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HEMATOLOGY > Blood Collection, Anticoagulants And Others (including safety) > Flashcards

Blood Collection, Anticoagulants And Others (including safety) Flashcards

1
Q

Greek:
Haima = blood
Logos = study

A

Hematology

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2
Q

Red liquid circulating in the heart, veins (5mm), arteries (4mm and capillaries (8 um)

A

Blood

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3
Q

Functions of the blood

A

Respiratory
Nutritional
Excretory
Buffering action
Maintenance of body temperature
Transport of hormones
Defense mechanism

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4
Q

Blood composition: Solid part

A

Erythrocytes
Leukocytes (Granular - Neutro, Eosi, Baso) (Agranular - Mono, Lympho)
Thrombocytes

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5
Q

Technique to obtain blood from:
Newborns/ Pediatric
Burned px
Px whose veins are reserved for therapeutic purposes
Extremely obese
Elderly px

A

Skin puncture

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6
Q

Puncture site for infants (< 1 yr old)

A

Plantar surface (Medial or lateral side)

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7
Q

Puncture site children (>1 yr old) and adults

A

Palmar surface of non-dominant hand (3rd or 4th finger)

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8
Q

Depth of skin puncture (infants and small children)

A

< 2 mm

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9
Q

Depth of skin puncture (adults)

A

2 to 2.5 mm

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10
Q

Devices of collecting blood through skin puncture

A

Capillary tubes
Microcollection tubes

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11
Q

Order of draw (Skin puncture) “T S E O S”

A

Tube for blood gas analysis
Slide
EDTA
Other anticoagulants
Serum

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12
Q

Most common site (Venipuncture)

A

Superficial veins of antecubital fossa

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13
Q

Choice of veins

A
  1. Median cubital
  2. Cephalic
  3. Basilic
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14
Q

Angle bet. skin and needle (Venipuncture)

A

< 30 degrees

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15
Q

Tourniquet application (Lenth of time)

A

Less than 1 minute

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16
Q

Effects of prolonged tourniquet application

A

Hemoconcentration
Hemolysis
Shortened coagulation time

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17
Q

Most important practice to prevent spread of infectious disease
At least 15 seconds

A

Handwashing

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18
Q

Tourniquet application (Distance)

A

3 to 4 inches
7.5 to 10 cm

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19
Q

Common needle size and length for adult venipuncture

A

21 G (Needle size)
1 inch (Length)

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20
Q

Causes of specimen hemolysis (5)

A

Prolonged tourniquet application
Moisture/ contamination in blood collection tube
Needles with too small bore
Excessive agitation
Frothing of blood sample

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21
Q

Anticoagulants for venipuncture (3)

A

EDTA
Heparin
Sodium citrate

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22
Q

Prefererred anticoagulant for platelet countd

A

EDTA

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23
Q

Lavender/ Purple top
No. of inversions = 8x
For hematology
Action = Chelation of calcium

A

EDTA or Ethylenediaminetetraacetic acid

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24
Q

Green top
No of inversions = 8x
Used for = Flow cytometry, Plasma chemistry, OFT, Blood gas studies
Action = Binds to anti thrombin
Optimal anticoagulant concentration = 15-20 units/ml of blood

A

Heparin

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25
Q

Light blue top
No of inversions = 3-4x
For coagulation studies
Action = Chelation of calcium

A

3.2 Sodium citrate

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26
Q

Order of draw (Venipuncture) “B C S H E S”

A

Blood culture
Citrated
Serum
Heparin
EDTA
Sodium fluoride

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27
Q

Other blood collection tubes:
SPS (Sodium Polyethanol Sulfonate) or ACD (Acid Citrate Dextrose)
For blood culture

A

Yellow top

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28
Q

Other blood collection tubes:
K2 EDTA
Lead determination = contains < 0.01 ug/ml lead

A

Tan top

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29
Q

Other blood collection tubes:
K2 EDTA
For toxicology, trace element determination = low levels of trace elements

A

Royal blue top

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30
Q

Other blood collection tubes:
K2 EDTA with GEL
For molecular diagnostic tests

31
Q

Other blood collection tubes:
3.8% Sodium citrate
For westergren/ ESR

32
Q

Other blood collection tubes:
K2 EDTA
For blood bank test and whole blood hematology determination

33
Q

Other blood collection tubes:
Either be 3.2% sodium citrate or CTAD (Citrate, Theophyline, Adenosine, Dipyridamole)
For coagulation tests or Platelet function tests

A

Light blue top

34
Q

Peripheral Blood Smear:
Sources of Specimens

A

EDTA blood
Anti-coagulant free blood

35
Q

EDTA blood spears should be made within _____ hours after collection.

