Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Revision
| Question | Answer |
|---|---|
| Identify the 2 major divisions of a clinical lab | • Clinical analysis • Anatomical pathology |
| Describe the indication that would require the wearing of a gown as PPE | • When splashes/sprays of blood or body fluids are possible • During patient contact |
| List the first 3 steps that needs to be taken in the event of someone sustaining electrical shock | • Shut off the source of electrical power • If source cannot be shut off use non conducting material to remove source from patient • Call for medical assistance. |
| Give 3 functions of the nose as part of the respiratory system | • Warms air • Filters air • Moistens air • Resonance chamber • Receptors for smell |
| Name any 3 coagulation tests | • Partial thromboplastin time (PTT) • D-Dimer • Fibrin split products • INR/PT • Thrombin Time (TT) |
| Identify the root in the medical term ‘myocarditis” | • Myo & card |
| Identify the cell characteristics of cardiac muscle as described below | • Lightly striated • Single nucleus • Intercalated discs |
| Give the correct term for the internal space of a blood vessel through which blood flows | Lumen |
| What is the risk of wearing a mask around the neck after use? | Become reservoirs for bacteria and viruses |
| Identify the larger vein from which the axillary vein, cephalic vein and basilic vein are branches | Subclavian vein |
| Give the correct term for blood cell production | Haematopoiesis/ hemopoiesis |
| Define the medical directional term “distal” | Furthest from the centre of body or point of attachment. |
| Identify 3 areas in phlebotomy that are subject to quality assurance | • Patient preparation procedures • Specimen collection procedures • Delta checks |
| In medical terminology, what is the purpose of the combining vowel | Make pronounciation easier |
| Name the muscle found in the dermis layer of the skin | Arrector pili muscle |
| Give the singular term for alveoli | Alveolus |
| Give the correct term for the program or process designed to prevent future problems by evaluating present and past performance | Quality Assurance |
| Identify the type of isolation that would require the wearing of a sterile gown, and give an example/indication for such use | • Reverse isolation • Any immunocompromised patient |
| Where would you find the bicipital aponeurosis | Antecubital fossa |
| What is the benefit of using a bevelled needle for venepuncture | • Easy slip into the skin • Without coring the skin or vein |
| Provide 2 reasons why ETS components must be from the same manufacturer | • Needles may become unscrewed • Tubes popping off the needle during venepuncture |
| Give the correct term for “bedsore” | Decubitus ulcer |
| Identify the specific blood cell from which macrophages originate | Monocyte |
| Provide 3 factors that will influence the size/volume of the evacuated tube for a blood draw | • Age of the patient • Amount of blood needed for testing • Size and condition of the patients vein. |
| Identify the blood test analyte that may be falsely elevated following an I.M. injection | Creatine Kinase |
| Identify the large bone marrow cell from which platelets are produced and released | Megakaryocyte |
| Describe the difference between haemophilia A and haemophilia B | • Hemophilia A – factor VIII deficiency • Hemophilia B - factor IX deficiency |
| Explain what you understand by the term “needle gauge” | • Gauge indicates the diameter of the lumen. • The diameter and gauge have an inverse relationship. • The higher the gauge number the smaller the diameter of the needle • Needle gauge is selected according to the size and condition of the patient vein |
| What is the purpose of the flanges on the tube holder | Aids in tube placement and removal |
| Provide 5 reasons for how a tube can have premature loss of vacuum | • Improper storage of the tube • Dropping the tube • Opening the tube • Advancing or placing the tube too far in the tube holder before use • If the bevel of the needle is partially out of the skin during venepuncture. |
| What is the purpose of the shorter needle of the butterfly needle | Allows a smaller angle of insertion |
| Explain the main differences between the two types of EDTA that may be found in blood tubes | • K2 EDTA is dipotassium • K3 EDTA is tri-potassium • Both are available in liquid form or salt/spray dried |
| When performing coagulation tests, what needs to be added to the back to the specimen during testing so that clotting can be initiated and timed? | Calcium |
| Provide 2 reasons why the rubber stopper on the evacuated tube is covered with a plastic shield | • Shield designed to prevent aerosol formation from the rubber stopper when the cap is removed. • Plastic shield prevents the thumb roll “pop off” technique which causes aerosol formation |
| Identify the 3 heparin formulations used in tubes | • Ammonium heparin • Lithium heparin • Sodium heparin |
| Besides its anticoagulant action, explain 2 other benefits of sodium polyanethol sulfonate | • Reduces the action of a protein called complement that destroys bacteria. • Slows down phagocytosis • Reduces the activity of certain antibiotics |
| Describe what happens to thixotropic gel when a specimen tube containing gel is centrifuged | • The gel changes in viscosity/ thickness • Moves between the cells and the serum/plasma • Forms a physical barrier between cells and serum/plasma |
| Explain the 3 steps a phlebotomist can take if a patient admits to having a fear of needles | • Have the most skilled phlebotomist perform the procedure • Have the patient lie down for the procedure • Apply ice pack to site 10-15 minutes prior to the procedure. |
| Give the 3 specific use/function for adding an additive to an evacuated tube | • To enhance clotting • To prevent clotting • To preserve certain blood components |
| List the 3 physical property types of tube additives | • Liquid • Spray dried • Powder |
| Besides the light blue coagulation tube, in which other tube would you find sodium citrate | Black top (ESR tube) |
| Explain why heparinised plasma is preferred over serum for urgent/stat electrolytes | • Because the blood will clot in the serum tube • Potassium will be released from the cells into the serum • Causing falsely elevated potassium results |
| Explain what the manufacturer will guarantee if tubes are used within the specified expiration date as indicated on the tube | • The reliability of the additives in the tube • Tube vacuum |
| What tube is required to obtain a plasma specimen for testing | Tube with anticoagulant |
| Which one of the heparin types is preferred for chemistry testing | Lithium heparin |
| Explain 2 reasons why sodium fluoride tubes are used to collect ethanol specimens | • To prevent a decrease in alcohol through glycolysis • To prevent increase in alcohol due to fermentation by bacteria. |
| Identify 2 incidents when cleaning preparing the skin for venepuncture may differ to the preparation used for a routine venepuncture procedure | • When cleaning the skin prior to a blood ethanol level • When cleaning the site prior to blood culture procedure |
| Provide 2 indications for using a yellow top ACD tube | • DNA testing • HLA phenotyping (paternity and transplant compatibility) |
| Describe any 6 required requisition information that needs to be included on an outpatient request form | •Dr ordering tests •Pt full name and surname •Pt gender •Pt DOB •Tests to be performed •Relevant information/ instruction •Test status ( fasting, timed, priority of tests) •Collection site ( if applicable) •Billing information and ICD10 codes |
| How does the application of the torniquet make needle insertion into the vein easier? | • The distention of the vein when filled with blood • Makes the walls thinner and easier to penetrate with a needle |
| What 4 main aspects/criteria are established during the process of vein palpation | • Vein patency • Vein size • Vein depth • Vein direction |
| The term “turgid” means | Distended with blood |
| Name the 3 areas in Phlebotomy that are subject to Quality Assurance | •Patient preparation •Specimen collection •Delta checks |
| Needle cap or cover | Needle sheath |
| Name 3 ways how you can protect yourself against airborne biohazard exposure | •Safe handling practices •Wearing appropriate PPE •Working behind safety shields or splash guards |
| When obtaining informed consent, what is meant by a "conflicting statement” | • The patient has given permission for the procedure • But taken back that permission in the same statement |
| Identify 2 analytes most affected by fist pumping | • Potassium • Calcium |
| Name a common test done in Immunohematology | •Antibody screen •Direct antiglobulin test •Type and screen •ABO Blood group and Rh •Type and crossmatch •Compatibility testing |
| The application of safety precautions taken to ensure the safe handling of biological substances that pose risk to health | Biosafety |
| Lying down | Recumbent |
| Name activities that can lead to ingestion of biohazards | •Neglecting to sanitize hands before handling food, gum, candy, cigarettes or drinks •Covering mouth with hand instead of tissue when coughing or sneezing •Biting nails •Chewing on pens or pencils •Licking fingers when turning pages in books |
| PCP | Pneumocystis pneumonia |
| Name 3 means for sterilizing objects | •Heat •Radiation •Chemical |
| Name 4 Aseptic techniques important to blood collection personnel | •Proper hand hygiene •Keeping supplies within easy reach to prevent dropping them •Opening equipment avoiding contamination •Safe disposal of contaminated equipment •Clean up of infectious material •Wear gloves and other PPE for blood collection |
| Intense fear of needles | Needle phobia |
| Name 4 reasons why tubes can loose its vacuum prematurely | • Improper storage • Opening the tube • Dropping the tube • Advancing the tube too far onto the needle before venepuncture • If the needle bevel becomes partially out of the skin during venepuncture |
| The principles of Radiation safety are distance, shielding and time. Explain these 3 principles | This means that the amount of radiation you are exposed to depends upon how far you are from the source of radioactivity, what protection you have from it, and how long you are exposed to it. |
| Name bloodborne pathogens | •Cytomegalovirus •Hepatitis B virus •Hepatitis C virus •HIV •Treponema pallidum that causes syphilis •Microbes that cause Malaria – Plasmodium species •The agent that causes Creutzfeldt-Jakob disease •West-Nile virus |
