By K. Grobock. Reed College. 2018.

We also put no limits on language or time to capture the global literature and early studies purchase 300mg trileptal visa. Once we tagged the articles for content order 600mg trileptal free shipping, we assessed whether those that passed our inclusion criteria were pertinent to specific key questions buy cheap trileptal 150mg line. Many articles were analyzed in several phases of medication management and sections of the report cheap 600 mg trileptal otc. The quality of included studies was assessed using the same criteria employed by Jimison et al. Observational studies with before–after, time series, surveys, or qualitative methods were not assessed for quality because few well-validated instruments exist. Bibliographies of systematic and narrative reviews were examined to identify studies, and select reviews were integrated into sections of the report. Data were abstracted from relevant articles and tagged for applicability to the various key questions. Given the range of questions addressed, data abstraction was performed by a core group of staff and entered into online data abstraction forms. One reviewer did the abstraction, and a second, senior reviewer checked its accuracy. The reviewers were not blinded to the identity of the article authors, institutions, or journal. Definitions for medication errors and related terms were often inconsistently used. To make data abstraction easier, we established working definitions, which can be found in Appendix F of the full report. Meta-analysis was not performed on any data because of the heterogeneity of the studies in terms of interventions, populations, technologies used, and outcomes measured, as well as the presence of mostly descriptive and observational studies. After duplicates were removed, 32,785 articles were screened at title and abstract stage. From a full-text screen of 4,578 articles, we identified 789 articles that were eligible for inclusion in this report. Of these articles, 361 met only our inclusion criteria for content and did not have group comparisons, hypothesis testing, or appropriate analysis. Prescribing and monitoring were the most frequently studied phases of medication management (Table A), with hospital and ambulatory care settings well-represented to the near exclusion of long-term care, home, and community (Table B). Though dealing with prescriptions and medications, pharmacists were poorly represented in studies, most focused on physicians (Table C). The evidence is strongest specifically during the prescribing and monitoring phases. Those that did often did not show statistically significant improvements in clinical outcomes. Survey studies of satisfaction and use reflect similar findings of acceptance and satisfaction, although most indicated room for improvement. Distribution in the number of studies across the five phases, plus reconciliation and education, was not equal. Prescribing was studied in 174 studies, order communication in 16 studies, dispensing in 9 studies, administering in 19 studies, and monitoring in 47 studies. The prescribing phase is well studied (174 studies), especially in hospital (61 percent of studies) and ambulatory care settings (39 percent). Long-term care centers (one study) and community and home settings (no studies) are not well studied. Many of the studies of health care providers who were not physicians were purely descriptive of the people involved with them, and the systems themselves. Both systems, either alone or, more often, integrated, are well studied (multiple studies with strong methods). Errors related to prescribing and ordering were reduced in hospital-based studies (68 percent, 15 of 22 studies), but prescribing errors were not studied as often in ambulatory settings (two of two studies were positive). Reductions in time were related to the time taken to order or prescribe or the speed of the prescribing-to-administering processes. Most reductions in time were not seen as often in hospital-based studies (four of seven studies positive), but were positive more often in ambulatory settings (four of five studies). Workflow was not evaluated in these studies of changes in process, although issues of workflow are addressed in qualitative studies in other sections of this report. Order communication, like dispensing, is one of the two medication management phases with the least number of studies—only 16 were identified. The changes in process were also varied (two studies of errors, two of prescribing changes, five on time considerations, and three on workflow). Most studies were done using quantitative observational methods and all showed positive results. All process changes that were evaluated were found to be positive: four on modifications of the drugs that the pharmacists dispensed, three on errors, two on workflow, and one on adherence to good practice. Many articles dealing with administering medications were not included in this report because they were descriptive and did not include comparative data. Error-reduction goals were common in the studies and almost always found to be improved (8 of 13 studies of errors). Errors were mixed, as some related to transcription and some to timing of administration, while some identified more serious errors. Four studies showed no improvement in errors while one study showed increases in errors, mostly related to 12 timing of administration. Four of five studies showed reductions in time from ordering to administering medication. In our analysis, 70 percent (33 of 47 studies) of the included studies were associated with a 50 percent improvement in half or more process measures. Studies that involved laboratory-based medication monitoring were most likely (76 percent of the time) to be associated with a greater than 50 percent improvement in a process outcome(s) than sign- or symptom-based medication monitoring. The most successful types of studies focused on changing prescriber behavior, improving response time to generated alerts, and improving the diagnosis and management of chronic diseases. Reconciliation is the matching of medication lists over time, from different health care systems or from different prescribers. The evidence on reconciliation of medication lists is sparse, especially for systems that are fully integrated and capable of providing electronic comparisons of historical and current medications for individual patients at hospital discharge or on transfer to other facilities. All four studies showed improvements in agreement among lists of medications and two extended the evaluation to show 13 14 improved prescribing and reduced errors. Training in the use of systems was often mentioned in articles but was not evaluated. More information on health care professional and patient education is included in the sections of this report dealing with intermediate outcomes.

