L4: Specimen Handling and Processing

Question 1

approximately ___% to ___% of lab errors occur prior to analysis

Answer 1

46% to 68%

Question 2

gentle inversion of the specimen tube evenly distribute the ___

it is usually between __ to __ gentle inversions

Answer 2

additive

3-10

Question 3

rough handling of specimen results to ? (4)

Answer 3

• hemolyze specimens
• activate platelets
• affect coagulation
• break the test tube

Question 4

the specimens should be transported with the ___

Answer 4

stoppers

Question 5

the specimens should be placed in a liquid-tight closure plastic bags with a visible ___ logo and a slip pocket for paperworks

Answer 5

biohazard

Question 6

the specimen will ___ or ____ if allowed to cool below body temp

Answer 6

precipitate, agglutinate

Question 7

specimens should be transported at a near ___ temp

Answer 7

37 degrees or body temperature

Question 8

what to use when transporting specimens?

how many mins can it hold from removal from the incubator?

Answer 8

portable heat blocks

15 mins

Question 9

this can be used for specimens that can withstand a temperatureslightly higher than 37 degree celsius

Answer 9

heel warmer

Question 10

when dealing with chilled specimens, the specimen tube should be completely submerged in crushed __ amd __ slurry during transport an immediately ___ or ___ , if necessary

Answer 10

ice, water
tested, refrigerated

Question 11

it slows the metabolc process

Answer 11

chilling

Question 12

exposure to light can affect the result of a specimen

Answer 12

light-sensitive specimen

Question 13

when dealing with light-sensitive specimen, the phlebotomist should wrap the tube with _______ or use _____, _____-colored container

Answer 13

aluminum
light-blocking
amber

Question 14

the routine blood specimen is expected to reach the lab within? centrifugation needed by the specimen should be done in ____?

Answer 14

45 mins
1hour

Question 15

hematology specimens with ___ should not be centrifuged

Answer 15

EDTA

Question 16

this specimen is marked as ___ or ___ which takes priority over all other specimens

Answer 16

STAT or emergency

Question 17

1. Blood smear from EDTA specimen - prepared ___ from collection
2. EDTA specimen for CBC - analyzed wihin ___ but is stable ___ from collection if stored at room temperature
3. EDTA specimen for erythrocyte sedimentation rate (ESR) determination - tested ___ (room temp) and ___ (refrigerated)
4. EDTA specimen for reticulocyte counts - stable for ___ (room temp) and ___ if refrigerated
5. glucose test drawn in sodium fluoride tubes - stable for ___ (room temp) but stable for up to ___ when refrigerated at 2 - 8 degrees celc
6. Prothrombin time (PT) - stable for ___ and partial thromboplastin time (PTT) should be analyzed within ___ from collection

Answer 17

1. 1hour
2. 6 hours, 24 hours
3. 4 hours, 12 hours
4. 6 hours, 72 hours
5. 24 hours, 48 hours
6. 24 hours, 4 hours

Question 18

used to separate cells, plasma, or serum of blood specimens

Answer 18

centrifuge

Question 19

____ is achieved by spinning the blood tubes inside the vessel at a high speed such that the ____ force will cause the separation of the specimens

Answer 19

centrifugation, centrifugal

Question 20

it is important to leave the stoppers on the tube before and during centrifuge to ? (4)

Answer 20

• contamination
• evap
• aerosol formation
• pH changes

Question 21

true or false. the process of centrufugation should not be repeated

Answer 21

true

Question 22

the plasma specimen collected in tubes with ____ should be centrifuged immediately without delay

serum specimen needts to be completely ___ prior to centrifugation

Answer 22

anticoagulants
clotted

Question 23

complete clotting takes around __ to __ minutes at room temp

Answer 23

30 - 60

Question 24

used to cover the stopper to catch drops of blood that may leak or to prevent the aerosol that may be released during the process

Answer 24

gauze/ tissue

Question 25

________ refers to a portion of a sample specimen taken for chemical analysis or testing. It is prepared when multiple tests are ordered on a single specimen ________ method of dividing or separating specimens into separate containers

Answer 25

aliquot aliquoting

Question 26

RA 11058

Answer 26

Occupational Safety and Health Standards Act (OSHA)

Question 27

What law states about required protective equipment worn when processing specimen

Answer 27

OSHA / RA 11058

Question 28

Hemolyzed specimens can affect ____, _____ and most ___ tests

Answer 28

potassium, magnesium, enzyme

Question 29

inadequate mixing of anticoagulated tubes results to? (2)

Answer 29

micro clot formation, erroneous test results

Question 30

inadequate mixing of gel seperation tubes results to?

Answer 30

clotting may be incomplete

Question 31

TRUE OR FALSE: if non-additive tube, then do not mix

Answer 31

true

Question 32

in transporting specimens, the primary container must have 2 compartmenets: with ___ logo

Answer 32

sample and requisition form biohazard

Question 33

- system that propels cylindrical containers through networks of tubes by compressed air or by partial vacuum - more traumatic - faster delivery

Answer 33

Pneumatic Tube System / Pneumatic Tube Transport (PTT)

Question 34

Extreme temperature results to rupture of ____

Answer 34

RBCs

Question 35

documentation of proper sample identification from the time of collection to the receipt of laboratory results

Answer 35

chain of custody

Question 36

needed when handling blood specimens to protect its condition and quality

Answer 36

special care

Question 37

specimens ___ at cold temperature

Answer 37

precipitate

Question 38

these are proteins that precipitate at cold temperature

Answer 38

cold agglutinins, cryoglobulin, cryofibrinogen

Question 39

Tests that require chilling of specimen

Answer 39

Adrenocorticotropic hormone (ACTH) Acetone Ammonia Acid Phosphatase Catecholamines Lactic acid Parathyroid hormone pH/blood gases

Question 40

chilling of uncentrifuged blood will elevate __?

