Test Tube Flashcards
Green Top Additives 1,2
▪ Sodium heparin
▪ Lithium heparin
LABORATORY USES:
lithium level
use sodium heparin
LABORATORY USES:
ammonia level
use sodium/lithium
heparin
LABORATORY USES of Green top
▪lithium level (use sodium heparin)
▪ ammonia level (use sodium/lithium
heparin)
▪ Blood gas analysis to check
oxygenation level and blood pH
NUMBER OF INVERSIONS of Green top
8 to 10x inversions
Green top will have _______ background when stained with Wright Stain
Bluish
Light Green Top Additive
Gel and Lithium Heparin
LABORATORY USE/s of Light Green Top
Plasma chemistries
MODE OF ACTION:
Plasma is separated with gel at
the bottom of the tube and
lithium heparin inhibits
coagulation
NUMBER OF INVERSIONS of Light Green Top
8 to 10 X inversions
Prevents coagulation by
precipitating calcium
Citrate
Inactivates thrombin by accelerating anti-thrombin III and prevent
formation of fibrin clot
Heparin
Forms calcium salts, in a non-ionized form or
soluble complex
Citrate
Traps/ binds (chelation) calcium preventing coagulation or
participation in coagulation cascade
EDTA
Form a weakly dissociated Ca++ component
Oxalate
light blue TOP additives
Buffered sodium citrate (BD)
▪ 0.105 M (≈3.2%) glass
▪ 0.109 M (3.2%) plastic
LABORATORY USES of Light Blue Top
▪ Coagulation tests (PT and PTT)
PT and PTT means
Prothrombin time
Partial Thromboplastin time
NUMBER OF
INVERSIONS: light blue top
3 – 4 X inversions
Black Top Additive
Same as Light Blue Top
Buffered sodium citrate (BD)
▪ 0.105 M (≈3.2%) glass
▪ 0.109 M (3.2%) plastic
LABORATORY USES of Black Top
▪ Westergren erythrocyte sedimentation rate
▪ Uses 4:1 ratio of blood to anticoagulant
NUMBER OF INVERSIONS of Black Top
3 – 4 X inversions
Clear with light blue Stopper Additives
▪ Citrate
▪ Theophylline
▪ Adenosine
▪ Dipyridamole
LABORATORY USES of Clear With Light blue stopper
▪ Selected platelet function assays
▪ Routine coagulation determination
Number of Inversions of Clear with Light Blue Stopper
3 – 4 X inversions
Prevents coagulation by binding or
chelating calcium
EDTA
EDTA means
Ethylenediamineactetic Acid
Additives of Lavender Top
▪ Spray-dried dipotassium EDTA
(plastic)
▪ Liquid tripotassium EDTA (glass)
LABORATORY USES: EDTA
▪ Hematology (CBC)
▪ Blood bank (Crossmatching)
NUMBER OF INVERSIONS: EDTA
8 – 10 X inversions
SOURCES of Lavender Top
▪ Disodium salt of EDTA (powder) : Versene or versenate
▪ Dipotassium salt of EDTA (liquid) : Sequestrene
SPECIAL CONSIDERATIONS of Lavender Top
▪ Blood smear should be performed not more than 4 hours as it may cause red cell
shrinkage/crenation
Pink Top Additive
▪ Spray-coated/ dried dipotassium K2 EDTA
(plastic)
Number of Inversions of Lavender Top
8-10x inversions
Laboratory Uses of Pink Top
▪ Whole blood hematology
determinations
▪ Molecular diagnostics
▪ Blood bank (crossmatching)
White Top or Pearl Top Additive
▪ Dipotassium EDTA and gel for plasma separation
NUMBER OF INVERSIONS of White Top or Pearl Top
▪ 8 – 10x inversions
LABORATORY USES of White Top or Pearl Top
▪ Helpful in working with HIV positive patients
▪ Molecular diagnostic tests such as PCR and DNA amplification techniques
Tan Top additive
Dipotassium EDTA (plastic)
NUMBER OF INVERSIONS of Tan Top
▪ 8 – 10x inversions
LABORATORY USES of Tan Top
Lead determinations (tube contains less than 0.1ug/mL of lead)
Prevents coagulation by
precipitating calcium
OXALATE
Substance that prevents glycolysis
Antiglycolytic Agents
If glycolysis is not prevented, glucose concentration in a blood specimen decreases at a rate of _____ mg/dL per hour
decreases at a rate of 10 mg/dL per hour
Most common antiglycolytic agent
Sodium Fluoride
Preserves glucose up to 3 days
SODIUM FLUORIDE
Inversions of Sodium Fluoride
