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MLT Semester #1 > 1010 Unit 4 > Flashcards

1010 Unit 4 Flashcards

1
Q

What is in the hepatic (river) package/panel

A
  • ALT
    -AST
  • bilirubin
    -ALP
    -ALB
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2
Q

What is in the cardiac panel/package?

A

-CK
-LDH
- troponin
-CK-MB

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3
Q

What is in the lipid package/panel?

A
  • Triglycerides, cholesterol
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4
Q

What is in the kidney panel/package?

A

-BUN
-TP
- creatinine
-ALB

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5
Q

Describe specimens collected in lavender tops

A

-EDTA gel
-used for hematology testing
-examples
→CBC
→G6-PD
→ hgb
→ hct
→ESR
→HA1c

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6
Q

What is the draw order for ETS?

A

1) blood culture or sterile yellow tube
2) light blue
3) red
4) SST
5) PST
6) green
7) lavender
8) gray

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7
Q

What is plasma?

A

Liquid portion of non-clotted blood

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8
Q

What are input devices?

A
  • Monitors
  • touch screen
  • barcode readers
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9
Q

What is a buffy coat?

A

Middle layer of plasma speciemen which contains platelets and leukocytes

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10
Q

Describe heel stick procedure

A

1) Warm feet ‘
2) use tender foot lancet
3) pierce <2.0 mm deep on medial or lateral surface
4) wipe away first drop
5) note how much blood is drawn from neonate

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11
Q

What is a hematoma?

A

Collection of blood under skin
→ can be caused by failure to remove tourniquet before removing needle

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12
Q

What is interface?

A

Ability of computers to talk to each other

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13
Q

What is an output device?

A
  • Monitors
  • printers
  • on board instrument displays
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14
Q

What is middleware?

A

Software that connects software components or applications

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15
Q

What is serum?

A

Liquid portion of clotted blood, does not contain fibrinogen

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16
Q

Hemoconcentration

A

Concentration of hemoglobin caused by leaving the tourniquet on longer than one minute

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17
Q

What are tests that need to be put on ice?

A
  • Lactic acid
  • ammonia
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18
Q

What is order of draw for capillary?

A
  • Blood gases
  • EDTA
  • other additives
  • serum
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19
Q

What are post analytical functions of LIS?

A
  • Laboratory report
  • critical patient results
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20
Q

What are analytical functions of LIS?

A
  • Molecular and genetic data
    -autoverification
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21
Q

Describe green top tubes

A

-chemistry department
- contains sodium heparin or lithium heparin

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22
Q

Describe pink top tube

A
  • contains EDTA
  • used for blood bank
  • examples
    →ABO/Rh
    → type and crossmatch
    → type and screen
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23
Q

What are common sites for venipuncture?

A
  • Median cubital vein (preferred)
  • cephalic vein
  • basilic vein
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24
Q

What is a sign of icterus?

A

Brown or yellowish serum or plasma due to excess bilirubin

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25
Q

What is a sign of lipemia?

A

Plasma or serum that looks milky due to high lipid counts

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26
Q

What is a sign of hemolysis?

A

Plasma or serum that looks red or pink due to lysed RBCs

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27
Q

What needs to be protected from light?

A
  • Vitamins
  • bilirubin
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28
Q

What are the 5 identifiers?

A
  • Patient name
  • ID number
  • date
  • time
  • tech initials
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29
Q

What is the most important step in infection control between patients?

A

Washing hands

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30
Q

What are pre analytical function of LIS?

A
  • Patient demographics
  • testing ordering
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31
Q

What color tube tops are for serum?

A
  • Red
  • marble
  • gold
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32
Q

What is autoverification?

A

Computer based algorithms automatically perform actions on a defined subset of laboratory results without the need for manual intervention

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33
Q

What should you do it patient has IV in one arm?

A

Draw the other arm or below one in both arms

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34
Q

What colors represent plasma tubes?

A
  • Lavender
  • light blue
  • green
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35
Q

What occurs when drawing blood from a vein too quickly from small or delicate veins?

A

Vein collapse

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36
Q

What color tube is associated coagulation?

A

Light blue

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37
Q

How are needles color coded?

A

By their gauge size

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38
Q

What does the royal blue top for?

