MediaLab, Inc. Course Preview Pages

• 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
• Silent Carrier
• Alpha Thalassemia Minor
• Alpha Thalassemia Intermedia
• Alpha Thalassemia Major
• 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
• Hemoglobin H bodies
• Reticulocytes
• Normal Cells
• Question
• Case History
• Complete Blood Count Results
• Question
• Question
• Serum Chemistry Results
• Question
• Question
• Repeat Hemoglobin Electrophoresis
• Summary
• 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 Low-Incidence Antigens
• Examples of Antibodies to High-Incidence Antigens
• Initial Steps for Identifying an Antibody
• Initial Observations of Antibody Panel
• Case Study: Immune Alloantibody
• Rule-Out Procedures
• Rule-Out Procedures, continued
• Question
• Ruling Out Procedures, continued: Selecting Additional Rule-Out Cells
• Rule-Out Procedure, continued: Selecting Additional Rule-Out Cells-- Example
• Picking Selected Panel Cells Conservatively
• Rule-Out Procedure Summary Guidelines
• Question
• When to Suspect Multiple Antibodies
• Example of Dosage and/or Multiple Antibodies Influencing the Strength of Reactions
• Multiple Antibodies: Example
• Multiple Antibodies Example, continued: Selected Cell Rule-Out Panel
• Multiple Antibodies Example, continued: Explanation of Varying Strengths of Reactions
• When to Suspect an Autoantibody
• Cold antibodies
• Cold Autoantibody Example
• Example Of An Autoantibody (warm)
• Is It a Cold or a Warm Autoantibody?
• Question
• Enzyme Panels
• Effect of Enzymes and Dithiothreitol (DTT)
• References
• Copyright and Disclosures
• Autoimmune Diseases
• Autoimmune Disease (continued)
• Systemic Autoimmune Rheumatic Diseases
• Antinuclear Antibody Test
• Question
• Question
• History of ANA Testing
• Fluorescent ANA Testing
• Colorzyme®
• Other Methods for ANA Testing
• Cell Morphology
• Stages of Mitosis
• Question
• Reading ANA Patterns Using a HEp-2 or HEp-2000® Substrate
• Question
• ANA Testing Scheme
• Question
• Follow-up Testing
• Antigen Chart
• Question
• ANA patterns
• Negative
• Homogeneous
• Speckled
• Nucleolar
• Centromere
• SSA/Ro Pattern
• Proliferating Cell Nuclear Antigen (PCNA)
• Nuclear Membrane
• Question
• Overview
• NSp I or Multiple Nuclear Dots (MND)
• NSp II or CENP-F
• Nuclear Matrix
• Midbody
• Other Unusual ANA Patterns
• Question
• Overview
• Homogeneous and Speckled
• Homogeneous and Centromere
• Homogeneous and SSA/Ro (on HEp-2000®)
• Speckled and SSA/Ro
• Scl-70
• Other Mixed Patterns
• Question
• Overview
• Cytoskeletal
• Mitochondrial
• Ribosomal P
• Golgi
• Mitotic Spindle
• NuMA
• HsEg5
• Question
• References
• Introduction
• Platelets and Aspirin
• Aspirin Dosing
• Aspirin Resistance
• Algorithmic Approach For a Patient With Suspected Aspirin Resistance
• Factors that May Limit the Effectiveness of Aspirin
• Question
• Platelets and Clopidogrel
• Clopidogrel Dosing
• Clopidogrel Resistance
• Question
• Specimen Collection for Platelet Function Testing
• Specimen Processing for Platelet-Rich Plasma
• Monitoring Response to Aspirin Therapy
• Aspirin Response Analysis: Platelet Function Testing for Aspirin Resistance
• Aspirin Response Analysis: Urinary 11-Dehydrothromboxane B2 for Aspirin Resistance
• Question
• Question
• Aspirin Response Analysis: Optical Light Transmission Aggregometry
• Aspirin Response Analysis: Whole Blood Impedance Aggregometry
• Aspirin Response Analysis: Shear Flow Technology
• Aspirin Response Analysis: Cartridge-Based Platelet Aggregation
• Aspirin Response Analysis: Helena Laboratories PlateletWorks Kit
• Aspirin Response Analysis: AspirinWorks Analysis
• Question
• Question
• CYP2C19 Genotyping for Clopidogrel
• Clopidogrel Response Analysis: Light Transmittance Aggregometry (LTA)
• Clopidogrel Response Analysis: Whole Blood Impedance Aggregometry
• Clopidogrel Response Analysis: P2Y12 Analysis
• Clopidogrel Response Analysis: Helena Laboratories PlateletWorks Kit
• Clopidogrel Response Analysis: Thromboelastography
• Question
• Question
• Treatment Alternatives When Aspirin or Clopidogrel Non-responsiveness is Detected
• References
• Definition of Thrombocytopenia
• Symptoms Seen in Thrombocytopenia
• Question
• Increased platelet destruction
• Idiopathic Thrombocytopenic Purpura
• Acute Idiopathic Thrombocytopenia
• Chronic Idiopathic Thrombocytopenic Purpura
• Thrombocytopenia in Neonates
• Treatment for ITP
• Question
• Drug-induced thrombocytopenia
• Pathophysiology of Heparin-Induced Thrombocytopenia
• Additional Complications Related to Heparin-Induced Thrombocytopenia
• Question
• Thrombotic Thrombocytopenic Purpura and Hemolytic Uremic Syndrome
• Laboratory Findings
• Treatment of TTP
• Question
• Disseminated Intravascular Coagulation
• Clinical Findings
• Laboratory Findings
• Treatment of DIC
• Question
• Diseases and Disorders That Affect the Bone Marrow and Decrease Platelet Production
• Question
• Increased Splenic Sequestration and Thrombocytopenia
• Dilutional Thrombocytopenia
• Preanalytic Variable Leading to False Thrombocytopenia
• Pseudo-thrombocytopenia: Platelet Satellitism and Platelet Clumping
• Importance of Addressing Platelet Variables
• Question
• References
• What are Lean and Six Sigma?
• History of Lean and Six Sigma
• Lean and Six Sigma Timeline
• Question
• Principles of Lean
• Five Steps to Lean Thinking
• Waste in the Laboratory
• Recommended Lean Processes: Waste Walk
• Recommended Lean Processes: 5S
• Additional Lean Processes and Concepts
• Batch Size Reduction
• Laboratory Work Cell
• Question
• Measuring Quality
• Process Sigma and Defects Per Million Opportunities (DPMO)
• DPMO and Process Sigma (Sigma Level) Example
• Six Sigma Level of Quality in Health Care
• Roles and Responsibilities in a Six Sigma Team
• Team Dynamics
• Question
• DMAIC Process
• Project Selection
• DMAIC: Define Phase
• Project Charter
• "Define Phase" Tools: Failure Mode and Effects Analysis (FMEA)
• Example of FMEA
• "Define Phase" Tools: Quality Function Deployment
• "Define Phase" Tools: Voice of the Customer (VOC)
• "Define Phase" Tools: Supplier, Inputs, Process, Outputs, and Customers (SIPOC) Diagram
• DMAIC: Measure Phase
• Process Map
• Data Collection Plan: Baseline Measurement
• DMAIC: Analyze Phase
• Cause and Effect Diagram and DOE
• Pareto Chart
• Process Analysis
• DMAIC: Improve Phase
• DMAIC: Control Phase
• Question
• Conclusion
• References
• Defining Thalassemias
• Defining Beta Thalassemia
• Beta Thalassemia Genetics Overview
• Anemia in Beta Thalassemia
• Question
• Beta Thalassemia Major
• Beta Thalassemia Intermedia
• Beta Thalassemia Minor
• Beta Thalassemia Minima
• Delta-Beta Thalassemia
• Question
• Normal Chromosome 11
• Chromosome 11 Beta Thalassemia Minima (Silent Carrier) Bsc/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+/B+
• Chromosome 11 Beta Thalassemia Intermedia B0/B+, B0/B
• 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
• Peripheral Morphology vs Cytospin Morphology
• Neutrophils
• Neutrophils continued
• Eosinophils vs. Neutrophils
• Question
• Normal Lymphocytes
• Lymphocytes
• Lymphocytes vs. Monocytes
• Viral Lymphocytes vs. Monocytes
• Lymphocytes and Atypical Lymphocytes
• Atypical Lymphocytes
• Viral Lymphocytes
• Plasma Cells
• Question
• Monocytes
• Monocytes vs Lymphocytes
• Monocytes and Macrophages
• Macrophages
• Hemophagocytosis
• Siderophage
• Histiocytes
• Question
• Question
• Ependymal Cells
• Ependymal Clumps
• Choroid Plexus Cells
• Bone Marrow Contamination in Cerebrospinal Fluid
• Question
• Mesothelial Cells
• Mesothelial Cells continued
• Reactive Mesothelial Cells
• Synovial Lining Cells
• Synovial Lining Cells
• Bronchial Lining Cells
• Bronchial Lining Cells continued
• Question
• Infectious Organisms in Body Fluids
• Intracellular and Extracellular Diplococci
• Intracellular Diplococci
• Peritoneal lavage Trauma STAT
• Trauma STAT
• Septic Arthritis
• Yeast
• Candida albicans - Germ Tube Formation
• Hyphae
• Central Nervous System (CNS) Toxoplasmosis
• Central Nervous System (CNS) Toxoplasmosis continued
• Question
• Leukemic Fluids
• Acute Lymphoblastic Leukemia (ALL): L1 Morphology
• Central Nervous System (CNS) Relapse: L2 Acute Lymphoblastic Leukemia (ALL)
• L3 Burkitt Lymphoma
• Non-Hodgkin Lymphoma
• Anaplastic Large Cell Lymphoma (ALCL)
• Acute Myeloid Leukemia (AML)
• Acute Myeloid Leukemia (AML) continued
• Acute Monoblastic Leukemia (AMoL)
• Question
• Metastatic Tumors in Fluid Cytospins.
