Specimen Consideration Flashcards

1
Q
  • Contain a vacuum
  • Used with vacutainer and Syringe Systems
  • Stoppers universal color coded: indicates
    contents
  • Have an expiration date
A

BLOOD COLLECTION TUBES

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2
Q

TOP TUBES THAT HAVE NO ANTI-COAGULANT

A

Red-top tube, Gold or Mottled-red-gray top tube

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3
Q
  • (Most common use in clinical chemistry)
  • 5x invertions
A

Red-top tube

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4
Q
  • In vitro clotting due to GLASS
  • No additive
  • Glass surface activates clotting sequence
  • Do not mix
  • SERUM: use for TDM (Therapeutic Drug
    Monitoring)
A

. Red-top tube: GLASS

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5
Q
  • Contain additive to activate clotting
    sequence
  • contain inert gel → SST (Serum Separator
    Tube)
  • Do invert to mix additive and initiative
    clotting sequence
  • SERUM
A

Red-top tube: PLASTIC

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6
Q
  • Contain clot activator and gel (SST)
  • Invert to mix and initiate clotting sequence
  • Serum
  • 5 x inversion
    -Not cos-effective
    -5-15 mins clotting
    -chem, sero, and immuno test
A

Gold or Mottled-red-gray top tube

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7
Q
  • Trace metal-free
  • Iron, copper, zinc
A

Royal blue-top tube

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8
Q

Label color indicates contents:
- Red:
- Purple:
- Green:

A
  • Red: no additive = serum
  • Purple: EDTA = whole blood or plasma
  • Green: heparin = whole blood or plasma
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9
Q
  • Anticoagulant = sodium citrate
  • Binds calcium
  • Must be full
    Blood: anticoagulant ratio critical
  • Must be on ice if not analyzed within 30 minutes
  • Coagulation studies
  • Common test examples are: PT, Platelets, aPPT
A

Blue-top tube

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10
Q

important ion for coagulation,
necessary for clotting. Factor IV ionic Ca2+

A

CALCIUM

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11
Q

Anticoagulant = heparin
* Inhibits thrombin formation
* Must be full and on ice if need pH, ionized Ca
* Most chemistry tests, STAT lab (PST)
* Decreases time needed for blood to clot, makes
turnaround time better

A

Green-top tube:

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12
Q

– natural anticoagulant inside the body
(in vivo)

A

Heparan

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13
Q

Three formulations of Heparin

A

Lithium heparin,
Ammonium heparin, Sodium heparin

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14
Q

ionized Ca

A

Green-top tube

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15
Q

Commonly used for viral toxicology and stat
tests
- Arterial blood gas (ABG), Osmotic fragility
test (OFT), Ammonia

A

Green-top tube

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16
Q
  • Anticoagulant = EDTA
    (Ethylenediaminetetraacetic acid)
  • Binds calcium
  • Chelates calcium
  • Hematology studies: CBC
A

Purple-top tube (Lavender)

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17
Q

spray-dried: plastic tube; will not
dilute the sample

A

K2 – Versene

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18
Q

liquid form: glass tubes; dilutes the sample 1-2%

A

K3 – Sequestrene

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19
Q

Grey-top tube:
* Anticoagulant = ?
- Binds calcium
- PLASMA, Whole blood

A

potassium oxalate

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20
Q

Grey-top tube:
* Antiglycolytic agent = ?
- Maintains plasma glucose levels
- Prevent glycolysis

A

sodium fluoride

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21
Q

Limited use: glucose, lactic acid

A

Grey-top tube

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22
Q

Prevents glycolysis because it fluoride forms and
ionic complex with magnesium thereby inhibiting
the Mg++ dependent enzyme,

A

ENOLASE

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23
Q
  • Light blue top tube with 2 yellow bands on the
    label
  • Contains soya bean thrombin which causes the
    blood to clot immediately
A

. Fibrin-split Products

24
Q

Yellow-top tube:
* ACD = ?
- Paternity testing
- DNA

A

acid citrate dextrose

25
Q

Yellow-top tube:
* SPS =?
- Used for special blood culture studies
- Inhibits certain antibiotics

A

sodium polyanethol sulfonate

26
Q
  • Both bind calcium
  • PLASMA, whole blood
A

Yellow-top tube:
* ACD = acid citrate dextrose
* SPS = sodium polyanethol sulfonate

27
Q

means against or preventing

A

Anti

28
Q

– Pertaining to coagulation or act of
clottin

A

Coagulant

29
Q

main purpose of anticoagulants

A

To prevent the clotting process by interfering in the
coagulation cascade;
And to preserve certain analytes and cell
morphology prior to testing

