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CCHM 2 > LAB1 - preanalytical variables > Flashcards

LAB1 - preanalytical variables Flashcards

1
Q

components of
PRE-ANALYTICAL PHASE

A
  1. Test ordering / requisition
  2. Patient identification
  3. Phlebotomy
  4. Specimen transport
  5. Specimen examination
  6. Centrifugation
  7. Time to testing and storage
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2
Q

Any influence before testing of the specimen that causes the
test to fail to reflect the patient’s in vivo body functions

A

PRE-ANALYTICAL VARIABLES

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3
Q

any influences that may be cause false-positive/negative,
false-increase/decrease results

A

PRE-ANALYTICAL VARIABLES

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4
Q

FACTORS LEADING TO PRE-ANALYTICAL VARIABILITY

A
  1. Complex biochemical and cellular reactions measured in assays
  2. Liability of several analytes
  3. Dependence of reactions on certain substances
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5
Q

examples of pre-analytical variables

A

diet (food and beverages)
fasting
posture/position
tourniquet application
exercise
stress/ anxiety
smoking
altitude
age and gender
pregnancy
diurnal variation
medication

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6
Q

serum and plasma right after eating

A

Serum or Plasma may appear lipemic, cloudy or turbid appearance right after eating

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7
Q

Serum or Plasma may appear lipemic, cloudy or turbid appearance due to the presence of ____

A

fatty compound

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8
Q

what chemical test iare mostly affected of diet after eating

A

glucose and triglyceride

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9
Q

2 reasons why lipemic sample affects any test result

A
  1. It will affect the optical measurement or absorbance reading
    (spectrophotometry analysis)
  2. Cause of lipemia (chylomicrons) itself interfere the test
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10
Q

a phenomenon called ____ is a turbidity of the serum or plasma
and potentially interfering with instrument readings
(happens after eating)

A

Hyperchylomicronemia

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11
Q

(compounds/ analytes which affected immediately after eating

A

Elevate ↑

plasma potassium,
alkaline phosphatase,
5 HIAA (hydroxyindoleacetic acid)

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12
Q

what will decrease to lipid values of a Long-time vegetarian

A

✓ Low-density lipoproteins (LDLs)
✓ Very-low-density lipoproteins (VLDLs)
✓ Total lipids
✓ Phospholipids
✓ Cholesterol
✓ Triglycerides

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13
Q

what vitamin deficiency will long vegetarian will have due to low lipid intake?

A

Vitamin b12

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14
Q

➢ A high meat or other protein-rich diet will increase what analytes/compounds

A

✓ Serum urea
✓ Ammonia
✓ Urate levels

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15
Q

why A high meat or other protein-rich diet will increase urea, ammonia, and urate levels?

A

because these compound are end product of
metabolism of PROTEIN

Protein - made up of AMINO ACID (once
amino acid undergo deamination, it will become
AMONIA, as amonia binds itself with carbon
dioxide, it will form UREA)

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16
Q

analytes or compounds that will increase in High protein, low carbohydrate diets

A

greatly increase ketones in the urine and increase the serum blood urea
nitrogen (BUN) (Atkins Diet)

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17
Q

what are the ketone bodies that will increase if you eat a lot of protein but low carbs

A

acetone
acetoacetic acid
3 betahydrobutyric acid

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18
Q

High unsaturated-to-saturated fatty acid will cause a decrease it what analyte

A

decreased
serum cholesterol

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19
Q

Purines will primarily increase what NPN(non protein nitrogen)

A

urea (urate value )

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20
Q

Bananas, pineapples, tomatoes, and avocados will elevate what analyte or compound?

A

urine excretion of 5 HIAA (5 hydroxybutyric acid)

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21
Q

Obesity will be observed with what analyte?

A

increased serum LD activity, cortisol
production, and glucose.

