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mt > hema - veni and anticoagulant > Flashcards

hema - veni and anticoagulant Flashcards

1
Q

first step in skin preparation

A

cleanse the skin with alcohol swab

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2
Q

what should be maintained in skin preparation?

A

asepsis

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3
Q

2 sources of microbial contamination

A
  1. hand of the phlebotomists
  2. skin of the patient
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4
Q

what are the blood collection method in skin puncture

A

capillary blood/peripheral blood

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5
Q

site of the capillary blood

A

finger, earlobe and medial/lateral portion of the plantar surface of the foot

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6
Q

skin puncture order of draw

A

lavender-plasma additive-serum tubes

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7
Q

puncture site for infants under 12 mos

A

lateral/medial plantar heel surface

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8
Q

puncture site for infants below 12 mos, children and adult

A

palmar surface of last digit of 2nd, 3rd, 4th finger

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9
Q

two methods of venipuncture

A

syringe and evacuated tube method

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10
Q

needle length range

A

1 inch for routine venipuncture and 1.5 inches for patients with deep veins

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11
Q

angle of the syringe

A

15 degrees

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12
Q

suitable needle gauge for adults

A

19-21 g

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13
Q

suitable needle gauge for childreen

A

23g

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14
Q

needle used when blood is to be collected from a very small vein

A

butterfly needles (21, 23, 25 g)

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15
Q

site for venipuncture?

A

antecubital fossa

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16
Q

veins in the antecubital fossa

A

median cubital, median cephalic, and basilic

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17
Q

alternate sites

A

ventral forearm, wrist area, back of the hand and ankle/foot

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18
Q

order of draw

A

yellow - blue - red - green - lavender - gray

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19
Q

specimen rejections

A

clotted specimen, severely hemolyzed specimen, improperly labeled specimen, specimen too old, failure to meet volume criteria, improperly dilluted capillary specimen, leaking tube, delay in transport and collection of specimens in wrong tube.

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20
Q

immediate local complications

A

haemoconcentration, collapse of the vein, failure of blood to enter the syringe.

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21
Q

immediate general complications

A

syncope

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22
Q

late local complications

A

thrombosis of the vein, thrombophlebitis, hematoma

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23
Q

errors in s.c

A

misidentification of patient, mislabeling of specimen, short draws, mixing problem, wrong anticoagulant, hemolysis/lipemia, hemoconcentration of prolonged torniquet, extreme temperature, delayed delivery, processing errors

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24
Q

peaks at 4-6 am, lowet at 8 pm to 12 am

A

cortisol

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25
Q

lower at night, increased with stress

A

adrenocorticotropic hormone

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26
Q

lower at night, increased with supine>standing

A

plasma renin activity

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27
Q

lower at night

A

insulin, aldosterone

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28
Q

higher in the afternoon and evening

A

growth hormone, acid phosphate

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29
Q

increase with exercise

A

thyroxine

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30
Q

higher with stress and 4-8 am and 8-10 pm

A

prolactin

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31
Q

peaks early in the morning, decreases up to 30%

A

iron

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32
Q

4% decrease supine

A

calcium

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33
Q

commonly used anticoagulants

A

edta, double oxxalate, sodium citrate, sodium flouride, heparin, acd, cpd and cpda.

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34
Q

chelates ca (calcium)

A

EDTA

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35
Q

uses of edta

A

cell count, blood smear, platelet count and for routine hematology

36
Q

EDTA salts

A

sodium, potassium and lithium

37
Q

____ more soluble than _____

A

dipotassium, disodium

38
Q

equally effective, sample of blood can be used for chemical investigations

A

dilithium

39
Q

liquid form edta salt

A

tripottassium

40
Q

disadvantage of tripotassium edta salt

A

dilution, shrinkage of rbc, decrease in 2-3% PCV in 4 hours and gradual increase in MCV

