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MT6317 CLIN CHEM 1 > U2 LEC: SPECIMEN COLLECTION AND HANDLING > Flashcards

U2 LEC: SPECIMEN COLLECTION AND HANDLING Flashcards

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1
Q

Types of Blood Samples

A
  • Arterial
  • Venous
  • Capillary
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2
Q

Types of Samples for CC

A
  • Blood
  • Urine
  • CSF
  • Paracentesis fluids
  • Amniotic fluid
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3
Q

This is an ultra filtrate of plasma.

A

Cerebrospinal Fluid (CSF)

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4
Q

This refers to the general term for body cavity fluids.

A

Paracentesis fluids

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5
Q

Paracentesis fluids include?

A
  • pleural (lungs)
  • pericardial (heart)
  • peritoneal (abdominal)
  • synovial fluid (joint)
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6
Q

This is used for Amniocentesis.

A

amniotic fluid

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7
Q

This is present inside the placenta, and is checked for Fetal Lung Maturity and Hemolytic disease.

A

amniotic fluid

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8
Q

What should be checked before and after centrifugation?

A

Color

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9
Q

1.0mL and above

A

Macro method

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10
Q

0.1 to 0.9mL

A

Micro method

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11
Q

0.01 to 0.09mL

A

Ultramicro method

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12
Q

0.001 to 0.009mL

A

Nanoliter method

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13
Q

Collection method for purplish venous blood

A

Venipuncture

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14
Q

Collection method for bright red arterial bood

A

Arterial puncture

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15
Q

Arterial blood is used for?

A

Arterial Blood Gas (ABG) Test and pH

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16
Q

Artery of choice for Arterial puncture?

A

Radial artery

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17
Q

This is usually contaminated with tissue juices.

A

Skin puncture

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18
Q

Skin puncture is a method of choice for?

A
  • pediatric and geriatric patients’
  • extremely obese adults
  • severe burn
  • thrombotic tendencies
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19
Q

In what finger is capillary puncture done in adults?

A

Ring or middle, lateral

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20
Q

Endothelium

A

Tunica intima

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21
Q

Smooth muscle

A

Tunica media

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22
Q

Connective tissue

A

Tunica adventitia

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23
Q

This refers to the plasma and cellular components, mixed with anticoagulant.

A

Whole Blood

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24
Q

Whole blood requires what following blood collection?

A

immediate mixing

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25
Q

This is the clear supernatant on top upon settling of whole blood.

A

Plasma

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26
Q

Liquid portion of unclotted blood

A

Plasma

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27
Q

Liquid portion of clotted blood

A

Serum

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28
Q

T/F: Plasma is clearer than serum.

A

False

Serum is clearer than plasma

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29
Q

T/F: Plasma has a shortened TAT.

A

True

No need to clot

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30
Q

Serum requires what, and how many minutes before centrifugation?

A

complete clotting, 30 minutes

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31
Q

Serum is the only liquid portion that undergoes?

A

rimming

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32
Q

Why is serum lighter than plasma?

A

Decreased fibrinogen

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33
Q

Type of blood in EDTA

A

Whole Blood

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34
Q

Centrifugation must be done for

A

1000 to 2000g for 10 minutes

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35
Q

Alternative centrifugation speed and time

A

2200 to 2500rpm for 15 minutes

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36
Q

T/F: You should not mix specimens in red tube top even with clot activators.

A

False

Pwede i mix basta may clot activators, and also not vigorously

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37
Q

Sepration of serum and RBCs must be ASAP because serum results would be?

A

False increase (↑)

Inclusions of RBCs will seep out, masasama sa serum

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38
Q

Gel in yellow tube top

A

Thixotropic gel

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39
Q

Veins in the Antecubital fossa

A
  • Median cubital
  • Cephalic
  • Basilic
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40
Q

Other veins for Venipuncture sites

A
  • Brachial vein
  • Femoral vein
  • Radial vein
  • Ankle veins
  • Veins of the dorsal hand
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41
Q

Inappropriate venipuncture site

Involves breast removal and lymphedema

A

Arm on the side of mastectomy

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42
Q

Inappropriate venipuncture site

Areas with fluid accumulation

A

Edematous areas

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43
Q

Inappropriate venipuncture site

This refers to clots of saturated or concentrated blood in superficial skin

A

Hematomas

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44
Q

Inappropriate venipuncture site

A
  • Arm in which blood is being transfused
  • Scarred area
  • Arms with fistulas or vascular grafts
  • Sites above an IV cannule
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45
Q

Inappropriate venipuncture site

Instructions for blood collection in IV site

A
  • Turn off IV for 2 minutes
  • Apply tourniquet below IV site
  • Collect 5mL then discard first to avoid contamination
  • Catch method (using tube or aspirate using syringe)
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46
Q

Red (glass)

