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Hematology > Basic Methods 1 & 2 > Flashcards

Basic Methods 1 & 2 Flashcards

1
Q

______ is vital in the lab’s first step to reporting accurate and reliable results

A

Proper patient specimen blood collection

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2
Q

Necessary things to achieve accurate and reliable results in the hematology laboratory

A
  • knowledge of equipment & supplies
  • technical skills
  • strict attention to patient & specimen ID
  • awareness of & adherence to institutional safety requirements
  • proper specimen transport techniques
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3
Q

the skill, the good judgment, and polite behavior that is expected of a person who is trained to do the job well

A

Professionalism

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4
Q

2 skills necessary for phlebotomists

A
  • good interpersonal skills

- good communication skills

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5
Q

True or False

Lab results and personal info about a patient can be discussed with other medical technologists on duty

A

False, should not be discussed unless relevant to the patient’s care

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6
Q

True or False

All body fluids are treated as biohazards except the plasma as it contains nutrients

A

False, no exceptions

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7
Q

True or False

Disposable syringes can only be reused twice

A

False, should not be reused

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8
Q

3 kinds of samples used in the hematology lab

A
  • whole blood
  • plasma
  • serum
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9
Q

Majority of biochemical & blood bank test are performed on ____

A

Serum

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10
Q

Main coagulation difference between serum and plasma

A

Presence of fibrinogen

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11
Q

How long and at what temp should you let whole blood stand to obtain the serum?

A

30 mins - 1 hour at room temp

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12
Q

How long and at what speed should you centrifuge the clotted blood?

A

10 mins at 3000 rpm

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13
Q

At what temperature should serum be stored in relation to the delay in testing?

A
  • 4°C if to be tested after 30 mins-1 hr

- -20°C if to be tested after more than 1 hr

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14
Q

How long can serum be stored at -20°C?

A

3 months

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15
Q

True or False
Frozen specimens should be thawed on the bench or in a water bath at 60°C, then inverted several times to ensure homogeneity

A

False, room temperature

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16
Q

How does one defibrinate whole blood?

A

Before the blood clots, place it in a receiver (e.g., conical flask) containing a central glass rod onto which small pieces of glass capillary/glass beads/paper clips have been fused. Blood is then whisked around the central rod through moderate rotation of the rod.

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17
Q

How long does a patient need to fast if his/her blood is to be collected for FBS and cholesterol?

A

6 and 12 hrs, respectively

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18
Q

What is the effect of smoking on the blood?

A

Increases neutrophils

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19
Q

Which pre-collection factor increases a patient’s platelet count?

A

Physical activity (within 20 mins)

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20
Q

How does stress affect the blood?

A

Increases WBC count

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21
Q

True or False

WBC count is highest during mornings and decreases towards the afternoon.

A

False, lowest in the mornings and increases to mid afternoon

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22
Q

How does posture affect the substances present in the blood?

A

Enzymes, proteins, calcium, and iron increase with changes in position

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23
Q

What happens when tourniquet pressure is prolonged?

A

Hemoconcentration (increase in total protein)

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24
Q

What causes hemolysis during blood collection?

A

Excessive negative pressure when drawing blood with a syringe

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25
Q

How can insufficient anticoagulant affect specimens during post-collection?

A

Causes agglutination

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26
Q

Which post-collection error causes dilution of the blood sample?

A

Excess anticoagulant

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27
Q

How long does it take for blood samples to be deemed unusable?

A

2 hrs.

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28
Q

Which type of blood is used when large quantities of blood is needed?

A

Venous blood

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29
Q

True or False

Arterial blood is necessary for most tests that require anticoagulation

A

False, venous blood

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30
Q

Why are anticoagulated blood not used for peripheral blood smears?

A

Anticoagulants produce changes in platelets that may cause clumping and distort WBC that make identification difficult.

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31
Q

When is capillary peripheral blood usually used?

