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MLAB 123 > 1- Blood Collection Tubes > Flashcards

1- Blood Collection Tubes Flashcards

1
Q

Gold top tube - Department, Specimen Type, Action, Additive

A

Serum separator tubes(SST) - not immediate clotting must wait 30 mins
• silicone/gel (serum separating material)
• Contain thixotropic gel that forms a physical barrier of separation, separates the cellular components from the liquid portion of the blood.
Not suitable for Blood Bank or therapeutic drug monitoring
Biochemistry electrolytes, Magnesium, Phosphorus, Calcium, Proteins, lipids and alcohol, immunogloblulins

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2
Q

Light Blue top tube - Department, Specimen Type, Action, Additive

A 
Department - Hematology
Specimen Type - Plasma
 Action - Anticoagulant 
Additive - Sodium Citrate
oagulation studies include
•	PT 
•	APTT
•	Factor assays Factor V, Factor VIII
•	Activated protein C 
•	Antithrombin III
•	D-dimer
•	Fibrinogen
•	Platelet function tests

MUST BE FILLED COMPLETELY and centrifuge

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3
Q

Lavender top tube - Department, Specimen Type, Action, Additive

A

Department- Hema
Specimen Type- whole blood
Action: Anticoagulant
Additive = EDTA (ethylenediaminetetraacid)
Hematology tests: CBC, WBC count, Hemoglobin, Hematocrit, Platelet count, Reticulocyte count, differential.
Chemistry tests: RBC Folate

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4
Q

Dark Green top tube - Department, Specimen Type, Action, Additive

A

Department- Chemistry
Specimen Type - Plasma
Action -Anti-coagulant
Additives: sodium heparin

stat VBG

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5
Q

Light Green top tube - Department, Specimen Type, Action, Additive

A

Department- Chemistry
Specimen Type - Plasma
Action -Anti-coagulant
Additive is lithium heparin
PST = Plasma Separator Tube - STAT chemistry testing immediate clotting
Has gel which, after centrifugation, permanently separates plasma from red blood cells
Biochemistry
electrolytes, ammonia level, Magnesium, Calcium, Arterial blood gas, Proteins, lipids and alcohol

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6
Q

Red top tube - Department, Specimen Type, Action, Additive

A 
Department - Blood Bank
Specimen Type -  Clotted Blood
Action- None
Additive - None
•	May contain additives called colt activators that speed up the clotting process. Activators are substances that increase platelet activation and include silica, cellite, and glass particles.  •	Let blood sit for 30 minutes for clot formation

SERUM NEVER HAS ANTICOAGULANT

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7
Q

Pink top tube - Department, Specimen Type, Action, Additive

A 
Department-Blood bank 
Specimen Type - Whole Blood
 Action- Anti-coagulant
Additive - EDTA
1) ABO/Rh testing
2) Antibody screen AKA indirect antiglobulin test (IAT).
3) Type and Screen (T&S)
4) Crossmatch
5) Direct Antiglobulin Test (DAT or DC)
6) Rh Immune Globulin (RHIG) or Rhogam workup
7) Antibody titer
8) Antigen typing
9) Requests for components such as RBCs, platelets, cryoprecipitate (CRYO) and fresh frozen plasma (FFP) will be delivered to the blood bank.
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8
Q

Yellow top tube - Department, Specimen Type, Action, Additive

A

Department- Blood Bank
Specimen Type - Whole Blood
Action- Cell preservative
Additive- .(acid citrate dextrose) (ACD)

DNA testing, paternity testing, blood grouping

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9
Q

Red top tube - Department, Specimen Type, Action, Additive

A 
Department - Immunology 
Specimen Type -  Serum - 
Action- None
Additive - None -•	No anticoagulant. 
CRP, Mono, Hepatiti
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10
Q

Red/Yellow marble top tube - Department, Specimen Type, Action, Additive

A

Department - Chemistry
Specimen Type - Serum
Action- Clot activator
Additive - Glass particles

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11
Q

Red/grey serum separator marble top tube - Department, Specimen Type, Action, Additive

A 
Department - Chemistry 
Specimen Type -  Serum
Action- Clot activator
Additive - Thixo-tropic gel
Biochemistry 
 electrolytes, ammonia level, Magnesium, Phosphorus, Calcium, Proteins, lipids and alcohol
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12
Q

