfarin cont.
• Question
• CYP450 Induction and Inhibition
• CYP450 Induction and Inhibition
• Question
• Genotype versus Phenotype
• Genotype versus Phenotype
• TDM and PGx
• The Bottom Line
• References
• Defining Thalassemia
• Defining Thalassemia
• Defining Alpha Thalassemia
• Alpha Thalassemia States
• Anemia in Alpha Thalassemia
• Question
• Alpha Thalassemia Major
• Alpha Thalassemia Intermedia
• Alpha Thalassemia Minor
• Silent Carrier
• Question
• Normal Chromosome 16
• Chromosome 16 Alpha Thalassemia Silent Carrier
• Chromosome 16 Alpha thalassemia Minor
• Alpha Thalassemia Minor - Homozygous
• Alpha Thalassemia Minor - Heterozygous
• Chromosome 16 Alpha Thalassemia Intermedia
• Chromosome 16 Alpha Thalassemia Major
• Question
• Alpha Thalassemia Major
• Alpha Thalassemia Intermedia
• Alpha Thalassemia Minor
• Silent Carrier
• Question
• Serum Iron
• Serum Bilirubin
• Lactate Dehydrogenase
• Serum Haptoglobin
• Hemoglobin Electrophoresis Theory
• Migration of Hemoglobin in Alkaline Electrophoresis
• Normal Hemoglobin Electrophoresis
• Sample Alkaline Hemoglobin Electrophoresis
• Densitometer Tracings
• Question
• Brilliant Cresyl Blue stain
• Hemoglobin H bodies
• Reticulocytes
• Normal Cells
• Question
• Case History
• CBC Results
• Question
• Question
• Question
• Question
• Serum Chemistry Results
• Question
• Question
• Repeat Hemoglobin Electrophoresis
• Summary
• References
• Overview
• Overview
• Targets
• Basis of Molecular Testing
• Nucleotides
• Writing the Code
• Types of Nucleic Acid Synthesis
• Human Genome
• Question
• Question
• Unique Terminology
• Terms and Definitions
• Question
• Question
• Overview
• Specimen Collection and Handling
• Pre-analytical Variables
• Transport
• Resources
• Question
• Question
• Classification
• Classification
• Question
• Overview
• Direct Nucleic Acid Testing
• Amplified Nucleic Acid Testing
• Question
• Direct Nucleic Acid Testing Principle
• Direct Nucleic Acid Tests
• Amplified Nucleic Acid Testing Principle
• Amplified Nucleic Acid Tests
• Amplification
• Thermal Cycling
• Amplification Issues
• Hybridization
• Factors Affecting Hybridization
• Detection
• Question
• Question
• Question
• Overview
• Why Choose a Molecular Method?
• Selection
• When Nucleic Acids Get Altered
• Infectious Diseases
• Pharmacogenetics
• Pharmacogenetics
• Advantages of Molecular Testing
• Disadvantages of Molecular Testing
• Question
• Question
• References
• Introduction
• Principle of Electrophoresis
• Amphoteric
• Isoelectric Point (pI)
• Question
• Question
• Mobility or Rate of Migration
• Rate of Migration
• Question
• Role of Buffers
• Buffers and pH
• Question
• Specimens
• Question
• Types of Support Media
• Agarose Gel
• Polyacrylamide Gels
• Question
• Question
• Electrophoresis Equipment
• Automation
• Question
• Types of Electrophoresis
• Routine Electrophoresis
• High Resolution Electrophoresis (HRE)
• Polyacrylamide Electrophoresis (PAGE)
• Denaturing Polyacrylamide Gels
• Isoelectric Focusing (IEF)
• IEF Advantages and Applications
• Capillary Electrophoresis (CE)
• CE Advantages and Applications
• Two-Dimensional Electrophoresis
• Two-Dimensional Electrophoresis Advantages and Applications
• Immunochemical Electrophoresis
• Immunofixation Electrophoresis
• Electroimmunoassay Electrophoresis
• Pulsed Field Electrophoresis
• Question
• Question
• Question
• Visualization and Detection Methods
• Stains and Dyes
• Densitometry
• Labeled Probes
• Question
• Technical Considerations and Electrophoresis Troubleshooting Topics
• Sample Application
• Buffers
• Support Media
• Electroendosmosis
• Wick Flow
• Troubleshooting Irregular, Distorted or Atypical Bands
• Question
• Question
• Resurgence of Electrophoresis
• Electrophoresis and Molecular Diagnostics
• Blotting Techniques
• Uses of CE in Molecular Diagnostics
• References
• Course Introduction
• Significance of Reactions at Different Phases of Testing
• Products Used to Facilitate Antibody Identification
