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Lab Di 1st lab exam
| Question | Answer |
|---|---|
| The way blood specimens are obtained, as an incision of a vein | phlebotomy |
| What is penetrating a vein with a needle and collection apparatus or syringe called? | venipuncture |
| What is a skin/dermal puncture? | the collection of CAPILLARY blood after an incision is made in the skin with a lancet (finger stick, heel stick) |
| In which blood specimens is anticoagulant used? | whole blood and plasma |
| What is a whole blood specimen? | Tube which contains anticoagulant, tube contains cells(RBS, WBCS, plts) AND plasma. TUBE MUST BE MIXED WELL. |
| what is serum blood specimen? | Blood is allowed to clot (no anticoagulant for about 20 mins) and then centrifuged. The clotted cellular elements go to the bottom of tube, and the upper portion is the serum. |
| What is whole blood used for? | hematology cell counting |
| Serum contains no? | no fibrinogen |
| What is serum used for? | most chemistry, and serology testing, blood banking |
| What is plasma blood specimen? | Whole blood (use anticoag) is centrifuged - uncoagulated cellular elements are pushed to the bottom of the tube, upper portion is called plasma. |
| What does plasma contain? | fluid portion of blood which contains fibrinogen |
| What type of experiments is plasma used for? | coagulation studies, plasma chemistries |
| What is capillary blood, and who is it used most on? | A combo of venous and arterial blood, and tissue fluid obtained thru a skin puncture usually used on newborns and children |
| Why is capillary blood not as good of a sample? | tissue fluid within, and mixture of the bloods |
| What may compromise the integrity/reliability of a specimen? | 1. inappropriate method of collection 2. mishandling of specimen after collection |
| What is hemolysis in relation to compromised reliability? | rupture of RBCS resulting in plasma/serum appearing pink/red d/t release of hbg |
| What causes specimen hemolysis? | traumatic phlebotomy (rarer cases of intravascular dz and RBC fragility) |
| What else does specimen hemolysis release? | hgb, K+, LDH |
| What is interfered with chemical analysis of specimen hemolysis? | color interfernece |
| What is specimen lipemia? | specimen has a clody turbid appearance due to the presence of lipids ( may indicate non-fasting specimen) |
| What is interferred with chemical analysis with specimen lipemia? | chylomicron interference |
| In order to obtain proper ratio of blood to anticoagulant, tubes should be filled until...? | Tubes should be filled until the vacuum is exhausted |
| What test do improperly filled tubes affect? | most important for coagulation testing |
| How does specimen contamination occur? | by improper antiseptic cleaning of venipuncture site (blood cultures) |
| What are four sources of compromised reliability? | 1. hemolysis 2. lipemia 3. improperly filled tubes 4. specimen contamination |
| What are 4 specimen handling requirements? | 1. fasting 2. timed 3. iced 4. protection from light |
| How long must a pt not eat or drink for before venipuncture for glucose/triglyceride tests? | 8-12 hours |
| What are examples of timed specimens, meaning they must be collected @ a specific time? | cardiac panels antibiotic levels |
| Why must some specimens be iced?... and what are examples of testing that should be iced? | Should be chilled to slow down the metabolic processes which continue after blood is drawn ex: ammonia levels, arterial blood gases |
| What is an exmaple where the specimen's protection from light is important? | When components test for a break down when exposed to light, like in bilirubin testing... aluminum foil is wrapped around or placed in light inhibiting container |
| What two things are collection tubes colored for? | 1. the type of specimen that will be obtained (plasma, serum, whole blood) 2. the type of additive the tube contains |
| Place these in order of first to last for multiple draws: serum tubes w/ or w/o gel or clot activator EDTA tubes heparin tubes blood culture tubes oxalate/fluride tubes sodium citrate tubes | Blood culture tubes or vials sodium citrate tubes serum tubes w/ or w/o gel or clot activator heparin tubes EDTA tubes oxalate/fluoride tubes |
| If only coagulation studies are being drawn, what do some labs advise drawing first? | A plain red top tube to clear the release of tissue thromboplastin from the skin puncture |
| What color tube is used for wholbe blood count? and CBC? | lavender |
| what color tube had EDTA in it? | lavender |
| What can't lavender tubes test for? | Ca2+ because they remove calcium to prevent clotting |
| If the tube is not red, it has what in it? | anticoagulant, and preservation |