Navy -royal blue top tube - Department, Specimen Type, Action, Additive

A

Department - Chemistry
Specimen Type - Serum
Action- None
Additive -

  • Therapeutic drug monitoring (TDM)
  • Toxicology
  • Trace metal assays
  • Nutritional analysis.
  • Drugs; Digoxin, Gentamicyn, Valproic Acid, Tobramicyn, Phenytoin, Carbamazipane, phenobarb, salysiataes, acetaminophen
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13
Q

Navy -royal blue top tube- Department, Specimen Type, Action, Additive

A

Department - Chemistry
Specimen Type - Plasma
Action-Anti-coagulant
Additive - These tubes display additive-specific color coding on the label: a red bar on the label indicates a clot activator, a lavender or blue bar on the label indicates EDTA, and a green bar on the label indicates heparin.

  • Therapeutic drug monitoring (TDM)
  • Toxicology
  • Trace metal assays
  • Nutritional analysis.
  • Aluminum
  • Arsenic
  • Mercury
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14
Q

Grey top tube Department, Specimen Type, Action, Additive

A

Department - Chemistry
Specimen Type - Plasma
Action-Anti-coagulant and a cell preservative
Additive -Sodium fluoride and Potassium oxalate

lactic acid , pyruvate tests, glucose tolerance and alcohol levels : tube are placed in a icy water slurry (a cup with ice and water to keep the sample cold)

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15
Q

Yellow ivory top tube Department, Specimen Type, Action, Additive

A

Department - Micro
Specimen Type - Whole blood
Action-Anti-coagulant
Additive -Sodium poly-anetholesulfonate (SPS)

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16
Q

White top tube Department, Specimen Type, Action, Additive

A

Department - Molecular Diagnosis
Specimen Type - Whole blood
Action-Anti-coagulant
Additive -K2EDTA and gel for plasma separation

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17
Q

What is the order of draw?

A
  1. Blood culture bottles (sterile) or yellow SPS tubes
  2. Coagulation tubes
  3. Red top
  4. Gel tubes (serum separator)
  5. Heparin (green)
  6. EDTA (lavender)
  7. EDTA (pink)
  8. Fluoride (grey)
  9. Black/Blue citrate (ESR)
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18
Q

What does Heparin do? and which tubes is it in?

A

• Heparin Tubes-green
o Heparin inhibits the action of thrombin and prevents coagulation for up to 24 hours
o Cannot be used for hematology because it causes background staining.
o Concentration is 0.4% or 0.2mL/1mLof blood

19
Q

What are routine chemistry tests - electrolytes? and what tubes

A 
o	Sodium (Na) 
o	Potassium (K) 
o	Chloride (Cl) 
o	Bicarbonate (HCO2)
  • SST Tubes -red/gray or gold
  • PST Tubes- green with lithium heparin or green/gray (non hemogard)
20
Q

Tan top tube

A

Contains EDTA
• Use for lead levels in blood
• Chemically cleaned tubes and lead free

21
Q

What do Potassium oxalate and sodium fluoride

A
  • The additives inhibit the glycolytic activity of cells which helps maintain the glucose level for a minimum of 24 hours.
  • Oxalates and fluoride remove calcium to prevent clotting.
  • Fluoride is a powerful enzyme poison. Concentration 10mg/1mL blood it is a powder
  • Used for lactate, pyruvate and glucose must place tube in a icy water slurry (a cup with ice and water too keep the sample cold)
22
Q

What does EDTA do?

A
  • Binds calcium
  • Prevents platelet aggregation (clumping)
  • Preserves the shapes of blood cells.
  • Too much EDTA to blood will rupture the platelets
Used for:
•	CBC’s (Complete blood counts) 
•	Smears (blood film)
•	 Hemoglobin electrophoresis
•	Renin activity (transport on ice)
•	Reticulocyte
•	Molecular Diagnosis

• EDTA cannot be used for coagulation studies because it affects coagulation factor V one of the proteins involves in coagulation

23
Q

What does sodium citrate do?