• Adenocarcinoma in Peritoneal Fluid
• Alveolar Rhabdomyosarcoma (ARMS) in Plerual Fluid
• Atypical Teratoid/Rhabdoid Tumors (ATRT) in Cerebrospinal Fluid
• Metastatic Melanoma in the Cerebrospinal Fluid
• Agranular Metastatic Melanoma in Cerebrospinal Fluid
• Medulloblastoma in Cerebrospinal Fluid
• Neuroblastoma in Pleural Fluid (NBL)
• Neuroblastoma Tumor Clump vs. Mesothelial Clump in Pleural Fluid
• Primitive Neuroectodermal Tumor (PNET) in Cerebrospinal Fluid
• Retinoblastoma in Cerebrospinal Fluid
• Question
• References
• Introduction to Bone Marrow Aspirates and Biopsies
• Bone Marrow Biopsy
• Bone Marrow Aspirate and Biopsy Collection
• Clinical Laboratory's Role: Bone Marrow Aspirates and Biopsies
• Question
• Bone Marrow Collection: Patient Bedside
• Bone Marrow Delivery
• Question
• Bone marrow Smear Preparation
• Bone marrow Smear Preparation: Selecting Fragments
• Long Slide Preparation Techniques: Wedge Smear
• Long Slide Preparation Techniques: T-prep
• Long Slide Preparation Techniques: Pull Prep
• Coverslip Smear Preparation Technique
• Biopsy Touch Preparation Technique
• Bone Marrow Smear Techniques Video
• Question
• Manual Staining of Bone Marrow Preparations
• Manual Staining of Bone Marrow Preparations: Wright's and Wright-Giemsa Stain
• Automated Stainers
• Iron Staining
• Question
• Bone marrow Differentials
• Myeloblast
• Promyelocyte
• Myelocyte
• Myelocytes: Eosinophils and Basophils
• Metamyelocyte
• Band Neutrophil
• Segmented Neutrophil
• Question
• Erythrocytic Cells: Introduction
• Pronormoblast (Proerythroblast)
• Basophilic Normoblast
• Polychromatophilic Normoblast
• Orthochromic Normoblast
• Question
• Monoblast
• Promonocyte
• Monocyte
• Macrophage (Histiocyte)
• Hemophagocytosis
• Lymphocyte
• Hematogone
• Plasma Cell
• Question
• Megakaryocyte: Immature
• Megakaryocyte: Mature
• Osteoclast
• Osteoblast
• Stromal Cells
• Rules for Bone Marrow Differentials
• Rules for Bone Marrow Differentials, continued
• Rules for Bone Marrow Differentials, continued
• Calculating and Reporting the Myeloid:Erythroid (M:E) Ratio
• Cellularity and Additional Information
• Responsibility of the Technologist versus Hematopathologist
• References
• Introduction
• Organizations and Agencies
• The Human Heart
• Question
• Terminology Describing Ischemic Heart Disease and Heart Failure
• Acute Coronary Syndrome
• Risk Factors for Heart Disease
• Question
• Question
• Atherosclerosis
• Fibrous Cap
• Lipids
• Monitoring Lipids
• Question
• Heart Disease and Cardiac Biomarkers
• Uses of Cardiac Biomarkers
• Optimal Cardiac Biomarkers
• Current Cardiac Biomarkers
• History
• Troponins
• cTnI
• cTnT
• Use of Troponins
• cTnI Versus cTnT
• Troponin Measurement and Ranges
• Question
• CK-MB
• CK-MB Measurement and Ranges
• Myoglobin
• CK-Isoforms
• Diagnosis of an Acute Myocardial Infarction (AMI)
• Pattern of AMI Biomarker Levels
• 2007 Guidelines for Cardiac Markers in AMI Diagnosis
• Biomarker Sampling Guidelines
• Question
• Question
• Question
• Question
• Cardiac Biomarkers and Congestive Heart Failure
• Function of BNP
• BNP Versus NT-ProBNP
• BNP and NT-ProBNP Measurement and Ranges
• Question
• Question
• Risk Stratification
• Screening Biomarkers
• High Sensitivity C-Reactive Protein (hs-CRP)
• Use of hs-CRP, Measurement, and Ranges
• Homocysteine
• Ischemia Modified Albumin (IMA)
• Myeloperoxidase
• Future Cardiac Biomarkers
• Question
• Comparisons of Concentrations of CRP and hs-CRP
• Comparisons of Concentrations of CRP and hs-CRP
• References
• Question
• Question
• The Superoxol Test
• Question
• Review 1
• Question
• Question
• Acute Onset Pneumonia
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Pneumococcal Resistance
• Review 1
• Question
• Question
• Question
• Clinical History
• Question
• Question
• Question
• Extended-Spectrum Beta-Lactamases (ESBLs) Review
• Extended-Spectrum Beta-Lactamases (ESBLs)
• Extended-Spectrum Beta-Lactamase (ESBL) Screening by Disk Diffusion
• ESBL Screeing by Broth Microdilution
• Phenotypic Confirmation by Disk Diffusion and Reporting
• Extended-Spectrum Beta-Lactamase (ESBL) Activity
• Phenotypic Confirmation by Broth Microdilution and Reporting
• Review 1
• Question
• Question
• Clinical History
• Question
• Pyrrolidonyl Arylamidase (PYR) Differential
• Question
• Enterococcus Identification
• Enterococcus faecium Identification
• 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 Blood Agar
• Question
• Question
• Staph aureus Mannitol
• Methicillin-Resistant Staphylococcus aureus (MRSA) Screen
• Methicillin-Resistant Staphylococcus aureus (MRSA) Disk Test
• Review 1
• Review 2
• Review 3
• Question
• Question
• Question
• Question
• Spleen Specimen
• Question
• Question
• S. anginosus ("milleri") CO2
• S. anginosus ("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 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
• References
• What is Cerebrospinal Fluid (CSF)?
• Three Main Functions of CSF
• Chemical Substances Present in CSF
• Cells Present in Normal CSF
• CSF Evaluation and Diagnosis
• Question
• Question
• CSF Specimen Collection Process
• Collection Tubes, continued
• Specimen Labeling and Transport
• Specimen Handling and Storage
• Initial Specimen Examination
• Safety Precautions
• Question
• Question
• Abnormalities
• Turbidity
• Clot/Pellicle
• Bloody Specimen
• Detecting Subarachnoid Hemorrhage
• Xanthochromia
• Other Causes of Xanthochromia
• Causes of Xanthochromia in Premature Infants
• Important Aspects of Xanthochromia
• Question
• Question
• Question
• Normal Cell Counts
• Examining CSF Using the Hemocytometer
• Examining CSF Using the Hemocytometer, continued
• Counting Nucleated Cells in a Bloody CSF Specimen
• Cell Counting Guidelines
• Question
• Question
• Question
• Question
• Question
• Stained Cytospin Preparations of CSF
• Cytocentrifuge Technique
• Nucleated Cells That May Be Present In CSF
• Lymphocytes
• Neutrophils
• Bacterial Meningitis
• Monocyte/Macrophage
• Macrophages As Indicators of Previous Subarachnoid Hemorrhage (SAH)
• Normal Peripheral Blood Cells
• Bone Marrow Contamination of CSF Sample
• Blast Cells
• More Blast Cells
• Malignant Cells
• Malignant Cells, continued
• Malignant Cells, continued
• Question
• Question
• Question
• Question
• Chemical Urinalysis Reagent Strips
• Urine Specimen Collection
• Urine Specimen Processing and Transportation
• Reagent Strip Procedure
• Precautions in Urinalysis Chemical Reagent Strip Analysis
• Question
• Question
• Question
• Question
• pH Analysis: The Urine Specimen
• Basis of the Urine pH Test
• Urine pH: Acidic and Alkaline
• Question
• Question
• Question
• Protein Error of Indicators
• Confirmatory Testing for Urine Protein
• Clinical Significance of Urine Protein
• Clinical Significance of Urine Protein (continued)
• Follow-up Testing for Positive Urine Protein
• Question
• Question
• Urine Glucose Analysis
• False Positive and Negative Urine Glucose Results
• Test for Reducing Substances Other than Glucose
• Clinical Significance of Glucose in the Urine
• Question
• Question
• Ketones Overview
• Testing for Ketones in the Urine
• Ketone Bodies
• False Positive and Negative Ketone Results
• Clinical Significance of Positive Urine Ketones
• Question
• Question
• Question
• Overview of Bilirubin
• Testing for Urine Bilirubin
• False Positive and Negative Urine Bilirubin Results
• Confirmatory Testing for Urine Bilirubin
• Clinical Significance of Urine Bilirubin
• Question
• Question
• Introduction to Hematuria
• Reagent Test Pad for Blood
• False Positive and Negative Results
• Clinical Significance of Blood in Urine
• Question
• Question
• Question
• Urine Analysis for Nitrites
• Nitrites and Bladder Infections
• Nitrite Test Sensitivity
• False Positive and Negative Results
• Clinical Significance of Nitrites in Urine
• Question
• Question
• Introduction to Urobilinogen
• Urobilinogen Analysis
• False-Positive and False-Negative Urobilinogen Results
• Confirmatory Testing for Urobilinogen
• Clinical Significance of Urobilinogen in Urine
• Question
• Question
• Presence of Granulocytes in Urine
• Leukocyte Esterase on the Urine Chemical Reagent Strip
• False Positive and Negative Urine Leukocyte Esterase
• Clinical Significance of Leukocyte Esterase in Urine
• Question
• Question
• Measuring Specific Gravity
• Advantages and Limitations of the Chemical Reagent Strip Method for Specific Gravity
• Clinical Significance of Specific Gravity
• Question
• Semi-Automated Instruments
• Quality Control
• Question
• Question
• Question
• Reasons for Performing Confirmatory or Secondary Macroscopic Urine Tests
• Urine Glucose
• Reducing Sugars
• Testing Methods for Urine Glucose and Other Reducing Substances
• Specimen Processing for Urine Sugar Testing
• Testing for Reducing Substances Other Than Glucose
• Copper Reduction Reaction
• Question
• Question
• Diseases Associated with Proteinuria
• Screening and Secondary Tests for Protein
• SSA Test Procedure and Results Interpretation
• SSA Procedural Notes and Test Limitations
• Microalbumin Test
• Question
• Question
• Question
• Question
• Urinary Ketones
• Causes of Ketonuria
• Detection of Ketone Bodies
• Acetest®
• Urine Bilirubin
• Bilirubinuria
• Confirmation of Urine Bilirubin Result
• Diazo Tablet Test
• Limitations of the Procedure
• Question
• Question
• Introduction
• Current Good Manufacturing Practice (cGMP) Defined
• Donor vs Transfusion Service
• Redundancy
• Question
• Quality Control Unit
• Personnel Requirements
• Building Requirements
• Plant & Facilities
• Equipment
• Control of Components & Reagents
• Production and Process Controls
• Packaging and Label Control
• Holding & Distribution & Traceability
• Laboratory Controls
• Records & Reports
• Code of Federal Regulations (CFR) Records and Reports, continued
• Complaint and Adverse Reaction Files
• Returned and Salvaged Drugs
• Question
• Definitions
• Shipment Temperatures 600.15
• Establishment Inspections
• Inspections, Continued
• Annual Reporting
• Question
• CGMP For Blood and Blood Components
• Standard Operating Procedures
• Additional Procedures
• Procedures of Other Organizations
• Container Label
• Container Label Design
• Label Contents
• Specific Label Statements
• ABO and Rh Labels
• Machine Readable Label Contents
• Emergency Labeling
• Autologous Labeling
• Question
• Instruction Circular
• Compatibility Testing
• Deviation Reporting
• Question
• Registration and Listing
• Exemption from Registration
• Question
• Testing for Communicable Diseases
• Testing For Communicable Diseases, continued
• Donor Deferral & Lookback
• Dating Period of Blood Components
• Additional Container Labeling Requirements
• Additional Container Labeling Requirements, continued
• Question
• Additional Standards for Human Blood
• Red Blood Cells
• Platelets
• Plasma
• Cryoprecipitate
• Immune Globulin
• Reissue of Blood
• QC Requirements for Platelets and Cryoprecipitated AHF
• Question
• 640.120 Alternative Procedures
• 21CFR 660.20 Blood Grouping Reagents
• Question
• Conclusion
• References
• Intent of this program
• Requirements for Retraining
• 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
• Donor completes certification statement
• Collector packages specimen
• Distribution of custody and control form
• Question
• When problems occur
• Indwelling Catheter and External Urine Bag
• 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 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
• Differences between Department of Transportation (DOT) and Department of Health and Human Services (HHS) Mandatory Guidelines for Federal Drug Testing...