A

To minimize trace elements contamination ( heavy metals)

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39
Q

What happens of patient has no ID band?

A

Notify patients nurse. No blood can be drawn without an I’d band.

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40
Q

What tube color and department will you find GS -PD?

A
  • Lavender
  • hematology
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41
Q

What are reasons for skin puncture to be preferred ?

A
  • Mastectomy
  • IV in both arms
  • burn patients
  • obesity
  • damaged veins/too fragile/too small
  • geriatric and pediatrics
  • diabetes
  • chemotherapy
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42
Q

What tube color top is for antibody ID?

A

Pink/purple

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43
Q

Define quality assessment

A
  • Maintain and control processes involving the patient and laboratory analysis of specimens
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44
Q

What do you do when an adult patient refuses their blood to be taken?

A
  • Just document on requisition, ,It is their right
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45
Q

Describe things to keep in mind when dealing with geriatric patients

A

-treat w/dignity and respect
- address as Mr. And Mrs.
- be aware of difficulties such as dementia, hearing and sight loss

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46
Q

What is isolation as safety system?

A

Separation of a seriously ill patient to stop the spread of infection or to protect the patient from irritating factors

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47
Q

What are standard and additional precautions tor infection control?

A
  • Contact precautions
    -airborne precautions
  • droplet precautions
  • reverse isolation precautions
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48
Q

What are some things that could affect blood collection?

A

-fasting/non-fasting
-medicines
- activity
- time of day (circadian/diurnal)
- posture
- smoking
- alcohol

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49
Q

What are two blood collection procedures?

A
  • Venous blood
    → veins
  • peripheral
    → capillary or skin
    → → finger sticks
    → → heel sticks
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50
Q

How can you tell plasma and serum apart?

A

Plasma has fibrinogen

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51
Q

What is an additive?

A
  • Substance added to the blood draw tube
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52
Q

What are anticoagulants?

A

Substances that prevent blood from clotting

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53
Q

Describe the sodium fluoride additive

A

-antiglycolytic agent
-keep glucose from breaking down

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54
Q

What are common anticoagulants and what are their roles ?

A
  • Dipotassium EDTA → binds or chelates calcium
  • sodium citrate → binds calcium
  • heparin → inhibits thrombin
    -oxalates→precipitate calcium
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55
Q

What are some adverse effects of additives?

A

-interferes with assay
-removal of constituents
- effect on enzyme action
- alteration of cellular constituents
- incorrect amount of anticoagulant

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56
Q

What components are needed for syringe techniques?

A
  • Needles(21 - 23 gauge and 1-1 1/2inch)
  • syringe ( barrel, graduated and plunger)
  • syringe transfer device
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57
Q

What is the order of draw for syringes?

A
  • Yellow ‘
    -light blue
  • lavender
  • green and grey
  • gold
  • red
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58
Q

What supplies is needed for venous blood collection?

A
  • Gloves
  • antiseptic→70% isopropyl alcohol, povidone-iodine, and 0.5% chlornexidine gluconate
  • gauze
  • bandages
  • needle/sharps container
  • sharpie
    -tourniquet
    -needles
    → gauge
    → length
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59
Q

Describe gauges

A
  • Number related to diameter of lumen
  • larger the gauge number,the smaller the actual diameter of needle
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60
Q

Describe length of needle

A
  • 1 to 1 1/2 inch most common
  • slightly longer to accommodate reshearthing feature
  • 1/2 to 3/4 inch for butterfly needle
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61
Q

What is the most common method of blood collection?

A

Evaluated tube system

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62
Q

Describe syringe system

A
  • Most unsafe
  • different draw order
    -No anticoagulant in syringe
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63
Q

Describe infusion winged set

A
  • Most effective for small veins
    -Very costly
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64
Q

What are the 2 combination systems in blood collection?

A

1) winged with ETS
2) winged with syringe

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65
Q

What is the initial steps to blood collection ?

A
  • Properly ID patient
    – wash hands
  • assemble an equipment
  • put on gloves
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66
Q

How do you prepare the venipuncture site?

A

-clean site with antiseptic in concentric circle
-wipe dry w/ gauze using sterile technique

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67
Q

Describe termination of the blood collection

A
  • Release tournishet before removing needle
  • if pressure not applied after removing needle, it will cause a hematoma
    -label all tubes
    -Clean area appropriately
    -thank patient and wash hands
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68
Q

What are complications of blood collection?

