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PMLS > Module 5: Pre- Analytical Considerations > Flashcards

Module 5: Pre- Analytical Considerations Flashcards

1
Q

refers to values which patient results are compared to.

A

Reference range

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2
Q

-this refers to the resting metabolic state of the body early in the morning after fasting for approximately 12 hours.

-ideal for establishing reference ranges on inpatients because the effects of diet, exercise, and other controllable factors on test results are minimized or eliminated.

A

Basal state

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3
Q

Comparing previous results of Px to present result (same Px)

A

Delta Check

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4
Q

Examples of blood components that differs in AGE

A

RBC and WBC
Kidney functions- creatinine clearance

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5
Q

RBC and WBC is normally higher among newborns than adults. True or False

A

True

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6
Q

Kidney Functions decrease with age. True or False

A

True

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7
Q

What is creatinine clearance?

A

Test creatinine in blood. It is expected that results be higher in older ppl. due to the fact that have decreased kidney functions.

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8
Q

How does Altitude affect some blood analytes

A

may cause variations of results in higher elevation compared to results in sea level.

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9
Q

What increases in higher altitudes?

A
  1. RBC count
    2.Hemoglobin and Hematocrit
    3.Uric Acid
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10
Q

Why does RBC and Hemoglobin increase in higher altitudes?

A

Due to the fact that in higher altitudes there is a decrease in O2, thus body produce more RBC to compensate with the reduce of O2 in body. As RBC increase Hemoglobin and Hematocrit also increases.

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11
Q

What decreases as altitude increases?

A
  1. Urinary Creatinine
  2. Plasma Renin
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12
Q

Analytes generally take ______(1)_____to adapt to high elevations/altitude; however, they adapt to return to sea level within ___(2)______.

A

Weeks; Days

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13
Q

What is the term for decrease of body fluids?

A

Dehydration

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14
Q

One way Dehydration can occur?

A

Persistent vomiting or diarrhea

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15
Q

What is Hemoconcentration?

A

Blood components cannot easily leave bloodstream, thus becoming concentrated in smaller plasma volume.

This can result to false increase of formed elements of blood

Mas dumadami ung blood components kasi nababawasan ung fluid

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16
Q

How does plasma volume decrease during dehydration?

A
  • water is lost since it is absorbed by the body- dilutional effect.
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17
Q

What analytes increase during dehydration
Clue: Richmond Can Eat Ice Cream Sticks

A
  1. RBC
  2. Calcium
  3. Enzyme
  4. Iron
  5. Coagulation factors
  6. Sodium
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18
Q

Dehydrated patients may accurately reflect the patient’s normal status. True or False

It is often easy to obtain blood specimens from dehydrated patients. True or False

A

BOTH FALSE

  • not accurately
    -difficult
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19
Q

What can happen to test results following ingestion of food?

A
  • alter results causing false negatives or false positives.
    -unsuitable for lab tests
    -vary depending of amount and type of food
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20
Q

What is fasting?

A
  • no ingestion of food appx. 8-12 hours. but water is allowed in minimal amounts.
    -done overnight- after last meal until morning before breakfast.
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21
Q

term used to say food and water cannot be ingested (by mouth)

A

nil per os- nothing by mouth

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22
Q

What is Overfasting?

A
  • exceeded 12 hours mark
  • cause serious health prob.s
    -electrolyte imbalance and heart rhythm disturbances
    -cannot be accepted
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23
Q

Refraining from drinking water while fasting can result in dehydration, which can negatively affect test results and also make blood collection more difficult.
True or false?

A

True

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24
Q

Elevated with high-protein diets
Clue: Ako Ung Umupo

A

Ammonia, urea, uric acid

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25
Q

Ingestion of food/ bev. with caffeine
Clue: Christine Angela

A

1.Cortisol
2. Adrenocorticotropic hormone

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26
Q

increase with ingestion of carbohydrates and sugar-laden subs.

A

Glucose

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27
Q

How long does Glucose go back to normal?

A

2 hours if glucose metabolism is normal

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28
Q

eating carbohydrate decrease insulin levels?

A

False.It increases like glucose

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29
Q

drinking too much water can…

A

decrease hemoglobin level and cause eletrolyte balance

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30
Q

Ingestion of butter, margarine, cheese, cream, and enteral (feeding tube) preparations

A

Lipid level increase

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31
Q

What does Lipid mean?

A

fat-soluble. they do not dissolve in water causing them to be suspended in plasma and serum

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32
Q

Specimens with Lipid can appear…

A

milky/ cloudy white or turbid - LIPEMIC

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33
Q

Why does triglyceride tests need a 12 hour fast?

A

Lipemia can be present for 12 hours. lipemic tests interferes with testing procedure

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34
Q

Chronic consumption or recent ingestion of large amounts of alcohol

A

-Triglycerides, liver enzymes, and liver function analytes increase

-cause hypoglycemia

35
Q

What increases in long-term starvation?
Clue: CUK

A
  • Creatinine
    -Ketone
    -Uric Acid
36
Q

Decreased with long term startvation
Clue: CUT

A
  1. Cholesterol
    2.Triglycerides
    3.Urea
37
Q

What is diurnal and circadian

A

Diurnal: Happening daily
Circadian: 24hr cycle

38
Q

factors that play role in DIURNAL VARIATIONS

A
  1. Posture
    2.Activity
    3.Eating
    4.Awake or Asleep
  2. Daylight or Darkness
39
Q

DIURNAL/ CIRCADIAN:

example: Melatonin

A

increase at night, decrease during day

40
Q

DIURNAL/ CIRCADIAN:

Cortisol

A

Peaks at 8AM

41
Q

DIURNAL/ CIRCADIAN:

Renin and Thyroid-stimulating hormone

A

peaks at pre-dawn or morning during sleep

42
Q

DIURNAL/ CIRCADIAN:

Peaks in the morning?
Clue: Angela Buys Ivy Roses In The Pot House

A

Aldosterone, Bilirubin, Insulin, RBC ,Iron, testosterone,Potassium,Hemoglobin

43
Q

DIURNAL/ CIRCADIAN:

Lowest in the morning?
Clue: Go Get Everyone to Create Pot

A

Glucose, Growth Hormones, Eosinophils, Triglycerides, Creatinine, Phosphates

44
Q

Drugs can also interfere with the actual test procedure, causing false increases or decreases in test results.

