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Hematology Part 1 Flashcards

1
Q

Hematology

A

The study of blood and its components.

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2
Q

Blood Percentage of Total Body Weight

A

7-8% of total body weight.

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3
Q

Average Blood Volume (Male)

A

5-7 liters.

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4
Q

Average Blood Volume (Female)

A

4-6 liters.

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5
Q

Why Do Females Have Less Blood?

A

Due to smaller average body size and monthly menstruation.

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6
Q

Blood Composition

A

55% Plasma, 45% Formed Elements (RBCs, WBCs, Platelets).

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7
Q

Plasma

A

The liquid portion of blood containing proteins, nutrients, and waste.

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8
Q

Serum

A

Plasma without clotting factors.

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9
Q

Formed Elements

A

Red Blood Cells (RBCs), White Blood Cells (WBCs), Platelets.

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10
Q

Fibrinogen

A

A plasma protein essential for blood clot formation.

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11
Q

Fibrinogen Conversion

A

Converted to fibrin during clot formation.

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12
Q

Plasma Water Content

A

90-92% of plasma is water.

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13
Q

Albumin Function

A

Maintains oncotic pressure and prevents fluid leakage from blood vessels.

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14
Q

Why Blood Volume Matters

A

Important for oxygen transport, heart function, and kidney filtration.

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15
Q

Effects of Low Blood Volume

A

Leads to tachycardia, poor circulation, and heart strain.

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16
Q

Effects of High Blood Volume

A

Causes hypertension, fluid overload, and kidney strain.

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17
Q

Edema

A

Accumulation of water in tissues due to decreased albumin levels.

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18
Q

Hemoconcentration

A

Increased blood component concentration due to plasma loss.

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19
Q

Role of Kidneys in Blood Volume

A

Filters excess fluid and maintains balance in the body.

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20
Q

Nephron

A

Smallest functional unit of the kidney responsible for filtering blood.

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21
Q

Effects of Increased Blood Volume on Heart

A

Increases workload, leading to potential heart failure.

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22
Q

Transfusion-Associated Circulatory Overload (TACO)

A

A condition caused by excessive blood transfusion leading to fluid overload.

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23
Q

Phlebotomy

A

The art and science of collecting blood specimens.

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24
Q

Step-by-Step Process

A

A systematic method to ensure correct blood collection.

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25
Q

Methods of Blood Collection

A
  1. Arterial Puncture, 2. Venipuncture, 3. Skin Puncture.
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26
Q

Venipuncture Site

A

Antecubital fossa (inner elbow).

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27
Q

Preferred Vein for Venipuncture

A

Median Cubital Vein (well-anchored and does not roll).

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28
Q

Alternative Veins for Venipuncture

A

Basilic Vein (inner arm) and Cephalic Vein (outer arm).

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29
Q

Uses of Skin Puncture

A

Used for infants, young children, patients with poor veins, and point-of-care testing.

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30
Q

Skin Puncture Site for Infants

A

Medial/Lateral portion of the plantar surface of the foot.

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31
Q

Most Common Finger for Skin Puncture

A

Middle Finger.

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32
Q

Maximum Depth for Skin Puncture

A

No more than 2.0 mm deep.

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33
Q

Heel Puncture Age Limit

A

Only for infants under 1 year old.

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34
Q

Arterialized Capillary Blood

A

Capillary blood warmed for arterial gas analysis.

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35
Q

Warming Time for Arterialized Blood

A

25 minutes at 42°C.

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36
Q

Common Sites for Arterialized Capillary Blood

A

Fingers, Earlobes, Heels.

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37
Q

Tourniquet Length

A

18-20 inches long.

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38
Q

Tourniquet Width

A

1 inch wide.

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39
Q

Tourniquet Placement

A

Should be positioned away from the puncture site.

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40
Q

Maximum Tourniquet Application Time

A

No more than one minute.

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41
Q

What Happens if Tourniquet is Left Too Long?

A

Remove and reapply after two minutes to prevent hemoconcentration.

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42
Q

Needle Gauge Number Rule

A

Higher gauge number = Smaller needle diameter.

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43
Q

Gauge for Blood Donation

A

16g.

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44
Q

Gauge for Blood Transfusion

A

18g.

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45
Q

Most Common Gauge for Venipuncture

A

21g.

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46
Q

Other Common Venipuncture Gauges

A

19, 20, 21, 22.

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47
Q

Preferred Needle Length for Venipuncture

A

1.0 - 1.5 inches.

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48
Q

Gauge Number and Needle Hub Color

A

18g - Pink, 19g - Brown/Yellow, 20g - Yellow, 21g - Green, 22g - Black, 23g - Blue-Green/Blue.

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49
Q

Red Tube

A

Non-additive (used for serum collection).

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50
Q

Light Blue Tube

A

Sodium Citrate (used for coagulation tests).

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51
Q

Gray Tube

A

Sodium Fluoride/Potassium Oxalate (used for glucose testing).

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52
Q

Green Tube

A

Lithium Heparin or Sodium Heparin (used for chemistry tests).

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53
Q

Lavender Tube

A

EDTA (used for hematology tests).

