MLSP 106– Phlebotomy & Specimen Collection: Lesson 1 NOTES & Flashcards

flashcards covering phlebotomy, specimen collection, pre-analytical processes, safety, consent, lab divisions, and common tests.

What is the primary purpose of phlebotomy?

To obtain blood for diagnostic testing and to monitor prescribed treatments.

Name the three main methods used to collect blood in phlebotomy.

Venipuncture, arterial puncture, and capillary puncture.

What is venipuncture?

Collecting blood by penetrating a vein with a needle for routine laboratory testing.

What is arterial puncture primarily used for?

Arterial blood gas (ABG) analysis.

When is capillary puncture commonly used?

For infants/young children, elderly with fragile veins, severely burned patients, and some point-of-care testing.

Name a major safety practice to prevent infection in phlebotomy.

Hand hygiene and use of personal protective equipment (PPE).

What does Universal (Standard) Precautions involve?

Treat all blood and body fluids as potentially infectious and use PPE; follow isolation procedures as needed.

What is the purpose of PPE?

To protect the phlebotomist from exposure to bloodborne pathogens and other hazards.

What does TDG stand for in this course?

Transportation of Dangerous Goods.

Name the two most common coagulation tests.

Prothrombin Time (PT) and activated partial thromboplastin time (aPTT).

What does PT/INR monitor?

Warfarin (Coumadin) therapy and liver function assessment in some contexts.

What does aPTT monitor?

Heparin therapy and overall clotting function.

What is the D-dimer test used to evaluate?

Thrombin and plasmin activity; assess DIC and monitor thrombolytic therapy.

What is fibrinogen testing used for?

Identify fibrinogen deficiency and monitor bleeding risk in coagulation disorders.

What is the Blood Bank responsible for?

Preparing blood products for transfusion and testing donor and recipient compatibility.

List four common Blood Bank tests.

Type and Rh, Antibody (Ab) screen, Type and crossmatch, Direct antiglobulin test (DAT).

What is Ab Screen used for?

Detects antibodies in patient plasma that could cause transfusion reactions.

What is crossmatch?

Testing donor and recipient blood for compatibility prior to transfusion.

What does DAT detect?

Autoimmune hemolytic anemia, hemolytic disease of the newborn (HDN), and transfusion incompatibility.

What are the three components of a complete Urinalysis (UA)?

Physical, Chemical, and Microscopic evaluations.

What does the physical UA examine?

Color, clarity, and specific gravity.

What chemical components are evaluated in UA?

Blood, bilirubin, glucose, ketones, leukocyte esterase, pH, protein, nitrite, and urobilinogen.

What does leukocyte esterase indicate in UA?

Urinary tract infection.

What does nitrite indicate in UA?

Bacterial infection of the urinary tract.

What does the microscopic portion of UA assess?

Presence of red/white blood cells, bacteria, crystals, casts, and tissue cells.

What specimen type is typically used in Chemistry analyses?

Serum (though plasma or urine may also be used).

Name three common liver-related chemistry tests.

ALT, AST, ALP.

What does ALT indicate when elevated?

Liver injury or disease.

What does AST indicate when elevated?

Liver dysfunction or myocardial infarction.

What is ALP (Alkaline Phosphatase) used to assess?

Biliary obstruction and bone disease.

What is the significance of bilirubin in chemistry?

Indicator of liver function and red blood cell destruction.

What does BUN measure?

Kidney function and nitrogen waste in the blood.

What does creatinine indicate?

Renal impairment or kidney function.

What does CK (Creatine kinase) measure?

A CK test measures the level of this enzyme in the blood, which rises when there is muscle damage including myocardial injury

What does GGT (Gamma-Glutamyl Transferase) help diagnose?

Liver and hepatobiliary problems.

What does troponin I indicate?

Cardiac muscle injury; early marker of myocardial infarction.

What is the significance of lipids in chemistry panels?

Cholesterol and triglycerides are measured to assess cardiovascular risk.

What is the CMP?

Comprehensive metabolic panel; broader panel including electrolytes, liver enzymes, kidney markers, and proteins.

Name a CMS-approved chemistry panel and its components.

Basic Metabolic Panel (BMP): glucose, BUN, creatinine, sodium, potassium, chloride, CO2, calcium.

Which department commonly performs urinalysis?

Chemistry (though it can be in other layouts depending on the lab).

What are the three evaluation parts of UA?

Physical, Chemical, and Microscopic.

What is the Pap smear?

A cytology test for early detection of cervical cancer.

What is histology?

The study of the microscopic structure of tissues; uses biopsies and frozen sections.

What is cytology?

The study of cells to diagnose malignant or premalignant conditions.

What is Flow Cytometry used for?

A lab technique used in immunology/molecular diagnostics to analyze cell populations.

What are the subdepartments of Microbiology?

Bacteriology, Parasitology, Mycology, Virology.

What is the purpose of Gram stain?

Classify bacteria (Gram-positive vs Gram-negative) to guide antibiotic therapy.

What does Culture and Sensitivity (C&S) tell us?

Which organism is present and which antibiotics inhibit its growth.

What is Acid-fast Bacilli (AFB) testing used to detect?

Mycobacterium tuberculosis (TB).

What is Ova and Parasites testing used for?