A
  • No ac, MOA
  • Serum for Serology, CC
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47
Q

Red (plastic)

A
  • Clot activator
  • Serum for Serology, CC
  • Silica clot activator
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48
Q

Lavender (glass)

A
  • K3EDTA, liquid
  • Whole blood for Hematology
  • Chelates/binds calcium
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49
Q

Lavender (plastic)

A
  • K2EDTA, spray dried
  • Whole blood for Hematology
  • Chelates/binds calcium
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50
Q

Pink

A
  • K2EDTA, Spray dried
  • Whole blood for Hematology, Molecular Diagnostics
  • Chelates/binds calcium
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51
Q

White

A
  • EDTA and gel
  • Plasma for Molecular Diagnostics
  • Chelates/binds calcium
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52
Q

Light blue

A
  • Sodium citrate
  • Plasma for Coagulation
  • Chelates/binds calcium
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53
Q

Light blue

A
  • Thrombin and soybean trypsin inhibitor
  • Plasma for Coagulation
  • Fibrin degradation products
54
Q

Black

A
  • Sodium citrate
  • Plasma for ESR, Hematology
  • Chelates/binds calcium
55
Q

Light green / black

A
  • Lithium heparin and gel
  • Plasma for chemistry
  • Inhibits thrombin formation
56
Q

Green

A
  • Lithium heparin, sodium heparin
  • Plasma for chemistry
  • Inhibits thrombin formation
57
Q

Royal blue

A
  • Sodium heparin, K2EDTA
  • Plasma for chemistry and toxicology
  • Inhibits thrombin formation, Binds calcium
58
Q

Gray

A
  • Sodium fluoride, Potassium oxalate (anticoagulant)
  • Plasma for glucose testing
  • Inhibits glycolysis
59
Q

Yellow

A
  • Sodium polyanetholsulfate
  • Serum for microbiology culture
  • Aids in bacterial recovery by inhibiting complement, phagocytes, and certain antibiotics
60
Q

Yellow

A
  • Acid citrate dextrose
  • Plasma for blood banking, Human Leukocyte Antigen (HLA), phenotyping, paternity testing
  • WBC preservative
61
Q

Tan (glass)

A
  • Sodium heparin
  • Plasma for lead testing
  • Inhibits thrombin formation
62
Q

Tan (plastic)

A
  • K2EDTA
  • Plasma for lead testing
  • Chelates/binds calcium
63
Q

Yellow, gray, and orange

A
  • Thrombin
  • Serum for chemistry
  • Clot activator
64
Q

Red, gray and gold

A
  • Clot activator separation gel
  • Serum for chemistry
  • Silica clot activator
65
Q

Incorrect anticoagulant

EDTA

A
  • ALP, Creatinine, Leucine aminopeptidase, Calcium and Iron: Decrease ↓
  • PT and PTT: Increase ↑
  • Platelet aggregation: prevent
66
Q

Incorrect anticoagulant

Oxalate

A
  • Acid phosphatase, ALP, Amylase, LD, Calcium: Decrease ↓
  • Sodium and potassium: Increase ↑
  • Cell morphology: Distorted
67
Q

Citrate

A
  • ALT, AST, ALP, Amylase, Calcium: Decrease ↓
  • Acid phosphatase, Sodium and potassium: Increase ↑
  • Labile coagulation factors: Preserved
68
Q

Heparin

A
  • Triiodothryonine, Thyroxine, PT and PTT, Lithium (LiHep), Sodium (NaHep): Increase ↑
  • Wright’s stain = blue background
69
Q

Fluorides

A
  • Acid phosphatase, ALP, Amylase, CK, ALT, AST = Decrease ↓
  • Cell morphology: Distorted
70
Q

Tests done without tourniquet

A
  • Ammonia
71
Q

Troubleshooting

Bevel on upper wall

A

increased angle

72
Q

Troubleshooting

Bevel on lower wall

A

atras

73
Q

Troubleshooting

Collapsed

A

Through & through (apply pressure)

74
Q

Phases of Laboratory Testing

A
  • Pre Analytical
  • Analytical
  • Post-Analytical
75
Q

Under physiologic considerations

A

Patient preparation

76
Q

Under specimen collection, transportation, preparation/processing, and storage

A
  • Laboratory request
  • Entry to logbook
77
Q

Physiological factors

A
  • Diet
  • Medication or herbal supplements
  • Circadian rhythm
  • Patient posture
78
Q

Patient preparation factors

A
  • Fasting
  • 24 hour urine collection
79
Q

Collection and sample processing factors

A
  • Venipuncture technique
  • Tube selection
  • Tourniquet use
  • Specimen transport and storage
80
Q

Higher in afternoon and evening

A
  • Growth hormone (matulog ng hapon)
  • Acid phosphatase (boner sa umaga)
81
Q

Peaks early in the morning

A
  • Iron (plantsa ng uniform)
82
Q

Decreased supine

A
  • Calcium (gatas)
83
Q

Lower at night

A
  • ADH
  • Plasma renin
  • Aldosterone
  • Insulin
84
Q

Higher with stress

A
  • Cortisol
  • Prolactin
85
Q

Higher with exercise

A
  • Thyroxine
86
Q

This involves any form of physical activity.

