introductio Flashcards
where are the puncture site for infants <1 year during skin puncture
plantar surface
medial side of the heel
lateral side of the heel
for older child and adults the site for skin puncture ____
palmar surface of the non-dominant hand
(3rd or 4th finger distal portion)
recommended depth of skin puncture for infants?
<2.0mm
recommended depth of skin puncture for adults and older children.
2.0-2.5 mm
what are the possible effects of squeezing, milking the site?
cause hemolysis and introduce to excess interstitial fluid
why do we need to discard the 1st drop of blood?
to discard excess tissue fluid
to discard dead epidermal cells
to facilitate free flow of f blood
order of draw for skin puncture
tube for blood gas analysis
slides
EDTA microcollection tube
other microcollection tube with anticoagulant
serum micro collection tube
what is the 1st tube collected from skin puncture?
blood gas
what is the 1st micrrocollection tube to be collected in skin puncture?
EDTA
MOST COMMON SITE FOR VENPUNCTURE
SUPERFICIAL VENIS ON THE ANTECUBITAL FOSSA
CLEANSE THE SITE USING __ SCRUB WITH MOVEMENT _____
FRICTION
BACK AND FORTH
VEINS TO BE USED IN ORDER OF PREFERENCES
H PATTERN
MEIDAN CUBITAL VEIN
CEPHALIC VEIN
BASILIC VEIN
VEINS TO BE USED IN ORDER OF PREFERENCE FORR M PATTER
MEDIAN VEIN
ACCESSORY CEPHALIC VEIN
BASILIC VEIN
ANGLE BETWEEN SKIN AND NEEDLE
<30 DEGREE
OR 7.5-10 CM
WHAT IS THE LENGTH OF TIME FOR TOURNIQUET APPLICATION
LESS THAN 1 MINUTE
DISTANCE OF TOURNIQUET
3-4 INCHES
EFFECTS OF PROLONGEED TOURNIQUET APPLICATION
HEMOLYSIS
HEMOCONCENTRATION
SHORTENED COOAGULATION TIME
SOME SITE TO AVOID DURING VENIPUNCTURE
VEINS IN THE INNER WRIST
VEINS OF THE FEET
FISTULA
ARTERIES
Inflammous SITE
EDEMATOUS SITE
SOME CAUSE OF SPX HEMOLYSIS
PROLONGED TOURNIQUET APPLICATION
MOISTURE/CONTAMINATION IN THE BLOOD COLLETION TUBE
USING NEEDLE WITH TOO SMALL. BORE
EXCESSIVE AGITATIOM
FROTHING OF THE BLOOD SAMPLE
MOST COMMON. SKIN ANTISEPTIC
70% ISOPROPYL ALCOHOL
MOST COMMON NEEDLE SIZE FOR ADULTS
AND LENGTH
21 G
LENGTH OF 1 INCH
MOST COMMON CAUSE OF A NEEDLE PUNCTURE FROM OTHER SHARP OBJECT IS ____
IMPROPER DISPOSAL
MOST COMMONLY USED BLOD COLLECTION TUBE IN THE HEMA SECTION
EDTA (LAVENDER/PURPLE TOP)
ANTICOAGULANT USED FOR HEMA DETERMINATION
K2 EDTA
CBC IS ALSO CALLED
HEMOGRAM
POSSIBLE CAUSES OF CLOTTED BLOOD SPECIMEN
DIFFICULT PHLEBOTOMY
BLOD SAMPLE WAS NOT INVETED IN THE CORRECT NUMBER OF TIMES
EEXPIRED BLOOD TUBE
OVERFILLED TUBE
OPTIMAL ANTICOAGULANT CONCENTRATION IS FOR EDTA
1.5 MG PER ML OF BLOOD
BLOOD SPECIMENS FOR CBC MUST BE ANALYZED WITHIN (IF STORED IN ROOM TEMP)
6 HRS OF COLLECTION
BLOOD SPECIMENS FORR CBC MUST BE ANALYZED WITHIN __ (STORED AT 4C)
24 HOURS
PREFFERED ANTICOAGULANT FOR PLATELET COUNT
EDTA
BLOOD. SMEAR SHOULD BE MADE WITHIN
3 HOURS OF COLLECTION
WHAT IS THE CAUSE OF INSUFFICIENT EDTA
OVER FILLED TUBE
WHAT IS THE EFFECT OF INSUFFICIENT EDTA
PRESENCE OF CLOT
WHAT IS THE CAUSE OF EXCESSIVE EDTA
UNDER-FILLED TUBE
WHAT IS THE EFFECT OF EXCESSIVE EDTA
FALSE LOW HCT, ESR,
DEGENERATIVE WBC
FALSE HIGH MCHC AND PLATELET COUNT
FORMATION OF RING. SHAPED MOLECULAR COMPLEX N SHICH METAL ION IS COVALENTLY BOUND
CHELATION
A PROCESS WHICH A CURRENT TEST RESULT IS COMPARED WITH THE RESULT OF THE SAME TEST FROM THE PREVIOUS SPECIMEN FROM THE SAME PATIENT
DELTA CHECK
TEST BEING ORDERED AUTOMATICALLY BASED ON THE RESULT PRIOR TEST PF [RESET PARAMETERS
REFLEX TEST
ANY NUMERICAL VALUE THAT DEPICTS AN ENTIRE POPULATION
PARAMETER
USED FOR FLOW CYTOMETRY
PLASMA CHEM DETECTION
OSMOTIC FRAGILITY TEST
GREEN TOP (HEPARIN)
OPTIMAL ANTICOAGULANT CONCENTRATION OF HEPARIN IS
15-20. UNITS PER ML OF BLOOD
HEPARIN IS ANTICOAGULANT OF CHOICE FOR
BLOOD GAS ANALYSIS
OSMOTIC FRAGILITY TEST
CAUSE THE LEAST INTERFERENCE IN CHEMISTRY TESTING
LITHIUM HEPARIN
MOST WIDELY USED ANTICOAGULANT FOR PLASMA AND WHOLEE BLOOD CHEM
LITHIUM HEPARIN
USED FOR COAG TEST
BLUE TOP (3.2% SODIUM CITRATE)
HEPARIN CAN CUASE CELLULAR CLUMPING WHICH LEAD TO:
[SEUDOLEUKOCYTOSIS AND PSEUDOTHROMBOCYTOPENIA
CRITICAL RATIO OF BETWEEN 3.2% SODIUM CITRATE AND BLOOD:
1:9.
