Question

Silvia Gonzales, a 51-year-old female, is at the office for a 3-month return check for her newly diagnosed Type 2 diabetes. She states that she has taken the medication she received for her “sugar” and she knows the doctor wants to a do a special “sugar test” this time. Her medication list includes Januvia® 100 mg daily.

The physician has ordered a fasting blood sugar (FBS) and a hemoglobin A1C blood test. You will need to perform both of these waived tests in your office lab.

Discussion Questions:

1. Identify equipment used by a medical assistant in an office laboratory.

2. You will be measuring Sylvia’s fasting blood glucose using a glucometer. You know this is classified as a waived test. What does the classification of waived test mean?

3. The glucometer contains an instrument called a photometer. How is blood glucose measured using a photometer?

4. Measuring blood glucose is a quantitative test. What does this mean?

5. What type of controls do you expect to use when measuring Sylvia’s blood glucose?

6. When should you run the controls?

Please answer all 6 questions separately. Thank you so much.

Answer 1

ANSWER :

1) Equipment used :

• Fasting blood glucose : Glucometer
• HbA1c test : Point-of-care HbA1c devices or glycated hemoglobin analyzer

2)CLIA classified tests based on their level of complexities :

• Waived tests
• Moderate complexity test
• High complexity test

Waived test :

• Simple one step procedure and results are accurate
• No risk or harm to the patient
• Examples : glucose test , hemoglobin test , urine test etc

3)Measurment of blood glucose by photometer :

• The photometer uses infrared light to determine blood glucose
• Test strip consists of substrate, polymeric membrane and reagent on the bottom surface of membrane
• Droplet of blood to be tested is placed in the aperture of substrate --------> blood reacts with reagent present on bottom surface of membrane -----> forms reacting components ------->amount of light reflected from the reacting components is converted into blood glucose values

4)Blood glucose is quantitative test because :

• It is used to determine or monitor the quantity or concentration of glucose levels in the blood in people who have been diagnosed with diabetes mellitus
• Results include values or numbers

5)Type of controls used :

• Liquid control solutions are used that are produced with a set amount of glucose

6)Run the controls :

• To check the accuracy of the strips for the meter
• When we open a new container of strips or use it occasionally
• When we get unusual results
• When we drop down the glucometer