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PMLS 2 > TUBE ADDITIVES > Flashcards

TUBE ADDITIVES Flashcards

1
Q

TUBE ADDITIVES Can be in the form of:

A

○ Anticoagulant
○ Clot activator
○ Antiglycolytic agent
○ Thixotropic agent

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2
Q

The _____________ will indicate what
additive is in it

A

Color of tube

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3
Q

The ________ will let you know the “mode
of action”

A

Additive

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4
Q

The ____________ will tell the laboratory
use

A

mode of action

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5
Q

There is a certain number of ______________ to
facilitate the function and process of each
tube additive

A

inversion

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6
Q

So that you will not over/under fill the
tube

A

Blood to anticoagulant ratio

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7
Q

ADDITIVE OR ANTICOAGULANTS

A
  1. Potassium oxalate
  2. Sodium fluoride’
  3. Sodium citrate
  4. Sodium polyanethol sulfonate (SPS)
  5. Solutions A and B (ACD)
  6. EDTA
  7. Lithium heparin
  8. Sodium heparin
  9. Ammonium heparin
  10. Silica/glass particles
  11. Thrombin
  12. Silicon
  13. No additive
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8
Q

Precipitates calcium

A

Potassium oxalate

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9
Q

Inhibits glycolysis

  • Example use: Testing for FBS
    or RBS but cant centrifuge
    sample within 30 minutes
A

Sodium fluoride

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10
Q

Binds calcium and allows bacteria to
grow for culture

A

Sodium polyanethol
sulfonate (SPS)

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11
Q

Binds calcium

A

Sodium citrate; Solutions A and B
(ACD); EDTA

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12
Q

Inhibits prothrombin to thrombin

A

Lithium heparin; Sodium heparin; Ammonium heparin

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13
Q

Accelerates clotting

A

Silica/glass particles; Thrombin

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14
Q

Promotes faster centrifugation and a
sample with fewer cells

A

Silicon

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15
Q

Natural formed clot

A

No additive

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16
Q

Substances that prevent blood from clotting (coagulating)

A

ANTICOAGULANTS

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17
Q

2 METHODS OF ANTICOAGULANTS

A
  1. chelating (binding) or precipitating calcium
  2. By inhibiting the formation of thrombin needed
    to convert fibrinogen to fibrin
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18
Q

Inactivates thrombin by accelerating
antithrombin III and prevent formation of
fibrin clot

A

Heparin

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19
Q

Forms calcium salts in a NON-IONIZED form
or soluble complex

A

Citrate

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20
Q

Traps/binds (chelation) calcium preventing
coagulation or participation in coagulation
cascade

A

EDTA

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21
Q

Forms a weakly dissociated Ca++

component

A

Oxalate

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22
Q

Prevents clotting by inhibiting thrombin
formation

A

Heparin

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23
Q

GREEN TOP
Additives:
Number of Inversions:
Laboratory Uses:

A

Additives: Sodium/ Lithium Heparin
Number of Inversions: 8 to 10x inversions
Laboratory Uses:
○ Lithium level - Sodium heparin
○ Ammonia level -Sodium /Lithium heparin
○ Blood gas analysis to check oxygenation
level and blood pH (Henry) pO2, pCO2, pH

24
Q

Special Considerations when using heparin

A

○ Very expensive
○ NOT ideal for blood smears
○ If test be done in 2-3 hours, SPECIMEN
must be refrigerated
○ NOT used for coagulation studies

25
Q

LIGHT GREE TOP
Additives:
Mode of Action:
Number of Inversions:
Laboratory Uses:

A

Additives: Gel and Lithium heparin
Mode of Action: Plasma is separated with gel at the
bottom of the tube and lithium heparin
inhibits coagulation
Number of Inversions: Plasma is separated with gel at the
bottom of the tube and lithium heparin
inhibits coagulation
Laboratory Uses: Plasma chemistries

26
Q

Prevents coagulation by precipitating calcium

A

CITRATE

27
Q

LIGHT BLUE TOP
Additive (include percent):
Number of Inversions :
Laboratory Uses (include ratio):

