UNIT 8 Flashcards
1
Q
Determines the
blood type and Rh
factor
Detectable time: NONE
A
Blood bank: Blood
type and screen
2
Q
Checks the
compatibility
between the donor’s
and the recipient’s
blood
Detectable time: Patient’s serum or
plasma and
donor’s
RBCs
A
Blood bank:
Cross-match test
3
Q
Determines the
presence of
infection, identifies
the type of organism
involved, and
measures the extent
of infection.
ADULTS= 20 to 30
mL per culture
with a minimum of
10 mL per draw
for patients
weighing more
than 80 pounds.
INFANTS= only 1%
to 4% of the total
blood volume.
A
Blood culture
4
Q
Evaluates the blood
clotting function
Microclots are
avoided by gently
inverting
anticoagulants
tubes three or four
times after
collection.
A
Coagulation test
5
Q
Screens for diabetes
and other metabolic
disorders
Must be obtained
2 hours after meal
A
2-hour Postprandial
Glucose
6
Q
Diagnoses problems
in carbohydrate
metabolism an and
checks the ability to
metabolize glucose
through the tolerance
level
1 hour for
gestational
diabetes and
3 hours for other
glucose
metabolism
evaluation
A
Glucose Tolerance
Test
(GTT) and Oral
Glucose
Tolerance Test
(OGTT)
7
Q
Determines the lack
of mucosal lactase
which is responsible
for conversion of
lactose into glucose
Same procedure
as 2-hour GTT but
an equal amount
of lactose is
substituted for
glucose
A
Lactose Tolerance
Test
8
Q
Verifies the
probability that the
patient fathered a
particular
child
Follows the
chain-of-custody
protocol and
specific
identification
procedures
A
Paternity/Parentage
Testing
9
Q
Tests the drug levels
at specific intervals
to establish proper
drug dosage and
avoid toxicity.
A
Therapeutic Drug
Monitoring
10
Q
Treats polycythemia (increase in RBC
count)
and
hemochromatosis (Disease of iron metabolism that is
characterized by excess deposition of
iron in the tissues.)
Involves
withdrawal of
approximately
500 mL as part of
the treatment
A
Therapeutic
Phlebotomy
11
Q
Checks the presence
of toxins in the blood,
hair, urine, and other
substances
in very small
amounts
A
Toxicology test
12
Q
Checks the presence
of aluminum,
arsenic, copper,
lead, iron, and zinc
Measured in small
amounts
A
Trace Elements
13
Q
2 Laboratory categories in a Hospital Setting:
A
Clinical Pathology Lab - Sections are
hematology, clinical chem, bacteriology, blood
bank
Anatomic pathology
14
Q
● blood collection from donors, processing of
samples, donors selection, preparation of blood
components
● Place where blood is collected and stored before it is
used for transfusions
● Perform tests to ensure that blood from donors and
other blood products are safe before blood transfusion
A
BLOOD BANK
15
Q
Errors in blood bank
○ Should not receive sent samples: Laboratory
should be the one to collect the samples
○ Labeling the tubes with patients initials
A
TRUE
16
Q
The following information must be included:
A
Full name with Middle Initial
Hospital Number
Social Security for outpatients
Room Number for inpatients
Date of birth
Date and time of collection
Initials of Phlebotomist
17
Q
Blood donors should be 17 to 66 years of age, with a
minimum weight of 110 Lbs.
○ Must have completed the physical exam and
declared their medical history.
○ Medical history is recorded, and a brief
examination is conducted prior to the collection.
○ All donor data are confidential and a written
permission must be submitted by the donor for
documentation purposes since all blood
components of a unit must be traceable as part
of the look-back program.
A
TRUE
18
Q
Cases when there is an autologous donation in which the
patients donate blood for their own use especially for
elective surgeries.
○ This eliminates risks associated with blood
transfusion.
○ After securing a written permission from the
physician, blood can be collected within a
minimum of 72 hours from the surgery
schedule.
