Podcast
Questions and Answers
Which formulation of heparin is most widely used for plasma and whole blood chemistry tests?
Which formulation of heparin is most widely used for plasma and whole blood chemistry tests?
What is the optimal anticoagulant concentration of heparin for use in blood studies?
What is the optimal anticoagulant concentration of heparin for use in blood studies?
What action does sodium citrate perform in coagulation tests?
What action does sodium citrate perform in coagulation tests?
Which of the following is NOT a consequence of using heparin as an anticoagulant?
Which of the following is NOT a consequence of using heparin as an anticoagulant?
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What is the critical ratio for sodium citrate when used in coagulation tests?
What is the critical ratio for sodium citrate when used in coagulation tests?
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What effect does excessive agitation have on coagulation test results?
What effect does excessive agitation have on coagulation test results?
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Which heparin formulation should not be used for sodium level determination?
Which heparin formulation should not be used for sodium level determination?
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What result may be indicated by the presence of clots in a coagulation test?
What result may be indicated by the presence of clots in a coagulation test?
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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.
