Podcast
Questions and Answers
Which factor is known to increase the concentration of analytes in a specimen after food ingestion?
Which factor is known to increase the concentration of analytes in a specimen after food ingestion?
- Tourniquet application
- Diet-related changes (correct)
- Exercise
- Tobacco smoking
What is a potential effect of vigorous hand exercise, such as fist clenching, on potassium levels?
What is a potential effect of vigorous hand exercise, such as fist clenching, on potassium levels?
- Decreases potassium concentration
- Increases potassium concentration (correct)
- Has no effect on potassium level
- Causes potassium to fluctuate unpredictably
Which hormone is known to show a postprandial rise in concentration after eating?
Which hormone is known to show a postprandial rise in concentration after eating?
- Insulin (correct)
- Cortisol
- Testosterone
- Thyroxine
What type of variations are usually transient and easily controlled in laboratory tests?
What type of variations are usually transient and easily controlled in laboratory tests?
Which accrediting agency requires laboratories to document specimen collection methods?
Which accrediting agency requires laboratories to document specimen collection methods?
What is the primary reason for applying a tourniquet before specimen collection?
What is the primary reason for applying a tourniquet before specimen collection?
Which of the following substances is likely to show an increase in concentration due to strenuous exercise?
Which of the following substances is likely to show an increase in concentration due to strenuous exercise?
What effect does tobacco smoking have on laboratory test results?
What effect does tobacco smoking have on laboratory test results?
What can cause specimen quality to be compromised due to incomplete barrier formation in gel tubes?
What can cause specimen quality to be compromised due to incomplete barrier formation in gel tubes?
Which of the following is a common error in specimen collection that could lead to contamination?
Which of the following is a common error in specimen collection that could lead to contamination?
What is the most problematic additive carry-over in specimen collection?
What is the most problematic additive carry-over in specimen collection?
How can evaporation of specimens affect electrolytes?
How can evaporation of specimens affect electrolytes?
Which error is associated with prolonged tourniquet application?
Which error is associated with prolonged tourniquet application?
What is the potential effect of severe hemolysis on analytes present in serum or plasma?
What is the potential effect of severe hemolysis on analytes present in serum or plasma?
Which analytes become clinically significant after 24 hours of unseparated serum or plasma?
Which analytes become clinically significant after 24 hours of unseparated serum or plasma?
How does bilirubin interfere with serum measurements?
How does bilirubin interfere with serum measurements?
What is a consequence of lipemia in a serum sample?
What is a consequence of lipemia in a serum sample?
Which analytic constituent is least stable if not removed from the clot within 30 minutes?
Which analytic constituent is least stable if not removed from the clot within 30 minutes?
What corrective measure can help prevent the shift of electrolytes leading to erroneous potassium levels?
What corrective measure can help prevent the shift of electrolytes leading to erroneous potassium levels?
After how many hours does serum become unstable if not separated from the clot?
After how many hours does serum become unstable if not separated from the clot?
Which of the following analytes might be significantly affected by hemoconcentration?
Which of the following analytes might be significantly affected by hemoconcentration?
What might happen to triglycerides when serum exceeds a specific concentration?
What might happen to triglycerides when serum exceeds a specific concentration?
Which electrolyte is prone to false increases due to shifts from high metabolic activity of white blood cells (WBCs)?
Which electrolyte is prone to false increases due to shifts from high metabolic activity of white blood cells (WBCs)?
What is the optimal storage temperature for serum or plasma if analysis is to be delayed for longer than 4 hours?
What is the optimal storage temperature for serum or plasma if analysis is to be delayed for longer than 4 hours?
Which of the following is a reason for specimen rejection?
Which of the following is a reason for specimen rejection?
Which additive is specifically used to prevent blood from clotting in vacuum tubes?
Which additive is specifically used to prevent blood from clotting in vacuum tubes?
What can excessive centrifugation lead to in specimen handling?
What can excessive centrifugation lead to in specimen handling?
Which analytes must be chilled during transport and storage at 4℃?
Which analytes must be chilled during transport and storage at 4℃?
What is a common effect of hemolysis on laboratory results?
