Medical Review Officer Online Course with Live Discussion (Includes Digital Syllabus)-2020 Online Tab 7

2020 Online Tab 7 - MRO Syllabus

Pdf Summary

The document provides information on forensic laboratory urine testing for drug screening. It includes presentation slides on laboratory drug testing and specimen validity testing. The goals of a forensic drug testing laboratory are to determine drug presence, identify specimen validity, and detect any substitution or adulteration. The laboratory flow chart for drug testing involves specimen collection, screening, confirmation, and reporting. The initial test or screening test is used to eliminate negative specimens, and it must meet FDA requirements. Negative specimens have drug concentrations below the cut-off while positive specimens have concentrations equal to or above the cut-off. The cut-off is an arbitrary point used to divide specimens into negatives and positives. The document also includes the HHS mandated screening cut-offs for various drugs. The confirmatory test is a second analytical procedure using chromatographic separation and mass spectrometric identification. It must be validated before use. Specimen validity testing includes tests for substitution, creatinine concentration, specific gravity, pH, and various adulterants. Adulterated specimens can have abnormal physical characteristics or reactions, while substituted specimens have low creatinine concentration and specific gravity values. Dilute specimens have low creatinine concentration but normal specific gravity values. The document also mentions drugs not currently included in the HHS panel, such as synthetic cannabinoids and synthetic cathinones. The types of adulterants mentioned include traditional household chemicals, designer adulterants, and interferences with immunoassays or confirmation assays. The document also briefly discusses hydrogen peroxide and peroxidase as adulterants.

Keywords

forensic laboratory urine testing

drug screening

specimen validity testing

substitution

adulteration

cut-off

HHS mandated screening cut-offs

confirmatory test

creatinine concentration

specific gravity