AAMRO Exam Review 100% VERIFIED ANSWERS 2024/2025 CORRECT STUDY SET, Exams of Health sciences

Download AAMRO Exam Review 100% VERIFIED ANSWERS 2024/2025 CORRECT STUDY SET and more Exams Health sciences in PDF only on Docsity! AAMRO Exam Review 100% VERIFIED ANSWERS 2024/2025 CORRECT STUDY SET What steps does the collector take... before the employee provides a Urine specimen? * Secure bathroom for the exam * Check donor ID * Collector has ID * Basic procedure explained * Outer clothing removed * Donor washes hands * Select urine kit * Direct to bathroom (45ml, no flush, reasonable time) * Be alert for attempts to adulterate What happens it the employee refuses to hand his hands? It is considered a refusal When can the collector give the employee permission to leave? Only after the testing process is complete; urine obtained (45ml) and both collector and employee complete CCF What happens if the employee leaves the collection site prior to completion of the testing process? It is a refusal. Shy Bladder What if the employee does not prove 45ml of Urine? * Discard insufficient specimen and note time on CCF * Encourage to drink up to 40oz * Patient has 3 hours to provide (always a fresh cup) * no specimen within 3 hours, discontinue, note on CCF, contact DER What does the collector check for when the employee presents a specimen? *Temperature * Signs of adulteration What if the collector see signs of adulteration? Second collection conducted under Direct Observation Remarks line links 1 of 1 (1st collection) and 2 of 2 (2nd collection) Notify DER was a DO When is a directly observed collection conducted? * When directed by DER * Invalid result no medical explanation * Canceled (+) test- no split available * Negative-dilute with Creatinine concentration > 2mg/dl but < 5mg/dl * Return to Duty or Follow Up test * When determined by the collector How is a D.O. collection conducted? * Same gender "body to bottle" * Observer does not need to be trained * Employee declines it is "refusal" Are all DOT specimens split? Heroine --> 6-AM --> Morphine What are the major metabolites of codeine? codeine-->morphine codeine --> hydrocodeine->hydromorphone What are the metabolites of morphine? Morphine --> Normorphine & Morphine glucuronides Morphine --->hydromorphone What are the metabolites of Hydrocodone? hydromorphone 6-hydrocodone What are the metabolites of Oxycodone? Oxymorphone --> Oxymorphine glucuronide also hydrocodone impurities True/False Consumption of hemp or other non-prescription marijuana related products can be accepted for basis of a NEGATIVE marijuana test? False True/False Consumption of cocoa teas can be accepted as an explanation for verifying a cocaine test as NEGATIVE? False How is an codeine/morphine test less than 2000 ng/ml interpreted? Negative lab report. Can be reported by the staff Codeine/Morphine level reported between 2,000-15,000 ng/mL is positive if: 1) admission of misuse 2) evidence of abuse on clinical exam Codeine/Morphine level reported between 2,000-15,000 ng/mL is negative if: 1) Donor has valid Rx 2) No admission of misuse AND no clinical evidence found Can passive inhalation be an acceptable reason for (+) THC on urine exam? No. Levels are not high enough Prescription medications that cause (+) THC 1) Dronabinol (Marino, Syndros) 2) Sativex (CBD-Cananda) 3) Epidolex (CBD) 4) Protonix What positive test would indicate the the donor was smoking or consuming marijuana? THC-V What prescription medications would cause a positive amphetamine? L-meth: selegiline, Vicks (OTC) D-meth Desoxyn, Gradumet LD- meth didres, famprofaxone ADHD meds: Vynase, Adderall, ritalin etc True/False You must not verify a test negative based on information a physician recommended medical marijuana? The test will be positive Can extended use of CBD lead to a (+) THC urine? yes Benzoylecgonine can be detected in the urine of donor using? Cocaine Can passive inhalation of cocaine lead to a (+) benzoylecgonine? NO What can be the medical alternatives for Cocaine? Surgical use (in system 2-3 days after) TAC Is there any alternative medical explanation for PCP? NO What are the cutoff levels for THC? Immunoassay: 50ng/mL GC/MS: 15ng/mL What are the cutoff levels for Cocaine (Benzoylecgonine)? Immunoassay: 150ng/mL GC/MS: 100ng/mL What are the cutoff levels for Codeine/Morphine? Immunoassay: 2000ng/mL GC/MS: 2000ng/mL What are the cutoff levels for Hydrocodone/Hydromorphone? Immunoassay: 330ng/mL GC/MS: 100ng/mL What are the cutoff levels for Oxycodone/Oxymorphone? How long after use can the cocaine metabolite benzoylecgonine be detected by urinalysis? 60 hours What may the presence of morphine without codeine indicate? Heroine abuse Will synthetic narcotics (such as methadone) test positive for morphine and/or codeine? No In federally regulated testing, what step is required for MRO during opiate verification that is not required when verifying the other 4 classes of drugs? · Evidence of rx and physical signs of abuse. When can quantitative results be released to the employer? For legal cases only When can quantitative results be released to the donor? With in 10 days of written request What are the MRO's responsibilities in regard to split specimen testing? * Notify right for a split for (+) or adulteration or substitution * No split for an INVALID * Donor has 72 hours to request * Inform how to request * Employee may be billed by the employer * Inform lab to split * Inform DER of split order Under what conditions may the donor request a test of split specimen? * MRO verified specimen Positive and/or adulterated, or substituted * Donor has 72 hours to request * Additional tests (DNA) no authorized Can the donor request a split specimen if he/she has admitted to drug use? Yes Split specimens are for: MRO Verified Positive, Adulterated or Substituted specimens. NOT INVALID What cutoff levels are used in split specimen testing? · You must conduct this test without regard to the cutoff concentrations What is being tested for in the split specimen? Tests for whatever was confirmed positive in Bottle A Can/should the split specimen test be done at the same laboratory as the first test? No. Sent to a 2nd lab What if 2nd lab fails to reconfirm? Run SVT Send to a third lab If drug test is (+) Codeine and (+) THC and the donor has a RX for codeine, how does the MRO proceed? Test is negative for codeine Split can be ordered for THC but not codeine What information can be released to the donor? Any tests from MRO Lab package SAP evaluation report NOT SAP Follow up plan 1/3 Under what circumstances may the MRO report a positive test to the employer without first having spoken with the donor? 