• Additional Resources
• Introduction
• Protect Yourself and Your Patient
• Question
• Venous, Arterial, and Capillary Blood Specimens
• Dermal Puncture vs Venipuncture
• Question
• Using the Fingers for Dermal Puncture
• Using the Heel for Dermal Puncture
• Question
• Puncture Devices
• Miscellaneous Equipment
• Question
• Patient Identification
• Site Preparation
• Let Gravity Be Your Friend
• Finger Puncture
• Heel Puncture
• Properly Filling and Mixing a Microcollection Container
• Order of Draw
• Positioning the Puncture Device for a Fingerstick
• Question
• Question
• Oh No...The Blood Has Stopped Flowing
• Inappropriate Sites/Patients for Capillary Puncture
• Infants and Geriatric Patients: Monitor the Amount of Blood Obtained
• Protect Me From the Light
• Question
• The Need for Metabolic Testing on Newborns
• Capillary Blood Collection for Metabolic Testing
• Processing Filter Cards after Collecton
• Question
• Hematology Specimens
• Capillary Blood Gases
• Question
• Lead - An important public health concern
• Using Sucrose as an Analgesic Prior to Heel Puncture and Capillary Blood Collection
• References
• Red Blood Cell Indices: Definitions and Calculations
• Red Blood Cell Distribution Width (RDW): Definition and Calculation
• Interpretation of Red Blood Cell (RBC) Histograms
• Question
• Question
• Question
• Question
• Red Blood Cell (RBC) Size Variation
• Red Cell Distribution Width (RDW) Correlated with Peripheral Smear
• Red Blood Cell (RBC) Color Variation
• RBC Size and Color Descriptions
• Red Blood Cell Parameters Correlated with Red Blood Cell Morphology, Summary
• Question
• Question
• Question
• Anemia Defined and Classified
• Morphologic Classification of Anemias
• Pathophysiologic Classification of Anemias
• Question
• Question
• Question
• Question
• Question
• Delta Check Alerts Using Red Blood Cell Indices
• Question
• References
• Introduction to Statistics
• Why Statistics?
• Descriptive Statistics
• Samples and Populations
• Statistics and Parameters
• Independent and Dependent Variables
• Discrete and Continuous Data
• Question
• Question
• Question
• Question
• Question
• Importance of Professional Tables and Graphs
• Table Specifications
• Figures Specification
• 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
• Introduction: Coagulation Inhibitors
• Coagulation Inhibitors
• Introduction: Factor Deficiencies
• Coagulation Inhibitors and Coagulation Screening Tests
• Coagulation Factors Involved in the aPTT Test
• Elevations in PT or aPTT assays
• Preanalytical Variables That Can Cause Falsely Elevated PT or aPTT Results
• Summary of Initial Elevations in the PT and aPTT
• Question
• Coagulation Factors Monitored By the PT Test
• When To Perform a Mixing Study
• Question
• Introduction to Mixing Studies
• Mixing Study Test Principle
• Question
• Mixing Study: Specimen Requirements
• Performance of a Mixing Study
• Performance of a Mixing Study
• Performance of a Mixing Study
• Question
• Analyzing the Mixing Study Results
• Interpreting the Mixing Study Results
• Question
• Analyzing the Mixing Study Results (cont.)
• Mixing Study Methodology Differences
• Analyzing the Mixing Study Results (cont.)
• Interpreting the Mixing Study Results: A Case Study
• Interpreting the Mixing Study Results: A Case Study (cont.)
• Interpreting the Mixing Study Results: A Case Study (cont.)
• Question
• Interpreting the Mixing Study Results: Case Study 2
• Question
• Interpreting the Mixing Study Results: Case Study 3
• Question
• Further Analyses for Factor Deficiencies
• Further Analyses for Factor Deficiencies (cont.)
• Further Analyses for Factor Deficiences: Factor Activity Curves
• Treatment for Factor Deficiencies
• Lupus Anticoagulant
• Further Analyses for Coagulation Inhibitors- Lupus Anticoagulant
• Further Analyses for Coagulation Inhibitors (cont.)
• Treatment for Coagulation Inhibitors
• References
• Introduction
• Case Studies
• Organizations and Agencies
• Case A
• Case B
• Case C
• Blood Glucose and Hormonal Control
• Question
• Question
• Diabetes - A Metabolic Disorder
• Hemoglobin A1C and Diabetes Diagnosis
• HbA1C versus Blood Glucose Measurement
• Diagnosis of Diabetes
• Case Studies
• Question
• Categories of Increased Risk for Diabetes
• Categories of Increased Risk for Diabetes
• Reference Ranges
• Question
• Classification of Diabetes
• Type 1 Diabetes
• Type 2 Diabetes
• Type 2 Diabetes Continued
• Type 1 or Type 2
• Gestational Diabetes
• Other Causes of Diabetes
• Case Studies (continued)
• Question
• Risks and Complications of Diabetes
• Microvascular Damage
• Macrovascular Complications
• Other Complications
• Question
• Screening for Diabetes
• Benefits of Earlier Screening
• Question
• Clinical Testing
• Blood Glucose
• Whole Blood Glucose Testing
• Question
• Urine Glucose
• Urinary Albumin
• Urinary Albumin Excretion
• Microalbuminuria
• Ketones
• Insulin and C-Peptide
• Insulin Antibodies
• Glycated Proteins
• HbA1C
• Monitoring Diabetic Glycemic Control
• Fructosamine
• Oral Glucose Tolerance Test
• Question
• Question
• Estimated Average Glucose
• Relationship Between HbA1C and eAG
• Question
• The Laboratory's Role in Diagnosis and Monitoring of Diabetes
• 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
• 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
• What are Erythrocyte Inclusions?
• Question
• Reticulocytes
• Normal Erythrocytes
• Polychromatophilic Red Blood Cells (RBCs)
• Polychromatophilic Cells, continued
• Stress Reticulocytes
• Question
• Question
• Basophilic Stippling
• Example of Fine Basophilic Stippling
• Coarse Basophilic Stippling
• Coarse Basophilic Stippling, continued
• Question
• Question
• Howell-Jolly Bodies
• Howell-Jolly Body
• Another Howell-Jolly Body
• Howell-Jolly Body in Nucleated Red Cell
• Question
• Question
• Question
• Question
• Pappenheimer Bodies
• Pappenheimer Bodies, continued
• Pappenheimer Bodies, continued
• Basophilic Stippling contrasted with Pappenheimer Bodies
• Howell-Jolly Bodies and Pappenheimer Bodies
• Comparison of Erythrocyte Inclusions
• Siderotic Granules
• Siderocytes and Ringed Sideroblasts in Bone Marrow
• Siderocyte
• Sideroblast
• Question
• Question
• Question
• Question
• Cabot Rings
• Cabot Rings, continued
• Cabot Rings, continued
• Question
• Question
• 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
• Introduction to the Fundamentals of Coagulation
• Introduction to the Fundamentals of Coagulation, continued
• Introduction to the Fundamentals of Coagulation, continued
• Question
• Introduction to Hemostatic Mechanisms
• Introduction to Primary Hemostasis
• Primary Hemostasis: The Vascular System
• Primary Hemostasis: The Vascular System, continued
• Primary Hemostasis: The Vascular System and Platelet Involvement
• Primary Hemostasis: Platelet Production
• Primary Hemostasis: Characteristics of the Platelet
• Primary Hemostasis: Platelet Function
• Summary of Primary Hemostasis
• Question
• Overview of Secondary Hemostasis
• Secondary Hemostasis: Fibrin Formation via the Coagulation Cascade
• Consequences Linked to Deficiencies in Coagulation Factors
• Question
• Coagulation Factors in the Coagulation Cascade
• Secondary Hemostasis: The Extrinsic Pathway
• Secondary Hemostasis: The Extrinsic Pathway, continued
• Secondary Hemostasis: The Intrinsic Pathway
• Secondary Hemostasis: The Intrinsic Pathway, continued
• Secondary Hemostasis: The Intrinsic Pathway, continued
• Secondary Hemostasis: The Intrinsic Pathway, continued
• Secondary Hemostasis: The Common Pathway
• Secondary Hemostasis: The Common Pathway, continued
• Secondary Hemostasis: The Common Pathway, continued
• Secondary Hemostasis: Coagulation Factor Characteristics
• Question
• The Fibrinolytic System
• The Fibrinolytic System, continued
• Laboratory Testing of Hemostatic Function
• Collecting Blood Specimens for Coagulation Testing
• Specimen Rejection Criteria
• Prothrombin Time (PT)/INR
• PT/INR, continued
• Activated Partial Thromboplastin Time (aPTT)
• Heparin Anti-Xa Assay
• Question
• Fibrinogen Assay
• Fibrin/Fibrinogen Degradation Products and D-Dimers
• Platelet Function Assay
• Mixing Studies
• Factor Assays
• Question
• Coagulation Disorders
• Coagulation Disorders: Inherited
• Coagulation Disorders: Acquired
• Coagulation Disorders: Platelet Disorders
• Coagulation Disorders and Liver Disease
• Question
• Anticoagulation Therapy
• Heparin Therapy
• Oral Anticoagulant Therapy
