HEMA LEC - Phlebotomy

Question 1

Double oxalate

Answer 1

Salts of ammonium & potassium(NH4K) in 3:2 ratio

Question 2

ratio of ammonium to potassium in double oxalate

Answer 2

3:2 ratio

Question 3

Ammonium oxalate only –

Answer 3

RBC swelling

Question 4

Potassium oxalate only –

Answer 4

shrinkage of RBC

Question 5

type of oxalate used for coagulation studies

Answer 5

Sodium oxalate

Question 6

-for RBC ct., Hgb, Hct, ESR (all RBC evaluation tests since there is no effect on RBCs)

Answer 6

oxalates

Question 7

only an in vitro anticoagulant,

Answer 7

Oxalates –

Question 8

3 forms of oxalate

Answer 8

1. Double oxalate – most common
2. Lithium oxalate – collecting bloody body fluids
3. Sodium oxalate – coagulation studies

Question 9

recommended amount when using oxalate

Answer 9

1 – 2 mg/ml of blood

Question 10

oxalate color

Answer 10

gray

Question 11

oxalate MoA

Answer 11

binds Ca

Question 12

citrate MoA

Answer 12

binds Ca

Question 13

most common oxalate

Answer 13

Double oxalate

Question 14

oxalate for collecting bloody body fluids

Answer 14

lithium oxalate

Question 15

other names of oxalate (3)

Answer 15

Balance oxalate, Wintrobe fluid, Paul-Heller’s fluid

Question 16

oxalate not for blood transfusion because

Answer 16

it’s toxic

Question 17

Causes agglutination or clumping of WBC & platelets hence causing erroneous counting

Answer 17

oxalate

Question 18

Not recommended for peripheral blood smear because it has same ill effects EDTA when used for more than 2 hours

Answer 18

oxalate

Question 19

oxalate has has same ill effects with ??? when used for more than 2 hours

Answer 19

EDTA

Question 20

– most commonly used for OFT (sickle cell anemia) & immunophenotyping

Answer 20

heparin

Question 21

recommended amount when using heparin

Answer 21

• 10-20 units/ml of blood

Question 22

color of heparin

Answer 22

green

Question 23

• MoA of heparin

Answer 23

inihibits thrombin

Question 24

• 2 Forms of heparin

Answer 24

1. Lithium heparin

2. Sodium heparin

Question 25

heparin

 Not recommended for coagulation studies because

Answer 25

it affects all stages of blood coagulation

Question 26

heparin

Not recommended for blood smear preparation because It

Answer 26

causes blue background when stained with Romanowsky stains

Question 27

heparin

Not for WBC count, causes

Answer 27

agglutination of WBCs

Question 28

heparin

Not for Plt ct.

Answer 28

enhances platelet aggregation

Question 29

most expensive additive

Answer 29

heparin

Question 30

– most common & preferred for coagulation studies

Answer 30

Citrates

Question 31

citrate color

Answer 31

light blue

Question 32

blood anticoagulant ratio for light blue

Answer 32

3.2% or 0.109 M NaCitrate (9:1)

Question 33

blood anticoagulant ratio for black for standard westergreen method for ESR

Answer 33

0.105M NaCitrate (4:1)

Question 34

• Changes in old EDTA blood:

Answer 34

o	Vacuolization of leukocyte cytoplasm
o	Artefact/crystal formation
o	Phagocytosis of crystals by WBCs
o	Cloverleafing of WBC nucleus
o	RBC crenation
o	Platelet disintegration

Question 35

• Platelet may adhere to neutrophils In old EDTA blood, phenomenon called

Answer 35

PLATELET SATELLITISM

Question 36

• Standard time for EDTA:

Answer 36

2 hrs

Question 37

• Not recommended for coagulation studies BC

Answer 37

(interferes with fibrinogen-thrombin reaction)

Question 38

• Recommended amount of EDTA:

•

Answer 38

1.2 mg/ml of blood

Question 39

Uses of EDTA:

Answer 39

RBC, WBC Hgb, Hct, ESR, Plt, Peripheral smear

Question 40

• 3 forms of EDTA

Answer 40

i. Dipotassium EDTA – most soluble, hence preferred
ii. Disodium EDTA
iii. Tripotassium EDTA

Question 41

EDTA MoA

Answer 41

• MoA: binds the non-ionized Ca then chelates Ca molecules in a complex (No Calcium no clotting)

Question 42

– chemical substance which interferes in blood coagulation through various mechanisms

Answer 42

Anticoagulant

Question 43

Orange

• faster clotting than usual red tube (usual clotting time: 10-15 mins)
• with clot activator (opposite of anticoagulant)

Answer 43

Rapid Serum Tube

Question 44

Gold

-with gel that separates serum from RBC when centrifuged

Answer 44

SST (Serum separator tube)

Question 45

Keynotes to Remember in Venipuncture

Answer 45

needle insertion
needle gauge
tourniquet

Question 46

Prolonged application of tourniquet may lead to

Answer 46

hemoconcentration

Question 47

Methods of blood collection through Venipuncture

Answer 47

1. Syringe method – open system, two-way needle
2. Evacuated tube method – closed system, less exposure to air
   - evacuated tube: with vacuum