Special Collections and Point-of-Care Testing Flashcards
1
Q
POCT is also known as?
A
- Alternate Site Testing
- Ancillary test
- Bedside test
- Near-patient test
Bedside test is most common
2
Q
what do you call the portable tests that can be performed bedside or anywhere?
A
Point-of-care testing
3
Q
why is POCT developed?
A
so that healthcare needs are more accessible
brings laboratory testing to the location of the patient
4
Q
what does CLIA stand for?
A
Clinical Laboratory Improvement Amendments
5
Q
how does CLIA define POCT?
A
as waived tests; include systems cleared by the FDA for home use
6
Q
what device is used for measuring glucose that is based on electrochemical method?
A
glucometer
7
Q
what device uses an electrochemical strip w/ an enzyme electrode containing glucose oxidase or dehydrogenase that reacts w/ capillary blood?
A
glucometer
8
Q
what device is based on reflectance photometry that compares color of light passing through a hemolyzed blood?
A
Hemoglobinometer
9
Q
why should we not massage or squeeze middle/ring finger before and during capillary puncture?
A
because sample will be diluted w/ tissue fluid leading to false results
(sabi ni masangkay hehe)
9
Q
why should we not massage or squeeze middle/ring finger before and during capillary puncture?
A
because sample will be diluted w/ tissue fluid leading to false results
(sabi ni masangkay hehe)
10
Q
two types of bleeding time method
A
- Ivy’s method
- Duke’s method
11
Q
Differentiate Ivy’s method and Duke’s method
A
- Ivy is on the arm while Duke’s is on the finger (daliri)
12
Q
site for Ivy’s bleeding method
A
- inner (medial) aspect of the volar surface of the forearm
- lateral aspect of the volar surface of the forearm
13
Q
among the two sites in Ivy’s bleeding method, what is the preferred one?
A
- lateral aspect of the volar surface of the forearm
this is more preferred but it’s more painful (nerves & muscles), & prone to scarring
14
Q
where should the puncture site be in Ivy’s bleeding method?
how far from the antecubital fossa?
A
5cm away from the antecubital fossa
15
Q
what device is used in Ivy’s bleeding method? what about in Duke’s bleeding method?
A
Bleeding time device; Lancet
16
Q
Instead of a tourniquet, what do you use in Ivy’s method?
A
blood pressure cuff
cuff is set to 40mmHg then puncture w/in 30 to 60 seconds for accuracy
17
Q
every how many seconds do you blot the blood in bleeding time?
A
every 30 seconds
18
Q
what is the normal value for bleeding time?
A
2-8 mins Ivy’s; 2-5 mins Duke’s
19
Q
3 types of clotting time methods
A
- Lee & White method
- Slide method
- Capillary tube method
20
Q
how many tubes do you use in Lee & White’s clotting time method?
Lee & White is also known as whole blood clotting method
A
3 tubes
21
Q
How many degrees celsius should the water bath containing the tubes be in Lee & White’s method?
A
tubes should be contained in water bath at 37oC
22
Q
how much should you put in each tube for Lee & White’s method?
A
1 mL each tube
1 mL each tube then put back in bath then observe every 30 seconds
23
Q
what is the normal value for clotting time in Lee & White’s method?
A
5-15 mins
24
Normal value for slide method clotting time?
2-4 mins
25
Normal value for capillary tube method of clotting time
2-4 mins
26
what do you call the clotting time method wherein you use 2 slides, making use of the 2nd and 3rd drops of blood, then u draw blood horizontally (using a lancet) **every 30 seconds** until threads cling to the lancet?
slide method
27
What are the typical requirements for blood bank specimens?
* Patient’s full name (including middle initial)
* Patient’s hospital identification number (or other unique
identifier)
* Patient’s date of birth
* Date and time of collection
* Phlebotomist’s ID number or full name (or initials)
28
what do you call the place where blood is collected and stored before it is used for transfusions?
blood bank
## Footnote
blood bank perform tests to ensure that blood from donors and other blood products are safe before transfusion
29
what tubes do we use for blood bank specimens?
pink top EDTA tubes
| non-additive glass red tubes are used in some cases
30
one of the most common tests performed by the blood bank, called blood type and screen, determines a patient's what?
blood type (ABO) and Rh factor (posi or nega)
31
what are the two types of cross-matching procedures?