• Test Methods
• Naturally Occurring Antibodies
• Example Of A Naturally Occurring Antibody
• Immune Antibodies
• Example of Clinically Significant Immune Antibody
• Question
• Antibodies to Low- and High-Incidence Antigens
• Examples of Antibodies to High-Incidence Antigens
• Examples of Antibodies to Low-Incidence Antigens
• Initial Steps for Identifying an Antibody
• Panel 1- Example
• Case Study One- Immune Alloantibody
• Ruling Out and Ruling In
• Exception to Homozygous Rule
• Ruling Out and Ruling In Procedure
• Panel 1 Example- Rule Outs
• Selected Cell Panels
• Picking Selected Panel Cells Conservatively
• Example- Choosing Selected Cells
• When to Suspect Multiple Antibodies
• Example 4- Multiple Antibodies
• Example 4b- Selected Cell Rule-Out Panel
• Example 4c - Explanation of Varying Strengths of Reactions
• When to Suspect an Autoantibody
• Example Of An Autoantibody (warm)
• When to Suspect Dosage
• Example 5 Dosage
• Case Study Two
• Case Study Two- Explanation
• When to Use an Enzyme Panel
• When to Use an Enzyme Panel - Results on a Regular Panel
• Reactions with an Enzyme Panel
• Case Study Three
• Case Study Three Rule-Outs Key
• Case Study Three - Selected Cells
• Case Study Three - Conclusion
• Cold antibodies
• Cold Autoantibody Example
• Is It a Cold or a Warm Autoantibody?
• Question
• Case Study - Case 4
• Case Study Four- Antibody Panel
• Case Study Four- Selected Cell Panel
• Case Study Four- Enzyme Panel
• Case Study Four- Selected Cell Panel 2
• References
• Defining Thalassemias
• Defining Beta Thalassemia
• Beta Thalassemia States
• Anemia in Beta Thalassemia
• Question
• Beta Thalassemia Major
• Beta Thalassemia Intermedia
• Beta Thalassemia Minor
• Delta-Beta Thalassemia
• Question
• Normal Chromosome 11
• Chromosome 11 Beta Thalassemia Silent Carrier B++s/B
• Beta Thalassemia Minor
• Chromosome 11 Beta Thalassemia Minor B+/B
• Chromosome 11 Beta Thalassemia Minor B0/B
• Chromosome 11 Delta-Beta Thalassemia Minor
• Beta Thalassemia Intermedia
• Chromosome 11 Beta Thalassemia Intermedia B+s/B+s
• Chromosome 11 Beta Thalassemia Intermedia B0/B+s
• Chromosome 11 Delta-Beta Thalassemia Intermedia
• Chromosome 11 Beta Thalassemia Major
• Chromosome 11 Delta-Beta Thalassemia Major
• Question
• Hematologic Findings For Various Types of Beta Thalassemia
• Serum Iron
• Serum Bilirubin
• Question
• Hemoglobin Electrophoresis Theory
• Migration of Hemoglobin in Alkaline Electrophoresis
• Normal Hemoglobin Electrophoresis
• Normal Hemoglobin Electrophoresis Densitometer Tracing
• Hemoglobin electrophoresis patterns in Beta thalassemia
• Case History
• Laboratory Test Results
• Question
• Question
• Question
• Question
• Question
• Case History Summary
• References
• Introduction
• Question
• Overview
• Question
• Storage Iron
• Question
• Iron Intake and Recycling
• Question
• Regulation of Iron Equilibrium
• Question
• Question
• Iron Transport
• Question
• Altered Iron Absorption
• Question
• Development of Iron Overload
• Question
• HFE and Other Genes
• Question
• Specific HFE Mutations
• Question
• Question
• Epidemiology of HFE Mutations
• Question
• Incomplete Penetrance
• Question
• Prevalence of HFE
• Question
• Non-HFE Mutations
• Question
• General Clinical Considerations
• Question
• Signs and Symptoms of HH
• Question
• Secondary Disorders of Iron Overload
• Question
• Diagnosing HH
• Question
• Prognosis and Mortality
• Question
• General Overview of Testing
• Question
• Serum Iron
• Question
• Transferrin and Total Iron Binding Capacity
• Question
• Transferrin Saturation
• Question
• Question
• Serum Ferritin
• Question
• UIBC
• Question
• Screening Controversies
• Question
• Molecular Tests
• Question
• Definitive Tests for Iron Overload
• Question
• Quantitative Phlebotomy
• Rationale for Treatment
• Question
• Initial Treatment
• Question
• Maintenance Therapy
• Question
• Other Treatments
• Question
• References
• Who Must Receive Training?