| Name the 2 reasons for isolation procedures to be implemented | •To prevent the spread of infection from a patient who has or is suspected of having a contagious disease •To protect a patient whose immune system is compromised |
| A portion of a specimen used for testing | Aliquot |
| Degree to which a microbe is capable of causing disease | Virulence |
| Name 4 Fire Safety Do’s | •Pull the nearest fire alarm •Call the fire department •Attempt to extinguish a small fire •Close all doors & windows if leaving the area •Smother a clothing fire with a fire blanket •Crawl to the nearest exit if there is heavy smoke present |
| Why should a phlebotomist not deeply depress the skin by forcefully pushing down on the needle as it is inserted | •It causes pain •It enlarges the vein opening, increasing the risk of blood leakage at the site |
| Why is the needle removed before placing the gauze? | To minimize the chance of needlestick injury |
| The position of the patient’s arm for arterial blood gas collection | Abducted |
| Sx | Symptoms |
| Anything harmful or potentially harmful to health | Biohazard |
| Structures that carry messages to the nerve cell body | Dendrites |
| SA | Sinoatrial |
| Why are sodium fluoride tubes used to collect ethanol specimens? | • To prevent either a decrease in alcohol concentration due to glycolysis • Or an increase due to fermentation by bacteria |
| Redness | Erythema |
| ISO | International organisation for standardization |
| State of decreased blood volume | Hypovolemia |
| Medical term for brain dysfunction caused by toxic levels of bilirubin | Kernicterus |
| SAD | Seasonal affective disorder |
| MMR | Measels mumps rubella |
| Provide 4 desirable characteristics of a safety feature | •Fixed safety feature, create a barrier between hands&needle •Allow hands to remain behind needle •Important part of device, not an accessory •Permanent feature •Must be simple requiring little/no training •Musnt interfere with delivery point of care |
| Urine specific gravity (SG) can be determined by the instrument known as: | Refractometer |
| Identify the colour stopper of the intermediate collection tube and identify the additive in the tube | • Yellow top tube • Sodium polyanethol sulphonate |
| Ascites is a collection of fluid in which body cavity? | Abdominal cavity |
| Plasma ceramides affects which body system? | Cardiovascular system |
| List 2 serious health problems that may occur if patients are allowed to fast for longer than 12 hours | • Electrolyte imbalance • Heart arrhythmias |
| C-UBT | C - urea breath test |
| Give two reasons for colour coding a tube stopper | • Indication of the specific additive in the tube • Indicates a special property of the tube |
| Give 3 benefits/ advantages for using needles smaller than 22G when performing an arterial blood gas | • reduce risk of arterio-spasm • reduce risk of haematoma • lessen pain. |
| Name the small hair like projections on certain cells ( eg- respiratory tract) | Cilia |
| Explain the procedure that should not be used when removing a tube stopper | Do not “pop” it off using a thumb roll technique |
| Name the laboratory test used to detect neural tube defects such as spina bifida and downs syndrome | Alpha fetoprotein |
| Give 4 examples of a reservoir (chain of infection) | • Humans • Animals • Food / water • Soil • Contaminated articles and equipment |
| Which two additives may be added to blood culture bottles to inactivate antimicrobial therapy/ antibiotics? | • Activated charcoal • Resin beads |
| Infection of the lining of the heart | Endocarditis |
| Identify the preferred specimen type for a urine for cytology | Fresh clean catch urine. |
| Give one disadvantage of using a small needle (such as 25G) when drawing an arterial blood gas sample | • Air bubbles • Haemolysis |
| Identify the larger vein from which the axillary vein, cephalic vein and basilic vein are all branches | Subclavian vein |
| What is the procedure to follow when a torniquet has been tightened for longer than one minute before venepuncture? | Released for 2 minutes before re-tightening/applying. |
| Provide 2 reasons why blood is the preferred sample for ethanol/ETOH and not urine | • Blood and urine results will not correlate. • ETOH is volatile and false negatives will result if specimens are uncapped. • False positive results may result due to fermentation processes if the urine certain microorganisms |
| Identify the special cell membrane of cardiac muscle that is not found in other muscle tissue | Intercalated discs |
| Provide 2 reasons why urine is the preferred specimen for drug screening | • Easy to obtain • Many drugs can be detected in urine and not in blood • A variety of drug metabolites can be detected in urine for a longer time than blood |
| Provide 3 examples of entry pathways (chain of infection) | • Body orifices /openings • Mucous membranes (eyes, nose, mouth) • Breaks in the skin |
| PTS | Pneumatic tube system |
| The consequence of water on a flammable liquid fire will result in | Spreading of the fire due to dispersion of liquid |
| Describe the correct site for performing a capillary puncture on adults and children over one year old | • Palmer surface • Of the distal/end segment • Of the middle or ring finger • Of the non-dominant hand • On the fleshy pad slightly to the side of centre • Perpendicular to the whorls of the fingerprints |
| Tc B | Transcutaneous bilirubin |
| What is the correct method to remove a rubber stopper from a tube? | Cover the stopper with gauze or tissue to catch blood drops or aerosols |
| Identify which urine sample would not be suitable for cytology testing, and give a reason for your answer | • First morning specimen • As cells may have disintegrated in the bladder overnight |
| Explain why blood collected in an additive tube is not transferred into another tube | • Different additives may interfere with each other and affect the testing process. • If the additive is the same- there will be excess additive to blood ratio • Having a negative effect on results |
| Provide the three situations where patient confidentiality may be legally breeched (without permission)as stipulated by HPCSA | • In terms of statutory provision • Instructed by the court. • In the best interest of the public |
| Provide 3 benefits of performing tests on urine | • Readily available & easy to collect. • generally inexpensive • provides information on many of the body’s metabolic functions |
| Scalelike | Squamous |
| An adverse reaction between donor cells and the recipient | Transfusion reaction |
| Altered or destroyed by heat | Thermolabile |
| Spiral pattern of the ridges and grooves that form a fingerprint | Whorls |
| QNS | Quantity not sufficient |
| Discuss the stipulation of HPCSA regarding the alteration of records | • No information may be removed from a health record. • An error may be corrected by placing a line through the error. • in ink and correcting it. • Date of change must be entered. • signed in full. • reason for amendment specified on the record |
| Tubes that carry urine from the kidneys to the urinary bladder | Ureters |
| Name tests that are negatively affected by the pneumatic tube system | • Potassium • Plasma haemoglobin • Acid phosphatase • Lactate dehydrogenase |
| Provide examples of how urine components may change if urine is not tested promptly or preserved | • cellular components decompose. • bilirubin breaks down to biliverdin. • bacteria multiply |
| Deepest layer of the epidermis | Stratum germinativum/stratum basale |
| Name 2 reasons why some specimens need to be chilled | It slows down cell metabolism It protects thermolabile (i.e., altered of destroyed by heat) analytes |
| Name the most frequent reason for rejecting Haematology specimens | Clotting |
| Explain when patient information (other than the legal requirement listed above) may be divulged by a practitioner | • With the express consent of the patient. • In the case of a minor under 12-with the written consent of the parent or legal guardian. • in the case of a deceased patient- with the written consent of his next of kin or executor of the estate. |
| Scientific study of poisons | Toxicology |
| Pertaining to the treatment of obesity | Bariatric |
| A substance present in tissue fluid that activates the extrinsic coagulation pathway and can interfere with coagulation tests when picked up by the needle during venepuncture | Tissue thromboplastin |
| AED | Automated external defibrillator |
| From where in the body- may non-blood specimens be found/obtained? | • Intracellular and interstitial spaces • Within various organs (such as bladder) • Within body cavities (such as abdominal cavity) • Within some joints (elbow, knee) |
| The tracing and testing of blood donors and recipients when a blood product has been determined to be potentially contaminated with a bloodborne pathogen | Lookback |
| CRP | C-reactive protein |
| Define the term health care personnel | • Term that applies to health care providers • And health care workers |
| Any substance placed within a tube other than the tube stopper or the coating of the tube The structure that generates the electrical impulse that initiates heart contraction Sino-atrial node/pacemaker | Tube additive |
| Adding the blood to the culture bottle | Media inoculation |
| Explain the specimen handling instructions for Ammonia after collection and the reason why | • Blood ammonia levels increase rapidly at room temperature. • For accurate results, ammonia specimens must be immediately placed in ice slurry, • Transported STAT, • and separated from the cells within 15 minutes of collection |
| IGRA | Interferon-gamma release assay |
| Why should specimens that needs to be chilled, not be put directly on ice? | • Contact with a solid piece of ice can freeze parts of the specimens, • Resulting in hemolysis • And possible analyte breakdown |
| Thin threads of tissue that attaches the atrioventricular valves to the walls of the ventricles to help keep them from flipping back into the atria | Chordae tendineae |
| Explain what is meant by the term health care worker and provide an example | • works in the medical field • Not required to register with a statutory body • Admin staff, drivers |
| The plane that divides the body vertically into right and left portions | Sagittal plane |
| Decreased platelets | Thrombocytopenia |