A
TRUE
19
Q
Testing of donor cells with patient/recipient’s serum to detect
antibodies in the patient
REMEMBER “PSDR” - Patients
Serum is Matched to the Donors Red
Cell
A
MAJOR CROSS-MATCH
20
Q
contain
antibodies
A
PATIENT SERUM
21
Q
contain
antigen
A
DONOR’S RED CELL
22
Q
patient/recipient’s RBCs to detect
antibodies in donor serum
■ Checks for blood agglutination and
lysis
■ REMEMBER “DSPR” - Donor’s
Serum Matched with Patient’s Red
Cell
A
MINOR CROSS-MATCH
23
Q
One blood bag contains a maximum of 450mL of blood
A
TRUE
24
Q
Agglutination and lysis are manifestation/sign of
incompatibility
A
TRUE
25
If there are antibodies present in the serum and it is a positive result or agglutination, it means to say that there are antigens in the red cell in major cross match
TRUE
26
In minor cross match, if there are antibodies in
the donor serum against an antigen in the red
cells of the patients, then it is a minor
incompatibility
TRUE
27
BLOOD BANK - DONOR ELIGIBILITY CHECK
- 17-66 y/o
- Must be less than or equal to 37.5 C or 99.5 F
○ Should have NO FEVER
- 10.5mL of blood/kg of donor weight for whole
blood collection – 110 lbs
○ At Least 110lbs to be able to collect 450mL of
blood
- Normal blood pressure
○ 180mm Hg – systolic pressure
○ 100mm Hg – diastolic pressure
- Normal pulse rate
○ Between 50-100 bpm
- Acceptable hemoglobin levels
○ Greater than or equal to 12.5g/dL
○ Hematocrit (HCT) = 38%
- Absence of skin lesions
○ Skin disorders that are not cause for deferral:
ivy and other rashes
○ There are instances that there are open wound that would make individuals not eligible
TRUE
28
The collection bag contains an anticoagulant and
preservative solution and is placed on a mixing unit while
the blood is being drawn
TRUE
29
The unit is normally filled by weight but typically contains
around 450mL of blood when dull. Only one needle
puncture can be used to fill a unit. If the unit only partially
fills and the procedure must be repeated, an entire new
unit must be used
TRUE
30
Pre-donation of patient’s own blood (pre-operative blood
transfusion)
Usually done prior to elective surgery
Collected several weeks prior scheduled surgery
Reduces the chance of hemolytic reactions and
transmission of blood-borne diseases
There should be no need for cross matching or
compatibility testing because this is your own blood
If you already have a blood-borne disease, your blood
cannot be used for others
BLOOD BANK PROCEDURE – AUTOLOGOUS DONATION
31
presence of bacteria in the blood;
it is an infection
BACTEREMIA
32
the bacterial infection is found all
throughout the body
SEPTICEMIA
33
help determine the
presence and extent of induction as well as
indicating the type of organism responsible and the
antibiotic to which it is most susceptible
BLOOD CULTURE
34
counting the colony to be able to estimate the extent of infection by
knowing the number of organisms present
COLONY COUNT
35
Collected 30 minutes to 2 1⁄2 hours prior to the fever peak,
before the body can eliminate some of the
microorganisms
TRUE
36
Testing for
what antibiotic to use against the particular
organism
Sensitivity or Susceptibility Testing
37
Allowing preferential growth of
aerobic and facultative anaerobic
microorganisms
Filled first if winged blood collection is
done
Generally, there are organisms that
need oxygen to survive (aerobic
microorganisms)
AEROBIC BOTTLE
38
Allowing preferential growth of strict
anaerobic bacteria
➢ Allows growth for strict anaerobic
bacteria or strict or obligate anaerobe
➢ Do not grow in the presence of
oxygen; Oxygen is toxic to the
organism
➢ The causative agent that cause
bacteremia or septicemia is a
anaerobic organism then they should
grow in anaerobic bottle
ANAEROBIC BOTTLE
39
is a test that checks the blood for pathogens
for patients who have a fever of unknown origin (FUO).
● The test determines the existence of bacteria in the blood
that results in bacteremia or the presence of
microorganism and toxins in the blood that causes
septicemia
○ The physician orders this test only if there is a
probability of bloodstream microorganism
invasion.
BLOOD CULTURE
40
- Timing is important because the doctors would specifically
mention 2 or 3 or 4 collections
2-4 blood cultures are needed to optimize the detection of
microorganisms in the blood
Drawn 30 to 60 minutes apart
Drawn consecutively and immediately from different sites
Ratio of blood to broth
○ 1:5-1:10
For adults or people weighing greater than 80 lbs
○ Recommended volumes for blood cultures are 20-30 mL per culture with a minimum of 10mL per draw
TRUE
41
Less than 1kg - 2ml
2kg- 4ml
12.7 kg- 6ml
36.3kg - 10ml
Greater than 36.3kg - 2ml-30ml
For pediatrics
42
a butterfly and a specially designed
holder are used.