36
Q

Advantages of EDTA Blood Smear (3)

A

Multiple blood smears
May be prepared at a later time
Proventd platelet clumping or aggregation

37
Q

Disadvantages of EDTA blood smear (2)

A

Platelet satellitosis
EDTA-induced platelet clumping

38
Q

Advantages of Anticoagulant-free blood (2)

A

Made at the px side
Some artifacts may be prevented

39
Q

Disadvantages of Anticoagulant-free blood (2)

A

Platelet clumpingb
Few films can be made

40
Q

Methods of blood film preparation (3)

A

Two-glass method (Manual wedge method)
Coverslip method
Automated methods

41
Q

Angle bet. pusher slide and film slide

A

30 to 45 degrees

42
Q

Scanning methods (2)

A

Longitudinal - Tail to head
Battlement - Bakcck and forth serpentine

43
Q

Two types of coverslip technique

A

Glass slide-coverslip method or Beacom’s
Two-coverslip method or Ehrlich’s

44
Q

Methods of film preparation:
Rarely used
Used for making Bone marraw aspirate
Excellent for WBC distribution

A

Coverslip technique

45
Q

Two types of automated methods

A

Miniprep = semi auto, prortable
Centrifugal (Spinner) Type = uses 0.2 well-mixed anticiagulated blood and has even distribution of blood cells
Coulter LH
Sysmex SP-10

46
Q

Techniques for blood film staining:
1. Fixative
2. Stain
3. Buffer

A
  1. Methanol
  2. Wright or wright-giemsa
  3. 0.5 M Sodium Phosphate
47
Q

Any stain which consists methylene blue and halogenated flurescein dye

A

Romanowsky-type stain

48
Q

Basic stain
Stains nucleus and some cytoplasmic structures a blue or purple color

A

Methylene blue

49
Q

Acidic stain
Stains cytoplasmic structures an orange-red color

50
Q

What type of stain are the following:
Wright stain
Giemsa
May-grunwald stain

A

Romanosky-type stain

51
Q

Techniques of staining (3)

A

Manual
Automated
Quick

52
Q

Characteristics of Well-stained Smear (Macroscopic)

A

Pink to purple

53
Q

Characteristics of Well-stained Smear (Microscopic)
What are the demostrated color of the following:
1. RBC
2. WBC Nuclei
3. Neutrophil cytoplasm
4. Eosinphil granules

A
  1. Orange to salmon pink
  2. Purple to blue
  3. Pink to tan with violet to lilac granules
  4. Bright-orange
54
Q

Evaluation of PBS:
Unusual findings = Blood film bluer than normal

A

Increased blood proteins
Plasma cell myeloma or Multiple myeloma

55
Q

Evaluation of PBS:
Unusual finding = Grainy appearance

A

RBC agglutination

56
Q

Evaluation of PBS:
Unusual findings = Holes all over the films

A

Increased lipid levels

57
Q

Evaluation of PBS:
Unusual findings = Blue specks

A

Markedly increased WHC counts and platelet counts

58
Q

Microscopic Examination
Objective that:
Assess overall film quality
Detect snoplow effect
Detect fibrin strands
Recognize rouleaux formation

A

10x objective or LPO

59
Q

Microscopic examination
Objective that:
Red cells have central pallow
Cells are appropriately stained

A

40x high dry or 5x OIO

60
Q

Multiplication factor of 40x high dry

61
Q

Multiplication factor of 50x OIO

62
Q

Microscopic examination
Objective that:
Examine nuclear details of WBC
For tabulation of actual WBC differential and estimation of platelet count

63
Q

Parasites that may appear in the blood smear (3)

A

Malaria
Filaria
Trypanosomes

64
Q

Malaria species that infect humans (5)

A

P. falciparum
P. vivax
P. ovale
P. malariae
P. knowlesi

65
Q

Patients resistant to falciparum infection.

A

Sickle cell patients

66
Q

Most pathologic malaria specie

A

P. falciparum

67
Q

Most prevalent plasmodium specie

68
Q

Blood films:
Ideal for initial screening of blood
Stained with a water-based wright giemsa without methanol fixation

A

Thick blood films

69
Q

Blood films:
For species identification and determination of percent parasitemia
Stained after methanol fixation

A

Thin blood films

70
Q

How many fields on the thick and thin blood films must be examined for malaria?

A

300 fields

71
Q

Filaria species that infect humans (3)

A

Wuchereria bancrofti
Brugia malayi
Loa loa

72
Q

Trypanosomes species that infect humans (3)

A

Trypanosoma brucei rhodesiense
Trypanosoma brucie gambiense
Trypanosoma cruzi

73
Q

Storage of blood smear slides

A

At least 7 days before proper disposal

HEMATOLOGY (5 decks)

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