A
  • Vascular (bleeding from site and hematomas most common
    -infections (2nd most common)
  • anemia
    -neurological
  • cardiovascular (hypotension ,syncope, shock and cardiac arrest)
  • dermatological (allergies to iodine)
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69
Q

Describe blood culture collection

A
  • Must be sterile
  • clean with alcohol followed by iodine
  • special tubes (yellow) or bottles are used
    -A request for 2 blood cultures→ collect in two different locations
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70
Q

What is an important step when performing skin puncture?

A
  • Must always wipe away first drop,
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71
Q

What is found in capillary blood?

A

-venous
-arterial fluids
-tissue fluid

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72
Q

What is the use for skin punctures?

A
  • Blood clot collection for neonatal screening programs
  • capillary blood for testing at the bedside (point-of-care testing)
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73
Q

What are the supplies needed for skin puncture?

A
  • Lancets
  • capillary tubes
  • gauze pads
    -band-aids
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74
Q

How do you prepare site for skin puncture?

A

-use alcohol to cleanse
- wipe dry w/ gauze pad

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75
Q

Describe process of the actual skin puncture

A
  • Use a lancet for finger sticks
  • use a tenderfoot lancet for need sticks ( equal to or less than 2.00 mm)
  • always wife away first drop
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76
Q

What is the appropriate site for a heel stick?

A

-medial or lateral plantar surface
- never arch or the heel

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77
Q

What is the appropriate site for a finger stick?

A

-used 3rd or 4th finger
-puncture to the side of the whorls

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78
Q

Describe procedure for capillary blood for microspecimens

A
  • Wife away 1st drop, apply slight pressure
    -touch 2nd drop to lip of microtube
  • continue applying slight pressure and release to collect enough speciemen
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79
Q

Describe procedure for collection of blood for slides

A

-wife away 1st drop, touch 2nd drop to slide
- do not touch the skin

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80
Q

Describe laser equipment in skin puncture

A

-Vaporizes tissue about 1-2 mm into capillary bed
- can draw 100 ul blood sample

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81
Q

Describe processing blood specimens

A

-use of serum separator tubes
→→ gel barrier: weight is in between serum and cells
- centrifuging the specimens
→→ once clotting has taken place, specimens must been spun down for testing

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82
Q

What are unacceptable specimens?

A

-hemolyzed
- icteric
-lipemic

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83
Q

What are drug effects on specimens?

A
  • Certain medications give invalid chemistry results
    -in vivo or in vitro
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84
Q

Describe logging and reporting processes

A
  • All laboratory specimens must be logged in to the laboratory
  • all reports must be printed and sent to the physician
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85
Q

Describe preserving and storing specimens

A
  • Storage of processed specimens
    →prefer to test laboratory specimen immediately
    → if testing is delayed, specimen can be refrigerated or put in the freezer (lower temperature give agreater stability of chemical constituents)
    → never freeze CSF
  • always check the laboratory manual for details concerning test storage
  • some test must be protected from light or put on ice
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86
Q

What are the types of urine specimens?

A

1) random specimen ‘
2) first morning specimens
3) midstream clean-catch speciemen
4) 24 hour or timed specimen
5) catheter collection specimen
6) suprapublic aspiration specimen
7) pediatric specimen collection

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87
Q

What is a random specimen?

A

Anytime

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88
Q

Describe a 24 hour or timed speciemen

A

Collected over a period of time

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89
Q

Describe suprapubic aspiration specimen

A

Collected by a needle inserted into the bladder from the abdominal wall

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90
Q

What are some containers for urine collection?

A

-urine collection cups
-urinalysis tubes
- 24 hour collection container (some contain acid)
-urine culture containers
- urine transport tubes

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91
Q

Describe preservation of urine specimens

A
  • Decomposition of urine begins in 30 minutes
  • refrigerate if testing must be delayed
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92
Q

Describe labeling and processing of urine specimens

A
  • Labels ‘
  • collection date and time
  • collection method
  • proper preservation
    -light protection
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93
Q

What is an synonyms of bronchoalveolar savage?

A

-bronchial washings

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94
Q

What are cerebrospinal fluid synonyms?