## Footnote
cross-matching = compatibility testing b4 transfusion
- Major cross-match (donor's RBCs w/ px's serum)
- Minor (donor's serum w/ px's RBCs)
## Footnote
this test checks for blood agglutination and lysis
32
blood donors should be at least how old?
| from what age until what?
17 to 66 yrs old
## Footnote
- 66 above = blood center physician discretion
- 76 above = written approval from physicians
33
blood donors should have a temperature of less than or equal to?
less than or equal to 37.5oC or 99.5oF
34
what must be the weight of the blood donor?
~ 110 lbs
| blood collected is 10.5mL per kg of donor weight
## Footnote
110 lbs = 49ish kg
35
the blood pressure of the blood donor should be?
180 mmHg systolic pressure; 100 mmHg diastolic pressure
36
what must be the pulse rate for a blood donor?
between 50-100 bpm
37
the hemoglobin levels of a blood donor should be? what about hematocrit?
12.5 g/dL Hgb; 38% HCT
38
what is the needle gauge used in blood donations?
16- to 18-gauge needles
39
a unit of blood typically contains how much blood?
450 mL when full
40
what anticoagulant is used for collecting units of blood for transfusion purposed?
CPD (Citrate Phosphate Dextrose)
## Footnote
The citrate prevents clotting by chelating calcium. A phosphate compound stabilizes the pH, and dextrose provides energy to the cells and helps keep them viable
41
____ is the tracing and testing of blood donors and recipients when a blood product has been determined to be potentially contaminated with a bloodborne pathogen.
Lookback
## Footnote
Lookback can only occur when the blood service is made aware of the possibility of a transfusion-related infection.
42
____ is the process by which a person donates blood for his or her own use.
Autologous donation
## Footnote
done preoperatively for elective surgeries when transfusions are anticipatedly needed
43
the minimum time between donation and surgery for autologous donation must be more than how many hours?
more than 72 hours
## Footnote
but blood is collected several weeks prior to the scheduled surgery
44
a blood infection characterized by bacteria in the blood is called?
bacteremia
45
a blood infection characterized by bacteria with their toxins in the blood is called?
septicemia
## Footnote
septicemia is a type of bacteremia that is more established & affects a part of your body alr; life-threatening
46
bacteremia or septicemia can lead to a life-threatening condition called? this condition is an overwhelming, unregulated response by the body that can lead to tissue damage, organ failure, and death
sepsis
47
when is blood culture usually requested?
30 minutes to 2 1/2 hours prior to fever peak or during fever spike
48
in blood culture, why do we need to collect from two different sites?
to know the **extent** of infection
49
what are the two sets of specimen bottles in blood culture?
aerobic & anaerobic bottles
50
which specimen bottle (in blood culture) is filled first if winged infusion set is used (butterfly)?
aerobic bottle
51
what is the cap color of an aerobic bottle? what about an anaerobic one?
anaerobic = yellow; aerobic = blue
| this is according to a pic in the book
## Footnote
tip: associate blue w/ the sky; sky has air so aerobic
52
what is the anticoagulant used in blood culture?
0.025% to 0.050% Sodium polyathenolsulfate (SPS)
53
how many bottles are usually needed to optimize detection of microorganisms in blood? & they are drawn with an interval of how many minutes?
**2-4** blood cultures drawn **30-60** minutes apart
54
what is the ratio of blood to broth in blood culture bottles?
1:5 - 1:10
55
what is the recommended volume of blood for blood cultures?
20 to 30 mL with a minimum of 10mL per draw
56
when utilizing direct inoculation in blood culture, which bottle should you fill first?
aerobic bottle
## Footnote
direct inoculation makes use of the butterfly, thus, aerobic muna
57
when utilizing syringe inoculation in blood culture, which bottle should you fill first?
anaerobic one
## Footnote
never forgetti to use a safety transfer device
58
what antiseptics are used in blood culture?
- povidone iodine & 70% ethyl alcohol combination
## Footnote
Tincture of iodine, chlorhexidine gluconate, and a povidone/70% ethyl alcohol combination have all been shown to be effective antiseptics for cleaning blood culture collection sites.
