Question 1 · Hard
After a reagent change, a photometric magnesium method is recalibrated with five calibrators, using point-to-point calibration. Blank-corrected absorbances: 0 mmol/L, 0.000; 0.50 mmol/L, 0.121; 1.00 mmol/L, 0.240; 1.50 mmol/L, 0.418; 2.00 mmol/L, 0.481. The manufacturer states that the method is linear to 2.50 mmol/L, and the zero calibrator reads the same as the reagent blank. With the new curve, the low control (target 0.80 mmol/L) reads 0.80 mmol/L, but the high control (target 1.70 mmol/L) reads 1.47 mmol/L. The most likely cause is:
- AStray light at high absorbances
- BLoss of linearity above 1.00 mmol/L
- CA faulty 1.50 mmol/L calibrator
- DRaised absorbance of the reagent blank
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Answer: C · A faulty 1.50 mmol/L calibrator
Four calibrators lie on a straight line with a slope of about 0.240 per mmol/L, including the top one, but the 1.50 mmol/L calibrator reads 0.418 instead of the expected 0.360, about 16% high. A calibrator reconstituted with too little water, or left open to evaporate, is more concentrated than its label. With point-to-point calibration the analyzer treats 0.418 as 1.50 mmol/L, so samples between 1.00 and 2.00 mmol/L read low: a true 1.70 mmol/L gives about 0.409, which falls on the faulty segment and reads 1.47. The fix is a fresh calibrator and recalibration before patient results are released. Loss of linearity or stray light would bend the top of the curve, but the 2.00 mmol/L calibrator is exactly on the line.
- A: Stray light lowers readings at high absorbance; here a middle calibrator reads high.
- B: The 2.00 mmol/L calibrator lies on the line, so the response is still linear.
- D: The zero calibrator matches the blank, and a blank error would shift every point equally.