A

-spinal fluid
-lumbar puncture fund
- ventricular fluid
- meningeal fluid

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95
Q

What are synonyms of peritoneal fluid?

A
  • Dialysate fluid
  • paracentesis fluid
  • ascitic fluid
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96
Q

What are synonyms of pericardial fluid?

A

-fluid from around the heart
- pericardiocentesis fluid

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97
Q

What are synonyms of pleural fluid?

A
  • Chest fluid
  • thoracic fluid
  • thoracentesis fluid
98
Q

What is an synonyms of a seminal fluid?

99
Q

What is the synonym of joint fluid?

A

Joint fluid

100
Q

Describe cerebrospinal fluid

A
  • Spinal fluid collected by a spinal tap
  • testing for meningitis→ must be tested immediately
  • collect 3 tubes
    → 1st chemistry
    → 2nd microbiology
    → 3rd hematology
101
Q

Describe synovial fluid

A
  • Fluid found in the joint spaces
  • testing for crystals
102
Q

Describe pericardial, pleural, and peritoneal fluids?

A
  • Serous fluids found in the cavities
  • testing for cell counts in inflame nation
    Inflammation
103
Q

Describe seminal fluid

A
  • Semen analysis
  • testing for infertility and post vasectomy assessment
104
Q

What are swab for culture

A
  • Throat culture collection
    → strep screen/ culture
  • feces
    →testing for occult blood, o and P
  • sweat
    → testing for cystic fibrosis
    -saliva
    → used for testing avariety of analytes
    →→viruses, bacteria, hormones, and drugs
105
Q

Describe chain of custody documentation

A

Must be signed by every person who has handled the specimens involved in the case in question

106
Q

What is the purpose of point of care testing?

A
  • Smaller blood specimens
  • reduced TAT
    -improved patient management
107
Q

What is the disadvantage of POC testing?

108
Q

What is point of care testing]

A

Tests are performed near the patient

109
Q

What are categories from CLIA testing

A

① waived test (POCT mostly here)
② moderately complete tests
③ highly complex tests
④ provider-performed microscopy

110
Q

Define waived test

A

Simple procedures with without chance of negative outcomes

111
Q

What are 5 characteristics of POC testing?

A

① rapid turn around time ‘
② easy portability with single-use disposable reagent cartridges or test strips
③ easy-to-perform protocol
④ accuracy and precision of results
⑤ minimal qc tracking

112
Q

What are advantages of POC testing

A

① storage at ambient temperature for reagents ‘
② bar-code technology
③economical lost and maintenance free
④ software for automatic calibration, system lockouts, and data management
⑤ hard copy or electronic data output that interferes with an LIS or other trading software

113
Q

Describe held hand equipment

A
  • Instrument based and automated methods
  • contain microprocessors that provide automated testing with calibration and QC on board
114
Q

What is the most common specimen used for hand held equipment?

A

-whole blood

115
Q

What tests use handheld equipment

A
  • Coagulation → PT or PTT ‘
  • blood gases
  • hematocrit
  • electrolytes
  • urea
  • glucose
116
Q

What are computers being used for ?

A
  • Manage data
  • monitor patients vital signs
  • aid in diagnosis
117
Q

What is informatics software divided into?

A
  • sample- centric LIMS
  • patient-centric LIS
118
Q

What are functions of the laboratory information system?

A
  • Patient identification
  • patient demographics
  • test ordering
    -specimen collection
  • speciemen analysis
  • test results
  • test interpretation
119
Q

Describe barcode

A
  • linear
  • consists of a series of parallel lines of varying widths that encode data
  • read by laser optical device known as a scanner or reader
120
Q

Describe radio frequency identification device

A
  • Automatic identification method that stores and retrieves data using lags or transponders
121
Q

What are some data storage devices?

A

-hard drives
- CD/DVD
- solid State drives
- cloud storage

122
Q

What is software?

A

The encoded instructions for the operation of computer

123
Q

What is middleware?

A

Software that connects software components or applications

124
Q

What is interfacing?

A

Ability of computers to talk to each other

125
Q

What are the two types of analyzer interface?

A
  • Unidirectional →information only goes one way, from analyzer to LIS
  • bidirectional→ data can go back and forth between two systems
126
Q

What is the selection of LIS based on?

