Patient Prep Flashcards
PRE-ANALYTICAL VARIABLES/FACTORS CONTRIBUTING TO THE VARIATION OF RESULTS:
- Exercise
- Fasting
- Diet
- Posture and Position
- Tourniquet application
- Tobacco Smoking
- Alcohol ingestion
- Stress (anxiety)
- Drugs
Exercise
Volume shifts between the vascular and interstitial compartments, volume loss by______ and changes in_____ concentrations
sweating
hormone
Exercise
Transient increased in
lactate
fatty acid
ammonia
Exercise
Long-term increases in
CPK - Creatine phosphokinase
AST - Aspartate transaminase
LD - Lactate dehydrogenase
aldolase
Exercise
Increased
prolactin
testosterone
luteinizing hormone (LH)
Exercise
Elevated levels of______ in urine
proteins
(proteinuria)
Exercise
Vigorous hand exercise (fist clenching) increases
potassium
lactate
phosphate
Exercise
Decreased plasma levels of ____ and ____ in long distance athletes.
FSH and LH
NPO (nothing by mouth)
Non peroral
Fasting
Glucose
8-10
Fasting
lipids and lipoproteins
10-12
48 hrs fasting – increase
serum bilirubin
72 hrs fasting – increase______ while_____ decreases in women to 45 mg/dL
triglycerides
glucose
Fasting
Basal state collection:
glucose, cholesterol, triglyceride and electrolytes
Fasting
Requires fasting specimen: FaGoTLGI
FBS - Fasting blood sugar
GTT - glucose tolerance test
TAG - Triglyceride level test
Lipid Profile test
gastrin
insulin
High protein diet – increase
urea
__________– increase urea
High protein diet
Diet
(3) may show variation post absorptive hormonal effects
Glucose
lipids
catecholamines
Diet
High protein, low carbohydrate diets increased_____ in urine
ketones
Fat-rich food may increase
potassium
ALP - Alkaline phosphatase
TAG - Triglyceride
5-HIAA - 5-Hydroxyindoleacetic acid
Serotonin-rich food (banana, pineapple, tomato, and avocado) increase the_______
urinary excretion of 5-HIAA (5-hydroxyindoleacetic acid)
_____increases concentrations of glucose; it promotes the release of____ from the adrenal medulla and brain tissue.
Caffeine
catecholamines
Increased in obese persons:
LD - Lactate Dehydrogensase
cortisol
glucose
Preferred position during phlebotomy:
upright position or supine
Changing from supine to sitting or standing position increased levels of
ACE
albumin
calcium
enzymes
Changing from sitting to supine - increase levels of
proteins
lipids
BUN (blood urea nitrogen)
iron
calcium
Changing from standing to supine position - decreased levels of
cholesterol
triglycerides
lipoproteins
Prolonged standing for more than 30 minutes - increased______
potassium
Prolonged bed rest - decreased
plasma albumin
Tourniquet
______application is recommended
1 minute
Tourniquet
Prolonged application =
hemoconcentration and
anaerobiosis
Tourniquet
Increase levels:
PPELCA
potassium
proteins (albumin)
enzymes
lactate
cholesterol
ammonia
Prolonged use of tourniquet with fist exercise -increase
potassium (1 mmol/L)
For measurement of_____ - tourniquet use should be minimal, and the patient should not clench his or her fist otherwise will result to elevated levels of lactate
lactate
ALCOHOL INGESTION
• Increased level of
• (chronic alcoholism)
urate, triglycerides, and gamma glutamyl transferase (GGT).
Hypoglycemia
STRESS (ANXIETY)
Affects _______secretion
adrenal hormone
Stress
Increased:
catecholamines
cortisol
ACTH
prolactin
insulin
albumin
glucose
lactate
Stress
_______has been reported to increase with mild stress, and_______ to decrease by as much as 15%.
Total cholesterol
HDL cholesterol
Stress
- affects acid-base balance
Hyperventilation
Drugs
______ can elevate liver function enzymes
Hepatotoxic drugs
Drugs
Diuretics can cause decreased ______ and ______
plasma sodium
potassium
Drugs
cause increases in liver and pancreatic enzymes.
Opiates
Drugs
can cause decreased plasma sodium and potassium.
Diuretics
Affected by diurnal variation:
increased in AM:
ACTH, aldosterone, cortisol, and iron.
Affected by diurnal conc
decreased in PM:
Acid phosphatase
Growth hormone
Parathyroid hormone
Thyroid Stimulating hormone
Affected by_____ (increased levels): albumin, Alkaline phosphatase, cholesterol, and phosphorus
age
Affected by _____ (increased levels):
: Albumin, ALP. creatinine, uric acid, cholesterol, BUN
: HDL, iron and cholesterol
Gender
Male
Female
Affected by _______
increased levels - glucose, TAG, gastrin, free calcium
decreased levels - electrolytes (CI-, K+, P+), ALP, AMS
recent food ingestion: