(M) Lesson 4: Special Procedures and POCT Flashcards
Is non-routine, requires additional prep, and requires other specimen (urine & feces)
Special Collection Procedures
Refers to blood typing and crossmatching for blood transfusions
Screening
What are the two types of blood classifications?
ABO and Rh
T or F: You can rely on verbal blood type declaration by the patient
False
T or F: In screening for infectious diseases, notify the donor if results come back negative
False (positive)
Refers to non-infectious blood that is stored prior to crossmatching
Cleared blood
What is the standard blood donation volume?
450mL
What specimen is donated for transfusions?
Whole Blood
What is the month interval for donating whole blood?
Every 3 months
What is the age range for blood donors?
18-65 years old
What is the minimum weight requirement for donating blood?
110 pounds/50 kg
T or F: If the blood volume of an underweght donor is less than the prescribed 450mL, the blood-anticoagulant ratio in the blood bag will not be satisfied
True
Refers to blood donation for yourself in future procedures
Autologous Donation
Refers to developing antibodies to blood you receive due to frequent donations
Alloimmunization
T or F: Autologous donation increases disease transmission risk
False
T or F: Autologous donations can be used for those with rare blood types and multiple antibodies
True
Type of autologous donation done 5-6 weeks before a procedure
Preoperative
Type of autologous donation that allows shedded blood to be used as long as it is washed with saline
Intraoperative
Type of autologous donation used for emergency cases wherein shedded blood can be washed or not
Postoperative
T or F: Intra and post autologous collection is done outside the surgical room
False (inside)
This test checks for blood pathogens
Blood culture
Process that refers to screening for bacteria
Bacteremia
Process that refers to screening for microorganisms and toxins
Septicemia
T or F: Bacteremia is more severe than septicemia
False
T or F: Bacteremia can develop into septicemia
True
How many blood culture sets are prepared for aerobic and anaerobic testing?
2-4
T or F: Blood cultures use opposite sites of collection for uniformity (left and right side)
True
What is the order of substances in skin antisepsis for blood cultures?
Alcohol -> Iodine -> Alcohol (again)
Refers to the introduction of a specimen with a culture medium (agar plate) for incubation
Inoculation
How many days should cultures be checked daily?
5 days
T or F: Culture growth beyond the 5th day is considered to be a contaminant and is rejected
True
When inoculating the medium directly into the bottle, this is done ______ collection
During
When inoculating the medium collected in a syringe, this is done ______ collection
After
When inoculating the medium through intermediate collection tubes, this is done where?
In the lab
This specimen assesses blood clotting functions especially if patient has unexplained bleeding
Coagulation specimen
What tube is used to collect coagulation specimen?
Blue (sodium citrate)
What is the blood to anticoagulant ratio in sodium citrate?
9:1
Refers to deficiencies in fibrinogen, prothrombin, and factors: 5, 7, 8, 9, and 10
Prothrombin Time (PT)
Refers to deficiencies in Pre-K, HMWK, prothrombin, fibrinogen, and factors: 12, 11, 9, 8, and 10
Activated partial thromboplastin time (aPTT)
Refers to the clotting time
Thrombin Time (TT)
This test screens and monitors for diabetes, metabolic problems, and insulin therapy as it is supplemental to FBS testing
2-Hours Postprandial Glucose
In 2-Hours Postprandial Glucose, how many days prior to testing is a high-carb diet introduced?
2-3 days
How many hours should a patient fast for the 2-hours postprandial glucose test?
8-10 hours
T or F: Fasting glucose specimen can be collected after the 2-hours postprandial glucose procedure
False (before)
How many grams of the glucose load will be given on testing day?
100g
How many hours after intake of the glucose load is the blood glucose specimen collected?
2 hours
This test observes carbohydrate metabolism and is also called oral glucose tolerance testing (OGTT)
Glucose Tolerance Test (GTT)
What is the GTT procedure interval for gestational diabetes mellitus patients?
1 hour
Gestational diabetes mellitus patients are usually pregnant women in what trimester?
