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Module 5: Pre- Analytical Considerations Flashcards

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1
Q

refers to values which patient results are compared to.

A

Reference range

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2
Q

-this refers to the resting metabolic state of the body early in the morning after fasting for approximately 12 hours.

-ideal for establishing reference ranges on inpatients because the effects of diet, exercise, and other controllable factors on test results are minimized or eliminated.

A

Basal state

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3
Q

Comparing previous results of Px to present result (same Px)

A

Delta Check

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4
Q

Examples of blood components that differs in AGE

A

RBC and WBC
Kidney functions- creatinine clearance

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5
Q

RBC and WBC is normally higher among newborns than adults. True or False

A

True

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6
Q

Kidney Functions decrease with age. True or False

A

True

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7
Q

What is creatinine clearance?

A

Test creatinine in blood. It is expected that results be higher in older ppl. due to the fact that have decreased kidney functions.

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8
Q

How does Altitude affect some blood analytes

A

may cause variations of results in higher elevation compared to results in sea level.

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9
Q

What increases in higher altitudes?

A
  1. RBC count
    2.Hemoglobin and Hematocrit
    3.Uric Acid
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10
Q

Why does RBC and Hemoglobin increase in higher altitudes?

A

Due to the fact that in higher altitudes there is a decrease in O2, thus body produce more RBC to compensate with the reduce of O2 in body. As RBC increase Hemoglobin and Hematocrit also increases.

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11
Q

What decreases as altitude increases?

A
  1. Urinary Creatinine
  2. Plasma Renin
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12
Q

Analytes generally take ______(1)_____to adapt to high elevations/altitude; however, they adapt to return to sea level within ___(2)______.

A

Weeks; Days

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13
Q

What is the term for decrease of body fluids?

A

Dehydration

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14
Q

One way Dehydration can occur?

A

Persistent vomiting or diarrhea

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15
Q

What is Hemoconcentration?

A

Blood components cannot easily leave bloodstream, thus becoming concentrated in smaller plasma volume.

This can result to false increase of formed elements of blood

Mas dumadami ung blood components kasi nababawasan ung fluid

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16
Q

How does plasma volume decrease during dehydration?

A
  • water is lost since it is absorbed by the body- dilutional effect.
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17
Q

What analytes increase during dehydration
Clue: Richmond Can Eat Ice Cream Sticks

A
  1. RBC
  2. Calcium
  3. Enzyme
  4. Iron
  5. Coagulation factors
  6. Sodium
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18
Q

Dehydrated patients may accurately reflect the patient’s normal status. True or False

It is often easy to obtain blood specimens from dehydrated patients. True or False

A

BOTH FALSE

  • not accurately
    -difficult
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19
Q

What can happen to test results following ingestion of food?

A
  • alter results causing false negatives or false positives.
    -unsuitable for lab tests
    -vary depending of amount and type of food
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20
Q

What is fasting?

A
  • no ingestion of food appx. 8-12 hours. but water is allowed in minimal amounts.
    -done overnight- after last meal until morning before breakfast.
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21
Q

term used to say food and water cannot be ingested (by mouth)

A

nil per os- nothing by mouth

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22
Q

What is Overfasting?

A
  • exceeded 12 hours mark
  • cause serious health prob.s
    -electrolyte imbalance and heart rhythm disturbances
    -cannot be accepted
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23
Q

Refraining from drinking water while fasting can result in dehydration, which can negatively affect test results and also make blood collection more difficult.
True or false?