A

Used usually in infants less than 1 year old or when it is impossible to obtain venous blood

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32
Q

What are the disadvantages of using capillary peripheral blood?

A
  • liable to give erroneous results
  • greater likelihood of contamination
  • greater risk of disease transmission
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33
Q

True or False

Capillary blood is free flowing and can be arteriolar in origin

A

True

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34
Q

Which type of blood has a higher packed cell volume, red cell count, and hemoglobin?

A

Capillary blood

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35
Q

Why does capillary blood have a lower platelet count compared to venous blood?

A

Due to adhesion of platelets at the site of skin puncture

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36
Q

the release of hemoglobin from ruptured red cells into the plasma

A

Hemolysis

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37
Q

Hemolyzed red cells act as ________ in activating plasma clotting factors

A

Tissue thromboplastin

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38
Q

True or False

When obtaining capillary peripheral blood, the puncture site should be squeezed/milked to allow the blood to flow

A

False, do not squeeze puncture sites!

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39
Q

3 Methods of Venous Blood Collection

A
  1. Butterfly infusion set
  2. Evacuated tube system
  3. Syringe method
40
Q

the method of choice for small fragile or damaged veins

A

Syringe method

41
Q

True or False

Blood should never be poured from one tube to another since tubes can have different additives or coatings

A

True

42
Q

With regards to needles, the larger the gauge number, the ______ the needle bore

A

Smaller

43
Q

additive present in yellow tubes for blood cultures

A

Sodium polyanethol sulfonate (SPS)

44
Q

True or False

Green tubes with heparin come after lavender EDTA tubes in the order of draw

A

False, before

45
Q

additive present in light blue tubes

A

Sodium citrate

46
Q

CLSI

A

Clinical Laboratory Standards Institute

47
Q

CAP

A

College of American Pathologists

48
Q

JC

A

Joint Commissions

49
Q

recommended patient safety goals requirement

A

Minimum of 2 patient identifiers when collecting blood

50
Q

Where should the tourniquet be applied?

A

3-4 inches above the antecubital fossa

51
Q

At what angle should the needle be positioned in relation to the vein?

A

15-30°

52
Q

venipuncture technique used for children under 2 years of age

A

Dorsal hand venipuncture

53
Q

advantage of dorsal hand technique over heel stick method

A
  • more blood can be collected
  • less chance of hemolyzing the sample
  • less chance of contaminating the sample w/ tissue fluid
54
Q

Methods of blood collection for infants

A
  • cord blood
  • external jugular vein procedure
  • skin/dermal puncture
55
Q

Where is cord blood obtained from?

A

The umbilical cord

56
Q

Drawing excessive amounts of blood from small infants can cause _____

A

Anemia

57
Q

Dermal punctures are preferred over venipuncture when patients:

A
  • are burned or scarred
  • are receiving chemotherapy
  • have thrombotic tendencies
  • are geriatric
  • have very fragile veins
  • are obese
  • are apprehensive
  • require home glucose monitoring and point-of-care tests
58
Q

Composition of Capillary blood

A
  • venous blood
  • arterial blood
  • interstitial fluids
  • intracellular fluids
59
Q

True or False

Capillary blood composition more closely resembles arterial blood than venous blood

A

True

60
Q

When performing dermal puncture, CLSI recommends that the incision depth should not exceed _____ in a device used to do heel sticks

A

2 mm

61
Q

True or False

The depth of puncture is more critical than the width of the incision to produce adequate blood flow

A

False, less important

62
Q

Where is the major vascular area of the skin located?

A

Dermal subcutaneous junction

63
Q

Where is the dermal subcutaneous junction located in newborns?

A

0.35 - 1.6 mm below the skin

64
Q

Where is the dermal subcutaneous junction located in adults?

