Basics Flashcards
Most common site
Antecubital fossa
H pattern
Veins for venipuncture
Located near the center of the antecubital fossa
Median cubital vein
Preffered vein
Median cubital
Fairly well anchored
Cephalic vein
Often harder to palpate
Cephalic vein
Not well anchored
Basilic vein
Rolls easily
Basilic vein
Increased eisk of puncturing a median cutaneous nerve branch or the brachial artery
Basilic vein
Veins that Can be used for venipuncture
- back of the hand
- wrist
Vein that should never be used
- underside of the wrist
Veins that can be used but not without the permission of the patient’s physician
Foot
Ankle
Leg
Turbidity of serum
Clear
Turbidity of plasma
Clear to slightly hazy
Turbidity of nonfasting serum with lipids
Cloudy
Centrifugation of serum
10 minutes RCF at 1000-2000g
It contains fibrinogen
Plasma
Stat and TAT are often collected in tubes containing _____ because they can be centrifuged immediately to obtain plasma
Heparin
Contains both cells and plasma
Whole blood
Must be collected in an anticoagulant tube to keep it from clotting
Whole blood
Used for most POCT and hema especially in acute care and stat
Wholr blood
Methods of veni
ETS
Needle and syringe
Butterfly set
Why ETS is preferred
Minimize the risk of spx contamination and exposurr of blood
Used on small, fragile, damaged veins
Needle and syringe
Discourahrd by CLSI due to safety and spx QUALITY issues
Needle and syringe
Can be used with the ETS or a syringe
Butterfly set
For infants and children method
Butterfly set
Hand veins method
Butterfly set
Method used for difficult-draw situations
Butterfly set
Pathway activated by glass stopper
Intrinsic
Activates extrinsic pathway
Factor 3
Restrict venous flow but not arterial flow
Tourniquet
Tourniquet must not be left longer than
1 minute
Size of tourniquet
1 inch wide x 15 inches long
Gauge and bore are ____ related
Inversely
Preferred needle length
1 inch
Considered standard for routine venipuncture
21 gauge
Components of ETS
Multisample needle
Evacuated tubes
Tube holder
Includes a plastic syringe, a needle, and a transfer device
Syringe system
Gauge for pedia
23
Accuvein is a Handheld device that emits ______ and is held about ___ inches over the potential phlebotomy site
Infrared light
7
For serum/chemistry and serology stopper
Red (glass)
Red (hemogard)
For whole blood/hematology stopper
Lavender glass
Lavender plastic
For molecular diagnostics
Pink
White
For whole blood and bb
Pink
Whole blood
Both Lavender
Pink
Plasma
All except Red, Lavender, Pink, Thrombin, Clot activator separation gel, SSP
Plasma/coagulation
LIGHT BLUE:
- Na citrate
- Thrombin and soybean trypsin
Lead testing
TAN
- Sodium heparin
- K2EDTA
Paternity testing
ACD
HLA phenotyping
ACD
Plasma/chemistry
Lithium heparin and gel
Sodium heparin
Lithium heparin
Toxicology
Royal blue
Glucose testing
Sodium fluoride
Potassium oxalate
Serum/chemistry
Thrombin
Clot activator separation gel
Anticoagulant of gray
Potassium oxalate
Antiglycolytic agent of Gray
Sodium fluoride
Preferred for PBS
K3EDTA in liquid form
Preferred for hema
K2EDTA/spray-dried
Wbc preservation
ACD
Fibrin degradation products
Thrombin and soybean trypsin
Universal anticoagulant
Heparin
Alternative antiglycolytic
Iodoacetate
Ratio of sodium citrate to blood in black top
4:1
Sodium fluoride binds to ____ thus inhbiting the __-dependent enzyme, ____
Mg
Enolase
Silica clot activator
Clot activator or with separation gel
Activates coagulation
Red (glass)
Does red glass has an anticoagulant?
None
Spray-dried K2EDTA
Lavender (plastic)
Pink
Anticoagulant of white
EDTA and gel
Order of draw
Sterile
Coag
Serum tube with/without clot activator
Heparin
EDTA
Glycolytic inhibitor
Length of lancet
Less than 2 mm
Heparinized syringe
For Arterial puncture
Method used for arterial puncture
Syringes instead of ETS (cuz of the pressure)
Can be collected without a tourniquet
Arterial
Primary arterial sites
Radial
Branchial
Femoral
Major complications of arterial puncture
Thrombosis
Hemorrhage
Possible Infection
Done before the collecting of arterial blood from radial artery
Modified Allen Test
Used to determine the collateral circulation of ulnar artery to the hand after the radial artery puncture
Modified Allen Test
Analytes increased in Stress
Pag Stress ang ulo, it needs CAP-C
Cortisol
ACTH
Prolactin
Catecholamines
First to increase in adrenaline rush
Catecholamines
Analytes increased with exercise
Lactic acid, LD
AST
Creatine
Thyroxine
CK
Analytes decreased in exercise
Cholesterol
TAG
Increased when standing
Cholesterol
Albumin
Calcium
Aldosterone
Increased in ambulatory px
CK
Analytes increased after recent food ingestion
TAG
iCa
Glucose
Insulin
Gastrin
Analytes decreased after recent food ingestion
Phosphorus
Amylase
Potassium
ALP
Chloride
It does not require fasting
Total Cholesterol
HDL
Analytes affected with age
Cholesterol
Albumin
Phosphorus
ALP (increased in older)
Analytes increased in females
Gamma-globulins
Alpha-lipoproteins
Fe
Cholesterol
Lower at night
(si PIAA mababa sa gabi)
Plasma Renin
Insulin
ACTH
Aldosterone
Higher in afternoon and evening
GH
ACP
Cortisol is lowest at
8Pm to 12am
Cortisol is _____ at 8PM than 8am
50% lower
Prolactin is higher at
4 and 8am
8 and 10pm
Iron peaks
Early to late morning
Iron _____ during the day
Decreases 30%
Array of signs and symptoms resulting from high cortisol
Cushing syndrome
Black people has
High TP, low Albumin
Black males has
High CK/LD, IgG 40% high
White male has
20% high IgA
White & >40 yrs old:
High cholesterol and TAG
Cushing disease increased in
ACTH resulting to high cortisol
Difference of Cushing syndrome from Cushing disease
Signs and symptoms from high cortisol - Cushing syndrome.
Cushing disease, ACTH involvement
Spx Require Ice (immediate cooling)
Lactic Acid, Ammonia, Blood gas
What happens if bloof gas is not cooled
Low pH and pO2
Causes marked hemolysis
CK
What happens in marked Hemolysis
Low sodium in ECF becomes diluted
Hemolysis
Potassium
pO4
Fe
Mg
ALT
AST
LD
ALP
catecholamines
CK
Stat is a medical meaning “immediately” from the Latin
statim