• 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
• Hemoglobinopathies
• Examples of Structural Abnormalities
• Question
• Sickle Cell Disorders
• Genetics of Hemoglobin S
• Normal and HbS Beta Chain DNA Base Sequences
• Question
• Sickling Process Overview
• The Sickling Process
• The Sickling Process, Continued
• Normal Blood Flow
• Blood Flow During Sickling
• Vascular Occlusion
• Cellular Dehydration
• Question
• Clinical Manifestations
• Vaso-occlusive Crisis
• Vaso-occlusive Crisis, Continued
• Sequestration Crisis
• Hemolytic Crisis
• Aplastic Crisis
• Question
• Question
• Complications
• Risk Factors
• Question
• Hb SS and Hb SA
• HbS with Other Hemoglobins
• HbS / Thalassemia
• Hb S with Hereditary Persistence of Fetal Hemoglobin
• Treatment for Sickle Cell Anemia
• Supportive Care
• Pain Management
• Pharmacotherapy
• Non-pharmacotherapy
• Blood Tranfusions
• Molecular Therapy
• Investigative Therapies
• RBC Dehydration Prevention
• Natural HbF Inducers
• Transplantation and Gene Therapy
• Question
• Laboratory Diagnosis
• Comparison of Laboratory Results Among Hemoglobin S Disorders
• Solubility Test
• Solubility Test Errors
• Hemoglobin Electrophoresis Theory
• Migration of Hemoglobin in Alkaline Electrophoresis
• Migration of Hemoglobin in Acid Electrophoresis
• Normal Hemoglobin Electrophoresis (alkaline)
• Normal Hemoglobin Electrophoresis Densitometer Tracing
• Densitometer Tracing of Various Hemoglobins
• Hemoglobin Electrophoresis Patterns in Sickle Cell Disorders (Alkaline)
• Hemoglobin electrophoresis patterns in Sickle Cell Disorders (acid)
• Question
• RBC Morphology in Sickle Cell Trait (HbSA)
• RBC Morphology in Sickle Cell Disease (HbSS)
• RBC morphology in Sickle Cell Anemia variant (HbSC)
• Question
• CBC results and RBC morphology
• Hemoglobin Electrophoresis
• CBC and RBC morphology
• Hemoglobin Electrophoresis
• CBC and RBC morphology
• Hemoglobin Electrophoresis
• CBC and RBC morphology
• Hemoglobin Electrophoresis
• CBC and RBC morphology
• Hemoglobin Electrophoresis
• References
• Foreword
• Advance Organizer
• Introduction
• Immunization to D Antigen
• Factors That Affect Production of Anti-D
• Primary versus Secondary Response
• Typical Case of Rh HDFN (Prior to RhIg)
• Question
• ABO HDFN - Etiology and Symptoms
• ABO HDFN - Diagnostic Tests
• ABO HDFN - Expected Findings
• ABO HDFN - Treatment
• Question
• Symptoms and Laboratory Findings in Severe HDFN Due to Anti-D
• HDFN Due to Other Antibodies
• Question
• Question
• Question
• Question
• Question
• Fetal Monitoring: Doppler Ultrasonography
• Fetal Monitoring: Amniocentesis
• Fetal Monitoring: Cordocentesis
• Prenatal Treatment
• Choosing Donor RBC for IUT and IVT
• Postnatal Treatment: Exchange Transfusion
• Criteria for Transfused Red Blood Cells
• Other Postnatal Treatment
• Question
• Question
• Introduction
• Immunogenicity
• Routine Serologic Tests - Mother
• Routine Serologic Tests - Father
• Newborn Serologic Testing Protocols
• Question
• Molecular Genotyping - Introduction
• Molecular Genotyping - Mother
• Molecular Genotyping - Father and Fetus
• Determining Risk for HDFN Using Molecular Genotyping
• Question
• Question
• Follow-up Investigative Tests (Mother)
• Follow-up Investigative Tests (Father)
• Follow-up Investigative Tests (Fetus)
• Follow-up Investigative Tests (Newborn)
• Question
• Question
• Introduction
• History
• Constituents
• Mechanism of Action
• Question
• Use in Pregnancy
• Related Uses
• RhIg and Rh Complexity
• RhIg & Variants of D
• RhIg Policies for Weak D
• International RhIg Policies
• Clinical Relevance of D Phenotypes
• RhIg Dosage
• RhIg 'Failures'
• Passive Anti-D following RhIg Administration
• Protocols to Deal with RhIg-Derived Anti-D
• Question
• Question
• Question
• Question
• Introduction
• Screening for FMH
• Rosette Test
• Quantifying FMH
• Kleihauer-Betke Test
• Flow Cytometry
• Calculating RhIg Dosage
• Question
• Question
• Question
• Question
• Main Learning Goals
• Literature and Online Resources
• 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
• What is HIPAA?
• Updates for 2013
• Updates for 2013, continued
• Who Does HIPAA Apply To?
• Question
• Privacy is Your Responsibility.
• Importance of Privacy - An Example
• Relevant Components of HIPAA
• What is the HIPAA Privacy Rule?
• What Information is Protected?
• The HIPAA Privacy Rule
• Complaints Regarding HIPAA Non-compliance
• Investigation
• Individual's Rights Under HIPAA
• HIPAA Enforcement
• Administrative Requirements
• Safeguards
• Physical Safeguards
• Administrative Safeguards
• Technical Safeguards
• Fax Machines
• Question
• Question
• Notification
• Authorization
• Limiting Use and Disclosure of PHI
• Question
• Question
• Minimum Necessary Use and Disclosure
• Question
• Question
• Business Associate Agreement
• Business Associates And the Privacy Rule
• HIPAA Breach Notification Rule
• HIPAA Breach Notification Rule, continued
• Question
• De-Identified Health Information
• Question
• HIPAA Harmonization with the Clinical Laboratory Improvement Amendments (CLIA)
• What is the HIPAA Security Rule?
• 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.
• E-mail Security
• Question
• Follow your own Facilities' Policies and Procedures.
• References
• 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
• Caring for HIV/AIDS patients
• Identifying risks and behaviors associated with HIV/AIDS
• Goals of HIV/AIDS Treatment
• Antiretroviral treatment (ART) in HIV/AIDS patients
• Antiretroviral treatment in HIV/AIDS patients cont.
• Types of ART Medications
• Question
• Introduction to HIV/AIDS Stigma
• Counteracting HIV/AIDS Stigma
• Question
• Legislative Intent
• Informed Consent
• Confidentiality
• Reporting results
• Preliminary and Confirmatory Testing
• Question
• References
• Basic Structural Components
• HIV Envelope
• HIV Capsid
• Question
• Proteins Involved in Adsorption
• Adsorption
• Adsorption, continued
• Penetration and Infection
• DNA Conversion from RNA
• HIV is a Retrovirus
• Infection of the Host Cell
• Infection of the Host Cell, continued
• Spread of Infection
• Spread of Infection, continued
• Spread of Infection, continued
• Destruction of the Host Cell
• Question
• Question
• Mutations
• Question
• Stages of HIV Infection
• Question
• HIV Test Methods: Introduction
• Anti-HIV Immunoassays
• Test Interpretation
• Rapid Anti-HIV Assays Using Alternate Specimen Types
• Fourth Generation Immunoassays
• Supplemental Testing Methods
• Nucleic Acid Testing (NAT)
• Reverse Transcriptase PCR (RT-PCR)
• HIV Detection Methods: Comparison Table
• Question
• Question
• References
• Introduction
• Organizations and Agencies
• HPV Structure
• HPV Viral Types
• Low-Risk and High-Risk HPV Types
• HPV Genome and Proteins
• Question
• Question
• HPV as a Sexually Transmitted Infection
• Clinical Diseases Caused by HPV STI Types
• Question
• HPV and Cervical Cancer
• Immune Mediated Regression
• Life Cycle of Human Papillomavirus
• Additional Cervical Cancer Factors
• Carcinogenesis of Cervical Cancer
• Review: Tumor Suppressor Genes, Proto-Oncogenes and Oncogenes
• Carcinogenesis of Cervical Cancer Continued
• Question
• Pap Smear
• Pap Smear Images
• Pap Smear and Cervical Cancer
• Pap Smear Limitations
• Molecular Detection of HPV in Cervical Cytology Specimens
• Nucleic Acids: DNA and RNA
• Base Pairing in Nucleic Acids
• Comparison of DNA and RNA
• Molecular Testing Basics
• Hybridization
• Amplification
• Question
• Question
• Molecular Methods for HR-HPV Testing
• High-Risk HPV Hybrid Capture (HC) 2 DNA Test
• Step 1 High-Risk HPV HC2 DNA Assay
• Step 2 High-Risk HPV HC2 DNA Assay
• Step 3 High-Risk HPV HC2 DNA Assay
• Step 4 High-Risk HPV HC2 DNA Assay
• Step 5 High-Risk HPV HC2 DNA Assay
• Cervista HPV DNA
• Cervista HPV DNA Oligonucleotides
• Cervista HPV DNA Primary Reaction
• Cervista HPV DNA Primary Reaction Continued
• Cervista HPV DNA Secondary Reaction
• Comparison of HPV DNA Testing
• Question
• Question
• Recommended Use of HPV DNA Testing in Cervical Cancer Screening
• Inappropriate Use of HPV DNA Testing
• Case A Michelle
• Question
• Case B Darlene
• Question
• Case C Josephine
• Question
• Case D Debra
• Question
• HPV Vaccines
• HPV Vaccines; Gardasil and Cervarix
• Question
• References
• 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)
• Why Biological Agents Would be Chosen as WMDs
• Why Biological Agents Would be Chosen as WMDs (cont.)
