Clinical Patient Investigation Overview
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Questions and Answers

Which step in patient investigation directly follows the Physical Examination?

  • Laboratory Tests (correct)
  • Diagnosis
  • Patient History
  • Imaging Techniques

In the patient investigation process, which step is primarily responsible for determining the appropriate treatment plan?

  • Patient History
  • Evaluation
  • Diagnosis
  • Therapy (correct)

What is a primary characteristic of the core lab facility in a clinical chemistry laboratory?

  • It operates 24 hours a day, 7 days a week. (correct)
  • It requires minimal automation and labor.
  • It operates only during business hours.
  • It focuses primarily on non-stat tests.

Which step is essential for assessing the effectiveness of the treatment administered?

<p>Evaluation (D)</p> Signup and view all the answers

Which statement best describes special chemistry tests?

<p>They are rarely ordered and often use manual methods. (C)</p> Signup and view all the answers

Where are point of care testing (POCT) instruments typically found?

<p>In direct patient care areas like ER and ICU. (A)</p> Signup and view all the answers

Which step involves the collection of significant details about the patient's previous health and current symptoms?

<p>Patient History (A)</p> Signup and view all the answers

What step in patient investigation typically utilizes techniques such as X-rays or MRIs?

<p>Imaging Techniques (C)</p> Signup and view all the answers

What is a significant feature of the instruments used in the core lab facility?

<p>They are highly automated with multi-analyte capabilities. (B)</p> Signup and view all the answers

Why are special chemistry tests classified as generally non-stat tests?

<p>They do not necessitate results to be retrieved immediately. (A)</p> Signup and view all the answers

What year did the Hamilton Regional Laboratory Medicine Program begin its operations?

<p>1998 (A)</p> Signup and view all the answers

Which of the following departments is NOT part of the Hamilton Regional Laboratory Medicine Program?

<p>Clinical Neurology (B)</p> Signup and view all the answers

How many specific procedures does the Hamilton Regional Laboratory Medicine Program perform?

<p>Over 5,000 procedures (D)</p> Signup and view all the answers

What is the gross income generated by the Hamilton Regional Laboratory Medicine Program from tests?

<p>4.5 million dollars (A)</p> Signup and view all the answers

Which of these testing services does the Laboratory Reference Centre NOT provide?

<p>Routine blood tests for local patients (B)</p> Signup and view all the answers

What is a primary characteristic of Laboratory Medicine as a discipline?

<p>It provides diagnostic tests to assess individual health. (C)</p> Signup and view all the answers

What role does Laboratory Medicine play in hospital interactions?

<p>It has a dynamic interaction with all hospital departments to maximize healthcare. (B)</p> Signup and view all the answers

In terms of financial operations, how must the Laboratory Medicine Program function?

<p>It must operate as a non-profit business. (C)</p> Signup and view all the answers

Which of the following best describes the focus of Laboratory Medicine?

<p>To prioritize patient care in an effective and economical manner. (B)</p> Signup and view all the answers

What aspect of Laboratory Medicine is crucial for maintaining the flow and accuracy of information?

<p>Interaction with all departments to maintain and improve data flow. (B)</p> Signup and view all the answers

What is the primary reason special chemistry tests are not available on auto-analyzers?

<p>Low demand for these tests (D)</p> Signup and view all the answers

Which statement accurately reflects the training requirements in a Special Chemistry Lab compared to a Core Lab?

<p>More training is required for Special Chemistry Lab protocols. (D)</p> Signup and view all the answers

What type of instruments are commonly used in Special Chemistry Labs?

<p>Batch analyzers or specialized research instruments (B)</p> Signup and view all the answers

What must justify the existence of a Special Chemistry Lab?

<p>The volume of specimens processed (D)</p> Signup and view all the answers

In what setting are Special Chemistry Labs most likely to be located?

<p>Larger testing centers (C)</p> Signup and view all the answers

What feature allows the instrument to perform specific tests on a given sample?

<p>Random access customization (C)</p> Signup and view all the answers

Which analytical technique involves measuring a change in potential through a specific membrane?

<p>Ion-selective electrode (B)</p> Signup and view all the answers

How does the core lab system handle reagent management?

<p>Reagents are loaded directly onto the instrument as kits. (C)</p> Signup and view all the answers

What is the purpose of the waste management feature in the core lab system?

<p>To monitor the amount of consumables and waste generated (B)</p> Signup and view all the answers

Which statement best describes the automation capabilities of the instrument?

<p>Automation facilitates fully automated pipetting, mixing, and measurements. (C)</p> Signup and view all the answers

Which test is NOT categorized under electrolytes?

