Module 9 Flashcards
What are fasting samples used for?
Fasting glucose, lipid profile testing, floated, gastrin and insulin.
Spot glucose and some cholesterol don’t require fasting.
What does lipid profile testing detect?
Cholesterol
HDL
LDL
Triglycerides
What does fasting glucose detect?
Detects glucose metabolism disorders due to:
Inability of beta islet cells to produce insulin
Reduced number of insulin receptors
Inability of intestine to absorb glucose
Inability of liver to accumulate and breakdown glycogen
Presence of increased amounts of certain hormones (ACTH)
What is the reference range for fasting glucose?
4-6mmol/L
What are problems associated with fasting glucose?
Hyperglycaemia- increased blood sugar, diabetes mellitus
Hypoglycaemia- decreased blood sugar, overdose of insulin
What happens if a known/suspected diabetic is experiencing dizziness, weakness or fainting?
Try to obtain a sample before insulin is given.
If there’s a delay, give glucose.
When are timed interval specimens obtained and why?
Collected at specific times due to:
Medication being taken
Changes in blood levels due to circadian rhythms
Tracking the effectiveness of a course of treatment
How is a 2hr PC glucose test performed? What does it test?
Screen for diabetes, monitors treatment.
High carb diet for 2-3 days prior.
Not required to fast.
Breakfast of 100g carbs.
Specimen collected 2hrs after meal.
Glucose level is determined and compared to reference.
What is the purpose of the glucose tolerance test?
Diagnosis of diabetes mellitus (2-3hr) or reactive hypoglycaemia (5hr).
Determines removal rate of glucose.
Response peaks at 30-6min, normal within 3hrs.
How is the GTT performed?
12hr fast, sample collected
Given standard glucose load
Begin timing when drink is started or finished
Collect specimens at regular intervals
Label and store properly
What is the purpose of the O’Sullivan test? How is it performed?
Screens pregnant women for gestational diabetes.
Performed at any time of day.
Give patient 50g of glucose drink.
Collect sample after 1hr.
When is a gestational glucose tolerance test performed and how?
Performed on pregnant woman at doctor’s request.
Fasting specimen collected, don’t proceed before receiving results (should be within limits).
Collect at 1hr, 2hr and 3hr.
What is the purpose of therapeutic drug monitoring?
Monitors drug levels to ensure dose doesn’t reach toxic levels in the body.
What does TDM monitor?
Peak levels- 15-30min after administration
Trough levels- when lowest level is expected, right before nest dose
When should routine TDM commence?
Steady state- equilibrium between dose administered and amount eliminated from serum
What is the lab responsible for in regards to TDM?
Collection at proper time.
Report time collected on req and report.
Record time of last dose.
What info should a req contain for TDM samples?
Name of drug
Dose schedule
Length of time on regimen
Time of last dose
What is toxicology/drug testing performed on?
Serum, gastric and/or urine samples.
What is progressive testing protocol?
The drug class is identified only.
Further testing is done only if the screen is positive for that group.
What samples are used for toxicology screens?
Blood is less sensitive than urine but correlates with clinical condition better.
Urine is sample of choice.
What are forensic specimens used for?
Solving crimes.
What information does a chain of custody form include?
Who collected and processed the specimen.
Who witnessed the procedure.
Who transported the specimen.
Who received the specimen for processing.
What alcohols does blood alcohol test for?
Ethanol, methanol, isopropanol, acetone.
What can’t be used when collecting blood alcohol specimens?
Alcohol swab or tincture of iodine.
What’s the difference between nonlegal and legal assays?
Nonlegal- collected with SST/PST
Legal- collected with special, sealed collection kit
What metals can be detected by trace element/metal samples?
Lead, mercury, arsenic, aluminum, chromium, cadmium, manganese, zinc.
What materials are required to collect trace elements?
Royal blue monoeject stoppered tube (centrifuged to give serum).
Nonpowdered gloves.
Stainless steel needle.
What are the types of blood bank collections and their functions?
Type and screen- performed on all transfusion patients to determine ABO and Rh groups and antibodies that may complicate the procedure, crossmatch to determine compatibility, want to avoid agglutination and lysis
Direct antiglobulin test- detects antibody and or complement coating the red cell, requires EDTA test
What are preventable errors in blood bank collection?
Specimen collected from wrong patient
Specimen labelled with wrong info
Incorrect ABO/Rh reported
Blood or products mislabelled
Patient transfused with wrong blood
How is a transfusion patient identified?
Blood bank ID system req- full name and hospital number.
Check armband against req.
Identity must be verified by two individuals separately.
Unknown- traceable number or symbol is used.
How is a sample obtained for blood bank?
Two EDTA tubes are collected.
Labelled at bedside with full name, hospital number and collection date and time.
ID arm band is labelled at bedside with full name, hospital number and date and time.
Paperwork is completed- ensure req has blood bank ID, sign name.
Who performs what parts of prenatal screening?
CBS- blood incompatibilities
ProbLab- serology testing
What is therapeutic phlebotomy and what are some examples?
Drawing blood as a part of treatment program.
Polycythemia- abnormal amount of RBCs produced, removed for donation.
Hemochromatosis- abnormal amount of iron stored in liver, red cells are removed to reduce stress.
What is autologous transfusion?
Patient donates their own blood before anticipated surgery, receives at a later date.
Safest product.
What is direct donation?
Special arrangements are made.
Ie) from parent to child
When and why are fasting specimens created?
Collected when the patient is in the basal state (12-14hr after last meal).
Used for reference intervals/normal values.