Detect parasites in stool or other specimens.

What is a Viral Studies panel used for?

Detects viral infections (e.g., HIV, HCV, EBV).

What is ANA used for?

Screening for autoimmune disorders such as systemic lupus erythematosus.

What is ASO titer used for?

Indicator of previous streptococcal infection.

What is RPR used for?

Screening test for syphilis; positives require confirmation.

What is HCG used for?

Pregnancy detection (in serum or urine).

What is CMV testing used for?

Confirmation of cytomegalovirus infection.

What is EBV testing used for?

Indication of infectious mononucleosis.

What is HBsAg testing used for?

Indicator of current hepatitis B infection.

What is HCV testing used for?

Screen for HCV antibodies; HCV-RNA confirms active infection.

What is CRP used for?

Indicator of inflammation; hs-CRP is used to assess cardiovascular risk.

What does RF indicate?

Rheumatoid factor; indicator of rheumatoid arthritis.

What is Type & Rh?

ABO blood typing and Rh factor testing.

What is Type & Screen?

ABO/Rh typing plus antibody screen to assess transfusion risk.

What is Type & Crossmatch?

Testing donor and recipient blood for compatibility prior to transfusion.

What is DAT used for?

Direct antiglobulin test; detects autoimmune hemolytic anemia and transfusion incompatibility.

What are the major divisions of the clinical laboratory described?

Clinical Analysis Areas (specimen processing, hematology/coagulation, blood bank/immunohematology, chemistry, microbiology, immunology/serology, cytogenetics, flow cytometry) and Anatomical Pathology (histology and cytology).

What does Histology study?

Tissue structure and pathology; uses biopsy and frozen section analysis.

What does Cytology study?

Cells to diagnose malignant or premalignant conditions; includes Pap smear.

What is the role of LIS in labs?

Laboratory Information System; manages orders, specimens, results, and documentation.

What is accessioning in the lab?

Recording orders in the LIS and matching specimens to paperwork; obtaining the accession number.

What does accession number represent?

A unique identifier assigned to a specimen.

What does it mean to reject a specimen?

Specimens not suitable for testing; require recollection.

What is a STAT order?

An order that requires immediate processing due to emergency or urgency.

What is the purpose of a phlebotomist’s professional image?

Contributes to how the lab is portrayed; professionalism, courtesy, empathy, and respectful interaction with patients.

What is the purpose of breaking the chain of infection?

To prevent transmission of pathogens during specimen collection and processing.

What safety practices are emphasized for phlebotomists?

Hand hygiene, appropriate PPE, safe needle use, proper disposal in sharps containers.

What is the importance of patient confidentiality?

Protects patient privacy and complies with legal and ethical standards.

What is the role of the blood bank in transfusion medicine?

Prepares blood products and ensures compatibility to prevent transfusion reactions.

What is meant by ‘line draw only’ on a requisition?

A specific instruction indicating only a line-draw collection is requested.

What should be done when drawing from an indwelling catheter?

Draw and discard 5 mL of blood or six times the dead-space volume of the catheter.

What is the 9:1 blood to anticoagulant ratio?

A critical ratio to ensure accurate coagulation test results in citrate tubes.

What is the significance of EDTA specimens in Blood Bank labeling?

Used for certain hematology tests and proper labeling reduces risk of misidentification.

Which department uses the term BBID (Blood Bank Identification) in specimen labeling?

Blood Bank; for accurate patient and specimen identification.

What is the role of a Medical Laboratory Technologist (MLS/MLS) vs Medical Laboratory Technician (MLT)?

MLS/MLS typically perform the full range of testing and QC; MLT perform routine testing and assist in operations.

What is a Clinical Laboratory Assistant’s role?

Phlebotomy experience; specimen processing; assisting MLS/MLT.

What does POCT stand for and what is its purpose?

Point-of-care testing; testing performed at the patient’s side with its own QC.

Why is sample labeling and documentation critical?

Ensures correct patient, correct test, and traceability through the LIS.

What is the purpose of universal precautions in specimen transport?

To prevent exposure to pathogens during transport and handling.

What is the role of the phlebotomist in consent?

Acquire informed consent before collecting specimens when required.

What is “expressed consent”?

Formal, verbal or written consent; required for high-risk procedures.

What is “implied consent”?

Consent inferred from a patient’s actions, such as extending an arm for collection.

What are key barriers to informed consent in some patients?

Minors, language barriers, mental impairment, unconsciousness.

What is required when a patient cannot consent?

A substitute decision-maker may provide consent per facility policy.

What is a utility of the CBC in Hematology?

Measures RBC, WBC, hemoglobin, hematocrit, and platelets; assesses overall blood status.

What does the ESR indicate?

Elevated ESR suggests inflammation or necrosis.

What does the reticulocyte count assess?

Bone marrow activity and turnover of young red blood cells.

What is osmotic fragility testing used for?

Assess red cell membrane fragility in certain anemias.

What is LE cell testing associated with?

Systemic lupus erythematosus (SLE) diagnosis.

What is the role of a “line draw only” instruction in a test requisition?

Indicates a need for a straight draw without additional lines or tests.

What is the significance of bilirubin in the liver panel?

Indicates liver function and bilirubin metabolism.