| Cloudy, as in the appearance of serum or plasma with high levels of lipids | Turbid |
| Provide 4 provisions where health care practitioners may make records available ( as stipulated by HPCSA) | • With a court order. • When a HCP is been sued by a patient • for defence purposes in the case of a disciplinary hearing. • statutory obligation (child abuse) • Non-disclosure puts public at risk |
| Processes used to create standardization for quality service or product and prevention of problems | Quality assurance |
| What effects can rough handling and agitation during transportation have | • Rough handling causes haemolysis, • Activates platelets and affects coagulation tests • It can also cause breakages |
| Explain what it means if some analytes are photosensitive | • It is sensitive to light • And are broken down by light • Resulting if false decrease values |
| BZK | Benzalkonium chloride |
| When does a patient develop a state of shock? | When there is insufficient return of blood flow to the heart, resulting in an inadequate supply of oxygen to the brain and all other organs and tissues of the body |
| Name 2 conditions that uncontrolled bleeding can lead to | Hypovolemia Hypovolemic shock |
| The study of an individual’s concept and use of space | Proxemics |
| The destruction of microorganisms on the skin | Skin antisepsis |
| ESRD | End stage renal disease |
| Name the 2 methods for collecting POCT specimens and what would the method type be dependent on | Capillary puncture Venepuncture Dependent on the type of testing and instrument used |
| Why can’t autologous blood donations (not used during surgery) not be used for patients other than the donor? | It is discarded because rules for autologous is less strict, and therefore the blood doesn’t meet safety standards required for blood that is used for other patients |
| High blood glucose levels during pregnancy | Gestational diabetes |
| Name 2 conditions that can lead to some degree of shock | • Haemorrhage • Heart attack • Trauma • Drug reactions |
| What is more important than timing in the collection of blood cultures for detecting the causative organism of septicaemia | The volume of blood |
| TIBC | Total iron binding capacity |
| Facilities that provide blood products for transfusion purposes | Blood Donor Centres |
| Fungus or yeast in the blood | Fungemia |
| Iron overload | Hemochromatosis |
| FAN | Fastidious antimicrobial neutralization |
| OGCT | Oral glucose challenge test |
| Why can a transfusion with incompatible blood be fatal | It can be fatal because of agglutination (clumping) AND lysis (rupturing) of red blood cells within the patient’s circulatory system |
| Describe 3 ways on how media inoculation can occur | • Directly into the bottle during specimen collection • After collection when blood has been collected in a syringe • Use a special intermediate collection tube to collect the sample for inoculation later in the laboratory and not at the bedside |
| ARD | Antimicrobial removal device |
| What is the reason for mixing blood culture bottles by inversion directly after removing from the holder | Bottle inversion mixes the blood with the broth to prevent clotting and neutralize antibiotics in the blood if the bottle contains antibiotic absorbing resin beads |
| Name 2 reasons why blood cultures should not be drawn from vascular lines | Draws from vascular lines are known to have a high contamination rate May cause a person to receive antibiotic therapy when not needed |
| VRE | Vancomycin resistant Enterococcus |
| What can undetected errors in blood bank specimen collection result in | Administration of an incompatible blood product and the possibility of a fatal transfusion reaction |
| Name 3 reasons why a doctor would request a 2hr PP test | • Excellent screening test for diabetes • And gestational diabetes • Also used to monitor insulin therapy |
| Name 3 uses for Therapeutic drug monitoring | •To manage pts being treated with certain drugs-to help establish a drug dosage •When adjusting the dosage •In identifying noncompliant patients •In maintaining dosage at a therapeutic level •To avoid drug toxicity |
| BAC | Blood alcohol content/concentration |
| Name 3 symptoms of Septicaemia | • Fever • Chills • Malaise • Low blood pressure • Changes in mental status |
| Name 3 reasons why the use of an intermediate tube for blood culture is discouraged | •When added to BC bottle, SPS in collection tube increases the final concentration of SPS •Transfer of blood from intermediate tube to BC bottle can cause contamination •Transfer of blood to culture bottles presents an exposure risk to lab staff |
| PCV | Packed cell volume |
| Why is the aerobic bottle filled last when a syringe is used to collect blood cultures | Because any air in the top of the syringe could be drawn into the last bottle filled |
| SO2 | Oxygen saturation |
| Explain the difference between a FAN and an ARD blood culture bottle | • FAN bottles contain activated charcoal, which helps to neutralize the antibiotic • ARD bottles contain a resin that removes antimicrobials from the blood |
| Give 3 categories of drugs that typically require Therapeutic monitoring | • Antibiotics • Antifungals • Anticonvulsants • Bronchodilators • Cardiac drugs • Chemotherapy drugs • Immunosuppressants • Protease inhibitors • Psychiatric drugs |
| Give the rational for reminding the patient to finish the glucose beverage withing 5 min in the GTT procedure | • Results may be inaccurate if the patient takes longer to drink the beverage • As the glucose may start to be metabolized by the body, thus affecting the results |
| During TDM, explain the peak and the trough level for a drug to be beneficial | • 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 |
| Name 3 specimens used to do Toxicology tests | • Blood • Hair • Urine |
| ACT | Activated clotting time |
| Give the rationale for Marking the minimum and maximum fill on each of the culture bottles when collecting blood cultures | Blood culture bottle vacuum typically exceeds 10mL, so the amount of blood added must be carefully monitored |
| Name the 2 tests to diagnose Hemochromatosis | • Transferrin saturation (Total iron binding capacity) • Serum ferritin |
| What is the difference between clinical toxicology and forensic toxicology | • Clinical toxicology is concerned with the detection of toxins and treatment for the effects they produce • Forensic toxicology is concerned with the legal consequences of toxin exposure, both intentional and accidental |
| Name the specimen type used for glucose POCT | Whole blood |
| Which collection tube is preferred for lead analysis | Tan-top tubes containing K2EDTA |
| Name 3 cleaning solutions that can be used to clean the skin for ETOH specimen collection | • Aqueous benzalkonium chloride • Aqueous povidone iodine • Soap and water |
| Which collect tube is preferred for Blood alcohol specimens | Glass grey-top sodium fluoride |
| Why should a trace element tube be drawn in a separate draw and not a multi-draw | •Prevent introducing contaminating substance in the tube (amounts are in micro- / nanograms) •Contaminants in stoppers accumulate in the needle when a tube is pierced in a multi-tube collection •This carry over to the royal blue tube, changing results |
| Name the causes of secondary hemochromatosis | • Multiple blood transfusion • Hemolytic disorders • Iron supplements • Excess iron intake from foods |
| Name 2 uses for Ionized calcium in the body | • Critical functions such as muscle contraction • Cardiac function • Transmission of nerve impulses • Blood clotting |
| SAD | Seasonal affective disorder |
| Which 2 enzymes is released when the heart muscle is damaged during a heart attack? | • Creatine kinase • Aspartate aminotransferase |
| What is the difference between Grave’s disease and Hypothyroidism? | • Grave’s disease is characterized by weight loss, nervousness and protruding eyeballs, Increased metabolic rate • Hypothyroidism results in decreased metabolic rate, weight gain and lethargy |
| What is the major structural difference between arteries and veins | • The presence of valves in the veins • Arteries don’t have valves |
| How does the ADH decrease urine production? | It makes the distal convoluted tubule more permeable to water |
| Name 3 methods used to sterilize equipment | • Heat • Radiation • Chemical means |
| Describe 2 complications of diabetes | • Retinopathy – Damage to blood vessels of the retina (blindness) • Ulcers of the foot – often predispose to amputation |
| How often should bleach solutions for disinfection be changed? | • Daily How long does air drying take after cleaning the site? • 30 seconds – 1 minute |
| What is the difference between SST’s and RSTs? | • SST’s contain Silica clot activator and require 15-30 minutes to clot • RST’s contain Thrombin based clot activator |
| Why should tubes be held vertically when transferring blood from syringe to the tube? | • To prevent blood in the tube from touching the needle, this can cause the additive to be transferred to the next tube that is filled and contaminate it |
| DNR | Do not resuscitate |
| Why is the Sino-atrial node called the pacemaker? | It sets the basic pace or rhythm of the heartbeat |
| MMR | Measles, mumps and rubella |
| If untreated Hypothyroidism can lead to which condition? | Myxoedema |
| ED – Emergency department EMLA | Eutectic / Easily melted mixture of local anaesthetics |
| Hormones are synthesized from _________ or __________ | Amino acids or cholesterol based lipids |
| What is the advantage of the short needle on the winged infusion set? | The short needle allows a smaller angle of insertion |
| Except for causing hemolysis, why else would you not push on the syringe plunger to fill the tube? | It can cause the tube stopper to pop off |
| ISO | International organization of standardisation |
| Give a reason why the pituitary gland is often called the master gland of the Endocrine system | It secretes hormones that stimulate the other glands |
| The royal blue top tube is used for trace element testing. Which other tube can be used for lead testing? | The tan top tube |
| CP | Cerebral palsy |
| In which condition does lack of Thyroxine result in decreased metabolic rate? | Hypothyroidism |
| Give the function of the alpha and beta cells | • Alpha cells secrete glucagon to raise blood sugar • Beta cells secrete insulin to lower blood sugar |
| SA | Sinoatrial |
