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SPX COLLECTION/PX PREP ANALYTES VARIATIONS Flashcards

1
Q

Enumerate some physiologic factors affecting pre-collection variables
[7]

A

Diurnal variation
Exercise
Diet
Stress
Posture
Age
Gender

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2
Q

hormones that are increased at AM

A

CAPPAII
cortisol
adrenocorticotropic hormone
plasma renin activity
aldosterone
insulin

prolactin
iron

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3
Q

hormones where levels are low at night

A

Cortisol
ACTH
Plasma renin activity
ALDO
Insulin

Prolactin
Iron

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4
Q

hormones where levels are INCREASED w/ stress

A

Cortisol
ACTH

Prolactin

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5
Q

hormones where levels are INCREASED w/ standing than supine

A

Plasma renin activity

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6
Q

hormones where levels are DECREASED w/ supine position than standing, and how many percent?

A

Calcium

4%

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7
Q

Patient variables that may affect chemistry values [6]

A

Diurnal variation
Day-to-day variation
Recent food ingestion
Alcohol
Posture
Activity

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8
Q

What are the analytes increased in diurnal variation at PM:

A

GA
Growth hormone
ACP

PTH
TSH

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9
Q

[#]% Percentage effect of day-to-day variation to these analytes ___________

A

ABC ST
≥20%
ALT
Bilirubin
CK
Steroid hormones
TAGs

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10
Q

what are the analytes increased in terms of recent food ingestion?

A

CGGIILTS [si guilty kumain ]
calcium
gastrin
glucose
insulin
iron
LD
TAGs
Sodium

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11
Q

what are the analytes decreased in terms of recent food ingestion?

A

chloride
phosphate

K+ fasting required:
fasting glucose
lipid panel
TAGs

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12
Q

what are the analytes increased in terms of alcohol intake?

A

TAGS
GGT

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13
Q

what are the analytes decreased in terms of alcohol intake?

A

glucose

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14
Q

what are the analytes increased in terms of posture?

A

CHOLE TIKDO [POSTURE] KWANAN ALBUMin
albumin
chole

when standing:
calcium
phosphate
plasma renin activity

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15
Q

what are the analytes increased in terms of activity?

A

in ambulatory px:
CK

ACCPPPLL
with exercise px:
AST
Creatinine
CK
protein
Potassium
phosphate
Lactic acid
LDH

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16
Q

what are the analytes increased in terms of stress?

A

ACTH
cortisol
catecholamines

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17
Q

what are the analytes affected in terms of age, gender, race, drugs?

A

various

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18
Q

Common interferences in Pre-collection variables
[1] in vivo
[4] in vitro

A

Tobacco smoking

Hemolysis
Hemoconcentration
Hemodilution
Icteric/Lipemic spx

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19
Q

Rupture of RBCs so HB released from RBC

A

Hemolysis

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20
Q

Serum appears yellow due to high bilirubin

A

ICTERIC

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21
Q

Serum appears milky or turbid due to high lipid

A

Lipemic

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22
Q

Order of draw via tubes

A
  1. blood culture tubes [yellow]
  2. coagulation sodium citrate tubes [blue]
  3. serum tubes w/ or w/o clot activator or gel seperator [red/gold]
  4. heparin tubes w/ or w/o gel [green]
  5. EDTA [lavender]
  6. Glycolytic inhibitor tubes [gray]
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23
Q

Evacuated tube indicated for the ff:
Blood
Citrate
CBC
Glucose determination

A

SPS [yellow]

Blue/Light blue, Non-additive

EDTA [violet]

Sodium citrate [blue] or Potassium oxalate/Sodium Fluoride [gray]

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24
Q

Evacuated tube indicated for the ff:
Chemistry
Immunochemistry
TDMs

Plasma chemistry

Some chemistries: Lactic acid, Glucose tolerance

A

Red/Gold
Red/Gold, Light green
Red

Green, Light green

Gray

25
Q

Gray tube is a?

A

Glycolytic inhibitor tube
Sodium fluoride tube
Potassium oxalate

26
Q

Difference of green and light green tube?

A

Light green has its gel for plasma separation, while the green one has no gel.

27
Q

Evacuated tube indicated for the ff:
Coagulation

Viral markers

Hematology

Transfusion services

A

Blue

Red/Gold

Lavender

Pink

28
Q

Evacuated tube indicated for the ff:
Flow cytometry
Cytogenetics

Trace elements

Toxicology

A

Green
Green, Lavender

Royal Blue
Royal Blue

29
Q

What are the clot-activator tubes?

A

Gold

Royal Blue

30
Q

What are the spray-coated K2 EDTA tubes?

A

Lavender
Pink

31
Q

Tube for STAT & Routine chemistry?