59
why is the use of intermediate tubes to transfer blood to blood culture bottles discouraged in blood culture?
1. when added to culture bottle, SPS in the collection tube increases the final conc of SPS
2. transfer of blood presents another opportunity for contamination
3. presents an exposure risk to lab staff
60
what is the anticoagulant for coagulation tests?
sodium citrate (in light blue top)
61
what do you do if the only request is coagulation test?
use a discard tube
## Footnote
applicable esp when using a butterfly
62
what is the ratio of blood to anticoagulant in coagulation tests?
9:1
63
how long should the coagulation tests be performed after sample collection?
within 4 hours of sample collection
## Footnote
plasma should be frozen for within 1 hour of harvesting
64
postprandial glucose test is used to?
measure blood glucose exactly 2 hours after a meal
## Footnote
this test is also a screening test for diabetes mellitus & insulin levels
65
what are the prep steps in postprandial glucose testing?
- FBS before the collection
- 100g meal or 75g beverage
- collection after 2 hours
66
in normal patients, blood glucose levels peak within?
within 30 minutes to 1 hour
67
The peak in glucose levels triggers the release of insulin, which brings glucose levels back down to fasting levels within about ____ and no glucose spills over into the urine.
2 hours
68
what do you call the condition wherein glucose levels after postprandial test is higher than normal glucose levels? what about if lower?
| normal gluc levels from FBS
hyperglycemia; hypoglycemia
69
what test is used to determine if the patient lack the enzyme necessary to convert lactose into glucose and galactose?
Lactone Tolerance test
70
what will be the glucose curve if the px lacks mucosal lactase?
flat
## Footnote
if px has mucosal lactase, glucose curve will be similar to GTT (glucose tolerance test)
71
The test to determine if a man is the biological father of a specific individual is called a ____. The test to determine if a woman is the biological mother of a specific individual is called a ____.
paternity test; maternity test
72
what is the preferred sample for DNA profiling (genetic fingerprinting)?
blood samples; alternatives r buccal/cheek swabs
73
what do you call the testing of drug levels in the bloodstream at specific intervals?
Therapeutic drug monitoring
74
For a drug to be beneficial, the ____ must not exceed toxic levels, and the ____ must remain within the therapeutic range.
peak (max) level; trough (min) level
75
when trough levels are required in TDM, blood sample should be drawn when?
should be drawn right before next dose
76
For peak level determination of TDM, blood sample should be drawn when?
1 hour after oral administration; 30 mins if IV administration
77
involves the withdrawal of large volumes of blood usually measured by the unit (as in blood donation), or approximately 500 mL (450mL talaga)
Therapeutic Phlebotomy
78
____ is a disease involving the body’s overproduction of
RBCs, which is detrimental to the patient’s health and the most common reason for performing therapeutic phlebotomy.
Polycythemia
79
____ (also called iron overload) is a disease characterized by excess iron deposits in the tissues, especially those of the heart, liver, and pancreas.
Hemochromatosis
80
____ (also called iron overload) is a disease characterized by excess iron deposits in the tissues, especially those of the heart, liver, and pancreas.
Hemochromatosis
81
____ is concerned with the detection of toxins and treatment for the effects they produce. ____ is concerned with the legal consequences of toxin exposure, both intentional and accidental.
Clinical toxicology; Forensic toxicology
## Footnote
Toxicology tests examine blood, hair, urine, and other body
substances for the presence of toxins, which often exist in very small
amounts.
82
A special area must be maintained for urine collection
| True or False
True
## Footnote
area has no water daw (accdg to sir ebe)
82
A special area must be maintained for urine collection
| True or False
True
## Footnote
area has no water daw (accdg to sir ebe)
82
A special area must be maintained for urine collection in drug testing
| True or False
True
## Footnote
area has no water daw (accdg to sir ebe)
83
A split sample may be required for confirmation or parallel testing in drug tests
| True or False
True
84
Drug testing is typically performed on urine rather than blood because it is easy to obtain and a wide variety of drugs or their
metabolites
| True or False
True
85
Trace elements are collected in what tubes?
Royal Blue Top
86
Lead analysis usually is placed in what tube?
Tan-top tube
87
Lead analysis usually is placed in what tube?