<p>Calcium (Ca) (D)</p> Signup and view all the answers

Which of the following is primarily used as a tumour marker?

<p>Prostate Specific Antigen (PSA) (A)</p> Signup and view all the answers

What is the critical value associated with blood gas testing?

<p>Oxygen saturation (B)</p> Signup and view all the answers

Which category includes triglycerides?

<p>Lipids (B)</p> Signup and view all the answers

Which of the following is a toxicology test?

<p>Methanol (A)</p> Signup and view all the answers

What is a primary advantage of using Point of Care Testing (POCT) compared to central laboratory testing?

<p>POCT allows for immediate management based on test results. (A)</p> Signup and view all the answers

Which of the following tests is NOT typically performed using Point of Care Testing (POCT)?

<p>Full blood count (B)</p> Signup and view all the answers

What type of result can be obtained from Point of Care Testing (POCT)?

<p>Both qualitative and quantitative results (C)</p> Signup and view all the answers

What technology is commonly utilized in many Point of Care Testing devices?

<p>Immunoassay technology (B)</p> Signup and view all the answers

What is a disadvantage of Point of Care Testing (POCT) compared to laboratory tests?

<p>POCT tests are usually more expensive. (C)</p> Signup and view all the answers

Which aspect of Point-of-Care Testing (POCT) requires careful consideration regarding the responsibility for testing personnel?

<p>Test result interpretation (D)</p> Signup and view all the answers

What is a critical factor to ensure reliability in Point-of-Care Testing (POCT) amidst various testing procedures?

<p>Quality control protocols are strictly followed (B)</p> Signup and view all the answers

Which element is important to consider when determining the integration of Point-of-Care Testing (POCT) with existing hospital systems?

<p>Interfacing with Laboratory Information Systems (LIS) (D)</p> Signup and view all the answers

What is a primary use of electrophoresis in a Special Chem Lab?

<p>To separate serum proteins into distinct bands (B)</p> Signup and view all the answers

When assessing Point-of-Care Testing (POCT) standardization, which question is most relevant?

<p>Are POCT results comparable to standard lab tests? (B)</p> Signup and view all the answers

Which analytical method is primarily utilized for measuring hemoglobin variants?

<p>HPLC (D)</p> Signup and view all the answers

In the context of Point-of-Care Testing (POCT), who typically bears the financial responsibility for the required instruments and reagents?

<p>Hospital administration (B)</p> Signup and view all the answers

In which scenario would you likely use radioimmunoassay (RIA)?

<p>For detecting low levels of testosterone (D)</p> Signup and view all the answers

Which of the following statements is true regarding GC-MS and LC-MS?

<p>They are primarily utilized for quantitative drug measurement. (B)</p> Signup and view all the answers

What is one of the applications of infrared spectroscopy in a Special Chem Lab?

<p>To analyze components of kidney stones (C)</p> Signup and view all the answers

Flashcards

Core Lab Facility

A 24/7 clinical chemistry lab in hospitals, highly automated and providing routine tests.

Special Chemistry tests

Less common tests, often manual and time-consuming. Not urgent.

Point of Care Testing (POCT)

Clincial chemistry tests at a remote location within a hospital (such as ER,ICU).

Core Lab Automation

Advanced technology for fast and accurate clinical chemistry testing.

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Non-stat tests

Chemistry tests results are not urgently needed.

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Patient History

Gathering information about the patient's symptoms, medical history, and lifestyle.

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Physical Examination

Checking the patient's body for signs of illness.

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Laboratory Tests

Performing tests on body fluids to identify specific elements or compounds.

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Imaging Techniques

Using tools like X-rays and scans to visualize structures in the body.

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Diagnosis

Identifying the patient's disease or condition.

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Laboratory Medicine Role

Provides diagnostic tests for doctors to assess patient health.

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Hospital Department Interaction

Works closely with ER, ICU, CCU, and outside doctors to improve patient care.

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Diagnostic Assay Development

Creates, studies, and uses new medical tests.

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Patient Care Driven

Main goal is caring for patients in an efficient and affordable way.

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Non-Profit Business Model

Laboratory budget must be managed and utilized effectively according to the organization's mission.

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HRLMP

The Hamilton Regional Laboratory Medicine Program that combines all Hamilton Hospital Laboratories, aiming to optimize resources and improve services.

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LRC

The Laboratory Reference Centre within HRLMP, providing specialized testing to other institutions in Central Ontario and across Canada.

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What is the annual budget of HRLMP?

Over 50 million dollars annually.

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How many staff members does HRLMP have?

