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73 Cards in this Set
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hematology
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study of blood cells and blood forming tissues
study of hemostasis or blood clotting |
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immunohematology
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study of human blood groups, associated genetics and transfusion therapy
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clinical chemistry
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study of manual and automated biochemical analysis of body fluids
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microscopy
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a microscopic and biochemical study of blood fluids, including urine, cerebrospinal fluid, gastic juice, peritoneal, amnoitic, synovial and seminal fluids
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naacls
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national accrediting agency for clinical laboratory sciences
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ascp
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american society of clinical pathologists
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ascls
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american society for clinical laboratory science
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hepatitis A
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infectious hepatitis - fecal/oral
incubation: 2-6 weeks onset: abrupt mortality: 0.6% GGP: protects 80% within 2 weeks stools of patients, active virus test using serological antigen (Ag) antibody (Ab) method 3 weeks for antibodies to appear |
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hepatitis B
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serum hepatitis
parentenal: intervenousn subcutaneous, intramuscular incubation: 8-24 weeks onset: insidious (slow) mortality: 1.4% GGP: within 24 hours liver function tests- liver enzymes in blood, liver biopsy |
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hepatitis C
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non A, non B, HCV
parentenal/insidious incubation: 2-25 weeks chronic state: 50-85% mortality: 1-2% GGP: none Almost all patients become chronic, liver cancer |
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hepatitis D
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delta hepatitis, incomplete virus develops only in presence of B (serious rapidly progressive form)
incubation: 3-13 weeks onset: abrupt parenteral/sexual chronic: 10-15% mortality: 30% GGP: prophylaxis for hep B test for viral RNA & antibodies |
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hepatitis E
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fecal/oral route, unsafe water (Asia, Africa, Mexico) rarely U.S.
incubation: 3-6 weeks onset: abrupt mortality: 1-2%, 20% preggers GGP: unknown |
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polyothemia vena
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makes too many RBCs too thick blood, draw blood for treatment. ^rbc ^wbc ^platelets
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cryoglublinemia
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cold proteins in the blood - antibodies clump up in the cold, use plasmapheresis to break up antibodies
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hemochromatosis
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too much iron in the blood - hereditary, the iron deposits in tissues
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blood
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- plasma - clear/yellow liquid
- cells - solid part RBCs WBCs Platelets |
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buffy coat
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leukocytes
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coagulation factors
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when blood clots, clotting factors I,II,V,VIII are used up
-platelets get caught up in it and make a fibrin clot |
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serum
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coagulation factors are removed, missing factors I II V VIII
- looks like plasma but is different - some tubes have anticoag for testing plasma - some don't have anticoag in them for testing serum clotting involves platelets, 12 clotting factors (I-XIII, no VI) IV is calcium |
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anti-coaqulants
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potassium oxalate, double oxalate, sodium citrate, potassium EDTA, Heparin
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RBC
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biconcave disk, carry oxy. to tissues
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WBC
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segmented neutrophil, foreign diseases/bacteria
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eosinophile
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(red) grandules, allergies
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basophils
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(basic) dark red/blue dye, swelling in mucus
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lymphocyte
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fights off viruses
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monocyte
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phagocytic, clean up, eat up garbage
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platelets
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small purple dots, stick to injured tissue stick to eachother - platelet plug and fibrin clot - cement, co ag factors
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potassium oxalate
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precipitates out calcium ions, so blood can't clot
- Ca oxalate decreases, K+ --> (potassium goes into blood) - also has sodium flouride in tube - very weak, pair with another, becomes powerful enzyme poison, prevents glycolysis |
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Double oxalate
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potassium and ammonium oxalate
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sodium, lithium oxalate
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- all will bind with calcium and precipitate it out
-can't use sodium oxalate to measure sodium (all alike) |
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sodium citrate
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-also binds with calcium - Ca Citrate decreases Na+ in
- used for coagulation studies, prevents deterioration of V and VIII - tissue contains III - tissue thromboplastin, so sodium citrate will be the second vile taken so III doesn't premature start clotting 1:9 ratio delution is important |
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Potassium EDTA
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(ethylene diamine tetra acetic acid)
- binds it into a ring- like structure - chelates Ca+ instead of precipitates - good for hematology because it does RBC, WBC and platelet morpholgy |
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heparin
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natural anticoag
anti-thrombin II2 doesnt activate process ends doesn't bind calcium causes minimal hemolysis - accurate potassium reading - only 24 hours |
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red top
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no anticoag
-tube is siliconized, tube used for serum - "modeled" red top has a gel that is inert but will activate clotting easter to pipet out serum - prevents blood from sticking to the sides of vial |
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clot activator
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get comes on top of clot
prevents step for getting serum barrier clot on bottom of vial |
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ideal conditions for venepuncture
