CAP Pro Course - Immunology - Human Chorionic Gonadotropin and Fetal Fibronectin

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Author: Kevin F. Foley, PhD, DABCC, MT, SC
Reviewer: Alexandru Casapu, MBA, MLS(ASCP)CM, PBTCM

Continuing Education Credits

Objectives

  • Explain the physiologic role of hCG, and how and why this protein is measured both qualitatively and quantitatively.
  • Explain the methodologies used to measure hCG.
  • Explain the limitations of urine hCG testing in the clinical setting.
  • Compare and contrast the use of hCG testing during pregnancy from its use as a tumor marker.
  • Describe the physiology, clinical utility, and test methodology for fetal fibronectin.

Course Outline

  • Explain the physiologic role of hCG, and how and why this protein is measured both qualitatively and quantitatively.
      • Human Chorionic Gonadotropin
      • The Beta Subunit and Pregnancy
      • Measuring hCG
      • A patient who became pregnant 30 days ago was tested in the lab for serum hCG and had a concentration of 280 mIU/mL. A second patient tested at the sa...
      • A medical laboratory scientist is asked about the difference between their laboratory's urine and plasma hCG tests. Which of the statements below is a...
      • The hormones LH, FSH, and TSH share alpha-subunit homology with hCG. Given this fact, which physiologic finding is commonly seen in the lab?
      • A physician calls the lab to inquire about the serum hCG assay being used. Specifically, the physician wants to know how soon after intercourse would ...
      • A patient calls the laboratory and asks, "How soon after a conception or a missed period can the laboratory tell if I am pregnant?" What would be the ...
  • Explain the methodologies used to measure hCG.
      • Immunoassays
      • Immunoassays, continued
      • Using hCG Immunoassays
      • When using a qualitative hCG testing device, which of the following is not true?
      • A laboratory using an immunometric (sandwich) assay for hCG has a problem with the wash step after adding the secondary (reporter) antibody. Which of ...
      • Urine creatinine can be used to augment an hCG test in which of the following ways?
      • Which is the recommended specimen for urine hCG testing?
  • Explain the limitations of urine hCG testing in the clinical setting.
      • Limitations with hCG Assays: Heterophile Antibodies
      • False-Negatives
      • Hook Effect
      • Caveats with hCG testing
      • Which of the following definitions correctly describes a heterophile antibody?
      • A laboratory supervisor is working with the surgery department to define a pre-surgical workup testing panel. Which of the statements below should be ...
      • While working in the laboratory, a medical laboratory scientist receives a phone call from a nurse in the Emergency Department. The nurse is angry and...
      • What should be done if a medical laboratory technician suspects a heterophile antibody is present?
  • Compare and contrast the use of hCG testing during pregnancy from its use as a tumor marker.
      • hCG as a Tumor Marker
      • Other sources of hCG
      • A medical laboratory scientist receives a call from a physician who accidentally ordered serum hCG testing on her 59-year-old patient. Interestingly, ...
      • Why is finding pituitary-secreted hCG significant?
      • Which of the following is not a physiologic source of hCG?
  • Describe the physiology, clinical utility and test methodology for fetal fibronectin.
      • Predicting delivery
      • Fetal Fibronectin
      • Which of the following statements is true?
      • A medical laboratory scientist is asked to explain the result of a positive fFN test. Which of the following would be a correct response?
      • In which of the following scenarios would it be appropriate for the laboratory to perform fetal fibronectin testing?
  • 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: Kevin F. Foley, PhD, DABCC, MT, SC is the director of clinical pathology for the Kaiser Permanente Northwest region. He also teaches clinical chemistry at Oregon Health Sciences University. Dr. Foley earned his PhD in clinical pharmacology and toxicology at East Carolina School of Medicine in North Carolina.
Reviewer Information: Alexandru Casapu, MBA, MLS(ASCP)CM, PBTCM, has over 20 years of experience as a medical laboratory scientist, section supervisor, and laboratory manager. He is the former Director of Clinical Laboratory Technology Program at Georgia Piedmont Technical College. He is currently a Program Director at MediaLab, Inc. Alex holds BS degrees in Biology and Medical Technology from Clark Atlanta University and an MBA from the University of Georgia.

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