• Why Biological Agents Would Not Be Chosen as WMDs
• Question
• 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
• 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
• Final Remarks
• Additional Information
• Flow Cytometry Course Introduction
• Definitions
• Acceptable Samples
• Sample Preparation
• Sample Analysis
• Detection of Cellular Characteristics
• Detection of Intrinsic Cellular Characteristics: Cell Size and Granularity
• Detection of Extrinsic Cellular Characteristics: Surface Antigens
• Question
• Staining Illustration
• T-Helper Cell Example
• Suppressor Cell Example
• Flow Cytometry and Human Immunodeficiency Virus Clinical Application
• Calculating Absolute Cell Counts
• Calculating Absolute Cell Counts- continued
• Question
• Identifying General Cell Types Associated With Surface Markers
• Cytogram for Cellular Scatter: Intrinsic Characteristics
• White Blood Cells and Cytogram for Cellular Scatter
• Extrinsic Cell Characteristics
• Question
• Gating: Selecting the Population of Interest
• Using Cell Surface Markers as Tools For Diagnosis
• Diagnostic Process
• Principles of Flow Cytometry
• Data Analysis for Flow Cytometry
• Case One
• Scatter and CD45
• Question
• CD19 and CD20
• Question
• CD10, HLA-DR, Kappa, and Lambda
• Question
• T Cell Markers
• Question
• Final Interpretation of Case #1
• Case Two
• Scatter and Gating
• T Cell Analysis
• B Cell Analysis and Final Interpretation of Case Two
• References
• Quality Control and a Quality Control Plan
• Question
• Quality Control Tools
• Intralaboratory (Internal) Quality Control
• Assayed and Unassayed Controls
• Internal Quality Control Program
• Determining the Frequency for QC Testing
• Additional Variables
• Instrument Maintenance
• Record Keeping
• External Quality Assessment
• Question
• Question
• Delta Checks
• Accuracy and Precision
• Mean and Standard Deviation
• Calculating Acceptable Ranges
• Calculating Acceptable Ranges, continued
• Coefficient of Variation
• Question
• Question
• Levey-Jennings Quality Control Charts
• Random and Systematic Error
• Random and Systematic Errors, continued
• Westgard Multi-Rule Approach
• Westgard Multi-Rule Approach, continued
• Responding to Out-of-Control Results
• Question
• Question
• References
• Importance of Understanding the ABO System
• The History of the ABO System
• The History of the ABO System, continued
• 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
• Strength of the A Antigen
• A1 and A2 Subgroups
• 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
• 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
• Determining Possible Offspring
• Punnett Squares
• Question
• Question
• Question
• Question
• 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
• Sepsis Definition
• Additional Criteria for Diagnosis of Sepsis
• Severe Sepsis
• Septic Shock
• Sepsis and Bacterial Toxins
• Question
• Biomarkers
• Glucose
• C-Reactive Protein (CRP)
• Procalcitonin (PCT)
• Procalcitonin (PCT) as a Sepsis Biomarker
• Lactic Acid (Lactate)
• Lactic Acid (Lactate), continued
• Question
• Question
• Question
• Question
• Mechanism of C-Reactive Protein (CRP)
• Mechanism of Procalcitonin (PCT)
• Mechanism of Lactic Acid (Lactate)
• Other Causes of Increased Lactic Acid (Lactate) Concentration
• Question
• Increase in Sepsis Cases
• Novel Biomarkers That Focus on Immunosuppression
• References
• Laws and Rules of the Florida Board
• Your Role
• The Board of Clinical Laboratory Personnel
• Question
• Clinical Laboratory Personnel License
• Types of Licenses
• Special Licenses
• Director Responsibilities
• Director Qualifications
• Supervisor Responsibilities
• Supervisor Qualifications
• Technologist Responsibilities
• Technologist Qualifications
• Technician Responsibilities
• Technician Qualifications
• Summary of Qualifications
• Public Health Laboratory Scientists
• Approved National Certifying Agencies
• 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 License
• Question
• Question
• License Fees
• Continuing Education Requirements for Renewal
• CEBroker
• Question
• Rules Violations
• Competency and Licensing Violations
• Advertisement and Report Violations
• Personal Conduct Violations
• Capability Violations
• Kickback and Inducement Violations
• Disciplinary Violations
• Failing to Report a Violation
• Penalties for Violations
• License on Probation
• Question
• Question
• More Information and Web Links
• 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
• State of Health Care Quality
• Six Institute of Medicine Aims
• Six Institute of Medicine Aims (continued)
• Improving Effectiveness
• Focusing upon Patient-Centered Care and Timeliness
• Preventing Medical Errors Through Patient Involvement
• Focusing upon Efficiency and Equity
• Question
• Clinical Laboratory Services and Safety
• Question
• Clinical Laboratory Services and Effectiveness
• Clinical Laboratory Services and Patient-Centered Care
• Clinical Laboratory Services and Timeliness
• Clinical Laboratory Services and Efficiency
• Clinical Laboratory Services and Equity
• Question
• Medical Errors
• Question
• Total Testing Process
• Safe Preanalytic Component of Total Testing Process
• Safe Analytic Component of Total Testing Process
• Safe Postanalytic Component of Total Testing Process
• Patient-Centered Preanalytic Component of Total Testing Process
• Patient-Centered Analytic Component of Total Testing Process
• Patient-Centered Postanalytic Component of Total Testing Process
• Timely: Reduce Wait Times and Harmful Delays
• Timely: Reduce Waits and Harmful Delays (continued)
• Question
• Outcomes of Laboratory Services
• Reporting of Errors
• Root Cause Analysis
• Root Cause Analysis (continued)
• Root Cause Analysis Example
• Failure Mode and Effect Analysis
• Question
• Monitoring Laboratory Processes to Prevent Medical Errors
• Data sources to identify errors
• Question
• The Joint Commission National Patient Safety Goals 2013 for Clinical Laboratories
• National Patient Safety Goal: Identify Patients Correctly
• Question
• National Patient Safety Goal: Improve Staff Communication
• National Patient Safety Goal: Prevent Infection Through Hand Hygiene
• Measurement and the Improvement of Clinical Laboratory Services
• References
• 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
• 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
• Metabolic Syndrome
• Other Names for Metabolic Syndrome
• Medical Complications of Metabolic Syndrome
• The Importance of Diagnosing Metabolic Syndrome
• Question
• Question
• Risk Factors
• Insulin Resistance
• Obesity
• Other Contributing Factors
• Adipose Tissue as an Endocrine System
• Role of Adipokines
• Adipokines Significant to Metabolic Syndrome
• TNF-alpha
• IL-6
• PAI-1
• Adiponectin
• Angiotensinogen
• Leptin
• Resistin
• Question
• Question
• Adipokines and Atherosclerotic Inflammatory Process
• Adipokines and Atherosclerotic Inflammatory Process Continued
• Endothelial Dysfunction
• Question
• Dyslipidemia and Metabolic Syndrome
• Small Dense LDL Molecules
• Atherogenic Dyslipidemia
• Question
• Question
• Hyperglycemia
• Hypertension
• Prothrombotic State
• C-Reactive Protein (CRP)
• CRP Measurement
• Question
• Question
• Question
• Question
• Variation in Diagnostic Criteria
• Adult Treatment Panel III
• NCEP: ATP III Diagnostic Criteria for Metabolic Syndrome
• Question
• Treatment
• Magnesium, Calcium, and Vitamin D
• Question
• Clinical Laboratory Testing in Metabolic Syndrome
• Analytes and Target Ranges Pertinent to Metabolic Syndrome
• Question
• Question
• References
• Prior to 1985
• Chlamydia trachomatis and Neisseria gonorrhoeae
• Human Papilloma Virus (HPV) and Mycobacterium
• Hepatitis and Viral Load Testing
• Question
• Question
• The Key Benefits: Improved Sensitivity of Detection
• The Key Benefits: Improved Sensitivity of Detection, continued
• The Key Benefits: Specificity of Identification
• The Key Benefits: Reduced Turnaround Time
• Question
• Question
• Challenges for Implementation: Space Requirements
• Challenges for Implementation: Separation of Key Activities
• Challenges for Implementation: Workflow Requirements
• Challenges for Implementation: Required Work Skills
• Challenges for Implementation: Cost
• Question
• Question
• Categories of Methods
• Polymerase Chain Reaction (PCR)
• Reverse Transcriptase Polymerase Chain Reaction (RT-PCR)
• Detection and Identification of Polymerase Chain Reaction (PCR) Products
• Detection and Identification of Polymerase Chain Reaction (PCR) Products: Advantages of Real-Time PCR
• Question
• Question
• Identification of Staphylococcus aureus with Peptide Nucleic Acid (PNA)-Fluorescence In Situ Hybridization (FISH)
• Detection and Identification of Methicillin-resistant Staphylococcus aureus (MRSA) by Polymerase Chain Reaction (PCR)
• Development of Assays
• Molecular Versus Culture - Pros and Cons
• Current and Future Prospects
• Question
• Question
• Prior Traditional Methods and the Need for Change
• Introduction of Molecular Methods
• 2009 - Swine Flu
• Improvements for Influenza Testing
• Question
• Question
• Clinical Significance
• Previous Methodologies: Culture and Cell Cytotoxicity Neutralization Assay (CCNA)
• Previous Methodologies: Antigenic Detection of Toxin and Glutamate Dehydrogenase (GDH)
• Molecular Methods
• BD GeneOhm™
• illumigene®
• Question
• Question
• References
• Methicillin Resistant Staphylococcus aureus
• Vancomycin Resistant Enterococci
• Clostridium difficile
• Question
• Staphylococcus aureus
• Staphylococcus aureus Virulence Factors
• Question
• Clinical significance of Staphylococcus aureus
• Beta-lactam antibiotics and S. aureus
• Question
• Question
• Beta-lactams and Methicillin Resistant Staphylococcus aureus
• Healthcare (Hospital)-Associated MRSA versus Community-Associated MRSA
• Risk Factors
• Question
• Question
• Laboratory Identification of Staphylococcus aureus
• Screening Cultures for MRSA
• Question
• Susceptibility Testing
• Selection of Drugs for Testing
• Interpretation of Oxacillin Broth Dilution Tests.