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anti-coAg
time temperature - 37 or ice correct patient - labeling equipment - tubes/needles, alcohol wipes, needle disposal |
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patient approach
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respectful
ask what their name is check hospital number - identifying patient special requirements (fasting) position: comfortable back to patient when working quick bevel up examine are anticubital fassa |
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label vial
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name
ID (Hospital) RM # Date & Time Initials |
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sterilize
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natural flora bacteria on skin
70% alcohol wash povidone iodine 3-4 inch circle allow to dry, 1-2 min kill bacteria |
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butterfly
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needle with tubing attached
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Blood cultures & preventive measures
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- done if bactermia is suspected
- identify the bacteria - etiologic agent = bacteria causing the disease - find out antibiotic susceptability skin anti-sepsis - get rid of all bacteria, even normal flora |
1st - 70% alcohol, 3-4 inch circle
2nd - povidone iodine, 2-3 times 3rd - allow iodine 1-2 mins to dry 4th - swab the tube |
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arterial blood
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used for blood gas
radial brachial femoral pO2 pCO2 pH |
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time of blood drawn is important
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diurnal, different testing
corticoteroids glucose tolerance test therapeutic drug monitoring |
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coumadin
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prevents blood clotting
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capillary blood on infants
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plantar surface, heel, hitting bone can cause osteochronditis
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capillary blood puncture
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2.4 mm deep, wipe away 1st drop, no milking = hemolyzing, label
lower K+, total protein, Ca+ than venous - taken in finger - venules, arterioles, interstitial fluid, intracellular fluids - used for blood smears - hemolysis is greater - can only do 1 test with such little blood - low platelet count |
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Crying
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^WBC, ^RBC, ^hemaglobin, ^Hc+ (hemocrit)
platelets stick to injured tissue |
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hemolysis ex vivo
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RBCs break and release content
RBC high in potassium, low in sodium -outside -squeezing -w/o anticoAg while clotting in centrifuge -too small of a needle -forcing through needle in syringe -syringe pulled too forcefully -rough mixing of tubes |
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in vivo
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- draw from hemotoma
- hemolytic anemia - liver disease - transfusion rxn |
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osha
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occcupational safety and health administration
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order of test tubes
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1. sterile tube blood cultures
2. no additives (lithium) 3. coAg tube (sodium citrate) 4. additives |
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hematoma
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hemorrhage into tissue
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enrichment media
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encourage growth of bacteria, tube has to have an anticoag
sps - sodium polyanethol sulfonate: decreases WBC activity, neutralize any antibiotic present |
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quality control
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standard to any operating procedure in the lab
increase accuracy (actual value) precision (repetition) |
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accuracy
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true value, obtained with reference method, material of known concentration
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precision
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reproducibility of test value, reflects error (variants) smaller the error greater precision
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reliability
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combines accuracy and precision
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data
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series of related observations
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population
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all the possible values for a particular characteristics
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sample
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any part of the population used to make inferences, want a random sample, not preference to any certain part of the population
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2 types of variants
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flucuations in data
random - cant identify control - due to chance flux in either direction, does not affect mean systemic - problem that will influence data consistently in one direction or the other, effects mean |
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clinical significance
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1 point doesn't make a dif in glucose but it does in potassium, determine if it is within acceptable limits
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standard deviation
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spread of values from true value, greater the spread = less precise
square root sum of number - mean squared dived by number - 1 |
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coefficient variation
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compare precision between two dissimilar samples or sets of data
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levy jennings quality chart
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30 points data, +/- S.D. 95% confience limits
can't report until all values are within limits |
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shift
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6 successive points on the mean or on one side
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trend
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6 successive points in 1 direction
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false positive
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positive test but person doesnt have disease
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true positive
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true positive test and person has disease and condition
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% sensitivity
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true (+) / true (+) + false (-) x 100
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false negative
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negative test and person doesn't have disease or condition
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specificity
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only picks up the substance needed with no interfering substances
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% specificity
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true (-)/ false (+) + true (-)
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