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Specimen Consideration Flashcards

1
Q
  • Contain a vacuum
  • Used with vacutainer and Syringe Systems
  • Stoppers universal color coded: indicates
    contents
  • Have an expiration date
A

BLOOD COLLECTION TUBES

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2
Q

TOP TUBES THAT HAVE NO ANTI-COAGULANT

A

Red-top tube, Gold or Mottled-red-gray top tube

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3
Q
  • (Most common use in clinical chemistry)
  • 5x invertions
A

Red-top tube

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4
Q
  • In vitro clotting due to GLASS
  • No additive
  • Glass surface activates clotting sequence
  • Do not mix
  • SERUM: use for TDM (Therapeutic Drug
    Monitoring)
A

. Red-top tube: GLASS

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5
Q
  • Contain additive to activate clotting
    sequence
  • contain inert gel → SST (Serum Separator
    Tube)
  • Do invert to mix additive and initiative
    clotting sequence
  • SERUM
A

Red-top tube: PLASTIC

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6
Q
  • Contain clot activator and gel (SST)
  • Invert to mix and initiate clotting sequence
  • Serum
  • 5 x inversion
    -Not cos-effective
    -5-15 mins clotting
    -chem, sero, and immuno test
A

Gold or Mottled-red-gray top tube

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7
Q
  • Trace metal-free
  • Iron, copper, zinc
A

Royal blue-top tube

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8
Q

Label color indicates contents:
- Red:
- Purple:
- Green:

A
  • Red: no additive = serum
  • Purple: EDTA = whole blood or plasma
  • Green: heparin = whole blood or plasma
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9
Q
  • Anticoagulant = sodium citrate
  • Binds calcium
  • Must be full
    Blood: anticoagulant ratio critical
  • Must be on ice if not analyzed within 30 minutes
  • Coagulation studies
  • Common test examples are: PT, Platelets, aPPT
A

Blue-top tube

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10
Q

important ion for coagulation,
necessary for clotting. Factor IV ionic Ca2+

A

CALCIUM

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11
Q

Anticoagulant = heparin
* Inhibits thrombin formation
* Must be full and on ice if need pH, ionized Ca
* Most chemistry tests, STAT lab (PST)
* Decreases time needed for blood to clot, makes
turnaround time better

A

Green-top tube:

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12
Q

– natural anticoagulant inside the body
(in vivo)

A

Heparan

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13
Q

Three formulations of Heparin

A

Lithium heparin,
Ammonium heparin, Sodium heparin

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14
Q

ionized Ca

A

Green-top tube

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15
Q

Commonly used for viral toxicology and stat
tests
- Arterial blood gas (ABG), Osmotic fragility
test (OFT), Ammonia

A

Green-top tube

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16
Q
  • Anticoagulant = EDTA
    (Ethylenediaminetetraacetic acid)
  • Binds calcium
  • Chelates calcium
  • Hematology studies: CBC
A

Purple-top tube (Lavender)

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17
Q

spray-dried: plastic tube; will not
dilute the sample

A

K2 – Versene

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18
Q

liquid form: glass tubes; dilutes the sample 1-2%

A

K3 – Sequestrene

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19
Q

Grey-top tube:
* Anticoagulant = ?
- Binds calcium
- PLASMA, Whole blood

A

potassium oxalate

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20
Q

Grey-top tube:
* Antiglycolytic agent = ?
- Maintains plasma glucose levels
- Prevent glycolysis

A

sodium fluoride

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21
Q

Limited use: glucose, lactic acid

A

Grey-top tube

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22
Q

Prevents glycolysis because it fluoride forms and
ionic complex with magnesium thereby inhibiting
the Mg++ dependent enzyme,

A

ENOLASE

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23
Q
  • Light blue top tube with 2 yellow bands on the
    label
  • Contains soya bean thrombin which causes the
    blood to clot immediately
A