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54
Q

Yellow Tube (SPS)

A

Used for blood culture collection.

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55
Q

Yellow Tube (ACD)

A

Contains Acid Citrate Dextrose (used for DNA testing).

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56
Q

Tubes Containing EDTA

A

Lavender, Pink, White, Tan.

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57
Q

Sodium Citrate Tube Cap Colors

A

Black (3.8%) or Light Blue (3.2%).

58
Q

Function of Sodium Citrate

A

Prevents clotting in coagulation studies by binding calcium.

59
Q

Function of EDTA

A

Prevents clotting by binding calcium, used in hematology tests.

60
Q

Function of SPS

A

Used for blood culture collection.

61
Q

Blood Culture Machines

A

BacT/ALERT, Bactec.

62
Q

Why Should Tourniquets Not Be Left for Long?

A

Prolonged application may cause hemoconcentration and inaccurate test results.

63
Q

Why is the Order of Draw Important?

A

Prevents cross-contamination of additives and ensures accurate test results.

64
Q

Front (Term)

A

Back (Definition)

65
Q

D. ORDER OF DRAW FOR EVACUATED TUBES AND SYRINGE (HENRY 22ND ED.)

A

Young boys should easily learn good nursing

66
Q
  1. Blood culture bottles
67
Q
  1. Citrate
68
Q
  1. Serum tubes
A

Red - Non additive tubes - Chem and Sero

69
Q
  1. Heparin Green
A

For FOT (Erythrocyte Osmotic Fragility Test)

70
Q
  1. EDTA / Lavender
A

For Hem (CBC) & HBA1C

71
Q
  1. NaF
A

Gray - For glucose, anti-glycolytic agent; prevents glycolysis

72
Q

E. ORDER OF DRAW FOR SKIN PUNCTURE

A

1) Blood gases, 2) Slides/Smear, 3) EDTA, 4) Other additive tubes (green/gray), 5) Serum tubes

73
Q

Mnemonic

A

“Busy Si Ed na 05”

74
Q

Antiseptics used to clean the venipuncture site

A

70% Isopropyl alcohol

75
Q

Angle of the needle to the skin during venipuncture

A

15-30 degrees

76
Q

Brachial Arterial Puncture

A

45-60 degrees

77
Q

Femoral Arterial Puncture

A

90 degrees

78
Q

Bevel position

A

Bevel of the needle should be facing upward

79
Q

Patients with IV lines

A

IV line should be stopped for 2 minutes

80
Q

Blood collection volume requirement

A

5 mL of blood should be collected and discarded

81
Q

Gentle inversions

A

Usually at least 8-10 times

82
Q

Technologist/student patient attempt rule

A

A technologist or a student should not stick a patient more than 2 times

83
Q

Complications of Phlebotomy

A

• Ecchymosis (bruise), • Hematoma, • Syncope (fainting), • Edema, • Thrombophlebitis

84
Q

Notes on complications

A

• Do not slap the collection, • Let the site dry, • Apply pressure on the site

85
Q

Hyperventilation effect

A

Increases respiration rate

86
Q

How to prevent hyperventilation

A

Breathe in and out through paper bag

87
Q
  1. EDTA (ETHYLENEDIAMINETETRAACETIC ACID)
A

Most commonly used anticoagulant in Hematology

88
Q

Types of EDTA

A

• Spray-dried EDTA = K2 EDTA, • Liquid EDTA = K3 EDTA

89
Q

EDTA function

A

Prevents clotting by chelating calcium ions

90
Q

EDTA concentration

A

1.5 mg per mL of blood

91
Q

Effects of excess EDTA

A

• RBC shrinkage, • Hct becomes falsely decreased, • ESR becomes falsely decreased

92
Q

Timeframe for proper use

A

Preserves morphology of blood used within 2 HOURS

93
Q

Na+ & osmolality | hyper-osmolar | hypertonic

A

RBCs SHRINK

94
Q

Na+ & osmolality | hypo-osmolar | hypotonic

A

RBCs SWELL

95
Q

More common and more preferred EDTA

A

K3 EDTA (liquid)

96
Q

Heparin

A

Acid mucopolysaccharide (mucoitin polysulfuric acid)

97
Q

Where Heparin is found

A

Naturally occurring (anticoagulant) produced by the LIVER (hep)

98
Q

Heparin function

A

Acts by inhibiting THROMBIN

99
Q

Heparin cofactor

A

Acts together with the cofactor ANTI-THROMBIN III

100
Q

Concentration

A

15-20 uM of blood

101
Q

Use in testing

A

Used for FOT (Erythrocyte Osmolality Fragility Test)

102
Q

Why Heparin is NOT used for blood film preparation

A

Because it causes BLUE coloration of the background of blood films stained with Romanowsky stain

103
Q

Heparin is found in

104
Q

If Px is undergoing heparin therapy but is unresponsive, what should be requested?

