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Miscellaneous
| Question | Answer |
|---|---|
| What is the scope of the phlebotomist miscellaneous procedures | Assist doctors/pathologists/nurses with preparation of equipment, care of patient before, during and after the procedure |
| The following are examples of duties of a phleb during a bone marrow biopsy except A) Assist Pt to assume post procedure position B)Open containers in aseptic manner C)Prepare/Make Slides | C) Prepare/Make slides |
| Name 3 areas where red bone marrow is mainly found | •Hip Bone(iliac crest) •Sternum •Skull |
| Where is yellow bone marrow mainly found | In the hollow interior(shaft portion) of long bones. |
| Name the thin fibrous membrane that covers most bones | Periosteum |
| Name the hormone that stimulates the production of RBC in the bone marrow and the organ that secretes it | Hormone- Erythropoietin Organ-Kidneys |
| True or False. During critical blood loss, the red bone marrow can be activated and transformed into yellow bone marrow. | False. The Yellow bone marrow is reverted into red bone marrow |
| Give the term for the process by which blood cells are produced in the body | Hematopoiesis |
| Where does hematopoiesis take plac3 | In the bone marrow |
| List 4 hematologist indications for Bone Marrow Biopsy | •Cancers of bone marrow/blood such as leukemia+lymphoma •Anemias/Low RBC count •Blood cell conditions such as polycythaemia/leukopenia •Hemochromatosis(iron build up) |
| What is the difference between bone marrow biopsy and bone marrow aspiration | Aspiration is usually done prior to biopsy, it removes a small amount of body fluid+cells for cytology, chromosome disorders+infection. Biopsy is obtained once Aspiration is done,removes bone+bone marrow inside to examine under microscope for histology |
| TB and FUO are indications for Bone marrow biopsy. True or False | True |
| What medication is important to document if Pt is taking prior to bone marrow biopsy | Anticoagulants |
| List equipment necessary for bone marrow biopsy | •Sterile Gloves •Bone marrow biopsy tray •Cleaning solutions(iodine+chlorhexidine gluconate) •Local Anaesthetic(1% lignocaine) •25G+22G needles •EDTA+Heparin Tube's •Hematology slides •Specimen Jars •Fixative |
| Which site is most used to obtain bone marrow sample | Posterior Superior iliac crest |
| Name 2 positions that a Pt may be placed in for bone marrow biopsy | •Lateral Decubitus •Prone |
| Which antiseptic is used to prepare the skin for bone marrow biopsy | Iodine+Chlorhexidine Gluconate |
| What needle gauge is used to infiltrate local anesthetic into superficial tissue | 25G |
| What needle gaugwis used to infiltrate local anesthetic into deeper tissue | 22G |
| Briefly explain bone marrow aspiration | Incision is made with a scalpel blade, bone marrow aspiration needle+stylet locked in place is inserted. It's rotated until cortical bone is penetrated+bone marrow cavity entered. Stylet is removed+replaced with a 20cc syringe+bone marrow aspirated to |
| Which two blood Tubes may the pathologist request during a bone marrow procedure if a delay in slide preparation is anticipated | EDTA(Paeds edta to avoid excess exposure to anticoagulant) Heparinised Tube(for cytogenetic analysis) |
| Name the needle commonly used to perform bone marrow biopsy | Jamshidi Needle |
| Name the most common side effects of bone marrow biopsy | •Excessive Bleeding •Infection •Allergic reaction to local anesthesia and cleaning solutions •long lasting discomfort at the biopsy site |
| Define iontophoresis | Electrical stimulation from electrodes placed on the skin. Used in the production of sweat in the sweat chloride test |
| Pilocarpine | A sweat stimulating drug used in the swear chloride test |
| What is cystic fibrosis | A genetic endocrine disorder affecting cells that produce mucus,sweat and digestive juices |
| What is the purpose of sweat test | Measures the concentration of chloride excreted in sweat(which is higher in Pt with C.F due to the defective chloride channels) |
| Nanoduct collection is a A)_______screening test for B)________ | A)Qualitative B)Cystic Fibrosis |
| Macroduct collection is a A)_______sweat test usually done after a B)______nanoduct result | A)Quantitative B)Positive |
| A result of more than A) 60mmol/l B) 0.6g/ml C)6mmol/l | A)60mmol/l |
| List the basic sequential components of sweat test | 1. Sweat stimulation(Iontophoresis) 2.Sweat collection 3. Sweat analysis |
| Precautions for Nanoduct Sweat test | •Infant to weigh +2kg •Pt not dehydrated + not on open oxygen therapy •Skin free of eczema+oedema •Site=inner aspect of forearm. Never on separate limbs/chest •Pilocarpine gel disc checked for expiry date+cracks prior to use |
| What risks does a sweat test pose to Pt | Irritation of skin due to pilocarpine,small risk of burns |
| What is measured during macroduct test | Chloride and Sodium |
| What is the minimum sweat volume for testing | 20 microlitres(3-4 coils of the spiral collection tubing) |
| How long is sweat stimulation time and sweat collection time | Stimulation: 5-10 minutes Collection: 25-45 minutes |
| Besides the forearm, what other sites can be used for sweat test | Legs or thighs on infants or toddlers |
| PAP | Papanicolaou |
| What is the purpose of PAP Smear | Method of cervical screening used to detect potentially precancerous and cancerous processes in the cervix by looking for cell changes on the cervix that might become cervical cancer if not appropriately treated |