A

● Additive:
○ 3.2% (0.105 M) or 3.8% (0.129 M) buffered
sodium citrate (Henry)
○ Buffered sodium citrate (BD):
■ 0.105 M (≈3.2%) GLASS
■ 0.109 M (3.2%) PLASTIC

● Number of inversions:
○ 3 to 4x inversions
● Laboratory uses:
○ Coagulation tests (PT and PTT)
○ Uses 9:1 ratio of blood to anticoagulant

28
Q

BLACK TOP
Additive:
Laboratory Uses:
Number of Inversions:

A

● Additive:
○ Same as light blue top
● Laboratory uses:
○ Westergren erythrocyte sedimentation
rate
○ Uses 4:1 ratio of blood to anticoagulant
● Number of inversions:
○ 3 to 4x inversions

29
Q

Clear with Light Blue Stopper
Additive:
Number of Inversions
Laboratory Uses:

A

● Additives (CTAD):
○ Citrate
○ Theophylline
○ Adenosine
○ Dipyridamole
● Number of inversions:
○ 3 to 4x inversions
● Laboratory uses:
○ Selected platelet function
○ Routine coagulation determination

30
Q

Lavender Top
Additive:
Number of Inversions:
Laboratory Uses:

A

● Additive:
○ Spray-dried dipotassium EDTA(plastic) k2
○ Liquid tripotassium EDTA (glass) k3
● Number of inversions:
○ 8 to 10x inversions
● Laboratory uses:
○ Hematology (CBC) PC, PBS
○ Blood bank (Crossmatching)
○ Chemistry test (determine of glucose in
RBCs in the last 3 months)

31
Q

Pink Top
Additive:
Number of Inversions:
Laboratory Uses:

A

● Additive:
○ Spray-coated/ dried dipotassium K2 EDTA
(plastic)
● Number of inversion:
○ 8 to 10x inversions
● Laboratory uses:
○ Whole body hematology determinations
○ Molecular diagnostics
○ Blood bank (crossmatching)

32
Q

White or Pearl Top
Additive:
Number of Inversions:
Laboratory Uses:

A

● Additive:
○ Dipotassium EDTA and
gel for plasma separation
● Number of Inversions:
○ 8 to 10x inversions
● Laboratory uses:
○ Helpful in working with HIV positive
patients (HIV Viral Load)
○ Molecular diagnostic tests such as PCR
and DNA amplification techniques

33
Q

Tan Top
Additive:
Number of Inversions:
Laboratory Uses:

A

● Additive:
○ Dipotassium EDTA (plastic)
● Number of inversions:
○ 8 to 10x inversions
● Laboratory uses:
○ Lead determination (tube contains less
than 0.1ug/mL of lead)

34
Q

Prevents coagulation by precipitating calcium; Antiglycolytic agents

A

Oxalate

35
Q

If glycolysis is not prevented, glucose
concentration in a blood specimen
decreases at a rate of ____________ per hour

A

10 mg/dL

36
Q

Most common antiglycolytic
agent

A

Sodium flouride

37
Q

GRAY TOP
Additive:
Laboratory Use:
Mode Of Action:
Number of Inversions:

A

● Additive:
○ Sodium fluoride/ Potassium oxalate
○ Sodium fluoride/ Sodium EDTA
○ Sodium fluoride
● Laboratory use:
○ Glucose measurements
● Mode of action:
○ Potassium oxalate or Sodium EDTA
(anticoagulant)
○ Sodium fluoride (antiglycolytic agent and
not an anticoagulant which preserves
glucose up to 3 days)
● Number of inversions:
○ 5 to 10x inversions

38
Q

Sodium Flouride preserves glucose up to

A

3 days

39
Q

in combination with potassium oxalate to provide plasma specimens

A

oxalate

40
Q

yellow top
Additive:
Number of Inversions:
Lab Uses:

A

● Additive:
○ Sodium polyanethol sulfonate (SPS)
○ Acid citrate dextrose (ACD)
● Number of inversions:
○ 8 to 10x inversions
● Laboratory uses:
○ SPS: Blood culture (Microbiology)
○ ACD: Human leukocyte antigen
tissue typing; Paternity testing; DNA studies

41
Q

○ Blood collected is transferred to these
tubes
○ Can cater to recovering/growing an array
of microorganisms

A

Bacterial blood culture

42
Q

○ Has labeled slots per hole
○ Do not open machine unless absolutely
needed

A

Blood Culture System

43
Q

internal controlled temperature
of Blood Culture System is about?

