Unit 11 Flashcards
(102 cards)
1
Q
Liquid connective tissue that circulates inside blood vessels
A
blood
2
Q
Formed elements and fluid components in the blood
A
Formed elements
- Erythrocytes
- Leukocytes
- Platelets
Fluid component
- Plasma
3
Q
Blood cells have a short life span and are continuously replaced by _____________.
A
hematopoiesis
4
Q
Average volume of blood
A
4-5 L
5
Q
Functions of blood
A
- Transports nutrients, waste products, hormones, protein, ions, oxygen, CO2 and formed elements
- Regulate body temperature
- Protection – immune defense
- Prevents blood loss
6
Q
Identify the protein:
Immunology and Serology
A
antibodies and the antigen
7
Q
Identify the protein:
Blood Banking
A
surface glycoproteins (on RBCs for example)
8
Q
Identify the protein:
Clinical Chemistry
A
enzymes which are proteinous intracellular biocatalysts
9
Q
Identify the protein:
Endocrinology
A
polypeptide and the glycoprotein hormones
10
Q
Coagulation Factor I
A
Fresh Plasma: ✔
Fresh Serum: ✖
11
Q
Coagulation Factor II
A
Fresh Plasma: ✔
Fresh Serum: ✖
12
Q
Coagulation Factor V
A
Fresh Plasma: ✔
Fresh Serum: ✖
13
Q
Coagulation Factor VIII
A
Fresh Plasma: ✓
Fresh Serum: ✖
13
Q
Coagulation Factor VII
A
Fresh Plasma: ✔
Fresh Serum: ✔
14
Q
Coagulation Factor IX
A
Fresh Plasma: ✔
Fresh Serum: ✔
15
Q
Coagulation Factor X
A
Fresh Plasma: ✔
Fresh Serum: ✔
16
Q
Coagulation Factor XI
A
Fresh Plasma: ✔
Fresh Serum: ✔
17
Q
Coagulation Factor XII
A
Fresh Plasma: ✔
Fresh Serum: ✔
18
Q
Coagulation Factor XIII
A
Fresh Plasma: ✔
Fresh Serum: ✖
19
Q
The clear liquid that can be separated from clotted blood without an anticoagulant
A
Serum
20
Q
Serum contains about ___% water with dissolved proteins, minerals, hormones and carbon dioxide and is an important source of electrolytes.
A
90
21
Q
In the blood, the serum is the component that is neither a blood cell nor a clotting factor; it is the blood ___________ with the fibrinogens removed
A
plasma
22
Q
protein from which fibrin is produced by the action of the enzyme thrombin
A
fibrinogen
23
Q
T/F:
Serum does not contain white or red blood cells.
A
True
24
Most common chemistry specimen
Serum
25
___% of the clinical chemistry department requires serum sample
90
26
study of serum
Serology
27
Blood that has been removed from the body will coagulate or clot within ____ to ____ minutes.
30-60
28
Serum can be separated from the clot by ______________.
centrifugation
29
Describe the appearance:
normal fasting serum
Clear, pale-yellow fluid
30
Very yellow-colored serum can be observed among what type of patients?
patients with leptospirosis and bilirubin and liver problems
31
remaining fat that encloses or traps the serum
Chyle
32
What should be done to the film that encloses or traps the serum?
A wooden stick can be used to pop or wring the film and aspirate the serum sample.
33
Why are some coagulation tests not performed on serum?
because some of the coagulation factors (e.g., fibrinogen) are used up in the process of clot formation
34
Why are some chemistry tests, such as ammonia and potassium, not performed on serum?
because clotting releases these substances from the cells
35
Test tube for serum sample
plain tube without an anticoagulant
36
Preparation of serum:
Allow the blood to clot by leaving it undisturbed at (what temperature?) which usually takes ___-___ minutes, but not longer than __ hour(s) before centrifugation.
room temperature (22°C–25°C)
15-30
1
37
Preparation of serum:
The sample is centrifuged for ___ minutes at _____-_____ rpm.
15
2000-2500
38
Liquid portion of an unclotted blood with an anticoagulant
Plasma
39
T/F:
Plasma does not contain fibrinogen, while serum does.
False;
plasma - has fibrinogen
serum - no fibrinogen
40
Describe the appearance:
Normal fasting plasma
clear to slightly hazy pale-yellow
41
T/F:
Some red blood cells remain in the plasma.
True
42
Plasma composition
91.5% - water
7% - plasma proteins (55% - albumin, 38% - globulin, 7% - fibrinogen)
1.5% - other substances (nutrients, water, electrolytes, nitrogenous wastes, respiratory gases)
43
Preparation of plasma:
The blood is mixed with an appropriate amount of anticoagulant.
