review for clinical laboratory procedures final exam Flashcards

red blood cells
Terms Definitions
Why is the metric system used in laboratory procedures?
It is more reliable, accurate, precise, and easily standardized.
What are the 3 types of glass used in lab glassware?
Flint, Borosilicate and Quartz.
What are 3 common plastics used in lab glassware?
Polyethylene, polypropylene and polystyrene.
What are beakers used for?
Estimating the amount of liquid, mixing solutions or holding liquids.
What are the 2 common flasks used in the lab?
Erlenmeyer-used to hold liquids, mix solutions or measure noncritical volumes. Volumetric-used for making critical measurements.
What are test tubes used for?
Containers for holding blood, urine or serum.
What are graduated cylinders commonly used for in the lab?
To measure the volume of 24-hour urine specimens.
What are pipets?
Glass or plastic tubes used to measure and transfer precise volumes of liquid.
What are the different types of pipets?
To deliver, to contain, volumetric, serological or graduated, micropipets and micropipetters.
What is the routine process for cleaning labware?
1. Wash by hand 2. Rinse with tap water 3. Rinse 2-3 times with reagent-grade water 4. Final rinse in Type 1 reagent water several times. (contaminated labware also soaked in disinfectant solution)
What are the different types of centrifuges?
Microfuge, microhematocrit, clinical, serological, high-speed refrigerated and ultracentrifuge.
What is an autoclave used for?
To sterilize items with steam under pressure.
What pH is considered alkaline? Acidic?
A pH below 7 is considered acidic, a pH above 7 is considered alkaline.
What are the 3 types of laboratory grade water?
Type 1, Type 2 and Type 3; Type 1 being the purest.
What type of microscope is a clinical microscope?
A light microscope.
What are the major parts of the microscope?
Oculars, objective lenses, light source, condenser, diaphragm, coarse and fine focus adjustments, stage.
What are the 3 common objectives used in the lab?
Low power, high power, oil immersion.
What are the 3 types of blood vessels?
Arteries, capillaries and veins.
What is the difference between an artery and a vein?
Veins carry deoxygenated blood back to the heart while arteries carry oxygenated blood away from the heart. The only exceptions being the pulmonary vein and artery.
What is the complex solution in which blood cells are suspended?
Plasma.
Where are all blood cells derived from?
A bone marrow cell called the hemopoietic or hematopoietic stem cell.
What is the most common procedure done in the hematology lab?
CBC or complete blood count.
After centrifuging a capillary tube for a hematocrit test, what is the layer that separates the red blood cells and the plasma called?
Buffy coat.
What type of capillary tube should you use for a hematocrit test using capillary blood?
A heparinized tube (has a red ring).
What is the primary constituent of red blood cells?
Hemoglobin
What is specific gravity?
The density of a solution.
What is a hemacytometer and what is it used for?
A heavy, precision-made glass slide with two counting areas. Used for manual blood cell counts.
What common test would you use a stained blood smear for?
A CBC.
What does morphology mean?
Structure
What is the only anticoagulant that should be used when making a blood smear?
EDTA
Blood smears should be made within __ hours of blood collection.
2
What is the preferred specimen for a blood smear?
Capillary blood. However, venous blood that has EDTA added to it can also be used.
What are the 2 most commonly used blood stains in the US?
Wright's stain and Giemsa stain.
Where should stained smears be stored?
In the dark in a dust-free slide box or container.
Which area of a blood smear is examined microscopically?
The feathered edge using the oil-immersion objective.
What is the average number of red blood cells per cc?
4.5-5 million
What is the center of the red blood cell called?
The central area of pallor.
What are the different types of white blood cells?
Neutrophil, lymphocyte, monocyte, eosinophil, basophil. (Remember, Never Let Monkeys Eat Bananas!)
What are platelets fragments of?
A larger cell called the Megakaryocyte, which is found in the bone marrow.
What is the ESR or Sed Rate commonly used for?
An indicator of inflammation and malignancies.
What is the term for cells that are arranged like rolls or stacks of coins?
