MLT-1351: PROBLEM SOLVING TECHNIQUES FOR THE MEDICAL LABORATORY

MLT-1351: Problem Solving Techniques for the Medical Laboratory 1 MLT-1351: PROBLEM SOLVING TECHNIQUES FOR THE MEDICAL LABORATORY Cuyahoga Community College Viewing:MLT-1351 : Problem Solving Techniques for the Medical Laboratory Board of Trustees: 2011-09-22 Academic Term: 2012-08-28 Subject Code MLT - Medical Laboratory Technology Course Number: 1351 Title: Problem Solving Techniques for the Medical Laboratory Catalog Description: Review of basic algebra and measurement systems. Study of formula evaluation, unit analysis and conversions, dilutions, concentrations, calculations specific to clinical analytes and Beer's Law. Construction of standard curves, calculation and application of quality control parameters related to clinical laboratory medicine. Application and activities to build skills in problem solving. Credit Hour(s): 2 Lecture Hour(s): 2 Requisites Prerequisite and Corequisite MATH-1410 Elementary Probability and Statistics I, and departmental approval. I. ACADEMIC CREDIT Academic Credit According to the Ohio Department of Higher Education, one (1) semester hour of college credit will be awarded for each lecture hour. Students will be expected to work on out-of-class assignments on a regular basis which, over the length of the course, would normally average two hours of out-of-class study for each hour of formal class activity. For laboratory hours, one (1) credit shall be awarded for a minimum of three laboratory hours in a standard week for which little or no out-of-class study is required since three hours will be in the lab (i.e. Laboratory 03 hours). Whereas, one (1) credit shall be awarded for a minimum of two laboratory hours in a standard week, if supplemented by out-of-class assignments which would normally average one hour of out-of class study preparing for or following up the laboratory experience (i.e. Laboratory 02 hours). Credit is also awarded for other hours such as directed practice, practicum, cooperative work experience, and field experience. The number of hours required to receive credit is listed under Other Hours on the syllabus. The number of credit hours for lecture, lab and other hours are listed at the beginning of the syllabus. Make sure you can prioritize your time accordingly. Proper planning, prioritization and dedication will enhance your success in this course. The standard expectation for an online course is that you will spend 3 hours per week for each credit hour. II. ACCESSIBILITY STATEMENT If you need any special course adaptations or accommodations because of a documented disability, please notify your instructor within a reasonable length of time, preferably the first week of the term with formal notice of that need (i.e. an official letter from the Student Accessibility Services (SAS) office). Accommodations will not be made retroactively. For specific information pertaining to ADA accommodation, please contact your campus SAS office or visit online athttp://www.tric.edu/accessprograms. Blackboard accessibility information is available athttp://access.blackboard.com. Eastern (216) 987-2052 - Voice Metropolitan (216) 987-4344 -Voice Western (216) 987-5079 - Voice

