LESSON 3: SPECIMEN HANDLING AND PROCESSING

Question 1

All steps taken before the actual testing
➢ Specimen handling, processing, and blood
collection are part of this phase. Patient
identification, preparation of materials.

Answer 1

Pre-analytical phase (Pre-examination)

Question 2

This is the actual testing phase. All procedures belonging to measurement methods belong to this phase

Answer 2

Analytical phase (Examination)

Question 3

Processes after the test performance such as
reporting of results, interpolation of results,
recording of results, relaying of results to
physician. Everything done after test
performance.

Answer 3

Post-analytical phase (Post-examination)

Question 4

Factors that alter test results that are introduced into the specimen before testing, including before and during collection, and during transport, processing, and storage.

Answer 4

Pre-analytical errors

Question 5

PRE-ANALYTICAL VARIABLES
○ Physiologic
○ Lifestyle (smoking, diet, exercise, alcohol intake)
○ Drug administration

Answer 5

Controllable

Question 6

PRE-ANALYTICAL VARIABLES
Non-controllable includes:

Answer 6

Biological Influences
Environmental factors
Long term cylindrical changes
Underlying Medical conditions

Question 7

high altitude could affect the

Answer 7

Oxygen level

Question 8

Heat expands the plasma volume and could cause significant decrease on

Answer 8

plasma protein

Question 9

Factors affecting the variation of results

Answer 9

Patient Preparation

Question 10

Affects skeletal muscle enzymes

Answer 10

Exercise

Question 11

If you exercised before collection, your
_____________ may be increased falsely

Answer 11

aldolase and creatine kinase

Question 12

Basal state collection means blood is collected

Answer 12

early in the morning before rising

Question 13

Glucose requires _______ hours of fasting

Answer 13

6 - 8 hrs

Question 14

lipid profile (triglyceride, total cholesterol, HDL, LDL) requires ______ fasting

Answer 14

10-12 hours maximum of 14.

Question 15

If both glucose and lipid profile is need, required fasting is __________

Answer 15

8-12 hrs

Question 16

serotonin-rich banana and tomato increases
production of

Answer 16

5-HIAA, a metabolite of serotonin

Question 17

Sudden position change could result to

Answer 17

Hemoconcentration and Hemodilution

Question 18

Also known as circadian rhythm

Answer 18

Physiologic Variation

Question 19

Highest in the morning

Answer 19

Potassium
Renin
Iron
Calcium
Insulin
Aldosterone

Question 20

Highest at night

Answer 20

Growth hormone
Testosterone
TSH
Prolactin

Question 21

Vigorous mixing may result in

Answer 21

Hemolysis

Question 22

How to transfer different type of specimen
■ Blood specimens

Answer 22

plastic bag with biohazard
logo, liquid tight closure, slip pocket for
paperwork

Question 23

How to transfer different type of specimen
■ Non-Blood specimens

Answer 23

Leak proof containers

Question 24

How to transfer different type of specimen
■ Pneumatic tube system

Answer 24

protected from shock,
sealed in zipper type plastic bag

Question 25

Blood samples are allowed to clot within

Answer 25

20-30 minutes

Question 26

Arrived within the laboratory within _____ minutes of collection

Answer 26

45 minutes

Question 27

Once arrived in the lab, separate serum to cell within _____of collection

Answer 27

1 hour, OSHA recommended maximum time is 2 hours.

Question 28

Temperatures related to specimen handling

Answer 28

○ Body temperature : 36.4°C - 37.6°C ○ Room temperature : 15°C - 30°C ○ Refrigerated temperature : 2°C - 10°C ○ Frozen temperature : -20°C or lower

Question 29

Examples of tests that require chilling of specimen

Answer 29

Gastrin Ammonia Lactic Acid Catecholamines Pyruvate PSH(Parathyroid Hormone)

Question 30

To chill specimens, you can use

Answer 30

Ice packs or crushed ice in water

Question 31

In case of needing freezing temperature, you can use

Answer 31

Solid CO2 and nitrogen gas

Question 32

anaerobic conditions, such as in

Answer 32

Blood gas analysis (BGA), Ionized/ non-ionized calcium

Question 33

Examples of tests that require transport of specimens at 37°C

Answer 33

Cold agglutinins Cryofibrinogen Cryoglubulins

Question 34

Tests that requiring protection from light

Answer 34

Billirubin All Vitamin Levels Beta carotene Porphyrins Folate

Question 35

Set centrifuge at

Answer 35

850 - 1000 gravitation force for 10 - 15 mins 1000 - 3000 RCF for 10 minutes

Question 36

Removal of stopper may result

Answer 36

Loss of CO2 and Increases pH

Question 37

Repeated centrifugation results to

Answer 37

Hemolysis and Analytes deterioration

Question 38

Complete clotting :

Answer 38

30-60 minutes at room temperature

Question 39

Clotting time of other tubes

Answer 39

SST and tubes with clot activators = 20 - 30 minutes ➢ Thrombin tubes = 5 minutes ➢ Anticoagulant medication = longer time to clot

Question 40

Incomplete clotting result to

Answer 40

Fibrin formation

Question 41

Reasons for rapid separation of blood (after centrifugation)

Answer 41

○ To prevent glycolysis ○ To prevent lipolysis ○ Certain substances are very unstable ○ To prevent shift of electrolytes ○ To prevent hemolysis

Question 42

The tests that require plasma specimens are the

Answer 42

Prothrombin time and activated partial thromboplastin time (uses citrate tube)

Question 43

Aliquot?

Answer 43

The portion of specimen that is used for testing

Question 44

When transferring, used

Answer 44

disposable transfer pipettes (Pasteur pipette)

Question 45

TRUE OR FALSE: ● Yellowish discoloration is not really a reason for rejection. It could be due to increased bilirubin levels due to a condition.

Answer 45

True

Question 46

TRUE OR FALSE: if serum is turbid / milky could be due to high triglyceride level. If the patient fasted properly, then serum is still accepted

Answer 46

True