41
Q

EDTA salt that is not recommended because of high pH

A

trisodium edta

42
Q

coding of vial of EDTA

A

lavender cap

43
Q

recommended EDTA concentration

A

1.5-2.0 mg/ml

44
Q

binds ca in soluble complex

A

Na citrate

45
Q

used for coagulation studies

A

na citrate

46
Q

vial coding of na citrate

A

blue

47
Q

acts as chelating calcium in blood used as 3.2% and 3.8%

A

trisodium citrate

48
Q

gets rid of the calcium but not strongly as edta

A

na citrate

49
Q

binds ca to form insoluble Ca oxalate

A

oxalate

50
Q

disdvantages of oxalate

A
  1. Calcium in the blood combines with oxalate to form insoluble calcium oxalate which precipitates.
  2. They are phagocyted by neutrophils-distort WBC morphology-good for smears
  3. Never used In blood to be transfused- as it is toxic and calcium oxalate precipitate may harm.
51
Q

prevents glycolysis

A

flouride

52
Q

double action of sodium flouride

A
  1. prevents clotting by chelating calcium
  2. prevents all phosphatase action
  3. prevents glycolysis for 3 days
53
Q

flouride is used for ___

A

determination of sugar

54
Q

in bacterial septicemia, fluoride inhibition of glycolysis is neither

A

adequate nor effective

55
Q

common disadvantages with calcium chelators

A
  1. Amylase activity inhibited by oxalate and citrate
  2. LDH and Acid Phosphatase inhibited by oxalate.
  3. Fluoride, heparin OR EDTA interfere with accurate determination of electrolytes.
56
Q

concentration of lithium or sodium salt

A

10-20 ml

57
Q

recommended add in heparin

A

lithium

58
Q

heparin is produced by

A

basophils and mast cells

59
Q

heparin accelerates

A

antithrombin III

60
Q

heparin neutralizes ____ and prevents formation of ____

A

thrombin ; fibrin

61
Q

heparin prevents formation of

A

clots and extension of existing clots

62
Q

heparin don’t ___

A

break down clots already formed

63
Q

blood storage for heparin

A

5-10 ml

64
Q

sample collection for heparin

A

0.5-2.0ml

65
Q

uses of heparin

A

ammonia, carboxyhemoglobin, blood gases, electrolytes, esr, methamoglobin, osmotic fragility and hla typing

66
Q

disadvantages of heparin

A

costly, Not suitable for blood counts as it often induces platelet and leucocyte clumping, Should not be used in study of PCR with restriction enzymes because it inhibits enzyme activity.

67
Q

used for routine hematology

A

edta (lavender)

68
Q

used for coagulation studies

A

sodium citrate (blue)

69
Q

fused for glucose determination

A

k-oxalate/sodium fluoride (grey)

70
Q

used for collection of serum

A

no additive, red

71
Q

used for preservation of RBC for blood banking and HLA typing

A

ACD (yellow)

72
Q

used for inhibition of thrombin activation

A

Heparin (green)

73
Q

required volume for preservation of blood

A

15mL of ACD and 14mL of CPD and CPDA-1 is required for preservation of blood

74
Q

initial pH of acd, cpd and cpda

A

Initial pH of ACD 5.0 and of CPD & CPDA-1 is 5.6

75
Q

storage time at 2-6 degree celcius for ACD, CPD AND CPDA-1

A

storage time at 2-6 degree celsius for ACD and CPD is 21 days and for CPDA-1 is 35 days.

76
Q

causes chelation of calcium

A

citrate

77
Q

prevents fall in pH

A

sodium diphosphate

78
Q

addition of glucose prolongs survival of stored RBC as it is required for metabolism. Glucose passes from plasma to RBC and is utilized for energy production.

A

dextrose

79
Q

2 pathways for energy production

A

90% embedem mayeroff and 10% pentose phosphate

80
Q

there is breakdown of glucose into lactate though anaerobic glycolysis.

A

90% embedem mayeroff pathway

81
Q

added in modified CPD as it improves viability of RBC because of enhanced ATP production.

A

adenine

82
Q

pathway through aerobic glycolysis

A

10% pentode phosphate

83
Q

fairly weak tribasic hydroxy acid.

A

citric acid

84
Q

storage environment of RBC is altered by adding certain nutrients after removal of plasma.

A

additive system

85
Q

adjust osmotic pressure

A

sodium chloride

86
Q

maintains high level of ATP in RBC

A

adenine

87
Q

prevents disintegration of RBC

A

mannitol

mt (54 decks)

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