• Interpretation of Oxacillin and Cefoxitin Disk Diffusion Tests
• Detection of Oxacillin Resistance
• Question
• Question
• MRSA Treatment/Vancomycin Resistance
• VISA and VRSA
• Testing for Vancomycin Susceptibility
• Question
• Future perspectives
• Future Perspectives, continued
• Future Perspectives, continued
• Question
• Enterococci
• Risk Factors and Resistance
• Question
• Vancomycin Resistant Enterococci Phenotypes
• Question
• Identification of Enterococcus species from clinical cultures
• Screening Cultures for Vancomycin Resistant Enterococci
• Susceptibility testing of Enterococci
• Detecting Vancomycin Resistance
• HLR screening
• Question
• Question
• Newer antibiotics for Treatment of Resistant Enterococci
• Clostridium Species
• Clostridium difficile
• C. difficile Toxin A and Toxin B
• Pathogenisis of C. Difficile-Associated Diarrhea
• Risk factors for Clostridium difficile Infection
• Clostridium difficile-associated Diarrhea
• Question
• Strain BI/NAP1/027
• Laboratory Detection of Clostridium difficile
• Stool Culture
• Cell Cytotoxicity Neutralization Assay (CCNA)
• Enzyme Immunoassay Methods
• Question
• Glutamate Dehydrogenase (GDH) Antigen Assays
• Molecular Methods
• Question
• Treatment of Clostridium difficile Infection (CDI) and C. difficile Associated Disease (CDAD)
• Disinfection & Control of C. difficile Infection
• Future perspectives - CDI/CDAD
• References
• 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 to the Identification of Molds
• Terminology Related to Morphologic Features of Molds
• Preliminary Identification Methods for Various Yeasts
• Morphologic Features of Yeast Colonies
• Microscopic Morphologic Features of Yeast
• Malassezia
• Question
• Question
• Interpretation of Growth Patterns on Cornmeal Agar
• Examples of Cornmeal Agar Morphologies
• Question
• Question
• Question
• Evaluating the Need for Full Identification of Yeast
• Recommended Procedure for Identification of Cryptococcus neoformans
• Question
• Question
• Question
• What are Dimorphic Fungi
• Microscopic Morphologic Features of the Mold Forms of Various Dimorphic Fungi
• Microscopic Morphologic Features of the Yeast Forms of Various Dimorphic Fungi
• Culture Confirmation Methods
• Histoplasma capsulatum
• Coccidioides immitis
• Sporothrix schenckii
• Blastomyces dermatitidis
• Paracoccidioides brasiliensis
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Differentiating Dimorphic Fungi from Saprophytic Molds
• Inhibiting the Growth of Saprophytic Molds
• Question
• Question
• References
• The Cellular Components of Blood
• Erythrocytes or Red Blood Cells (RBC's)
• Leukocytes or White Blood Cells (WBC's)
• Thrombocytes or Platelets
• Identifying Peripheral Blood Cells
• Question
• Introduction to Segmented and Band Nuclei
• Appearance of a Band Neutrophil
• Maturing into Segmented Neutrophil
• Segmented Neutrophils
• Differentiating Bands from Segs
• Question
• Question
• Eosinophils
• Difference Between Eosinophilic Granules and Neutrophilic Granules
• The Nucleus of a Eosinophil
• Question
• Basophils
• Basophil Granules and Chromatin Pattern
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Primary Function of Neutrophils
• More on Phagocytosis in Neutrophils
• Eosinophil Function and Lifespan
• Basophil Function and Lifespan
• Mast Cells
• Question
• Question
• Question
• Mononuclear Cells: Lymphocytes and Monocytes.
• Lymphocytes
• Large Lymphocytes and Reactive Lymphocytes
• When Lymphocytes Transform
• Question
• Question
• Monocyte Appearance
• Differentiating Monocytes from Large Lymphocytes
• Differentiating Monocytes from Large Lymphocytes: Table.
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• What is the Function of Lymphocytes?
• Null Cells
• Monocytic Function
• Question
• Question
• Question
• Question
• Platelet Appearance
• Platelet Clumps
• Platelet Kinetics
• Platelet Function
• Question
• Appearance of the Erythrocyte
• Erythrocyte Function and Kinetics
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Glossary of Terms A through M.
• Glossary of Terms N through Z.
• You Are At Risk!
• About This Course
• What Causes Hepatitis B Infection?
• Occupational Exposure to HBV
• Spread of HBV In The Community
• Blood Needed For Transmission
• What Happens After HBV Infection?
• Chronic Hepatitis B Infection
• Infectious Period
• Who is infected?
• How Can HBV Be Prevented?
• What Causes HIV Infection?
• How is HIV Contracted?
• What Happens After HIV Infection?
• How Easily is HIV Transmitted?
• How Can HIV Be Prevented?
• Hepatitis C Virus (HCV)
• HCV Infection
• Information From The Centers for Disease Control and Prevention (CDC) Regarding Hepatitis C
• What Happens After Hepatitis C Infection?
• Question
• Question
• Occupational Exposure Standard
• Components of the OSHA Bloodborne Pathogens Standard
• The Exposure Control Plan
• Preventive Measures
• The Hepatitis B Vaccination
• Standard Precautions
• Methods of Control
• Engineering Controls
• Work Practice Controls
• Sharps
• Needles, safety needles, and needleless systems
• Sharps Safety Summary
• Handling Specimens
• Transporting Specimens
• Labeling and Color-Coding Specimen Containers for Storage and Transport
• Housekeeping
• Small Surface Spills
• Broken Glassware
• Contaminated Wastes
• Contaminated Sharps
• Biohazard Labeled Bags
• Contaminated Laundry
• Labeling
• Labeling not Required
• PPE and the OSHA Standard
• Personal Protective Equipment
• Gloves Must be Worn...
• Gloves
• Face and Eye Protection
• Garments worn as Personal Protective Equipment
• Question
• Question
• Importance of Hand Hygiene
• Handwashing Procedure
• Antiseptic Hand Cleanser
• Exposure Incident
• If an Exposure Occurs
• Evaluation and Treatment
• Avoiding Exposure
• Question
• Question
• References
• Introduction
• The Hazards of Electricity
• Basic Elements of Electricity
• Static Electricity
• Electricity-induced Injury
• Factors that Determine the Degree of Electricity-induced Injury
• Alternating Current vs. Direct Current
• Electrical Resistance and Current Pathway Through the Body
• Question
• Question
• Extension Cords
• Adapters
• Unplugging an Electrical Cord
• Ground
• Space Heaters
• Space Heater Requirements
• Checks and Inspections
• Electrical Hazard Awareness
• Potential Electrical Hazards
• Circuit Breaker Panels
• Question
• Question
• Performing Maintenance or Repair Tasks on Electrical Equipment
• Lockout/Tagout (LOTO) Procedures
• Question
• Class C Fires
• Electrical Fires
• Electrical Fires, continued
• Question
• Question
• Electrical Shock
• Electrical Burns
• Question
• References
• Introduction
• Be Alert and Knowledgeable
• Question
• Classes of Fire and Proper Types of Extinguishers
• Class A Fires
• Class B Fires
• Class C Fires
• Question
• Fire Safety Responsibility
• Laboratory Situations That May Create or Contribute to a Fire
• Question
• Fire Safety Policies and Procedures
• Know the Work Area
• Good Housekeeping
• Proper Storage of Flammable or Combustible Liquids and Gases
• Fire Plan & Fire Drills
• Question
• Remain Calm
• Decision to Fight or Evacuate
• Question
• PASS
• Question
• RACE
• References
• What is Formaldehyde?
• Where is Formaldehyde Used?
• What Does Formaldehyde Do?
• Symptoms of Overexposure
• A Carcinogen
• Relevant OSHA Standards
• Surveillance Questionnaire
• Manufacturer's Label
• Safety Data Sheet
• Environment Monitoring for Formaldehyde
• How is Exposure to Formaldehyde Monitored?
• Monitoring Results
• 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)
• In Case of Contamination
• In Case of a Spill
• References
• Introduction
• Respect!
• In the Past
• In the Present
• Haz-Com
• Regulation of Chemical Hazards in the Laboratory
• Question
• Employer Responsibility
• Your Responsibility
• Globally Harmonized System for Labeling of Chemicals
• Hazard Labels: National Fire Protection Association (NFPA)
• Other Labeling Systems
• Labeling Secondary Containers
• Question
• Right to Know
• Be Prepared
• Sections
• SDS Example
• Sections Two and Three
• Section Four
• Sections Five and Six
• Sections Seven and Eight
• Sections Nine Through Eleven
• Sections Twelve Through Sixteen
• Question
• General Laboratory Precautions
• Ingestion Prevention
• Management of Spill & Disposal
• Wash Your Hands!
• Personal Protective Equipment
• Eyewash Stations
• Reducing the Risk of Fires Involving Chemicals
• Monitoring
• Question
• Common Sense Rules
• Common Sense Rules, continued
• Keep It Safe!
• References
• Organizations Responsible for Regulating Transport of Hazardous Materials
• Updates
• Information Related to Packaging and Shipping Category A Infectious Substances: IATA Updates
• Information Related to Packaging and Shipping Category A infectious Substances: FedEx Updates
• Packaging and Shipping Infectious Substances
• 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
• IATA and US Postal Service Exempt Specimens
• Exempt Specimen Packaging and Labeling
• DOT Classification Decision Tree
• IATA Classification Decision Tree
• Classification Scenario 1
• Classification Scenario 2
• Classification Scenario 3
• Question
• Classification Scenario 4
• Transporting Infectious Substances by Motor Vehicle
• Exceptions for Category B Substances When Transported by Motor Vehicle
• 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
• General Labeling Requirements
• 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
• FedEx Requirements: 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
• Air Waybill
• Question
• Question
• Question
• Question
• Security Awareness
• Security Plan for Category A Infectious Substances
• Security Training Resource
• References
• 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 Metabolism, continued
• Question
• CYP450 Induction and Inhibition
• CYP450 Induction and Inhibition, continued
• Question
• Genotype versus Phenotype
• Genotype versus Phenotype, continued
• TDM and PGx
• The Bottom Line
• The Bottom Line, continued
• References
• Select Agents of Bioterrorism
• Development of the Laboratory Response Network (LRN)
• Purpose of the Laboratory Response Network (LRN)
• Question
• Definition of a Sentinel Laboratory
• Role of a Sentinel Laboratory
• Basic Sentinel Laboratory within the Laboratory Response Network (LRN)
• Advanced Sentinel Laboratory within the Laboratory Response Network (LRN)
• Question
• Role of Reference and National Laboratories Within the Laboratory Response Network (LRN)
• Question
• Protocols
• Additional Resources
• Question
• Why Certain Agents are Used as Weapons of Mass Destruction (WMD)
• Question
• Categories of Biological Agents
• Category A Agents
• Category A Agents: Reasons Why They May be Used to Create Public Health Emergencies
• Category B Agents
• Category B Agents: Reasons Why They May be Used to Create Public Health Emergencies:
• Category C Agents
• Question
• Sentinel Laboratory Safety Protocols
• Agent Biosafety Level (BSL) Requirements and Laboratory Exposure Risk
• Question
• Bacillus anthracis
• Yersinia pestis
• Francisella tularensis
• Brucella species
• Burkholderia species
• Question
• Bacillus anthracis
• Yersinia pestis
• Francisella tularensis
• Brucella species
• Burkholderia species
• Question
• Bacillus anthracis
• Yersinia pestis
• Francisella tularensis
• Brucella species
• Burkholderia species
• Question
• Considerations When Using Automated Identification Systems
• Commonly Misidentified Agents
• Question
• Bacillus anthrasis
• Yersinia pestis
• Francisella tularensis
• Brucella species
• Burkholderia species
• Question
• Location Where Organisms Naturally Occur, Disease Produced, and Mode of Transmission
• Location Where Organisms Naturally Occur, Disease Produced, and Mode of Transmission, continued:
• Question
• Role of a Sentinel Laboratory Regarding Toxins and Viruses
• Toxins
• Viruses
• Question
• References
• What is Quality Control?
