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CCHM > Week 4 Lab: Pre-Analytical Variables > Flashcards

Week 4 Lab: Pre-Analytical Variables Flashcards

1
Q

Components of Pre-analytical Phase?

A
  1. Test ordering/requisition
  2. Patient identification
  3. Phlebotomy
  4. Specimen transport
  5. Specimen examination
  6. Centrifugation
  7. Time to testing and storage
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2
Q

Any influence before testing of the specimen that causes the test to fail to reflect the patient’s in vivo body functions

A

Pre-analytical variables

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3
Q

Factors leading to preanalytical variability?

A
  • Complex biochemical and cellular reactions measured in assays
  • Lability of several analytes
  • Dependence of reactions on certain substances
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4
Q

Tests most affected by diet?

A

Glucose and Triglycerides

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5
Q

It can interfere with any test result.

A

Lipemia

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6
Q

turbidity of the serum or plasma and potentially interfering with instrument readings

A

Hyperchylomicronemia

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7
Q

Diet elevates?

A

plasma potassium, alkaline phosphatase, and 5-HIAA (5-Hydroxy indoleacetic acid)

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8
Q

Effects of long-time vegetarian diets?

A

decreased concentrations of low-density lipoproteins (LDLs), very-low-density lipoproteins (VLDLs), total lipids, phospholipids, cholesterol, and triglycerides.

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9
Q

A high meat or other protein-rich diet affects?

A

serum urea, ammonia, and urate levels

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10
Q

High protein, low carbohydrate diets cause?

A

greatly increase ketones in the urine and increase the serum blood urea nitrogen (BUN)

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11
Q

High unsaturated-to-saturated fatty acid causes?

A

decreased serum cholesterol

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12
Q

Purines cause?

A

increased urate value

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13
Q

Bananas, pineapples, tomatoes, and avocados cause?

A

elevated urine excretion of 5-HIAA due to serotonin content

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14
Q

Obesity causes?

A

Increased serum LD activity, cortisol production, and glucose. Plasma insulin concentration –> increased; glucose tolerance is impaired.

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15
Q

Obese men causes?

A

reduced testosterone concentration

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16
Q

Alcohol consumption causes?

A

transient elevation in glucose levels

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17
Q

Chronic alcohol consumption causes?

A

tests associated with the liver and increases triglycerides

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18
Q

Caffeine causes?

A

affect hormone levels; elevate plasma free fatty acids and cause catecholamine release from the adrenal medulla and brain tissue

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19
Q

Drinking too much liquid affects?

A

hemoglobin levels and electrolyte balance

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20
Q

Basal state collection is used for what tests?

A

glucose, cholesterol, triglyceride and electrolytes

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21
Q

Specimen that requires fasting?

A

FBS, GTT, TAG, lipid and lipoprotein tests, gastrin and insulin

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22
Q

8-14 hours fasting is used for what tests?

A

glucose, lipids, and lipoproteins

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23
Q

48 hours of fasting may?

A

increase serum bilirubin

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24
Q

72 hours of fasting may result to?

A

increase of plasma triglyceride while glucose decreases in health women to 45 mg/dL (2.5 mmol/L), while men show an increase in plasma triglycerides, glycerol, and free fatty acids, with no significant change in plasma cholesterol

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25
Q

Changes in patient posture from a supine to an erect position affects?

A

cellular elements, plasma proteins, compounds bound to plasma proteins, and high molecular-weight substances

26
Q

NIH recommends?

A

that patients be lying or sitting for 5 minutes prior to blood collection for lipid profiles to minimize the effects caused by posture

27
Q

Congestive heart failure and liver diseases cause?

A

increased fluid to remain in the tissue

28
Q

Changing from supine to sitting or standing causes?

A

Increased levels of albumin, enzymes, and calcium

29
Q

Changing from sitting to supine causes?

A

Increased levels of proteins, lipids, BUN, iron and calcium

30
Q

Changing from standing to supine causes?

A

Decreased levels of cholesterol, triglycerides and lipoproteins

31
Q

30 minutes of standing causes?

A

Significant elevation of potassium

32
Q

Prolonged bedrest causes?

A

Decreased plasma albumin

33
Q

Standing effects?

A

Plasma renin is higher than supine position

34
Q

It is recommended that tourniquet application should not be more than?

A

one minute

35
Q

Prolonged tourniquet application results in ________________. The pressure from the tourniquet causes biological analytes to leak from the tissue cells into the blood.

A

hemoconcentration and anaerobiosis

36
Q

Prolonged tourniquet application causes increased levels of?

