long quiz

• Blood smear: place a blood in 2-3mm in diameter.
• Good smear: 30-45 degrees
• ASAP

  • Angle
  • Speed
  • Amount of blood
  • Pressure
• Good smear

  • Tongue shaped with smooth tail
  • Does not cover entire slide
  • Has thick and thin areas
  • Do not contain any lines or holes
  • Well-developed feathery edge
  • Monolayer just behind edge
• Bleeding time - ability of small blood vessels to control the free flow of blood after injury
• Measure of the function of platelets - Bleeding time
• Prolonged bleeding time may be due to blood vessel defect, platelet aggregation defect, and thrombocytopenia
• Normal bleeding time: 2-4 minutes
• Blot with filter paper every 30 seconds - bleeding time
• Clotting time - coagulation time
• Period required for blood to clot or solidify - clotting time
• Helps assess risk of excessive bleeding for thrombosis in blood vessels - clotting time
• Prolonged clotting time is caused by liver diseases, factor V deficiency, or anti-thrombin deficiency.
• Normal clotting time - 2 to 8 minutes
• Special Collections and POCT

  • Blood culture
  • CT/BT
  • OGTT or timed glucose specimen
  • drug test
  • TDM
• COF (Chain of custody form) - drug test
• Antimicrobial removing device (ARD) - blood culture
• • Blood bag for polycythemia collection - blood donation
  • Benzalkonium Chloride - blood culture
  • Ice - lactate test
  • Sphygmomanometer - bleeding time
  • Filter paper - bleeding time
• performed to diagnose septicemia or bacteremia - blood culture
• sterile technique or aseptic technique = blood culture
• specimens collected in special bottles containing culture medium, aerobic and anaerobic bottles = blood culture
• blood culture collection tubes usually contain different anticoagulant = SPS (sodium polyanethol sulfonate)
• order of draw

  Needle and syringe

  1. anaerobic
  2. aerobic

  Butterfly

  1. aerobic
  2. anaerobic
• ethanol, iodine, ethanol = aseptic technique

  incubate 4 weeks = brucellosis

  incubate 14 days = anaerobic infection
• lactic acid used as a marker of the severity of metabolic acidosis and stress response = lactate test
• lactate test

  • avoid torniquet for electrolyte and lactic acid to release it after blood begins to flow into the tube. If the torniquet is released before blood is drawn, wait about a minute before drawing. Within 15 minutes of draw, separate the plasma from blood by centrifugation for 10 minutes.
  • Draw without patient clenching fist.
• Coagulation test specimen

  • PT and APTT PT AND APTT specimens must have a 5:1 ratio of blood to anticoagulant
  • Discard tube must be used for blood draw solely for coagulation test
  • Completely fill blue top tubes should be used and invert 3-4 x immediately after drawing.
• Glucose tests

  • OGCT - pre eclampsia, glucose solution is drank by the pregnant woman and glucose test is performed an hour after
  • OGTT – diagnosis of type 2 diabetes, fasting of 8 hours, no activities should be done
  • HbA1C or Glycated Hemoglobin – determining 3 month glucose level using EDTA (plasma)
  • 2 hour post prandial test – full meal is taken, blood sample is taken after eating
  • FPG (Fasting Plasma Glucose) – heparin or EDTA can be used,
• OGCT

  • needs fasting
  • 75g glucose
  • normal fasting glucose = 70 to 99 mg/dl
  • pre-diabetes = 100 to 125 mg/dl
  • gestational diabetes = 126 mg/dl
• OGTT

  • needs fasting
  • 100g glucose
  • normal glucose tolerance = less than 140 mg/dl
  • pre-diabetes = 140-200 mg/dl
  • type II diabetes = over 200 mg/dl
• unit of blood is removed and not replaced = blood donor
• Testing of drug levels at specific intervals to help establish a drug dosage to avoid drug toxicity = TDM
• Trough level

  • drug level collected when the lowest serum concentration of the drug is expected usually prior to the administration of the next scheduled dose

  Peak level

  • drug level collection at its highest serum concentration of drug during a dosing interval
• TRACE ELEMENT TESTING

  • tube to contain samples should be made of materials that are as free of trace element contamination as possible. Typically, tubes are royal blue.
  • It is best to draw it by itself using a needle, tube assembly, or a syringe. When using a syringe, change the transfer device before filling the royal blue tube
• Also known as bedside testing is defined as medical diagnostic testing or near the point of care, that is, the time and place of patient care. = POCT
• POCT

  • often accomplished through the use of transportable, portable and hand held instruments
  • Bench analyzers are also available for blood gas, etc - The advantage of this is to bring test immediately and conveniently to the patient.
  • Disadvantages are poor quality of analysis, poor record keeping, lack of report interpretation, failure to detect abnormal results
• POCT DEVICES are unable to detect lipemic, and hemolyzed samples
• Blood vessels that are 5-10 um in diameter that conveys blood to the venules from arterioles. = capillary
• Capillary puncture

  • Superficial puncture of skin with a sharp point to draw small amount of blood.
  • Samples are put into calibrated glass tubes (capillary tube), slides, or reagent strips
  • Blood can be drawn from the fingers, heel of the toe, and ear lobes
  • Method of collection of newborns, infants, and obese patients.
• Capillary blood

  • Mixture from: •Arterioles •Venules •Capillaries •Intracellular and Interstitial Fluid
  • It contains more Arterial Blood
  • Serum potassium and calcium, protein lower and glucose is higher than venous