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22
Q

describe the insulin concentration of an obese as well as their glucose tolerance

A

Plasma insulin concentration is increased and the glucose tolerance is impaired

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23
Q

describe the testosterone of an obese man

A

decreased

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24
Q

describe the glucose level of a person after alcohol consumption

A

transiently elevated

nababalik pa rin sa normal yes yes yow

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25
Q

Chronic alcohol consumption - tests associated with the liver and increases which type of lipid

A

triglycerides

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26
Q

____ use as marker of chronic
alcoholism

A

Gamma glutamyl transferase (GCT)

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27
Q

fill in the blanks according to the discussed topic

Caffeine - affect ____ levels; elevate plasma _____ and cause _____ release from the
adrenal medulla and brain tissue

A

hormone; free fatty acids; catecholamine

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28
Q

it refers to the balance of the solute and solvent in the body

A

osmolality

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29
Q

what are affected if you drink to much liquid as per the discussed topic?

A

hgb and electrolyte balance

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30
Q

samples collected in basal state

A

glucose, cholesterol, triglyceride
and electrolytes

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31
Q

what does basal state means

A

Basal state- resting metabolic state

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32
Q

Specimen that requires fasting

A

Glucose: FBS, GTT, TAG,
Lipid profile: lipid and lipoprotein tests,
Analyte: gastrin and insulin

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33
Q

desired fasting hours of glucose, lipids and lipoproteins

A

8-14 hours

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34
Q

48 hours of fasting may ____ serum bilirubin

increase, decrease

A

increase

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35
Q

72 hours of fasting may result to ___ of plasma triglyceride while glucose _____in health women to 45
mg/dL (2.5 mmol/L),

A

increase; decreases

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36
Q

upon fasting,
Men show an increase in plasma triglycerides, glycerol, and free fatty acids, with no significant change in ___

A

plasma
cholesterol.

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37
Q

National Institutes of Health recommends that patients be lying or sitting for how many minutes prior to blood collection for lipid profiles to minimize the effects caused by posture

A

5 minutes

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38
Q

POSTURE :

variation in blood constituent increase about ___ within 10mins.

A

4-15%

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39
Q

for patients with cirrhosis and congested heart failure are more concentrated in what areas

A

interstitial spaces

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40
Q

effects of Changing from supine to
sitting or standing on the following:

albumin, enzymes and calcium

A

increased

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41
Q

effects of Changing from sitting to
supine to the following:

proteins, lipids,
BUN, iron and calcium

A

Increased

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42
Q

Changing from standing to
supine

A

↓ Decreased levels of cholesterol,
triglycerides and lipoproteins

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43
Q

effect of 30 minutes of standing in potassium

A

Significant elevation of potassium
Prolonged bedrest ↓ Decreased plasma albumin

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44
Q
A
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45
Q

effect of Prolonged bedrest to plasma albumin

A

Decreased plasma albumin

46
Q

effect of Standing to plasma renin

A

Plasma renin is higher than supine
position

47
Q

describe what will happen to serum aldosterone and catecholamine upon standing within 1 hr

A

could double up within
an hour

48
Q

patient that have prolong standing, they
should be lying down, in a specific sitting
position for at least __before
collecting samples)

A

30mins

49
Q

It is recommended that tourniquet application should not be
more than ___

A

one minute

50
Q

Prolonged tourniquet application results to
___.

A

hemoconcentration and anaerobiosis

51
Q

The pressure from
the tourniquet causes biological analytes to ___

A

leak from the tissue cells into the blood

52
Q

there will be an increased level of

____ if the tourniquet takes more than 1 mn

A

○ Potassium (1 mmol/L)
○ Proteins (albumin)
○ Enzymes
○ Lactate
○ Cholesterol
○ Ammonia

53
Q

the most affected analyte in prolonged tourniquet application

A

potassium

54
Q

Decreased levels of ___ are observed in prolonged tourniquet

A

○ Venous pO2
○ pH (acidic)

55
Q

if the oxygenation in blood is decrease, what will happen to the blood’s pH level