| Which needle defects is checked for when inspecting the needle? | • Blocked, blunt or bent tips • Rough bevels or shafts |
| At what temperature should tubes be stored in the bleeding rooms? | Between 4 – 25ºC |
| List 3 basic steps that can be taken to minimize trauma associated with venepuncture in someone that has needle phobia | • Have only the most experience and skilled phlebotomist perform the venepuncture • Have the patient lie down during the procedure, with legs elevated • Apply an ice pack to the site 10-15 minutes to numb it before venepuncture |
| ESRD | End stage renal disease |
| Name the hormones secreted by the adrenal cortex | • Aldosterone • Cortisol • Androgens |
| What is the function of oxytocin? | Stimulates contraction of uterus during labour and lactation |
| Why is the use of cotton wool for applying pressure not recommended? | • The cotton fibres tend to stick to the site. When the cotton wool is removes, the platelet plug sealing the site can be disrupted and bleeding reinitiated |
| Name 4 tubes in which Thixotropic gel is an additive | • SST – Serum separator tube • RST – Rapid serum tube • PST – Plasma separator tube • PPT – Plasma preparation tube |
| Why should sharps containers not be overfilled? | Overfilling creates a danger of sharps injury or other biohazard exposure (e.g. contact with infectious substances) to subsequent users |
| What should be done with a tube that has a powder additive before using it? | Lightly tap it before use so that the additive settle at the bottom of the tube |
| Name 2 functions of the sodium fluoride in the grey top tube | It preserves glucose and inhibits the growth of bacteria |
| How long should you observe the site for bleeding before applying a plaster | 5 – 10 seconds |
| Why is it better to use small volume tubes when drawing with winged infusion sets? | • It reduces the chances of specimen hemolysis |
| What is the function of the bevel of the needle? | The bevel allows the needle to easily slip into the skin and vein without coring (removing a portion of the skin or vein) |
| Which 2 methods does anticoagulants use the prevent blood from clotting? | • By binding or precipitating calcium so it is unavailable to the coagulation process • By inhibiting the formation of thrombin needed to convert fibrinogen to fibrin in the coagulation process |
| Why should adhesive bandages not be used on babies younger than 2 years? | They can aspirate and suffocate on it |
| Why should blood collected in an additive tube not be transferred to another additive tube? | • Different additives may interfere with each other or the testing process • If the additives are the same, an excess of the additive is created, which can negatively affect testing |
| Fist pumping during venepuncture mostly affects which 2 analytes? | • Potassium • Ionized calcium |
| Which factors would you consider when choosing the volume of a tube? | • Age of the patient • Amount of blood needed for the test • The size and condition of the patient’s vein |
| Why should a student Phlebotomist identify themselves as a student? | It is part of informed consent and the patients rights |
| Cross contamination / transfer of additives from one tube to the next | Carryover |
| Brain dysfunction caused by toxic levels of bilirubin | Kernicterus |
| Why is EDTA tubes used for haematology tests? | • It preserves blood cell morphology • And inhibits platelet aggregation |
| What can happen if you invert a citrate tube for an excessive number of times? | It can activate platelets and shorten clotting times |
| A persistent irrational fear of pins and needles | Belonephobia |
| Degree to which a microbe is capable of causing disease | Virulence |
| Metabolism of glucose | Glycolysis |
| A fibrous membrane that overlies the median vein and the lateral aspect of the median cubital vein | Bicipital aponeurosis |
| What unwanted effect does liquid EDTA have on specimens? | It dilutes the specimen and results in lower hemoglobin values, RBC and WBC counts, platelet counts, and packed cell volume |
| What is the first step in the preanalytical phase? | Test request |
| Needle that is attached to a syringe | Hypodermic |
| When palpating for a vein, what do you need to assess? | • Patency of the vein • Size and depth of the vein • Direction or the path the vein follow |
| To remove all blood | Exsanguinate |
| If a defective needle is used for venepuncture, what can be the consequences? | • Could injure a patients’ vein • Can cause unnecessary pain • Can result in venepuncture failure |
| A portion of a specimen used for testing | Aliquot |
| What is the purpose of a needle safety device? | Prevent percutaneous injury |
| Why do sodium citrate tubes need to be inverted immediately after collection? | To prevent activation of the coagulation process and microclot formation |
| Redness | Erythema |
| Whip like projection that propels a sperm cell | Flagellum |
| Process by which WBC move from capillaries into the tissues | Diapedesis |
| Explain why the grey top tube is drawn after the EDTA tube | • Because the potassium oxalate • Damages the cell membrane of the RBC • Resulting in abnormal cell morphology |
| Explain why capillary puncture is not appropriate for patients who are dehydrated | • Specimens may be difficult to obtain • Specimens may not be representative of the patient’s condition |
| Rod like device that fits into the barrel of a syringe and creates a vacuum when pulled back in the process of filling a syringe | Plunger |
| Hormone involved with the medical condition Diabetes insipidus | Anti diuretic hormone |
| Nerves that carry impulses away from the CNS | Motor / efferent nerves |
| Warming devices should not exceed what temperature? | 42 degrees C |
| Describe the correct procedure and order for removing the following PPE (gloves gown and mask) when leaving an isolation room | • Gloves are removed first • careful not to touch the outer aspect of the gloves) • The gown is removed second • Turned inside out • Held away from the body • Rolled up before discarding • Mask is removed last • Touching only the strings |
| Explain the meaning of dialysis | • Is a medical procedure/treatment • for patients with renal failure • have their blood artificially filtered to remove waste products |
| Examine by feel or touch | Palpate |
| Explain the difference between using a needle that is too large for the vein and a needle that is too small for the vein | • A needle that is too large for the vein may result in vain damage • needle too small for the vein may haemolyse the blood |
| Hg | Mercury |
| Provide 3 examples of what may not be done immediately after cleansing of the venepuncture site with an antiseptic (resulting in contamination of the site) | • Do not dry the alcohol / site with a swab • Do not fan or blow on the site • Do not touch the site after cleaning |
| Control material: • Consists of normal, low and high levels of analyte been tested. | Device or substance/solution needed for the quality control process |
| Provide the meaning for the root word “cubit” | Elbow |
| Explain the function of the alpha and beta cells of the pancreas | • Alpha cells secrete glucagon • Which increase blood sugar • Beta cells secrete insulin • Which lower blood sugar |
| Brain dysfunction caused by toxic levels of bilirubin | Kernicterus |
| Body system that includes the Meissner corpuscle | Integumentary system |
| In which layer of skin would you find the capillary bed? | Dermis |
| Define the function of the haematology department of the lab | Identify and monitor diseases associated with blood and blood forming tissue |
| List 2 of the most common diagnostic techniques that may be used in the histology department | • Tissue biopsy • Frozen section |
| Trapping of blood in an extremity by the compression of veins | Venostasis |
| Calibration | Process of testing and adjusting a specific instrument for testing. |
| Identify the principal function of antidiuretic hormone (ADH) | Decreases urine production |
| Identify any 3 tests that may be done on a bone marrow sample | • Chromosome studies • Bacterial cultures • Histological examination • Haematological examination of cells |
| Artery located on the medial aspect of the wrist | Ulnar artery |
| List 6 methods you could implement to assist in the location of difficult/ hard to find veins | • Rotating the arm slightly • Use a flashlight to assist finding veins on infants • Wiping the site with alcohol • Gently massage the arm from wrist to elbow. • Apply a warm compress to the arm for a few minutes • Use a vein locating device |
| Quality Control | • Checks included in a Quality Assurance process. • Used to identify and correct errors to ensure the quality of the product or service. |
| Give another name for the blood bank department of the lab | Immunohematology |
| What does a sphygmomanometer record? | Blood pressure |
| Using the correct medical terminology, identify 2 sites a doctor/pathologist may obtain a bone marrow sample for analysis | • Iliac crest • Sternum |
| Define the term phlebotomist | • Name given to a person who collects blood from veins for diagnostic purposes and blood donation. • It also includes instructing the patient in the collection of non-blood specimens. |
| Using the correct terminology, define the term PAP test/smear | • Papanicolaou • Screening test that looks for cell changes/ cervical cancer |
| Common artery used to monitor blood pressure | Brachial artery |
| Explain the procedure to follow if you accidently draw a tube in the wrong order | Draw a few ml of blood into a discard tube before using the correct tube |
| What is the depth of effectiveness of EMLA and how long does it take to achieve this? | • 5mm • One hour |
| Provide the term used to describe the relationship between the needle diameter and gauge, and give the meaning of the term | • Inverse/opposite relationship • The higher the gauge number, the smaller the diameter of the needle |
| Plural term given to the separating partitions that separates the various chambers of the heart | septa |
| Identify the disease condition due to a lack of ADH | Diabetes insipidus |
| Identify the function of the coagulation section of the lab | • Study the ability of the blood to form and dissolve clots • Monitor patients who are on anticoagulant therapy. |
| Name any 2 sampling tools/equipment that may be used for obtaining the sample from the cervix | • Specialised brushes • Specialised swabs • Spatulas |