2 MLT-1351: Problem Solving Techniques for the Medical Laboratory Westshore (216) 987-5079 - Voice Brunswick (216) 987-5079 - Voice Off-Site (216) 987-5079 - Voice III. ATTENDANCE TRACKING Regular class attendance is expected. Tri-C is required by law to verify the enrollment of students who participate in federal Title IV student aid programs and/or who receive educational benefits through other funding sources. Eligibility for federal student financial aid is, in part, based on your enrollment status. Students who do not attend classes for the entire term are required to withdraw from the course(s). Additionally, students who withdraw from a course or stop attending class without officially withdrawing may be required to return all or a portion of the financial aid based on the date of last attendance. Students who do not attend the full session are responsible for withdrawing from the course(s). Tri-C is responsible for identifying students who have not attended a course, before financial aid funds can be applied to students accounts. Therefore, attendance will be recorded in the following ways: For in-person courses, students are required to attend the course by the 15th day of the semester, or equivalent for terms shorter than 5-weeks, to be considered attending. Students who have not met all attendance requirements for an in-person course, as described herein, within the first two weeks of the semester, or equivalent, will be considered not attending and will be reported for non-attendance and dropped from the course. For blended-learning courses, students are required to attend the course by the 15th day of the semester, or equivalent for terms shorter than 5-weeks, or submit an assignment, to be considered attending. Students who have not met all attendance requirements for a blended-learning courses, as described herein, within the first two weeks of the semester, or equivalent, will be considered not attending and will be reported for non-attendance and dropped from the course. For online courses, students are required to login in at least two (2) times per week and submit one (1) assignment per week for the first two (2) weeks of the semester, or equivalent to the 15th day of the term. Students who have not met all attendance requirements for an online course, as described herein, within the first two weeks of the semester, or equivalent, will be considered not attending and will be reported for non-attendance and dropped from the course. At the conclusion of the first two weeks of a semester, or equivalent, instructors report any registered students who have Never Attended a course. Those students will be administratively withdrawn from that course. However, after the time period in the previous paragraphs, if a student stops attending a class, wants or needs to withdraw, for any reason, it is the student's responsibility to take action to withdraw from the course. Students must complete and submit the appropriate Tri-C form by the established withdrawal deadline. Tri-C is required to ensure that students receive financial aid only for courses that they attend and complete. Students reported for not attending at least one of their registered courses will have all financial aid funds held until confirmation of attendance in registered courses has been verified. Students who fail to complete at least one course may be required to repay all or a portion of their federal financial aid funds and may be ineligible to receive future federal financial aid awards. Students who withdraw from classes prior to completing more than 60 percent of their enrolled class time may be subject to the required federal refund policy. If illness or emergency should necessitate a brief absence from class, students should confer with instructors upon their return. Students having problems with class work because of a prolonged absence should confer with the instructor or a counselor. IV. CONCEALED CARRY STATEMENT College policy prohibits the possession of weapons on college property by students, faculty and staff, unless specifically approved in advance as a job-related requirement (i.e., Tri-C campus police officers) or, in accordance with Ohio law, secured in a parked vehicle in a designated parking area only by an individual in possession of a valid conceal carry permit. As a Tri-C student, your behavior on campus must comply with the student code of conduct which is available on page 29 within the Tri-C student handbook, available athttp://www.tri-c.edu/student-resources/documents/studenthandbook.pdfyou must also comply with the College s Zero Tolerance for Violence on College Property available athttp://www.tri-c.edu/policies-and-procedures/ documents/3354-1-20-10-zero-tolerance-for-violence-policy.pdf Outcomes A. Review basic mathematics skills, manipulate equations/conversions and systems applications. 1. 1. Review fractions and decimals and associated calculations. 2. 1. Review fractions and decimals and associated calculations. 3. 2. Calculate percentages using correct units. 4. 1. Calculate percentages using correct units. 5. 3. Solve a simple ratio/proportion and evaluate the unknown quantity. 6. 1. Solve a simple ratio/proportion and evaluate the unknown quantity. 7. 4. Rearrange a simple linear equation to make an equivalent equation, then solve. 8. 1. Rearrange a simple linear equation to make an equivalent equation, then solve.

MLT-1351: Problem Solving Techniques for the Medical Laboratory 3 9. 5. Employ proper units of measure and level of significant figures in recording all laboratory calculations. 10. 1. Employ proper units of measure and level of significant figures in recording all laboratory calculations. C. Perform solution concentration and conversion. 1. 1. Interpret the various expressions used to state a dilution instruction. 2. 1. Interpret the various expressions used to state a dilution instruction. 3. 3. Determine the concentration of a reagent after a dilution. 4. 1. Determine the concentration of a reagent after a dilution. 5. 4. Apply factor label skills to determine solution concentration using: percent, molarity and normality. D. Perform dilution calculations. 1. 1. Apply factor label skills to determine solution concentration using: percent, molarity and normality. 2. 1. Differentiate between the dilution and the dilution factor. 3. 1. Differentiate between the dilution and the dilution factor. 4. 2. Apply the correct dilution factor in calculating a final solution concentration for simple and serial dilutions. 5. 1. Apply the correct dilution factor in calculating a final solution concentration for simple and serial dilutions. 6. 1. Calculate the dilution factor for manual blood cell counts. 7. 2. Calculate the volume correction factor for manual blood cell counts. 8. 1. Calculate the volume correction factor for manual blood cell counts. E. Perform calculations used in hematology. 1. 1. Calculate the dilution factor for manual blood cell counts. 2. 3. Nucleated red blood cell (RBC) correction. 3. 1. Nucleated red blood cell (RBC) correction. 4. 4. Percent and absolute counts. 5. 1. Percent and absolute counts. 6. 5. Perform calculations for: reticulocyte count, corrected reticulocyte count (CRC) and the reticulocyte production index (RPI) and explain the significance of results. 7. 1. Perform calculations for: reticulocyte count, corrected reticulocyte count (CRC) and the reticulocyte production index (RPI) and explain the significance of results. 8. 6. Calculate RBC indices of mean corpusular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular volume(mcv). 9. 1. Calculate RBC indices of mean corpusular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular volume(mcv). F. Perform calculations used in clinical chemistry and urinalysis and discuss clinical relevance. 1. 1. Define conditions of normal renal function, anuria, and oliguria. 2. 1. Define conditions of normal renal function, anuria, and oliguria. 3. 2. Assess renal function by calculating 24 hour urine volume in ml/minute. 4. 1. Assess renal function by calculating 24 hour urine volume in ml/minute. 5. 3. Calculate renal clearances like the creatine clearance, and correlate results with clinical significance. 6. 1. Calculate renal clearances like the creatine clearance, and correlate results with clinical significance. 7. 4. Employ nomogram to obtain body surface area. 8. 1. Employ nomogram to obtain body surface area. 9. 5. Osmolality and electrolytes. 10. Osmolality and electrolytes. 11. 6. Acid-base and buffer systems. 12. 1. Acid-base and buffer systems. 13. a. State the equilibrium equation for the bicarbonate buffer in water. 14. 1. State the equilibrium equation for the bicarbonate buffer in water.