A

Exercise

87
Q

What is increased and decreased in short term effects (one hour after) exercise?

A
  • Lactic acid, fatty acids, alanine: Increase ↑
  • Glucose: Decrease ↓
88
Q

What is increased and decreased in long term effects of exercise?

A
  • LDH, ALD, CK, AST: Increase ↑

LAKAS

89
Q

This affects the liver.

A

Drugs/Alcohol

90
Q

The liver is characterized by?

A

first-pass metabolism

91
Q

Drugs

A

Hepatic microsomal enzyme release: Increase ↑

92
Q

Alcohol

A
  • Acetate, Acetaldehyde, Gamma-glutamyl transferase (GGT): Increase ↑
93
Q

Acute effects of Tobacco Smoking due to Nicotine

A

Plasma catecholamines (Epinephrine, Norepinephrine), Cortisol: Increase ↑

94
Q

Chronic effects of Tobacco Smoking

A

WBC count, Carboxyhemoglobin, MCV: Increase ↑

95
Q

What specific WBC is elevated in chronic effects of tobacco smoking?

A

Monocyte

96
Q

Stress

A

Cortisol, adrenal hormones (catecholamines): Increase ↑

97
Q

Stress leads to?

A

hyperventilation

98
Q

This is the disturbance of acid-base balance, which affects ABG test.

A

hyperventilation

99
Q

Age

A
  • ALP, Albumin, Phosphorous, Cholesterol
100
Q

Gender

A

Males: CK

Females: Cholesterol

101
Q

Posture

A

Albumin, cholesterol, aldosterone, Ca

102
Q

Activity

A

LD, Lactic acid, Creatinine, CK, AST

Decreased: Cholesterol, triglycerides

103
Q

Race

A

Cholesterol, triglycerides

104
Q

Require fasting

A
  • FBS
  • Glucose tolerance test (GTT)
  • Triglycerides
  • Lipid panel
  • Gastrin
  • Insulin
  • Aldosterone/Renin
105
Q

Anaerobic (require Ice slurry)

A
  • Lactic acid
  • Ammonia
  • Blood gas

Decrease in pH and po2

106
Q

How to transfer serum/plasma?

A

Aliquot

107
Q

Hemolysis is caused by?

A

Hemoglobin

108
Q

Icterus is caused by?

A

Bilirubin

109
Q

Lipemia is caused by?

A

fat

110
Q

This is the result from prolonged tourniquet time?

A

Hemoconcentration

111
Q

This is the self destruction of enzymes or Acid Phosphatase.

A

Enzymatic Degradation

112
Q

Extracellular

A

Na, Cl

113
Q

Intravascular

A

K, Mg

114
Q

Enzymes

A

ACP, AST, LDH

115
Q

This is the increased lipid concentration.

A

Lipolysis

116
Q

Open system

A
  • Syringe
  • ↑ pO2, ↑ pH, ↓ pCO2
117
Q

Closed system

A
  • ETS
  • ↓ pO2, ↓ pH, ↑ pCO2
118
Q

Hydrolysis of organic phosphate esters cause changes in?

A

Changes in PO3-4 (Phosphate)

119
Q

Under bacterial changes include the following:

A
  • Glycolysis
  • Urea concentration: Decrease ↓
  • NH3: Increase ↑
120
Q

This is the rapid swelling at or near the venipuncture site due to blood leaking into the tissues.

A

Hematoma

121
Q

This is anemia as a result of treatment, or frequent blood draws.

A

Iatrogenic anemia

122
Q

This refers to the blind insertion of central venous catheter (CVC).

A

Inadvertent arterial puncture

123
Q

Lactate dehydrogenase

A

16:1, 272.0

124
Q

Aspartate aminotransferase

A

4:1, 220.0

125
Q

Potassium

A

23:1, 24.4

126
Q

Alanine aminotransferase

A

6.7:1, 55.0

127
Q

Patient complications

A
  • Allergy
  • Excessive Bleeding
  • Fainting/syncope
  • Nausea or vomiting
  • Pain
  • Petechiae
  • Seizures/convulsions
128
Q

What specimen is protected from light?

A

Bilirubin

129
Q

Storage of specimen

A
  • Refrigeration at 4C for 8 hours
  • Freezing at 20C for longer periods
130
Q

This refers to all lab tests related to crime or accident.

A

Forensic testing

MT6317 CLIN CHEM 1 (8 decks)

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