A

3 mm below the skin

65
Q

With dermal puncture, sufficient blood flow should be obtained from incision widths no larger than ______

A

2.5 mm

66
Q

Factors on which type of lancet should be used during skin puncture

A
  • age of patient
  • amount of blood sample required
  • collection site
  • puncture depth
67
Q

amount of blood collected by microhematocrit tubes

A

approx. 50 - 75 µL

68
Q

additive present in some microhematocrit tubes

A

Ammonium heparin

69
Q

chemicals contained in a heel warmer

A
  • sodium thiosulfate

- glycerin

70
Q

True or False
After performing the skin puncture, every drop of blood must be collected in order to obtain a sufficient amount for testing

A

False, the first drop should be wiped away

71
Q

Why should you not collect blood from the side of a mastectomy?

A

In mastectomy, the lymph nodes are also removed so there would be a greater chance for an infection to occur.

72
Q

the ideal site for skin puncture on infants younger than 1 year

A

Heel

73
Q

What areas of the heel are acceptable for skin puncture in infants?

A

The medial and lateral areas of the plantar surface of the heel

74
Q

Why are finger punctures not performed on infants younger than 1 year?

A

Their fingers do not contain enough tissue to prevent contact with bone

75
Q

Why should the finger puncture be perpendicular to the ridges of the fingerprint?

A

So that there would be a greater chance for the wound to easily open up and more blood can be collected

76
Q

Why should the finger puncture be off center?

A

The tips and sides of the finger only contain half the tissue mass of the center, increasing the possibility of bone injury

77
Q

Why are the 3rd and 4th fingers preferred for finger puncture?

A

They have the least problems

  • thumb has calluses
  • index has increased nerve endings
  • pinky has decreased tissue
78
Q

How does warming affect blood flow?

A

Warming dilates the blood vessels, therefore increasing arterial blood flow

79
Q

temperature of water during warming

A

42°C

80
Q

Aside from warming, how can one increase blood flow to the finger or heel?

A

By massaging the area

81
Q

How do air bubbles in the tubes affect blood samples?

A

Air bubbles limit the amount of blood that can be collected per tube and interfere with blood gas determinations

82
Q

How does one prevent the introduction of air bubbles in tubes?

A

Hold capillary tubes and micropipettes horizontally while being filled

83
Q

Analogy
Pink/lavender cap: CBC
Light/dark green: ____

A
  • chemistry K+

- glucose

84
Q

Main source of error for skin puncture

A

Hemolysis

85
Q

Causes of Hemolysis

A
  • failure to dry site after cleaning
  • very deep puncture
  • failure to wipe away first drop of blood
  • vigorous massaging of area
  • air bubbles
86
Q

Modes of action of anticoagulants

A
  • removing calcium by adding oxalates, citrates, & EDTA
  • inactivating thrombin & thromboplastin by adding heparin
  • removing fibrin by defibrination
87
Q

Why should EDTA not be used as anticoagulant when K assay is to be performed?

A

Potassium salts of EDTA interfere with K assay

88
Q

What additive should not be used when BUN is to be performed on a sample?

A

Ammonium oxalate

89
Q

What is affected if oxalates are used as anticoagulant on samples for peripheral smears?

A

White cell morphology

90
Q

anticoagulant of choice for prothrombin time & partial thromboplastin time

A

Sodium citrate

91
Q

Which clotting factor is relatively stable in citrated blood?

A

Factor V (proaccelerin/labile factor)

92
Q

anticoagulant of choice for platelet counts & platelet function tests

A

EDTA

93
Q

optimal concentration of EDTA

A

1.5 mg EDTA per ml blood

94
Q

What is the effect of excessive amounts of EDTA on the blood sample?

A

Excessive amounts of EDTA induces red cell shrinkage and causes a decrease in hematocrit and ESR values

95
Q

anticoagulant of choice for osmotic fragility test

A

Heparin

96
Q

effect of potassium oxalate on RBC

A

Shrinkage

97
Q

effect of ammonium oxalate on RBC

A

Swelling

Hematology (3 decks)

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