The holder is connected to the Luer
connector of the butterfly collection
set.
The aerobic vial is filled first and each
container is mixed after removal from
the holder.
The needle is removed after
completing the collection and the
safety device is activated as pressure
is applied over the site.
DIRECT INOCULATION
43
blood is transferred to culture bottles
after completing the draw using a
safety transfer device, which is
activated as soon as the needle is
removed from the site.
The safety transfer device is attached
to the syringe.
The bottle is pushed into the device
until it reaches the stopper. The blood
will be drawn from the syringe filling
the vacuum in the container.
The bottle should be placed on a solid
surface or in a rack.
SYRINGE METHOD
44
performed in the laboratory rather
than at the patient's bedside.
not recommended because the
sodium polyanethole sulfonate (SPS)
in collection tubes increases its
concentration when added to the
blood culture bottles.
The transfer of blood increases the
risk of contamination and the
exposure of laboratory staff.
if it could not be avoided, the
yellow-top SPS tube is acceptable for
collection purposes.
INTERMEDIATE COLLECTION TUBE
45
APTT (Activated Partial Thromboplastin Time
and PT (Prothrombin Time)
- Require special collection
- doesn’t require ice during
transport
Tests should be performed within 4 hours of sample
collection, or plasma should be frozen within 1 hour
of harvesting.
○ If you are not able to conduct the test
within 4 hours, first you centrifuge because
what we need/use in APTT and PT is
citrated plasma (collected using sodium
citrate) and your resulting sample is whole
blood; but in APTT and PT you need to
make use of the plasma as the sample
TRUE
46
(1:9 ratio of
citrate to blood) is the anticoagulant of choice
TRUE
47
(9:1) blood to coagulant
ratio.
To ensure proper mixing, invert the tubes gently
3 to 4 times immediately after collection.
TRUE
48
If the specimen is collected using an indwelling
catheter, draw and discard 5 mL of blood
before collecting the specimen. When
heparin is introduced to the line, flush with
5 mL saline before drawing the discard
blood and collecting the specimen.
TRUE
49
Measurement of blood glucose exactly 2 hours after
eating a meal
Screening test for diabetes mellitus
Monitoring of insulin levels
2-HOUR POSTPRANDIAL GLUCOSE BLOOD
50
High-carbohydrate diet for 2 to 3 days prior to
the test (150 grams)
○ Patient should be tested for FBS (8-10 hours of
fasting)
○ The patient should eat a meal (100g high carb
meal)
○ Blood sample for glucose testing is then drawn
2 hours after the patient finishes eating
TRUE - 2 HOUR POSTPRANDIAL GLUCOSE BLOOD
51
In normal patients, blood glucose levels peak within 30
minutes to 1 hour following glucose ingestion.
● The peak in glucose levels triggers the release of insulin,
which brings glucose levels back down to fasting levels
within about 2 hours and no glucose spills over into the
urine.
TRUE
52
Increased than normal glucose
HYPERGLYCEMIA
53
Lower than normal glucose
HYPOGLYCEMIA
54
A patient who could be suffering from carbohydrate
metabolism problems is subjected to the -----
This is to evaluate the ability of the body to metabolize
glucose by measuring the tolerance level to high glucose
level.
glucose
tolerance test (GTT), oral glucose
tolerance test (OGTI).
55
Insulin response to a measured dose of glucose is
recorded by specimen collection at given intervals. The
GTT length is 1 hour for gestational diabetes while it is 3
hours for other evaluations.
TRUE
56
Before the procedure, the patient must eat a balanced
meal containing approximately 150 grams of
carbohydrates for 3 days
● Fasting for 12 to 16 hours before scheduled test
● Drinking water is allowed to avoid dehydration because
urine specimen is also collected
GTT
57
Give the patient the glucose beverage dose.
Adult dose is 75 g while children are given 1 g
glucose per kilogram of weight. For gestational
diabetes, the dose should be between 50 g t0
75 .
TRUE- GTT (STEP 4)
58
Used to determine if a patient lacks the enzyme
necessary to convert lactose, or milk sugar, into glucose
and galactose.
● The patient experiences increased amount of feces and
more frequent defecation; and a soft or watery stool
LACTOSE TOLERANCE TEST
59
an enzyme that converts lactose into glucose or
galactose.