Over 600 staff members, including doctors, scientists, technicians and administrative personnel.

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What are the core departments of HRLMP?

Clinical Chemistry and Immunology, Hematology and Transfusion Medicine, Microbiology, Genetics, and Anatomical Pathology.

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Core Lab

A high-volume lab that performs common, time-sensitive tests. These tests are often crucial for diagnosis and treatment.

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Electrolytes

Essential minerals like sodium, potassium, and chloride, found in bodily fluids. They regulate fluid balance, nerve function, and muscle contractions.

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Blood Gases

Measurements of oxygen, carbon dioxide, and pH levels in the blood, indicating how well the lungs are functioning.

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Tumour Markers

Substances produced by cancer cells, detected in the blood to diagnose and monitor cancer progression.

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Toxicology Tests

Tests to identify the presence of drugs, alcohol, or other harmful substances in the blood.

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Core Lab Analyzer

An automated instrument performing various tests on patient samples.

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Sample Handling (Core Lab)

Barcoded test tubes are loaded, tests are selected through a menu, and samples are processed automatically.

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Customization (Core Lab)

The instrument can perform specific tests on a given sample, enabling personalized analysis.

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Reagent Management (Core Lab)

All reagents for specific tests are loaded onto the instrument in kits, simplifying work and reducing error.

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Waste Management (Core Lab)

The instrument monitors consumables and waste generated, ensuring efficient and safe operation.

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Special Chemistry Lab

A laboratory focused on performing less common and often complex clinical chemistry tests.

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Low Test Demand

The reason why many Special Chemistry Lab tests are not automated: there aren't enough orders to justify automation.

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Why Manual Procedures?

Many Special Chemistry tests involve complex steps that are difficult or impossible to automate, such as sample extraction.

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Training in Special Chemistry

Special Chemistry Lab personnel require more training compared to Core Lab staff, due to the complex techniques and specialized equipment.

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Cost Justification

The high cost of Special Chemistry Labs is justified by the specialized tests they provide and the limited number of orders for these tests.

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POCT Funding

Who pays for the POCT instrument and reagents?

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POCT Personnel

Who performs the Point-of-Care Tests?

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POCT Quality Control

Who ensures tests are accurate and reliable?

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POCT Integration

Does the POCT instrument interface with the hospital's Lab Information System?

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POCT Standardization

Are the POCT results consistent with lab tests?

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What is POCT?

Point-of-Care Testing (POCT) is a method of performing medical tests at the patient's bedside or other non-laboratory locations, providing immediate results to guide patient care.

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Why use POCT?

POCT is used for urgent tests where results directly impact immediate patient management. It's faster than sending samples to a central lab, allowing for quicker diagnosis and treatment.

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What types of tests are common POCT?

Common POCT tests include blood glucose monitoring, urinalysis, blood gas analysis, electrolyte checks, cardiac marker tests (Troponin), and drug screens.

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Is POCT more expensive?

POCT devices and reagents are often costlier than centralized laboratory tests, but the time-saving benefit and faster treatment often outweigh this difference.

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What is a common technology in POCT?

Many POCT devices rely on immunoassay technology, which uses antibodies to detect specific substances in a sample.

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Electrophoresis

A technique used to separate molecules based on their size and charge. It's commonly employed to analyze serum proteins, lipoproteins, and enzyme isoforms.

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Infrared Spectroscopy

This method uses infrared light to identify and quantify various compounds in a sample by analyzing how they absorb the light.

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Radioimmunoassay (RIA)

A sensitive technique that uses radioactive isotopes to measure minute amounts of substances (like hormones) in a sample.

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GC-MS/LC-MS

A powerful combination of techniques: gas chromatography (GC) or liquid chromatography (LC) separates components of a sample, followed by mass spectrometry (MS) to identify and quantify them. It's particularly valuable for drug analysis.

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Study Notes

Clinical Chemistry Laboratory Organization

  • Core Lab Facility

    • Found at virtually all hospitals
    • Operates 24 hours a day, 7 days a week
    • Provides essential, most requested tests
    • Highly automated environment
    • Instruments have multi-analyte capabilities

  • Special Chemistry

    • Less frequently ordered tests
    • Labor intensive and often manual methods
    • Generally non-stat tests (results not required immediately)

  • Point of Care Testing (POCT)

    • Instruments located outside of chemistry laboratory (e.g., CCU, ER, ICU or satellite centre (clinic))

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Description

Test your knowledge on the steps of patient investigation, including the role of physical examination, lab facilities, and treatment assessment. This quiz covers essential concepts related to clinical chemistry and point of care testing. Perfect for students and professionals in the medical field.

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