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Hematology > Lab Safety, Blood Collection, Hemocytometer, RBC Counting > Flashcards

Lab Safety, Blood Collection, Hemocytometer, RBC Counting Flashcards

1
Q

It is a discipline that studies the development and diseases of the blood.

A

Hematology

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2
Q

This regulation requires that laboratories develop, implement, and comply with a plan that ensures the protective safety of laboratory staff to potential infectious bloodborne pathogens, HBV, and HIV.

A

Occupational Exposure to Bloodborne Pathogens by Occupational Safety and Health Administration (OSHA)

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3
Q

The OSHA-mandated program becomes law in _____.

A

March 1992

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4
Q

The standard precaution which concerns the handling of all patient specimens is recommended by the _____.

A

Center for Disease Control and Prevention (CDC)

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5
Q

The ______ also issued guidelines for the lab worker in regard to protection from bloodborne diseases spread through contact with patient specimens.

A

Clinical and Laboratory Standards Institute (CLSI)

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6
Q

It is the single most important source of HBV, HIV, and other bloodborne pathogens in the occupational setting.

A

Blood

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7
Q

It is the most widespread control measure required by the OSHA and CLSI.

A

use of puncture-resistant sharps containers (that has a biohazard symbol, and are white-mounted)

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8
Q

It can be present in extraordinarily high concentrations in blood.

A

Hepatitis B virus

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9
Q

It can be present in extraordinarily lower concentrations in blood.

A

Human Immunodeficiency virus

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10
Q

HBV may be stable in dried blood and blood products at ______ C for up to _______ days.

A

25 C; 7 days

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11
Q

HIV retains infectivity for more than _____ days in _____ specimens at room temperature and for more than _____ week in an ______ environment at room temperature

A

3 days; dried specimens

1 week; aqueous environment

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12
Q

It was issued by OSHA in 1991 which mandates employers to provide the HBV vaccine to all employees who have or may have occupational exposure to blood or potentially infective materials.

A

Federal Standard

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13
Q

It is intended to prevent occupational exposures to bloodborne pathogens.

A

Standard Precautions

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14
Q

This approach eliminates the need for separate isolation procedures for patients known or suspected to be infectious.

A

Standard Precautions

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15
Q

It states that all human blood and other body fluids are treated as potentially infectious for HIV, HBV, and other bloodborne microorganisms that can cause disease to humans.

A

Standard Precautions

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16
Q

It is considered the most important safety precaution.

A

Handwashing

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17
Q

Handwashing must be performed ______.

A

after contact with patients and laboratory specimens

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18
Q

______ should be used as an adjunct to and not a substitute for handwashing.

A

Gloves/wearing gloves

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19
Q

OSHA requires the laboratory to have a _____ program

A

Personal Protective Equipment (PPE)

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20
Q

The volume of bleach to volume of water ratio is _____.

A

1:10 ratio or 1:10 dilution

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21
Q

The most commonly used bleach/EPA-registered disinfectant is _____.

A

Sodium hypochlorite

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22
Q

The sodium hypochlorite has a percentage of ______.

A

0.5%

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23
Q

The sodium hypochlorite solution has a percentage of _____.

A

10%

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24
Q

It is a vital life-sustaining fluid that circulates in the blood vessels.

A

Blood

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25
Q

Function of blood:

A 
Respiratory
Homeostasis (maintains acid-base system)
Nutrition
Excretory
Immunity
Regulation
Transport of Hormones
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26
Q

Reminders in Blood Collection:

A 
Patient Identification (Pre-Analytical)
Standard Precautions (Handwashing and Wearing of PPE)
Antiseptic Technique (Analytical)
Sharp Objects (Post-Analytical)
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27
Q

It refers to wearable equipment that is designed to protect DHCP from exposure to or contact with infectious agents.

A

Personal Protective Equipment (PPE)

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28
Q

It is used for newborn infants and geriatric patients.

A

Capillary puncture/Skin puncture

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29
Q

Micro method of drawing blood wherein only a small amount is obtained.

A

Capillary puncture/Skin puncture

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30
Q

Things that are avoided/prevented when performing Capillary/Skin puncture:

A

avoid too much squeezing and too much application of pressure

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31
Q

Depth of puncture for Capillary/Skin puncture is _____.