• What is a Control?
• Safety and Handling of Controls
• Appearance of Controls
• Why Run Controls?
• Assayed and Unassayed Controls
• 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
• Calculating Sensitivity
• Sensitivity Example: Calculations (1)
• Sensitivity Example: Calculations (2)
• Sensitivity Example: Comparison
• Specificity versus Sensitivity
• Question
• Types of Error
• Random Error
• Systematic Error
• Question
• Internal Quality Control
• External Quality Control
• External Quality Control, continued
• External Quality Control, continued
• Comparing Types of Quality Control
• Question
• Reference Ranges
• Mean
• Histograms
• Standard Deviation
• Acceptable Standard Deviation (SD)
• Establishing Quality Control Limits
• Question
• Levey-Jennings Control Charts
• What is a Levey-Jennings Chart?
• Question
• Using Westgard Rules
• Westgard Rule 13S
• Westgard Rule 22S
• Westgard Rule 41s
• Westgard Rule R4s
• 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 Actions
• Possible Corrective Actions, continued
• Possible Corrective Action, continued
• Possible Corrective Action, continued
• Possible Corrective Action, continued
• Question
• Verification of Performance Specifications for Nonwaived Testing
• Verification for Nonwaived Testing
• References
• What is the Value of a Direct Smear?
• Determine the Quality of a Sputum Specimen
• Determine the Quality of a Urine Specimen Submitted for Culture
• Provide the Clinician With Same-Day Information Regarding Possible Pathogens
• Cerebrospinal Fluid and Specimens Collected from Other Sterile Sites
• Correlate Direct Smear Results With Culture Results
• Question
• Question
• Gram Stain Principle
• Quality Control Smears
• Macroscopic Evaluation of the Smear
• Thick Smears
• Thin Smears
• Properly Decolorized Smears
• Under-decolorized or Over-decolorized Smears
• Reporting Microscopic Findings
• Contaminated Gram Stain Solution
• Summary of Gram Stain Reading and Reporting Procedure
• Question
• Question
• Question
• Question
• Question
• Gram-positive Cocci
• Gram-positive Diplococci
• Gram-negative Cocci
• Intracellular Bacteria
• Gram-negative Diplococci
• Special Considerations for Genital Smears
• Gram-positive Bacilli
• Gram-negative Bacilli
• Significance of Specific Findings
• Question
• Question
• Question
• Size and Appearance of Nonbacterial Cellular Elements on Gram Stained Smears
• Question
• Question
• Question
• Question
• References
• Culture, Isolation, and Identification of Microorganisms
• Question
• Question
• Gram Stain
• Preparation of a Gram Stained Smear From Culture
• Quality Control (QC)
• Gram Stain Quality Control (QC) Organisms
• Examining the Smear
• Question
• Question
• Cocci and Rods
• Variations in the Shape of Cocci
• Variation in the Shape of Bacilli
• Gram-Negative Rods (GNRs)
• Question
• Question
• Cellular Arrangement
• Single Cell Arrangement
• Pair Cell Arrangement
• Chain Cell Arrangement
• Tetrad Cell Arrangement
• Clusters of Gram-Positive Bacteria
• Yeast Cells
• Question
• Gram-Positive Organisms Recovered From Culture
• Images: Gram-Positive Cocci (GPC) Recovered From Culture
• Images: Gram-Positive Rods (GPRs) Recovered From Culture
• Gram-Negative Organisms Recovered From Culture
• Images: Gram-Negative Organisms Recovered From Culture
• Question
• Organisms Expected From Common Body Sites/Specimens
• Organisms Expected From Common Body Sites/Specimens, continued
• Organisms Expected From Common Body Sites/Specimens, continued
• Gram-Stained Smears From Culture: Importance and Reporting
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• References
• Historical Landmarks in Molecular Diagnostics
• Molecular Composition of DNA
• Molecular Composition of RNA
• DNA/RNA Structural Diagram
• Formation of DNA and RNA Strands
• Question
• Question
• DNA Isolation
• Automated Vs. Manual Extraction
• Question
• PCR Introduction
• Reaction Mixture
• DNA Primers
• DNA Polymerase
• Question
• Denaturaton
• Annealing (Hybridization)
• Extension
• Repetitive Cycling
• Diagram of PCR Process
• Question
• Analyzing PCR Results
• Reverse Transcriptase PCR (RT-PCR)
• Introduction to Real-Time PCR
• Advantages of Real-Time PCR
• Stages of Real-Time PCR
• Diagram of the Real-Time PCR Stages
• Detection Methods
• FRET
• Question
• Question
• Real-Time Reverse-Transcriptase- PCR
• Quantification
• Real-Time PCR Computer Results
• Question
• Laboratory Applications
• Multiplexing
• Microbe Detection
• SNP Detection
• Viral Load
• Question
• Question
• Conclusion
• References
• Normal Red Blood Cell (RBC) Morphology
• Evaluating Initial Red Blood Cell (RBC) Morphology
• Criteria for Peripheral Blood Smear Review
• Introduction to Red Blood Cell Morphology Reporting
• Guidelines for Reporting Red Blood Cell Morphology
• Question
• Red Cell Morphology Reference Tables
• Anisocytosis Reference Table
• Hemoglobin Content Reference Table
• Poikilocytosis Review Table
• Rouleaux and Agglutination
• Dimorphic (Double Cell) Population
• Introduction to Red Blood Cell Nonneoplastic Conditions Case Studies
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Hemoglobin E (Hb E) and HbE/Beta Thalassemia
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Question
• Ovalocytes/Elliptocytes
• Stomatocytes
• Question
• Question
• Question
• Case History
• Splenectomy Morphologies
• Poikylocytosis and Basophilic Stippling
• References
• Red Blood Cell (RBC) Morphology
• Assessing Red Cell Morphology: Area of Evaluation
• Normal Red Cells
• Abnormal Red Cells
• Artifactual Morphology
• Question
• Question
• Anisocytosis
• Normal RBC Size
• Microcyte
• Microcyte with Normal Hemoglobin Content
• Macrocyte
• Another Example of Macrocytosis
• Question
• Question
• Hemoglobin Concentration
• Color of Erythrocytes
• Hypochromia and Hyperchromia
• Normochromic Red Cells
• Polychromasia
• Hypochromia
• Question
• Question
• Question
• Poikilocytosis
• Red Cell Variations in Shape
• Acanthocytes
• Acanthocytes, continued
• Target Cells (Codocytes)
• Target Cells, continued
• Teardrop Cells (Dacrocytes)
• Teardrop Cells, continued
• Sickle Cells (Drepanocytes)
• Sickle Cells, continued
• Burr Cells (Echinocytes)
• Elliptocytes (Ovalocytes)
• Elliptocytes, continued
• Fragmented Red Blood Cells
• Prekeratocytes or Blister Cells
• Keratocytes
• Keratocytes, continued
• Spherocytes
• Conditions Associated with Spherocytes
• Stomatocytes
• Stomatocytes, continued
• Summary
• Question
• Question
• Question
• Question
• Question
• Question
• Rouleaux and Autoagglutinaton
• True Rouleaux
• Artifactual Rouleaux
• Autoagglutination
• Another Example of Autoagglutination
• Question
• Question
• Question
• References
• Introduction
• Case Presentation
• ABO, Rh, and Antibody Screen
• Question
• Question
• Antigram to explain prior question
• Question
• Perinatal Testing Programs
• Immunogenicity
• Routine Serologic Tests - Mother
• Routine Serologic Tests - Father
• Routine Serologic Tests - Newborn Protocols
• Routine Serologic Tests - Newborn
• Question
• Question
• Introduction
• Antibody Exclusion Protocol (General)
• Question
• Antibody Exclusion Protocols (RhIg)
• Passive or Active Immunization?
• Antibody Titration
• RhIg-Derived Anti-D Reaction Strength
• Factors Affecting RhIg Reaction Strength
• How Long Can RhIg Be Detected?
• How Much Testing?
• Question
• Question
• Question
• Question
• Constituents
• Suppliers / Trade Names
• Mechanism of Action
• Question
• Question
• Question
• Use in Pregnancy
• Related Uses
• RhIg and Rh Complexity
• RhIg & Variants of D
• RhIg Policies for Weak D
• International RhIg Policies
• Clinical Relevance of D Phenotypes
• RhIg Dosage
• RhIg 'Failures'
• Question
• Question
• Question
• Question
• Question
• Introduction
• Mini-Panel Antibody Exclusion
• Question
• Serologic Tests on Newborn
• Question
• Question
• Question
• Newborn's Clinical Status
• Question
• Screening for Fetomaternal Hemorrhage
• Rosette Test
• Quantifying FMH
• Kleihauer-Betke Test
• Flow Cytometry
• Calculating RhIg Dosage
• Assessing FMH and RhIg Dosage
• Crossmatch Issues
• Crossmatch Implications of RhIg-associated Passive Anti-D
• Crossmatch Practices Related to RhIg - Introduction
• LIS Issues Related to RhIg
• Crossmatch Practices Related to RhIg - Examples
• Question
• Question
• Question
• Question
• Question
• Case Summary
• Main Learning Goals
• Literature and Online Resources
• Introduction to Risk Management
• Introduction to Risk Management (continued)
• Definitions of Risk and Risk Management
• Why Manage Risk?
