VENIPUNCTURE & PBS

Question 1

Effects of prolonged torniquet

Answer 1

Hemoconcentration
Hemolysis
Slow coagulation

Question 2

Condition in which venous flow is slowed

Answer 2

Stasis

Question 3

Stasis results in the local accumulation of factor ______ and ______

Answer 3

Facto VIII and VWF

Question 4

Distance of tourniquet

Answer 4

3-4 inches or 7.5 to 10 cm

Question 5

Most common needle size for adult

Answer 5

21 gauge 1-1.5 inches

Question 6

CBC is also called

Answer 6

Hemogram

Question 7

Optimal anticoagulant concentration of EDTA

Answer 7

1.5 mg per ml of blood

Question 8

Blood specimens for CBC must be analyzed within ____ hrs of collection (at room temp) and ___ hrs (if stored at 4C)

Answer 8

6 hours ; 24 hours

Question 9

Blood smeares should be made within ____ hrs of collection

Answer 9

3 hours

Question 10

Cause of excessive EDTA

Answer 10

Underfilled tube or short draw

Question 11

Effects of excessive EDTA

Answer 11

Falsely low HCT
Falsely low ESR
Degenerative changes in WBCs
Falsely increase MCHC and plate count

Question 12

Formation of a ring shaped molecular complex in which a metal ion is covalently bound

Answer 12

Chelation

Question 13

A test being ordered automatically based on the results of prior tests or preset parameters

Answer 13

Reflex test

Question 14

Any numerical value that depicts an entire population

Answer 14

Parameter

Question 15

Tube for flow cytocentrifuge, plasma chem determination, osmotic fragility test, blood gas studies

Answer 15

Green top/heparin tube

Question 16

Optimal heparin concentration is

Answer 16

15-20 u/ml of blood

Question 17

Action of heparin to thrombin and factor Xa

Answer 17

It binds anti-thrombin (inhibits thrombin and factor Xa

Question 18

A heparin formulation that cause the least interference in chemistry testing

Answer 18

Lithium heparin

Question 19

Most widely used anticoagulant for plasma and whole blood chemistry tests

Answer 19

Lithium heparin

Question 20

Heparin causes cellular clumping (especially of platelets) which leads to ________ (falsely elevated WBC count) and __________ (falsely decreased platelet count)

Answer 20

Pseudoleukocytosis ; thrombocytopenia

Question 21

Critical ration between 3.2 sodium citrate and blood

Answer 21

1:9

Question 22

Factors affecting coagulation test results (SHORTENED COAG RESULTS)

Answer 22

Hemolysis
Excessive agitation
Prolonged tourniquet application
Excessive needle manipulation
Platelet contamination

Question 23

Factors affecting coagulation test results (PROLONGED COAG RESULTS)

Answer 23

Presence of clots
Increased anticoagulant concentration

Question 24

Blood smears should be made within ___ hours after collection

Answer 24

3 hours

Question 25

Disadvantages of EDTA blood smear

Answer 25

Plate satellitosis EDTA induced platelet clumping

Question 26

Effects of platelet satellitosis on platelets

Answer 26

Pseudothrombocytopenia

Question 27

Effects of EDTA platelet clumping

Answer 27

Pseudothrombocytopenia Pseudoleukocytosis

Question 28

Correction for Pseudothrombocytopenia and leukocytosis

Answer 28

Recollect blood using 3.2% sodium citrate

Question 29

Correction factor for Pseudothrombocytopenia and Pseudoleukocytosis

Answer 29

Plt count (obtained from light blue top) x 1.1 WBC ct (obtained from light blue top) x 1.1

Question 30

Most frequently used blood film preparation

Answer 30

Two-gas’s slide method (Manual Wedge Technique)

Question 31

Angle between two slide

Answer 31

30-45 degrees

Question 32

Too high angle causes

Answer 32

Thicker smear

Question 33

Too low angle causes

Answer 33

Thinner smear

Question 34

Distance between the drop of blood from the label of the slide

Answer 34

1 cm

Question 35

Size of drop of blood

Answer 35

2-3 mm

Question 36

Too fast speed of the spreader

Answer 36

Too thick

Question 37

Increased Hematocrit is seen in the case of

Answer 37

Poplycythemia vera

Question 38

If hematocrit is high, the angle should be _____.

Answer 38

Lowered as low as 25 degrees

Question 39

Decreased hematocrit is seen in

Answer 39

Anemia

Question 40

In the case of anemia, the angle of the spreader should be ___

Answer 40

Raised

Question 41

Buffer used for blood film staining

Answer 41

0.05 M sodium phosphate (pH 6.4) or Aged distilled water (placed in a glass bottle for at least 24 hours ; pH 6.8)

Question 42

pH for staining must be

Answer 42

6.4-6.8

Question 43

Defined as any stain which contains methylene blue (and/or its products of oxidation) and a halogenated fluorescein dye (commonly eosin B or eosin Y)

Answer 43

Romanowsky-type stain

Question 44

Basic stain, it colors the nucleus and some cytoplasmic structures ; a blue or purple color (Stained structures are described to be basophilic)

Answer 44

Methylene blue

Question 45

An acidic stain, it colors some cytoplasmic structures ; an orange red color

Answer 45

Eosin

Question 46

Wright stain, giemsa stain, may-grunwald stain are examples of

Answer 46

Romanowsky-based stain

Question 47

MIDA III, HEMA-TEK, COULTER LH, SYSMEX SP10 are examples of

Answer 47

Automated staining

Question 48

Macroscopic color of a well stained blood smear

Answer 48

Pink-purple

Question 49

Rbc color in a well stained blood smear

Answer 49

Orange to salmon-pink

Question 50

WBC nuclei color in a well stained blood smear

Answer 50

Purple to blue

Question 51

Neutrophil cytoplasm color in a well stained blood smear

Answer 51

Pink to tan (With violet to lilac gran)

Question 52

Eosinophil granules color in a well stained blood smear

Answer 52

Bright to orange

Question 53

Problems: RBCS gray or blue WBCs too dark Eosinophil granules gray Causes: ?

Answer 53

Stain/buffer is too basic (most common) Inadequate rinsing Heparinized blood was used

Question 54

Problems: RBCs too pale or red WBCs barely visible

Answer 54

Stain/buffer is too acidic (most common) Under buffering Over rinsing

Question 55

Objective used to detect “snowplow” effect

Answer 55

10x objective

Question 56

Objective used to locate rare abnormal WBCs

Answer 56

10x

Question 57

Detect fibrin strands

Answer 57

10x

Question 58

Recognize rouleaux formation or RBC agglutination

Answer 58

10x

Question 59

Average no. Of WBCs per HPF X ______ = estimated What is the WBC multiplication factor for HPF (40X)

Answer 59

2000

Question 60

What is the WBC multiplication factor for OIO (50X)

Answer 60

3000

Question 61

Storage of blood smear slide:

Answer 61

At least 7 days before proper disposal

Question 62

Objective used for estimation and tabulation of the actual WBC differential

Answer 62

100X OIO

Question 63

Objective used for estimation and tabulation of the actual WBC differential

Answer 63

100X OIO