| Give the correct term for the program or process designed to prevent future problems by evaluating present and past performance | Quality assurance |
| To which 2 structures do the chordae tendineae attach | • Atrioventricular valves to the • Walls of the ventricles |
| Name the specific instrument used during a PAP test/screen to visualise/access the cervix | Speculum |
| Describe the purpose of HIV pretest information/counselling | • Is an information sharing session given to a patient prior to HIV testing. • To perform a risk assessment and correct misinformation. • To enable the patient to make an informed choice on whether to proceed with testing or not. |
| Identify the two components of bone marrow sampling | • Biopsy • Aspiration |
| To which lab department is a PAP sent for analysis | Cytology |
| Destruction of RBC’s of an Rh positive foetus by the antibodies produced by the Rh negative mother | Haemolytic disease of the newborn |
| If an EDTA tube is under filled, what will the test results show | • Red blood cells will shrink • Abnormally low blood cell counts and haematocrits • Will negatively affect the morphological examination on a blood smear • Alter the staining characteristics of the cells on a blood smear |
| Identify 6 causes of haemoconcentration | • Tourniquet on for longer than one minute • Massaging the site • Vigorous hand pumping • Drawing blood from sclerosed or occluded veins • Probing for a vein • Long term IV therapy |
| The clear top portion of a urine sample after it has been centrifuged | Supernatant |
| Briefly explain the POPI Act | • Legislation that safeguards the integrity and sensitivity of private information. • Companies are required to carefully manage the data capture and storage process of Personal Information within the lawful framework as set out in the Act |
| As per Booklet One of the HPCSA ,General guidelines for the Healthcare Professions , state what the healthcare practitioners should do with regards to patient participation in their own healthcare | •Respect the rights of pts to be involved in decisions about there Rx, even if they are not legally competent to give the consent •Respect the rights of pts to refuse Rx •Inform the pts that they have a right to seek a second opinion |
| As per Booklet Two of the HPCSA , Ethical and Professional Rules of the HPCSA , state any 5 main responsibilities of healthcare practitioners A practitioner shall at all times | •Act in best interests of pts •Respect pt confidentiality •Maintain highest standards of personal conduct &integrity •Provide adequate information about the patient’s diagnosis, treatment etc •Keep professional knowledge& skills up to date Etc |
| Why should a phlebotomist pay special attention to personal hygiene and give two examples as to how one may maintain good personal hygiene. | •For optimal personal health •Phlebotomy involves dealing with patients& has close patient contact •Shower/Bathe •Regular use of deodorant •Use of mouthwash& brushing of teeth •Hair clean& neatly combed •Fingernails clean,short& neatly trimmed |
| According to the CLSI , briefly explain the correct procedure to transport blood tubes | Transport vertically Stopper up to reduce agitation&prevent haemolysis Allows blood to drain away from stopper to decrease chance of aerosols released when stopper is removed Aids clot formation in SST Prevents clot from sticking to stopper |
| What is the medical term for: Arterial composition of capillary blood has been increased by warming the site to increase blood flow | Arterialized |
| Give benefits of daily exercise | • Improves the quality of life • Strengthens the immune system • Increases energy • Reduces stress by releasing endorphinswhich creates a peaceful state • Able to relax even when under stress • Reduces symptoms of depression/anxiety |
| Obstruction of a blood vessel by an embolus | Embolism |
| Distended from being filled with blood | Turgid |
| List ways to control Stress | •Identify problem& talk about it •Learn to relax – relaxation techniques •Exercise regularly •Avoid making too many changes at once •Spend at least 15 minutes planning your day •Set realistic , practical goals •Avoid procrastination |
| Define Fomite | Inanimate objects eg. Computer keyboards that can harbour material containing infectious agents |
| Disorder involving the over production of RBC | Polycythaemia |
| List the components of a healthy , balanced diet | • Variety of natural foods • Good balance of carbohydrates, fats, proteins, vitamins, minerals and fibre |
| Define Iontophoresis | Electrical stimulation from electrodes placed on the skin , used in the production of sweat in the sweat chloride test |
| List strategies to prevent back injuries | Instructions concerning back mechanics , lifting exercises , lumbar support and exercise |
| Substance that coats the walls of the alveoli , lowering the surface tension and help keep the alveoli inflated | Surfactant |
| What is the major drawback/ disadvantage to using EMLA as a pain intervention? | Takes one hour to work/ anaesthetize the area |
| Briefy explain how you would apply a tourniquet on an elderly patient and why | Applied looser •the veins of elderly are often more easily found due to loss of elasticity of the skin •Skin may become entrapped in the buckle of the tourniquet if applied too tightly •May make the veins collapse more easily if tightened too tight |
| Explain the rationale of flushing the arterial line after obtaining a blood sample | • Clears the line of blood • To prevent blood clots |
| List instances when a capillary puncture must be done | •Fragile veins/veins kept for chemo •Several unsuccessful venepunctures-if test can be collected by this method •Pt with thrombotic/clot forming tendencies •Pt with belonophobia •No accessible veins–IV/scarred/burns •POCT procedures eg. Glucose |
| Provide indications/uses of an arterial line | • Continuous blood pressure monitoring • Administration of drugs • Collection of blood samples |
| What needs to be checked when receiving a rectal swab | • Check that there is stool on the swab |
| List challenges a phlebotomist may encounter when dealing with an elderly patient | •Skin changes •Hearing impairment •Visual Impairment •Mental impairment •Mobilty issues because of arthritis/patients in wheelchairs •Diabetes •Coagulation problems •Decreased immunity leading to infection •Safety issues – falls due to hazards |
| Describe ways a Phlebotomist can prevent the reflux of an additive during Venepuncture | •Keep pts arm in a downward angle so tube is always below the collection site allowing it to fill from bottom up •Avoid moving tube until the tube is removed •Tap powder tubes before collection to ensure that additives do not stick to stopper |
| After drawing the blood sample, describe the position the stop-cock valve/tap of an arterial line should be positioned. | • Open between the patient and the pressure bag • Closed to air/syringe port |
| Name the association (ASISA) that sets out protocols and standards for all aspects of Life Insurance | Association for Savings & Investment South Africa |
| List indications for environmental swabs | • Microbial monitoring • Allergen detection • Residue detection • Cross-contamination prevention |
| If a person is lactose intolerant, what mucosal enzyme do they lack? | • Lactase |
| Explain the following guidelines for good practice (as stipulated by HPCSA) Signing of official documents | • Sign Initials and Surname in block letters • Next to the signature |
| What is the definition of Confidentiality | • Medical confidentiality is both an ethical and legal duty • That the health care provider will keep secret all information relating to a patient that has been obtained either directly or indirectly during their duties with that patient |
| Explain the difference between serum and plasma | Serum is the product of clotted blood that is spun down in the centrifuge Plasma is the liquid portion of blood after centrifuging a specimen containing anticoagulated blood Serum don't have fibrinogen or clotting factors - its been used up in the clot |
| When reading a skin prick allergy test result, what 3 aspects need to be recorded on the request form | • Wheal • Flare (erythema) • Itch |
| Explain the process of haemoconcentration | When tourniquet remains on too long, pressure causes localised venostasis.Some of the plasma&filterable components of blood pass through capillary walls&into tissues Causing decrease in fluid component of blood&increase in nonfilterable large molecules |
| Explain the following guidelines for good practice (as stipulated by HPCSA) Reporting of impairment or unprofessional, illegal or unethical conduct: | •A student/practitioner shall report another student/practitioner to the Board if he convinced that the person is impaired •Report his/her own impairment •Report any unprofessional, illegal or unethical conduct of another student/qualified practitioner |
| State the primary purpose of performing environmental swabs | To assess the cleanliness and hygiene of surfaces in various settings, including healthcare facilities, food processing plants, laboratories, and public spaces |
| Describe the rule regarding the measurement of the positive control for a skin allergy test | • Must be 3mm • More than the negative control |
| Define the term “standard of care” | • Is the normal level of skill and care • That a health care practitioner at a specific level of training/qualification • Would be expected to adhere to • In order to provide due care for his/her patient |
| Briefly explain what organizations hope to achieve by doing environmental swabs | • monitor and identify potential sources of contamination • prevent the spread of infections • ensure compliance with health and safety standards |
| What is the function of the Lactase | • Breaks lactose • Into glucose and galactose |
| What is considered to be the ethical corner stone of professional behaviour in the health care field? | Confidentiality |
| Describe the difference between bone marrow aspiration and bone marrow biopsy | • Aspiration- done first. It removes bone fluid and cells • Biopsy- obtained after aspiration. It removes bone with marrow inside |
| What test may a doctor request the day before performing a lactose tolerance test? | • A 2hour GTT |
| Explain the process of haemolysis | • Is when the membrane of the red blood cell is damaged or broken • And the haemoglobin they contain is released into the serum or plasma • Giving the serum or plasma its pink to dark red colour (depending on the degree of haemolysis) |
