Laboratory Results and Delta Checks
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Questions and Answers

What is the purpose of delta checks in laboratory assays?

  • To set reference intervals for laboratory tests
  • To detect the presence of high concentration of interfering substances in the specimen
  • To compare current laboratory results with previous results from the same patient (correct)
  • To assess the clinical significance of laboratory results

    • What is a common cause of inadequate samples in laboratory tests?

  • Insufficient sample volume
  • Presence of high concentration of lipids in the specimen (correct)
  • Contamination of the sample
  • Presence of hemoglobin in the specimen

    • What is the term used to describe the range of values into which 95% of non-diagnosed individuals will fall?

  • Normal range
  • Clinical significance
  • Reference interval (correct)
  • Normal value

    • What is the purpose of flags in laboratory testing?

    <p>All of the above</p> Signup and view all the answers

    What is the term used to describe the process of comparing current laboratory results with previous results from the same patient?

    <p>Delta checks</p> Signup and view all the answers

    What is hemolysis in the context of laboratory testing?

    <p>Presence of hemoglobin in the specimen</p> Signup and view all the answers

    What is the purpose of assessing clinical significance of laboratory results?

    <p>To determine the relevance of laboratory results to a patient's condition</p> Signup and view all the answers

    What is the term used to describe the range of values into which most healthy individuals fall?

    <p>Reference interval</p> Signup and view all the answers

    What is the primary goal when performing a confirmatory test?

    <p>To rule out false positives and ensure high specificity</p> Signup and view all the answers

    What is the effect of altering the test cutoff on sensitivity and specificity?

    <p>Alterations have a reciprocal effect on sensitivity and specificity</p> Signup and view all the answers

    What is the likelihood ratio of a test?

    <p>The ratio of the probability of a given test result in the disease state to the probability of the same result in the non-disease state</p> Signup and view all the answers

    What does an increased Red Cell Distribution Width (RDW) in the cell histogram correlate with?

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

    What is the purpose of post-analysis in clinical laboratory testing?

    <p>To examine the clinical laboratory testing process</p> Signup and view all the answers

    What is the relationship between sensitivity and specificity?

    <p>They are inversely proportional</p> Signup and view all the answers

    What is the probability that a patient indeed has the disease given a positive test result?

    <p>Positive predictive value</p> Signup and view all the answers

    What is anisocytosis?

    <p>Changes in RBC size</p> Signup and view all the answers

    What does the presence of spherocytes signify?

    <p>Hemolytic anemia</p> Signup and view all the answers

    What does the predictive value of a positive test increase with?

    <p>Disease prevalence</p> Signup and view all the answers

    What is necessary to obtain the post-test probability of disease using Bayes Theorem?

    <p>Test characteristics and disease prevalence</p> Signup and view all the answers

    What does a prolonged PT signify?

    <p>Factor VII deficiency</p> Signup and view all the answers

    What is the relationship between the likelihood ratio of a test and the cutoff value?

    <p>The likelihood ratio changes with the cutoff value</p> Signup and view all the answers

    What does the presence of codocytes signify?

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

    What is the significance of Elevation of Leukocyte Alkaline Phosphatase (LAP) score?

    <p>It differentiates Leukemoid reaction vs Chronic Myelogenous Leukemia</p> Signup and view all the answers

    What is the significance of a prolonged PT and aPTT?

    <p>Factor I, II, V, &amp; X deficiency or presence of lupus anticoagulant</p> Signup and view all the answers

    What can be determined by examining urinary sodium, potassium, and osmolarity?

    <p>The causes of hyponatremia and hypernatremia</p> Signup and view all the answers

    Which of the following is NOT a type of anemia?

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

    What can liver function tests distinguish?

    <p>Six different diseases of the liver</p> Signup and view all the answers

    What is the term for low potassium levels?

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

    Which of the following is an example of a liver disease?

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

    What is the term for high sodium levels?

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

    What is the primary use of blood gas results in determining acid-base imbalance?

