test: pre-analytical considerations Flashcards
One way a physician evaluates a patient’s test results is by comparing them to reference ranges and, if applicable, previous results on the same patient.
If a specimen has been compromised and the results are not valid, a physician could make a decision based upon incorrect information and thus jeopardize the patient’s care.
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Which of the following values is directly related to the age of the patient, which must be factored in when test results are being calculated?
Platelet and MCHC only
Creatinine Clearance
Platelets
Hemoglobin
Creatinine Clearance
Puncturing the skin releases tissue __________, which activates the coagulation process in the blood drops.
Thromboplastin
Dehydration (decrease in total body fluid), which occurs, for example, with persistent vomiting or diarrhea, causes hemoconcentration, a condition in which blood components that cannot easily leave the bloodstream become concentrated in the smaller plasma volume.
Blood components affected include RBCs, enzymes, iron (Fe), calcium (Ca), potassium (K), and coagulation factors.
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A lancet is a sterile, disposable, sharp-pointed or bladed instrument that either punctures or makes an incision in the skin to obtain capillary blood specimens for testing.
True or False
True
Environmental factors such as temperature and humidity can affect test values by influencing the composition of body fluids.
Acute heat exposure causes interstitial fluid to move into the blood vessels, increasing plasma volume and influencing its composition.
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It is a condition characterized by increased bilirubin (a product of the breakdown of RBCs) in the blood, leading to deposits of yellow bile pigment in the skin, mucous membranes, and sclerae (whites of the eyes), giving the patient a yellow appearance .
Jaundice
SLE
Contact Dermatitis
Food Allergy
Jaundice
1 as the first order of draw while 4 as the last order of draw. \_\_\_\_ Blood gas \_\_\_\_ EDTA \_\_\_\_ Other additives \_\_\_\_ Serum
1, 2, 3, 4
Opiates such as morphine decrease levels of liver and pancreatic enzymes.
True or False
False
Decreased oxygen levels at higher altitudes cause the body to produce more RBCs to meet the body’s oxygen requirements.
The lower the altitude, the greater the increase.
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There is no risk of accidental sharps injury, and no need for sharps disposal when using what type of lancet?
Laser lancet
What analyte is expected to be increased in capillary puncture than whole blood specimen using the syringe system?
Glucose
What specimen is the preferred specimen for some tests, such as newborn screening tests?
Capillary blood
What do you call the equipment used during capillary puncture procedure which are disposable, narrow-bore plastic or plastic-clad glass capillary that holds up to 50-75uL of blood?
Microhematocrit tubes
The levels of many blood components normally exhibit diurnal (happening daily) or circadian (having a 24-hour cycle) variations or fluctuations.
Factors that play a role in diurnal variations include posture, activity, eating, daylight and darkness, and being awake or asleep
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Patients are typically asked to fast approximately 8 to 12 hours, depending on the test.
Fasting is normally done overnight after the last evening meal, with specimens collected the following morning before the patient has eaten
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A patient’s gender affects the concentration of a number of blood components. Most differences are apparent only after sexual maturity and are reflected in separate normal values for males and females.
Which of the following physiological variables that are normal values are higher for males than for females?
Red Blood Cells, Hemoglobin and Hematocrit
Red blood and Hemoglobin only
MCHC and Platelet
None of the choices are correct.
Red Blood Cells, Hemoglobin and Hematocrit
Which of the following values is normally higher in newborns than in adults? Some physiological functions, such as kidney function, decrease with age?
Platelet and MCHC only
Red blood cells
Platelets
Hemoglobin
Red blood cells
Many drugs are toxic to the liver, as evidenced by decreased levels of liver enzymes such as aspartate aminotransaminase (AST)—also called serum glutamic-oxaloacetic transaminase (SGOT), alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) and decreased production of clotting factors.
True or False
False
RBC counts and related determinations such as hemoglobin (Hgb) and hematocrit (Hct) have higher reference ranges at higher elevations.
Other analytes that increase at higher elevations include C-reactive protein and uric acid.
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Levels typically return to normal soon after the activity is stopped. The following are examples of the effects of exercise on a number of blood components:
Arterial pH and PaCO2 levels are reduced by exercise.
Glucose, creatinine, insulin, lactic acid, and total protein can be elevated by moderate muscular activity.
Potassium (K+) is released from the cells during exercise, increasing levels in the plasma. Levels generally return to normal after several minutes of rest. EXERCISE PHYSIOL
Thiazide diuretics can elevate calcium and glucose levels and decrease sodium and K+ levels. Other thiazide-type medications that lower blood volume can increase
Arterial pH and PaCO2 levels are reduced by exercise.
Glucose, creatinine, insulin, lactic acid, and total protein can be elevated by moderate muscular activity.
Potassium (K+) is released from the cells during exercise, increasing levels in the plasma. Levels generally return to normal after several minutes of rest. EXERCISE PHYSIOL
Chemotherapy drugs cannot cause a decrease in blood cells, especially WBCs and platelets.
True or False
False
Which of the following is best for setting reference ranges on inpatients because the effects of diet, exercise, and other things that can be controlled are minimized or eliminated?
Basal-state specimen
Urine test specimen
Fasting blood sugar
Random blood sugar.
Basal-state specimen
Chronic smoking often leads to decreased pulmonary function and increased RBC counts and hemoglobin levels. Smoking can also affect the body’s immune response, typically lowering the concentrations of:
immunoglobulins IgA, IgG, and IgM but increasing levels of IgE
immunoglobulins IgA, IgG, IgM IgE
immunoglobulins IgA, IgG, IgM, Ig E and Ig D respectively
None of the choices are correct
immunoglobulins IgA, IgG, and IgM but increasing levels of IgE
A recent intramuscular injection can increase levels of creatine kinase (CK) and the skeletal muscle fraction of LDH. Consequently, it is recommended that CK and LDH levels be drawn before intramuscular injection or at least 4 hour after injection.
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