3rd
T or F: Collection method for GTT must be consistent (same time interval and same collected volume)
True
How much of a carb diet should a GTT patient undergo for 3 days prior to testing?
150g
How many hours should a patient fast for GTT?
8-10 hours
T or F: In GTT, you must advise the patient that intaking only juice will be allowed during the testing period
False (water)
When glucose is checked, it should have a value of how many mg/dL to proceed?
200
T or F: Fasting urine can be collected in GTT if needed
True
How much is the glucose load in GTT for adults?
75 grams
How much is the glucose load in GTT for children?
1 gram per kg weight of the child
How much is the glucose load in GTT for GDM patients?
50-75 grams
T or F: Diabetes is not normal in pregnant women
False (heightened diabetes caused by pregnancy hormones)
Within how many minutes should the glucose beverage be ingested in GTT?
5 minutes
How many hours is the interval of specimen collection for GTT?
1 hour
What is the maximum amount of collections done for GTT?
3 times
How many specimen are collected in GTT?
4 (fasting specimen, hour 1, hour 2, and hour 3)
GTT sample is to be transported immediately or within how many hours to the lab?
2 hours
This test measures the body’s ability to process lactose and determines if a patient lacks lactase
Lactose Tolerance Test
What converts lactose into glucose or galactose?
Lactase
T or F: if lactase is not converted, it can results to gastrointestinal distress and diarrhea as there is intolerance
False (lactose)
T or F: A 2-hour GTT should be administered a day before the lactose test for comparison purposes
True
T or F: Amount of glucose given in GTT < amount of lactose given for LTT
False (equal amounts)
T or F: The GTT curve and lactose curve will be similar if the patient has mucosal lactase
True
These curves are for those detected with lactose intolerance since no glucose was metabolized therefore there is no change in the graph
Flat curves
Slow gastric emptying, Crohn’s diseases, and cystic fibrosis can all show what type of results in LTT?
False-positives
The specimen collected for this test are blood, hair, urine, and nails
Drug Testing
This type of toxicology examines toxins and prescribes treatment
Clinical toxicology
This type of toxicology deals with legal consequences of toxin exposure
Forensic toxicology
T or F: In forensic toxicology, specimens are ordered by law enforcement
True
What are the 2 most common specimens for alcohol testing?
Breath and blood
T or F: Urine is used for drugs and DNA testing while blood is used for drug screening
False (urine for drug screening; blood for drugs and DNA analysis)
This form tracks the specimen upon collection up to release of results and is required when performing drug tests
Chain of custody
This test is done by companies, institutions, and groups who are allowed to hold random screening tests without prior notice
Drug Screening
What is the most preferred specimen type of drug screening?
Urine (drug metabolites are detected longer within the urinary tract as byproducts compared to the blood which metabolizes quicker)
T or F: A chain of custody is not implemented in drug screening
False
What do you call the individual undergoing the drug screening?
Donor
T or F: A witness should be present when the drug screening form is signed
True
Refers to waterless urinals that prevent contamination of urine sample
Special Area
T or F: A special bottle is used instead of the usual plastic cup for urine collection in drug screening
True
T or F: Witness should be present to ensure that the specimen belongs to the donor
False (proctor)
T or F: Split samples in drug screening can be used for parallel testing
True
If sample A comes back positive for drug screening, what must be done for sample B?
Test as well and confirm the donor
Where can drug test analyst (DTA) training be done?
Reference laboratory for drugs of abuse (East Avenue Medical Center)
This test measures drug levels at designated time intervals for appropriate dosage
Therapeutic Drug Monitoring
T or F: In therapeutic drug monitoring, amount in the bloodstream is expected to drop to reach a trough (minimum) which screens drug toxicity
False (expected to RISE)
T or F: In therapeutic drug testing, a gradual fall to a trough (minimum) ensures that the levels are within therapeutic range
True
Refers to drawing large volumes of blood (500mL) from a patient as part of their treatment plan
Therapeutic Phlebotomy
This condition is characterized by the following:
- RBC overproduction
- hematocrit test checks RBC level
- removal of blood is done if value exceeds a certain level
Polycythemia
This condition is characterized by the following:
- excess iron deposits in the tissues
- problems with iron metabolism
- result of multiple transfusions or excessive iron intake
Hemochromatosis
Law enforcement orders this test for individuals involved in traffic accidents (driving under the influence)
Blood Alcohol Concentration Tests (BAC)
T or F: ETOH requires a chain of custody while BAC does not
False (ETOH test DOES NOT require a chain of custody while a BAC should follow a chain of custody protocol)
ETOH uses what aqueous antiseptics?
