46 Questions
What is the primary requirement for the precise application of clinical laboratory testing?
Identifying a healthy population to estimate the normal range of variation
Which criterion defines normality for establishing reference intervals for laboratory analytes?
Absence of chronic/acute disease
What type of tube is used for collecting whole blood for serum?
Red topped tube with no reagent
In specimen collection, what happens to heavy and light components of blood after spinning in a centrifuge?
Heavy components sink to the bottom, while light components migrate to the top
What does the Sonoclot Analyzer measure?
Coagulation and platelet function in whole blood or plasma
What does the Sonoclot Analyzer differentiate between?
Mechanical versus hemostatic bleeders
What is the purpose of Thromboelastography with platelet mapping (TEG-PM)?
Measure platelet function and sensitivity to antiplatelet medications
What does Platelet aggregometry measure?
Platelet clumping using several agonists
What does the Sonoclot Analyzer provide in addition to a qualitative graph?
Quantitative results on clot formation time
What is the purpose of the Onset and Clot RATE results in the Sonoclot Analyzer?
Automatically calculated and appear on the LED display
What is the main function of Arachidonic acid (AA) in Thromboelastography with platelet mapping (TEG-PM)?
Sensitive to aspirin (nonsteroidal anti-inflammatory drugs)
What is the primary sensitivity of Adenosine diphosphate (ADP) in Thromboelastography with platelet mapping (TEG-PM)?
Sensitive to clopidogrel
What does LQC stand for in the context of clinical laboratory quality control?
Liquid Quality Control
What is the purpose of EQC in clinical laboratory quality control?
Verifies internal components' functionality
What does Thromboelastography (TEG) measure?
Global viscoelastic properties of whole blood clot formation
What is the purpose of Calibration in clinical laboratory quality control?
Adjusting the output of a measurement device to align with a known standard's accuracy
What can lead to unreliable readings from Glucometers/ketone meters?
Impaired peripheral circulation
What does ROTEM measure?
Viscoelastic hemostatic properties
What does the Dose Response Cartridge predict?
The loading dose of heparin
What does HMS Plus technology monitor?
Anticoagulation, medication effects, heparin anticoagulation, temperature, and dilution
What is the purpose of Quantitative heparin tests in clinical laboratory analysis?
Determine the actual heparin concentration
What can cause heparin resistance?
Lower slope in clotting response
What does EQC verify in clinical laboratory quality control?
Internal components' functionality
What does Reference Interval refer to in clinical laboratory quality control?
The normal range for proficiency testing
What is the purpose of using purple top tubes containing EDTA for blood collection?
To prevent clotting and collect plasma
What can cause hemolysis in a blood sample?
Aging and external factors such as medications
What is the role of the Point of Care Coordinator in a clinical laboratory?
Managing instrument compliance with regulations
What does analytical sensitivity refer to in laboratory testing?
Ability to measure low concentrations of the analyte
What is the purpose of the Centers for Medicare & Medicaid Services (CMS) Clinical Laboratory Improvement Amendments (CLIA)?
Regulate the quality and safety of U.S. clinical laboratories
What is the responsibility of the Medical Director in a clinical laboratory?
Oversee all testing and ensure compliance with regulatory standards
What does clinical specificity measure in laboratory testing?
Incidence of negative results in persons without the disease
What can lead to false positives and false negatives in laboratory testing?
Interference by other substances
What is the purpose of using red top tubes for blood collection?
To collect serum
What is the responsibility of the laboratory in ensuring reliable test results?
Ensuring accuracy, precision, sensitivity, and specificity of analytical methods
What is the role of the Medical Director in managing laboratory testing?
Overseeing all testing and ensuring compliance with regulatory standards
What does specificity ensure in laboratory testing?
The test is not subject to interference by other substances
What is the primary difference between TEG® and ROTEM®?
TEG® involves cup movement, while ROTEM® uses an immobile cup
What is the function of RapidTEG®?
Triggering the extrinsic pathway and enabling faster testing
What can TEG® evaluate using functional fibrinogen and platelet mapping tests?
Platelet function and clot formation with or without heparin
What is the role of TEG® in assessing Antiplatelet (clopidegrel)?
Evaluating bleeding risk
What do TEG® machines with resonance technology use instead of the traditional pin-in-cup technique?
Resonance technology
What measurements does TEG® provide to assess clot formation and stability?
Reaction time (R value), kinetics (K value), angle (α-angle), and maximum amplitude (MA)
How can TEG® guide treatment decisions based on the measured parameters?
Recommend fresh frozen plasma, cryoprecipitate, platelets, or fibrinolytic agents
What are equivalent variables in ROTEM® to TEG®'s reaction time (R value) and maximum amplitude (MA)?
Clotting time (CT) and maximum clot firmness (MCF)
What are the initial processes of platelet aggregation regulated by?
Interactions between subendothelial macromolecules, glycoprotein receptors, and platelet-derived substances
What is the mechanism of action of major antiplatelet drugs such as clopidogrel and aspirin?
Block platelet activation and inhibit the upregulation of glycoprotein GPIIb/IIIa receptors
Study Notes
Thromboelastography (TEG®) and ROTEM® Viscoelastic Hemostatic Assays Overview
- Thromboelastography (TEG®) and rotational thromboelastogram (ROTEM®) are viscoelastic hemostatic assays that measure physical clot properties in whole blood.
- TEG® predominantly measures clot properties with a pin suspended in a cup, while ROTEM® is an alternative assay widely available commercially.
- TEG® involves placing whole blood in a citrated tube, transferring it to a tube containing kaolin (activator), and measuring the physical properties of the clot.
- RapidTEG® uses kaolin and tissue factor as activators, triggering the extrinsic pathway and enabling faster testing, suitable for managing massive transfusions in trauma patients.
- TEG® offers functional fibrinogen and platelet mapping tests to evaluate platelet function and clot formation with or without heparin.
- Antiplat (clopidegrel) can be assessed using TEG® to evaluate bleeding risk, and newer TEG® machines use resonance technology instead of the traditional pin-in-cup technique.
- TEG® provides various measurements such as reaction time (R value), kinetics (K value), angle (α-angle), and maximum amplitude (MA) to assess clot formation and stability.
- TEG® can guide treatment decisions based on the measured parameters, such as recommending fresh frozen plasma, cryoprecipitate, platelets, or fibrinolytic agents.
- TEG® and ROTEM® have differences in diagnostic nomenclature and operation, with TEG® involving cup movement and ROTEM® using an immobile cup, making their results not directly comparable.
- Equivalent variables in ROTEM® include clotting time (CT), α-angle, clot formation time (CFT), maximum clot firmness (MCF), and clot lysis (CL).
- The initial processes of platelet aggregation involve interactions between subendothelial macromolecules, glycoprotein receptors, and platelet-derived substances, regulated by antiplatelet drugs such as clopidogrel and aspirin.
- Major antiplatelet drugs act to block platelet activation and inhibit the upregulation of glycoprotein GPIIb/IIIa receptors, essential for platelet aggregation, providing insights into their mechanisms of action.
Test your knowledge of Thromboelastography (TEG®) and ROTEM® viscoelastic hemostatic assays with this quiz. Explore the differences between TEG® and ROTEM®, understand the measurements they provide, and learn about their clinical applications in guiding treatment decisions.
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