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2nd Year Final Examination of Diploma in Medical Technology Course: January-2022

Group: Laboratory Medicine

Subject: Laboratory Technique (Paper-I)

Q-1-a) Write down the Professional code of Conduct in laboratory technique. (Jan-2022)

Ans: Please see Jan-2021 (Q-1-a).

Q-1-b) Define oxygen therapy. State the procedure of  oxygen therapy. (Jan-2022 )

Ans: Please see Jan-2021 (Q-1-c).

Q-1-c) Name 5 superficial veins from which blood is collected.(Jan-2022)

Ans: Please see Jan-2021 (Q-2-c).

Q-1-d)  What is cross infection?.How will you prevent  cross infection? (Jan-2022)

Ans: Please see Jan-2021 (Q-1-d).

Q-1-e) Name some anticoagulants with their uses. (Jan-2022 )

Ans: Please see Jan-2021 (Q-3-c).

Q-2-a) What are the indications of blood transfusion?. Name some diseases which are transmitted by blood transfusion? (Jan-2022 )

Ans: Please see Jan-2021 (Q-1-e).

Q-2-b) Define medical record. What are the importance of record keeping? (Jan-2022 )

Ans: Please see Jan-2021 (Q-2-e).

Q-2-c) Define ELISA. Give the principle of ELISA. (Jan-2022)

Ans:

Definition of ELISA:

  • ELISA stands for ‘enzyme-linked immunosorbent assay. 
  • ELISA is a plate-based immunological assay commonly used to detect the presence of antibodies,antigens, proteins, and glycoproteins in biological samples. 

Some examples of ELISA tests: 

  • Diagnosis of HIV infection
  • HBsAg test
  • Hormonal assay, e.g. thyroid hormone (T3, T4, TSH).
  • Tests for Dengue virus, Rota virus.

Principle of ELISA method:

In simple terms, in ELISA, an unknown amount of antigen is affixed to a surface, and then an antibody is applied over the surface so that it can bind to the antigen. This antibody is linked to an enzyme, and in the final step a colourless chromogenic substance is added that the enzyme can convert to some detectable signal, most commonly a colour change in a chemical substrate. 

Q-2-d) Name the biochemical and haematological instruments used in laboratory. (Jan-2022) 

Ans:

Instruments used in haematological laboratory:

1. Microscope 

2. Centrifuge machine

3. Photometer

 4. Water Bath

5. Haematology analyzer, coagulation analyzer

6. Tube stands

7. ESR tubes rack 

8. Slide-staining racks

9. Stop watch

10. Sahli’s haemoglobinometer 

11. Haemoglobin pipettes

12. Haemocytometer: counting chamber (Neubauer improved counting chamber), RBC pipette, WBC pipette, cover-slip 

13. Wintrobe’s tubes

14. Westergren’s tubes 

15. Test tubes

16. Disposable syringes, needles and lancets

Instruments used in the biochemical/ Clinical Chemistry Laboratory:

  1.  Centrifuge machine
  2. Colorimeter
  3. Spectrophotometer 
  4. Flame photometer
  5. pH meter 
  6. Chemical balance
  7. Autoanalyzer (Blood gas analyser, chemistry analyser, electrolyte analyser, urinalysis analyser, etc.)
  8. Elisa reader 
  9. Incubator 
  10. Water bath 
  11. Autoclave
  12. Urinometer 
  13. Refrigerator and freezer 
  14. Test tube holder and rack
  15. Timer 
  16. Spectrofluorometer  
  17. Mixer/rotator/shaker/stirrer / disruptor
  18. General laboratory stands, racks, filter paper 
  19. Micropipettes etc.

Extra topics:

Laboratory Glasswares:

  • Test tubes
  • Glass beakers
  • Flasks
  • Measuring cylinders
  • Reagent bottles
  • Burettes
  • Petri dish
  • Micropipettes
  • Glass Pasteur pipette
  • Graduated pipette
  • Funnel
  • Folin Wu tube
  • Glass syringes
Q-2-e) Write about the procedure of safe transportation of specimen. (Jan-2022)

Ans:

Every laboratory specimens are considered infectious, so safety measures are needed during transport of specimens –

  • from a ward or outpatient department (OPD) to the laboratory, and
  • between laboratories, e.g., from upazila health complex laboratory to the district hospital laboratory or national public health laboratory.

