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Medical Lab Assistant > Med. Lab Procedures - Module 1&2 > Flashcards

Med. Lab Procedures - Module 1&2 Flashcards

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USMLE® Step 1 flashcards
1
Q

What is phlebotomy?

A

The practice of drawing blood

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2
Q

What did the earliest phlebotomists draw blood for?

A

To cure disease and maintain a state of wellness in the body

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3
Q

Why do phlebotomists practice today?

A

diagnosis and monitoring treatment of disease conditions

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4
Q

Name the vein on the pinky side used as a last choice, of the 3 main veins?

A

Basilic vein

Near brachial artery and nerve
Least firmly anchored

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5
Q

Name the vein on the thumb side we use as a second choice?

A

Cephalic vein

It is usually more difficult to locate and has a tendency to move

Often only vein palpable on obese patients

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6
Q

Which vein is usually the best choice for venipuncture?

A

Median Cubital Vein

Well anchored
It is large and does not tend to move when the needle is inserted

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7
Q

What colour tube can an iron deficiency test(ferritin) be done in?
(FER)

A

Gold or Green

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8
Q

What colour tube would you use for a hematology profile blood draw?

(CBC) (HP)

A

Lavender

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9
Q

What colour tube would you use for an INR test?

(INR) (PT) (PTT)

A

Light Blue

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10
Q

What colour tubes do you use for glucose chemistry testing?

A

Fasting = Green (Island Health)
Random - Gold (Life Labs)
Hemoglobin A1C (HGA1/A1C) - Lavender

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11
Q

When testing electrolytes what colour tube would you use?

Na, K+, ALB, ALP/ALK, ALT, BILI, GGT, TP, Crea, Ca, CK

A

Green (Island Health)

Gold (Life Labs)

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12
Q

If you were doing a screening panel for suspected prostate cancer what colour tube should you use?

A

Gold

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13
Q

What angle do you enter the vein with a butterfly needle?

A

10-15º

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14
Q

There is an easy way to know if you’re in the vein with a butterfly needle, what is it?
It involves the tubing.

A

A flash (small amount) of blood will appear in the tubing

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15
Q

What is the order of draw?

A

1 - Blood Cultures (sterile) -
2 - Light Blue (sodium citrate) for coagulation studies don’t want to get heparin or EDTA in these tubes
3 - Red (No additive)
4 - Gold (SST)
5 - Green (Heparin)
6 - Lavender (EDTA)
7 - Grey (sodium fluoride)

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16
Q

What is used on non living objects to reduce the risk of infection?

A

Disinfectants

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17
Q

What is used on living skin to reduce the risk of infection?

A

Antiseptic

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18
Q

What does 2, 2 and 2 mean?

A

Hold pressure for 2 minutes (on the venipuncture site)
Leave the bandage on for 20 minutes
and, No heavy lifting for 2 hours

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19
Q

What are the parts named?
5 - as a whole what is it?

A

1 - Bevel
2 - Shaft
3 - Hub
4 - Retractable Sheath
5 - Multisample Needle
6 - Tube holder
7 - Evacuated Tube
8 - Assembled system

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20
Q

What are three types of blood specimens used for analysis?

A

Whole Blood
Serum
Plasma

21
Q

What is whole blood?

A

Blood collected and mixed with an anticoagulant so it’s unclotted.

22
Q

What is serum?

A

Fluid portion of blood that remains AFTER clotting

Clotting begins 30-60 minutes after it’s been drawn

Does NOT contain fibrinogen & other clotting factors

23
Q

What is plasma?

A

Fluid portion of the blood

INCLUDES fibrinogen & other clotting factors

obtained by ADDING an anticoagulant before centrifuging

24
Q

What additives bind to calcium inhibiting coagulation of the blood?