| List 2 indications for a semen analysis | • To assess fertility • To assess the effectiveness of a vasectomy • Forensic/legal reasons |
| Explain the meaning of vicarious liability | • Health establishments are liable for the unlawful acts of persons employed by them • During the course and scope of their work |
| Explain the guidelines regarding the alteration of records | • No information may be removed from a health record • An error may be corrected by placing a line through it in ink and correcting it • Date of change must be entered • Correction must be signed in full • Reason for amendment specified on the record |
| Define Phlebotomy | It is the practice of drawing blood from a vein or through a cut in the skin |
| Define Kinesic slip | When verbal and non verbal messages do not match |
| List the common Hospital acquired Infection pathogen , which is antibiotic resistant | • Clostridium Difficile • MRSA (Methicillin Resistant staphylococcus aureus • Enterococcus |
| Define Exanguinate | To remove all blood |
| List four reasons why a Phlebotomist will be removed from the register | •Dont pay annual fees within 3 months of due date •Failure to notify Registrar of change of address •Failure to pay registration fees •Absent from SA for 3 years •Request to have their name removed •Have been registered in error or due to fraud |
| Define Kinesics | The study of non verbal communication , includes characteristics of body motion, language such as facial expression and gestures and eye contact |
| State Good Lab practices as per the text book Phlebotomy Essentials | •Keep current product insert for test in use •Follow instructions for specimen collection+handling •Proper pt ID •Label specimen correctly+attach barcode number •Inform pt of test prep (Fasting) •Read product insert before test •Follow storage |
| State the goals of Quality Assurance and Quality Control | •QA is to improve necessary work processes in the lab so that errors dont occur when producing the service or test result •QC is to ID weaknesses/errors in the lab processes at the practice level that could cause poor patient service or test result |
| Define window period | Time of initial infection/exposure until detectable HIV antibodies are isolated in the infected person’s blood |
| List the laws that protect HIV infected persons | • Labour Relations Act (66 of 1995) • Employment Equity Act (55 of 1998) • Basic conditions of employment Act (75 of 1997) • Occupational Health and Safety Act (85 of 1993) |
| Explain the impact of collecting a urine sample for MC&S that is contaminated | • Poorly collected, contaminated samples may result in the failure to isolate the causative organism. • It could lead to inappropriate treatment of the patient. It could be of no clinical benefit to the patient/the patient would not get well |
| Define Venepuncture | Involves collecting blood by penetrating a vein with a needle attached to a blood collection device or syringe |
| Describe 2 of the most common procedures that are used for phlebotomy | •Venepuncture- inserting a needle into the vein (attached to either a syringe or ET system) for the means of obtaining venous blood for testing •Capillary puncture- collecting dermal blood after pricking the skin with a specialised&age appropriate lancet |
| State the procedure to follow, should a venepuncture site continue to bleed post venepuncture | • Continue to apply pressure until the bleeding stops • Should the bleeding continue after 5 minutes of applying pressure , inform the patient’s physician/nurse |
| Explain why saline adenine glucose mannitol (SAGM) is added to red cell concentrates | Extends the expiry date of RBC from 21 to 42 days |
| Briefly explain how the quality and sterility of a needle or lancet is ensured prior to use | •All puncture devices come in sealed, sterile containers •Must only be used once&discarded •If seal is broken, discard and use a new needle •Defects in needles eg. rough edges, can be avoided by inspecting every needle after unsheathing |
| Define Proxemics | The study of an individual’s concept and use of space |
| Define HIV | Human Immunodeficiency Virus – a retrovirus that attacks and destroys the CD4 cells of the body resulting in a weakened immune system |
| Explain why it is not permissible to draw specimens for coagulation studies by means of a dermal puncture | • Puncturing the skin releases tissue thromboplastin • Which will activate the coagulation cascade and result in erroneous coagulation results |
| What is the storage requirements of Packed red cells | 2-6 ◦C |
| What is Packed red blood cells processed from | Whole blood , plasma and buffy coat removed |
| What are the purpose of therapeutic phlebotomy | • To reduce blood volume • to reduce RBC mass • To reduce iron stores |
| Define incubation period | From the time that the virus enters the body until the patient presents with symptoms |
| Define Capillary puncture | Involves collecting blood after puncturing the skin with a lancet or special incision device |
| Define risk management and state 2 ways how this can be managed | • An internal process focussed on identifying and minimizing situations that pose a risk to patients and employees • Managed by controlling risk to avoid incidents paying for occurrences after they have happened |
| Define Seroconversion | Process whereby detectable HIV antibodies are produced and where the patient will convert from HIV negative to HIV positive |
| Define Ambulatory Health Facility | Caters for Outpatients |
| Define AIDS | Acquired Immune deficiency syndrome – following a HIV exposure and subsequent infection , an increased viral load and decreased CD4 count results in opportunistic infections |
| List the 7 Stages of the life cycle of the HI Virus | 1.Binding/Attachment 2.Fusion 3.Reverse Transcriptase 4.Integration 5.Replication 6.Assembly 7.Budding |
| On which patients is capillary puncture not appropriate? | • Dehydrated patients • Patients who are shocked (due to peripheral shut down) • Patients who have poor circulation to the extremities |
| Briefly explain the instructions that you would give to a patient post venepuncture after the application of a plaster | • Patient to leave plaster on for at least 15 minutes and not longer than 30 minutes to avoid irritation • Patient not to carry any heavy objects using that arm • To not carry out any strenuous activity or exertion with that arm • Do not bend the arm |
| What is the pack additives in the bag for Packed red blood cells | • CPD • SAGM |
| What is the function of Citrate in the CPD additive | Prevents clotting by binding the calcium in the blood |
| List the analytes commonly measured on a blood gas sample | • Ph • PaO2 • PaCO2 • HCO3 • O2 Saturation • Base Excess |
| Describe according to the Children’s Act (38 of 2005) the conditions for obtaining informed consent from a child for medical treatment | A child may consent to his medical treatment or the medical treatment of his child if: •the child is over 12 years and •is of sufficient maturity and has the mental capacity to understand the benefits, risks, social and other implications of treatment |
| Explain what the main role of the HPCSA is | •Serving+ protecting the public+all consumers of health care •Providing guidance to registeredbHCP on educational, professional+ethical issues •Certify qualified phlebotomists after successful completion education requirements and passing of exam |
| State what information , besides patient identification , demographics , signature , DR’s details , should be recorded on a request form prior to taking a blood gas sample | •Pt’s temperature •Respiratory Rate •Ventilaton Status •Fraction of inspired Oxygen •Is the pt on room air/Oxygen therapy •Is the pt in a stable/steady state – no exercise /suctioning /or respirator changes for at least 20-30 minutes prior |
| Patient conditions that may indicate need for therapeutic phlebotomy | • Hemochromatosis, • Polycythemia vera |
| What is the function of Phosphate in the CPD additive | Stabilises the Ph of the blood |
| What is the function of Dextrose in the CPD additive | Provides energy for the cells and keeps them viable |
| Briefly explain what you understand by the terms ‘ethical behaviour’ in phlebotomy ? | •Requires conforming to a standard of right+wrong conduct to avoid harming a pt. Putting the welfare of pts before own needs+making the right choices to maintain a high level of personal respect •As well as for colleagues, pts and the profession |
| Effective communication with a patient is extremely vital for excellent patient care .List barriers a phlebotomist may face in this regard | • Culture diversity (race, gender) • Emotions • Language • Age • Physical issues (deafness, unconsciousness) • External factors (noise, distractions) |
| State reasons why a light green top tube is an excellent choice for stat (urgent) potassium? | • The blood does not need to clot – time is not wasted. • The heparin does not interfere with the results • The gel prevents potassium leakage from the red blood cells into the plasma. |
| Explain the action of an Antiglycolytic | Is a substance that prevents glycolysis, the breakdown / metabolism of glucose by the cells |
| List the important steps to follow when troubleshooting failed venepuncture | • Stop all needle movement • Assess the situation • Correct the problem |
| Define the term “antecubital fossa” | Shallow depression on the anterior aspect of the elbow where the main veins for phlebotomy are found |
| Describe how you may be directly exposed to blood borne pathogens in the work place? | • An injury with a sharp contaminated object • Direct skin contact with blood/ or certain body fluids ( especially on unbroken skin) • Blood or certain body fluids coming in contact with your mucous membranes ( eg.splashes in eyes and mouth and up nose) |
| Define pre-analytical | From the time the test is ordered until testing begins |
| Provide 5 examples of tubes that contain EDTA | •Lavender top Tubes •Pink tubes used at Blood Bank •Royal Blue tubes with lavender colour coding on the label •Tan top tubes used for lead analysis •White/pearl top tubes with thixotropic gel separator •Micro collection tubes with lavender tops |
| Identify the first step to take when cleaning any blood spill | Put on the appropriate PPE (gloves, apron, show covers) |