A
  • Ease of input
  • format of output
  • customized software capabilities
127
Q

What are the objectives of LIS?

A

-file results
- accumulate statistics
- determine workload
- generate report forms
- monito quality assurance and quality control in the laboratory

128
Q

What are advantages of LIS?

A
  • Accuracy
    -flexible options
  • efficiency
129
Q

What are specific tasks of LIS?

A
  • Admit patients ‘
    -request test orders
  • print labels
  • enter results
  • inquire about results
  • generate report
130
Q

Explain ID code or tech code

A
  • Code may not be confidential
  • identifies person entering data
  • for purpose of accruing workload
131
Q

How can functions be selected?

A

-icons
-mnemonic code
-numeric system

132
Q

Describe the data entry phase

A

-requisition entry program
- same procedure for any system
-accession number generated

133
Q

Describe accession number

A

-generated in specimen requisition program
-a unique number for each specimen
-identified with the specimen as long as it is in the laboratory

134
Q

What are benefits of automation?

A

-reduction of medical errors
-reduced specimen sample volume
-Increased accuracy and precision
-improved safety for laboratory staff
-faster turnaround time of results
-partially alleviating the impending shortage of skilled laboratory staff

135
Q

What are major steps designed to mimic manual techniques?

A

-specimen collection and processing
-specimen and reagent measurement and delivery
-chemical reaction phase
-measurement phase
-signal processing and data handling

136
Q

What are the eight factors of specimen collection that are monitored by QA methods?

A

1) preparation of a patient for any specimens to be collected
2)collection of valid samples
3) proper specimen transport
4) performance of the requested laboratory analyses
5)validation of test results
6) recording and reporting the assay results
7) transmitting test results to the patient’a medical record
8) documentation, maintenance, and availability of records describing quality assessment practices and quality control measure

137
Q

What are error-prone phases of the testing cycle?

A
  • venous, arterial, and capillary blood collection
138
Q

What are the leading causes of pre analytical errors?

A

-specimen tube not filled correctly
-patient identification error
-inappropriate specimen collection tube or container
-test request error

139
Q

What is Patient Care Partnership?

A

The delivery of health care involves a partnership between patients and physicians and other health care professionals

140
Q

What does Patient Care Partnership
Emphasize?

A

-high quality hospital care
-clean and safe environment
-involvement by patients in their care
-protection of patients privacy
-help for patients when leaving the hospital
-help for patients with billing claims

141
Q

What is the purpose of precautions?

A

Minimize the risk for infection and to maximize the safety level within the health care facility’s environment

142
Q

What is the two-tiered system developed for precautions?

A

-standard
-transmission prevention (droplet, airborne, and contact)

143
Q

What is the Standard Precaution theory?

A

Recognizes the need to reduce the risk for microbial transmission from unidentified and identified sources

144
Q

Describe contact precautions

A

-designed to stop the spread of micro-organisms through direct contact or no direct contact
-wearing gloves when touching patients skin or when touching object that patient had direct contact with

145
Q

The does a chain of infection requires a continuous link of what three primary factors?

A

1) Reservoir: an infected symptomatic or non-symptomatic
2) means of transmission: a contaminated object/food/water
3) susceptible host: a patient, healthcare worker or visitor

** other links include a portal of exit and portal of entry

146
Q

Describe droplet precautions

A

-protect health care workers, visitors, and other patients from droplet that may be expelled during coughing, sneezing or talking
-wear mask when working close with infected patient
-important with influenza and whooping cough

147
Q

Describe airborne precautions

A

-designed to provide protection from airborne bacteria or dust particles, which may be suspended in the air for an extends period of time
-use of respiratory protection (N95) and use of special air-handling systems
-measles or TB

148
Q

What are two general sources of blood for clinical use?

A

Venous and peripheral (capillary) blood

149
Q

What kind of blood is need for analysis of blood gas?

150
Q

What form does blood in vivo and In vitro?

A
  • in vivo (inside body) —> liquid form
    -in vitro (outside body) —> clots with a few minutes
151
Q

What happens if you leave blood sitting for several hours without an anticoagulant?

A

-first few minutes, will clot
-will begin to shrink after a hour
-can complete disappear after 24 hours

152
Q

Describe serums physical characters

A

-light yellow fluid
- separate from blood clot and appears in upper portion of the tube.