What is a common effect of hemolysis on laboratory results?
Which of the following is an additive in evacuated tubes that helps in clotting?
Which of the following is an additive in evacuated tubes that helps in clotting?
What does an antiglycolytic agent do in specimen handling?
What does an antiglycolytic agent do in specimen handling?
Which condition could result from the movement of water into cells during specimen collection?
Which condition could result from the movement of water into cells during specimen collection?
What is the effect of low temperature storage on LDH isoenzymes?
What is the effect of low temperature storage on LDH isoenzymes?
What is a common cause of hematoma formation during venipuncture?
What is a common cause of hematoma formation during venipuncture?
Which action can lead to a hemolyzed specimen?
Which action can lead to a hemolyzed specimen?
Why is skin puncture often preferred in geriatric patients?
Why is skin puncture often preferred in geriatric patients?
Which factor is NOT associated with the risk of hemolysis?
Which factor is NOT associated with the risk of hemolysis?
What is the primary indication of a hematoma?
What is the primary indication of a hematoma?
Which of the following is a potential complication from inappropriate blood collection in premature infants?
Which of the following is a potential complication from inappropriate blood collection in premature infants?
How should the bevel of the needle be positioned for optimal venipuncture?
How should the bevel of the needle be positioned for optimal venipuncture?
Why is capillary blood collection preferred for infants and young children?
Why is capillary blood collection preferred for infants and young children?
What is syncope more commonly referred to as?
What is syncope more commonly referred to as?
Which condition must be reserved exclusively for parenteral therapy in sick infants?
Which condition must be reserved exclusively for parenteral therapy in sick infants?
Which technique can contribute to the failure of blood to enter the syringe or ETS?
Which technique can contribute to the failure of blood to enter the syringe or ETS?
Which of the following is a late general complication of improper blood collection techniques?
Which of the following is a late general complication of improper blood collection techniques?
What can cause excessive probing during venipuncture?
What can cause excessive probing during venipuncture?
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Study Notes
Laboratory Responsibilities
- Laboratories must establish standard procedures for patient preparation, sample collection, transportation, and preservation to minimize errors.
- Accreditation agencies like CAP require detailed manuals documenting specimen collection methods and error minimization.
Pre-Collection Causes of Variation
- Factors influencing analyte concentration include tourniquet application, exercise, and tobacco smoking.
- Diet-related changes in lab tests often result from postprandial responses, causing transient increases in various analytes.
Hemolysis and Hematoma Prevention
- Hemolysis can occur from using excessively small needles, rapid plunger pulls, or vigorous mixing.
- Hematomas may develop due to needle size mismatch, excessive probing, or improper pressure application post-venipuncture.
Capillary Blood Collection
- Capillary punctures are preferred for infants and young children due to smaller blood volume and risks associated with venipuncture.
- Microcapillary blood collections are essential when venipuncture is not feasible.
Electrolyte and Analyte Stability
- Certain substances like potassium, phosphorus, and glucose are unstable and can significantly alter lab results if not processed quickly.
- Blood samples must be separated from clotting agents within 30 minutes to maintain analyte stability.
Specimen Storage and Transport
- Serum or plasma should be stored at 4-6℃ if analysis is delayed beyond four hours to prevent degradation.
- Specific specimens require chilling (e.g., ammonia, blood gases, lactic acid) during transport.
Additives in Evacuated Tubes
- Additives in evacuated tubes prevent clotting and glycolysis, ensuring the integrity of the sample.
- Common anticoagulants include EDTA, citrate, and heparin, with each having specific functions in the collection process.
Common Errors in Specimen Collection
- Misidentification, mislabeling, short draws, inadequate mixing, and the use of wrong anticoagulants are frequent errors.
- Proper order of draw is critical to avoid contamination and ensure accurate results.
General Guidelines
- Excessive centrifugation can cause cell lysis, elevating potassium and LDH levels.
- Electrolyte levels can be affected by evaporation prior to testing, compromising specimen quality.
- Clear labeling, appropriate handling, and timely delivery to the lab are essential for accurate diagnostic testing.
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