(NHA) Medical Assisting Certification Study Guide

CC

Chief Complaint

Segment

Line between two waveforms

P Wave

Arterial Depolarization

How many 1mm boxes are in a 6 second rhythm strip?

30 one millimeter boxes

The SA node represents which waveform on the EKG?

Only the P wave

What is the reading you can get from the RR interval?

Ventricular Pulse

What is the primary stage of Hemolysis?

Vascular phase and platelet phase together

What is Electrophoresis?

Analyzation of the chemical components of blood, e.g. hemoglobin, serum, urine, cerebrospinal fluid based on electrical charge.

Positive testing for occult blood in a stool sample turns which color?

Turns blue on a positive test for occult blood in feces

The stages of Hemostasis

1. Vascular, 2. Platelet Phase, 3. Coagulation Phase,

4. Fibronolysis

Blood vessels

Aorta, Arteries, Arterioles, Capillaries, Venues, Veins, Superior and Inferior Vena Cavae

Outer connective tissue layer of a blood vessel

Tunica Adventitia

Inner endothelial tissue of a blood vessel

Tunica Intima

The inner smooth layer of a blood vessel

Tunica tunica media

The standards of right and wrong in a medical setting

Code of Ethics

What do you find in capillaries?

A mixture of venous and arterial blood is found

The average adult has how many liters of blood?

5-6 Liters

What is the percentage of water in the blood?

92%

Percentage of plasma in the blood?

55%

Percentage of formed elements in the blood?

45%

99% of formed elements in the blood

RBC,s or Erythrocytes

Where do you find hemoglobin?

RBC,s

Where do all blood cells originate?

Bone marrow

How many RBC,s per microliter of blood

4.2-6.2 million

What is the second most numerous WBC

Lymphocyte with 20-40%

Their numbers increase in intracellular infections and TB

Monocytes

Their numbers increase in bacterial infections and are often first on the scene

Neutrophils

These WBC,s play an important role in viral infection as well as in immunity

Lymphocytes

Number of leukocytes for average adult per microliter

5000-10000

Leukopenia

Decrease in WBC,s seen with viral infection and leukemia

Comprises 3-8% of WBC or leukocytes

Monocytes

Largest in size of the leukocytes

Monocytes

Carries histamine

Basophil

Injury to a blood vessel that causes it to constrict, slowing the clod of blood.

Vascular phase of Hemostasis

Preferred site for a venipuncture

Antecubital Fossa

Test used to evaluate the intrinsic pathway and monitor heparin therapy

APTT also know as PTT

Test used to evaluate the extrinsic pathway and also used to monitor warfarin therapy

PT

Fibrinolysis

Breakdown and removal of a clot

Converts the temporary platelet plug in a stable fibrin clot

Coagulation Phase

2nd choice vein for venipuncture and most often the only one palatable in an obese Pt.

Cephalic vein

Antiseptics used in Phlebotomy

70% isopropyl alcohol pads most common, provolone - iodine for BC,s and Chlorhexidine gluconate for patients that are allergic to Betadine/ Iodine

Length of needle commonly used in venipuncture

1 inch (up to 1.5")

Average gauge of needle used for drawing blood

21-22

Gauge of needle that can cause hemolysis

smaller than 23 gauge

3 skills of the phlebotomist

Social, clerical, technical

Analytical errors during collection of blood

Extended tourniquet time, hemolysis, wrong order of draw, failure to invert tubes, faulty technique under filling tubes

Analytical errors before collection of blood

Patient misidentification, improper time, wrong tubes, not fasting, exercise (Cortisol levels), Pt. Posture, Poor coordination with other treatments, improper site prep, medication interference

Analytical errors After collection of blood

Failure to separate serum from cell (Glycolisis), improper use of serum separator (Not inverting tubes or not spinning tubes), delays in processing, exposure to light, improper storage conditions, dimming clots

Fistula

Permanent surgical connection between an artery and a vein, never used for venipuncture

Edima

Accumulation of fluid in tissue

Thrombophlebitis

Inflammation of a blood clot formation

Explanation of Hemoconcentration

The increase in proportion of formed elements to plasma caused by leaving on the tourniquet for more than two minutes

Consequence of insufficient pressure applied after withdrawal of a needle

Thrombus

Additives in a green top tube

Heparin, sodium, lithium, ammonium

Why is the green top tube never used for hematology?

