(P) Week 5: Blood Collection and handling Flashcards
what is arterial puncture mainly used for?
blood gas analysis
T or F
for obese patients with difficult veins, you may use their wrist to collect blood
F (NO because it’s near arteries)
where may we collect a blood sample for obese patients with no viable veins in the antecubital fossa?
forearm or lower extremeties
what are the three conditions that prohibits us from extracting blood sample from a patient’s lower extremities?
- Compromised blood flow
- Patients with hemoglobin S / sickle cell anemia
- Diabetes mellitus
T or F
most hematology tests does not have fasting requirements
T
___________________ is a test to determine the hemoglobin levels that needs atleast 2 hours of fasting after a hefty meal
cyanmethemoglobin
plasma is ___________ after a hefty meal due to fats or lipids
turbid
This forms from fats or lipids which causes the plasma to be turbid
chyle
detection of lipids may cause falsely _________ hemoglobin
increased
These drugs may prevent platelet aggregation, it is advisable to not take these drugs for a week prior to platelet aggregation studies
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Aspirin
T or F
Blood is much more diluted if the
patient is sitting upright.
F (concentrated)
A sitting patient’s blood sample is how many more times concentrated than that of a patient who is lying down?
7-8% higher
How long must a patient fast for platelet aggregation studies?
6-8 hours
These drugs increase which granulocyte in the blood?
- corticosteroid
- cortisol
- lithium-containing drugs
- digitalis
- penicillin
neutrophil
T or F
epinephrine and cortisol falsely decrease WBCs in the blood
F (falsely elevate)
what are the two red cell indices?
MCH (Mean cell hemoglobin)
MCHC (mean cell hemoglobin concentration)
If Hgb is falsely elevated due to the turbidity caused by chyle formation, MCH an MCHC will be falsely (decreased / increased)
increased
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
prolonged torniquet application
hemolysis will result to decreased / increased:
RBC count
decreased
hemolysis will result to decreased / increased:
hematocrit
decreased
hemolysis will result to decreased / increased:
MCHC
Increased
hemolysis will result to decreased / increased:
WBC
Increased
hemolysis will result to decreased / increased:
MCV
decreased
hemolysis will result to decreased / increased:
MCHC
increased
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