Procedure/Guideline for safe transport of Specimens:

1. All specimens must be collected in leak-proof clean,dry and sterile containers. Make sure the specimen container is tightly closed and the cap is not leaking. 

2. The containers of the specimens must be labeled properly. The minimum information on a label should include the patient’s name, identification number, date and time of collection of specimen.

3. When hand carrying, the specimens are placed upright in racks in a closed container. The request forms (containing the nature of investigation and other information about the patient)

should be placed in a plastic bag that can be sealed.

4. When transporting specimens between laboratories, each specimen is wrapped in sufficient absorbent material and is placed individually or with others in a carton or strong plastic bag. Sufficient packing material is placed around the specimens to prevent

them moving in the container or bag. 

5. A freezer pack(s) or ice cubes (in sealed plastic bags) are placed around the container of specimens to keep low temperature.

6. Label the outer container biological specimens– Infectious substance preferably using the biohazard symbol.

7. Postal or courier service is used now a days to transport specimens. A clearly written delivery address label should be fixed to the outer container when transported by post or courier.

8. The postal system is appropriate for sending formal saline preserved biopsies or fixed smears to a histopathological laboratory.

Q-3-a) List the  corrosive chemicals used in the laboratory. How can you store and safely used these in  laboratory.(Jan-2022)

Ans:

List of corrosive chemicals are:

  • Phenol
  • Strong acids : concentrated sulphuric acid, nitric acid, glacial acetic acid, trichloroacetic,phosphoric acid.
  •  Caustic alkalis: sodium hydroxide (caustic soda), potassium hydroxide (caustic potash ).
  • Some disinfectant solutions.

Safe storage and use of corrosive chemicals:

Storage:

  • Corrosive chemicals should be stored at low level. 
  • Caustic alkalis should not be stored in a bottle having a ground glass stopper.

Safe use:

  • Never mouth-pipetting of a corrosive chemical.
  • A corrosive chemical is always poured at below eye level, slowly and with great care to avoid splashing. 
  • Use of protective gloves and a face visor or at least eyeshields, when opening a container of a corrosive chemical and when pouring it.
  •  A solid corrosive chemical such as sodium hydroxide is dissolved in water with great care, mixing in small amounts at a time to dissipate the heat produced.
  • When diluting concentrated acids, particularly sulphuric acid, always the acid is added to the water. Never water is added to acid, that can produce sufficient heat to break a glass container.
  • When weighing corrosive chemicals, e.g., phenol, damage to the balance is avoided by ensuring the chemical does not spill on the balance pan or other metal parts. 
  • A strong carrier is always used to transport bottles of corrosive chemicals.
Q-3-b) Define store. Write in short about store management. (Jan-2022) 

Store:

Store is a specified place/ room in a medical laboratory where drugs, reagents, chemicals, instruments, logistics, stationaries and other laboratory materials are kept in a systematic way for their regular and timely supply.

Store Management:

For the better management of a laboratory store- 

  • There must be a store keeper or manager.
  • Should prepare a stock list on a regular basis for controlling stock levels.
  • Index (name of the materials with page number).
  • Date-wise voucher number – receive / supply.
  • In every indent / voucher, signature and counter signature of the incharge medical technologist and the head of the department will be taken.
  • For procurement the incharge should issue indent/ requisition for short items at appropriate time.
  • 24-hour service must be ensured for smooth working of a medical laboratory.
Q-3-c) Write down the waste disposal system of a medical laboratory. (Jan-2022 )

Ans: Please see Jan-2020 (Q-1-e).

Q-3-d) What do you mean by SI unit?. Describe SI unit and SI derived unit. (Jan-2022 )

Ans: Please see Jan-2021 (Q-4-b).

Q-3-e) Define communication. Write down the ways of effective communication in the laboratory?. (Jan-2022)

Definition of Communication:

Communication is the accurate passing on or sharing of information.

There are three main ways of communication:

1. By writing (Written)

2. By speaking (spoken / verbal/ oral)

3. By action.

Written Communication:

The communication transmitted by Writing is called Written communication.

Example: Test reports, patient’s note, advice letter etc.

Spoken/Verbal communication:

The communication transmitted through speaking/ speech is called spoken or verbal communication.

Example: Personal contact, speeches, lectures, meetings, television/ telephone conversations, voicemail, video conference etc.

