Heparin: Anticoagulant Overview
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Questions and Answers

Which formulation of heparin is most widely used for plasma and whole blood chemistry tests?

  • Calcium heparin
  • Lithium heparin (correct)
  • Sodium heparin
  • Ammonium heparin

What is the optimal anticoagulant concentration of heparin for use in blood studies?

  • 15-20 units/mL (correct)
  • 10-15 units/mL
  • 5-10 units/mL
  • 20-25 units/mL

What action does sodium citrate perform in coagulation tests?

  • Inhibits platelet activation
  • Neutralizes thrombin
  • Chelates calcium (correct)
  • Promotes clot formation

Which of the following is NOT a consequence of using heparin as an anticoagulant?

<p>Increases platelet count (D)</p> Signup and view all the answers

What is the critical ratio for sodium citrate when used in coagulation tests?

<p>1:9 (D)</p> Signup and view all the answers

What effect does excessive agitation have on coagulation test results?

<p>Shortened clotting times (A)</p> Signup and view all the answers

Which heparin formulation should not be used for sodium level determination?

<p>Sodium heparin (B)</p> Signup and view all the answers

What result may be indicated by the presence of clots in a coagulation test?

<p>Prolonged coagulation test results (C)</p> Signup and view all the answers

Flashcards

Heparin anticoagulant

A substance used to prevent blood clotting, neutralizing thrombin, best for plasma chemistry and blood gas studies.

Heparin tube inversions

Must be inverted 8 times to ensure proper mixing and anticoagulation.

Sodium Citrate Ratio

A 1:9 ratio (Harr) is critical for accurate coagulation testing.

Sodium Citrate use

Used for coagulation tests, specifically chelating calcium for blood clotting studies.

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Excessive Mixing (Coagulation)

Can activate platelets and falsely shorten the clotting time affecting coagulation tests.

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Heparin formulations

Different forms of heparin, including ammonium, sodium, and lithium heparin for various testing.

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Lithium Heparin

Used for most plasma and whole blood chemistry tests, causing minimal interference in testing.

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Heparin Interference

Heparin can lead to false readings in some hematology tests, due to cellular clumping and morphological distortions.

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Hemolysis effect (Coagulation)

Hemolysis (red blood cell breakdown) can affect coagulation test results.

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Prolonged Tourniquet Application

Prolonging tourniquet application around a limb affects blood tests affecting coagulation times.

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Coagulation Test Factors

Factors such as hemolysis, excessive agitation, prolonged tourniquet application, etc can affect coagulation test results, either shortening or prolonging the results.

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Study Notes

Heparin

  • Found in: Green top tube
  • Inversions: 8x
  • Used for: Plasma chemistry and blood gas studies
  • Optimal anticoagulant concentration: 15-20 units/mL
  • Action: Neutralize thrombin
  • Choice anticoagulant for: OFT and blood gas studies
  • Three heparin formulations:
    • Ammonium heparin
    • Sodium heparin
    • Lithium heparin (least interference in chemistry testing; most widely used for plasma and whole blood chemistry)
  • Important reminder:
    • Lithium heparin: Not for lithium level determination.
    • Sodium heparin: Not for sodium level determination or electrolyte panel.
    • Ammonium heparin: Not for ammonia level determination.
    • Heparin causes cellular clumping (especially of platelets), leading to pseudoleukocytosis (falsely elevated WBC count) and pseudothrombocytopenia (falsely reduced platelet count).
    • Not used for blood smear preparation due to morphologic distortion of platelets and leukocytes.
    • Causes bluish coloration of background on blood smears stained with Romanowsky stain.
    • Not used for coagulation studies due to inhibiting thrombin.

3.2% Sodium Citrate

  • Found in: Light blue top
  • Inversions: 3-4
  • Used for: Coagulation tests
  • Critical ratio between anticoagulant and blood: 1:9
  • Action: Chelation of calcium
  • Forceful mixing/excessive inversions can activate platelets, shortening clotting times.

Factors Affecting Coagulation Test Results

  • H (Hemolysis): Prolongs coagulation test results
  • E (Excessive agitation): Shortens coagulation test results
  • P (Prolonged tourniquet application): Prolongs coagulation test results
  • E (Excessive needle manipulation): Prolongs coagulation test results
  • P (Platelet contamination): Prolongs coagulation test results
  • Presence of clots: Prolongs coagulation test results
  • Increased AC concentration: Shortens coagulation test results

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Description

This quiz covers essential information about heparin, including its formulations, uses, and actions in plasma chemistry and blood gas studies. Understand the optimal concentration and important reminders regarding its application and limitations in laboratory testing.

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