She recalls experiencing significant side effects as a result of being over-medicated trileptal 300mg overnight delivery, including cognitive difficulties (“you can’t think”) and describes herself as “just existing” and “not functioning” purchase 300 mg trileptal amex. Whilst Anna does not link these experiences to non-adherence in this extract buy discount trileptal 600mg on-line, it could contextualise her reported non-adherence to a complex medication regimen as acknowledged in the previous extract generic trileptal 600mg line. In the following extract, Travis challenges whether antipsychotic medication should be the first-line of treatment for people who experience psychoses, on the grounds that it causes side effects: Travis, 19/02/2009 T: If they’ve got a permanent illness and they need them [medication], then that’s it, you know, but if it can be calmed down and they can push through it without them, they’ll never have to worry about that, you know, but it’s never that easy, you know. But my view is it’s 176 a good thing but it would be lovely for newer tablets to come out with less side effects. T: Yeah and you know, it makes very motivated people just not want to get off the couch. The significance of side effects to consumers is highlighted above, through Travis’s representation of medication adherence as essential only for consumers who are chronically ill and are dependent on or “need” medication. He acknowledges the struggle associated with persevering with illness symptoms in the absence of medication by pointing out that consumers will have to “push through it” but constructs life “without” medication as a better alternative to medication adherence in unspecified circumstances, potentially for first episode consumers, for example, for whom the likelihood of relapse is uncertain. Despite recognizing the benefits of medication adherence for consumers (“it is a good thing”), Travis implies that the efficacy of antipsychotic medication is somewhat offset by associated side effects (“but it would be lovely for newer tablets to come out with less side effects”). Travis specifically links medication adherence to the side effects of decreased motivation, increased appetite and weight gain, using pre and post-medication adherence comparisons to emphasise the drastic impact of side effects. Travis’s stance in relation to medication adherence despite attributing medication adherence to saving his life highlights the significance of side effects to consumers. Research consistently indicates that the efficacy (or perceived efficacy) of medication in treating illness symptoms exerts a significant influence on adherence (i. The main utility of medication was seen as its ability to act directly on symptoms by stopping them or reducing them to make them more manageable. The degree to which consumers’ past and present medications treated illness symptoms varied. There was also inter-consumer variability in terms of responses to the same medications. The impact of medication on symptoms was emphasised through constructions of adherence as intrinsically linked to “sanity” or “normality”, which were contrasted with constructions of non-adherence as related to “insanity” or “abnormality”. The following extracts, thus, also tend to emphasise how mental illness can detract from consumers’ lives and how medication addresses detractions. It is noteworthy that like the “Reflection on Experiences” code, this code also emphasises that experiences with medications and adherence are interlinked. In the following extracts, direct correlations between adherence and sanity, and non-adherence and insanity, are made: 178 Ryan, 26/09/2008 R: Uh, um yeah, the difference between being sane and not being sane, so that’s how I’d encourage other people. Because like, being, being bad and then being good is two different sides of the fences, ya know? G: Because like, with the medication, it impacts a lot ‘cause we’re dependent, we’re not dependent on it, but… it helps keep us sane sort of thing, ya know, it helps. In the context of being asked how adherence could be encouraged amongst consumers, Ruth emphasises the effectiveness of medication in treating symptoms through her construction of medication adherence as “the difference” between two opposing mental states: “being sane and not being sane”. Gary also constructs medication adherence as the catalyst for a shift between contrasting mental states. He deploys a fence metaphor to illustrate how, by “over-rid[ing] the symptoms”, medication adherence is aligned with 179 “being good” and implies that non-adherence is aligned with “being bad”. Gary elaborates by attributing his maintained adherence, constructed as medication “dependence”, to the capacity of medication to “keep us sane”. Medication