Anticoagulants and CBC Overview

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Questions and Answers

What is the primary action of EDTA as an anticoagulant?

It inhibits the production of blood cells.

It bonds to calcium through chelation. (correct)

It prevents platelet activation.

It alters the pH of the blood.

How many inversions are required for proper mixing of blood in an EDTA tube?

8 (correct)

Which of the following statements about the storage of EDTA blood specimens is accurate?

Storage at 4°C allows analysis up to 48 hours.

Specimens should be analyzed within 4 hours at room temperature.

Blood smears must be made within 1 hour of collection.

Specimens should be analyzed within 6 hours when stored at room temperature. (correct)

What is a common cause of clotted blood specimens in EDTA tubes?

Expired tube. Signup and view all the answers

What effect does excessive EDTA have on blood tests?

Results in falsely low hematocrit values. Signup and view all the answers

What is the consequence of not making blood smears within the recommended time frame after collection?

Potential for inaccurate cell morphology assessment. Signup and view all the answers

Which parameter is associated with Mean Platelet Volume (MPV) when using EDTA?

EDTA causes an increase in MPV for the first hour. Signup and view all the answers

What is the optimal concentration of EDTA for blood collection?

15 mg/mL of blood Signup and view all the answers

What is the primary reason for using EDTA as an anticoagulant in hematology?

It prevents the aggregation of platelets. Signup and view all the answers

If blood for a CBC is collected in an EDTA tube, how soon must it ideally be analyzed to avoid false results?

Within 6 hours if stored at room temperature. Signup and view all the answers

Which condition can lead to insufficient EDTA in a blood sample?

Underfilling the tube during collection. Signup and view all the answers

What is the expected change in Mean Platelet Volume (MPV) in the first hour after blood collection with EDTA?

Approximately a 20% increase. Signup and view all the answers

Which of the following parameters is NOT included in the RBC parameters of a Complete Blood Count (CBC)?

White Blood Cell count Signup and view all the answers

What effect does excessive EDTA have on blood sample results?

Causes an increase in MCHC and platelet count. Signup and view all the answers

During a delta check, what is primarily being compared?

Current test results against previous test results from the same patient. Signup and view all the answers

Which of the following is an accurate statement about the optimal use of EDTA?

Blood specimens should be processed within specific time frames to minimize errors. Signup and view all the answers

Study Notes

Anticoagulants

EDTA (ethylenediaminetetraacetic acid) is commonly used as K₂EDTA
Found in lavender/purple-top tubes
Used for routine hematology tests
Optimal concentration is 15 mg/mL of blood
Blood specimens for CBC must be analyzed within 6 hours of collection (room temp) or 24 hours (refrigerated)
Blood smears should be made within 3 hours of collection
EDTA prevents platelet aggregation, therefore preferred for platelet counts
Mean Platelet Volume (MPV) increases by approximately 20% in the first hour, based on EDTA specimens that are between 1-4 hours old

Possible Causes of Clotted Blood Specimens

Difficult phlebotomy
Blood sample not inverted correctly
Expired blood collection tube
Overfilled tube

Complete Blood Count (CBC)

Also known as a hemogram
Performed on automated hematology profiling instruments
Includes:
- Red blood cell (RBC) parameters: RBC count, hemoglobin, hematocrit, Red cell Distribution Width (RDW), reticulocyte count
- White blood cell (WBC) parameters: WBC count, neutrophil (% and absolute), lymphocyte (% and absolute), monocyte (% and absolute), and eosinophil and basophil counts (% and absolute)
- Platelet parameters: Platelet count, Mean Platelet Volume (MPV)

Chelation: formation of a ring-shaped molecular complex in which a metal ion is covalently bound
Delta Check: a process in which a current test result is compared with the result of the same test from a previous specimen from the same patient
Delta check method of QC utilizes the patient's own data to monitor population values
Reflex test: a test being ordered automatically based on the results of prior tests or preset parameters
Parameter: any numerical value that depicts an entire population

EDTA Issues

Insufficient EDTA: cause - overfilled tube, effect - presence of clots
Excessive EDTA: cause - underfilled tube (short draw), effect - falsely low Hct, ESR, ↑MCHC, and platelet count

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Description

This quiz covers essential information about anticoagulants, specifically EDTA and its role in routine hematology tests like the Complete Blood Count (CBC). Additionally, it explores common issues that can arise from clotted blood specimens and their prevention. Test your knowledge on these key concepts and practices in hematology.