SPX COLLECTION/PX PREP ANALYTES VARIATIONS

Question 1

Enumerate some physiologic factors affecting pre-collection variables
[7]

Answer 1

Diurnal variation
Exercise
Diet
Stress
Posture
Age
Gender

Question 2

hormones that are increased at AM

Answer 2

CAPPAII
cortisol
adrenocorticotropic hormone
plasma renin activity
aldosterone
insulin

prolactin
iron

Question 3

hormones where levels are low at night

Answer 3

Cortisol
ACTH
Plasma renin activity
ALDO
Insulin

Prolactin
Iron

Question 4

hormones where levels are INCREASED w/ stress

Answer 4

Cortisol
ACTH

Prolactin

Question 5

hormones where levels are INCREASED w/ standing than supine

Answer 5

Plasma renin activity

Question 6

hormones where levels are DECREASED w/ supine position than standing, and how many percent?

Answer 6

Calcium

4%

Question 7

Patient variables that may affect chemistry values [6]

Answer 7

Diurnal variation
Day-to-day variation
Recent food ingestion
Alcohol
Posture
Activity

Question 8

What are the analytes increased in diurnal variation at PM:

Answer 8

GA
Growth hormone
ACP

PTH
TSH

Question 9

[#]% Percentage effect of day-to-day variation to these analytes ___________

Answer 9

ABC ST
≥20%
ALT
Bilirubin
CK
Steroid hormones
TAGs

Question 10

what are the analytes increased in terms of recent food ingestion?

Answer 10

CGGIILTS [si guilty kumain ]
calcium
gastrin
glucose
insulin
iron
LD
TAGs
Sodium

Question 11

what are the analytes decreased in terms of recent food ingestion?

Answer 11

chloride
phosphate

K+ fasting required:
fasting glucose
lipid panel
TAGs

Question 12

what are the analytes increased in terms of alcohol intake?

Answer 12

TAGS
GGT

Question 13

what are the analytes decreased in terms of alcohol intake?

Answer 13

glucose

Question 14

what are the analytes increased in terms of posture?

Answer 14

CHOLE TIKDO [POSTURE] KWANAN ALBUMin
albumin
chole

when standing:
calcium
phosphate
plasma renin activity

Question 15

what are the analytes increased in terms of activity?

Answer 15

in ambulatory px:
CK

ACCPPPLL
with exercise px:
AST
Creatinine
CK
protein
Potassium
phosphate
Lactic acid
LDH

Question 16

what are the analytes increased in terms of stress?

Answer 16

ACTH
cortisol
catecholamines

Question 17

what are the analytes affected in terms of age, gender, race, drugs?

Answer 17

various

Question 18

Common interferences in Pre-collection variables
[1] in vivo
[4] in vitro

Answer 18

Tobacco smoking

Hemolysis
Hemoconcentration
Hemodilution
Icteric/Lipemic spx

Question 19

Rupture of RBCs so HB released from RBC

Answer 19

Hemolysis

Question 20

Serum appears yellow due to high bilirubin

Answer 20

ICTERIC

Question 21

Serum appears milky or turbid due to high lipid

Answer 21

Lipemic

Question 22

Order of draw via tubes

Answer 22

1. blood culture tubes [yellow]
2. coagulation sodium citrate tubes [blue]
3. serum tubes w/ or w/o clot activator or gel seperator [red/gold]
4. heparin tubes w/ or w/o gel [green]
5. EDTA [lavender]
6. Glycolytic inhibitor tubes [gray]

Question 23

Evacuated tube indicated for the ff:
Blood
Citrate
CBC
Glucose determination

Answer 23

SPS [yellow]

Blue/Light blue, Non-additive

EDTA [violet]

Sodium citrate [blue] or Potassium oxalate/Sodium Fluoride [gray]

Question 24

Evacuated tube indicated for the ff:
Chemistry
Immunochemistry
TDMs

Plasma chemistry

Some chemistries: Lactic acid, Glucose tolerance

Answer 24

Red/Gold
Red/Gold, Light green
Red

Green, Light green

Gray

Question 25

Gray tube is a?

Answer 25

Glycolytic inhibitor tube Sodium fluoride tube Potassium oxalate

Question 26

Difference of green and light green tube?

Answer 26

Light green has its gel for plasma separation, while the green one has no gel.

Question 27

Evacuated tube indicated for the ff: Coagulation Viral markers Hematology Transfusion services

Answer 27

Blue Red/Gold Lavender Pink

Question 28

Evacuated tube indicated for the ff: Flow cytometry Cytogenetics Trace elements Toxicology

Answer 28

Green Green, Lavender Royal Blue Royal Blue

Question 29

What are the clot-activator tubes?

Answer 29

Gold Royal Blue

Question 30

What are the spray-coated K2 EDTA tubes?

Answer 30

Lavender Pink

Question 31

Tube for STAT & Routine chemistry?