1. You may verify a test result as a positive or refusal to test, as applicable, if the employee expressly declines the opportunity to discuss the test with you. 2/3 Under what circumstances may the MRO report a positive test to the employer without first having spoken with the donor? 2. If the DER has successfully made and documented a contact with the employee and instructed the employee to contact, you and more than 72 hours have passed since the time the DER contacted the employee. 3/3 Under what circumstances may the MRO report a positive test to the employer without first having spoken with the donor? 3. If neither you nor the DER, after making and documenting all reasonable efforts, has been able to contact the employee within ten days of the date on which the MRO receives the confirmed test result from the laboratory. What are the consequences of a positive test? Remove the employee involved from performing safety-sensitive functions What steps must a driver take before he/she may return to work? 1. Negative Return-to-work test 2. SAP determines completed education or treatment What are the testing requirements after he/she has returned to work? Follow up testing at least 6 times in the first year and then as required by the SAP 1. Screening Test - Breath or Oral 2. Confirmation Test-Evidentiary (EBT) . ONLY breath What are the steps for an initial test STT or BAT? 1. ID Donor 2. <0.02 complete form, report to DER 3. >0.02 go to confirmation test BAT only What are the first steps of Alcohol confirmation? * Ensure at least 15 min waiting period * Tell employee test at end of waiting period * ID donor * Steps 1 & 2 on AFT * >30 minutes do confirmation test * enter elapsed time * not invalidated, compliance DOT sanction What happens after alcohol confirmation test results? <0.02 end =/> 0.02 employee sign Invalid- cancel repeat if possible Valid results to DER Who can be the representative observer? As the BAT or STT, you must not allow any person other than you the employee or DOT agency representative to actually witness the testing process What does the screening test technician (STT) do if a saliva screening device does not activate? Discard and repeat What does DOT define as a dilute specimen (specific gravity/creatinine levels)? (40.93) Creatinine Concentration: > 2mg/dL but < 20mg/dL What are some causes of dilute specimens? Tampered with, increase hydration What steps must the MRO take if a specimen is found to be dilute? 1) Report to DER that specimen is +/- and dilute 2) Check “dilute” box Copy 2 CCF 3) Employer May direct employee repeat specimen immediately (DO if Cr Conc of neg dilute > 2mg/dL but < 5mg/dL) 4) immediate recollect under DO What is Urine specimen is found to be dilute after DO collection? If recollection under DO is repeat neg-dilute: 1) Ensure recollection was DO 2) If DO report to DER neg-dilute 3)If not DO, immediate recollection under DO What steps may the employer take if urine specimen is found to be dilute? Positive is positive even if dilute Request collect immediately DO for Cr Conc of neg dilute > 2mg/dL but < 5mg/dL Cr. Conc > 5 mg/dL may but not required to test immediately - Test not under DO unless other reason - Treat all employees equal Adulterated or Substituted Specimens: What doe DOT define as a substituted specimen (specific gravity/creatinine levels)? *Creatinine < 2mg/dL Specific gravity < 1.0010 * Or > 1.0200 on BOTH initial and confirmatory creatinine tests AND on BOTH initial and confirmatory specific gravity tests on @ separate aliquots Adulterated or Substituted Specimens: How is an adulterated or substituted result reported by the lab to the MRO? 1) Must report laboratory results directly, and only, to the MRO at his or her place of business. You must not report results to or through the DER or a service agent (e.g., C/TPA). 2) Quantitative values including Creatinine and SP Grav 3) Quant for opiate results morph/cod > 15,000 ng/mL 4) Copy 1 CCF Adulterated or Substituted Specimens: How does the MRO report adulteration or substitution to the employer? * Secure transmission * No preliminary reporting * Copy 2 of CCF and retain a copy, NOT COPY 1 CCF * NO Quant levels to DER or C/TPA but can for consulting SAP Adulterated or Substituted Specimens: What are the consequences for the donor of the adulterated or substituted specimen? Removal from performing safety-sensitive functions MRO Review of Results: What functions may be fulfilled by a staff person working under the direct supervision of an MRO? o Contact the donor to schedule a discussion o Advise donor to have medical information for the interview o Cannot gather medical information o No inquire if they want to speak with you ·After 72 hours/10 days or safety issue A negative result? (40.127-161) after verification MRO’s Reporting of Result: What part of the chain-of-custody form to report results to the employer? CCF2 MRO’s Reporting of Result: May the MRO use the lab copy of the chain-of-custody form to report results to employer? No send CCF2 all reports are signed, stamped and dated MRO’s Reporting of Result: Transmitted to employer Phone, fax, mail and via C/TPA · MRO’s Reporting of Result: How should the MRO report the use of family member’s prescription medication? Positive , Authorized only in the donor's name MRO Contact and Interview with the Donor: When the donor is notified of positive test how long does he have to validate with RX 5 days to produce a Rx if valid 5 days to have doctor produce fit for work What are the reasons for a Direct Observation? RTD Invalid no med explanation Cancelled (+) and no split Creatinine concentration > 2 and < 5 Creatinine concentration >5 if other reasons Observed tampering by collector, adulteration Temp out of range Negative test results required for ? Return to Duty Pre-employment Follow up Creatinine Conc >5