153
Q

Describe fibrinogen

A

-found in PLASMA of circulating blood
-necessary for coagulation
-convert into fibrin and lends structure to clot in form of “fine threads” embedded with RBC and WBC

154
Q

Describe serum

A

-to obtain, separator gel additive helps
-chemical testing
-serological testing
-obtained after centrifugation

155
Q

Describe plasma

A

-anticoagulant is used to separate plasma
-straw colors fluid
-cellular components: RBC, WBC, and platelets

156
Q

What happens when an anticoagulant blood specimen is allowed to “settle”?

A

-settle into 3 distinct layers
1. Plasma -> top layer (55%)
2. Buffy coat -> grayish white cellular middle (WBCs, platelets) (1%)
3. Erythrocytes -> bottom layer, composed of RBC (45%)

157
Q

What are environmental factors that can influence evacuated tubes used to collect blood?

A

-ambient temperature
-altitude
-humidity
-sunlight

158
Q

Describe how ambient temperature affects evacuated tubes for testing?

A

-If evacuated tube is stored at low temps, the pressure of gas in tube decreases (leading to increased draw in volume. VIS VERSA.
-increased temp can affect stability of certain additives

159
Q

Describe how altitude can affect the evacuated tubes for testing?

A
  • > 5000 ft, draw volume may be affected
  • ambient pressure at high altitudes is lower
    The result draw will be lower
    -
160
Q

Describe how humidity affects the evacuated tubes for testing?

A

-can only affect plastic tubes
-extremely high humidity leads to migration of water vapor inside tube.
-extremely low humidity could hasten the escape of the water vapor from a tube containing wet additive
-can compromise accuracy

161
Q

Describe CTAD

A

-special additive mixture for coagulation testing that is sensitive to light
-found in glass tubes only
-minimize platelet activation after blood collection

162
Q

What does CTAD stand for?

A

-Citric acid
-theophylline
-adenosine
-dipyridamole

163
Q

Describe expiration dates of evacuated tubes

A

-has shelf life: stability of the additive and vacuum retention
- most evacuated tubes on market have 12 month shelf life
-glass tube expiration based on additives present
-plastic tubes do sustain measurable loss of vacuum over time

164
Q

Are evacuated tubes completely evacuated? Explain

A

No, small amount of air still resides in tube, at low pressure.

165
Q

What are dynamics of blood collection inside the tube based on?

A

Ideal gas law
-PV = nRT

166
Q

What is the ideal gas law equation? What does each letter stand for?

A

PV = nRT
P —> pressure inside tube
V —> volume gas occupies
n —> number of mole of gas inside tube
R —> universal has constant
T —> temperature inside tube

167
Q

If moles of gas and temperature do not change, what happens according the the ideal gas law?

A

The product of pressure and volume is constant

168
Q

Discuss what happens when blood starts filling tube referring to ideal gas law

A

-the residual gas inside is confined into decreasing volume, causing pressure of gas to increase
- when pressure of has reach ambient pressure, collection is completed

169
Q

What is a short draw?

A

The inability of evacuated tube to fill correctly

170
Q

What has been cited as the second most frequent cause of specimen rejection,

A

Under filling

171
Q

Explain VACUETTE separator gel tube

A

-used when temp and storage can not be monitored
-will collect 0.5 mL less than other tubes
-15 month shelf life

172
Q

What are evacuated tubes with no anticoagulant used for?

A

-Serum
-discard tube

173
Q

What are the additives in the lavender top tubes?

A

K(v2)EDTA
K(v3)EDTA

174
Q

What is the additive in the pink top tube?

175
Q

What are the additives in a light blue OR clear top tube?

A

-buffered sodium citrate
-CTAD
-(hemogard closure)

176
Q

What is the additive added to white top tubes?

A

K(v2)EDTA with gel

177
Q

What is the additive added to light gray/red or clear top tubes?

178
Q

What is the additive in the red color top tube?

A

-clot activator, silicon coated for plastic
-silicon coated for glass

179
Q

What is the additive in red/gray or gold/marbled red top tubes?

A

Clot activators and gel

180
Q

What is the additive in the gray too tube?

A

Sodium fluoride

181
Q

What are the additives in the yellow top tube?