adherence is ascribed a significant amount of power in the above extracts, as it is essentially associated with alleviating insanity. In the following extracts, interviewees promote adherence by indicating that through its efficacy in treating symptoms, medication can normalise consumers. I’ve never been on strong medication but if I don’t take my medication it ain’t funny you know? The number one strategy what I’d say to someone with schizophrenia to take their medication is that sometimes, being out of the hospital, say for the first episode, for me, for example, um, it uh, they give you medication in tablet form like I did, but they may give you injections and sure, it may be sedating, a bit tiring and lack of energy taking some of these different medications for schizophrenia but the reality is, uh, then you 180 realise you will turn to normal because it treats that, I guess that chemical imbalance in your mind. In the first extract, George explicitly describes that “bein’ happy and just bein’ normal” influences him to remain adherent, in contrast to being a “bit loopy” and to getting “sick” when he does not take his medication. Furthermore, he describes the effects of not taking medication as being obvious to others (“people know”) and implies that the public element of displaying symptoms partly influences his adherence, possibly reflective of self-consciousness in relation to his illness and awareness of the associated stigma. A clear contrast is worked up, functioning to present medication adherence as linked with being ‘normal’. In addition to George’s construction of being “sick” without medication, in the second extract, Ryan also appeals to the biomedical model of mental illness through his description of medication treating “that chemical imbalance in your mind”. As before, medication is constructed here as alleviating this illness or abnormality: Despite side effects (“sedating, a bit tiring and lack of energy”), through its efficacy in treating the “chemical imbalance”, medication allows an individual to “turn to normal”. Through Ryan’s reference to these side effects, followed by his construction of medication as a normalizing agent, it is suggested that the experience of side effects does not compromise the ‘normal’ status of consumers despite antipsychotic medication side effects being absent from the ‘normal’, mentally healthy human experience. In the following extracts, Ross and Steve associate their adherence with medication’s effectiveness in reducing the risk of suicide. This is contrasted with suicidal tendencies when symptoms were left untreated by 181 medication. They thereby construct medication adherence as enabling them to live: Ross, 14/08/2008 L: What sorts of things do you find that you um, are you able to enjoy now that you couldn’t if you weren’t on medication? Above, Ross indicates that he would not be able to “cope” and “wouldn’t be alive today” without medication. He implies that he experienced suicidal tendencies when symptomatic and untreated. Steve elaborates that “the voices would take over” which he would “act on” by committing “suicide”. Both Ross and Steve highlight the importance of the efficacy of their medication in reducing their symptoms, particularly given that when symptomatic, they become suicidal. Whilst neither of them directly link their 182 adherence with their medication’s capacity to reduce the risk of suicide, both could be seen to imply that adherence is a logical choice when their negative experiences associated with non-adherence are taken into account. In the following extracts, consumers highlight how by treating their symptoms, medication improves their lives. They construct the by-products of medication adherence, including symptom relief, cognitive, emotional and social gains, as reinforcing adherence: Anna, 18/02/2009 L: What would be then the main benefits I guess of taking your medication then? A: Well I seem to have um, a more meaningful life um, I’m able to socialize um, and make decisions for myself. A: More so the right decision rather than, anything went before; what happened, happened and yeah, never really thought of the consequences before. I mean, I get agitated when I’m unwell and that but the medication, I truly believe the medication helps keep me well. Anna and Rachel both refer to experiences of non-adherence and contrast this with experiences of adherence to emphasise how, by treating their symptoms, medication has changed them and rendered their lives more “meaningful” or fulfilling. Anna contrasts a lack of understanding of consequences when non-adherent to improved decision-making skills when adherent. Anna also contrasts a pre-adherence “couldn’t give a shit attitude” with enhanced consideration of others when adherent.