| What color top is used for blood typing and blood banking? | Red |
| The larger the gauge needle, the _____ the diameter of the needle | larger gauge, smaller diameter |
| The most commonly used needles are ___ gauge by ___ inche needle | 21 gauge by 15 inche needle |
| What is the mL range of collection tubes? | 2-15 mL |
| What are syringes used for? | for veins that are too fragile for the evacuated system |
| What is a butterfly used for? | for difficult veins, hand veins, pediatrics and elderly pts |
| A lancet should never exceed __ mm in depth? | 2.4 mm |
| The tornuquet should not be left on longer than ? | than 1 minute |
| Antiseptic pad is used to? | to prevent spsis, bacteriostatis.... used to clean site before venipucture |
| When is iodine used to clean before venipuncture? | for blood cultures |
| Bandages should not be used on which age group? | under 2 years because of aspiration |
| What are the 3 veins to choose from in the antecubital foosa? | cephalic, basilica, median cubital |
| Which vein is the vein of choice, anchored best, and easiest to access | median cubital |
| The tourniquet increase what? | venous stasis and vasodilation |
| If the toruniqet is left on for more than 1 minute what occurs? | hemoconcentration (increase in local cellular relase of metabolic waste prodcuts)& pt discomfort |
| What is hemoconcentration? | increase in local cellular relase of metabolic waste products |
| What is an extremely important 2nd step in venipucnture? | idefintifying the pt - asking pt to state full name and id number |
| How many inches above intended site should tourniquet be placed? | 3-4 inches |
| What is in the alcohol pad? | 70% isopropyl alcohol |
| When cleansing site you should make a ____ motion starting from the ___ | circular motion starting from the center moving outward |
| What degree is the needle entered at? | about 15-30 degree angle |
| When do you release the tourniquet once venipuncture has started? | after last tube begins to fill |
| if you pt is obese and hard to find veins what can u do? | apply a blood pressure cuff to help |
| Hemoconcentration is an increase of ___ in blodo | analytes |
| If a pt had a mastectomy what should be a precaution? | do not draw blood from same side as the mastectomy |
| what is the copper sulfate screening method for? | hemogolbin |
| How do you calculate HCT? | meausure ht in mm of total column of blood (plasma and cells) = A, and ht of RBCs = B. B/A x 100 = hct % |
| What does ESR measure? | how far the RBCS fall (in mms) in 1 hr |
| RBCs are negatively charged and repel each other defined as? | zeta potential |
| RBCs stack up like coins, name? | rouleaux formation |
| What causes rouleaux formation? | breakdown of zeta potential |
| What does rouleaux cause? | causes increased settling out of rbcs from the plasma due to increased wt |
| If there's an increase in inflammation what is seen with the esr? | see increase in rouleaux formation d/t increase of inflammatory proteins which breaks down zeta potential |
| what do inflammatory proteins break down? | the zeta potential |
| What are the two main blood grouping systems? | ABO systems ( 4 possible, A B AB O) and Rh systems (2 types Rh pos and Rh neg) |
| What is autosomal codominanct genetic expression and which system expresses this>? | Gene from mom and dad both expressed EQUALLY. The ABO system expresses this |
| What antigen does phenotype A have? and antibody? | Has the A antigen has the anti-b antibody |
| What antigen does phenotype B have? and what is the antibody? | Antigen: B antigen Antibody: A antibody |
| What % of the population is A phenotype? | 40% |
| What antigen does AB have? and what antibody? | Antigen: AB Antibody: NONE |
| What blood phenotype is the universal recipient? | AB + |
| What percentage of the population is phenotype B? | 11% |
| what % of the population is AB? | 4% |
| What percent ofthe population is O? | 45% |
| What antigen does O phenotype have and antibody? | Antigen: NONE, THERE IS NO O ANTIGEN Antibody: anti-A and Anti-B |
| The antibodies of ABO system are...? | are naturally occurring -present @ birth |
| With donations it is the recipient's _____ that react with the donor's ____ causing the RBCs to ____ if the blood is NOT ____ | it's the recipient's antibodies which react to the donor's RBC antigens causing the RBCs to hemolyze if the blood is not compatible |
| Which dzs have a 1:2000000 risk of being transfused? | Hep C and HIV |
| What is the lowest risk of transfusion? | Cytomegalovirus (infrequent) |
| NAT WNV RNA in a screening is? | West Nile Virus |
| Anti-CMV EIA antibody is what in a screening? | cytomegalovirus |