This preparation should be mixed immediately and thoroughly to avoid _______.
clotting
44
Preparation of plasma:
The sample is centrifuged for ___ minutes at _____-_____ rpm.
15
2000-2500
45
Blood that is in the same form as it is in the bloodstream
Whole blood
46
T/F:
Some tests cannot be performed on serum or plasma, including most hematology tests and some chemistry tests such as glycohemoglobin.
These tests must be performed on whole blood, which means that the blood specimen must not be allowed to clot or separate.
True
47
To obtain a whole-blood specimen, it is necessary to add an _____________.
anticoagulant
48
blood cells that are terminally differentiated structures lacking nuclei and completely filled with the oxygen-carrying protein hemoglobin
Erythrocytes (RBCs)
49
blood cells that leave the blood and migrate to the tissues where they become functional and perform various activities related to immunity
Leukocytes (WBCs)
50
Two major groups of WBCs
Granulocytes - neutrophil, eosinophil, basophil
Agranulocytes - lymphocyte, monocyte
51
5 types of WBCs
neutrophil
lymphocyte
monocyte
eosinophil
basophil
52
Neutrophil/ Polymorphonuclear neutrophil
Granulocyte or Agranulocyte:
Number of Lobes:
Specific Granules:
Differential count:
Function:
- Granulocyte
- 3-4 lobes
- Faint/ light pink granules
- 50-70
- kill and phagocytize bacteria (pus/ nana)
53
Lymphocyte
Granulocyte or Agranulocyte:
Shape:
Differential count:
Function:
Agranulocyte
Rather spherical
20-40
Effector and regulatory cells for adaptive immunity
54
Identify the type of WBC:
Important for viral infections and is strongly associated to cancers and tumors
Lymphocyte
55
Monocyte
Granulocyte or Agranulocyte:
Shape:
Differential count:
Function:
Agranulocyte
Indented or C-shaped
Differential count: 2-8
Function: Precursors of macrophages and other mononuclear phagocytic cells
56
Identify the type of WBC:
- Equal to macrophage with slight difference
- Found in peripheral blood
Monocyte
57
monocyte seen outside the blood normally in tissues and organs
macrophage
58
Eosinophil
Granulocyte or Agranulocyte:
Number of Lobes:
Specific Granules:
Differential count:
Function:
Granulocyte
Bilobed
Red or dark pink
1-4
Kill helminthic and other parasites, modulate local inflammation, for allergic reactions
59
Basophil
Granulocyte or Agranulocyte:
Number of Lobes:
Specific Granules:
Differential count:
Function:
Granulocyte
Bilobed or S-shaped
Dark blue/ purple
0.5-1
Modulate inflammation, release histamine during allergy, for hypersensitivity reaction
60
the smallest of the formed elements
Thrombocytes (platelets)
61
T/F:
Platelets are essential to coagulation (the blood-clotting process) and are the first cell on the scene when an injury occurs.
True
61
T/F:
Platelets are essential to coagulation (the blood-clotting process) and are the first cell on the scene when an injury occurs.
True
62
Enumerate the common tests that require serum.
Aspartate aminotransferase (AST, GOT, SGOT)
Bilirubin, total and direct
Calcitonin
Calcium, ionized (iCa2)
Carotene, beta (B-carotene)
Cholesterol and HDL ratio (Chol HDL)
Cortisol, timed
Creatinine
Lactate dehydrogenase (LD)
Urea nitrogen (BUN)
63
Enumerate the common tests that require plasma.
Ammonia (NH3)
Antithrombin III activity
Basic metabolic panel (BMP)
Electrolytes (preferred; can also be tested in serum)
Fibrinogen
Glucose, fasting (FBS)
Glucose tolerance (GTT)
Lactic acid (blood lactate) (Lact)
Partial thromboplastin time (Activated PTT) (PTT/ APTT)
Prothrombin time (PT)
63
Enumerate the common tests that require whole blood.
Antibody screen
Blood culture (BC)
Blood group & Rh type (ABO & Rh)
Carbon monoxide (carboxyhemoglobin) (CO level)
Complete blood count (CBC)
Differential (Diff)
Erythrocyte sedimentation rate (ESR)
Hematocrit (Hct)
Hemoglobin (Hgb)
Platelet count (Plt. ct)
64
a machine that spins blood and other specimens at a high number of revolutions per minute (rpm).
Centrifuge
65
In the centrifuge, what causes the cells and plasma or serum in blood specimens to separate?
the centrifugal force
66
T/F:
Specimens for tests that require serum must be centrifuged, while plasma samples do not require centrifugation.
False;
serum and plasma must be centrifuged.