. Fibrin-split Products

24
Q

Yellow-top tube:
* ACD = ?
- Paternity testing
- DNA

A

acid citrate dextrose

25
Yellow-top tube: * SPS =? - Used for special blood culture studies - Inhibits certain antibiotics
sodium polyanethol sulfonate
26
* Both bind calcium * PLASMA, whole blood
Yellow-top tube: * ACD = acid citrate dextrose * SPS = sodium polyanethol sulfonate
27
means against or preventing
Anti
28
– Pertaining to coagulation or act of clottin
Coagulant
29
main purpose of anticoagulants
To prevent the clotting process by interfering in the coagulation cascade; And to preserve certain analytes and cell morphology prior to testing
30
Ethylenediamine Tetra-acetic acid o Optimal concentration in the blood:
1.5mg/ml of blood
31
EDTA tube Mode of Action: Removes ionized calcium (Ca2+) through process referred to as
CHELATION
32
Anticoagulant of choice for Hematology because: - Preserves cellular morphology - Excellent for cell counting - Blood is stable for 2-3 hours before smearing - Prevents platelet aggregation
Ethylenediamine Tetra-acetic acid
33
EDTA tube disadvantage:
causes cell shrinkage in excess
34
used in blood banking for blood typing; Rh typing and antibody screening: K2EDTA
PINK-TOP
35
: EDTA + gel - Used more often for molecular diagnostic testing
WHITE-TOP
36
Mode of action - Precipitates calcium Anticoagulant of choice for COAGULATION STUDIES: Preserves the labile factors V and VIII better
CITRATE
37
CITRATE Two forms:
- BLUE TOP - BLACK-TOP
38
:0.105M or 3.2% : most commonly used Anticoagulant to blood – 1:9 Blood to anticoagulant – 9:1
BLUE-TOP SODIUM CITRATE TUBE
39
: 0.129M or 3.8% Blood to anticoagulant ration – 4:1 For Erythrocyte Sedimentation Rate using Westergren Method
BLACK-TOP CITRATE TUBE
40
HEPARIN o Optimal concentration:
15-20U/mL of blood
41
Mode of action: accelerating the action of antithrombin III, neutralizing thrombin and preventing the formation of fibrin
HEPARIN
42
Isolated from liver cells and is known to be the naturally occurring anticoagulant.
HEPARIN
43
HEPARIN two forms
Lithium heparin: Sodium Heparin:
44
- may be used for most chemistry tests except lithium and folate levels - For Lithium testing: Royal blue: Sodium heparin can be used instead -has light green top
Lithium heparin:
45
- Is the injectable form used for anticoagulant therapy; - Recommended for trace elements; lead and toxicology
SODIUM HEPARIN
46
o Concentration: 0.2mg/mL of blood o Anticoagulant of choice for: - Blood Gas Analysis (0.05 ml per ml of blood) - Osmotic Fragility Test - Trace elements and toxicology o DOES NOT affect levels of calcium o Preferred for potassium measurement o Gives a BLUE background with Wright’s stain after 2 hours
HEPARIN GREEN TOP TUBE
47
FLUORIDE o Gray top tube contains preservative or antiglycolytic agents such as:
- Sodium fluoride: (Preserves glucose for 3 days) - Lithium Iodoacetate : (Preserves glucose for 24 hours)
48
Mode of action: forms weakly dissociated calcium components
FLUORIDE
49
o Mode of action: combines with calcium to form an insoluble salt/comple
OXALATE
50
Three forms OF OXALATE
1. Potassium oxalate 2. Ammonium oxalate 3. Double oxalate
51
o Disadvantage: - Distorts ? - Potassium Oxalate: ? - Ammonium Oxalate: ?
o Disadvantage: - Distorts cell morphology - Potassium Oxalate: shrinks RBCs - Ammonium Oxalate: swells RBCs
52
Generally called the SSTs (Serum separator tubes) because they contain clot activator + separator gel)
Red/Gray and Gold tops
53
Mostly used for chemistry tests except for TDM, blood bank and immunologic reactions
Red/Gray and Gold tops
54
gel separator present in tubes
THIXOTROPIC
55
Clotting time: - With gel separators: ? - With clot activator: ? - Plain tubes: ?
- With gel separators: 30 minutes - With clot activator: 5 minutes - Plain tubes: 60 minutes
56
is a cofactor for other factors to complete the coagulation process
CALCIUM
57
* Dependent upon -Test - Amount of sample needed to perform test - Multiple labs needing the same specimen at the same time
TYPE AND AMOUNT OF SPECIMEN

PMLS (6 decks)

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