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For treatment generic trileptal 600 mg free shipping, manual detorsion may be attempted if the torsion has occurred within a few hours trusted 600mg trileptal. This consists of infiltration of the sper- matic cord near the external ring with lidocaine trileptal 150 mg low price. The left testis is rotated counterclockwise manually order 300mg trileptal mastercard, while the right testis is rotated clockwise manually. Manual detorsion usually is not effective because of the patient’s degree of pain. Emergent surgical scrotal exploration should be performed under general anesthesia. A scrotal incision is made, the spermatic cord is untwisted, and the testis is inspected. If the testis appears viable, it should be sutured in place to the surrounding tissue. The contralateral testis also should undergo orchiopexy during the same procedure. Torsion of the testicular appendages may mimic testis torsion and usually occurs in boys younger than 16 years of age. The appendix testis (remnant of the Müllerian duct) and appendix epididymis (remnant of the Wolffian duct) may twist and cause venous engorge- ment and infarction, producing the “blue-dot sign. If the pain persists or there is concern of testis torsion, emergent surgical exploration should be performed. Case Discussion The patient in Case 2 stated that the pain occurred suddenly about 2 hours previously and continued to be unbearable. Urinalysis was negative for white blood cells, and Doppler ultrasonography revealed decreased flow to the testis. The patient underwent emergent scrotal exploration in the operating room, where a testis torsion was found. The testis was sutured to sur- rounding tissue (orchipexy) to prevent future torsion and the con- tralateral testis also underwent orchiepexy. Epididymo-orchitis Acute epididymitis is extremely painful and may mimic the symptoms of testicular torsion. It is caused by urinary tract pathogens, such as gram-negative organisms, and often originates from prostatitis or an indwelling urethral catheter. Acute epididymitis also can be associated with sexually transmitted diseases, such as those caused by Chlamydia trachomatis or Neisseria gonorrhea. Laboratory findings reveal white blood cells in the urine and a pos- itive Gram stain. Ultrasonography reveals a hypervascular area consis- tent with the inflammatory response of infection. If a urinary pathogen is suspected, the patient should be given a quinolone or a trimethoprim sulfate until urine and blood culture sensitivities return. If a sexually transmitted disease is suspected, the patient should be given an injection of ceftriaxone followed by oral doxycycline or tetra- cycline. Depending on the severity of the infection, the patient may need pain medications, ice packs to the scrotum, and bed rest. Some patients progress to chronic epididymitis and require long-term antibiotic coverage and nonsteroidal antiinflammatory medication. Testis Masses Testis masses include benign lesions of the scrotum and testis tumors. They usually are benign, but they must be differentiated from testis tumors and inguinal hernias. Hydroceles in children usually are due to persistent patency of the processus vaginalis. Hydroceles in adults usually are due to fluid collection within the tunica vaginalis. They often are due to nonspecific epididymitis or orchitis or are a result of scrotal trauma. Occasionally, they can be related to testis cancer, tubercular epididymitis, or radiotherapy. Physical examination of the hydrocele reveals a uniformly enlarged mass in the scrotum. Ultrasonography confirms the diagnosis of hydrocele and rules out the presence of testis tumor or inguinal hernia. If the hydro- cele is small and the patient has no discomfort, the patient is man- aged conservatively. Scrotal Disorders 699 Testis mass Differential History and physical –Testis tumor –Varicocele –Spermatocele –Hydrocele –Tunica albuginea cyst Scrotal ultrasound Varicocele – Conservative – Surgery for pain Testis or infertility Tumor (see Algorithm Spermatocele 39. It usually is small, with the patient complaining of a nontender, firm testis mass. The sperma- tocele is located in the epididymis, posterior to the testis and clearly separate. The spermatocele is caused by obstruction of the tubules connecting the rete testis to the head of the epididymis. If the patient complains of persistent pain over a period of time, surgical excision may be performed. Varicocele A varicocele is the dilation of the pampiniform