(P) Week 5: Blood Collection and handling Flashcards by Nathalie Grace Castillo

Q

what is arterial puncture mainly used for?

A

blood gas analysis

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Q

T or F

for obese patients with difficult veins, you may use their wrist to collect blood

A

F (NO because it’s near arteries)

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Q

where may we collect a blood sample for obese patients with no viable veins in the antecubital fossa?

A

forearm or lower extremeties

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Q

what are the three conditions that prohibits us from extracting blood sample from a patient’s lower extremities?

A

Compromised blood flow
Patients with hemoglobin S / sickle cell anemia
Diabetes mellitus

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Q

T or F

most hematology tests does not have fasting requirements

A

T

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Q

___________________ is a test to determine the hemoglobin levels that needs atleast 2 hours of fasting after a hefty meal

A

cyanmethemoglobin

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Q

plasma is ___________ after a hefty meal due to fats or lipids

A

turbid

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Q

This forms from fats or lipids which causes the plasma to be turbid

A

chyle

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Q

detection of lipids may cause falsely _________ hemoglobin

A

increased

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Q

These drugs may prevent platelet aggregation, it is advisable to not take these drugs for a week prior to platelet aggregation studies

A

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Aspirin

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Q

T or F

Blood is much more diluted if the
patient is sitting upright.

A

F (concentrated)

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Q

A sitting patient’s blood sample is how many more times concentrated than that of a patient who is lying down?

A

7-8% higher

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Q

How long must a patient fast for platelet aggregation studies?

A

6-8 hours

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Q

These drugs increase which granulocyte in the blood?

corticosteroid
cortisol
lithium-containing drugs
digitalis
penicillin

A

neutrophil

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Q

T or F

epinephrine and cortisol falsely decrease WBCs in the blood

A

F (falsely elevate)

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Q

what are the two red cell indices?

A

MCH (Mean cell hemoglobin)
MCHC (mean cell hemoglobin concentration)

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Q

If Hgb is falsely elevated due to the turbidity caused by chyle formation, MCH an MCHC will be falsely (decreased / increased)

A

increased

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Q

The following are caused by which common error in venipuncture?

clotted blood sample
hemoconcentration on the site
blood is contaminated with tissue fluid
hemolysis due to RBC trauma

A

prolonged torniquet application

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Q

hemolysis will result to decreased / increased:

RBC count

A

decreased

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Q

hemolysis will result to decreased / increased:

hematocrit

A

decreased

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Q

hemolysis will result to decreased / increased:

MCHC

A

Increased

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Q

hemolysis will result to decreased / increased:

WBC

A

Increased

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Q

hemolysis will result to decreased / increased:

MCV

A

decreased

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Q

hemolysis will result to decreased / increased:

MCHC

A

increased

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hemolysis will result to decreased / increased: platelets

increased

what antiseptic is used for hematology tests?

70% alcohol

what antiseptic may be used for alcohol determination tests?

benzalkonium chloride

this antiseptic cannot be used for clinical chemistry as it affects potassium, urates, and phosphates, leading to erroneous results

iodine

what should be included in test tube labelling

patient's full name patient ID (If meron) Birthdate Date and time of sample collection Medical Technologist's initials

T or F When writing the time, it should be done using military time

T

What is the minimum amount of time needed after stopping the IV line prior to collection?

2 minutes minimum

closed blood collection system is intended for what type of testing?

microbiological testing

how many inversions for blood cultures (SPS)

8-10 TIMES

how many inversions for citrate tube

3-4

how many inversions for gold top

5

how many inversions for red top with plastic tube

5 times

how many inversions for red top with glass tube

none

how many inversions for rapid serum tube (orange top)

5-6 times

how many inversions for plasma separator tube

8-10

how many inversions for heparin

8-10

how many inversions for EDTA

8-10

how many inversions for PPT separator tube (pearl top)

8-10

how many inversions for fluoride tube (gray)

8-10 times

best anticoagulant for CBC as it doesn't alter cell morphology and prevents platelet clumping

EDTA

what are the two types of EDTA?

 Tripotassium EDTA (K3 EDTA)  Dipotassium EDTA (K2 EDTA)

what should be the concentration of EDTA used for hema?

1.5 ± 0.5 (other books say 1.25 to 1.8)

what happens to RBCs if EDTA concentration is higher than 1.8?

RBCs will shrink

>1.8 will cause this to (increase or decrease) Hematocrit

Decrease

>1.8 will cause this to (increase or decrease) MCV

decrease

>1.8 will cause this to (increase or decrease) MCHC

increase

type of EDTA preferred for manual hematocrit test

K2 / dipotassium EDTA

why is K3 avoided for manual HCT tests?

shrinks red cells by 2-3%

EDTA samples must be processed immediately or with a maximum of how many hours?

2-3 hours

what do you call an EDTA sample >3 hours ?

old EDTA sample

if the specimen is greater than 4 hours old what will happen?

