In some cases representatives from a government agency would appear unannounced at client sites while COLA was surveying a laboratory to verify that COLA's procedures were in agreement with what the regulators had intended. The scheduled on-site survey was always followed by an "exit briefing" when COLA surveyors gave the client a thorough review of which areas were considered to meet or exceed the regulatory standards, and which areas needed improvement. COLA agreed with the client about deadlines for correction of each of the problem areas. This agreement would be the basis for the Plan for Required Improvement which the client had to meet before receiving the accreditation certificate. The client could access COLA's toll-free Information Resource Center (IRC) which was staffed by medical technologists regarding any questions about COLA's survey process, CLIA standards and quality laboratory practices. Clients received several educational materials, such as a two-year subscription to COLA's bimonthly newsletter, copies of CLIA Fact Sheets and COLA Fast Facts by fax, to assist them with step-by-step improvements

31 In the case of antituberculous treatment toxicity, how high should the serum glutamic pyruvate transaminase (SGPT) rise before we should stop treatment?

32 After starting antituberculous treatment, when is the fever expected to subside and the erythrocyte sedimentation rate (ESR) to return to normal?

33 What are the indications of steroids in the treatment of tuberculosis?

34 I am a final-year medical student in India, where tuberculosis in all forms is one of the most common diseases with which we deal. I read that you feel there is no indication for steroids in tuberculosis. Is it not reasonable to give steroids with antitubercular therapy (ATT) in a patient with tuberculous pericarditis, meningitis, peritonitis and ocular manifestations due to tuberculosis, in order to reduce the damage caused by inflammation and fibrosis? If not, what suitable alternatives, other than steroids, would you recommend to reduce damage from postinflammatory fibrosis?

35 What dosage of steroids and duration of treatment should be given to patients with idiopathic pulmonary fibrosis? What are the new drugs, their recommended dosage and duration of treatment?

36 What is the poor prognostic factor in cryptogenic fibrosis: fibrosis or concomitant connective tissue disorder?

37 Are wheezes present in extrinsic allergic alveolitis?

38 Is the measurement of chest expansion with a tape a useful physical examination to indicate the severity of emphysema?

39 In asbestos-related pleural disease (pleural plaques and mesothelioma), how dof asbestos fibres get to the pleural space?

40 How do you differentiate clinically between thickened pleura and pleural effusion?