| Describe what is meant by the order of draw? | • The specific order in which tubes are drawn • to reduce risk of contamination with additives from other tubes |
| Identify what may be used to absorb a large blood spill | Special clay or chlorine-based powder or chlorine pads |
| What is the most common Antiglycolytic called | Sodium Fluoride |
| Explain the concept of “3 way” patient identification for a hospital patient | •The patient gives a verbal statement of their full name, surname, DOB •Checking the details on the patient’s ID bracelet •A comparison of the labelled specimen with the patient’s ID band and request form (before leaving the bedside) |
| Name the 3 layers of the blood vessels, starting from the outer layer, AND give a brief description of what each layer is composed of | • Tunica Externa/Adventitia - Made of connective tissue • Tunica media - Made of smooth muscle and elastic fibers • Tunica intima/interna - Made of single layer endothelial cells |
| Briefly list sections that you would find in the MSDS (Material Safety Data Sheet ) | •ID of chemical •Hazard ID •Composition+info on ingredients •First aid •Fire fighting •Accidental release •Handling+Storage •Exposure controls/Personal protection •Physical+chemical properties •Stability+Reactivity •Toxicological info |
| How is broken glass removed from a large blood spill? | Using tongs or heavy-duty utility gloves |
| EPO | Erthryopoietin |
| Following PPE , identify the first step to take when cleaning a dried blood spill | Moisten the spill with disinfectant (such as biocide) |
| Briefly describe the structure of capillaries | • Microscopic • One cell thick vessel • Connect arterioles and venules |
| State how a person may achieve lasting immunity to hepatitis B? | • Through previous infection with Hep B virus • Immunization against Hep B |
| Give a brief description of the steps required to perform a proper hand washing procedure in the workplace (as described in text book) | •Stand back so you have no contact with sink •Open tap+wet hands •Apply soap+work to a lather •Scrub all surfaces of hands, incl between fingers •Rub hands vigorously •Rinse hands •Dry hands with a clean paper towel •Turn off tap using paper towel |
| State 4 urine collection methods | • Regular voided specimen • Midstream urine / clean catch • Catheter specimen • Supra pubic aspiration |
| Describe the correct site for performing a capillary puncture on adults and children over one year | • Palmer surface • Of the distal/end segment • Of the middle or ring finger • Of the non-dominant hand • On the fleshy pad slightly to the side of centre • Perpendicular to the whorls of the fingerprints |
| Explain why it is important not to over energetically shake the Quantiferon tubes after filling with blood? | Over shaking could result in dislodgement of the gel and affect test results |
| State how keeping the skin folds separated and passing the first portion of urine into the toilet affect a clean catch sample for a female? | • Separation of the folds following the cleaning maintains site asepsis. • Washes away antiseptic residue and microbes remaining in the urinary meatus |
| State what CLSI recommends if a doctor specifically requests a blood culture to be drawn from a VAD | Blood is also drawn by venepuncture for comparison |
| List 4 criteria that are critical as quality control measures for any POC testing program | • Calibrate equipment • Run controls • Perform regular maintenance • Accurate record keeping |
| State the consequence if urine specimens are not tested/preserved promptly and provide an example of this | • Urine components can change / cellular elements decompose • Bilirubin breaks down to biliverdin and bacteria multiply , leading to erroneous results |
| Describe how to measure a Mantoux result 48- 72 hours after it has been performed | • Measure the broadest diameter • Of the area of induration • using a mm ruler • Do not measure the red area |
| List the Instructions for preparation to be given verbally or in writing to a patient BEFORE they undergo a 2-hour standard glucose tolerance test. | •Eat balanced meals of 150g carbohydrate 3 days before test •Fast 8 -12hrs, but not more than 16hrs prior to test •Have sips of water to remain hydrated •No strenuous exercise 12 hours before test •Do not smoke or chew gum 8 hrs prior to test |
| What makes the “LUBB” hear sound | Closing of Atrioventricular valves |
| List the items of equipment needed to perform a PAP smear | • Lubricant jelly • Speculum • Aylesbury spatula/ cervix brushes/ combi brushes • Liquid based cytology containers • Glass slides with fixative |
| List the 3 basic sequential components of a sweat test | • Sweat stimulation • Sweat collection • Sweat analysis |
| The purpose of an Initial Specimen Diversion device (ISD) is to: | Isolate the first 1.5-2ml of blood prior to blood culture |
| How do the FAN culture bottles differ from the other blood culture bottles? | They contain resins or charcoal |
| Which organ that secretes erythropoietin | Kidneys |
| Explain the procedural principles for lactose tolerance testing | •A 2-hour GTT should be performed the day before the test •A 2-hour lactose tolerance test is performed in the same way as the GTT •An equal amount of lactose is substituted for the glucose •Blood samples are drawn at same time as the previous GTT |
| Explain the basic requirement necessary for anyone who performs POC testing to ensure accurate patient results | To be able to carry out QC and maintenance procedures |
| Briefly explain the consequences that may result in erroneous results if urine samples are not tested promptly or preserved | • Bacteria may multiply • Cellular elements may decompose • Bilirubin may break down to biliverdin |
| Identify the urine collection method that involves the physician inserting a sterile needle directly into the urinary bladder and into a sterile syringe | Suprapubic aspiration |
| Explain 2 reasons why urine is not recommended to assess alcohol intoxication | • Ethanol is volatile /evaporates so may result in false negatives when uncapped • If the urine contains glucose or certain microorganisms (candida albicans) • It may result in false positive results |
| What is the main difference between the nanoduct collection and macroduct collection | • Nano duct is a screening for cystic fibrosis • Macroduct is a quantitative test performed after a positive nanoduct test |
| What makes the “DUPP” heart sound | Closing of semilunar valves |
| Identify the primary indication for performing a DNA /Cologuard stool test | Detects colon cancer |
| As per Booklet One of the HPCSA, General guidelines for the Healthcare Professions state what the healthcare practitioners should do with regards to patient participation in their own care | •Respect pt's rights to be involved in decisions about their Rx, even if they aren't legally competent to give consent •Respect pt's rights to refuse treatment •Inform pt's that they have a right to seek a second opinion |
| Explain the purpose of a blood cotinine test for insurance purposes | • To distinguish between tobacco users and non-users |
| Identify the procedure used to obtain a CSF specimen | Lumbar puncture |
| Briefly explain how the quality and sterility of a needle or lancet is ensured prior to use | •All puncture devices come in sealed, sterile containers •Must only be used once only •Check expiry date •Should the seal be broken, discard into sharps and use a new one •Defects in needles are avoided by inspecting every needle after unsheathing |
| What is the indication/trigger for the release of Erythropoietin and the effect it has once secreted | • Released when oxygen levels are low • Stimulates RBC production |
| Besides its anticoagulant qualities, briefly explain 2 other benefits of using sodium polyanethol sulfonate /SPS in blood culture | • Reduces the action of the compliment system (which destroys bacteria) • Slows down the ingestion of bacteria by leukocytes • Reduces the activity of certain antibiotics |
| Explain the criteria that need to be adhered to when urine collection instructions are explained to a patient to ensure a quality result | • Use a language the patient understands • Level of literacy • Explain without embarrassing the patient • Should be accompanied by written instructions • Preferably with illustrations to facilitate understanding |
| Identify the 3 areas which should not be touched with the swab when performing a throat swab | • Lips • Tongue • Uvula |
| Murmurs | Abnormal heart sounds |
| What temperature should tubes be stored | Between 4- 25 degrees C |
| Briefly explain the lactose tolerance test results if the patient is lactose intolerant | • Glucose levels will rise slightly from the fasting levels • Resulting in a flat curve |
| List 3 ways a bilirubin sample may be protected from light | • Wrapping the tube in foil • Collect blood into an amber container • Use light blocking transport tubes |
| Identify the test specific indication for performing the following timed urine test: CREATINE CLEARANCE | Kidney function |
| Explain the specimen handling requirement if urine specimens cannot be tested within 2 hours of collection | • Refrigerated • Chemically preserved |
| Describe the location of the Atrioventricular node | • Bottom of the right atrium • In the interatrial septum |
| List 2 possible consequences of forcing blood into a vacuum tube during a syringe to tube transfer | • The specimen may hemolyze • The tube stopper may pop off due to excess negative pressure |
| What is the term for the test used to determine if the donor unit of blood and the blood of the recipient are compatible | Crossmatch |
| Identify the test specific indication for performing the following timed urine test: 2-HR POSTPRANDIAL SPECIMEN | Monitor insulin therapy of diabetic patients |
| Between which vertebrae is the spinal needle inserted during the above-mentioned procedure to avoid injury to the spinal cord | Between 3rd & 4th lumbar vertebrae |
| Define quality indicators | Measurements of /values that provide information on the effectiveness of processes |
| Titre | Strength of naturally occurring antibodies |
| List patient complications/conditions that may occur either before, during or after venepuncture | • Allergies to equipment/supplies • Excessive bleeding • Fainting • Nausea & vomiting • Pain • Seizures • Petechiae |
| FAN | Fastidious antimicrobial neutralization |
| Identify the test specific indication for performing the following timed urine test: 5-HYDROXYINDOLEACETIC ACID | Serotonin levels/serotonin producing tumor |