    <p>To determine the causes of metabolic vs respiratory acidosis or alkalosis</p> Signup and view all the answers

    What is the significance of elevated eosinophils in blood tests?

    <p>It is a diagnostic stage of parasitic infection</p> Signup and view all the answers

    What does the presence of cysts/eggs/ova/larvae in a specimen indicate?

    <p>A parasitic infection</p> Signup and view all the answers

    What is the significance of a positive culture along with corresponding biochemical tests?

    <p>It provides a better diagnosis of bacterial, fungal, and viral infection</p> Signup and view all the answers

    What does the presence of dysmorphic RBC in urine indicate?

    <p>Glomerular hematuria bleeding</p> Signup and view all the answers

    What is the significance of elevated cardiac troponin in serum?

    <p>It is diagnostic of myocardial infarction</p> Signup and view all the answers

    Study Notes

    Laboratory Results and Quality Control

    • Delta checks are comparisons of current laboratory results with previous results from the same patient to assess accuracy and detect errors.
    • Alarms and flags can indicate problems with the specimen or result, such as interfering substances, numerical values outside the analytic range, or the need for confirmation.

    Assessment of Clinical Significance

    • Reference intervals are also known as "normal values" or "normal ranges" and are defined as the range of values into which 95% of non-diagnosed individuals will fall.
    • Confirmatory tests require high specificity to be certain of the diagnosis and are usually done by the National Reference Laboratory (NRL).

    Test Performance

    • Sensitivity refers to finding true positives, while specificity refers to finding true negatives.
    • Positive predictive value (PPV) is the probability that a patient has the disease given a positive test result, while negative predictive value (NPV) is the probability that a patient is disease-free given a negative test result.
    • Altering a test cutoff has a reciprocal effect on sensitivity and specificity, resulting in an inverse relationship between the two.

    Post-Analysis

    • The likelihood ratio of a test is the ratio of the probability of a test result in the disease state to the probability of the same result in the non-disease state.
    • The predictive value of a test increases with disease prevalence.

    Hematology

    • An increased Red Cell Distribution Width (RDW) correlates with anisocytosis.
    • Spherocytes indicate hemolytic anemia, while codocytes indicate thalassemia.
    • Leukocyte Alkaline Phosphatase (LAP) score differentiates Leukemoid reaction from Chronic Myelogenous Leukemia.

    Coagulation Studies

    • Prolonged PT (prothrombin time) signifies Factor VII deficiency, while prolonged aPTT (activated partial thromboplastin time) signifies Factor XII, XI, IX, or VIII deficiency.
    • Prolonged PT and aPTT signify Factor I, II, V, or X deficiency or the presence of lupus anticoagulant.

    Clinical Chemistry

    • Examination of urinary sodium, potassium, and osmolarity can determine the causes of hyponatremia and hypernatremia.
    • Liver function tests can distinguish six different liver diseases.

    Types of Anemia

    • Four types of anemia: iron deficiency, anemia of chronic disease, hemolytic anemia, and hyperadrenalism.

    Blood Gas Results

    • Blood gas results can determine the causes of metabolic vs respiratory acidosis or alkalosis.

    Parasitology and Bacteriology

    • Elevation of eosinophils indicates the presence of allergy and parasitic infection.
    • Presence of cysts, eggs, ova, or larvae in specimens can diagnose parasitic infections.
    • A positive culture along with corresponding biochemical tests provides a better diagnosis of bacterial, fungal, and viral infections.

    Urinalysis

    • Presence of dysmorphic RBCs in urine indicates glomerular hematuria, while presence of RTE cells (bubble cells) indicates acute tubular necrosis.

    Cardiac Biomarkers

    • Elevation of Cardiac Troponin (Troponin I) in serum is diagnostic of myocardial infarction in the proper clinical context.

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    Description

    This quiz covers the process of submitting laboratory results, delta checks, and flags for problem specimens. It's essential for laboratory professionals and medical record-keeping.

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