Podcast
Questions and Answers
What is a false positive in urine immunoassay drug testing?
What is a false positive in urine immunoassay drug testing?
Which of the following is a common cause of false positives in drug testing?
Which of the following is a common cause of false positives in drug testing?
How can tampering with a urine sample lead to false negatives?
How can tampering with a urine sample lead to false negatives?
What should one compare a urine specimen with to validate its results?
What should one compare a urine specimen with to validate its results?
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Which medication is known to cause false positives for PCP?
Which medication is known to cause false positives for PCP?
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What happens if a urine specimen returns results out of physiological range?
What happens if a urine specimen returns results out of physiological range?
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What is a potential consequence of a false negative test result?
What is a potential consequence of a false negative test result?
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Which substance is least likely to cause a false positive in urine drug testing?
Which substance is least likely to cause a false positive in urine drug testing?
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What is a primary purpose of diagnostics in healthcare?
What is a primary purpose of diagnostics in healthcare?
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Which of the following is NOT considered a type of diagnostic study?
Which of the following is NOT considered a type of diagnostic study?
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Clinical decision making involves which key aspect?
Clinical decision making involves which key aspect?
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What teaching style is emphasized for enhancing student experience in this course?
What teaching style is emphasized for enhancing student experience in this course?
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Which component is specifically designed to support the objectives in learning?
Which component is specifically designed to support the objectives in learning?
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What is a goal of applying diagnostic studies effectively?
What is a goal of applying diagnostic studies effectively?
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In the context of diagnostics, what does 'monitoring' include?
In the context of diagnostics, what does 'monitoring' include?
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Which of the following tools is included in the list of diagnostics?
Which of the following tools is included in the list of diagnostics?
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What is the main purpose of lithium in the treatment of bipolar disorder?
What is the main purpose of lithium in the treatment of bipolar disorder?
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What is the therapeutic serum reference range for lithium?
What is the therapeutic serum reference range for lithium?
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When should lithium levels be assessed after dosing?
When should lithium levels be assessed after dosing?
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What serum concentration is generally required for acute mania patients treated with lithium?
What serum concentration is generally required for acute mania patients treated with lithium?
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Which factor does NOT influence lithium toxicity in elderly patients?
Which factor does NOT influence lithium toxicity in elderly patients?
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What constitutes a toxic level of lithium?
What constitutes a toxic level of lithium?
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Which of the following statements about lithium treatment is incorrect?
Which of the following statements about lithium treatment is incorrect?
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During which phase of treatment is lower serum concentration levels typically desired?
During which phase of treatment is lower serum concentration levels typically desired?
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What lithium level is considered toxic?
What lithium level is considered toxic?
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Which of the following is NOT a symptom of lithium toxicity?
Which of the following is NOT a symptom of lithium toxicity?
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How often should lithium levels be monitored in the first year after stabilizing concentrations?
How often should lithium levels be monitored in the first year after stabilizing concentrations?
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What should be done immediately if lithium toxicity is suspected?
What should be done immediately if lithium toxicity is suspected?
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Why does the elderly population require closer monitoring for lithium toxicity?
Why does the elderly population require closer monitoring for lithium toxicity?
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What is the recommended timing for checking lithium levels after dosing?
What is the recommended timing for checking lithium levels after dosing?
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Which additional labs should be ordered when suspecting lithium toxicity?
Which additional labs should be ordered when suspecting lithium toxicity?
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What is the recommended action regarding lithium in cases of suspected toxicity?
What is the recommended action regarding lithium in cases of suspected toxicity?
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What abnormal result would you expect in a urine sample that indicates potential tampering?
What abnormal result would you expect in a urine sample that indicates potential tampering?
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Which urine drug testing characteristic reflects the patient's hydration status?
Which urine drug testing characteristic reflects the patient's hydration status?
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What would be a logical next step after obtaining questionable immunoassay results?
What would be a logical next step after obtaining questionable immunoassay results?
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Which of the following characteristics is considered within normal reference range for urine analysis?
Which of the following characteristics is considered within normal reference range for urine analysis?
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What is a possible explanation for a positive opioid screening in a patient who denies any drug use?
What is a possible explanation for a positive opioid screening in a patient who denies any drug use?
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What is the significance of urine temperature in the drug testing process?
What is the significance of urine temperature in the drug testing process?
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In evaluating a urine sample, what might a high creatinine level indicate?
In evaluating a urine sample, what might a high creatinine level indicate?
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During an assessment, the absence of fever in a patient with gastrointestinal distress suggests what?
During an assessment, the absence of fever in a patient with gastrointestinal distress suggests what?
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Study Notes
Clinical Laboratory & Diagnostics Overview
- Course Overview Focuses on diagnostic studies and their use in clinical decision making.
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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
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Tools:
- History
- Physical exam/vitals
- Screenings
- Imaging/radiology
- Laboratory tests
- Procedures
- Digital health applications
- Medical devices
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Diagnostic Studies:
- Diagnostic tests
- Radiological tests
- Imaging studies
- Laboratory tests
- Laboratory studies
What and Why: Diagnostic Studies
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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.
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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.
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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
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Clinical Presentation:
- Nephritis (kidney inflammation)
- Seizures
- Cardiac abnormalities
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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.
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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
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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.
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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.
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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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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.