venous plexus, which drains the testis. The higher prevalence of left varicoceles may be caused by the insertion of the left spermatic vein on the left renal vein. In a small number of men, these veins become painful, espe- cially when standing upright for long periods of time. Weiss a varicocele in an older man may be an indication of a renal tumor obstructing the spermatic vein. Varicoceles may affect the temperature of the testes and subsequently alter sperm count, sperm motility, and morphology. Physical examination of men with varicoceles should be performed with the patient in the upright position. The engorged veins can be pal- pated superior to the testis following the path of the spermatic cord. These veins usually dilate when the patient performs the Valsalva maneuver and empty when the patient is in the reclining position. Surgery may become necessary if the patient demonstrates diminished testicular size or abnormal sperm parameters or if the patient complains of persistent pain. Surgery may be performed by high ligation of the spermatic veins in the abdomen or ligation of the branches of inferior veins in the spermatic cord. Testis Tumors Testis tumors commonly occur in young men between the ages of 20 and 40 years old. There are two to three new cases of testis cancer per 100,000 men in the United States per year. Testis tumors tend to occur in an age group of men who often do not have routine physical examinations. Nonsemino- matous tumors include embryonal carcinoma (20%), teratoma (5%), choriocarcinoma (<1%), and mixed teratocarcinoma (40%).

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And to stay out of the workshop until the asbestos- containing belt had been replaced and the furniture painting had been moved to a different building purchase trileptal 300mg with visa. High Blood Pressure High blood pressure is one of the easiest problems to correct without resorting to drugs generic trileptal 150mg fast delivery. The most important change to make is to stop using caffeine as in coffee cheap 150mg trileptal, tea cheap 150mg trileptal otc, or carbonated beverages. Switch to hot milk or hot water if a hot beverage is desired, or any of the beverages given in the recipe section. If being without caffeine leaves you fatigued, take an arginine tablet in the morning (500 mg). Blood pressure is mainly controlled by the adrenal glands which sit like little caps on top of the kidneys. You could do your search in the kidneys since kidney tissue is available in grocery stores. Conducting or storing drinking water in containers of metal is as foolish a practice as eating food off the floor. You may not see what it picked up any more than you can see if it has picked up sugar or salt. If you find cadmium in your hot or cold water, you will never be able to filter it out. The amount of cadmium in your clothing from doing laundry with this water is already too much for your adrenals and kidneys. If you believe you already have plastic pipes or all copper (which leads to leu- kemia, schizophrenia and fertility problems) you will need to search every inch of plumbing for a very short piece of galva- nized pipe left in the system! The toxicity of cadmium, in fact, the high blood pressure connection, has been known a long time. All (100%) cases of high blood pressure I have seen could be easily cured by eliminating cadmium and other pollutants, followed by cleansing the kidneys. To test whether you still need your blood pressure medicine, wait until your pressure is down to 140/90 or better. If it has climbed back up you are not ready; go back to ¾ or a full dose of medicine. If your blood pressure stays down, cut your medicine in half again (you are now down to ¼ the regular dose) and see if your blood pressure stays improved. Better yet, make a salt that is a mixture of sodium and potassium chlorides (see Sources). The sodium portion could be sterilized sea salt (test and make sure it has no alumi- num silicate in it first). Rinse these thoroughly first, throw away shriveled ones, and add vitamin C to the cooking water. Bala Cuzmin, age 72, had high blood pressure for ten years but the upper (systolic) pressure remained high in spite of various medi- cines that were tried. She stopped using caffeine, switching to arginine tablets to get over the let-down. Her diet was changed to reduce phosphate and add calcium, and she took magnesium and Vitamin B6 to assist the kidneys. She killed parasites, cleansed kidneys but saw no drop in blood pressure which stayed at 150 to 170 