A

True

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24
Q

Elevated with high-protein diets
Clue: Ako Ung Umupo

A

Ammonia, urea, uric acid

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25
Ingestion of food/ bev. with caffeine Clue: Christine Angela
1.Cortisol 2. Adrenocorticotropic hormone
26
increase with ingestion of carbohydrates and sugar-laden subs.
Glucose
27
How long does Glucose go back to normal?
2 hours if glucose metabolism is normal
28
eating carbohydrate decrease insulin levels?
False.It increases like glucose
29
drinking too much water can…
decrease hemoglobin level and cause eletrolyte balance
30
Ingestion of butter, margarine, cheese, cream, and enteral (feeding tube) preparations
Lipid level increase
31
What does Lipid mean?
fat-soluble. they do not dissolve in water causing them to be suspended in plasma and serum
32
Specimens with Lipid can appear…
milky/ cloudy white or turbid - LIPEMIC
33
Why does triglyceride tests need a 12 hour fast?
Lipemia can be present for 12 hours. lipemic tests interferes with testing procedure
34
Chronic consumption or recent ingestion of large amounts of alcohol
-Triglycerides, liver enzymes, and liver function analytes increase -cause hypoglycemia
35
What increases in long-term starvation? Clue: CUK
- Creatinine -Ketone -Uric Acid
36
Decreased with long term startvation Clue: CUT
1. Cholesterol 2.Triglycerides 3.Urea
37
What is diurnal and circadian
Diurnal: Happening daily Circadian: 24hr cycle
38
factors that play role in DIURNAL VARIATIONS
1. Posture 2.Activity 3.Eating 4.Awake or Asleep 5. Daylight or Darkness
39
DIURNAL/ CIRCADIAN: example: Melatonin
increase at night, decrease during day
40
DIURNAL/ CIRCADIAN: Cortisol
Peaks at 8AM
41
DIURNAL/ CIRCADIAN: Renin and Thyroid-stimulating hormone
peaks at pre-dawn or morning during sleep
42
DIURNAL/ CIRCADIAN: Peaks in the morning? Clue: Angela Buys Ivy Roses In The Pot House
Aldosterone, Bilirubin, Insulin, RBC ,Iron, testosterone,Potassium,Hemoglobin
43
DIURNAL/ CIRCADIAN: Lowest in the morning? Clue: Go Get Everyone to Create Pot
Glucose, Growth Hormones, Eosinophils, Triglycerides, Creatinine, Phosphates
44
Drugs can also interfere with the actual test procedure, causing false increases or decreases in test results. 1. A drug may compete with the test reagents for the substance being tested, causing a falsely low or false-negative result. 2. The drug may enhance reaction, causing a falsely high or false-positive result.
TRUE
45
Chemotheraphy Drugs
WBC and platelets decrease
46
Most drugs that are toxic to liver ?
Increase: AST- Aspartate Aminotransferase Test ALP- Alkaline Phosphatase LDH- Lactate Dehydrogenase Decrease: Clotting factors
47
Oral Contraceptives? What increases and decreases?
Increase: Erythrocyte sedimentation rate Decrease: vitamin B12
48
Steroids and diuretics
Increase: Amylase and Lipase
49
Thiazide diuretics
Increase: Calcium and glucose Decrease: Sodium and potassium
50
How many hours should drugs that interfere with BLOOD TESTS be stopped?
4-24 hours prior
51
How many hours should drugs that interfere with URINE TESTS should be stopped?
48-72 hours
52
Increased due to moderate muscular activity
1. Glucose 2.Creatinine 3. Insulin 4.Lactic Acid 5.Total protein
53
Released from cells, increasing levels in plasma. -Goes back to normal after several minutes of rest
Potassium
54
Remain elevated for 24 hours or more after exercise
Creatinine Kinase and lactate dehydrogenase
55
Elevated up to 1 hour after exercise.
Cholesterol
56
Decreased due to exercise:
Arterial pH, Carbon dioxide, Platelets- falsely decrease due to platelet clumping (running/ vigorous activity)
57
Hormones affected by fever?
1. Cortisol 2. fever induced - hypoglycemia: increase insulin 3. increased glucagon
58
At what stage does most differences in no. of blood component based on gender are apparent only.
Sexual Maturity
59
Which has higher RBC, hemoglobin, and hematocrit levels?
-males have greater amounts than females
60
What increases with intramuscular injection?
- Creatinine Kinase and skeletal muscle. fraction of LDH
61
it is recommended that CK and LDH levels be drawn before intramuscular injection or at least 1 hour after injection. True or False
True
62
Breakdown of RBC —— increase bilirubin ——yellow pigment. What is this called?
Jaundice
63
Other term for jaundice and how to describe sample?
Icterus- icteric sample (yellow-brown color)
64
Effects of Jaundice?
1. interfere with blood chemistry tests based on color reactions. .Interfere with reagent— strip analyses on urine
65
What causes blood fluids to filter into tissues, thus decreasing plasma volume in adult up to 10%. Blood concentration of components that are protein i nature or bound to protein increases
Position: From supine to upright sitting or standing postion
66
Examples of protein-bound components and components that are protein in nature that may increase:
1. Aldosterone - Recumbent for 30 min to avoid false increase 2. Calcium 3.Iron 4. Cholesterol and HDL (15% variation)
67
Standing Position
15 min: RBC increase 30 min: Potassium ion levels increase Reason: release of intracellular potassium from muscle
68
Effects of increased body fluids in pregnant woman?
can have diluting effect on RBC, leading to to lower RBC count
69
Increase levels to patients who smoked prior to specimen collection
1. Cholesterol 2 Cortisol 3. Glucose 4. Growth Hormone 5. Triglycerides 6. WBC count
70
Chronic smoking increases?
1. RBC count 2. Hemoglobin levels
71
Generally, smoking can…
1. Decrease immunoglobulins IgA, IgG, IgM 2. Increase immunoglobulins IgE
72
Skin-puncture specimens is easy to obtain from smokers because of impaired circulation in the fingertips.
false. it is difficult
73
Effects of stress:
Increase WBC due to emotional stress such as anxiety, fear, trauma
74
When is blood collected in a crying infant?
after resting / sleeping for 30 mins. -note that px was crying if px is crying
75
Stress increases and decreases…
Increases: ACTH Catecholamines Cortisol Decreases: Iron
76
Acute heat causes what?
Interstitial fluid move in blood vessels, increasing plasma volume
77
Extensive sweeting increases w/o fluid replacement
cause hemoconcentration
78
Insulin increases with ingestion of?
Carbohydrates
79
High lipid levels in blood?
Lipemia
80
Alcohol can also cause?
Hypoglycemia (low blood pressure)
81
A change of several time zones can affect diurnal rhythm and the tests associated with it. Several days may be required to restore a normal rhythm.
True
82
Opiates such as morphine increases?
levels of liver and pancreatic enzymes.
83
increase of nitrogenous wastes in blood such as urea is called?
azotemia
84
What hormones are affected with stress in children
aldosterone and TSH, and GH

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