Rouleaux
The sed rate can be affected by..
The size, shape and number of RBC's.
The technical factors that can affect a sed rate are..
Must be kept vertical, on a counter free from vibration, correct temperature (20-25 degrees C), should be set up within 2 hours, length and diameter of sed tube, anticoagulated blood samples must be well mixed, and careful pipeting technique used.
What are 4 methods used for sed rate?
Westergren Method, Sediplast ESR system, Wintrobe Method and Automated.
What is the process of stopping the loss of blood from blood vessels?
Hemostasis
Hemostasis involves 4 systems. What are they?
The blood vessels, platelets, coagulation factors and fibrinolysis.
The narrowing of a vessel is called..
Vasoconstriction
When the endothelium lining of the blood vessels is damaged, what is exposed?
Collagen.
What happens to platelets when they are exposed to collagen?
They undergo a shape change and this contact initiates platelet adhesion, or the act of the platelets sticking to the damaged edge of a vessel.
Of all the coagulation factors, all are plasma proteins except for..
Factor 4, Ionized Calcium.
What does the term D-dimer mean?
Fragments left over from a clot.
What are the coagulation pathways?
Extrinsic, intrinsic and common.
What is the major difference between Heparin and Coumadin?
Heparin can only be given by needle. Coumadin is given orally.
What is the difference between a thrombus and an embolus?
A thrombus is a blood clot attached to a vessel wall. An embolus is a blood clot that travels through the circulatory system.
Which anticoagulants are used for prothrombin time (PT)?
Warafin/coumadin.
Which anticoagulant is used for the activated partial thromboplastin time (APTT) and fibrin assays?
Heparin.
What is the PT test used for?
Evaluating the function of the extrinsic and common pathways of hemostasis and to monitor coumadin therapy.
Where is prothrombin produced?
The liver
Which tube is used to collect blood for a PT/APTT?
Light Blue (Sodium Citrate)
What reagent is used when performing the APTT?
Partial thromboplastin.
What medical situations require rapid hemostasis test results?
Patient is receiving heparin therapy, or conditions such as Disseminated intravascular coagulation (DIC) and deep vein thrombosis (DVT) are suspected.
Hemostasis tests include..
Activated clotting time (ACT) and APTT.
What is Heparin?
An anticoagulant that inhibits forms of factors IX, X, and XII as well as platelet release factor.
A complication of deep vein thrombisis (DVT) can be..
Pulmonary embolism.
Tests for D-dimer are useful in diagnosing..
DIC, DVT, and pulmonary embolism.
The immune system can be involved in the initiation of disease. True or False?
True.
What is specific immunity and how is it characterized?
The type of immune response that recognizes and remembers different antigens. It is characterized by recognition, specificity and memory. This memory can also be called the anamnestic response.
The two major types of lymphocytes are..
T cells and B cells.
What are the primary lymphoid organs in mammals?
The bone marrow and the thymus.
What are B cells responsible for?
Humoral immunity and providing primary protection against bacteria, toxins and circulating antigens. B cells produce antibodies.
What are T cells responsible for?
Bringing about cell-mediated immunity, providing protection against viruses, fungi, tumor cells and intracellular organisms.
What are the classes of immunoglobulins?
GMADE.
Immune deficiencies can be acquired or congenital. Most abnormalities of the immune system are..
Acquired.
What does assay mean?
Measurement of immunoglobins.
What is agglutination?
the visible clumping or aggregation of cells or particles due to reaction with specific antibody.
Approximately how much blood is collected when donating?
1 pint or 0.5 L
What is the average amount of blood circulating in the adult human body?
10 pints
What is the major blood group system?
ABO
ABO grouping is based on the presence or absence of what?
Two blood group antigens- A and B, which are found on the cell membranes of RBC's.
The lack of both A and B antigens means a person is what blood type?
Type O.
Where are Rh antigens present?
On the surface of RBC's.
Antibodies to Rh antigens do not occur naturally in serum. True or False?
True.
What is the most important antigen in the Rh system?
The D antigen.
Rh Typing is important for..