systolic. She had all the metal in her mouth replaced and promptly saw a blood pressure drop to 145-1 50. She had phosphate crystals in her kidneys and was started on kidney herbs and a diet change to include milk and exclude soda pop. She was feeling so much better after the kidney cleanse that she decided to remove her last fillings and replace her bridge, too, since it was shedding ruthenium. On her way home from the dentist, her ears stopped ringing and soon her blood pressure was down to 126/68. She was still on half a dose of drugs because she was too afraid to go off entirely. This gave her the energy she wanted to play basketball with the grandchildren again. Then he could cut back on his medicines, measuring his blood pressure daily to guide him. After seven weeks it was down to 140/85, so he decided to do without medicine, a bit early. His next chore, which he approached gladly, was removal of all metal from his mouth. He still had some Ascaris and other health problems but was highly motivated to clean them up, too. Glaucoma In glaucoma the pressure in the eyeball gets too high, putting pressure on fragile retina cells that do your seeing. It is your tip-off, though, that something is not right and you should correct it now, when it is easy, and before other damage is done. Read the section on high blood pressure (page 210) to learn how to reduce it by going off caffeine, checking for cadmium poisoning from your water pipes, and cleansing the kidneys (page 549). Simply getting your blood pressure to normal is sufficient help for beginning glaucoma. Antonia Guerrero, age 51, had glaucoma for five years and was dete- riorating rapidly. She cleansed her kidneys, killed parasites and changed her diet to the anti-arthritic one since she also suffered from arthritis in her hands for ten years with painful enlarged knuckles. She got rid of her asbestos toxins by bringing her own hair blower with her to the hairdresser. After seven months she had pain relief for her arthritis (without aspirin) and her glaucoma was pronounced stable by her ophthalmologist. We must look at the enamel, dentine and root of the tooth as well as the bone they rest in for some answers. Since commerce determines which re- search can be done (that is, paid for) sacred territory can be ig- nored. For example, the effects of sugar-eating, gum-chewing, tooth brushing, fluoridation, tooth filling materials and diet can be ignored if it interferes with product sales. Trivial studies such as comparing shapes of toothbrushes, studying the chemical composition of plaque, and studies of bacterial structure and genes are done instead. His scientific studies stand as a bea- con even today because truths, once found, do not change. He described what he saw in a book, titled Nutrition and Physical 13 Degeneration.

What procedure would help to distinguish this antibody from other cold-reacting antibodies? An antibody identification panel reveals the Answers to Questions 12–15 presence of anti-Leb and a possible second specificity purchase trileptal 150 mg otc. C Lewis antibodies are usually not clinically significant neutralize the Leb antibody? Lewis antibodies are most easily removed Genes by neutralizing them with soluble Lewis substance buy trileptal 300mg low cost. B The Ortho Provue would result the patient with a screens on the Provue prevent a patient with a weak D phenotype as Rh negative buy cheap trileptal 150mg on-line, and if blood were weak D phenotype from forming anti-D? B The baby forward types as an A and the mother is Rh negative; the patient would receive O negative trusted trileptal 600mg. It is possible that anti-A,B from the Rh-negative blood mother is attaching to the baby’s red cells, causing a C. Therefore, the baby’s Rh-positive blood Rh type is unknown and the mother would be a D. An elution procedure followed by a 4+ 0 4+ 0 2+ panel performed on the eluate would help to identify the antibody. Screen cells and a panel performed on a patient’s serum showed very weak reactions with inconclusive results. Antigen typing the patient’s red cells Blood bank/Apply principles of special procedures/ Antibody identification/3 168 Chapter 4 | Immunohematology 16. A 33-year-old maternity patient is drawn for a type red cells from two O-positive donor units show and screen at 36 weeks’ gestation. Anti-A Anti-B Anti-A, B Anti-D A cells B cells 1 What action should be taken next? Wash the patient’s red cells and repeat the Blood bank/Select course of action/Incompatible forward grouping crossmatch/3 