WHAT WILL BE THE CLOTTING TIMES YOU HAPPEN TO FORCEFUL MIXING OR NUMBER OF INVERSION
SHORTEN CLOTTING TIME
ORDER OF DRAW FOR VENIPUNCTURE
BLOOD CULTURE TUBE (YELLOW)
CITRATE TUBE (LIGHT BLUE TOP)
SERUM TUBE (RED WITH OR WITHOUT ADDITIVE)
HEPARINIZED TUBE (GREEN)
EDTA (LAVENDER)
SODIUM FLUORIDE (GRAY)
NO OF INVERSION FOR YELLOW TOP C
8
NO OF INVERSION FOR LIGHT BLUE TOP
3-4
NO OF INVERSION FOR RED TOP (NON ADDITIVE)
0
NO OF INVERSION FOR RED TOP (PLASTIC HAS CLOT ACTIVATOR)
5
NO OF INVERSION FOR GREEN TOP
8
NO OF INVERSION FOR PURPLE TOP
8
NO OF INVERSION FOR GRAY TOP
8
WHAT BLOOD COLLECTION TUBES AND ANTICOAGULANT USED FOR LEAD DETERMINATION
TAN
K2 EDTA
WHAT BLOOD COLLECTION TUBES AND ANTICOAGULANT USED FR TOXICOLOGY, NUTRITIONAL CHEM
TRACE ELEMENT DETECTION
ROYAL BLUE TOP
K2 EDTA
WHAT BLOOD COLLECTION TUBES AND ANTICOAGULANT USED FOR MOLECULAR DIAGNOSTIC TESTS
WHITE TOP
K2 EDTA (WITH GEL)
WHAT BLOOD COLLECTION TUBES AND ANTICOAGULANT USED FOR WESTERGREN
ESR
BLACK TOP
3.8% SODIUM CITRATE
WHAT BLOOD COLLECTION TUBES AND ANTICOAGULANT USED FOR BLOOD BANK TEST AND WHOLE BLOOD HEMA DET.
PINK TOP
what are the cause of falsely high rbc
wbc >100,000, giant platelet cryglobulin, cryofibinogen,`
what are the causes of falsely low rbc
cold agglutinins, autoagglutination, clotting, microcytsis, schistocytes, hemolysis invitro
what are the causes of falsely high MCV
cold agglutinin
autoagglutination
high wbc (>50,000)
old specimen
hypersmolar state
reduced RBC deformability
what are the causes of falsely low mcv
cryoglobulin
cryofibrinogen
hemolysis (in vitro)
swollen rbc
giant platelets
what are the causes of falsely high mchc
lipemia, icterus, chylomicron, high wbc (>50,000)
spuriously high hb spuriously low rbc
what are the causes of falsely low MCH
spuriously low hb, falsely high rbc
what are the causes of falsely higch mchc
cold agglutinin
autoagglutination
hemolysis
clotting
spuriously high hb
falsely low hct
what are the causes of falsely low mchc
high wbc >50,000
spuriously high hct.
falsely low hb
what are the causes of falsely high hemoglobin
lipemia,
icterus
chylomicron
lysis resistant rbc with abnormal hb
WBC >20,000
platelet. >700 x109
parenteral nutrition
hypergammaglobulinemia
cyroglobin
cryofibrinogen
heparin
hyperbilirubinemia
hemolysis invitro
what are the causes of falsely low hb
clotting
what are the causes of falsely high hct
dehydration
hemoconcentration
iinsufficient centrifugation
buffy coat inclusion
hyponatrema
plasma trapping
what are the causes of falsely low hct
hemolysis,
improper sealing of capillary tube
increased anticoagulant concentration
introductin of excess tissue fluid
hypernatremia
cause of falsely high WBC count
lysis resistant rbc with abnormal hb
nucleated rbc
cryoglobulin
cryofibrinogen
platelet clump
giant platelets
micromegakaryoblasts
megakaryocyte fragements
heparin
monoclonal proteins
falsely low wbc
leukemia
leukoagglutnation
clotting
smudge cells
causes of falsely low neutrophils
neutrophil aggregation
neutrophil with hemosiderin granules
causes of falsely high lymphocytes
nucleated rbc
platelet clumping
giant platelets
malarial parasites
hypolobulated neutrophils
causes of falsely high monocytes
large reactive lymphocytes
lymphoblast
lymphoma cells
immature granulocytes
causes of falsely high eosinophil
neutrophil with hemosiderin granules
red cells with malarial pigment
what causes a falsely high platelet
leukemia
rbc fragments
microorganism
cryoglobulin
cryofibrinogen
hemolysis (in vivo)
hemolysis (in vitro)
microcyte red cell
red cell inclusion
wbc fragments
what cause the falsely low platelets
platelet clumps
old specimen
partial clotting
giant platelets
platelet satellitism
cold agglutination
clotting
heparin
what causes the false high mpv
old specimen
determining the MPV too early on EDTA specimen
