CAP Pro Course - Chemistry - Clinical Toxicology

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Author: DeRhonda Crawford, MT(ASCP)
Reviewer: Laurie Bjerklie, MA, MLS(ASCP)CM

Continuing Education Credits

Objectives

  • Identify issues pertaining to specimen adequacy that can impact toxicology testing.
  • Discuss testing and reporting methods that are applicable to drug and ethanol testing.
  • Recognize and respond appropriately to salicylate and acetaminophen test results that indicate toxicity.

Course Outline

  • Identify issues pertaining to specimen adequacy that can impact toxicology testing.
      • Uses for Drugs of Abuse Testing
      • Clinical versus Legal Drugs of Abuse Testing
      • Sample Identification, Collection, and Handling of Specimens for Medical Drugs of Abuse Testing
      • Adulteration of Specimens
      • A urine sample was collected for drugs of abuse (DOA) testing. The specific gravity of the freshly collected urine read 1.000. What does this indicate...
      • The laboratory performs whole blood ETOH testing on a handheld point-of-care meter. Whole blood is drawn into a syringe and then dispensed into the ha...
      • A police officer pulls over a car that is driving erratically. He suspects the driver is somehow impaired. He arrests the driver and takes him to a lo...
      • A urine sample was collected and checked for possible adulterants before accepting the sample for drugs of abuse testing. The pH of the sample read 11...
      • A serum blood collection tube for acetaminophen was delivered to the laboratory through a pneumatic tube system with only the patient's name on the bl...
      • A laboratory collects urine samples for drugs of abuse testing for workers' compensation cases. A man's urine sample was blue, and the temperature of ...
      • During her morning rounds, a nurse noticed a faint smell of alcohol from a patient who had been in the hospital for over a week. She relays her observ...
  • Discuss testing and reporting methods that are applicable to drug and ethanol testing.
      • Drugs of Abuse (DOA) Screening and Test Cutoff Values
      • DOA Confirmation Testing
      • DOA Report Requirements
      • DOA Report Requirements, continued
      • Ethanol Testing Methods
      • Laboratory Indicators of Excessive and Prolonged Ethanol Consumption
      • Along with running an ethanol assay, what is another good laboratory test that can indicate an increased ethanol level?
      • When collecting a sample for blood alcohol testing, what is the proper method for cleaning the venipuncture site?
      • Your laboratory performs a urine drug screen on a 32-year-old ER patient. The amphetamine result is 400 ng/mL. The cutoff for the drug is 400 ng/mL. W...
      • For a person who has a history of excessive alcohol abuse, which test listed below would be the best indicator to confirm there is alcohol abuse?
      • An ER doctor questions a positive immunoassay urine drug screen result. The amphetamine was reported as "positive - unconfirmed." The ER doctor called...
  • Recognize and respond appropriately to salicylate and acetaminophen test results that indicate toxicity.
      • Salicylates and Acetaminophen
      • Salicylate Toxicity
      • Acetaminophen Toxicity
      • Laboratory Testing for Salicylates and Acetaminophen
      • Most people who overdose on acetaminophen will initially be asymptomatic. When will clinical symptoms usually appear after acute ingestion?
      • What is the suggested time frame for salicylate testing to evaluate the level of toxicity in cases with significant ingestion?
      • A woman is transported to the ER with nausea and vomiting. She states she had taken a large amount of salicylates. The ER physician checks the patient...
      • A woman was being treated with a large maintenance dose of acetaminophen but accidentally took a lot more than was prescribed. She soon noted the onse...
      • What is the first symptom used in diagnosing salicylate toxicity if salicylate ingestion is known?
      • A woman is brought into the ER due to a known overdose of acetaminophen. The woman is currently asymptomatic. How should the ER treat this patient?
      • Which of the following is given to patients with confirmed acetaminophen toxicity?
  • References
      • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: This program is designed as an educational and training tool for MLS, MT, and MLT personnel, medical laboratory science students and interns, pathology residents, and practicing pathologists. 
Author: DeRhonda Crawford, MT(ASCP) is the chemistry supervisor at Gwinnett Medical Center in Lawrenceville, Georgia and the technical supervisor for the Gwinnett Medical Center in Duluth, Georgia. She holds a BS in Medical Technology from the Medical College of Georgia. 
Reviewer Information: Laurie Bjerklie, M.A., MLS(ASCP)CM is currently a Content Developer for MediaLab and LabCE. She earned a B.S. in Medical Laboratory Science from the University of North Dakota and an M.A. in Curriculum and Instruction from Saint Xavier University. She has over 14 years of experience in higher education and has held faculty positions in both MLT and MLS programs. She most recently served as the Program Manager of Medical Laboratory Science at Saint Louis University.

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