LabQ Clinical Exercise 2: Clinical Chemistry: Limitations of Immunoassays and Liquid Chromatography – Tandem Mass Spectrometry Screen and Confirm Testing

KYLE LUND, PHD

ROBERT L. FITZGERALD, PHD, DABCC

Department of Pathology

University of California San Diego 

San Diego, California

Primary Audience: Phlebotomists, Laboratory Technologists, Laboratory Directors

Secondary Audience: Pathologists, Clinical Scientists (Includes all sub-specialty areas), Students, Pathologist Assistants, Residents, and Students

Upon completion of this activity, you will be able to:

·         describe the limitations of immunoassays and liquid chromatography–tandem mass spectrometry (LC-MS/MS) screen and confirm approaches for urine drug testing;

·         describe the process for identifying unknown synthetic drugs in a urine sample;

·         explain the difference between high-resolution and low-resolution MS;

·         identify compounds that contain chlorine and bromine based on A+2 MS signatures; and

·         describe the process used to improve chromatographic peak resolution when challenged with coeluting compounds.