Answer 31

GREEN

Question 32

Prevents clotting by inhibiting thrombin and thromboplastin Prevents clotting by binding calcium

Answer 32

Green tube Lavender Pink Blue

Question 33

In gray-top tubes, Fluoride inhibits _______, and oxalate prevents _______ by precipitating ______.

Answer 33

glycolysis clotting calcium

Question 34

It is a clot activator promotes blood clotting with glass or silica particles. Gel separates serum from cells.

Answer 34

Red/Gold

Question 35

Analytes that require fasting? [7]

Answer 35

****FARGGILT**** [par di siya guilty] FBS ALDO/Renin Gastrin GTT Insulin Lipid panel TAG

Question 36

Analytes that require chilling? [7]

Answer 36

Ammonia Blood gas Lactic acid

Question 37

Analytes that are affected by light? [7]

Answer 37

Vit. A Vit. B6 Vit. B12 Bilirubin Carotene Folate Porphyrins Bili ako carots kaso late kana porphyrinse mo nalang

Question 38

Analytes that are affected by hemolysis? [7]

Answer 38

**CKLAMP** CK Catecholamines K+ LD AST ALT ALP Aldolase Ammmonia Magnesium Phosphate

Question 39

Inhibited in EDTA Inhibited in Oxalate Inhibited in Citrate

Answer 39

**CALI LAAA oxalate ayaw sayo-- ALL "AT"-**- CK ALP Leucine aminopeptidase **CALI LAAA oxalate ayaw sayo-- ALL "AT"-** LD ALP ACP Amylase **CALI LAAA oxalate ayaw sayo-- ALL "AT"-** ALP ALT AST

Question 40

Decreased in EDTA Decreased in Oxalate Decreased in Citrate

Answer 40

****IC ic ic ayaw-- decrease**** Iron Calcium Calcium Calcium Amylase

Question 41

Increased in EDTA Increased in Oxalate

Answer 41

PT PTT Sodium Potassium Sodium Potassium

Question 42

Prevented in EDTA Distorted in Oxalate/Fluoride Preserved in Citrate Stimulated in Citrate

Answer 42

Platelet aggregation Cell morphology Labile coagulation factors ACP

Question 43

Increased in heparin [5]

Answer 43

PT PTT Triiodothyronine Thyroxine Lithium Sodium

Question 44

Wright's stain in heparin

Answer 44

Blue background

Question 45

Decreased in Fluorides [5]

Answer 45

ALL "A" ALP ACP Amylase ALT AST CK

Question 46

Examples of Pre-analytical factors that may affect chemistry values

Answer 46

Use of Isopropyl alcohol wipes to disinfect veni site Squeezing site in capillary puncture Pumping fist Torniquet>1min IV fluid contamination Incorrect AC/draw contamination Hemolysis Light exposure Temp between collecting/testing Inadequate centri Recentri of primary tubes Delay in seperating serum/plasma Storage temp

Question 47

What happens when we use isopropyl alcohol that affect chemistry values

Answer 47

compromise blood alcohol determination that's why we use ethanol

Question 48

What happens when we squeeze the site in capillary puncture that affect chemistry values

Answer 48

increase K+

Question 49

What happens when we pump our fist that affects chemistry values

Answer 49

****NALaKLaKPHO**** increased K+, Ca, lactic acid, phosphorus decreased pH

Question 50

What happens when with prolonged tourniquet that affects chemistry values?

Answer 50

****NALaKLaKProtein**** Increase K+, total protein, lactic acid

Question 51

What happens when there is IV fluid contamination that affects chemistry values

Answer 51

**NaKCLGlue [Nak sali glue]** Increase K+, Na+, Cl-, glucose Possible dilution of other analyses

Question 52

What happens when there is incorrect AC/draw contamination that affects chemistry values

Answer 52

**NaLiK CaMagnum [Na leak ka may magnum]** Increase K+ [EDTA], Na+ [Na heparin], Lithium [Lithium heparin] Decrease Ca+, Mg [EDTA]

Question 53

What happens in terms of temperature between collecting and testing that affects chemistry values

Answer 53

chilling required for lactic acid, ammonia, blood gases

Question 54

What happens when there is an inadequate centrifugation that affects chemistry values

Answer 54

poor barrier in gel tubes causing INC in: K+, LD, AST, iron, phosphorus

Question 55

What happens when there is recentrifugation of primary tubes that affects chemistry values

Answer 55

INC hemolysis K+

Question 56

What happens when there is a delay in separating serum/plasma that affects chemistry values

Answer 56

INC: K+ Lactic acid LD Mg DEC: glucose [unless collected in fluoride]

Question 57

What happens with the storage temp that affects chemistry values

Answer 57

IN RT, INC: ammonia, lactic acid DEC: glucose [unless collected in fluoride] IN 4C: INC: ALP DEC: LD