Correct blood transfusion type, identifying females at risk of giving birth to infants with hemolytic disease of the newborn (HDN), family genetic studies and to establish paternity.
What are the major functions of the kidneys?
Elimination of waste products, regulation of pH, regulation of body fluids, production of hormones.
The concave region of the kidney is called the..
Renal hilus.
What is the outermost layer of the kidneys? What lies just beneath it?
The cortex. The medulla lies beneath it.
What is the functional unit in the kidneys called?
The Nephron.
What is the filtering unit of the kidney?
the glomerulus.
How much urine is produced in a healthy adult daily?
2L or 800cc.
What hormones affect kidney function?
PTH, calcintonin, aldosterone, ADH, ANP.
What hormones are produced by the kidneys?
Erythropoietin, renin, active vitamin D3.
What is the preferred urine specimen?
First morning clean-catch.
What are 24 hour urine specimens primarily used to assess?
Kidney function.
Urine specimens should be examined within __ hour of collection, with the exception of the 24 hour tests.
1
Urine can be stored for up to how many hours at 4-6 degrees C?
4
What are the physical characteristics of urine that should be observed?
Color, Clarity, Odor, Specific Gravity.
Glucose present in urine can indicate what?
Diabetes.
Bilirubin present in urine can indicate what?
Liver disease, bile duct obstruction or hepatitis.
Ketones present in the urine can indicate what?
Diabetes, starvation or prolonged dieting or fasting.
Blood present in the urine can indicate what?
Infection, trauma to the urinary tract, bleeding in the kidneys, glomerular damage or tumor.
Protein present in the urine can indicate what?
Vigorous exercise, UTI or the presence of albumin.
Urobilinogen present in the urine can indicate what?
Hepatic disease or hemolytic disease.
Nitrate present in the urine can indicate what?
Possible bacterial UTI.
Leukocyte Esterase present in the urine can indicate what?
Presence of leukocytes in urine, usually due to infection or inflammation in the urinary tract.
What are the common components present in urine sediment?
Cells, casts, crystals and amorphous deposits. Fibers, hair etc. can also be found.
What is hCG?
Human chorionic gonadotropin. Produced by the placenta shortly after fertilization.
What is a chemistry profile, also called a complete metabolic profile?
A group of tests performed simultaneously on a patient specimen to provide an assessment of the patient's general condition.
Blood chemistry tests can be organized in to what categories?
Routine and special.
What specimens can be used for chemical analysis?
Blood, urine, cerebrospinal fluid, synovial, pleural or pericardial fluids.
Reference or normal ranges of a substance are determined by what?
Measuring the level of the substance in a portion of the general population and applying statistical methods to the data.
What are some analytes commonly tested in a chemistry profile?
Protein, Electrolytes, mineral metabolism, kidney function, liver function, cardiac function, lipid metabolism, carbohydrate metabolism and thyroid function.
What are the 2 major types of serum proteins?
Albumins and globulins.
When measuring electrolytes, what ions are measured?
Sodium, potassium, chloride, bicarbonate.
Minerals measured in mineral metabolism for a chem profile are..
Calcium, phosphorous, iron.
In a chemistry profile, measurement of creatine, BUN and uric acid levels are used to test for what?
Kidney function.
What specimen is used for most clinical chemistry tests?
Serum.
What is serum?
The fluid portion that remains after blood has been allowed to clot.
What are the benefits of point of care testing or POCT?
Rapid results, less trauma-more patient participation, multiskilled personnel, reduced errors.
What are the components included in a point of care testing program?
Compliance with regulatory agencies, safety program, quality assurance program, personnel training and assessment, technical support, data management.
What is Glucagon?
The pancreatic hormone that increases blood glucose concentration by promoting the conversion of glycogen to glucose.
What is Glycogen?
The storage form of glucose found in high concentration in the liver.
What does insulin do?
Lowers blood glucose.
What increases blood glucose?
Growth hormone, epinephrine, cortisol, glucagon.
What is diabetes?
A chronic disease in which the body either produces insufficient insulin or is unable to use insulin properly.