A

decrease, lower oxygen will turn the blood to become acidic

56
Q

the effect of the exercise is depending on the ___ patient

A

physical fitness and muscle mass of the patient

57
Q

Moderate or strenuous exercise will increase which compound/analyte

A

○ blood levels of creatinine
○ fatty acids
○ lactic acid
○ aspartate aminotransferase (AST)
○ creatine kinase (CK)
○ lactic dehydrogenase (LD)
○ Aldolase
○ Hormones
○ Bilirubin
○ uric acid
○ high-density lipoprotein (HDL)
○ white blood cell (WBC) coun

58
Q

hormones released during Moderate or strenuous exercise

A
  • antidiuretic hormone
    • aldosterone
  • catecholamines
  • renin
  • growth hormone
  • angiotensin
  • cortisol
59
Q

compounds that are expected to decrease in moderate and strenuous exercise

A

○ Arterial pH
○ PCO2.

60
Q

a technique in venipuncture that must be avoided if the test is potassium and phosphate

A

fist clenching

61
Q

Affected analyte that will caused an Increased upon performing strenuous activity

A

▪ Prolactin
▪ Testosterone
▪ LH
▪ Protein (urine)
▪ Potassium,
Lactate
& Phosphate
(fist clenching)

62
Q

Affected analyte that will caused an transient Increased upon performing strenuous activity

A

▪ Lactate
▪ Pyruvate
▪ Fatty Acid
▪ Creatinine
▪ Ammonia

63
Q

Affected analyte that will caused an long term Increased upon performing strenuous activity

A

▪ CPK
▪ AST
▪ LD
▪ Aldolase

64
Q

Affected analyte that will caused an decrease upon performing strenuous activity

A

▪ FSH
▪ LH
(In long distance
athletes)

65
Q

STRESS / ANXIETY has an increased in what hormones

A

Increased levels of adrenal hormones (cortisol and
catecholamines),

66
Q

STRESS / ANXIETY has an increased in what cell count

A

wbc count

67
Q

what are common in long term increase in terms of analytes affected by exercise

A

Enzyme
found/ release
by skeletal
muscle

68
Q

the lab test affected and will decrease specially for patients who are actively performing and exercise is part of their daily routine

A

FSH and LH

69
Q

STRESS / ANXIETY wll decreased the result levels of what test

A

serum iron, and markedly affect arterial blood
gas (ABG) result

70
Q

what cell count collected from a violently crying newborn may
be markedly elevated

A

WBC counts

71
Q

Severe anxiety → hyperventilation (excessive release of CO2
which can cause ___)

A

alkalosis

72
Q

Total cholesterol has been reported to ____ with mild
stress, and HDL cholesterol to decrease by as much as
____

A

increase; 15%.

73
Q

Immediate effects of nicotine

A

→ increases in:
○ Plasma catecholamines

74
Q

cellular element effect of smoking

A

decreased numbers of eosinophils, while
neutrophils, monocytes, and plasma fatty free acids increase

75
Q

what will happen to
○ Glucose
○ Blood urea nitrogen (BUN)
○ Cholesterol
○ Triglycerides

upon smking

A

increased

76
Q

how many percent do Glucose and BUN can increase upon smoking?

A

by 10%

77
Q

how many percent can triglyceride increase upon smoking

A

triglycerides
by 20%

78
Q

in hema and imse , chronic smoking can increase the values of

A

Chronic smoking increases
hemoglobin,
red blood cell (RBC) counts,
the mean corpuscular volume (MCV) and
immunoglobulin (Ig) E.

79
Q

what are the immunoglobulins that will be affected during smoking

A

Immunoglobulins (MAG-yosi)IgA, IgG, and IgM are decreased,
lowering the effectiveness of the immune system

80
Q

Tobacco smokers have high blood ______
levels

A

carboxyhemoglobin

81
Q

pregnancy

Caused by the physiological changes in the body including
increases in ___

A

plasma volume

82
Q

Increased plasma volume may cause a dilutional effect
and cause lower ___

A

RBC counts, protein, alkaline
phosphatase, estradiol, free fatty acids, and iron values.

