Clinical Laboratory & Diagnostics Overview
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Clinical Laboratory & Diagnostics Overview

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Questions and Answers

What is a false positive in urine immunoassay drug testing?

  • A positive test result when the drug is present.
  • An inconclusive test result due to insufficient sample.
  • A positive test result with no presence of the identified substance. (correct)
  • A negative test result when the drug is actually present.

    • Which of the following is a common cause of false positives in drug testing?

  • Ingesting certain foods (correct)
  • Using expired test kits
  • Substituting urine with water
  • Diluting urine samples

    • How can tampering with a urine sample lead to false negatives?

  • By using multiple test kits on the same sample.
  • By consuming drugs after the sample was taken.
  • By altering the sample's temperature.
  • By diluting, substituting, or contaminating the sample. (correct)

    • What should one compare a urine specimen with to validate its results?

    <p>Standard urine composition ranges.</p> Signup and view all the answers

    Which medication is known to cause false positives for PCP?

    <p>Dextromethorphan</p> Signup and view all the answers

    What happens if a urine specimen returns results out of physiological range?

    <p>The validity of the sample is questioned.</p> Signup and view all the answers

    What is a potential consequence of a false negative test result?

    <p>Failure to receive medical treatment.</p> Signup and view all the answers

    Which substance is least likely to cause a false positive in urine drug testing?

    <p>Cocaine</p> Signup and view all the answers

    What is a primary purpose of diagnostics in healthcare?

    <p>To empower the health workforce in identifying diseases</p> Signup and view all the answers

    Which of the following is NOT considered a type of diagnostic study?

    <p>Psychological assessments</p> Signup and view all the answers

    Clinical decision making involves which key aspect?

    <p>Formulating a differential diagnosis</p> Signup and view all the answers

    What teaching style is emphasized for enhancing student experience in this course?

    <p>Experiential and collaborative learning</p> Signup and view all the answers

    Which component is specifically designed to support the objectives in learning?

    <p>Supplemental material</p> Signup and view all the answers

    What is a goal of applying diagnostic studies effectively?

    <p>To achieve the best health outcomes</p> Signup and view all the answers

    In the context of diagnostics, what does 'monitoring' include?

    <p>Regular assessments of health conditions</p> Signup and view all the answers

    Which of the following tools is included in the list of diagnostics?

    <p>Medical devices</p> Signup and view all the answers

    What is the main purpose of lithium in the treatment of bipolar disorder?

    <p>As a first-line mood stabilizer</p> Signup and view all the answers

    What is the therapeutic serum reference range for lithium?

    <p>0.8-1.2 mEq/L</p> Signup and view all the answers

    When should lithium levels be assessed after dosing?

    <p>8-12 hours</p> Signup and view all the answers

    What serum concentration is generally required for acute mania patients treated with lithium?

    <p>High serum concentration levels</p> Signup and view all the answers

    Which factor does NOT influence lithium toxicity in elderly patients?

    <p>History of seizures</p> Signup and view all the answers

    What constitutes a toxic level of lithium?

    <blockquote> <p>2.0mEq/L</p> </blockquote> Signup and view all the answers

    Which of the following statements about lithium treatment is incorrect?

    <p>Frequent measuring of lithium levels is unnecessary for acute mania.</p> Signup and view all the answers

    During which phase of treatment is lower serum concentration levels typically desired?

    <p>For prophylaxis against relapse</p> Signup and view all the answers

    What lithium level is considered toxic?

    <blockquote> <p>2 mEq/L</p> </blockquote> Signup and view all the answers

    Which of the following is NOT a symptom of lithium toxicity?

    <p>Increased appetite</p> Signup and view all the answers

    How often should lithium levels be monitored in the first year after stabilizing concentrations?

    <p>Every three months</p> Signup and view all the answers

    What should be done immediately if lithium toxicity is suspected?

    <p>Check lithium concentration levels and hydrate</p> Signup and view all the answers

    Why does the elderly population require closer monitoring for lithium toxicity?

    <p>Decreased renal function and co-morbidities</p> Signup and view all the answers

    What is the recommended timing for checking lithium levels after dosing?

    <p>8-12 hours</p> Signup and view all the answers

    Which additional labs should be ordered when suspecting lithium toxicity?

    <p>UA, kidney function and electrolyte levels</p> Signup and view all the answers

    What is the recommended action regarding lithium in cases of suspected toxicity?

    <p>Discontinue the medication</p> Signup and view all the answers

    What abnormal result would you expect in a urine sample that indicates potential tampering?

    <p>Low creatinine levels</p> Signup and view all the answers

    Which urine drug testing characteristic reflects the patient's hydration status?

    <p>Specific gravity</p> Signup and view all the answers

    What would be a logical next step after obtaining questionable immunoassay results?