Action communication:

The communication transmitted by facial expression and body movement is called communication by action.

Q-4-a) State the common hazards of upazila health complex laboratory?.How can you prevent biological hazard?.(Jan-2022)

Common laboratory hazards  of upazila health complex:

The following are important hazards:

  • Unsafe premises
  • Naked flames
  • Microbiological hazards
  • Sharps hazards
  • Equipments hazards
  • Explosions
  • Chemical hazards
  • Glassware hazards
  • Infestation by ants, rodents, cockroaches
  • Unreliable water supply

Prevention of biological hazards by personal health and safety measures:

  • All the specimens received in the laboratory should be considered as infectious 
  • Practice of personal hygiene by the laboratory staff:
  1.  Washing of hands and arms with soap and water before and after handling specimens / infected materials; and at the end of the day’s work. 
  2. Wearing closed shoes and not walking barefoot.
  3. Eating, drinking, smoking, chewing gum or applying cosmetics and handling contact lenses in work areas should be strictly prohibited. 
  4. Food or drink should never be stored in a laboratory refrigerator.
  5. Should avoid jewellery in the working area, particularly pendant and bracelets.
  1. Use of personal protective equipment (PPE):
  1.  Wearing hand gloves while handling specimens and during blood collections.
  2. Disposable gloves should not be washed or decontaminated for future use.
  3. Use of protective clothing (overall / apron).
  4. Use of splatter shields which provide protection from splatter of specimens and chemicals.
  5. Use of safety goggles to protect eyes, face shields and dust masks.
  • Vaccination/immunization of laboratory staff and periodical medical examinations.
  • Safe pipetting and dispensing – prohibition of mouth pipetting.
  • Safe use of syringe and needle- to prevent pricking oneself or one’s colleague. 
  • Avoiding infection from centrifuge accidents, spillages and breakages.
Q-4-b) Define chemicals and reagents. Difference between chemical and reagent? (Jan-2022)

Definition of chemicals:

A chemical is a substance that has a definite composition and characteristic properties. Chemicals can be simple substances, such as iron or oxygen, or they can be compounds, which are substances made up of two or more elements.

Definition of reagents:

A reagent is a substance or compound that is used to bring about a chemical reaction or to test for the presence of another substance. Reagents are typically used in laboratories and in industrial settings.

Please also see Jan-2021 (Q-3-a).

Q-4-c) Mention the name of important instruments which are used in district laboratory. (Jan-2022)

Ans:

Instruments used in district laboratory:

Haematological laboratory:

  • Microscope 
  • Centrifuge machine
  • Photometer
  • Water Bath
  • Haematology analyzer, coagulation analyzer
  • Tube stands
  • ESR tubes rack 
  • Slide-staining rack
  • Stop watch
  • cover-slip
  • Wintrobe’s tubes
  • Westergren’s tubes 
  • Test tubes
  • Disposable syringes, needles and lancets

Biochemical/ Clinical Chemistry Laboratory:

  • Centrifuge machine
  • Colorimeter 
  • Micropipettes
  • Spectrophotometer
  • Flame photometer
  • pH meter 
  • Chemical balance
  • Autoanalyzer (Blood gas analyser, chemistry analyser, electrolyte analyser, urinalysis analyser, etc.)
  • Elisa reader 
  • Incubator 
  • Water bath 
  • Autoclave
  • Urinometer 
  • Refrigerator and freezer 
  • Test tube holder and rack
  • Timer 
  • Spectrofluorometer  
  • Mixer/rotator/shaker/stirrer / disruptor
  • General laboratory stands, racks, filter paper etc.
Q-4-d) What are the criteria of an ideal laboratory?(Jan-2022)

Ans:

Criteria of an ideal Laboratory:

1. Laboratory premise:

  • Structurally sound and in good repair.
  • Reliable and adequate water supply.
  • A safe plumbing and waste disposal system.
  • Clean, uncluttered and free from obstructions.

2. Floor and bench space and storage areas:

  • Must be adequate for the workload, number of staff, storage and equipment requirements.

3. Floor:

  • Well constructed.
  • Non-slippery surface.
  • Impermeable to liquids.
  • Resistant to chemical and disinfectants normally used in the laboratory.
  • Beveled to the wall.
  • Accessible for washing
  • Must not be waxed or covered with matting.

4. Walls:

  • Smooth.
  • Free from cracks.
  • Impermeable to liquids.
  • Painted with washable light coloured paint.