| What does HPV test, tests for | Looks for the human papillomavirus that can cause these cell changes |
| When is it preferable to collect a pap smear | •2 weeks after first day of the LMP •5 days after the menstrual cycle has ended |
| When can the following groups of people have a PAP smear A)Younger than 21 yrs B)21-29 yrs C)30-65 yrs D)Over 65 yrs E)Post hysterectomy | A)1 yr after initial sexual intercourse B) Every 3 yrs C) Every 5 yrs(Every 3 yrs if previous abnormal PAP) D)Stop if no abnormal smears+HPV negative E)No screening if cervix removed |
| List 7 clinical information that needs to be recorded on request form when PAP smear is performed | •Menstrual status-LMP •Inter-menstrual&Post-coital bleeding •Use of IUCD •Pregnant/Post Partum •Radiation&Chemotherapy •Age/Post menopausal •Laser,Biopsy,Surgical History |
| List 5 items of equipment required for PAP smear, besides PPE | •Glass slides (with pencil to label slides) •Liquid based cytology containers •Lubricant(KY Jelly) •Various sizes of speculum(surgical steel/disposal) •Aylesbury spatula,cervical brushes,combi-brush |
| List 5 benefits of cervix brush and combi brush | •Reaches beyond the transformation zone" into the cervical canal •Reduces the number of Inadequate smears•Only requires 2 rotations during sampling•Reduces bleeding&pain associated with the spatulas•Used 4 slide preps&,LBC |
| Study page 68 notes | Procedure preparation and sampling procedure |
| True or False Phlebotomist may not be in the room during the performance of PAP smears | True |
| Study FNA,Skin Biopsy and shirt medical insurance | |
| What is Fine Needle Aspiration | A minimally invasive way to obtain a cell sample to confirm diagnosis or guide treatment often performed when a suspicious lump,enlarged lymph mode/abnormality is detected on an imaging test such as x-ray, ultrasound/mammography |
| FNA require anaesthetic True/False | False |
| FNA increases the risk of postoperative infection and scarring | False |
| List the equipment used for FNA | •25-22G hypothermic needle •5-10ml syringe •Slides •Fixative •Cleaning solutions •Sharps container&Biohazard bin |
| List the roles of a phleb during FNA | •Ensure necessary equipment +trolley is available •Antiseptic solutions •Sterile dressing+tape •Document anticoagulants+allergies to antiseptic •Assist with Pt positioning+support the Pt |
| What is skin biopsy | A procedure that removes a small sample of skin to diagnose skin conditions,infection or cancer |
| Name 3 types of skin biopsies | •Shave Biopsy •Punch Biopsy •Excision Biopsy |
| What does the skin Biopsy procedure entails | •Cleaning the area with alcohol /disinfectant •Injecting a local anesthetic to numb the area •Removing skin sample with biopsy punch,razor,scalpel •Suturing the wound, application of dressing |
| Briefly describe Shave biopsy | Uses razor blade/scalpel to remove a superficial layer of skin. A razor is used to scrape the surface of skin . |
| Briefly describe punch biopsy | Uses circular or elliptical blade to remove sample of skin that can include the full thickness of the skin. Rounded-tipped cutting tool is used to remove deep layers of skin |
| Briefly describe Excision biopsy | Use scalpel to remove the entire lesion along with some normal skin around it |
| What information does a phlebotomist need to confirm with Pt before skin biopsy | •Diabetic •Any previous skin infections •Any bleeding disorders •Taking blood-thinning medication |
| Post biopsy Pt education includes? | •Don't scratch the area •Do not apply any ointment other than those prescribed by Dr •Follow all dressing care instructions •Report any bleeding, redness,swelling,pain to the dr |
| ASISA in full | The Association for Savings and Investments South Africa |
| Function of ASISA | Sets out protocols and standards for all aspects of life insurance to ensure that insurance companies adhere to the highest standards in the screening of those who apply for insurance |
| Who may collect samples for insurance screening | •Dr •Registered+Enrolled Nurses •Registered Qualified Phlebotomist |
| Who may perform short medicals for insurance purposes according to ASISA | Registered and Enrolled Nurses |
| Besides SA ID book. What else can be used to confirm Pt ID | •Temporary SA ID •SA Passport •The new card driver's license |
| What do you need to check for prior to drawing blood /before short medical examination | •Ensure documents have not expired •Check photos are intact •Check ID book/passport is complete with no missing pages |
| List factors that influence the risk profile of a client | •Age •Occupation •Lifestyle •Gender |
| List 5 types of medicals that may be requested | •Full short medical (Questionnaire,BP,Pulse,Height,Weight,Urine lipstick,chest,abdomen girth for men only) •Limited health review(no Questionnaire+urine dipstick) •Myriad(Height,Weight,Bp) •3BP reading •BMI(Height and weight) |
| What demographic information is needed for insurance medical examination | •Referring insurance company name if not already on the form •Policy number of the client •Client's name,surname,DOB •Broker/Agent name •ID passport number of the client •Client's signature to consent to medical |
| List 7 components of a short medical | •Blood Pressure •Pulse •Weight •Height •Chest measurement on the mall clients •Waist girth measurement •Urine Dipstick |
| List 5 blood tests that are commonly requested for insurance purpose | •HIV •Cholesterol •Glycose/HBA1C •Gamma GT •Cotinine |
| Give the caution on lab visits confirmation slip | Do not place barcode on the copy given to client/broker. |
Created by:
ThandoTwala