A

37 oC

44
Q

Use in collecting units of blood for
transfusion.

A

Citrate Phosphate Dextrose (CPD)

45
Q

Prevents clotting by chelating calcium,
phosphate stabilizes pH, and dextrose
provides cells with energy and helps keep
them alive.

A

Citrate Phosphate Dextrose (CPD)

46
Q

Blue Top
Additive:
Number of Inversions:
Lab Uses:
Mode of Actions:

A

● Additive
○ Dipotassium EDTA (plastic)
○ Clot activator (plastic)
● Number of Inversion
○ 8 x inversion
● Laboratory Uses
○ Trace elements test
○ Nutrient determination
○ Best use for Toxicology
● Mode of Action
○ Designed to contain NO false positive for
contaminating metals.
○ Special stopper formulation provides low
levels of trace elements.

47
Q

Substance that enhances coagulation in
tubes used to collect serum samples.

A

Clot Activators

48
Q

these tubes can have gel separator or clot activator

A

SERUM TUBES

49
Q

IF THERE IS NO GEL SERPARATOR AND CLOT ACTIVATOR, GLYCOLYSIS COULD HAVE OCCURRED WHICH COULD HAVE EFFECT IN RESULTS. What effect is this?

A

false decreased results

50
Q

Inert (non-reacting) synthetic substance
initially contained in or near the bottom of
certain blood collection.

A

Thixotropic gel separator

51
Q

Thixotropic gel separator prevents cells from
continuing to __________ substances
such as glucose in the serum or plasma.

A

metabolize

52
Q

RED TOP:
Additive:
Mode of Action:
Number of Inversion:
Uses:

A

● Additive
○ None (glass) - Doesn’t have a clot
activator takes longer to clot.
○ Clot Activator (plastic) - With clot
activator, less time for the blood to clot.

● Mode of Action
○ Blood clots and serum are separated by
centrifugation.
● Number of Inversions
○ Glass - No inversion
○ Plastic - 5 inversion.
● Uses
○ Serum Chemistries (Most preferred)
○ Immunology and Serology
○ Blood Bank (Crossmatch)
○ Do rimming to remove the fibrin clots
○ Centrifuge 2 times

53
Q

Gold Top:
Additive:
Mode of Action:
Uses:
Number of inversions:

A

● Additive
○ Gel and Clot Activator
● Mode of Action
○ Serum separator tube (SST) contains a gel
at the bottom to separate blood from
serum during centrifugation.

● Uses
○ Serum Chemistries
● Number of Inversions
○ 5 Inversions

54
Q

Orange Top:
Additive:
Mode of Action:
Number of Inversions:

A

● Additive
○ Thrombin-based clot activator with gel
for serum separator.

● Mode of Action
○ Activates fibrinogen to fibrin.
○ Uses
■ STAT serum chemistries (Sodium
Potassium, Troponi-I, Serum
pregnancy test)
● Number of Inversions
○ 5 - 6x Inversions.

55
Q

Clear top with red/light gray stopper
Additive:
Uses:

A

● Additive
○ None (plastic)
● Uses
○ As a discard tube or secondary
specimen tube.

56
Q

ORDER OF DRAW 1

A

Blood Culture Tube or Vital → Citrated Tube → Serum
Tubes with or without Clot Activator, with or without Gel
Separator → Heparin Tube → EDTA Tube → Glycolytic
Inhibitor.

57
Q

ORDER OF DRAW 2

A

Stop (Sterile) → Light (Lt. Blue) → Red (Red) → Stay (SST) →
Put (PST) → Green (Green) → Light (Lavender) → Go (Gray)

PMLS 2 (15 decks)

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