A

• Sodium citrate prevents coagulation by binding calcium.
• The ratio of sodium citrate to blood in the typical adult sized tube should be 9 parts blood to 1 part anticoagulant. (4.5 ml blood to .5 anticoagulant) if the tube does not fill completely coagulation results will be prolonged
Needed for PT, APTT, • Factor assays Factor V, Factor VIII, Activated protein C ,Antithrombin III, • D-dimer, • Fibrinogen

24
Q

What ratio is needed in (Black)-Sodium Citrate tubes

A
  • Ratio of blood to anticoagulant is 4:1 .

* The greater ratio is needed for the Westergren sedimentation rate. - ESR

25
Q

What is in the yellow blood culture tubes

A

• Yellow tubes for blood cultures contain the additive sodium polyan-etholesulfonate (SPS) and sodium chloride.

26
Q

What are some light sensitive anayltes

A

o Bilirubin
o Erythrocyte Protoporphyrin
o Carotene
o Vitamin A

27
Q

What specimen have to be chilled

A 
o	ACTH
o	Acetone
o	ACE angiotensin converting enzyme
o	Aldosterone
o	Ammonia
o	Catecholamine
o	Free fatty acids
o	Lactate
o	Pyruvate
o	Renin activity
o	DHEA
o	Vitamin C
28
Q

• Pre-Warm specimens (sample must remain at body temp)

A

o Cold agglutinins

o Cryoglobulin

29
Q

How many times does EDTA have to be inversed?

A

8-10 times

30
Q

How many times does Citrate have to be inversed?

A

3-4 times

31
Q

How many times does SST gel have to be inversed?

A

5
Clot 30mins
Spin- 10 mins (swing)
15 mins (fixed)

32
Q

How many times does Serum have to be inversed?

A

5

33
Q

How many times does Sodium Fluoride have to be inversed?

A

8-10 times

34
Q

How many times does Heparin have to be inversed?

A

8-10 times

35
Q

How many times does PST gel have to be inversed?

A

Invert 8-10 times
No need to clot
Full speed

Spin- 10 mins (swing)
15 mins (fixed)
Gel Barrier Forms

36
Q

What are some common anticoagulants

A 
Binds Ca and form insoluble Ca salts
•	EDTA (ethylenediamine tetra-acetic acid)- prevents platelets from clumping
•	K Oxalate
•	Na Citrate
•	Heparin (Na, Li  Ammonium)
•	SPS 
•	ACD
37
Q

What preserves RBCs

A

• ACD (Acid Citrate Dextrose)

38
Q

anticoagulants for transfusions

A

• CPD (citrate phosphate dextrose –used in blood for transfusion)

39
Q

anticoagulants for glucose preservation

A

• Antiglycolytic agent- sodium fluoride

Preserves glucose up to 3 days and inhibits bacterial growth

40
Q

• Thrombin Tubes

A

orange or gray/yellow-Use for STAT chem. Tests

41
Q

Red top tube - Serum Blood bank

A

1) ABO/Rh testing
2) Antibody screen AKA indirect antiglobulin test (IAT).
3) Type and Screen (T&S)
4) Crossmatch
5) Direct Antiglobulin Test (DAT or DC)
6) Rh Immune Globulin (RHIG) or Rhogam workup
7) Antibody titer
8) Antigen typing
9) Requests for components such as RBCs, platelets, cryoprecipitate (CRYO) and fresh frozen plasma (FFP) will be delivered to the blood bank.

42
Q

Red top tube - Serum chemistry

A

Hormones such as Aldeterone, Thyroid function TSH, Free T4, Free T3 Total T4, and estradiol
• Protein electrophoresis
• Immunoglobulin IgG, IgA, IgM, IgE, IgD
• Serum HCG (pregnancy test)
• Iron studies Ferritin, TIBC, Iron B12 and serum Folate

43
Q

Red top serology

A

) Cold agglutinins (CAG) - specimen must be kept warm at 37º C.

2) Anti-streptolysin O titer (ASO) or screen such as Streptozyme
3) Infectious Mononucleosis (IM) tests such as Monospot
4) Rheumatoid arthritis (RA)
5) VDRL, RPR or FTABS to diagnose syphilis
6) Haptoglobin (HP)
7) Rubella
8) Pregnancy Testing
9) C-Reactive Protein (CRP)

MLAB 123 (11 decks)

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