What are the major functions of cholesterol?
A major constituent of cell membranes, protecting the skin from absorption of water-soluble substances, and to serve as a precursor to bile salts and steroid hormones.
What are the sources of cholesterol?
Body tissues (endogenous), Consumption (Exogenous).
What are the two fractions of cholesterol that are commonly measured?
HDL (high density lipoprotein) cholesterol and LDL (low density lipoprotein) cholesterol.
Which type of cholesterol is considered "bad"? "Good"?
HDL = good, LDL = bad.
Clinical microbiology encompasses the study of what?
Viruses, fungi, bacteria and parasites.
Bacteria usually multiply by what process?
Fission.
What are the three types of bacteria?
Coccus (round), Bacillus (rod), Spiral.
What is a gram stain?
A procedure that stains bacteria differentially according to the composition of their cell walls.
What are the characteristics of Gram positive and Gram negative bacteria?
Gram positive bacteria appear blue-purple, Gram negative bacteria appear pink-red.
What type of microorganisms invade the body and cause illness only when the body's immune defenses are impaired or absent?
Opportunistic pathogens.
Where can parasites be present in the body?
Blood, bone marrow, intestinal tract, liver, spleen, skin, hair or any organ system.
What is the most common blood parasite worldwide?
The malarial parasite, Plasmodium.
What is the difference between bacteria and a virus?
Bacteria-treated w/ antibiotics, viruses-anti-virals. Bacteria- RNA + DNA, viruses-EITHER DNA or RNA. Bacteria-seen using a clinical microscope, viruses-using electron microscope. Bacteria-grown on lab culture media, viruses-on living cells.
What is mycology?
The study of fungi (molds or yeasts)
What are the characteristics of molds? Yeasts?
Molds have branching filaments called hyphae. Yeasts are one celled and oval, and reproduce by budding.
What does the term aerobic mean? Anaerobic?
Aerobic- requires oxygen. Anaerobic- growing in the absence of oxygen.
What is normal flora?
Natural microorganisms inhabiting the human body.
What is agar?
A derivative of seaweed used to solidify liquid media.
What is primary medium?
The media on which the specimen collected from the patient is first inoculated.
What is selective medium?
A media containing ingredients that inhibit the growth of certain microorganisms while allowing the growth of others.
What can a bacterial smear be prepared from?
A swab from a wound or lesion, or from a culture such as an agar slant or petri dish.
What are the stains that are used in a gram stain?
Primary stain (crystal violet), Gram's Iodine (mordant), Decolorizer (alcohol/acetone), Counterstain (safranin).
What media will gram negative organisms grow on? Gram positive?
Gram negative- BA, EMB, MAC. Gram positive will only grow on BA.
What are two fecal occult blood tests?
Guaiac test, Immunochemical Test for fecal occult blood.
What is an ectoparasite?
A parasite on the exterior of the host.
The main host for an adult parasite is called..
Definitive host.
An organism required to complete a parasite's life cycle in addition to the definitive host is called..
Intermediate host.
An organism other than the main host that can harbor a parasite and serve as a source of infection is called..
Reservoir host.
A living carrier that transmits a parasite to an uninfected host is called..
Vector.
Where are the majority of parasites found?
Temperate to tropical climates.
What types of damage can a parasite cause to its host?
Mechanical (obstruction of an organ or vessel), irritative or toxic, allergic.
How do you prevent parasitic infection?
Block transmission, health education, improving sanitation, identifying and treating infected individuals to prevent spread of infection, vaccines.
What are the 3 major groups of parasites?
Protozoa (single celled), Helminths (worms), Arthropods (insects).
What types of specimens can be used for parasite examination?
Fecal, blood, specimens for immunological tests, sputum, vaginal secretions, CSF, and tissue.
What rules should you follow when collecting specimens for parasite examination?
1. specimen must not be contaminated with urine or water 2. wait 1 week after ingesting antidiarrheal meds, barium or oily laxatives 3. label container w/date and time 4. 3 separate specimens over 3-5 days 5. deliver within 2 hours.
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