P1 EXAM

Question 1

skin puncture/ demo puncture/ capillary puncture

Answer 1

limit milking for interstitial fluid not to mix up with blood

2-2.5 mm depth
<2 mm standard depth
warm 42°C for 2-5 mins (arterialize for bg)

Question 2

Tourniquet should be

Answer 2

3-4 inches above puncture site

1 min. in instances na way 1min choice 2 mins

Question 3

Standard needle gauge

Standard needle length

Answer 3

21

Question 4

Echymosis and Hematoma

Answer 4

Echymosis leakage of blood that does not swell hematoma swells

Question 5

Anticoagulant for Gray top tube

Answer 5

Potassium Oxalate
Sodium fluoride 8%

Additive:
2% sodium Fluoride

Question 6

Platelet clumping

Answer 6

in automatic analyzer platelet is read as wbc

cn be corrected through:

collect new sample using citrated tube and multiply result with 1.1

Question 7

When will we use Beacoms and Erlichs method

Answer 7

For bone marrow aspirate

recommended is erlich

Question 8

Whats the reason as to why there is hole in blood smear

Answer 8

physiologically: an increase amoung of lipid

or cause by dirty slides

Question 9

Romanowsky stains - stains that can either be basic or acidic

Answer 9

Giemsa stain

Wright stain

Question 10

Metheylene blue -basic dye

Answer 10

stain nucleus blue or purple

Question 11

pH of buffer used

Answer 11

6.2-6.8

Question 12

first cell produced in embryo

Answer 12

primitive erythroblast

Question 13

Embryonic hgb

Answer 13

Gower 1&2, Portland

Question 14

Spleen focus on

Answer 14

megakaryopoeisis and granulopoeisis

Question 15

transport of iron from enterocyte to circulation

Answer 15

ferroportin

Question 16

most sensitive marker for IDA

Answer 16

serum ferritin

Question 17

How many atoms of iron transferrin holds

Answer 17

2 atoms of iron

Question 18

TIBC principle

Answer 18

in IDA

Question 19

where does hgb synthesis happen

Answer 19

Mitochondria and cytoplasm

Question 20

Oxyhgb - red in aftery
Deoxyhgb - dark red veins
Carboxyhgb - (cherry red) carries carbon monoxide instead of O2
Methhemoglobin- oxidized hgb from ferrous to ferric - chocolate brown
Sulfhemoglobin- sulfur containing compounds attaching to hgb seen in cases of clostridium infection - mauve lavender

Answer 20

210x affinity of carbon monoxide more than oxygen

Question 21

Penthose phosphate pathway

NADPH production

Answer 21

Hexose monophosphate shunt

Question 22

Depth of Puncture for capillary

Answer 22

<2 mm - infant (standard)

2-2.5 mm - adult

Question 23

Warming the puncture site in 40-42°C and for 2-5 mins. would increase the blood flow by how many folds?

Answer 23

7 folds

Question 24

Sample of choice for BGA or blood gas analysis

Answer 24

Capillary puncture sample

Question 25

Puncture sites for capillary puncture in infants

Answer 25

Heel- median or lateral side of the plantar surface of the heel for ages 1-2 yrs old

Question 26

Puncture site for capillary puncture in adults

Answer 26

Palmar surface, distal portion of the 3rd or 4th finger of the non-dominant hand

Question 27

Angle of puncture for venipuncture

Answer 27

15-30' between skin and needle

Question 28

Standard needle length for venipuncture Standard needle gauge Where should tourniquet be tied

Answer 28

1-1.5 inches 21 3-4 inches or 7.5-10 cm above puncture site

Question 29

What analyte most affected due to prolonged application of tourniquet

Answer 29

Potassium

Question 30

Tourniquet should be left in the arm for

Answer 30

1 min if there's no 1 min, max should be ≤2 mins.