| HBsAg antibody is what in a screening? | hep B surface antigen |
| What is ANti-HBc antibody in a screening? | Hep B core antigen |
| What is NAT HCV RNA in a screening? | Hep C virus |
| How many antigens are associated with the Rh system? | 40! |
| Which antigens is the blood bank primarily concened with in the Rh system? | The 5 major ones: D C c E e |
| When are antibodies produced in the Rh system? | Only produced after in contact with antigen |
| What is the genotype of Rh pos? | DD, or Dd |
| Who can Rh pos/D receive from, and donate to? | Rh pos and Rh neg, and only donate to Rh pos |
| What % of population is Rh pos? | 85% |
| What does the d gene represent? | Represents the lack ofthe D antigen! |
| What antiobodies will Rh neg produce if in contact with Rh pos? | anti-D (igG) |
| With transfusion your must consider the donor's RBC _____ and the recipients ____ | Donor's RBC antigens and the recipients antibodies |
| What is the name given for hemolytic dz of the newborn? | Erythroblastosis fetalis |
| If a Rh pos baby has a placental tear in a Rh neg mother what happens? | Exchange of fetal blood, mother's blood sees it & makes anti-D and IgG, and now with future pregnancies she has the antibody which may cross the placenta & hemolyze babies RBCs |
| How does RHOGAM work? | take out any of baby's D antigen curculating in mothers blood BEFORE mother's body can respond by making anti-D |
| How many hours is needed for body to produce it's own antibody, like anti-D in mothers? | 72 HOURS |
| When is Rhogam given to mother and how? | Given to mother intramuscularly at 28 weeks gestation, and 72 hrs post partum |
| What is placenta previa? | 28 weeks gestation |
| If b | |
| How many mL is in a whole blood donation? | 500 mL |
| What consists of 200 mL of blood + 100 mL ADSOL? | packed red blood cells |
| What is the shelf life of packed red blood cells? | 42 days @ 1-6 degrees C |
| How many mLs are in platelet rich plasma? | 300 mL |
| Whole blood donations are divided into what? | Platlet rick plasma and packed red blood cells |
| What is the shelf life of donated platlets? | 5 days @ room temp |
| How many mLs of donated platlets are obtained? | 50 mL |
| What is platlet rich plasma from a whole blood donation divided into? | platlets and plasma |
| What is FP24? | Frozen plasma within 24 hours of collection |
| Within how many hours is fresh forzen plasma set to freeze? | within 8 hrs of collection |
| How many mL of plasma is collected? | 250 mL |
| What is the shelf life of plasma? | 1 year @ -18 degrees C |
| What can plasma be divided into? | Cryoprecipitate |
| What is the mL of cryoprceiptiate and what is the shelf life? | 15 mL and shelf life is 1 |
| Why would a dermal puncture (microcollection) be used in an adult? | Inability to find a vein for venipuncture burned or scarred pts geriatric pts with fragile veins pts receiving chemo and when only a small sample is needed |
| What is the composition of blood from a dermal puncture? | capillary blood, combo of venous, arterial and interstitial fluid |
| What is the best site for a finger puncture? | palmar surface of the dist phalanx of the ring or mid finger |
| Puncture should be ____ to fingerprint | perpendicular |
| Why should you always wipe the first drop of blood away after a finger puncture? | because it prevents contaimination of residual alcohol and intro of excess tissue fluid |
| Who receives heal puncture? | newborns and infants who have not started to walk |
| What is the location of the heal puncture? | the medial and lateral areas of the plantar surface |
| What is the mc test to evaulate circulating blood? | cbc |
| What is leukocytosis? | increase in the number of circulating wbcs greater than 11000 mm3 |
| what is leukopenia? | decrease in # of circulating wbcs less than 4000mm3 |
| What is done with the tube to collect wbcs? | lysing reagent mixed to remove rbcs from solution and strips wbc membrane, therefore wbc nuclei are counted |
| How are wbc and rbc counted? | by electrical impedance or light scattering methods |
| How is hgb sampled within the tube? | reagent is added to lyse RBCs and to form cyanmethehmogolbin and read directly by its abitlity to absrob light |
| How is hct calculated in a cbc? | based on MCV and RBC values hct= mcv x Rbc/10 |
| What are the rbc indices within a cbc? | mcv mch mchc |
| what is the manual mcv calcuation? | hct x10/ rbc x10^6/mm3 |
| mch is measured in what? | measured in picograms |
| how is mchc exopressed? | % |
| RDW is expressed as? | an absolute # or graphed on a histogram |
| What produces platlets? | megakaryoctyes |
| What is the life span of a platlet? | 8-10 days |
| What is MPV? | mean platlet volume |
