(P) Week 5: Blood Collection and handling Flashcards

1
Q

what is arterial puncture mainly used for?

A

blood gas analysis

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2
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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3
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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4
Q

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

A
  1. Compromised blood flow
  2. Patients with hemoglobin S / sickle cell anemia
  3. Diabetes mellitus
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5
Q

T or F

most hematology tests does not have fasting requirements

A

T

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6
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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7
Q

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

A

turbid

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8
Q

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

A

chyle

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9
Q

detection of lipids may cause falsely _________ hemoglobin

A

increased

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10
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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11
Q

T or F

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

A

F (concentrated)

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12
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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13
Q

How long must a patient fast for platelet aggregation studies?

A

6-8 hours

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14
Q

These drugs increase which granulocyte in the blood?

  1. corticosteroid
  2. cortisol
  3. lithium-containing drugs
  4. digitalis
  5. penicillin
A

neutrophil

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15
Q

T or F

epinephrine and cortisol falsely decrease WBCs in the blood

A

F (falsely elevate)

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16
Q

what are the two red cell indices?

A

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

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17
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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18
Q

The following are caused by which common error in venipuncture?

  1. clotted blood sample
  2. hemoconcentration on the site
  3. blood is contaminated with tissue fluid
  4. hemolysis due to RBC trauma
A

prolonged torniquet application

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19
Q

hemolysis will result to decreased / increased:

RBC count

A

decreased

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20
Q

hemolysis will result to decreased / increased:

hematocrit

A

decreased

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21
Q

hemolysis will result to decreased / increased:

MCHC

A

Increased

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22
Q

hemolysis will result to decreased / increased:

WBC

A

Increased

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23
Q

hemolysis will result to decreased / increased:

MCV

A

decreased

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24
Q

hemolysis will result to decreased / increased:

MCHC

A

increased

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25
Q

hemolysis will result to decreased / increased:

platelets

A

increased

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26
Q

what antiseptic is used for hematology tests?

A

70% alcohol

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27
Q

what antiseptic may be used for alcohol determination tests?

A

benzalkonium chloride

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28
Q

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

A

iodine

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29
Q

what should be included in test tube labelling

A

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

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30
Q

T or F

When writing the time, it should be done using military time

A

T

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31
Q

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

A

2 minutes minimum

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32
Q

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

A

microbiological testing

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33
Q

how many inversions for

blood cultures (SPS)

A

8-10 TIMES

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34
Q

how many inversions for

citrate tube

A

3-4

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35
Q

how many inversions for

gold top

A

5

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36
Q

how many inversions for

red top with plastic tube

A

5 times

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37
Q

how many inversions for

red top with glass tube

A

none

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38
Q

how many inversions for

rapid serum tube (orange top)

A

5-6 times

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39
Q

how many inversions for

plasma separator tube

A

8-10

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40
Q

how many inversions for

heparin

A

8-10

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41
Q

how many inversions for

EDTA

A

8-10

42
Q

how many inversions for

PPT separator tube (pearl top)

A

8-10

43
Q

how many inversions for

fluoride tube (gray)

A

8-10 times

44
Q

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

A

EDTA

45
Q

what are the two types of EDTA?

A

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

46
Q

what should be the concentration of EDTA used for hema?

A

1.5 ± 0.5 (other books say 1.25 to 1.8)

47
Q

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

A

RBCs will shrink

48
Q

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

A

Decrease

49
Q

> 1.8 will cause this to (increase or decrease)

MCV

A

decrease

50
Q

> 1.8 will cause this to (increase or decrease)

MCHC

A

increase

51
Q

type of EDTA preferred for manual hematocrit test

A

K2 / dipotassium EDTA

52
Q

why is K3 avoided for manual HCT tests?

A

shrinks red cells by 2-3%

53
Q

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

A

2-3 hours

54
Q

what do you call an EDTA sample >3 hours ?

A

old EDTA sample

55
Q

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

A

PLT will swell up and burst

56
Q

increased _____ is due to platelet swelling

A

Mean platelet volume

57
Q

Decreased ___________ due to platelet bursting

A

platelet count

58
Q

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

MCV

A

increased

59
Q

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

HCT

A

increased

60
Q

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

MCHC

A

decreased

61
Q

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

A

60 times

62
Q

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

A

mechanical rotator

63
Q

What is the anticoagulant combination for
Westergren?

A

EDTA + Citrate

64
Q

What is the anticoagulant combination for
Wintrobe?

A

Citrate + Oxalate

65
Q

These physiologic factors will (increase / decrease) ESR value

hyperproteinemia
hyperfibrinogemia
hypergammaglobulinemia
hypoalbuminuria
hypercholesterolemia
macrocytosis
menstruation
anemia
leukemia
After 3rd month of gestation

A

increase

66
Q

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

A

decrease

67
Q

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

A

increase

68
Q

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

A

decrease

69
Q

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

A

increase

70
Q

These clinical conditions will (increase / decrease) ESR value

cachexia
congestive heart failure
polycythemia vera

A

decrease

71
Q

These drugs will (increase / decrease) ESR value

dextran
heparin
vit a
procainamide
theophylline
penicillin amide

A

increase

72
Q

These drugs will (increase / decrease) ESR value

cortisol
cortisone
quinine
salicylates
ethambutol
ACTH administration
corticotropin

A

decrease

73
Q

anticoagulant used for PT and PTT

A

Sodium citrate

74
Q

prothrombin time normal value

A

12-14 secs

75
Q

partial thromboplastin time normal value

A

25-45 seconds

76
Q

2 concentrations for sodium citrate

A

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

77
Q

sodium citrate sample for ESR determination must be processed within

A

2 hours

78
Q

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

A

heparin

79
Q

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

A

hereditary spherocytosis

80
Q

heparin will falsely (increase / decrease) platelets in CBC

A

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

81
Q

heparin will falsely (increase / decrease) WBC in CBC

A

increase

82
Q

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

A

blue

83
Q

main objective of the two evacuated tube technique

A

prevent tissue fluid contamination

84
Q

what should be the blood anticoagulant ratio for coagulation studies?

A

9:1

85
Q

what is the anticoagulant used for coagulation studies

A

sodium citrate

86
Q

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

A

premature clotting

87
Q

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

A

excess citrate that will prolong PT / PTT

88
Q

 Ecchymosis
 Hematoma
 Fainting (syncope)
 Petechiae
 Allergies
 Nerve damage
 Seizures
 Vomiting

these complications are observed in
a. capillary puncture
b. venipuncture
c. arterial puncture

A

b

89
Q

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

A

blood pressure cuff

90
Q

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

A

40 mmHg

91
Q

Ideal depth for skin puncture on finger

A

2-3 mm

92
Q

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

A

c

93
Q

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

A

b

94
Q

cold agglutinins will (increase/ decrease)

RBC
HCT

A

decrease

95
Q

cold agglutinins will (increase/decrease)

WBC
MCV
MCH
MCHC

A

increase

96
Q

what are the parameters that have diurnal levels

A

eosinophil
iron
wbc

97
Q

what coagulant must be used to avoid platelet satellitism

A

citrate

98
Q

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

A

2-3 hours

99
Q

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

A

d

100
Q

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

A

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