Question 31

Result of prolonged tourniquet application

Answer 31

Hemolysis, hemoconcentration, decrease clotting time | H,H, dCT

Question 32

The most commonly encountered, complication of venipuncture characterized by purplish discoloration, leakage of SMALL amount of blood around the puncture site

Answer 32

Ecchymosis - has no swelling

Question 33

A complication of venipuncture characterize by purplish discoloration, leakage of LARGE amount of blood that rapidly swells

Answer 33

Hematoma

Question 34

3 most common complications of venipuncture in order

Answer 34

Ecchymosis Syncope Hematoma

Question 35

Bacteria that are inhibited by SPS

Answer 35

Neisseria spp

Question 36

Anticoagulant to blood ration for Light blue top tube (sodium citrate tube) as well as its inversion times

Answer 36

1:9 / 3-4 times

Question 37

What's the color of the background when Romanowsky stained is used for heparinized sample Clue: pH of heparins is slightly alkaline

Answer 37

Bluish

Question 38

The additives used in gray top tube, sodium fluoride 2%, inhibit what electrolytes

Answer 38

directly inhibit magnesium | indirectly inhibiting enzyme enolase

Question 39

Samples used in Peripheral blood preparation

Answer 39

``` Anticoagulant- free blood (bedside) EDTA blood (made within 2hrs after collection) ```

Question 40

It is a result of complications in EDTA blood sample that causes adherence of platelets in the WBC (specifically for neutrophils) thus causing a decrease in platelet count (pseudothrombocytopenia)

Answer 40

Platelet satellitosis

Question 41

How to correct samples with platelet satellitosis

Answer 41

- Collect new blood sample using citrated tube

Question 42

It is a result of complications in EDTA blood sample that is a result of improperly mixing and daghan na blood ang naa

Answer 42

Platelet clumping - results to pseudoleukocytosis and pseudothrombocytopenia

Question 43

In cases of polycythemia vera or increased rbc angle of spreader slide should be _____________, in decreased rbc _________

Answer 43

increased: . < angle decreased: . > angle

Question 44

Method of coverslip technique in smear preparation that uses glass slide and cover slip

Answer 44

Beacom's method

Question 45

Method of coverslip technique in smear preparation that should be used for bone marrow aspirates Note: both coverslip is used

Answer 45

Ehrlich's method -enables excellent/even wbc distribution

Question 46

Example of Romanowsky stain which is acidic and colors cytoplasmic structures an orange-red color

Answer 46

Eosin

Question 47

Example of Romanowsky stain which is basic and colors the nucleus and some cytoplasmic structures a blur or purple color

Answer 47

Methylene blue

Question 48

Cell that carries CD-24 and gives rise to other type of cells

Answer 48

Pluripotent stem cell

Question 49

Chief site of hematopoiesis for mesoblastic stage

Answer 49

Yolk sac

Question 50

Myeloid to erythroid ratio

Answer 50

2:4:1

Question 51

Site of maximal absorption of iron

Answer 51

Duodenum (1-2 mg) -jejunum can also absorb iron

Question 52

Soluble storage form of iron while Insoluble storage form of iron

Answer 52

Ferritin ---- Hemosiderin

Question 53

Transport of iron to circulatory system vs Transport of iron from enterocyte to circulation

Answer 53

Transferrin ---------- Ferroportin

Question 54

Reference range of serum ferritin in men: ___________; in women ______''

Answer 54

15-200 ug/dL | 12-150 ug/dL

Question 55

1 gram of Hgb is equals to how many grams of oxygen 1 gram of Hgb is equals to how many grams of iron

Answer 55

1. 34 mL of oxygen | 3. 47 mg of iron

Question 56

Heme synthesis starts with what chemical component

Answer 56

succinyl CoA and glycine

Question 57

Reference method for hemoglobin determination

Answer 57

CYANMETHEMOGLOBIN

Question 58

Pronormoblast/ Rubriblast

Answer 58

 Size: 14-20 um (same size mature monocyte)  Nucleoli: present  Thin nuclear membrane  Homogenous basophilic cytoplasm (bluish)  Earliest recognizable erythroid precursor using light microscope  Length of time: more than 24 hrs.  Nucleus to cytoplasm ration: 8:1

Question 59

Basophilic normoblast / Prorubricyte

Answer 59

 Size: 12-17 um  Nucleoli: 0-1 (may or may not contain)  Cytoplasm appears more abundant than in pronormoblast  Coarser chromatin  Last stage with a nucleolus  Nucleus to cytoplasm ration: 6:1  Length of time: slightly more than 24 hrs.