• Question
• Federal Regulations for Risk Management
• Clinical Laboratory Improvement Amendments of 1988 (CLIA)
• Health Insurance Portability and Accountability Act of 1996
• Occupational Safety and Health Administration (OSHA)
• Safe Medical Devices Act of 1990 (SMDA)
• The Patient Safety and Quality Improvement Act of 2005
• State Regulations for Risk Management
• Question
• Introduction to Patient Safety and Risk Exposures
• Preanalytic Phase
• Analytic Phase
• Postanalytic Phase
• Question
• Introduction to the Risk Management Process
• Identify and Analyze Loss Exposure
• Model of Accident Causation
• Root Cause Analysis
• The Fishbone Diagram
• Examining Alternative Risk Management Treatments
• Select the Best Risk Management Treatment(s)
• Errors Related to Risk Management
• Question
• Monitor and Improve Risk Management Treatment(s)
• Failure Mode and Effect Analysis
• Question
• Accrediting Organizations
• Risk Management Accrediting Organizations: Joint Commission
• Risk Management Accrediting Organizations: College of American Pathologists
• Risk Management Accrediting Organizations: Commission on Laboratory Accreditation
• Introduction to Risk Management and Employment Practices Liability
• Pre-Employment Screening
• Employee Competence Assessment
• Legal Concerns and Risk Management
• References and Recommended Reading
• 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
• Composition of Semen
• Purpose of Semen Analysis
• Limits of Semen Analysis
• Safety Precautions
• Question
• Question
• Specimen Identification
• Collection
• Collection (continued)
• Documenting Collection Information
• Question
• Question
• Beginning the Analysis
• Liquefaction
• Appearance of Semen
• Volume
• Viscosity
• pH
• Question
• Question
• Question
• Initial Microscopic Examination of Semen
• Motility: Standardization of Assessment Method
• Assessing Motility
• Assessing Motility: Example of Non-progressive Motility
• Wet Mount Assessment of Sperm Motility
• Automated Procedures
• Viability
• Sperm Concentration and Total Sperm Number
• Sperm Counting Methods
• Improved Neubauer Hemocytometer
• Diluting a Specimen for Counting on a Hemocytometer
• Loading the Hemocytometer and Performing the Count
• Criteria for Sperm Counts Using a Hemocytometer
• Other Counting Chambers
• Assessment of Post-Vasectomy and Azoospermic Specimens
• Question
• Question
• Other Cells in Semen: Epithelial cells
• Other Cells in Semen: Round Cells and Red Blood Cells (RBCs)
• Other Cells in Semen: Round cells and RBCs (continued)
• Round Cells in Semen
• Question
• Question
• Morphology of sperm
• Preparing Semen Smears for Evaluation of Sperm Morphology
• Evaluating Sperm Morphology
• Abnormal Forms
• Abnormal Heads
• Abnormal Tails
• Normal Head Shape
• Sperm with Enlarged Head and Split Tail
• Double-headed Sperm
• Pinhead
• Two Abnormalities
• Tapered head
• Constricted head sperm
• Question
• Question
• Question
• Summary: Reference Values
• References
• Introduction
• Effective Communication
• Sample Integrity
• Question
• Pediatric Patients
• Hints For Successful Pediatric Venipuncture
• Reducing Pain for Pediatric Patients
• Geriatric Patients
• Case Study One
• Case Study One: Discussion
• Patients with Needle Phobia
• Mentally and Physically Disabled Patients
• Language Barriers
• Cultural Diversity and the Phlebotomist
• What To Do if the Patient Feels Faints
• Hematoma
• Clean Up Your Act
• Case Study Two
• Case Study Two: Discussion
• Screening for Diabetes Mellitus and Gestational Diabetes
• Standard and Post Prandial Glucose Tolerace Testing
• Test for Gestational Diabetes
• Case Study Three
• Case Study Three: Discussion
• Therapeutic Drug Monitoring
• Peaks and Troughs
• Collection and Communication
• Question
• Blood Culture Overview
• Blood Culture Collection
• Question
• Special Tests May Mean Special Collections
• Procedure for Using a Winged Blood Collection Device to Collect a Specimen for Coagulation Tests
• Collection From a Line
• Intravenous Line
• Become and Remain a Competent Professional
• 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
• Influenza A Subtype H1N1: Various Names, Same Virus
• Genetic Components of Influenza A Subtype H1N1
• About the Virus
• About the Virus (continued)
• Question
• Epidemiology of the Virus
• Seasonal Influenza A
• How 2009 H1N1 Differs from Seasonal Flu Viruses
• Signs and Symptoms of the H1N1 Virus
• How Severe is the Illness?
• Question
• Impact of the 2009 H1N1 Virus
• WHO Declaration of Pandemic
• Question
• Guidelines for Diagnostic Testing and Treatment
• Laboratory Tests
• Specimen Collection and Storage
• Question
• Survival of the Influenza A 2009 H1N1 Virus
• Contact Precautions for Laboratorians
• Question
• Treatment Options for H1N1 Infection
• H1N1 Vaccine
• Prevention of H1N1 Infection
• Question
• Resources for CDC Surveillance Information
• CDC Surveillance of the Influena A 2009 H1N1 Virus
• Other CDC Actions for the Influenza A 2009 H1N1 Virus
• FDA Surveillance and H1N1 Preparedness
• WHO Surveillance
• References
• Microscopic Examination
• The Urine Microscopic Exam
• 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
• Granular Casts
• Waxy Casts
• Fatty Cast
• Broad Cast
• Cylindroids
• Squamous Epithelial Cell
• Recognition and Identification
• Question
• Question
• Question
• Cell Types Observed in Urine Sediment
• Squamous Epithelial Cells
• Squamous Cells Under Phase Contrast
• Renal Tubular Epithelial Cell
• Renal Epithelial Cells of Collecting Duct Origin
• Cuboidal Cells
• Transitional Epithelial Cells
• Epithelial Cell Groups
• Urine Sediment
• White Blood Cells Under Phase Contrast and High Power Magnification
• Large Clumps of White 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
• 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
• 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
• Transfusion Reactions: Introduction
• Risks of Transfusion
• Categories of Transfusion Reactions
• Incidence Rates of Transfusion Reactions
• In Vivo Red Cell Destruction
• Causes
• Clinical Signs and Symptoms
• Clinical Laboratory Tests
• Management and Prevention
• Question
• Febrile Nonhemolytic Transfusion Reactions: Definition/Manifestation/Prevalence
• Diagnosis, Treatment and Prevention
• Definition/Manifestations/Prevalence
• Pathophysiology
• Diagnosis, Treatment, and Prevention
• Question
• Question
• Definition and Epidemiology
• Clinical Presentation and Laboratory Findings
• Pathophysiology
• Diagnosis, Treatment, and Prognosis
• Evaluation of Donors Associated with Transfusion-Related Acute Lung Injury (TRALI)
• Prevention of Transfusion-Related Acute Lung Injury (TRALI)
• Question
• Definition and Incidence
• Diagnosis
• Severe Delayed Hemolytic Transfusion Reactions (DHTR)
• Prevention
• Question
• Definition and Incidence
• Clinical Presentation and Diagnosis
• Therapy and Prevention
• Definition/Manifestation/Prevalence
• Pathophysiology, Treatment and Prevention
• Question
• Question
• Presentation and Prevalence
• Bacteria Implicated in Contamination
• Sources of Contamination
• Reducing Transfusion-Associated Septic Reactions
• Question
• Transfusion-Associated Circulatory Overload (TACO)
• Physical and Chemical Mechanisms of Hemolysis
• Iron Overload
• Disease Transmission
• Procedure for a Suspected Adverse Reaction
• Preliminary Laboratory Investigation
• Additional Testing
• Question
• Question
• Records and Reporting
• References
• Introduction
• Tuberculosis Infection
• Symptoms
• How Tuberculosis is Spread
• Infection Control
• High-Risk Infection Groups
• High-Risk Progression Groups
• Vaccine for Tuberculosis
• Question
• Latent Tuberculosis Infection (LTBI) Detection Methods
• Tuberculin Skin Test (TST)
• TST Interpretation and Classification
• TST False Negative Reactions
• Two-Step Skin Testing
• Screening Newly-Hired Health Care Employees for Latent Tuberculosis Infection
• Question
• Centers for Disease Control and Prevention (CDC) Risk Categories
• Tuberculosis Exposure Control Plan
• Health Care Worker (HCW) Tuberculosis Screening
• Question
• Fundamentals of TB Infection Control
• Three Levels of TB Infection Control
• TB Infection Control in the Laboratory
• Biosafety Levels
• Biosafety Level Criteria and Requirements for Handling Specimens Suspected of Containing Mycobacterium tuberculosis
• Question
• Respiratory Protective Equipment
• Proper Use of an N95 Respirator
• Airborne Infection Isolation Room Practices
• Transporting TB Patients
• Protect Yourself
• References
• Variations in Morphology
• Importance of Recognition
• Question
• Hypersegmentation
• Conditions Associated with Hypersegmented Neutrophils
• Hypersegmented Neutrophils
• Hypersegmented Neutrophils (cont.)
• A Normally Segmented Neutrophil
• Question
• Hyposegmentation
• Conditions Associated with Hyposegmented Neutrophils
• Pelger-Huet Anomaly
• Normal Band Forms vs. Pelger-Huet Bands
• Bilobed Neutrophil
• Pelger-Huet Cells
• Single-Lobed Pelger-Huet Cells
• Question
• Barr Body
• Question
• Döhle Bodies
• Döhle Bodies, continued
• Unusually Darkly Staining Döhle Bodies
• Toxic Granulation
• Toxic Granulation and Vacuolation
• Cytoplasmic Vacuolation
• Neutrophil with Normal Granulation
• Question
• Auer Rods
• Auer Rods, continued
• Question
• Question
• Chediak-Higashi Anomaly
• Albinism and Chediak-Higashi Anomaly
• Chediak-Higashi Anomaly vs. Toxic Granulation
• Chediak-Higashi Anomaly Inclusions
• Question
• May-Hegglin Anomaly
• Alder Anomaly (Alder-Reilly Anomaly )
• Alder Anomaly, continued
• Question
• Question
• Question
• Question
• Question
• References
• Peripheral Blood Smear Preparation
• Evaluation Criteria: White Blood Cells and Platelets
• Criteria for Performing a Manual Review of the Smear
• Question
• Smudge Cells
• Platelet Estimates
• Question
• Additional Comments
• Leukemoid Reaction
• Toxic Changes
• Thrombocytosis Associated with Toxic Granulation
• Case History
• Question
• Question
• Question
• Question
• Pelger-Huet Anomaly
• Chediak-Higashi Anomaly
• Alder Anomaly
• May-Hegglin Anomaly
• Question
• WBC inclusions: Summary
• Familial disorders: summary
• Question
• Case One Follow-up
• Question
• Eosinophils
• Basophils
• Question
• Question
• Disorders and Diseases Associated With Increased Monocytes
• Case History One
• Case History Two
• Case History Three
• Multiple Myeloma
• References
• Giant Platelets
• Thrombocytopenia
• Pseudo-thrombocytopenia
• Thrombocytosis
• Question
• Question
• Question
• Question
• Question