Povidone-Iodine and Benzalkonium Chloride
T or F: Do not use alcohol/tincture of iodine as an antiseptic for ETOH since the sample to be collected is already an alcohol
True
T or F: An ETS is used for ETOH because alcohol evaporates faster when exposed to air—the vacuum method preserves the integrity of the sample
True
What tube is used for blood alcohol specimen?
Gray (fluoride)
Refers to the presence of aluminum, copper, lead, iron, and zinc
Trace elements
T or F: Trace elements are to be collected in small amounts and must use special element-free tubes (light blue)
False (royal blue)
This is performed to exclude the possibility of paternity for a particular child
Paternity/Parentage
T or F: Paternity tests can exclude some alleged parents
False
What 2 testing methods are used in paternity tests?
PCR and RFLP (restriction fragment length polymorphism)
What type of sample is collected for paternity testing?
Buccal sample (inside of the cheek acquires loose cheek cells)
How many hours can paternity tests be available?
48 hours
This test:
→ is done outside the centralized lab and near the site where the patient receives treatment (bedside manner)
→ shortens turn around times
→ states that not all physicians accept verbal results (print if needed)
→ is aka alternate site testing (AST), near-patient testing, remote testing, satellite testing, and rapid diagnostics
Point of Care Testing (POCT)
This test:
→ uses warfarin and heparin which can be evaluated using this POCT analyzer
→ common tests done are PT, international normalized ratio (INR), aPTT, activated clotting time (ACT), and platelet function
Coagulation Monitoring
This test:
→ evaluates capillaries for platelet plug formation
→ is indicative of a disorder in the platelet function or capillary integrity
→ serves as a pre-surgical screening and detection of problems involving hemostasis—done in pre-op
Bleeding Time
This test:
→ is used for emergency, pulmonary, and neonatal intensive care units
→ greatly improved turnaround time for patients in emergency situations
Arterial Blood Gases and Electrolytes
This specimen:
→ measures the status of lungs, heart, and kidney function
→ measures pH, partial pressure of carbon dioxide (PCO2), partial pressure of oxygen (PO2), and oxygen saturation (SO2)
→ checks the acid-base balance which shows metabolic (kidney) and respiratory (lungs) status
Arterial Blood Gas
Metabolic problems can be traced back to what organ?
Kidney
Respiratory problems can be traced back to what organ?
Lungs
What is the normal pH range of the human body?
7.35-7.45
Refers to the body having a pH lower than 7.35
Acidosis
Refers to the body having a pH higher than 7.45
Alkalosis
This is a good indicator of how well air is exchanged between the blood and lungs
PCO2
Condition wherein PCO2 increases abnormally
Hypoventilation
Condition wherein PCO2 decreases abnormally
Hyperventilation
This substance is representative of the pressure exerted by dissolved O2
PO2
Normal, healthy individuals exhibit what percent of oxygen saturation?
98%
This substance aids in moving nutrients in the body and in waste removal; it uses electrolytic panels to determine blood levels of Na, K, Cl, and iodized Ca
Electrolytes
Refers to high Na levels
Hypernatremia
Refers to low Na levels
Hyponatremia
Refers to high Cl levels
Hyperchloremia
Refers to low Cl levels
Hypochloremia
Refers to high K levels
Hyperkalemia
Refers to low K levels
Hypokalemia
Refers to high Ca levels
Hypercalcemia
Refers to low Ca levels
Hypocalcemia