4 MLT-1351: Problem Solving Techniques for the Medical Laboratory 15. b. Use the bicarbonate buffer to predict the change in ph when changes in the carbon dioxide or hydronium ion concentrations occur. 16. 1. Use the bicarbonate buffer to predict the change in ph when changes in the carbon dioxide or hydronium ion concentrations occur. 17. c. Define ph and interpret the changes in hydronium ion concentration and relate it to the change in ph. 18. Define ph and interpret the changes in hydronium ion concentration and relate it to the change in ph. 19. d. Solve the Henderson-Hasselbalch equation and determine acid-base state of patient. 20. 1. Solve the Henderson-Hasselbalch equation and determine acid-base state of patient. 21. e. Solve equations to determine components of lipids, proteins, bilirubin, and thyroid hormone. 22. Solve equations to determine components of lipids, proteins, bilirubin, and thyroid hormone. G. Prepare graphs and evaluate graphing data. 1. 1. Define Beer's Law and apply given a substance's molar absorptivity, concentration and the cell path length data. 2. 1. Define Beer's Law and apply given a substance's molar absorptivity, concentration and the cell path length data. 3. 2. Convert Absorbance to % Transmittance and vice versa. 4. 1. Convert Absorbance to % Transmittance and vice versa. 5. 3. Construct a standard curve using absorbance and concentration data. 6. 1. Construct a standard curve using absorbance and concentration data. 7. 4. Read a standard curve to determine the absorbance or concentration of unknown sample. 8. 1. Read a standard curve to determine the absorbance or concentration of unknown sample. 9. 5. Define linearity and recognize corrective actions for non-linear situations. 10. Define linearity and recognize corrective actions for non-linear situations. 11. 6. Define slope. 12. 1. Define slope. 13. 7. Differentiate between logarithms and antilogs, and respective graphs. 14. 1. Differentiate between logarithms and antilogs, and respective graphs. H. Discuss enzyme kinetics 1. 1. Describe the principle of end point reactions and their measurements. 2. 1. Describe the principle of end point reactions and their measurements. 3. 2. Describe the kinetic reactions, and their measurements. 4. 1. Describe the kinetic reactions, and their measurements. 5. 3. Explain the factors affecting enzyme reactions. 6. 1. Explain the factors affecting enzyme reactions. I. Apply the principles and measurements of quality control. 1. 1. Calculate mean, standard deviation, coefficient variation for a series of numbers. 2. 1. Calculate mean, standard deviation, coefficient variation for a series of numbers. 3. 2. Construct a Levy-Jennings chart, and interpret data distribution. 4. 1. Construct a Levy-Jennings chart, and interpret data distribution. 5. 3. Identify shifts and trends and the causes of both. 6. 1. Identify shifts and trends and the causes of both. 7. 4. Identify out of control situations and select appropriate corrective action. 8. Identify out of control situations and select appropriate corrective action. 9. 5. Evaluate control data and apply Westgard rules appropriately. 10. 1. Evaluate control data and apply Westgard rules appropriately. 11. 6. State Clinical Laboratory Improvement Act (CLIA) requirements for instrument/method quality assurance. 12. 1. State Clinical Laboratory Improvement Act (CLIA) requirements for instrument/method quality assurance. 13. 7. Measures of comparison of test methods such as the t-test. 14. 1. Measures of comparison of test methods such as the t-test. B. Apply systems of measure.