• What are the Training Requirements?
• What Records Must Be Maintained?
• Classifications of Hazardous Materials
• Categories of Division 6.2 Infectious Substances
• Definitions
• Category A Definition and Examples
• Category A Identification Numbers
• Category B Definition, Shipping Name, and Identification Number
• Exempt Substances
• Exempt Specimen Packaging and Labeling
• Classification Decision Tree
• Classification Scenario 1
• Classification Scenario 2
• Classification Senario 3
• Classification Scenario 4
• Packaging Considerations
• Selecting the Shipping Container
• Packaging for Category A Specimens
• Requirements for Packages Containing Category A Substances
• Packaging for Category B Substances
• Additional Packaging Requirements for Category A and Category B Substances
• Labeling a Package Containing a Category A Substance
• Labeling a Package Containing a Category B Substance
• Dry Ice
• Category A Packages - Shipper's Declaration For Dangerous Goods
• Completed Shipper's Declaration For Dangerous Goods Form
• Shipper's Declaration For Dangerous Goods- First Section
• Shipper's Declaration For Dangerous Goods- Second Section
• Shipper's Declaration For Dangerous Goods - Third Section
• Shipper's Declaration For Dangerous Goods - Fourth Section
• Question
• Question
• Question
• Question
• Security Awareness
• Security Plan for Category A Infectious Substances
• References
• Introduction
• Introduction cont.
• Risk Markers
• Atherosclerosis
• Atherosclerosis continued
• Patient Studies to Validate Risk Markers
• Question
• Question
• Transport of Lipophilic Substances
• Lipoprotein Particles
• Apolipoproteins
• Apolipoproteins cont.
• Question
• Importance of Determining Size and Number of Lipoprotein Particles
• Measuring Apolipoproteins
• ApoB and ApoA1
• ApoB/ApoA1: The Test
• Question
• High Sensitivity-C-Reactive Protein
• The hs-CRP Test
• Question
• Lp(a)
• Lp(a) Testing
• Oxidized LDL
• Oxidized LDL Physiology
• Oxidized LDL Tests
• Question
• LpPLA2
• LpPLA2 and Cardiovascular Risk
• Question
• Size and Number
• Assessing Lipoprotein Particle Number and Size
• Nuclear Magnetic Resonance
• LDL Phenotype by Electrophoresis
• Electrophoresis Testing
• Question
• Summary
• Adult Treatment Panel
• References
• Case Presentation
• Transfusion Service Laboratory
• ABO, Rh and antibody screen
• Question
• Question
• Crossmatch Results
• Pretransfusion Direct Antiglobulin Test Result
• Post-transfusion DAT Results
• Question
• Question
• Antibody investigation
• Question
• Other post-transfusion tests
• Consulting the patient's physician
• Follow-up with clinical staff
• Immediate HTR - Signs and symptoms
• Cause of Delayed HTR
• Delayed HTR - Signs and symptoms
• Signs and symptoms - Job Aids
• Signs and symptoms - Precaution
• Question
• Investigating weak antibodies
• Antibody identification (2 weeks post-transfusion)
• Antibody exclusion protocol
• Question
• Question
• Question
• Variations in antibody strength
• Question
• DAT change of status
• Antigen phenotyping
• Antigen phenotyping issues
• Antigen phenotyping results
• Question
• Evaluating inconsistencies
• Unexpected anomaly
• Reflecting on probability of the solution
• Question
• Question
• Using probability (p) values
• Using p values in medical research
• Using p values in antibody identification
• Understanding the "rule of three"
• The p value in this case
• Question
• Antibody identification checklist
• Question
• Summary
• Risks of transfusing unmatched RBC
• Balancing the risks
• Question
• Literature and online resources
• What is a voluntary compliance program?