B. Warm the patient plasma at 37°C for 10 minutes Blood bank records are checked and indicate that and repeat the reverse grouping 5 years ago this patient had an anti-Jkb. Antigen type units for the Jkb antigen and only crossmatch units negative for Jkb Answers to Questions 16–19 C. This indicates the possibility 4 Jkb-negative units of a high-frequency alloantibody or a warm Blood bank/Apply principles of laboratory operations/ autoantibody. A positive autocontrol indicates an autoantibody is present; a negative autocontrol and 18. A 56-year-old patient diagnosed with colon cancer positive screen cells indicates an alloantibody. A panel coated the patient’s red cells, and is directed against study is done and shows 10 cells positive as well as screening cells and donor cells. B A patient with a history of a significant antibody like anti-Jkb must receive blood that has been completely history of receiving 2 units of blood approximately 1 month ago. Issue O-negative cells performed to adsorb out the autoantibody and leave Blood bank/Evaluate laboratory data to determine best potential alloantibodies in the patient’s serum that course of action/Panel study/3 will need to be identified before transfusion of blood to the patient. An autoadsorption cannot be performed due to the fact that any alloantibodies would be absorbed by circulating donor cells from a month prior. Warming the plasma at 37°C will dissipate the antibody, preventing its reactivity with P1 antigen on the A1 cells. An O-negative mother with no record of any Answer to Question 20 previous pregnancies gives birth to her first child, a B-positive baby. C In this case, the maternal anti-A,B is probably coating positive and the negative control is negative. Te baby Anti-A,B from an O person is a single entity that cannot appears healthy but develops mild jaundice after be separated. Which formula correctly describes the relationship Answers to Questions 1–5 between absorbance and %T? All of these options Multiplying the numerator and denominator Chemistry/Identify basic principle(s)/Instrumentation/2 by 100 gives: 2. D Beer’s law states that A = a × b × c, where a is the Beer’s law/1 absorptivity coefficient (a constant), b is the path 4. A A solution transmits light corresponding in Spectrophotometry/2 wavelength to its color, and usually absorbs light of wavelengths complementary to its color. A green-colored solution would show highest red solution transmits light of 600–650 nm and transmittance at: strongly absorbs 400–500 nm light. A solution that is green would be quantitated using a wavelength that it absorbs strongly, such as 450 nm. A Visible spectrophotometers are usually supplied and adjusting the readout to zero %T with the with a tungsten or quartz halogen source lamp. Output 100%T control at maximum, the instrument increases as wavelength becomes longer peaking readout will not rise above 90%T. Insert a wider cuvette into the light path becomes insufficient to set the blank reading to C. A sharp cutoff filter and a variable exit slit generate a continuous spectrum of fairly uniform C. Interference filters and a variable exit slit intensity from 300–2,000 nm, making them useful D. A diffraction in order to measure the true absorbance of a grating produces a uniform separation of compound having a natural absorption wavelengths. D The photomultiplier tube uses dynodes of increasing voltage to amplify the current produced by the 10. Dispersion from second-order spectra because it responds to light fluctuations caused by D. C Stray light is caused by the presence of any light other than the wavelength of measurement reaching the detector. It is most often caused by second-order spectra, deteriorated optics, light dispersed by a darkened lamp envelope, and extraneous room light. A linearity study is performed on a visible Answers to Questions 11–14 spectrophotometer at 650 nm and the following absorbance readings are obtained: 11. D Stray light is the most common cause of loss of linearity at high-analyte concentrations. Light Concentration of Standard Absorbance transmitted through the cuvette is lowest when 10. C Sharp cutoff filters transmit almost all incident light standards and reagents, but results were identical until the cutoff wavelength is reached. D Wavelength accuracy is verified by determining Chemistry/Identify sources of error/Spectrophotometry/3 the wavelength reading that gives the highest absorbance (or transmittance) when a substance 12.

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