83
Q

____ is the normal fluctuation in blood levels at
different times of the day based on a 24-hour cycle of
eating and sleeping

A

Diurnal rhythm

84
Q

Levels are highest in the morning

A

○ Cortisolaldosterone
○ Renin
○ Luteinizing hormone
○ Follicle-stimulating hormone
○ Estradiol
○ Thyroid-stimulating hormone (TSH)
○ Testosterone
○ Bilirubin
○ Hemoglobin
○ Insulin
○ Potassium
○ RBC count
○ Serum iron

85
Q

Levels are lower in the morning

A

○ Eosinophil counts
○ Creatinine
○ Glucose
○ Triglyceride
○ Phosphate

86
Q

Medications that are toxic to the liver (Hepatotoxins) can
cause an increase in ___

A

blood liver enzymes and abnormal
coagulation tests

87
Q

IV administration of dyes used in diagnostic procedures,
including radiographic contrast media for kidney disorders
and fluorescein used to evaluate cardiac blood vessels,
can interfere with testing procedures

true or false

A

truthfully imnida

88
Q

_____ may be noted in patients taking medications that impair renal
function

A

Elevated BUN levels or imbalanced electrolytes

89
Q

Patients taking corticosteroids, estrogens, or diuretics can
develop ____ and would have elevated serum
amylase and lipase levels

A

pancreatitis

90
Q

test affected by diurnal variation, posture, and stress

cortisol

peaks:
lowest:
50% lower at:
_____ with stress

A

cortisol

peaks: 4-6 am
lowest: 8 pm - 12 am
50% lower at: 8pm than 8 am
increased with stress

91
Q

test affected by diurnal variation, posture, and stress

adrenocorticotropic hormone

lower at _____
____ with stress

A

lower at night
increased with stress

92
Q

test affected by diurnal variation, posture, and stress

plasma renin activity

lower at _____
_____ standing than supine

A

lower at night
higher standing than supine

93
Q

test affected by diurnal variation, posture, and stress

aldosterone
lower at _____

A

lower at night

94
Q

test affected by diurnal variation, posture, and stress

insulin
lower at _____

A

lower at night

95
Q

test affected by diurnal variation, posture, and stress

growth hormone

_____ in afternoon and evening

A

higher in afternoon and evening

96
Q

test affected by diurnal variation, posture, and stress

acid phosphatase

_____ in afternoon and evening

A

higher in afternoon and evening

97
Q

test affected by diurnal variation, posture, and stress

thyroxine

___ with exercise

A

increases with exercise

98
Q

test affected by diurnal variation, posture, and stress

prolactin

_____ with stress,
_____ levels at 4 and 8 am and at 8 and 10 on

A

higher

99
Q

test affected by diurnal variation, posture, and stress

iron

peaks at _____
______ during the day

A

peaks early to late morning
decreased up to 30% during the day

100
Q

test affected by diurnal variation, posture, and stress

calcium

_______ % decrease supine

A

4% decrease supine

101
Q

acetaminophen and certain antibiotic

what is the affected test/systems?

A

elevated liver enzymes and bilirubin

102
Q

cholesterol-lowering drugs

what is the affected test/systems?

A

prolonged PT and APTT

103
Q

certain antibiotics

what is the affected test/systems?

A

elevated BUN, creatinine, and electrolyte imbalance

104
Q

what is the affected test/systems?

corticosteroids and estrogen diuretics

A

elevated amylase and lipase

105
Q

what is the affected test/systems?

diuretics

A

increased calcium, glucose, and uric acid and decreased sodium and potassium

106
Q

what is the affected test/systems?

chemotherapy

A

decreased rbcs, wbcs, and platelets

107
Q

what is the affected test/systems?

aspirin, salicylates, and herbal

A

prolonged PT and bleeding time

108
Q

what is the affected test/systems?

radiographic contrast media

A

routine analysis

109
Q

what is the affected test/systems?

fluorescein dye

A

increased creatinine, cortisol, and digoxin

110
Q

what is the affected test/systems?

oral contraceptives

A

decreased apoproteins, transcortin, cholesterol, HDL, triglycerides, LH, FSH, ferritin and iron

111
Q
A

CCHM 2 (7 decks)

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