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This is the process of applying centrifugal force to separate solid materials from a liquid mixture
Centrifugation
What should you add to prevent glycolysis?
2 mg NaF/mL of blood
This additive prevents glycolysis for up to how many hours?
48-72 hours
Analytes that are unstable after 30 minutes
Potassium, phosphorus, glucose
Analytes that are unstable after 6 hours
Albumin, bicarbonate, Chloride, C-peptide, HDL, iron, LDL, total protein
In electrolyte shift, what analyte is falsely increased?
Potassium
In electrolyte shift, what analyte is falsely decreased?
Sodium
What are increased when you exercise?
Lactate, fatty acids, ammonia, creatinine, kinase, aspartate aminotransferase, lactate dehydrogenase, aldolase, prolactin, growth hormone
What are decreased when you exercise?
FSH, LH, Estrogen, Testosterone
Vigorous hand exercise (fist clenching) may increase what?
Potassium, lactate, and phosphate
How many hour is the required fasting?
8-12 hours
What are the analytes requiring fasting specimen
FBS, OGTT, LIPIDS, LIPOPROTEINS, GASTRIN, INSULIN
This is the collection of blood sample in the morning before rising, __ hours after ingestion of food
Basal State Collection; 12
Overfasting for 48 hours may result in?
Increased serum bilirubin
Overfasting for 72 hours in male may result in?
Increased triglycerides
Overfasting for 72 hours in female may result in?
Decreased glucose to 45mg/dL
High protein diet may result in?
Increased urea and uric acid
Alkins diet (low carb high protein diet) may result in?
Increased urea and urine ketones
High caffeine intake may result in? It is due to _______
Increased glucose; Catecholamine
Preferred position during phlebotomy
Upright/supine
It is recommended that a px should be seated/supine for how many minutes before blood extraction
15-20 minutes
There is a required minutes after a changed position before blood collection to prevent what?
Hemodilution/hemoconcentration
Supine to sitting may result in?
Increased Albumin, enzymes, calcium
Sitting to supine may result in?
Increased Proteins, lipids, BUN, iron, calcium
Standing to supine may result in?
Decreased lipids and lipoproteins
What is decreased in tobacco smoking
Vitamin B12
What is increased in tobacco smoking?
Ammonia, glucose, GH, lipids, urea, lactate, insulin, catecholamines, cortisol
What is decreased in alcohol ingestion?
Glucose
What is increased in alcohol ingestion?
Gamma glutanyl transferase, urate, lactate, triglycerides
What is increased when stressed?
Catecholamines, cortisol, ACTH, Prolactin, Albumin, glucose, cholesterol, lactate
More than 1 minute of tourniquet application may cause?
Hemoconcentration and anaerobiosis
What is increased in tourniquet application?
Potassium, protein, enzymes, lactate, cholesterol, ammonia
A test where a tourniquet should not be applied and fist should not be clenched during phlebotomy
Lactate determination
Prolonged tourniquet exercise + fist exercise may cause
Increased potassium by 1 mmol/L
In hemolysis, what is decreased? It is due to _____
Creatinine and glucose; dilution effect
Hepatotoxic drugs may result in?
Increased liver function enzymes
Diuretics may result in?
Decreased sodium and potassium
This is the most analyzed non blood specimen
Urine
Ultrafiltrate of plasma
Urine
This type of urine specimen collection is used for routine and qualitative urinalysis
Random
This type of urine spx collection is first voided urine after waking up from 8 hours of sleep
First Morning/8-hour urine
1st morning/8-hour urine is an ideal specimen for?
Routine urinalysis and pregnancy test
Among of the urine specimens which is the most concentrated
First morning/8-hour urine
2nd voided urine after fasting (for glucose determination)
Fasting/Second Morning
This is a random urine specimen collected in a special urine container
Urine for drug testing
Collected urine/pooling of multiple urine at a specific time period
Timed specimen
This timed specimen requires fasting and is optional for glucose tolerance test in blood
Glucose Tolerance Urine
How long is the fasting for glucose tolerance urine?
30 minutes and 1 hour
The 2-hour post prandial urine is done ____ hours after?