5. Doors:

  • A door at each end of the laboratory, if possible.
  • Open outwards.
  • Self closing internal door with upper viewing panes.
  •  External doors must be fitted with secure locks.

6. Windows and vents:

  • Can be opened
  • Should not face the prevailing winds
  • Fitted with sun blinds and insect proof screens.

7. Sections of the laboratory:

  • Divided into separate rooms or working areas for different sections, e.g. waiting room for patients, specimen collection, clinical pathology, biochemistry, microbiology, haematology, histopathology, washrooms, office etc.
  • The waiting room for patients – outside the laboratory,
  • Specimen collection room must be away from the testing area of the laboratory,
  •  A First Aid area containing a First Aid box, eyewash bottle and fire blanket.

8. Bench: its surfaces should be –

  • Without cracks.
  • Impervious.
  • Washable.
  • Resistant to disinfectants and chemicals used in the laboratory.
  •  Benches, shelving and cupboards are well constructed and kept free of insect and rodent infestation.

9. Storage facilities:

  • Should be arranged properly.
  • Free from accumulations of unwanted materials and objects.
  • A ventilated locked store for the storage of chemicals and expensive equipment.

10. Safe electricity and gas supply:

  • All electricity installations should be made and maintained in accordance with an electrical safety code.
  • Sufficient wall electric points.
  • A piped gas supply to the laboratory where required.

11 . A staff room:

  • Separate from the working area.
  • For refreshments and storage of personal food and other belongings safely.
  • A separate toilet and wash room.

12. Separate toilet and hand basin for patients with :

  • Running water.
  • Soap.
  • Paper towels/toilet paper.

13. Fire extinguishers sited at accessible points.

14. Illumination:

  • As good as possible.
  • Use of energy bulbs.
  • Use of window screens to protect from direct sunlight and glare.

15. Use of separate labeled containers for :

  • Infected materials.
  • Discarding needles.
  • Syringes, lancets, glassware, broken glass.
  • General laboratory waste.

16 . Use of safety signs and symbols:

  •  To promote safety awareness.
  •  Prohibition (do not) signs are crossed by a red line.
Q-4-e) Define quality control? How can you maintain quality Control in a laboratory? (Jan-2022)

Ans: Please see Jan-2021 (Q-3-d).

Q-5-a)  write short notes on: Reagent strip. (Jan-2022 )

Ans: Please see Jan-2021 (Q-5-e).

Q-5-b) Write short notes on: P.B.F (Jan-2022)

Ans:

 Peripheral blood film (PBF):

A peripheral blood film (PBF), also known as a blood smear, is a laboratory test that examines the blood cells under a microscope. It is a simple but powerful test that can be used to diagnose a wide range of blood disorders, including anemia, leukemia, and lymphoma.

Procedure:

To perform a PBF, a small sample of blood is collected from a vein in the arm. The blood is then spread on a glass slide and stained with a special dye. The stained slide is then examined under a microscope by a trained laboratory professional.

Utility of blood film:

The PBF can be used to assess the size, shape, and number of the different types of blood cells, including red blood cells, white blood cells, and platelets. The presence of any abnormal blood cells can help to diagnose a variety of blood disorders.

Here are some of the key features of a peripheral blood film:

  • Red blood cells: The PBF can be used to assess the size, shape, and color of the red blood cells. Abnormal red blood cells can be a sign of a variety of blood disorders, including anemia, sickle cell disease, and thalassemia.
  • White blood cells: The PBF can be used to assess the number of different types of white blood cells, including neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Abnormal white blood cell counts can be a sign of infection, inflammation, or other blood disorders.
  • Platelets: The PBF can be used to assess the number and size of platelets. Platelets are responsible for blood clotting. Abnormal platelet counts can be a sign of a bleeding disorder or leukemia.

The PBF is a simple but powerful test that can be used to diagnose and monitor a wide range of blood disorders.

Q-5-c) Write short notes on: Incineration. (Jan -2022 )

Ans: Please see Jan-2021 (Q-5-d).

Q-5-d) Write short notes on : Haemocytometer. (Jan-2022)

Ans: Please see Jan-2020 (Q-5-a).

Q-5-e) Write short notes on: autoclave. (Jan-2022 )

Ans: Please see Jan-2021 (Q-5-b).

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