5 – 10 inversions
True or False
Sodium Fluoride also inhibits growth of bacteria
True
Gray Top additives
▪ Sodium fluoride/ Potassium oxalate
▪ Sodium fluoride/ Sodium EDTA
▪ Sodium fluoride
LABORATORY USE of Gray Top
Glucose measurements
MODE OF ACTION of Gray Top
▪ Potassium oxalate or Sodium EDTA
(anticoagulant)
▪ Sodium fluoride (antiglycolytic agent
and not an anticoagulant which
preserves glucose up to 3 days)
Yellow Top Tube Additive
▪ Sodium polyanethol sulfonate (SPS)
- Stabilize bacterial growth
- Complement inactivation
▪ Acid citrate dextrose (ACD)
- For RBC preservation
What are the Yellow Tube Additives
▪ Sodium polyanethol sulfonate (SPS)
▪ Acid citrate dextrose (ACD)
LABORATORY USES: yellow top
▪ SPS: Blood culture (microbiology)
▪ ACD
- Human leukocyte antigen tissue
typing
- Paternity testing
- DNA studies
Citrate Phosphate Dextrose (CPD) usage
CPD is used in collecting units of blood for transfusion.
Citrate prevents clotting by ______
Chelating Calcium
Phosphate stabilizes ______
pH
Dextrose provides ___ with energy and helps them alive
Cells
Royal Blue Top Additives
▪ Dipotassium EDTA (plastic)
▪ Clot activator (plastic)
MODE OF ACTION of Royal Blue Top
▪ Designed to contain NO contaminating metals
▪ Special stopper formulation provides low levels of trace elements
Number of Inversions of Royal Blue Top
8 Inversions
Substance that enhances coagulation in tubes used to collect serum samples
Clot Activator
Clot activators include substances that provide more surface for platelet activation, such as:
× glass particles – 15 to 30 min
× Siliceous substances (e.g. Silica, Kaolin, Bentonite)
× inert clays like Celite
Serum Tubes clotting minute
Gel Separator -
Clot Activator -
Without GS/CA -
× Gel separator = clotting in 30 min
× Clot activator =clotting approximately in 5 min
× Without GS/CA = complete clotting in 60 min
Inert (nonreacting) synthetic substance initially contained in or near the bottom of certain blood collection tubes
Thixotropic gel separator
True or False
The density of the gel is between that of the cells and the serum or plasma
True
Separation prevents cells from continuing to metabolize substances such as glucose in the serum or plasma
What type of Tube?
Thixotropic Gel Separator
Using Thixotropic Gel:
T or F
Centrifuge immediately after drawing the blood.
False
Using Thixotropic Gel:
T or F
Allow the tube to clot for 20-30 minutes in a horizontal position.
False - (VERTICAL)
Using Thixotropic Gel:
T or F
Allow the blood to clot with the tube in a horizontal position.
False - VERTICAL
Using Thixotropic Gel:
T or F
Do not allow the tube to stand more than one hour before centrifuging
True
How many minutes should Thixotropic gel separator tube to be centrifuged?
10-15 min
Red Top Additives
× None (glass);
× Clot Activator (plastic)
MODE OF ACTION for Red Top
× Blood clots and the serum is
separated by centrifugation
Uses of Red top
× Serum Chemistries
×Immunology and Serology
× Blood Bank (Crossmatch)
×Number of Inversions of Red Top
× Glass - no inversion
×Plastic - 5 inversions
Gold Top Additives
Gel and Clot Activator
Mode of Action Gold Top
Serum separator tube (SST) contains a GEL at
the bottom to separate blood from serum during centrifugation
Uses of Gold Top
Serum Chemistries
Number of Inversions of Gold TOP
5 inversions
Additives of Orange Top
Thrombin-based clot activator with gel for serum separation
Mode of Action of Orange Top
Activates fibrinogen to fibrin
Uses of Orange Top
STAT serum chemistries
Number of Inversions Orange Top
5 – 6X inversions
Discard Tube
Clear Top with red/light gray stopper
Additive of clear top with red/light gray stopper
None (plastic)
Uses of clear top tube
As a discard tube or secondary specimen tube