32
Q

Prevents clotting by inhibiting thrombin and thromboplastin

Prevents clotting by binding calcium

A

Green tube

Lavender
Pink
Blue

33
Q

In gray-top tubes,

Fluoride inhibits _______, and oxalate prevents _______ by precipitating ______.

A

glycolysis
clotting
calcium

34
Q

It is a clot activator promotes blood clotting with glass or silica particles. Gel separates serum from cells.

35
Q

Analytes that require fasting?
[7]

A

FARGGILT [par di siya guilty]
FBS
ALDO/Renin
Gastrin
GTT
Insulin
Lipid panel
TAG

36
Q

Analytes that require chilling?
[7]

A

Ammonia
Blood gas
Lactic acid

37
Q

Analytes that are affected by light?
[7]

A

Vit. A
Vit. B6
Vit. B12
Bilirubin
Carotene
Folate
Porphyrins

Bili ako carots kaso late kana porphyrinse mo nalang

38
Q

Analytes that are affected by hemolysis?
[7]

A

CKLAMP
CK
Catecholamines
K+
LD
AST
ALT
ALP
Aldolase
Ammmonia
Magnesium
Phosphate

39
Q

Inhibited in EDTA

Inhibited in Oxalate

Inhibited in Citrate

A

CALI
LAAA oxalate ayaw sayo–
ALL “AT”--
CK
ALP
Leucine aminopeptidase

CALI
LAAA oxalate ayaw sayo–
ALL “AT”-
LD
ALP
ACP
Amylase

CALI
LAAA oxalate ayaw sayo–
ALL “AT”-
ALP
ALT
AST

40
Q

Decreased in EDTA

Decreased in Oxalate

Decreased in Citrate

A

IC ic ic ayaw– decrease
Iron
Calcium

Calcium

Calcium
Amylase

41
Q

Increased in EDTA

Increased in Oxalate

A

PT
PTT
Sodium
Potassium

Sodium
Potassium

42
Q

Prevented in EDTA

Distorted in Oxalate/Fluoride

Preserved in Citrate

Stimulated in Citrate

A

Platelet aggregation

Cell morphology

Labile coagulation factors

ACP

43
Q

Increased in heparin [5]

A

PT
PTT
Triiodothyronine
Thyroxine
Lithium
Sodium

44
Q

Wright’s stain in heparin

A

Blue background

45
Q

Decreased in Fluorides [5]

A

ALL “A”
ALP
ACP
Amylase
ALT
AST
CK

46
Q

Examples of Pre-analytical factors that may affect chemistry values

A

Use of Isopropyl alcohol wipes to disinfect veni site

Squeezing site in capillary puncture

Pumping fist

Torniquet>1min

IV fluid contamination

Incorrect AC/draw contamination

Hemolysis

Light exposure

Temp between collecting/testing

Inadequate centri

Recentri of primary tubes

Delay in seperating serum/plasma

Storage temp

47
Q

What happens when we use isopropyl alcohol that affect chemistry values

A

compromise blood alcohol determination that’s why we use ethanol

48
Q

What happens when we squeeze the site in capillary puncture that affect chemistry values

A

increase K+

49
Q

What happens when we pump our fist that affects chemistry values

A

NALaKLaKPHO
increased K+, Ca, lactic acid, phosphorus

decreased pH

50
Q

What happens when with prolonged tourniquet that affects chemistry values?

A

NALaKLaKProtein
Increase K+, total protein, lactic acid

51
Q

What happens when there is IV fluid contamination that affects chemistry values

A

NaKCLGlue [Nak sali glue]
Increase K+, Na+, Cl-, glucose

Possible dilution of other analyses

52
Q

What happens when there is incorrect AC/draw contamination that affects chemistry values

A

NaLiK CaMagnum [Na leak ka may magnum]
Increase K+ [EDTA], Na+ [Na heparin], Lithium [Lithium heparin]

Decrease Ca+, Mg [EDTA]

53
Q

What happens in terms of temperature between collecting and testing that affects chemistry values

A

chilling required for lactic acid, ammonia, blood gases

54
Q

What happens when there is an inadequate centrifugation that affects chemistry values

A

poor barrier in gel tubes causing INC in:

K+, LD, AST, iron, phosphorus

55
Q

What happens when there is recentrifugation of primary tubes that affects chemistry values

A

INC hemolysis
K+

56
Q

What happens when there is a delay in separating serum/plasma that affects chemistry values

A

INC:
K+
Lactic acid
LD
Mg

DEC:
glucose [unless collected in fluoride]

57
Q

What happens with the storage temp that affects chemistry values

A

IN RT,
INC: ammonia, lactic acid
DEC: glucose [unless collected in fluoride]

IN 4C:
INC: ALP
DEC: LD

CLIN CHEM (12 decks)

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