MUCOSAL LACTASE
60
If the patient is lactose intolerance (lacking the enzyme
lactase), the glucose curve will be flat, rising no more than
a few mg/dL from the fasting level
TRUE
61
Glucose specimen is drawn at the same time as
the previous GTT procedure.
○ The GTT curve and the glucose curve will be
similar if the patient has mucosal lactase
○ If the patient is lactose intolerant, the result will
yield a "flat” curve where glucose levels just
slightly rise over the fasting level
○ Patients with slow gastric emptying, Crohn's
disease and cystic fibrosis can show
false-positive results.
TRUE
62
Done to determine the probability that a specific individual
fathered a particular child.
● Requires chain-of-custody protocol and specific
identification procedures that may include fingerprinting
● The mother, child, and alleged father are all tested
● Blood samples are preferred for testing
PATERNITY/ PARENTAGE TESTING
63
Alternative: buccal / cheek swabs - USUALLY DONE IN BABIES
TRUE
64
most frequently used technique for
paternity testing; blood is needed
DNA profiling
65
Used in the management of patients being treated with
certain drugs in order to establish and maintain a drug
dosage, thus avoiding toxicity
Usually done for patients who are given heparin,
humadine anti-coagulants
Done in clinical chemistry laboratory
THERAPEUTIC DRUG MONITORING (TDM)
66
Drawing blood sample 1 hour after oral
administration is the rule of thumb.
○ Draw blood sample 0.5 hours after completion
of IV administration.
TRUE
67
For a drug to be beneficial, the peak (maximum) level
must not exceed toxic levels, and the trough (minimum)
level must remain within the therapeutic range.
TRUE
68
Withdrawal of approximately 500 mL of blood
THERAPEUTIC PHLEBOTOMY
69
Used in the Medical Field
Requires special prescription
Yellow prescription
Valium and Morphine
69
For forensic specimens, there is a need to track the
specimen from the time of collection until the time that the
results are released using a special protocol called chain
of custody.
TRUE
70
Ordered for purposes related to treatment, but could also
be for industrial or job-related reasons such as insurance
claims or programs and employee drug screening.
● The law enforcement department orders blood alcohol
concentration (BAC) for individuals involved in
traffic-related accidents.
● The ETOH test for treatment purposes does not require
the chain of custody to be accomplished but the results of
such a test can become evidence in court. However, BAC
tests for industrial and legal samples should follow the
chain-of-custody protocol.
TRUE
71
The ETOH specimen collection uses
aqueous
povidone-iodine and aqueous benzalkonium chloride
(BZK).
72
Companies, healthcare organizations, and sports
associations subject their potential employees to drug
screening as part of their pre-employment requirement.
● The specimen used is urine instead of blood. The
chain-of-custody protocol is strictly implemented since
legal implications are involved.
DRUG SCREENING
73
Measured in such small amounts that traces of
them in the glass, plastic or stopper material of
evacuated tubes may leach into the specimen,
causing falsely elevated test values.
TRACE ELEMENTS
ROYAL BLUE TOP
74
Utilizes small, portable, and often handheld testing
devices
● Mostly used in Satellite Areas
● Located outside laboratories.
● Obtains Fast Results.
● Convenience and short turnaround time = deliver
prompt medical attention, and expedite patient
recovery
● Performed where patient care is delivered including
physician office testing, various hospital locations
outside the laboratory, such as the emergency
department, operating room and intensive care unit
POINT-OF-CARE TESTING
AKA alternate site testing, ancillary, bedside,
near-patient testing, patient-focused testing
75
used to monitor warfarin
(e.g., Coumadin) therapy
➢ Measure the activity of coagulation factors
involved in extrinsic coagulation pathway
➢ Tests on whole blood from a fingerstick to
provide timely laboratory results
Prothrombin time (PT)
76
EXTRINSIC
PT
77
INTRINSIC
APTT
78
Used to monitor unfractionated heparin
therapy, to screen for intrinsic pathway
deficiencies, and to screen for lupus
anticoagulant
APTT OR PTT
79
Whole-blood clotting time test often used
in cardigan surgical suites
➢ Used to monitor high-dose unfractionated
heparin therapy
ACT
80
This testing allows the clinician to
determine a patient’s response to
medication before open heart surgery or
cardiac catheterization.