| what does mpv measure? | measures the avg volume (size) platlets |
| When does mpv increase? | in cases of non marrow causes a decrease of platelet number as normal bone marrow produces younger and larger platelets to compensate |
| when does mpv decrease? | decreases when lack of bone marrow functon is the cause of decreased platlet #. The megakaryocytes are small andtherefore platlets are small |
| What is PDW? | platelet distribution width - a measure of the degree of uniforminty of size of plts expressed both as an absolute number and graphed on a histogram |
| What is the automated diff (differential WBC count)? | gives relative #s of lymphocytes, monocytes, neutrophils, eosnophls and basophils |
| What are wbcs stained with? | wright stain |
| name the granulocytes? | neutrophils. eosinophils, basophils |
| name the agranulocytes | lymphocytes monocytes |
| neutrophil size? and %? | 10-15u (2x the size of an average RBC) and 60-70% of circulating WBCs |
| How does the nucleus of a neutrophil stain? | dark purple |
| What do eosinophils protect against? | protects against ingestion of parasites and limiting alerigc rxns |
| What cell nuc stains dark purple, usually blobed with coarsely clumped chromatin | eosinophils |
| what size and % of wbcs are eosinophils? | about 10-15 u, and 2-5% |
| Which wbc cell is involved with immediate hypersensitivity rxn by release of histamine and heparin from granules? | basophil |
| what is the size and % of basophis? | 10-15u, and 0-1% |
| which wbc has a segmented nuc but usually obscrubed by abundant large coarse blue-black staining cytoplasmic granules? | basophils |
| What wbc protects the body from infection by phagocytosis of bacteria and other foreign organisms, and provides defense against microorganisms, removal of damaged or dead cells and removal of cellular debris? | neutrophils |
| What type of wbc provides recognition and elimination of foreign stimuli includng synthesis and secretion of antibodies? | lymphocytes |
| Which type of lympocyte is responsible for humoral immunity? | B |
| what is the synthesis of antibodies in response to the antigen? | humoral immunity |
| What type of cells are responsible for cellular immunity? | T lymphocytes |
| What includes tumor suppression, graft rejection, protection from intracellular organisms, and delayed hypersensitivity? | cellular immunity (t-lympho) |
| T lymphocytes also function in the regulation of ____ _____ rxns by helping or suppressing the ____ and the regulation of _____ by producing colony stimulating factors | T lymphos regulate umoral immune rxns by helping or suprressing the b lymphos and the regulation of hematopoiesis by producing colony stimulating factors |
| What has a round unsegmented nucleus which stains dark blue-purple with coasrse and clumpy chromatin | lymphocytes |
| What is the size and % of lymphocytes? | size : 7-10 20-30% |
| What protects the body by phagocytosis of bacteria, fungi, viruses, dead and dying cells, and helps the neutrophil? | monocyte |
| in infection ____ rises after neutrophils increase | monocytes |
| what plays a role in processing specific antigens for the lymphocyte to recognize? | monocyte |
| what produces and secretes various substances : lysosomes, colony stimulating factor, thromboplastin, platelet activating substances, complement,cytokines? | monocytes |
| What size and % are monocytes? | size: 12-20 2-8% |
| what cell stains blue-purple and has a folding shape, often horseshoe, or kidney bean with moderately clumped chromatin? | monocytes |
| what cell often has a ground glass appearance in their cytoplam | monocyte |
| all blood smear reports should contain a ____ ____ estimate | a platelet number estimate |
| The standard varies from _____ per average oil immersion field of platelet estimate? Multipled by ____ gives the # per mm3 | 5-25 multi by 20,000 |
| rbcs should be observed for abnormalities in ___, ___ ,____ and ____ | size, shape, chromicity, and intracellular inclusions |
| what is variation in the size of rbcs due to a path condition? | anisocytosis |
| anisocytosis is a ____ finding and generally indicates a change in the ___ function | is a nonspecific finding generally indicates a change in the marrow function |
| What refers to rbcs that appear slightly basophilic? | polychromic/basophilia |
| what is the amount of basophilia related to? | the maturity of the cell |
| what is the actual cause of a hyperchromic cell? | by an increase in mean cell thickness |
| what is a variation in the shape of a rbc? | poikilocytosis |
| what is a definitive test to see if sickle cell anemia? | hbg electrophoresis |
Created by:
margaretrhager
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