Tan-top tube
88
what test analyzes activity of the intrinsic coagulation factors and is used to monitor heparin therapy?
Activated Clotting Time
| also called activated coagulation time
89
test, also called the protime test, is used to
**monitor warfarin** (e.g., Coumadin) therapy. It provides information on **how long it takes for a patient’s blood to clot**
Prothrombin time
## Footnote
PT measures extrinsic coagulation pathway
90
this test is used to monitor unfractionated heparin therapy, to screen for intrinsic pathway deficiencies, and to screen for lupus anticoag
Activated Partial Thromboplastin Time
## Footnote
APTT or PTT is for Intrinsic factors; PT is for extrinsic
91
____ testing allows the clinician to determine a patient’s response to medication before open heart surgery or cardiac catheterization. This can help prevent excessive bleeding or blood clots.
Platelet function testing
92
what is the normal value of pH of the body?
7.35 to 7.45
93
____ evaluate respiratory function. ____ measured by POCT include pH, partial pressure of carbon dioxide (pCO2), oxygen saturation (sO2), and partial pressure of oxygen (pO2)
ABGs (Arterial Blood Gases)
94
if arterial pH is below the normal value, what condition do you have? what about if it is higher than the normal pH?
Acidosis; Alkalosis
95
____ are minerals with an electric charge that are present in
blood and body fluids. They are important because they help carry electrical impulses across cell membranes.
Electrolytes
96
What is the most plentiful electrolyte in the blood and plays a major role in osmotic pressure and acid-base balance?
Sodium (Na+)
97
A decreased or low sodium level in the blood is called ____. An excessive or high blood level is called ____.
hyponatremia; hypernatremia
98
Electrolyte that is primarily concentrated within the cells with very little found in the bones and blood. It is released into the blood when cells are damaged. what is this?
Potassium
## Footnote
hypokalemia; hyperkalemia (lamona hehe)
99
Electrolyte that exists mainly in the extracellular spaces where it
joins with sodium to make sodium chloride and with
hydrogen in the stomach to make hydrochloric acid
Chloride
100
Electrolyte that plays a role in transporting CO2 to the lungs and in regulating blood pH. It is formed when carbonic acid is dissociated into H+ and HCO3− ions.
Bicarbonate Ion (HCO3-)
101
____ accounts for approximately 45% of the calcium in the blood; the rest is bound to protein and other substances.
Ionized Calcium
102
____ is a cardiac hormone produced by the heart in response to ventricular volume expansion and pressure overload. It is the first objective measurement for congestive heart failure (CHF).
B-type natriuretic peptide (BNP)
## Footnote
BNP levels help physicians differentiate chronic obstructive pulmonary disease (COPD) and CHF.
103
____ are **proteins specific to heart muscle**. Blood levels of cardiac TnT begin to rise within four hours of the onset of myocardial damage and may stay elevated for up to 14 days.
Cardiac Troponin T (TnT) & Troponin I (TnI)
104
____ also called packed cell volume (PCV), is a measure of the volume of RBCs in a patient’s blood. It is calculated by centrifuging a specific volume of anticoagulated blood and determining the proportion of RBCs to plasma.
Hematocrit (Hct)
105
____ cholesterol is called “bad” cholesterol because it contributes to atherosclerosis. ____ cholesterol is called “good” cholesterol because it is believed to carry bad cholesterol away from the arteries.
LDL; HDL
| Low-density lipoprotein = bad; High-density lipoprotein = good
106
Rapid syphilis tests detect antibodies to ____, the bacterium that causes syphilis.
Treponema Pallidum
107
When drawing a blood alcohol specimen, it is acceptable to
clean the arm with
a. benzalkonium chloride.
b. isopropyl alcohol.
c. methanol prep.
d. tincture of iodine.
A. Benzalkonium Chloride
108
Which of the following is the most critical part of blood
culture collection?
a. Adequately mixing the media vials
b. Antisepsis of the collection site
c. Selecting the collection site
d. Timing of the second set of cultures.