Platelet function
81
Non-instrumented test ordered by
physician to evaluate the capillaries for
platelet plug formation, an indicative of
disorder in the platelet function or
problems in capillary integrity
➢ Time required for blood to stop flowing
➢ Skin puncture is done.
Used for pre-surgical screening and
detection of problems involving
hemostasis
➢ Time interval required for blood to stop
flowing from a puncture wound on the
volar surface of the forearm
➢ Performed to evaluate vascular and
platelet function
Bleeding Time
82
Measured by POCT methods include pH,
partial pressure of carbon dioxide
(Pco2), oxygen saturation, (So2) and
partial pressure of oxygen (PO2).
➢ The most common electrolytes measured
by POCT are sodium (Na), potassium
(K), chloride (Cl), bicarbonate ion
(HCO3), and ionized calcium (iCa2).
ABG
83
aid in moving
nutrients in the body and remove wastes in the
cells of the body.
➢ The POCT uses -------- panels to determine
the blood level of sodium (Na+), potassium
(K+), chloride (Cl-), bicarbonate ion (HCO3- ),
and ionized calcium (iCa2+)
ELECTROLYTES
84
helps keep the normal balance of fluids
in the body as well and plays a role in
transmitting nerve impulses.
SODIUM
85
An elevated level of sodium is called
hypernatremia while a reduced level is known
as
HYPONATREMIA
86
is an electrolyte that helps in nerve
conduction and muscle function.
POTASSIUM
87
Increased blood potassium
HYPERKALEMIA
88
decreased blood
potassium is called
hypokalemia.
89
maintains the integrity of the cells by
helping in balancing the osmotic pressure as
well as the acid-base and water balance of the
body.
CHLORIDE
90
helps transport carbon dioxide
to the lungs and regulate blood pH.
BICARBONATE ION
91
is composed of small,
portable testing devices that measure analytes such as
sodium, potassium, chloride, and bicarbonate ion, blood
gas values for potential hydrogen, partial pressure of
carbon dioxide, partial pressure of oxygen, oxygen
saturation, BUN, glucose, hemoglobin, hematocrit, ACT,
lactate, and troponin.
● These instruments play an important role in emergency
conditions because of the short turnaround of the test
results. Some of the instruments include the following:
MULTIPLE TEST PANEL MONITORING
92
Proteins specific to heart muscle
○ Cardiac markers are analytes that are
utilized to assess the occurrence of
myocardial infarction (MI) or the extent of
damage produced by cardiovascular disease.
Cardiac troponin T (TnT) and troponin I (TnI)
93
measures the alanine transferase (ALT) of
patients under lipid-lowering medication.
LIPID TESTING
94
differentiates chronic
obstructive pulmonary disease (COPD) and congestive
heart failure (CHF).
B-TYPE NATRIURETIC PEPTIDE (BNP)
95
(CRP) detects and evaluates
infection, tissue injury, and other inflammation orders.
C-REACTIVE PROTEIN
96
is one of the most common POCT
procedures and is most often performed to monitor
glucose levels of patients with diabetes mellitus
GLUCOSE TESTING
97
is a diagnostic tool for
diabetes therapy monitoring.
GLYCOSYLATED HEMOGLOBIN
98
primary constituent of red blood cell
cytoplasm and transports molecular oxygen from the
lungs to the tissues and returns carbon dioxide to the
lungs.
● A small amount of blood sample is placed in a special
microcuvette and inserted into the machine for a reading.
HEMOGLOBIN
99
measures the volume of the red blood cells.
HEMATOCRIT
100
evaluates the severity of the lactic acid disorder
and the stress response of the patient.
LACTATE
101
detects gastrointestinal (GIT)
bleeding.
OCCULT BLOOD (GUAIAC)
102
Tests detect the presence of human chorionic
gonadotropin (hCG)
● Uses urine (rapid testing) or blood
● Hormone produced by the placenta that appears in both
urine and serum beginning ~10 days after conception.
● Test does not require any special preparation.
PREGNANCY TESTING
103
checks contact with allergens and determines if
the body has developed antibodies. Skin tests could be
tuberculin test (TB), Aspergillus, coccidioidomycosis
(cocci), and histoplasmosis (histo).
SKIN TEST
104
detects the presence of group A
streptococci.
STREP TESTING
105
Describes the results of a serum of screening tests
capable of detecting (ina semi-quantitative manner) renal,
urinary tract, metabolic and systemic diseases.
● Involves physical, chemical, and microscopic analyses of
the urine specimen
URINALYSIS