A

<2mm

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32
Q

The yellowish liquid portion of clotted blood (tubes with no additives)

A

Serum

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33
Q

It is found in between the plasma/serum and packed RBCs. It is composed of platelets and WBCs.

A

Buffy coat

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34
Q

Discarding the first drop of blood is important in Capillary puncture because:

A

It facilitates free flow of blood
It removes dead epidermal cells
It removes excess tissue fluid

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35
Q

Preferred puncture site for infants during capillary puncture:

A

Heel portion, specifically medial or lateral side

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36
Q

Preferred puncture site for older patients during capillary puncture:

A

Palmar surface of the non-dominant hand, specifically the ring or middle finger (3rd or 4th finger distal portion)

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37
Q

Order of draw for capillary puncture:

A
  1. Tube with additives

2. Tube with non-additive

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38
Q

The most ideal method of drawing/obtaining blood is _____.

A

Venipuncture

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39
Q

This procedure obtains venous blood.

A

Venipuncture

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40
Q

It is the most common collection site for venipuncture.

A

Ante-cubital fossa (specifically the median cubital vein)

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41
Q

Other puncture sites found in the antecubital fossa is:

A 
Basilic vein (near the brachial artery and least stable)
Cephalic vein (2nd preferred vein next to median cubital)
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42
Q

It is the most stable vein found in the antecubital fossa.

A

Median cubital vein

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43
Q

The preferred angle of blood collection using venipuncture is _____.

A

15-30 degrees

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44
Q

Tourniquet application must be:

A

Less than 1 min

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45
Q

Prolonged tourniquet application causes:

A

Hemoconcentration (concentrated blood sample; contains a high level of formed elements in the blood)
Hemolysis (destruction of RBCs)
Shortened Coagulation Time (blood clotted immediately)

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46
Q

The preferred distance of tourniquet application during venipuncture is ____.

A

3-4 inches from the preferred site of puncture

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47
Q

The needle length used in venipuncture is ____.

A

1-1.5 inch

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48
Q

The standard gauge used in venipuncture is ____.

A

21G

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49
Q

The gauge number indicates the size of the bore of the needle. The _______ the gauge number, the ______ is the size of the bore of the needle and vice versa.

A

higher, smaller (vice versa)

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50
Q

Three methods of venipuncture:

A

Syringe method
Evacuated Tube System
Butterfly/Winged-infusion method

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51
Q

Parts of syringe:

A 
plunger
graduated barrel
luer lock
needle cap
hub
needle shaft
bevel
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52
Q

Complications during venipuncture:

A

Ecchymosis (bruising) - most common
Syncope (Fainting) - second most common
Hematoma - purplish discoloration of the skin
Failure to draw blood
Petechiae - small red spots, indicates prolonged bleeding
Hemoconcentration - too concentrated blood sample
Hemolysis - destruction of RBCs
Edema - accumulation of too much fluid
Obesity

53
Q

If the patient is in IV line:

A

Draw the blood opposite to the IV line (stop the IV for 2 minutes then discard the first 5 mL)

In real laboratory setting: IV line is stopped for 5 mins before extraction (discarding of the first 5 mL is no longer necessary)

54
Q

If the patient has undergone mastectomy (surgical removal of the breast):

A

Draw blood from the arm opposite of the mastectomy site

55
Q

If the patient has undergone double mastectomy (surgical removal of the breast):

A

Perform skin puncture instead of venipuncture

56
Q

If the patient has undergone double mastectomy (surgical removal of the breast):

A

Perform skin puncture instead of venipuncture.

If blood extraction is needed, another suitable site is accepted.

57
Q

During patient identification, the patient must _____.

A

verbally introduce his or herself.

58
Q

What finger is being used in locating the vein during venipuncture?

A

index finger

59
Q

The alcohol used during the antiseptic technique is _____.

A

70% isopropyl alcohol

60
Q

When performing venipuncture the needle must always be ____.