B. Antisepsis of the collection site
109
TDM peak concentration may be defined as the
a. highest concentration of the drug during a dosing interval.
b. lowest concentration of the drug during a dosing interval.
c. concentration required for maximum drug effectiveness.
d. none of the above.
a. highest concentration of the drug during a dosing interval
110
In performing a glucose tolerance test, the fasting specimen
is drawn at 08:15 hours and the patient finishes the glucose
beverage at 08:20 hours. When should the one-hour
specimen be collected?
a. 09:15 hours
b. 09:20 hours
c. 09:45 hours
d. 09:50 hours
b. 9:20 hours
111
In performing a glucose tolerance test, the fasting specimen
is drawn at 08:15 hours and the patient finishes the glucose
beverage at 08:20 hours. When should the one-hour
specimen be collected?
a. 09:15 hours
b. 09:20 hours
c. 09:45 hours
d. 09:50 hours
b. 9:20 hours
112
What color is the stopper of a CTAD tube, for what type of
test is it used, and why?
a. Gray; blood alcohol; inhibits volatilization of alcohol
b. Lavender; molecular genetic testing; preserves DNA
c. Light blue; coagulation; to inhibit platelet activation
d. Orange; special chemistry, to decrease clotting time
C. Light blue; Coag; to inhibit platelet activation
113
Removing a unit of blood from a patient and not replacing it
is used as a treatment for
a. arthritis.
b. leukemia.
c. polycythemia.
d. tuberculosis.
C. polycythemia
114
Which of the following tests may require special chain-of-custody documentation when the specimen is collected?
a. Blood culture
b. Cross-match
c. Drug screen
d. TDM
C. Drug Screen
115
Individuals who wish to donate blood in most states must be
at least
a. 16 years old and weigh at least 105 lb.
b. 17 years old and weigh at least 110 lb.
c. 18 years old and weigh at least 120 lb.
d. 21 years old and weigh at least 125 lb.
b. 17 yrs old & at least 110 lb
116
Which of the following tests must have a 9:1 ratio of blood to
anticoagulant in the collection tube?
a. Two-hour PP
b. Blood culture
c. Electrolytes
d. Protime
d. Protime
117
Which of the following tests is collected in a trace element-free tube?
a. ABGs
b. Aluminum
c. BUN
d. Hemoglobin
b. Aluminum
118
Common chemistry tests performed by POCT instruments
include
a. Hgb and Hct.
b. Na and K.
c. PT and PTT.
d. T4 and TSH.
b. Sodium & Potassium
119
Which of the following is a test that measures packed cell
volume?
a. hCG
b. Hct
c. INR
d. TnT
B. Hct
120
Which test requires four special tubes collected using a
special order of draw?
a. ETOH
b. OGTT
c. PT/INR
d. TB-Gold
d. TB-Gold
121
Hemochromatosis
a. can be treated by removing blood.
b. causes iron deposits in the tissues.
c. is sometimes an inherited disorder.
d. all of the above.
D. All of the above
122
Which is a nonspecific marker of systemic inflammation?
a. ACT
b. BNP
c. CRP
d. TnT
C. CRP
123
A patient undergoing a GTT vomits one hour and five
minutes after drinking the glucose beverage. Which action
should the phlebotomist take?
a. Continue the test, and note on the laboratory slip that the
patient vomited and at what time.
b. Discontinue the test, and write on the requisition that the
patient vomited the drink.
c. Give the patient another dose of the glucose beverage and
continue with the test.
d. Notify the nurse or physician immediately to see if the test
should be rescheduled.
D. Notify the nurse or physician immediately to see if the test should be rescheduled
124
When does a blood glucose level in normal individuals
typically peak after glucose ingestion?
a. In 15 to 20 minutes
b. In 1/2 hour to 1 hour
c. In 1 to 1 and a 1/2 hour
d. In roughly 2 hours
b. In 1/2 hour to 1 hour
125
The definition of toxicology is
a. a protocol for drug trafficking.
b. the scientific study of poisons.
c. the study of drug therapy levels.
d. the tracking of illicit drug trade.
b. the scientific study of poisons
126
Septicemia is
a. a positive test for transmissible disease.
b. bacteria measurement in whole blood.
c. fever in which the cause is not known.
d. the presence of microbes in the blood.
d. presence of microbes in the blood
127
Rapid syphilis tests detect
a. Clostridium difficile
b. Neisseria meningitidis
c. Streptococcus pneumoniae
d. Treponema pallidum
d. Treponema pallidum