A

• A anti-thrombin III assay

105
Q

Romanowsky stain

A

Family of stains; composed of alkaline stain and acid stain

106
Q

Alkaline stain

A

Methylene blue

107
Q

Acid stain

108
Q

Sodium Citrate

A

Anticoagulant of choice for COAGULATION STUDIES

109
Q

Sodium citrate function

A

Inhibits calcium by forming soluble complexes

110
Q

Potassium oxalate function

A

Inhibits calcium by forming insoluble complexes

111
Q

Sodium Citrate Concentrations

A

• Light blue tube = 3.2%, • Black tube = 3.8%

112
Q

Uses of Sodium Citrate

A

Coagulation studies, ESR

113
Q

Effect of underfilled tubes

A

Leads to FALSELY PROLONGED PT and aPTT

114
Q

Adjustment in Polycythemia

A

In patients with PCV, PT and aPTT are FALSELY PROLONGED

115
Q

Formula

A

Hct = 595 - Hct x mL of blood / 595

116
Q

Methods of ESR

A

Westergren vs Wintrobe

117
Q

Types of Westergren Method

A

• Original, • Modified

118
Q

Original Westergren Method

A

Black tube = used original Westergren method

119
Q

Modified Westergren Method

A

Lavender tube = used modified Westergren method

120
Q

PCV (Hct) Modification

A

Tube too much RBC → Plasma vol ↓ → (Hct > 0.55L) → ↓ Sodium Citrate

121
Q

Errors in Venipuncture Preparation (Before)

A

• Improper patient identification, • Failure to check patient adherence to dietary restrictions, • Failure to calm patient prior to blood collection, • Use of improper equipment and supplies, • Inappropriate method of collection

122
Q

Errors in Venipuncture Procedure (During)

A

• Failure to dry the site completely after cleaning with alcohol, • Inserting the needle bevel side down, • Use of needle that is too small, causing hemolysis of specimen, • Venipuncture in an unacceptable area, • Prolonged tourniquet application, • Wrong order of tube draw, • Failure to mix blood collected in additive-containing tubes, • Pulling back on syringe plunger too forcefully, • Failure to release tourniquet prior to needle withdrawal

123
Q

Antiseptic vs Disinfectant

A

• Antiseptic = Animate (humans, animals), • Disinfectant = Inanimate objects

124
Q

Question,Answer

125
Q

Errors after Venipuncture Completion (After),”Failure to apply pressure immediately to venipuncture site

A

Agitating/shaking an anti-coagulated blood specimen

126
Q

SPECIMEN FOR DIFFERENT LABORATORY TESTS - EDTA Whole Blood,CBC

A

Platelet count

127
Q

SPECIMEN FOR DIFFERENT LABORATORY TESTS - Heparinized Whole Blood,EOPI

A

Solubility test

128
Q

SPECIMEN FOR DIFFERENT LABORATORY TESTS - Air dried blood or bone marrow smears,Prussian blue stain (Periodic Acid Schiff Sudan Black B

A

Acid phosphatase stain (with tartrate resistance) Non-specific esterase stain

129
Q

SPECIMEN FOR DIFFERENT LABORATORY TESTS - Citrated Whole Blood,Original Westergren method of ESR

A

Solubility test

130
Q

SPECIMEN FOR DIFFERENT LABORATORY TESTS - Platelet-poor Citrated Plasma,Prothrombin time

A

Activated Partial Thromboplastin time

131
Q

SPECIMEN FOR DIFFERENT LABORATORY TESTS - Serum,Haptoglobin

A

Viscosity test

132
Q

SPECIMEN FOR DIFFERENT LABORATORY TESTS - Defibrinated Blood,EOPI

A

Autohemolysis test for hereditary spherocytosis

133
Q

SPECIMEN FOR DIFFERENT LABORATORY TESTS - Capillary Blood,LAP stain

A

Peroxidase stain

134
Q

HEMOCYTOMETRY - RBC Diluting Fluids,Hayem’s fluid

A

Gower’s fluid

135
Q

HEMOCYTOMETRY - WBC Diluting Fluids,2-3% glacial acetic acid with Gentian violet

A

1% hydrochloric acid

136
Q

HEMOCYTOMETRY - Platelet Diluting Fluids,”Tocantin’s method: 1% ammonium oxalate

A

Rees & Ecker’s method: Uses crystal violet, sodium citrate, and formalin”

137
Q

Notes on Hemocytometry Diluting Fluids,Characteristic of diluting fluids for RBCs: Should be ISOTONIC to preserve the RBCs

A

Characteristic of diluting fluids for RBCs: Should be CAPABLE OF LYSING RBCs for light microscopy

138
Q

HEMOCYTOMETRY - Counting Chambers,1. Neubauer Counting Chamber

A
  1. Speirs-Levy Counting Chamber
139
Q

Neubauer Counting Chamber - Dimensions,Total area: 9mm² (3mm x 3mm)

A

Depth: 0.1mm (1/10 mm)

140
Q

Speirs-Levy Counting Chamber - Dimensions,Total Area: 10mm² (2mm x 5mm)

A

Depth: 0.2mm

141
Q

Fuchs-Rosenthal Counting Chamber - Dimensions,Total Area: 16mm² (4mm x 4mm)

A

Depth: 0.2mm

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