Answer 40

potassium

Question 41

routine blood specimens should arrive at the laboratory within _______ of collection Specimens that require separation of the serum or plasma from the cells should be centrifuged within ______

Answer 41

45 mins 1 hour

Question 42

maximum time limit for separating serum and plasma from the cells is ______ from time of collection

Answer 42

2 hours

Question 43

Serum tubes that have not been spun within 2 hours or refrigeration of serum tubes before centrifugation will : (2)

Answer 43

increase potassium, increase glucose

Question 44

Non-additive and gel-barrier serum tubes (SSTs): completely ____ before centrifugation Heparin gel-barrier tubes (PSTs) : can be ______ right away

Answer 44

clotted centrifuged

Question 45

Specimens in gel-barrier tubes do not require ______ separation

Answer 45

manual

Question 46

_________: after specimen collection and beforecentrifugation _________: when the specimen is in the centrifuge _________: after centrifugation and before removal of serum or plasma

Answer 46

Precentrifugation Centrifugation Postcentrifugation

Question 47

Allow blood in nonadditive, clot activator, and gel-containing tubes used for serum tests (e.g., SSTs) to clot for the serum to separate from the cells

Answer 47

precentrifugation

Question 48

specimens taht may take longer to clot (3)

Answer 48

◦ patients on anticoagulant medications, heparin or warfarin (e.g., Coumadin) ◦from patients with high WBC counts ◦ chilled specimens◦from patients with coagulopathies (bleeding disorders)

Question 49

tubes with clot activators clots within ____ tubes with thrombin clots in ______

Answer 49

30 minutes 5 minutes

Question 50

complete clotting can be determined by ____ or ____ the tube gently

Answer 50

tilting/ inverting

Question 51

Rimming the tube with an applicator stick to release the clot from the walls of the tube is a potential source of ______ and ______

Answer 51

hemolysis/ contamination

Question 53

specimens that require separation of the serum and plasma from the cells should be ____ within ____

Answer 53

centrifuged; 1 hour

Question 54

maximum time limit for separating serum and plasma from the cells is __ hours from time of collection

Answer 54

2

Question 55

Serum tubes that have not been spun within 2 hours or refrigeration of serum tubes before centrifugation will : (2)

Answer 55

increase potassium, decrease glucose

Question 56

prevents glycolysis

Answer 56

sodium fluoride

Question 57

SST: completely ___ before _____ PST: can be _____ right away

Answer 57

clotted; centrifugation centrifuged

Question 58

_________: after specimen collection and before centrifugation _________: when the specimen is in the centrifuge _________: after centrifugation and before removal of serum or plasma

Answer 58

precentrifugation centrifugation postcentrifugation

Question 59

Allow blood in nonadditive, clot activator, and gel-containing tubes used for serum tests (e.g., SSTs) to clot for the serum to separate from the cells

Answer 59

precentrifugation

Question 60

________ is a process in which centrifugal force is used to separate solid matter from a liquid suspension ________ machine that spins blood and other specimens at a high number of revolutions per minute (rpm) or centrifugal force

Answer 60

centrifugation centrifuge

Question 61

centrifugation: ___ minutes at 750 g to 1000g ___ minutes at 1000 g

Answer 61

15 10

Question 62

in centrifugation, removing the stopper will result to: (4)

Answer 62

Aerosol formation pH changes (loss of CO2 which can increase pH) Evaporation (leads to concentration of analytes) Contamination

Question 63

drop of sweat, interferes with _______ results

Answer 63

electrolyte

Question 64

powder from gloves, interferes with _____ determinations

Answer 64

calcium

Question 65

TRUE OR FALSE: specimen can be centrifuged more than once

Answer 65

FALSE. specimen should never be centrifuged more than once

Question 66

Repeated centrifugation can cause: (3)

Answer 66

- hemolysis - analyte deterioration - alter test results

Question 67

check the speed using a strobe light or a ______, an instrument designed for measuring rpm

Answer 67

tachometer

Question 68

STAT chemistry tests - _________ tubes to save time; reduce turn-around time (TAT)

Answer 68

green top heparin

Question 69

serum on gel barriers can be stored up to ___ hours at 4°C

Answer 69

48

Question 70

after centrifugation, the normal color is?

Answer 70

yellow

Question 71

Icterus - descp: - increased: Lipemia - descp: - increased: Hemolysis: - descp: - indication: - increased:

Answer 71

Icterus - descp: dark yellow - increased: bilirubin Lipemia - descp: cloudy, turbid - increased: lipids Hemolysis: - descp: pink/ red - indication: underlying condition, error in collection - increased: K+, ammonia, phosphate, enzymes

Question 72

TRUE OR FALSE: Pouring the serum or plasma into aliquot tubes is recommeded

Answer 72

FALSE. not recommended because it increases the possibility of aerosol formation or splashing