MLT-1351: Problem Solving Techniques for the Medical Laboratory 5 1. 2. Determine the amount of diluent and stock to prepare a dilution. 2. 1. Determine the amount of diluent and stock to prepare a dilution. 3. 6. Employ scientific notation appropriately. 4. 1. Recognize the proper English and metric units for mass, length, temperature, volume and pressure. 5. 1. Recognize the proper English and metric units for mass, length, temperature, volume and pressure. 6. 2. Convert English units to metric units and vice versa. 7. 1. Convert English units to metric units and vice versa. 8. 3. Compare freezing, boiling, and room temperatures; perform conversion calculations for Fahrenheit, Celsius, Kelvin. 9. 1. Compare freezing, boiling, and room temperatures; perform conversion calculations for Fahrenheit, Celsius, Kelvin. Methods of Evaluation: 1. Written assignments 2. Case studies 3. Examinations 4. Quizzes 5. Practice problems and worksheets Course Content Outline: 1. Review of basic math skills a. Fractions and decimals b. Percent c. Ratios and proportions d. Solving linear equations e. Scientific notation f. Significant figures 2. Temperature scales a. Fahrenheit b. Celsius c. Kelvin 3. Systems of measure a. Metric system i. Mass ii. Length iii. Temperature iv. Volume v. Pressure b. United States Customary System (English) i. Mass ii. Length iii. Temperature iv. Volume v. Pressure 4. Solution concentration and conversion problems a. Percent b. Molarity c. Normality 5. Dilution calculations a. Dilution vs. dilution factors b. Simple c. Serial 6. Hematology calculations a. Manual blood cell counts b. Nucleated RBC correction c. Percent and absolute counts d. Reticulocyte e. RBC indices 7. Clinical chemistry calculations

6 MLT-1351: Problem Solving Techniques for the Medical Laboratory a. Renal function b. Osmolality and electrolytes c. Acid-base and buffer systems i. Bicarbonate equilibrium ii. ph balance iii. Henderson-Hasselbalch equation d. Lipids, proteins, bilirubin, thyroid 8. Graphs and graphing a. Beer''s Law b. Absorbance/% Transmittance conversions c. Construction and application of standard curves d. Linearity e. Slope f. Logarithms, 9. Enzyme kinetics a. End point reactions b. Kinetic reactions i. Zero order ii. First order 10. Quality control a. Mean b. Standard deviation c. Coefficient variation d. Levy-Jennings charts e. Westgard rules Resources Turgeon, Mary Louise.Clinical Laboratory Science, The Basics and Routine Techniques.6th ed. St. Louis: Mosby/Elsevier, 2012. Essridge, Barbara and Reynolds, Anna.Basic Clinical Laboratory Techniques.5th ed. Albany, NY: Delmar, 2008. Doucette, Lorraine.Mathematics for the Clinical Laboratory.2nd ed. Maryland Hts., MO, 2011. Campbell, Joe, and June Campbell.Laboratory Mathematics Medical and Biological Applications.5th ed. Mosby Publishers, 1997. Lesmeister, Michele.Math Basics for the Health Care Professional.3rd ed. Upper Saddle River, NJ: Pearson, 2009. Johnson, Catherine W., Timmons, Daniel L., Hall, Pamela E.Essential Laboratory Mathematics.2nd ed. Long Grove, Il: Waveland Press, 2010. "MLO Articles" various. "Advance Articles" various. ASCLS. "Clinical Laboratory Science" various. ASCP. "Laboratory Medicine" various. Resources Other The following websites are recommended as references for this course: 1. Clinical Laboratory Improvement Act:http://www.cms.gov/clia/ 2. Easy Calculator, links to calculation formulas:http://www.easycalculation.com/statistics/standard-deviation.php

MLT-1351: Problem Solving Techniques for the Medical Laboratory 7 3. Westgard Rules: http://www.westgard.com/ Top of page Key: 2994