• Seven Fundamental Elements of a Voluntary Compliance Program
• Element 1
• Element 2
• Element 3
• Element 4
• Element 5
• Element 6
• Element 7
• Laws and Regulations Applicable to Medicare
• Confidentiality
• Billing
• Marketing and record retention
• Inducements
• Phlebotomists and equipment in client offices
• Utilization and other regulations
• Couriers and referral tests
• Documentation
• Medical necessity
• Advance Beneficiary Notice (ABN)
• Changes to ABN, Effective March 1, 2009
• ICD-9CM coding
• HCPCS and CPT coding
• Local medical review policies (LMRPs)
• Test Requisitions
• Issues Related to Test Ordering, Performance, and Resulting
• Written and verbal orders
• Ambiguous or Unclear Test Orders
• Panels and profiles
• Physician notices and acknowledgements
• Laboratory Administration's Responsibilities
• Management Personnel Responsibilities
• Management's Responsibilities for Preventing Allegations of Medicare Fraud and Abuse
• Employee's Responsibility
• Laboratory Billing Department Communication With Physicians and Patients
• Advance Beneficiary Notices (ABNs) and the Billing Department
• Documentation
• Excused charges and other inducements
• Client contracts
• Test pricing and antitrust
• Sales proposals and discounts
• Whistleblowers
• Case Study 1
• Case Study 2
• Case Study 3
• Case Study 4
• Case Study 5
• Case Study 6
• Case Study 7
• Case Study 8
• Case Study 9
• What is Venipuncture?
• Tools of the Trade
• Needles - What's the Point?
• Needles and Patient Safety
• Blood Collection Systems and Devices
• Winged Device
• Syringe
• Question
• Blood Tube Labeling Information
• Blood Collection Tubes
• Question
• Tourniquets, Alcohol, and Gauze
• Cleansing the Venipuncture Site
• Give Yourself a Chance
• Explore the Possibilities!
• Question
• When to Use Hand Veins to Obtain Blood
• Handle With Care
• Tips for Successful Venipuncture When Using Hand Veins
• Question
• Vein Palpation
• Assessing the Vein
• Unacceptable Sites for Venous Blood Collection
• Performing a Venipuncture on an Arm Containing an Intravenous Line
• Question
• Venipuncture Procedure At a Glance
• Specimen Collection Procedure
• Specimen Handling Post Venipuncture
• What are Pre-analytical Errors?
• Pre-analytical Errors
• What is a Hidden Error?
• Proper Patient Identification
• Importance of Using the Correct Blood Collection Tube
• Order of Draw
• Correct Fill
• Labeling Specimens
• Do Not Tamper With the Specimens
• Avoid Prolonged Tourniquet Time
• Question
• Question
• Protect Yourself
• Don't Get Stuck Without It
• Do It Right the First Time
• Don't Compromise Your Safety
• Question
• Question
• Scenario Conclusion
• Question
• Question
• References
• Ergonomics
• Ergonomic Evaluation
• Question
• Causes of Work-related Musculoskeletal Disorders
• Repetitive Motion Injuries
• Eyestrain
• Question
• Question
• Learn to Use Your "Ergonomic Eye"
• Body Position
• Ergonomic Guidelines for Computer Users
• Question
• Guidelines for Lifting, Lowering and Carrying
• Question
• Work Station
• Lighting
• Posture and Exercises
• Question
• Scenario #1
• Scenario #2
• Question
• Question
• Creating an Ergonomically Safe Work Environment
• The Four E's
• References