CAP Pro Course - Chemistry - Clinical Toxicology (2025 & 2026)

Author: DeRhonda Crawford, MT(ASCP)
Reviewers: Laurie Bjerklie, MA, MLS(ASCP)CM and Joshua J. Cannon, MS, MLS(ASCP)CMSHCM

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 specimen collected for DOA testing has a specific gravity of 1.040. What does this indicate regarding the specimen?
      • The laboratory received a blood sample from an adult male in the ER. The specimen was in a biohazard bag, but the specimen had no identification on th...
      • A man is transported to the emergency room to treat injuries following a multi-car accident. This man was determined to have caused the accident, so t...
      • A woman came in for a pre-employment drug screen required by the potential employer. The woman went into the bathroom with all of her personal belongi...
      • When a pending log is printed at 7:00 AM, the medical laboratory scientist (MLS) notices that the urine drug screen that was ordered along with a urin...
      • The ER physician ordered an alcohol level on a patient to assist in treatment. The laboratory received some specimens earlier in the evening from the ...
      • A man was admitted to the hospital after being seen in the emergency room. The next morning, after the new attending physician reviewed the patient's ...
      • Which one of the following should be avoided when urine specimens are collected and tested for drugs of abuse?
  • 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
      • A current associate was suspected of drug abuse. Her supervisor requested a drug screen on the associate. The drug screen tested positive for opiates....
      • The cutoff for cocaine in the laboratory is 300 ng/mL. The patient's drugs of abuse result for cocaine is 299 ng/mL. What statement would best describ...
      • Which liver enzyme is the most specific for alcohol-induced liver damage?
      • Along with the established cutoff ranges for drugs of abuse, what other information should be made available to the physicians?
      • Which one of these actions may falsely decrease a serum alcohol result?
  • 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
      • A female patient was brought to the emergency room with a possible overdose of acetaminophen. Since the type or amount of acetaminophen and the time o...
      • A patient who is brought to the emergency department has symptoms of fever, tinnitus, hyperventilation, respiratory alkalosis, metabolic acidosis, let...
      • In addition to ordering acetaminophen levels, the physician has ordered other tests, including aspartate aminotransferase (AST) and alanine aminotrans...
      • A laboratory assay for plasma salicylates returns a result of 50 mg/dL, and an acetaminophen assay performed on the same patient has a concentration o...
      • Why would an enzymatic/colorimetric or immunoassay procedure be preferred for clinical acetaminophen testing rather than a gas chromatography/mass spe...
      • 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 Information: 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, MA, MLS(ASCP)CM, is currently an Education Developer. 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 15 years of experience in higher education and has held program director and faculty positions in both MLT and MLS programs.
Joshua J. Cannon, MS, MLS(ASCP)CMSHCM received his Bachelor of Science and Master of Science in Medical Laboratory Science from Thomas Jefferson University in Philadelphia, PA. He holds Medical Laboratory Scientist and Specialist in Hematology certifications through the ASCP Board of Certification. He was a professor at Thomas Jefferson University for seven years before transitioning into his current role as an Education Developer. His areas of expertise and professional passions include clinical hematology and interprofessional education.

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