PLT will swell up and burst

increased _____ is due to platelet swelling

Mean platelet volume

Decreased ___________ due to platelet bursting

platelet count

if the sample is older than 6 hours, red cells will swell causing (decrease/ increase) in? MCV

increased

if the sample is older than 6 hours, red cells will swell causing (decrease/ increase) in HCT

increased

if the sample is older than 6 hours, red cells will swell causing (decrease/ increase) in MCHC

decreased

if the EDTA sample has been standing for a while, how many inversions must be done?

60 times

if the EDTA sample has been standing for a while, what machine should be used to reconstitute it?

mechanical rotator

What is the anticoagulant combination for Westergren?

EDTA + Citrate

What is the anticoagulant combination for Wintrobe?

Citrate + Oxalate

These physiologic factors will (increase / decrease) ESR value hyperproteinemia hyperfibrinogemia hypergammaglobulinemia hypoalbuminuria hypercholesterolemia macrocytosis menstruation anemia leukemia After 3rd month of gestation

increase

These physiologic factors will (increase / decrease) ESR value hyperalbuminemia / hyperproteinemia hyperglycemia high phospholipids high bile salts lecithin microcytosis sickle cells echinocytes spherocytosis acanthocytosis marked anisocytosis presence of Hgb C polycythemia marked leukocytosis

decrease

These technical factors will (increase / decrease) ESR value hot or humid room temp slanted or tilted tube vibration / unstable surface reading the result after 60 mins

increase

These technical factors will (increase / decrease) ESR value low / cold room temp bubbles within the glass column narrow ESR tube diameter use of heparin + oxalate as anticoagulant reading the result prior to 60 mins use of more than 2hr old EDTA samples

decrease

These clinical conditions will (increase / decrease) ESR value diabetes gout malignancy myocardial infarction multiple myeloma collagen vascular disorders rheumatoid arthritis syphilis rheumatic fever end stage renal disease acute bacterial infections leukemia anemia

increase

These clinical conditions will (increase / decrease) ESR value cachexia congestive heart failure polycythemia vera

decrease

These drugs will (increase / decrease) ESR value dextran heparin vit a procainamide theophylline penicillin amide

increase

These drugs will (increase / decrease) ESR value cortisol cortisone quinine salicylates ethambutol ACTH administration corticotropin

decrease

anticoagulant used for PT and PTT

Sodium citrate

prothrombin time normal value

12-14 secs

partial thromboplastin time normal value

25-45 seconds

2 concentrations for sodium citrate

3.2% (0.109 M) 3.8% (0.129 M)

sodium citrate sample for ESR determination must be processed within

2 hours

this anticoagulant has an anti-thrombin property and is commonly used for Erythrocyte Osmotic Fragility Test

heparin

erythrocyte osmotic fragility test (EOFT) is commonly used to diagnose

hereditary spherocytosis

heparin will falsely (increase / decrease) platelets in CBC

increase (nakalagay sa trans decrease but sabi ni sir sa rec lec ay increase DONT COME FOR ME ok labyu mwah)

heparin will falsely (increase / decrease) WBC in CBC

increase

heparin causes what color of staining if used in the blood smear?

blue

main objective of the two evacuated tube technique

prevent tissue fluid contamination

what should be the blood anticoagulant ratio for coagulation studies?

9:1

what is the anticoagulant used for coagulation studies

sodium citrate

what happens if there is too much blood and not enough anticoagulant

premature clotting

what happens if the blood is too little for the amount of anticoagulant?

excess citrate that will prolong PT / PTT

 Ecchymosis  Hematoma  Fainting (syncope)  Petechiae  Allergies  Nerve damage  Seizures  Vomiting these complications are observed in a. capillary puncture b. venipuncture c. arterial puncture

b

If the patient is obese and the torniquet is not long enough to go around their arm, what may be used instead?

blood pressure cuff

what is the recommended pressure for the blood pressure cuff used as a torniquet?

40 mmHg

Ideal depth for skin puncture on finger

2-3 mm

QUESTION: What should be the distance of pressure from the site of finger tip puncture during microsampling? a) 3 cm. b) 2 cm. c) 1 cm. d) any of these

c

QUESTION: If warm cloth is applied during blood collection, it's temperature should not exceed: (in degrees Celsius) a) 32 b) 42 c) 52 d) 37

b

cold agglutinins will (increase/ decrease) RBC HCT

decrease

cold agglutinins will (increase/decrease) WBC MCV MCH MCHC

increase

what are the parameters that have diurnal levels

eosinophil iron wbc

what coagulant must be used to avoid platelet satellitism

citrate

within how many hours from the time of collection should an EDTA blood sample be processed for PBS preparation or CBC?

2-3 hours

what is the recommended order of draw when the evacuated system is used a. gel separator, nonadditive coagulation, and blood culture b. additive, nonadditive, gel separator, and blood culture c. nonadditive, blood culture, coagulation, others d. blood culture, coagulation, non additive, and gel separator

d

you've reached the end of the cards (if you're a concrete sequential learner)

good luck with the exams !! pls rest and hydrate urself