    <p>Perform a confirmatory gas chromatography test</p> Signup and view all the answers

    Which of the following characteristics is considered within normal reference range for urine analysis?

    <p>Temperature of 98°F</p> Signup and view all the answers

    What is a possible explanation for a positive opioid screening in a patient who denies any drug use?

    <p>Consumption of poppy seeds</p> Signup and view all the answers

    What is the significance of urine temperature in the drug testing process?

    <p>Confirms that the sample was collected properly</p> Signup and view all the answers

    In evaluating a urine sample, what might a high creatinine level indicate?

    <p>Normal renal function</p> Signup and view all the answers

    During an assessment, the absence of fever in a patient with gastrointestinal distress suggests what?

    <p>Non-infectious illness</p> Signup and view all the answers

    Study Notes

    Clinical Laboratory & Diagnostics Overview

    • Course Overview Focuses on diagnostic studies and their use in clinical decision making.
    • Teaching Approach:
      • Emphasizes experiential and collaborative learning
      • Utilizes active learning, reflection, and group activities
      • Encourages critical thinking and non-cognitive skills development
      • Fosters a growth mindset and continuous improvement
      • Values student experience

    Diagnostics

    • Definition: "Diagnostics.…important tools that empower the health workforce in the identification of diseases or health conditions” - World Health Organization (WHO)

    What and Why: Diagnostics

    • Tools:
      • History
      • Physical exam/vitals
      • Screenings
      • Imaging/radiology
      • Laboratory tests
      • Procedures
      • Digital health applications
      • Medical devices
    • Diagnostic Studies:
      • Diagnostic tests
      • Radiological tests
      • Imaging studies
      • Laboratory tests
      • Laboratory studies

    What and Why: Diagnostic Studies

    • Importance:
      • Diagnosis: Identifying diseases or health conditions
      • Screening: Detecting potential health issues early
      • Monitoring: Tracking disease progression or treatment effectiveness
      • Management & Treatment Plans: Guiding healthcare decisions

    Clinical Decision Making (CDM)

    • Purpose: to reach a final diagnosis based on gathered information.
    • Process:
      • Formulate a differential diagnosis (list of potential conditions)
      • Utilize diagnostics to "rule in" or "rule out" possible diagnoses

    Lithium Levels

    • Background: Lithium is a mood stabilizer used primarily for Bipolar Disorder.
    • Clinical Use:
      • First-line treatment for manic and depressive phases of bipolar disorder
      • FDA approved for Bipolar I disorder
      • Off-label use for adjunct therapy in depressive disorder

    Lithium Level Considerations

    • Serum Reference Range: Therapeutic levels are typically between 0.8-1.2 mEq/L, but may vary based on individual needs and treatment goals
    • Monitoring: Levels are assessed every 8-12 hours after dosing, frequency may vary based on patient factors
    • Steady State: Most patients reach a steady state within 3-5 days, allowing for less frequent monitoring.
    • Toxicity: Levels above 2 mEq/L are considered toxic

    Lithium Toxicity

    • Clinical Presentation:
      • Nephritis (kidney inflammation)
      • Seizures
      • Cardiac abnormalities
    • Management:
      • No antidote
      • Hydration and medication discontinuation are essential

    Key Takeaways: Lithium Levels & Toxicity

    • Initiating Treatment: Lithium levels are typically checked twice weekly at the start of treatment.
    • Monitoring Frequency:
      • 8-12 hours after dosing when initiating treatment
      • 3-month intervals during the first year of stable levels
      • 6-month intervals thereafter, unless clinical changes occur
    • Elderly Considerations: Closer monitoring is needed due to increased risk of toxicity
    • Suspected Toxicity: Lithium levels should be checked immediately in patients presenting with signs of toxicity. Hydration and discontinuation of lithium should be initiated.

    Case Practice Examples

    • Case 1: Anxious 22-year-old female presenting with increased feelings of anxiousness and sleep difficulties. This case emphasizes baseline lab considerations for initial assessment of anxiety.

    • Case 2: 23-year-old male presenting for a urine drug screen. This case explores specimen validity testing, cross-reactivity of substances in drug testing, and the importance of confirming or refuting disputable findings.

    • Case 3: 68-year-old male with bipolar disorder presenting with nausea, vomiting, loose stools, and fatigue. This case raises awareness of possible lithium toxicity and demonstrates the clinical decision-making process when suspecting drug-related adverse effects.

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    Related Documents

    Clinical Science: Clinical Laboratory & Diagnostics PDF

    Description

    This quiz offers an overview of clinical laboratory practices and diagnostics in healthcare. It emphasizes the importance of various diagnostic tools and the role they play in clinical decision-making. Engage in experiential learning while enhancing your critical thinking and collaborative skills.

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