A

bevel up

61
Q

Order of draw in venipuncture:

A

Blood culture tube/Sodium Polyethanol Sulfonate/Plasma specimen (yellow stopper)

Coagulation tube/3.2% Sodium Citrate/Plasma specimen (light blue stopper)

Non-additive/Serum tube w/o clot activator or gel separator/Serum specimen (red stopper)
Routine Chemistry/Clot activator/Serum specimen (red-gray, gold, orange, yellow-gray stopper)

STAT Chem tube/Heparin/Serum specimen (green or light green stopper)

Hematology/K2EDTA or EDTA/Plasma specimen (K2EDTA purple stopper) (EDTA pink stopper)

Glucose test/Sodium fluoride/Plasma specimen, with or without EDTA or oxalate (gray stopper)

62
Q

Labeling is done _____

A

after extraction

63
Q

Label must have:

A

complete name of the patient
date and time of collection
initials of the phlebotomist

64
Q

Three commonly used anticoagulants in hematology laboratory

A

Dipotassium Ethylene Diamine Tetraacetic Acid or Tetraacetate (K2 EDTA)
3.2% Sodium Citrate
Heparin

65
Q

This is the anticoagulant of choice for blood cell counting and sizing because they produce less shrinkage of RBCs and less of an increase in cell volume and standing.

A

Dipotassium Ethylene Diamine Tetraacetic Acid or Tetraacetate (K2 EDTA)

66
Q

EDTA tube has what agent recommended by International Council for Standardization in Hematology?

A

salts of the chelating (calcium-binding) agent

67
Q

EDTA has 3 forms:

A 
dry additives (K2 EDTA or Na2 EDTA)
liquid additive (K3 EDTA)
68
Q

What is the action of EDTA?

A

Chelates/Destroys calcium

69
Q

EDTA tube is used for what tests?

A

CBC (RBC count, WBC count, etc.) & platelet count

70
Q

Over-filled blood sample in EDTA causes?

A

possible clotting

71
Q

Under-filled blood sample in EDTA causes?

A

decrease results in some lab tests such as hematocrit and Erythrocyte Sedimentation Rate (ESR)

72
Q

3.2% Sodium Citrate is the preferred tube for what test according to ICSH?

A

thrombosis and hemostasis of coagulation studies

73
Q

The correct ratio of 3.2% sodium citrate to blood is?

A

1 part anticoagulant, 9 parts whole blood (1:9)

74
Q

What is the action of 3.2% Sodium Citrate?

A

Binds calcium

75
Q

3.2% Sodium Citrate tube is used for what tests?

A

Coagulation studies (specifically Prothrombin Time and Activated Partial Thromboplastin Time)

76
Q

It is used as an in-vivo and in-vitro anticoagulant?

A

Heparin

77
Q

It acts as a substance that inactivates a blood clotting factor called thrombin. It is also known as the naturally occurring anticoagulant because it is normally found in blood circulation.

A

Heparin

78
Q

What is the action of Heparin?

A

It anti-coagulates thrombin and factor Xa

79
Q

Heparin tube is used for what tests?

A

Osmotic Fragility Test, Plasma Chemistry Tests

80
Q

It is an instrument that is used to count blood cells using the manual method.

A

Hemocytometer

81
Q

Meaning of hemocytometer:

A

hemo=blood
cyto=cells
meter=measurement

82
Q

The specimen for hemocytometry is _____.

A

EDTA whole blood

83
Q

The general steps involved in hemocytometry are:

A
  1. Dilution of whole blood using a diluting fluid
  2. Charging/Transferring of the counting chamber with the diluted sample
    (Note: Discard a few drops of diluted sample prior to charging)
  3. Enumeration of blood cells under the microscope
  4. Calculation of total blood cells
84
Q

It is where the diluted sample is placed and it has its own coverslip.

A

Counting chamber

85
Q

It is the pipette used in diluting blood samples.

A

Thomapipette

86
Q

Materials involved in hemocytometry are:

A

Counting chamber w/coverslip
RBC and WBC pipette
Thomapipette
Diluting fluid

87
Q

It is the most commonly used counting chamber in the laboratory. It is a thick glass slide with two ruling areas divided by an H-shaped gutter with two platforms on the side that supports the coverslip.

A

Improved Neubauer Counting Chamber

88
Q

Distance between the coverslip and ruled area or counting chamber is ____.

A

depth = 0.1 mm

89
Q

1 ruled area contains how many squares?

A

9 large squares

90
Q

1 ruled area has an area of?

A

3mm x 3mm

91
Q

Each large square measures _____.

A

1mm x 1mm

92
Q

WBC count is measured using the ______ of 1 ruled area.

A

4 large squares in the corners

93
Q

Large squares in the corner (for WBC count) are further divided into how many small squares?

A

16 small squares multiply by 4 (large squares in the corner) equals 64.

64 total squares for WBC counting.

94
Q

The central square is used for the counting of ______ and _______.