A

-SPS: blood culture
-acid citrate dextrose

182
Q

What is the additive in the royal blue top tube?

A

No additive for toxicology, trace metals

183
Q

What is the additive in the orange top tube?

184
Q

What is the additive in a black top tube?

A

Sodium citrate

185
Q

What is the additive in the tan top tube?

A

Sodium heparin

186
Q

Describe EDTA

A

-Spray dried in interior of plastic tubes
-ratio important because excess EDTA produces shrinkage of erythrocytes

187
Q

Describe K(v2)EDTA and K(v3)EDTA

A

-anticoagulant
-mode of action is that it removes ionized calcium through process of chelation.
-this process forms an insoluble calcium salt that prevents blood from coagulation

188
Q

What is EDTA used for?

A

-complete blood cell count
-hemoglobin tests
-packed cell volume tests
-total leukocyte counts
-leukocyte differentiation count
-platelet count
-blood grouping
-Rh typing
-antibody screening

189
Q

What is K(v2)EDTA in gel used to test?

A

-testing plasma in molecular diagnosis

190
Q

What is K(v3)EDTA use for?

A

Viral marker testing

191
Q

What is the additive of choice for the Westergren erythrocyte sedimentation rate (ESR)?

192
Q

Describe sodium citrate

A

-available in concentrations of 3.2% and 3.8%
-removes calcium from coagulation system by precipitating it into an unusable form
-used in APTT and PT

193
Q

Why is sodium citrate an effective anticoagulant?

A

Its mild calcium chelating properties

194
Q

What is the correct ratio for sodium citrate to whole blood?

A

1 part sodium citrate and 9 parts whole blood

195
Q

Describe Heparin

A

-used as in vitro and in vivo anticoagulants
-acts as an anti thrombin
-lithium heparin least likely to interfere when performing tests on other ions
-only additive that can be used for determination of pH, blood gases, electrolytes, and ionized calcium

196
Q

What is anti-thrombin?

A

Substance that inactivates the blood-clotting factor thrombin and factor Xa

197
Q

Describe clot activators

A

-promote blood coagulation
-may coat inside of tube and will require gentle inversion of tube five times

198
Q

Describe thrombin

A

-an enzyme that converts fibrinogen to fibrin
-thrombin tubes are often used for “stat” serum testing because of short clotting time

199
Q

Describe serum separators

A

-polymer gel
-provide a physical and chemical barrier between serum or plasma and the cells
-g-force applied to gel by centrifugation will cause it’s viscosity to decrease, allowing it to move/flow
-once centrifugation ceases, gel becomes immobile between the supernatant and the cells

200
Q

Describe preservative, sodium fluoride

A

-dry additive
-weak anticoagulant
- primarily used to preserve blood glucose by preventing glycolysis, or destruction of glucose

201
Q

What is the storage temperature for blood collection tubes?

A

-40-77 F
-4-25
-high temps can cause tube to loss pressure or implode

202
Q

What is a standard gauge needle for syringe or evacuate tube blood collection?

203
Q

Why is it important to use a evacuated tube for a discard tube?

A

To remove air from tubing attached to butterfly needle

204
Q

What is gray top tube used for?

A

-fasting blood sugars
-lactic acid
-alcohol level assays

205
Q

What is the lavender top tube used for?

A

-complete blood count
-sedimentation rate
-routine immunohematology testing
(ABO blood grouping)

206
Q

What are light blue top tubes used for?

A

Coagulation assays

207
Q

What are the pink top tubes used for?

A

-blood bank testing

208
Q

What is the Red top tube used for?

A

Blood bank, chemistry, and serology

209
Q

What are tan top tubes used for?

A

Blood lead level assay

210
Q

What are yellow top tubes used for?

A

Blood culture collection

211
Q

What is the best practice for reducing specimen identification errors?

A

-Bar code
-AUTO12 system

212
Q

What is a serious avoidable error in special blood collection

A

-blood culture contamination
- can cause false-positive results, diagnostic errors and increased cost and longer hospital stay

213
Q

What is an indication of cross contamination in a blood culture

A

When 1 out of 4 cultures ran was positive

214
Q

What antiseptics can be used to sterilize a site of injection?

