Anticoagulants

Question 1

Concentration of EDTA

Answer 1

1.5-2.0mg/mL of blood

Question 2

It removes ionized calcium through an irreversible process called chelation

Answer 2

EDTA

Question 3

Three forms of EDTA

Answer 3

a. Dry form- VERSENE
(Na2 EDTA, K2 EDTA)
b. Liquid form- SEQUESTRENE
(K3 EDTA)

Question 4

For routine cell count and blood smear preparation

Answer 4

EDTA

Question 5

If EDTA exceeds 2.0mg/ml of whole blood, platelets may swell and fragment that will lead to _____ platelet count.

Answer 5

False increase platelet count

Question 6

Not recommended for coagulation test

Answer 6

EDTA

Question 7

Coagulation factors that are not stable in EDTA

Answer 7

Factors V and VIII (labile factors)

Question 8

Effect of increase EDTA in ESR and hematocrit results

Answer 8

False decrease

Question 9

Rare phenomenon that occur when using EDTA

Answer 9

platelet satellitosis

Question 10

How to correct platelet satellitosis?

Answer 10

By using sodium citrate tube and multiply the result to 1.1.

Question 11

Purpose of EDTA tubes
a. puple
b. pink
c. royal blue
d. tan
e. pearl (pale tint of white)
f. white with gel separator

Answer 11

a. PURPLE- routine hematology and HbA1c
b. PINK- hematology and blood bank
c. ROYAL BLUE- trace elements
d. TAN- lead determination
e. PEARL- platelet preparation tube (PPT)
f. WHITE- molecular test (PCR and DNA)

Question 12

Binds to calcium and form soluble complex

Answer 12

Sodium citrate

Question 13

Anticoagulant of choice in coagulation studies

Answer 13

Sodium Citrate (Blue top tube)

Question 14

Anticoagulant of choice for Standard Westergren and ESR testing.

Answer 14

Sodium citrate (Black top tube)

Question 15

Blood:Anticoagulant
a. blue top tube
b. black top tube

Answer 15

a. 9:1
b. 4:1

Question 16

Preferred anticoagulant for ESR testing

Answer 16

Black top tube

Question 17

Underfilling/excess citrate/short draw can cause _____ due to excess citrate in plasma

Answer 17

prolonged PT and PTT

Question 18

Patient with increase hematocrit level (>55%)

Answer 18

polycythemic patient

Question 19

Concentration of oxalate (black top tube)

Answer 19

1-2mg/ml

Question 20

Different forms of oxalate

CLUE: “lisopodo

Answer 20

lithium oxalate
sodium oxalate
potassium oxalate
double oxalate

Question 21

most widely used oxalate

Answer 21

potassium oxalate

Question 22

used as an alternative for prothrombin time (PT) test

Answer 22

oxalated plasma

Question 23

double balanced plasma components

Answer 23

potassium oxalate + ammonium oxalate

Question 24

3 parts = can cause cell swelling
2 parts = can cause cell shrinkage

Answer 24

Ammonium oxalate (winthrobe’s)
Potassium oxalate (paul heller’s)

Question 25

acid mucopolysaccharide that inhibits coagulation by inactivation of thrombin

Answer 25

Heparin

Question 26

used as an in vitro and in vivo anticoagulant

Answer 26

heparin

Question 27

anticoagulant of choice on most chemistry test

Answer 27

lithium heparin

Question 28

optimum concentration of heparin

Answer 28

0.2mg/ml of blood

Question 29

reason why heparin is not for coagulation studies

Answer 29

it inhibits all stages of coagulation cascade especially thrombin

Question 30

reason why heparin is not for blood film preparation

Answer 30

it destroys WBC and platelets and can produce bluish background on romanowsky stained smear

Question 31

heparin is anticoagulant for _____

Answer 31

osmotic fragility test and LAP test

Question 32

used in preserving glucose, inhibitor of glycolysis and determination of lactic and blood alcohol/ethanol

Answer 32

sodium fluoride (gray top tube)

Question 33

Blood culture specimen collections in microbiology

Answer 33

sodium polyanethol sulfonate (SPS)

Question 34

Used in blood bank studies, lymphocytotoxicity testing, HLA phenotyping, DNA and paternity testing

Answer 34

acid citrate dextrose (ACD)

Question 35

A. It inhibits the labile factors B. It preserves the labile factors

Answer 35

A. EDTA B. Sodium citrate

Question 36

Used during Percutaneous Transluminal Coronary Angioplasty (PTCA) and Cardiopulmonary Bypass (CPB) to prevent clot formation

Answer 36

Heparin

Question 37

Inversions in Red Top Tube a. glass b. plastic

Answer 37

a. no inversions b. 5 inversions

Question 38

a. First tube in the order of draw b. Last tube in the order of draw

Answer 38

a. Yellow top tube - SPS b. Yellow top tube - ACD

Question 39

CTAD (sodium citrate)

Answer 39

Citrate Theophylline Adenosine Dipyridamole