A

EDTA, sodium and potassium

     ~ Sodium Citrate
     ~ Potassium Oxalate
     ~ Sodium Polyanethol Sulfonate (SPS)  -  used for blood cultures

These PREVENT clotting; anticoagulants

25
Q

What tests can’t be performed on blood from a capillary collection?

A

Test requiring larger volumes of plasma or serum,
Blood cultures
ESR (Erythrocyte sedimentation rate)
Coagulation tests

26
Q

What’s the difference between venous and capillary blood?

A

Blood from capillaries is a combination of venous and arterial blood.

27
Q

A capillary collection site should avoid ______, ______, ______ and ______

A

cuts, scars, bruises and rashes

28
Q

What is osteochondritis?

A

Inflammation of the bone or cartilage

29
Q

What is osteomyelitis?

A

bone infection

30
Q

What is the recommended puncture depth for preemies getting a capillary collection done?

A

.65mm - .85mm

31
Q

The lancet should not penetrate deeper than _____

A

3mm

32
Q

Why is a heel lancet depth different than a finger depth for capillary collection?

A

Because the heel bone is close to the surface

heel 2mm
finger 3mm

33
Q

What is the order of draw for capillary collection

A
  1. Light blue
  2. Lavender
  3. Green
  4. Gray
  5. Gold
  6. Red
34
Q

How long should you leave a warm pack on for?

A

3-5 minutes

35
Q

Where should you collect blood for a capillary collection on an adult and why?

A

The palmar surface of the distal segments in the middle finger or the ring finger should be used.

The thumb is too callused
Index has extra nerve endings and is more painful
Pinky has too little tissue.

36
Q

What is basal state?

A

When the body has been fasting for 8-12 hours and absent from strenuous exercise

37
Q

List some of the factors that can affect the sample quality

A
  • Age
  • Alcohol consumption
  • Altitude
  • Dehydration
  • Diurnal variation
  • Exercise
  • Medications and medical treatment
  • Fasting
  • Patient sex
  • Posture
  • Pregnancy
  • Obesity
38
Q

Frequent causes of hemolysis?

A
  • Using a needle smaller than 23 gauge
  • Using a small needle with a large vacuum tube
  • Using a small needle to transfer blood from syringe to tube
  • Mishandling and improper transport of specimen
  • Readjustment of the needle in the vein
39
Q

What are common issues faced in transportation of samples?

A

Time
Temperature
Light

40
Q

Chemistry specimen must be spun within what time frame?

A

2 hours

At the lab within 45 minutes to allow time to lab tech’s to spin and assess sample

41
Q

Hematology specimen should be analyzed within what time if left unrefrigerated?

A

4 hours

If it’s refrigerated it’s 12 hours

42
Q

How long do you wait for clotting before centrifuging an SST ?

A

30 - 60 minutes

43
Q

How long do you wait for clotting before centrifuging a Red tube?

A

Minimum 60 minutes

44
Q

What can cause a specimen to be rejected?

A
  1. Improper or inadequate identification
  2. Hemolysis
  3. Incorrect tube for the test ordered
  4. Tubes past their expiration date
  5. Inadequate ratio of blood to additive
  6. Insufficient volume for testing (QNS or NSQ)
  7. Drawing a specimen at the wrong time
  8. Contaminated specimen
  9. Improper handling
  10. Bringing a sample to the laboratory outside the appropriate time frame
45
Q

What is the purpose of a vacutainer holder?

A

Needle and tube holder

To prevent accidental pokes from the tube needle

46
Q

What does the tourniquet do to the veins?

A

Impedes venous blood flow, resulting in dilation of the vein

47
Q

Why do we use different needle gauges?

A

Type of collection, patient condition, size of vein

Different procedures - hand, vein, foot, antecubital fossa etc.

48
Q

What is the major duty of a phlebotomist and what is important about their responsibilities?

A

Obtain consent,
Select appropriate supplies
Prepare collection site
Collect sample while ensuring patient comfort and safety
Label samples correctly and transport

Medical Lab Assistant (19 decks)

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