67
Dos for tubes awaiting centrifugation
Stoppers should remain on tubes.
- to prevent loss of CO2 and increase of pH
- to prevent exposure to contamination, evaporation, aerosol formation
68
Dos for centrifuge operation
- Tubes must be balanced.
- The lid to the centrifuge should remain closed during operation and should not be opened until the rotor has come to a complete stop.
- A specimen should never be centrifuged more than once.
69
Why should you not centrifuge the specimen more than once?
Repeated centrifugation can cause hemolysis and analyte deterioration and alter test results.
70
T/F:
Specimens for tests performed on serum must be centrifuged immediately before they clot.
False;
Specimens for tests performed on serum must be completely clotted before they are centrifuged.
- If clotting is not complete when a specimen is centrifuged, latent fibrin formation may clot the serum and interfere with the performance of the test.
71
Complete clotting normally takes ___-___ minutes at what temperature?
30-60
room temperature (22°C–25°C)
72
Proper procedure for stopper removal
The tube stopper should be removed by pulling it straight up and off the tube, and not “popped” off using a thumb roll technique.
73
a portion of a specimen used for testing
aliquot
74
Aliquots are prepared by transferring a portion of the specimen into one or more tubes labeled with the same ID information as the specimen tube using what equipment?
disposable transfer pipettes
75
T/F:
Each aliquot tube should be covered or capped as soon as it is filled. Some tests require the specimen to be refrigerated or frozen for analyte stability, especially if testing is to be delayed.
Both True
76
T/F:
Serum or plasma should be poured into aliquot tubes carefully.
False;
Pouring the serum or plasma into aliquot tubes is not recommended because it increases the possibility of aerosol formation or splashing.
77
the arrest or stoppage of bleeding, the body response that stops the loss of blood after injury without affecting the flow of blood within the rest of the vascular system
Hemostasis
78
bleeding from a damaged vessel; opposite of hemostasis
Hemorrhage
79
results when RBCs are damaged or destroyed and the hemoglobin they contain escapes into the fluid portion of the specimen
Hemolysis
80
A sample may be hemolyzed due to?
traumatic extraction
prolonged application of tourniquet
having a fragile vein
improper transfer of sample
delayed processing of sample
81
T/F:
Clotted blood – can undergo hemolysis
Unclotted blood – more prone to hemolysis
FF;
Clotted blood – more prone to hemolysis
Unclotted blood – can also undergo hemolysis
82
Common Blood Bank and Immunohematology Tests
● Antibody (Ab) screen
● Direct antihuman globulin test (DAT)
● Type and Rh
● Type and crossmatch
● Compatibility testing
83
Determines blood group and serves as a general screen for antibodies of recipient’s blood
Type and cross-match
84
What test is done to check the compatibility of the donor and recipient for blood transfusion?
Type and cross-match
85
Why is the transfusion of incompatible blood fatal ?
because it can cause agglutination (clumping) and lysis (rupturing) of the RBCs within the patient’s circulatory system.
- hemolytic reactions
86
Whole Blood: should be used within ____-____ hours
24-48
87
Bags used in the blood bank
Major Bag
Satellite Bag (can be 2) – where plasma is separated
88
Blood Bag Colors
Type O – white
Type A – blue
Type B - yellow
89
Blood bank procedure: blood cross-matching
Major cross-match
Minor cross-match
90
Serology Procedure: which is recommended, plasma or serum?
Serum: recommended
- not significantly affected when stored
- Proteins are not precipitated
Plasma: not recommended
-
91
Sample Interference:
intensely yellow serum sample due to elevated bilirubin value
Icteresia (Icteric Serum)
92
Patient Complication:
yellow appearance of the patient
Jaundice
93
Patient Complication:
Jaundice in a patient is caused by a bilirubin level of greater than ____________
430 µM (25 mg/L)
94
Patient Complication:
Jaundice in a patient may indicate liver inflammation caused by what disease or virus?
hepatitis B or C virus
95
Sample interference that results in leakage of intracellular substances
Hemolysis or Hemolyzed Sample
96
Sample Interference:
In vitro hemolysis is more common which may be due to?
Use of vacuum tubes
Vigorous mixing
Effect of alcohol
Centrifugation and separation steps
97
Sample Interference:
obtained normally after a meal due to elevated chylomicrons
Lactescence (Lipemic Serum)
98
Sample Interference:
Characterized by milky or highly turbid serum
Lactescence (Lipemic Serum)
99
T/F:
In clinical chemistry (rarely), there are tests, where instead of serum, plasma is requested.
True
Ex.
Calcium – should be measured in plasma
Calcium is also present in serum but is consumed when blood is clotted.