A

RBC counting and platelet counting

95
Q

The central square is further divided into how many small squares?

A

25 small squares

96
Q

In the central square, how many squares are used for RBC and platelet counting?

A

5 squares only (1st, 5th, 13th, 21st, and 25th square)

97
Q

The 5 small squares are divided further into how many smaller squares?

A

16 smaller squares

98
Q

1 central square is divided into how many smaller squares?

A

400 smaller squares

99
Q

Another type of counting chamber is:

A

Fuchs-Rosenthal, Speirs-Levy

100
Q

Fuchs-Rosenthal’s depth between the coverslip and the counting chamber is?

A

0.2mm

101
Q

Fuchs-Rosenthal has how many ruled sections?

A

2 ruled sections

102
Q

How many big squares have Fuchs-Rosenthal counting chamber has in each ruled section?

A

16 big squares

103
Q

Each big square in the Fuchs-Rosenthal counting chamber is further divided into how many smaller squares?

A

16 smaller squares

104
Q

Speirs-Levy depth between the coverslip and the counting chamber is?

A

0.2mm

105
Q

Speirs-Levy has how many ruled sections?

A

4 ruled sections

106
Q

In the Speirs-Levy counting chamber, each section has an area of?

A

10mm x 10mm

107
Q

Each square in the Speirs-Levy counting chamber is further divided into how many smaller squares?

A

16 smaller squares

108
Q

Usually, the Speirs-Levy counting chamber is used for?

A

Eosinophil counting

109
Q

Place the coverslip first on the chamber before _____.

A

charging

110
Q

Rules in the counting of cells:

A
  1. Check the boundary lines first
  2. Only count the cells halfway in and out of the UPPER and LEFT boundary lines.
  3. Do not count cells which is halfway in and out in the lower and right boundary lines.
  4. Do not count dry cells, cells with an overcharge and undercharge counting chamber, cells artifacts
111
Q

If double-boundary line, the _______ is the boundary line.

A

outer line

112
Q

If triple-boundary line, the _______ is the boundary line.

A

middle line

113
Q

RBC pipette:

A

bore: narrow
length: shorter
color of bead: red
dilution range: 1:100 - 1:1000
outstanding remarks: 0.5, 1.0, 101.0
principal uses: RBC count, WBC count in leukemia (over 50,000 WBC/cu. mm)

114
Q

WBC pipette

A

bore: wide
length: longer
color of bead: white
dilution range: 1:10 - 1:100
outstanding remarks: 0.5, 1.0, 11.0
principal uses: WBC count, eosinophil count, cell count in CSF, and other body fluids

115
Q

Thickness of coverslip:

A

0.3mm, 0.4mm, 0.5mm

116
Q

Length of coverslip:

A

16x22mm, 22x23mm

117
Q

It lessens the concentration of blood samples to disperse the blood cells and facilitate its counting under the microscope.

A

Dilution fluid

118
Q

For RBC counting, the diluting fluid is ____.

A

isotonic solution

119
Q

For WBC counting, the diluting fluid is ____.

A

hypotonic solution

120
Q

For platelet counting, the diluting fluid must ____.

A

preserve the platelet integrity while inhibiting platelet aggregation

121
Q

Best RBC diluting fluid

A

Dacies fluid/Formol citrate

122
Q

Other RBC diluting fluid are:

A 
Hayem's diluting fluid
Gowers solution
Toissons fluid
Bethels fluid
NSS
3.8% sodium citrate
123
Q

It can prevent excessive rouleaux formation and autoagglutination

A

Normal Saline Solution

124
Q

WBC diluting fluids:

A

Glacial acetic acid
Turk’s diluting fluid
1% HCl

125
Q

This is used to see the general appearance of the counting chamber

A

Scanner

126
Q

______ is used for WBC counting

A

low power objectives

127
Q

______ is used for RBC and platelet counting

A

high power objectives

128
Q

False High Count:

A

Improper mixing
Uneven distribution of cell
Error in pipetting
Error in calculation
Blood is taken from the area of hemoconcentration
Yeast, dirt, and leukocyte were counted as RBC

129
Q

False Low Count:

A 
Blood diluted with tissue fluid
Undue delay in counting of cell
Clumping of the cell (AIHA)
Uneven distribution of cell
Faulty technique of counting
Improper standardized counting chamber

Hematology (1 decks)

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