2 hours after meal
This timed specimen is for diabetes screening/monitoring
2-hour post prandial urine
Collection and pooling of all urine voided within 24 hours
24-hours urine
Series of urine samples collected at specific time intervals for comparison
Fractional specimen (double-voided)
Px voids or urinates into a clean contained (no specific timing)
Regular voided
First and last drop of uninterrupted urination are discarded while _____ is collected
Midstream
Cleaning of genital prior to midstream collection
Midstream Clean-catch
Patient voids random urine inside a restroom with no water source located inside the testing area
Drug testing
Urine collection from a sterile catheter inserted through the urethra into the bladder
Catheterized
Collection through aspiration by inserting needle directly into the bladder
Suprapubic Aspiration
Catheterized is used for?
Bacterial culture
Suprapubic aspiration is used for?
Anaerobic bacterial culture and cell cytology
A soft, clear plastic bag with adhesive that are attached to the genitalia is used in?
Pediatrics
Weebags are checked every _______ until required volume is collected
15 minutes
CSF is the ___ major body fluid
3rd
Clear and colorless fluid that surrounds the brain and spinal cord
Cerebrospinal Fluid
Method of collection of CSF
Lumbar puncture/spinal tap between 3rd, 4th, or 5th vertebra
CSF is collected in ______ sterile tube
3 to 4
If only one tube is filled for CSF, in what order should the tests be?
Microbiology, Cell count, chemistry/serology
Diagnosis value for CSF
Diagnosis of meningitis, brain abscess, CNS cancer, multiple sclerosis
Tests of CSF collected (from 1st to 4th tube)
Chemistry, serology, microbiology, Cell count, microbiology, immunology
This is least affected by bacteria or blood introduced as a result of collection
Chemistry, serology
Least likely to be contaminated with bacteria introduced in spinal tap
Microbiology
Least likely to contain cells introduced in the spinal tap
Cell count
For better exclude skin contamination
Microbiology, immunology
The storage of CSF in chemistry, serology test should be?
Frozen
The storage of CSF in microbiology test should be?
Room temperature
The storage of CSF in cell count test should be?
Refrigerated
Ultrafiltrate of plasma found in between serous cavities
Serous fluids
Lubricates the membranes of serous cavities to prevent friction as a result of movement of enclosed organs (heart, lungs, peritoneum)
Serous fluids
WHat are the specimens used in serous fluids
Pleural, pericardial, peritoneal fluid
Pleural fluid is collected through?
Thoracentesis
Pericardial fluid is collected through
Pericardiocentesis
Peritoneal fluid is collected through?
Paracentesis
SEROUS FLUID. collection tube when performing cell counts and smears
EDTA
SEROUS FLUID. collection tube when performing chemistry
Heparin/Sodium fluoride
SEROUS FLUID. collection tube when performing culture and sensitivity
Sterile
SEROUS FLUID. collection tube when performing biochemical tests
Non-additive tube
Serous fluids that are to be tested should be delivered in the laboratory within?
2 hours
If delay is expected in serous fluid, it should be stored in? except for?
Refrigerator (4C); microbial culture
CHEMICAL EXAMINATION. Decreased in tuberculosis and malignancy
Glucose
CHEMICAL EXAMINATION. Malignancy
Lactate dehydrogenase
CHEMICAL EXAMINATION. Pancreatitis, GIT perforation, intestinal necrosis
Amylase
CHEMICAL EXAMINATION. Intestinal perforation
Alkaline phosphatase
CHEMICAL EXAMINATION. Increased in bacterial peritonitis, malignancy and tuberculosis
Lactate
CHEMICAL EXAMINATION. Ruptured bladder
BUN and Creatinine
CHEMICAL EXAMINATION. Perforated peptic ulcer, ruptured appendix, bower strangulation, ruptured bladder
Ammonia
CHEMICAL EXAMINATION. Transudates: >1:1 Exudates: <1:1
Serum ascites-albumin gradient
CHEMICAL EXAMINATION. Tumor markers
CEA and CA125
Synovial fluid is also known as the?
Joint fluid
This viscous fluid circulating in diarthroses (movable joints)
Synovial fluid
This is a collection of synovial fluid wherein it is done by aspiration collection through inserting needle in between joints
Arthrocentesis