30
Q

Ethylenediamine Tetra-acetic acid
o Optimal concentration in the blood:

A

1.5mg/ml of blood

31
Q

EDTA tube Mode of Action:
Removes ionized calcium (Ca2+) through process
referred to as

A

CHELATION

32
Q

Anticoagulant of choice for Hematology because:
- Preserves cellular morphology
- Excellent for cell counting
- Blood is stable for 2-3 hours before
smearing
- Prevents platelet aggregation

A

Ethylenediamine Tetra-acetic acid

33
Q

EDTA tube disadvantage:

A

causes cell shrinkage in excess

34
Q

used in blood banking for blood
typing; Rh typing and antibody screening: K2EDTA

A

PINK-TOP

35
Q

: EDTA + gel
- Used more often for molecular diagnostic
testing

A

WHITE-TOP

36
Q

Mode of action
- Precipitates calcium
Anticoagulant of choice for COAGULATION
STUDIES:
Preserves the labile factors V and VIII better

A

CITRATE

37
Q

CITRATE Two forms:

A
  • BLUE TOP
  • BLACK-TOP
38
Q

:0.105M or 3.2%
: most commonly
used
Anticoagulant to blood – 1:9
Blood to anticoagulant – 9:1

A

BLUE-TOP SODIUM CITRATE TUBE

39
Q

: 0.129M or 3.8%
Blood to anticoagulant ration – 4:1
For Erythrocyte Sedimentation Rate using
Westergren Method

A

BLACK-TOP CITRATE TUBE

40
Q

HEPARIN
o Optimal concentration:

A

15-20U/mL of blood

41
Q

Mode of action: accelerating the action of
antithrombin III, neutralizing thrombin and
preventing the formation of fibrin

A

HEPARIN

42
Q

Isolated from liver cells and is known to be the
naturally occurring anticoagulant.

A

HEPARIN

43
Q

HEPARIN two forms

A

Lithium heparin:
Sodium Heparin:

44
Q
  • may be used for most chemistry tests except
    lithium and folate levels
  • For Lithium testing: Royal blue: Sodium
    heparin can be used instead
    -has light green top
A

Lithium heparin:

45
Q
  • Is the injectable form used for anticoagulant
    therapy;
  • Recommended for trace elements; lead and
    toxicology
A

SODIUM HEPARIN

46
Q

o Concentration: 0.2mg/mL of blood
o Anticoagulant of choice for:
- Blood Gas Analysis (0.05 ml per ml of blood)
- Osmotic Fragility Test
- Trace elements and toxicology
o DOES NOT affect levels of calcium
o Preferred for potassium measurement
o Gives a BLUE background with Wright’s stain
after 2 hours

A

HEPARIN GREEN TOP TUBE

47
Q

FLUORIDE
o Gray top tube contains preservative or
antiglycolytic agents such as:

A
  • Sodium fluoride: (Preserves glucose for 3
    days)
  • Lithium Iodoacetate : (Preserves glucose
    for 24 hours)
48
Q

Mode of action: forms weakly dissociated
calcium components

A

FLUORIDE

49
Q

o Mode of action: combines with calcium to form
an insoluble salt/comple

A

OXALATE

50
Q

Three forms OF OXALATE

A
  1. Potassium oxalate
  2. Ammonium oxalate
  3. Double oxalate
51
Q

o Disadvantage:
- Distorts ?
- Potassium Oxalate: ?
- Ammonium Oxalate: ?

A

o Disadvantage:
- Distorts cell morphology
- Potassium Oxalate: shrinks RBCs
- Ammonium Oxalate: swells RBCs

52
Q

Generally called the SSTs (Serum separator
tubes) because they contain clot activator
+ separator gel)

A

Red/Gray and Gold tops

53
Q

Mostly used for chemistry tests except for
TDM, blood bank and immunologic
reactions

A

Red/Gray and Gold tops

54
Q

gel separator present in tubes

A

THIXOTROPIC

55
Q

Clotting time:
- With gel separators: ?
- With clot activator: ?
- Plain tubes: ?

A
  • With gel separators: 30 minutes
  • With clot activator: 5 minutes
  • Plain tubes: 60 minutes
56
Q

is a cofactor for other factors to complete the coagulation process

A

CALCIUM

57
Q
  • Dependent upon
    -Test
    • Amount of sample needed to perform test
    • Multiple labs needing the same specimen at the
      same time
A

TYPE AND AMOUNT OF SPECIMEN