| Provide ways you can avoid lawsuits in the workplace | •Correct pt ID •Get informed consent •Respect confidentiality •Listen to+respond to pt requests •Monitor pt before, during+after procedures •Adhere to facility protocols •Perform standard of care •Be CPD compliant •Use safety devices correctly |
| When should blood cultures ideally be collected if a patient is on antibiotics? | When the antibiotic is at its lowest blood concentration |
| List categories of drugs that typically require therapeutic drug monitoring | • Anticonvulsants • Antibiotics • Psychiatric drugs • Immunosuppressants • Bronchodilators • Cardiac drugs • Protease inhibitors • Chemotherapy drugs |
| Provide examples of specimen rejection criteria | •Special handling not met •Inaccurate patient ID •Delay in testing •Wrong tube •Expired tube •Haemolysis •Underfilled tube •Quantity insufficient for testing •Micro clots in sample •Delay in processing or testing •Contaminated specimen |
| The refractometer measures | Specific gravity |
| Provide 2 other names for POC testing | • Alternate site testing • Near patient testing • Ancillary/bedside testing |
| List 3 indications for performing a 2hour postprandial test | • Screening for diabetes • Screening for gestational diabetes • Monitoring insulin therapy |
| Half-life | Time for the body to metabolise half the amount of the drug |
| Give the correct term for the portion of specimen used for testing | Aliquot |
| Identify the test specific indication for performing the following timed urine test: DOUBLE VOIDED SPECIMEN | Test urine for glucose & ketones |
| List 4 reasons why the lid/cap of UA reagent strips should be tightly capped when not in use | • To protect from light • Protect from moisture • Protect from chemical contamination • Protect from heat |
| Give the correct term for an increase in serous fluid production, usually because of inflammation or an increase in serum protein levels | Effusion |
| Provide 8 details that are included on the cover page of an SOP | •Document number •Document name •Document type (sop/work instruction) •Revision number •Status (approved) •Prepared by, uploaded by, approved by •Implementation date •Next review date •Related documents (ECS) •Amendments |
| Transfusion reaction | Incompatible blood results in agglutination and lysis of the recipients red blood cells |
| Explain the process/ pathophysiology of haemoconcentration | •Tourniquet left on longer than 1 min cause increased pressure below the tourniquet •plasma+filterable components pass through capillary walls+into tissue •larger non filterable components increase in concentration resulting in falsely elevated results |
| When measuring the client’s height, list the parts of the body that needs to have direct contact with the stadiometer | • Back of the head • Shoulder blades • Buttocks • Heels |
| List the sections/ headings that you would find in the MSDS | •Chemical ID •Hazard ID •Composition&info on ingredients •First aid measures •Firefighting measures •Accidental release measures •Handling&Storage •Exposure controls •Physical&chemical properties •Stability&Reactivity •Toxicological info |
| State the primary purpose of performing environmental swabs and give an exampleof where these can be done | • To assess the cleanliness and hygiene of surfaces in various settings • including healthcare facilities, food processing plants, laboratories, and public spaces |
| Autologous | Blood donated for one’s own use |
| Distal | Farthest from the centre of the body, origin or point of attachment |
| Cartilage | Type of hard non-vascular connective tissue |
| Name the association that sets out protocols and standards for all aspects of Life Insurance | Association for Savings & Investment South Africa |
| Circadian | Biologic rhythms having a 24-hour cycle |
| Oedema | Swelling due to abnormal accumulation of fluid in the tissues |
| Plunger | Rodlike devise that fits snugly into the barrel of a syringe and creates a vacuum when pulled back. |
| List the blood tests commonly requested for insurance purposes? | • Cholesterol • Gamma GT • Glucose/HBA1C • Cotinine • HIV |
| Describe the difference between bone marrow aspiration and bone marrow biopsy | • Bone marrow Aspiration is done first -Removes bone fluid and cells • None marrow biopsy Biopsy is obtained after aspiration -Removes bone with marrow inside. |
| Arterialized | Arterial composition of capillary blood has been increased by warming the site to increase blood flow |
| Longest vein in the body | Great saphenous vein |
| Guaiac | Resin that is impregnated in filter paper and used for traditional occult blood testing |
| Prior to taking a clients height measurement for insurance purposes, what should the client be requested to remove? | Shoes |
| Provide 3 indications/uses of an arterial line | • Continuous blood pressure monitoring • Administration of drugs • Collection of blood samples |
| Buffy coat | Layer of white blood cells and platelets that forms between the RBCs &plasma when anticoagulated blood settles or is centrifuges |
| Differential | Test in which the number, type, and characteristics of blood cells are determined by examining a stained blood smear under a microscope |
| After drawing the blood sample, describe the position the stop-cock valve of an arterial line should be positioned. | • Open between the patient and the pressure bag • Closed to air/syringe port |
| Provide examples of documents that need to be retained in an employee’s personnel file | •curriculum vitae (CV) •Educational qualifications •Proof of registration with statutory body •Job description •Induction record •Proof of CPD •Record of HEP B status, signature record, PPE, confidentiality •Performance reviews •Incident records |
| Haematocrit | Percentage by volume of red blood cells in whole blood |
| Supernatant | Clear top portion of a urine sample that has been centrifuges |
| Besides being easy to obtain, provide 2 reasons why urine is preferred for drug screening? | • Many drugs are detected in urine and not blood • Drug metabolites are detected for a longer period in urine than in blood |
| List common coagulation tests | • Activated partial thromboplastin time • D-Dimer • Fibrin split products • Fibrinogen • Prothrombin time/INR • Thrombin Time |
| Bilirubin | By product of the breakdown of red blood cells |
| The degree of head tilt required for a nasopharyngeal swab is: | 70 degrees |
| Coronal plane | Divides the body into front and back portions. |
| Vasopressin | Antidiuretic hormone |
| Basophils | White blood cells that release heparin and histamine |
| Palpate | Examine by feel or touch |
| Glomerulus | Tuft of capillaries that filter water and dissolved substances, including wastes from the blood |
| Word root | Part of a medical term that establishes its basic meaning |
| Identify the 3-quality assurance pre-analytical phases that may invalidate test results if not monitored | • Patient preparation • Specimen collection procedures • Specimen handling |
| Quality indicators | Measurements or values that provide information on the effectiveness or quality of processes |
| List examples of the typical information found in a procedure manual | •Purpose of procedure •Specimen type&collection method •Equipment&supplies required •Step by step procedural steps •Limitations and variables of the method •Corrective actions •Normal values and references •Review dates •Approval signature&dates |
| Identify how risk factors in phlebotomy can be identified | By trends in incident reports |
| List 5 types of patient consent | • Informed consent • Expressed/express consent • Implied consent • Consent for minors (under 12 years) • Refusal of consent |
| List the typical functions of a hospital infection control program | • Implements procedures aimed at breaking the chain • Monitors and collects data on all infections occurring within the institution. • Implements special precautions in the event of outbreaks of specific infections |
| Turgid | Distended from being filled with blood |
| Bariatric | Pertaining to the treatment of obesity |
| Buccal swab | Swab of material collected from the inside of the cheek |
| Kinesics slip | When verbal and nonverbal messages do not match |
| Exsanguination | Blood loss to a point where life cannot be sustained |
| Kernicterus | Medical term for brain dysfunction/damage caused by toxic levels of bilirubin |
| Threshold value | A level of acceptable practice beyond which quality patient care cannot be assured |
| Define Risk Management | An Internal process to identify and minimise situations that poses a risk to patient and employees |
| Provide 2 negative consequences to wearing gloves that are too big/too loose | • Reduce dexterity • Increase possibility for contamination or injury |
| List the first 3 action steps to take if electrical shock occurs | • Shut off the source of electricity • If the electrical source cannot be turned off use a non-conducting material to remove the electrical source from the victim. • Call for medical assistance |
| Root cause analysis | Formalised investigation and problem-solving approach used after an event or problem has occurred. It also focuses on trends and the underlying root cause of the event |
| Define Standard of care | • The normal level of skill and care that • A HCP at a certain level of training would be expected to adhere to • To provide due care to the patient |
| A microorganism that primarily infects individuals with a weakened immune system is called | Opportunist |
| Explain the steps to correctly remove the second glove during the glove doffing procedure | • Slip the fingers of the ungloved hand • Under the second glove at the wrist • Pull it off the hand • With the first glove inside the second • With contaminated surfaces inside |
| List the required properties for a chemical spill kit clean up material to be effective | • Absorbent • Neutralising |
| Provide 2 reasons why food found on the shelves of grocery stores have little nutritional value | • It is Highly processed • and Chemically altered |
| List the factors that determine the 4 biosafety levels as established by the CDC | • How transmissible the microbe is • Its means of transmission • The seriousness of the disease • availability of an effective vaccine or treatment |
| Which blood test is an indicator of unstable atherosclerotic plaque? | Plasma ceramides |
Created by:
cisca