PMLS 2 Midterm 1
PMLS 2 Midterm 1
PMLS 2 Midterm 1
Centrifugation
Quality Assurance Cycle - Both pre-analytical and
- Ensured quality of specimens being analytical, but if there are no
released in laboratory. ‘both’ option, you choose pre-
- CPD (Continual Personnel analytical.
Development) Post-centrifugation (sample evaluation)
Pre-Analytic - Analytical
Examples:
• Patient/Client Prep Sample
Yielding results – analytical
Collection
Machinery – analytical
• Personnel Competency Test
Result already printed – post-analytical.
Evaluations.
Pre-analytical (MOST IMPORTANT, since
• Sample Receipt and Accessioning
this is where most errors occur.)
• Sample Transport
Analytic
• Quality Control (Testing)/ Processing
- Ensures machines are working
properly to produce accurate
results.
- Using known reagents to test if
it's reading.
PATIENT CONSIDERATION
Mainly involves “PREPARATION.”
Additional note:
Bilirubin – Destroyed in UV lights.
Outside Laboratory:
• Sample Transport
• Sample Handling
• Sample Collection
Patient’s demographics
• Patient’s name
• Sex
• Age
• Date of birth
• Date of admission (if applicable)
• Date of measurement
• Hospital number 1.) Generation of the laboratory result
form.
• Room number/OPD
2.) Final Evaluation of results
• Physician
(validation)
3.) Releasing of results (transmission,
Specimens labels should include:
interpretation and follow up)
1. Patient’s name
4.) QC (quality control) performed. (QC
2. Age
data from analytic phase is
3. Sex
processed).
4. Room number/OPD
5.) Waste management.
5. Draw time
6. Test names/section
Additional Notes from MLS 1F Sophia
Pulgado ily:
ANALYTICAL PHASE
(PROPER STAGES)
PHASES OF MICROBIOLOGY TESTING
1.) Pre-pre analytical
1. Pre-analytical phase
- No samples yet.
a.) Patient assessment and test
Process:
ordering
Request of physician -> Collection ->
b.) Specimen collection
Identification -> Transportation.
c.) Specimen transport
2.) Pre-analytical proper
2. Analytical phase
Preparation of samples:
a.) Specimen evaluation
1. Centrifuge
b.) Specimen processing 2. Aliquoting
c.) Validation results
3.) Analytical - Analysis
3.) Post-analytical phase
4.) Post-analytical
a.) Reporting
- reporting of results.
b.) Interpretation
5.) Post-post analytical
c.) Diagnosis and treatment
- interpretation.
Controls
- To test if the machine can detect
abnormal results.
Calibration
- Machine being set normal.
- Kind of quality control.
- Focuses on correcting the
machines.
Quality Control
- In ALL phases (machines).
- A continuous cycle of checking
the quality of the overall
laboratory results during the
analytical phase.
Quality Assurance
- Keeping QC in all phases.
- Must be full.
• Blood: anticoagulant
ratio critical
- Must be on ice if not analyzed - Anticoagulant = EDTA
within 30 minutes. (Ethylenediaminetetraacetic
- FOR COAGULATION STUDIES Acid)
5.) GREEN-TOP TUBE - Binds Calcium
Products:
- centrifuged: Plasma
- not centrifuged: Whole blood
Used for Hematology Studies: CBC
Inversion = 8x
7.) GREY-TOP TUBE
- Anticoagulant = HEPARIN
- Inhibits THROMBIN form.
Three (3) formulations:
o Lithium Heparin (most common)
o Ammonium Heparin
o Sodium Heparin
Products: Plasma, Whole Blood. - Anticoagulant = POTASSIUM
OXALATE
- Binds Calcium
- PLASMA, whole blood.
➢ Antiglycolytic agent = SODIUM
FLUORIDE
- Maintains plasma glucose
levels.
Limited use: glucose, lactic acid (by-product
of glucose, synthesis is lactic acid,
degradation of glucose turning to lactic
acid.)
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PMLS 2 (2nd Semester MIDTERM)
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- Mode of action: removes ionized ➢ Two (2) forms:
calcium through the process of 1.) BLUE-TOP:
chelation. o 0.105M or 3.2%: most
- Principle of EDTA: Chelation commonly used.
(removal of ionized calcium) o Blood to anticoagulant ratio:
- Ionized calcium (active form of 9:1
calcium. For coagulation to occur.) 2.) BLACK-TOP:
Anticoagulant of choice for hematology o 0.129 or 3.8% buffered
because: sodium citrate.
- Preserves cellular morphology. o Blood to anticoagulant ratio:
(morphology: size/shape of cells.) 4:1
- Excellent for cell counting. o For Erythrocyte
- Blood is stable for 2-3 hours before Sedimentation Rate using
smearing. (good preservative) Westergren Method
- Prevents platelet aggregation.
(Platelets will clump together if not - No hemolysis/lipemic sample. (can
for EDTA) interfere with method.)
Disadvantage: causes cell shrinkage in c.) HEPARIN
excess. - Optimal concentration:
15-20U/mL of blood (units)
➢ Two (2) forms: 0.2mg/mL of blood
1.) 𝑲𝟐 EDTA - Mode of action:
o spray-dried; plastic tube; will accelerating the action of
not dilute the sample. antithrombin III, neutralizing
2.) 𝑲𝟑 EDTA thrombin and preventing the
o liquid form; glass tubes; formation of fibrin
dilutes sample; 1.3% (DOES NOT DIRECTLY ACT UPON
THROMBIN)
PINK-TOP:
- used in blood banking for blood - Isolated from live cells and is known
typing; Rh typing and antibody to be the naturally occurring
screening; 𝐾2𝐸𝐷𝑇𝐴. anticoagulant.
(Liver cells produce heparin.)
WHITE-TOP: (What cells? Hepatocytes (liver cells).)
- EDTA + gel
- Used more often for molecular ➢ Two (2) forms:
diagnostic testing. 1.) Lithium heparin
b.) CITRATE - May be used for most chemistry
Mode of action tests except lithium and folate
- Precipitates calcium into an levels.
unusable form/nonsoluble complex; - For lithium test: Royal Blue Sodium
non-ionized form heparin can be used instead.
Anticoagulant of choice for COAGULATION 2.) Sodium heparin
STUDIES. - Is the injectable form used for
- Preserves the anticoagulant therapy.
labile factors V and - Recommended for trace elements,
VII better. lead and toxicology.
o Concentration:
0.2mg/mL of blood
- Anticoagulant of choice for:
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• Blood Gas Analysis e.) OXALATE
(0.05 ml per ml of blood) Mode of action:
• Osmotic Fragility Test - Combines with calcium to form an
• Trace elements and insoluble salt/complex
toxicology. ➢ Three (3) forms:
- DOES NOT affect levels of calcium. 1.) Potassium oxalate
- Preferred for potassium measurement. 2.) Ammonium oxalate
(LITHIUM HEPARIN green tube than red tube 3.) Double oxalate
because process of clotting can utilize) Disadvantages:
- Gives a BLUE background with Wright’s - Distorts cells morphology.
stain after 2 hours. (DON’T USE HEPARIN - Potassium oxalate: shrinks the RBCs
FOR SMEARING: gives a blue background) - Ammonium oxalate: swells RBCs
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PMLS 2 (2nd Semester MIDTERM)
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PMLS 2 (2nd Semester MIDTERM)
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14 | A . J . S . - M L S 1 H