A

-alcohol
-tincture of iodine
-chlorhexidine
-povidone-iodine (Betadine)

215
Q

What are some phlebotomy problems?

A

-refusal by patient
-cannot stick because needle bore wall of vein
-movement of vein
-movement of patient or phlebotomist
-bad needle angles resulting in missing veins
-problems with collapsed veins
-hematoma
-inadequate amount of blood in tube
-fainting or illness

216
Q

What is inhibited by refrigeration?

A

Bacteria growth

217
Q

Can serum, plasma, and whole blood be frozen?

A

-serum and plasma—> yes
-whole blood —> no, the RBC will rupture

218
Q

What needs to be tested immediately when it reaches the lab?

A

Blood gases and pH

219
Q

What are newborns tested for?

A

-PKU
-galactosemia
-hypothyroidism
-hemoglobinopathies

220
Q

What are disadvantages of POCT

A

-cost
-maintenance quality control and quality assurance
-proper integration of data into medical records

221
Q

What are the top 10 EDL tests

A
  1. Complete blood count
  2. Liver enzymes
  3. Renal function
  4. Microscopy
  5. Urinalysis
  6. Nucleic acid testing
  7. Electrolytes
  8. Microbiology culture and sensitivity
  9. Glucose
  10. Antigen testing in microbiology
222
Q

What are preanalytical LIS functionality?

A

-reduction of manual tasks (test ordering and specimen accessioning)
-specimen labels
-specimen tracking between workstations
-centrifugation and cap removal
-error reduction
-validation
-specimen integrity

223
Q

What are analytical examples of LIS functionality?

A

-automated results entry
-manual results entry
-quality control
-validation of results
-output data processing
-network to laboratory automation systems

224
Q

What are postanalytical examples of LIS functionality?

A

-archive of patient cumulative reports
-archive of specimens
-disposal of individual tubes
-workload recording
-billing
-network to other systems

225
Q

What are 2 activities that could be done in the postanalytical stage?

A

-laboratory reports
-communicating critical patient results

226
Q

Describe how a pregnancy test works?

A

Designed to detect minute amounts of the human chorionic gonadotropin

227
Q

Describe fecal occult blood test

A

-tiny samples of stool put on special card that is sent to lab.
-chemicals are used to detect blood that can not be seen with the naked eye
-low cost

228
Q

Describe fecal immunochemical test

A

-easier than FOBT
-no drug or food restrictions
-easier collection of stool
-more costly

229
Q

Describe stool DNA test

A

-looks for abnormal DNA from cancer or polyp cells
-costs the most

230
Q

What are the 2 types of FOBT?

A

-chemical testing
-immunologic testing

231
Q

Describe chemical testing in FOBT

A

-solution containing chemical guanaco and oxidizing chemical
-if blood is present, turns blue

232
Q

Describe immunologic testing in FOBT

A

-stool mixed with solution that contains an antibody to globin
-antibody is combined with small amount of gold
-antibody-gold complex binds to globin in stool
-shows as visible line on test strip

233
Q

What is included in the electrolyte panel?

A

-sodium
-potassium
-chloride
-carbon dioxide

234
Q

What is included in the basic metabolic panel?

A

-same as electrolytes followed by
-creatinine
-urea nitrogen (BUN)
-glucose

235
Q

What is included in comprehensive metabolic panel?

A

-same as basic followed by
-Alkaline phosphate
-AST
-ALT
-bilirubin, total
-calcium, total
-albumin
-total protein

236
Q

What are special requirements of vitamin A, B, and D when handling?

A

-cannot be hemolyzed
-must protect from light

237
Q

What are special requirements for PT and PTT when Handling?

A

-always draw max amount
-blue top
-can not be hemolyzed

238
Q

What is the basic workshop coagulation workshop

A
  1. Blue
    -PT
    -PTT
    -fibrinogen
    -TT
  2. Lavender
    -platelet count
239
Q

What is the DIC package?

A
  1. Blue
    - PT or PTT
    -fibrinogen
  2. Lavender
    -platelet count
  3. Blue with yellow label (thrombin)
    -FDP/FSP
    -D-dimer
240
Q

What is osteomyelitis

A

Inflammation of the bone marrow and adjacent bone or osteochondrotis, inflammation of the bone and cartilage, as result of infection

MLT Semester #1 (15 decks)

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