  1. A drug may compete with the test reagents for the substance being tested, causing a falsely low or false-negative result.
  2. The drug may enhance reaction, causing a falsely high or false-positive result.
A

TRUE

45
Q

Chemotheraphy Drugs

A

WBC and platelets decrease

46
Q

Most drugs that are toxic to liver ?

A

Increase:
AST- Aspartate Aminotransferase Test
ALP- Alkaline Phosphatase
LDH- Lactate Dehydrogenase

Decrease:
Clotting factors

47
Q

Oral Contraceptives? What increases and decreases?

A

Increase: Erythrocyte sedimentation rate
Decrease: vitamin B12

48
Q

Steroids and diuretics

A

Increase: Amylase and Lipase

49
Q

Thiazide diuretics

A

Increase: Calcium and glucose
Decrease: Sodium and potassium

50
Q

How many hours should drugs that interfere with BLOOD TESTS be stopped?

A

4-24 hours prior

51
Q

How many hours should drugs that interfere with URINE TESTS should be stopped?

A

48-72 hours

52
Q

Increased due to moderate muscular activity

A
  1. Glucose
    2.Creatinine
  2. Insulin
    4.Lactic Acid
    5.Total protein
53
Q

Released from cells, increasing levels in plasma.
-Goes back to normal after several minutes of rest

A

Potassium

54
Q

Remain elevated for 24 hours or more after exercise

A

Creatinine Kinase and lactate dehydrogenase

55
Q

Elevated up to 1 hour after exercise.

A

Cholesterol

56
Q

Decreased due to exercise:

A

Arterial pH, Carbon dioxide, Platelets- falsely decrease due to platelet clumping (running/ vigorous activity)

57
Q

Hormones affected by fever?

A
  1. Cortisol
  2. fever induced - hypoglycemia: increase insulin
  3. increased glucagon
58
Q

At what stage does most differences in no. of blood component based on gender are apparent only.

A

Sexual Maturity

59
Q

Which has higher RBC, hemoglobin, and hematocrit levels?

A

-males have greater amounts than females

60
Q

What increases with intramuscular injection?

A
  • Creatinine Kinase and skeletal muscle. fraction of LDH
61
Q

it is recommended that CK and LDH levels be drawn before intramuscular injection or at least 1 hour after injection. True or False

A

True

62
Q

Breakdown of RBC —— increase bilirubin ——yellow pigment.
What is this called?

A

Jaundice

63
Q

Other term for jaundice and how to describe sample?

A

Icterus- icteric sample (yellow-brown color)

64
Q

Effects of Jaundice?

A
  1. interfere with blood chemistry tests based on color reactions.

.Interfere with reagent— strip analyses on urine

65
Q

What causes blood fluids to filter into tissues, thus decreasing plasma volume in adult up to 10%. Blood concentration of components that are protein i nature or bound to protein increases

A

Position: From supine to upright sitting or standing postion

66
Q

Examples of protein-bound components and components that are protein in nature that may increase:

A
  1. Aldosterone - Recumbent for 30 min to avoid false increase
  2. Calcium
    3.Iron
  3. Cholesterol and HDL (15% variation)
67
Q

Standing Position

A

15 min: RBC increase
30 min: Potassium ion levels increase

Reason: release of intracellular potassium from muscle

68
Q

Effects of increased body fluids in pregnant woman?

A

can have diluting effect on RBC, leading to to lower RBC count

69
Q

Increase levels to patients who smoked prior to specimen collection

A
  1. Cholesterol
    2 Cortisol
  2. Glucose
  3. Growth Hormone
  4. Triglycerides
  5. WBC count
70
Q

Chronic smoking increases?

A
  1. RBC count
  2. Hemoglobin levels
71
Q

Generally, smoking can…

A
  1. Decrease immunoglobulins IgA, IgG, IgM
  2. Increase immunoglobulins IgE
72
Q

Skin-puncture specimens is easy to obtain from smokers because of impaired circulation in the fingertips.

A

false. it is difficult

73
Q

Effects of stress:

A

Increase WBC due to emotional stress such as anxiety, fear, trauma

74
Q

When is blood collected in a crying infant?

A

after resting / sleeping for 30 mins.

-note that px was crying if px is crying

75
Q

Stress increases and decreases…

A

Increases:
ACTH
Catecholamines
Cortisol

Decreases: Iron

76
Q

Acute heat causes what?

A

Interstitial fluid move in blood vessels, increasing plasma volume

77
Q

Extensive sweeting increases w/o fluid replacement

A

cause hemoconcentration

78
Q

Insulin increases with ingestion of?

A

Carbohydrates

79
Q

High lipid levels in blood?

A

Lipemia

80
Q

Alcohol can also cause?

A

Hypoglycemia (low blood pressure)

81
Q

A change of several time zones can affect diurnal rhythm and the tests associated with it. Several days may be required to restore a normal rhythm.

A

True

82
Q

Opiates such as morphine increases?

A

levels of liver and pancreatic enzymes.

83
Q

increase of nitrogenous wastes in blood such as urea is called?

A

azotemia

84
Q

What hormones are affected with stress in children

A

aldosterone and TSH, and GH

PMLS (6 decks)

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