Green tops additive heparin interferes with the Wright's stained blood test

Common tests for the lavender EDTA tube

CBC, differential or diff, ESR, sickle cell screening

Common tests for this color tube are Chemistry tests performed on plasma such as ammonia, carboxyhemoglobin and STAT electrolytes

Green top tube (Heparin) tests

How long does it take for blood to clot by the normal coagulation process in the red top tube

30-60 mins

The primary purpose is to provide reliable data about a patients health status by ensuring the accuracy of a test while detecting and eliminating error

What is Quality Control?

Common test for the red topped tube

Serum Chemistry tests, serology tests, blood bank (Glass only)

Order of the draw for capillary specimens

Lavender first, than tubes with other additives, than tubes without additives

Antiseptic not used on a dermal puncture site

Betadine (Because it interferes with several tests like bilirubin, uric acid, phosphorus, and postassim)

For which procedure would you warm the site for a minimum of 3-4 minutes to increase blood flow?

Dermal punctures (Heels sticks)

Which are the preferred sites for dermal punctures?

The distal segment of the third or fourth finger of the non-dominant hand

Heel sticks are performed on which patients?

Infants less than 1 years old

Where on the foot is the dermal puncture made on patients less than 1 years old?

The medial and lateral areas of the plantar surface of the foot

Dermal puncture is made in

The fleshy portion of the finger slightly to the side of the center perpendicular to the lines of the fingerprints

what will occur if you puncture the heel too deep? More than 2mm

Osteomyalitis

what are the identification requirements for the blood bank?

Patients full name or DOB, Hospital ID# or SNN for outpatient care, date and time of collection as well as the phlebotomist's initials

What does the toxicology section of the lab analyze?

Plasma levels of drugs and poisons

What is the percentage of the population with the D antigen present?

85% of the population

The 4 blood types

A, B, AB, O

Which blood type has neither the Anti-A nor the Anti-B plasma antibodies

AB

This section of the lab uses serum to analyze the presence of antibodies to bacteria, fungi, viruses, parasites, and antibodies against the body's own substances?

Serology (Immunology) Section

Mycology

Study of fungi

The physical examination of urine consists of

Color, Clarity, Specific gravity

A low power microscope has a magnifying power of

100X

Oil immersion objectives on the microscope reach a maximal magnification of

1000X

This objective of the microscope is used for observing bacteria, WBC differential count and RBC morphology

Oil immersion

Eyepiece of the microscope

Ocular lens

Focal length is?

The distance of the object to be examined to the center of the lens

Meter to inches

39.37

High power objective on a microscope magnification

400X

1000 meter are equal to

1km

1mm to inches

0.04

0.3 meter of tubing is how many inches

12 inches

1kg is how many pounds

2.2 pounds

Abbreviation of microliter

ul

Abbreviation for decimeter

dm

Gram stain positive stains

Deep violet (Violet to black)

Gram stain negative stains which color

Light to dark red

Bacteria that take up and retain the crystal violet and resist alcohol discoloration

Gram positive bacteria, appear blue to black

Bacteria that are decolorized completely by ethanol and take safrin counterstain

Gram negative bacteria, appear red

Gram stain sequence

Crystal violet, Gram's iodine, 95% ethyl alcohol/acetone mix/safranin stain

The degree of angle of the pusher slide

30 degrees

The urinary system

Two kidneys, two ureters, bladder, urethra

When checking for hormones in urine when do you collect the urine sample?

First voiding in the morning

Which urine specimen provides the clearest, most accurate results?

Clean catch midstream specimen

Which urine sample requires aseptic technique

Clean catch specimen

Examination of urine consists of

Physical, chemical, microscopic