A

Increased levels: potassium (1 mmol/L), proteins (albumin), enzymes, lactate, cholesterol, and ammonia

37
Q

Prolonged tourniquet application causes decreased levels of?

A

Venous pO2 and pH

38
Q

Moderate or strenuous exercise causes?

A

increasing the blood levels of creatinine, fatty acids, lactic acid, aspartate aminotransferase (AST), creatine kinase (CK), lactic dehydrogenase (LD), aldolase, hormones (antidiuretic hormone, catecholamines, growth hormone, cortisol, aldosterone, renin, angiotensin), bilirubin, uric acid, high-density lipoprotein (HDL), and white blood cell (WBC) count and decreasing arterial pH and PCO2

39
Q

Physical activity can have different effects on analyte concentrations, such as?

A

volume shifts between the vascular and interstitial compartments, volume loss by sweating and changes in hormone concentration

40
Q

Exercise causes increased?

A
  • Prolactin
  • Testosterone
  • LH
  • Protein (urine)
  • Potassium, Lactate, and Phosphate (fist clenching)
41
Q

Exercise causes a transient increase in?

A
  • Lactate
  • Pyruvate
  • Fatty Acid
  • Creatinine
  • Ammonia
42
Q

Exercise causes a long-term increase in?

A
  • CPK
  • AST
  • LD
  • Aldolase
43
Q

Exercise causes a decrease in?

A
  • FSH
  • LH (In long-distance athletes)
44
Q

Stress/Anxiety causes?

A

Increased levels of adrenal hormones (cortisol and catecholamines), increase WBC counts, decrease serum iron, and markedly affect arterial blood gas (ABG) results

45
Q

WBC counts collected from a violently crying newborn may be markedly?

A

elevated

46
Q

Severe anxiety causes?

A

hyperventilation –> acid-base imbalances and increased lactate and fatty acid levels

47
Q

Mild stress causes?

A
  • increase in total cholesterol
  • HDL cholesterol to decrease by as much as 15%
48
Q

Immediate effects of nicotine?

A
  • Increase in plasma catecholamines, cortisol (decreased numbers of eosinophils, while neutrophils, monocytes, and plasma fatty-free acids increase), glucose, blood urea nitrogen (BUN), cholesterol, and triglycerides
  • Glucose and BUN can increase by 10% and triglycerides by 20%
49
Q

Chronic smoking increases?

A

hemoglobin, red blood cell (RBC) counts, the mean corpuscular volume (MCV) and immunoglobulin (Ig) E

50
Q

Chronic smoking decreases?

A

Immunoglobulins IgA, IgG, and IgM are decreased, lowering the effectiveness of the immune system

51
Q

Tobacco smokers have high?

A

blood carboxyhemoglobin levels

52
Q

High-altitude areas such as the mountains where there is reduced oxygen levels cause?

A

RBC counts and hemoglobin (Hgb) and hematocrit (Hct) levels increased. The body produces increased numbers of RBCs to transport oxygen throughout the body.

53
Q

Laboratory results vary between infancy, childhood, adulthood, and the elderly because?

A

there is a gradual change in the composition of body fluids

54
Q

Hormone levels vary with age and gender. RBC, Hgb, and Hct values are higher for?

A

males than for females

55
Q

During pregnancy, there is increased plasma volume, which can cause?

A

a dilutional effect

56
Q

The dilutional effect causes?

A

lower RBC counts, protein, alkaline phosphatase, estradiol, free fatty acids, and iron values

57
Q

It is the normal fluctuation in blood levels at different times of the day based on a 24-hour cycle of eating and sleeping.

A

Diurnal rhythm

58
Q

Diurnal variation: which analyte levels are highest in the morning?

A

Cortisol, aldosterone, renin, luteinizing hormone, follicle-stimulating hormone, estradiol, thyroid-stimulating hormone (TSH), testosterone, bilirubin, hemoglobin, insulin, potassium, RBC count, and serum iron levels

59
Q

Diurnal variation: which analyte levels are lower in the morning?

A

Eosinophil counts, creatinine, glucose, triglyceride, and phosphate levels

60
Q

Medications that are toxic to the liver can cause?

A

an increase in blood liver enzymes and abnormal coagulation tests

61
Q

Patients taking medications that impair renal function cause?

A

Elevated BUN levels or imbalanced electrolytes

62
Q

Patients taking corticosteroids, estrogens, or diuretics can develop pancreatitis and would have?

A

elevated serum amylase and lipase levels

CCHM (4 decks)

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