HEMATOLOGY MODULE 1 UNIT 1-2 QUIZ

I. MATCHING TYPE

COLUMN A COLUMN B
B 1. Influenza virus A. Biosafety Level 1 Agent
C 2. Bacillus anthracis B. Biosafety Level 2 Agent
A 3. Mycobacterium gordonae C. Biosafety Level 3 Agent
D 4. Lassa Virus D. Biosafety Level 4 Agent
B 5. Human Immunodeficiency Virus

II. ILLUSTRATE AND LABEL THE NFPA SYMBOL

III. ESSAY. ANSWER EACH ITEM COMPLETELY BUT CONCISELY. CITE YOUR REFERENCE/S.
1. Compare and contrast biosafety and biosecurity?
Biosafety provides protection to public health and environment from accidental exposure to biological agents, whereas
biosecurity deals with the prevention of misuse through loss, theft, diversion, or intentional release of pathogens, toxins and
any other biological materials. Thus, biosafety and biosecurity are important in terms of biorisk management.

2. What is the difference between flammable and combustible reagents?

Generally, they differ based on the temperature or flash point they are exposed to in order to ignite. Flammable reagents has
the ability to catch on fire and burn easily at normal working temperature while on the other hand a combustible reagent will
burn at temperatures that are usually above working temperatures.
3. What are the safety precautions in the Clinical Laboratory?
All blood, body fluids, and unfixed tissues are to be handled as though they were potentially infectious.
4. What are the steps in disinfecting and decontamination of spills involved in blood and other biohazardous
materials?
For biological wastes disposal, except for urine, all must be placed in appropriate containers with a biohazard symbol. Urine
can be readily discarded in the laboratory sink. Wastes must be decontaminated following institutional policy whereas:

 Soaking the sample in 5% Lysol or 10% sodium hypochlorite solution for at least 15 minutes
 Autoclaving
VERGARA, ELYSSA DOMINIQUE THE GREAT L.
  Pickup by a certified hazardous waste company
5. Discuss the proper disposal of wastes generated in the laboratory.
In order to prevent biohazards compromise the public health, it is important to for us to be responsible to manage our wastes.
The segregation of wastes takes place using color coded garbage bag wherein:
Black = general wastes which includes dry and non-infectious wastes
Green for wet and non-infectious wastes
Yellow for wet and infectious wastes
Red puncture=proof containers for sharps
Orange for radioactive wastes
Yellow with black band for chemical wastes
For biological wastes disposal, except for urine, all must be placed in appropriate containers with a biohazard symbol. Urine
can be readily discarded in the laboratory sink. Wastes must be decontaminated following institutional policy whereas:

 Soaking the sample in 5% Lysol or 10% sodium hypochlorite solution for at least 15 minutes
 Autoclaving
 Pickup by a certified hazardous waste company
6. Discuss the order of draw for the three methods (i.e. syringe, evacuated, capillary) of blood sample collection.
SYRINGE
1. Blood culture tube (yellow stopper)
2. Coagulation tube (light blue stopper)
3. Serum tube with or without activator (red, gold, red-gray marbled, orange, or yellow-gray stopper)
4. Heparin tube (green or light green stopper)
5. EDTA tube (lavender or pink stopper)
6. Sodium fluoride with or without EDTA or oxalate (gray stopper)
EVACUATED
CAPILLARY
1. Tube for blood glass analysis
2. Slides, unless made from specimen in the EDTA microcollection tube
3. EDTA microcollection tube
4. Other microcollection tubes with anticoagulants
5. Serum microcollection tubes
7. What are the different additives of use in Hematological determinations? Give the action/purpose of each.
Clot activator

 Accelerates the clotting process and decreases the specimen preparation time
 Blood specimens for serum testing must first be allowed to clot for 30-60 minutes prior to centrifugation and removal
of serum
 Examples of clot activators include:
o glass or silica particles - activates factor XII in the coagulation pathway
o thrombin – an activated coagulation factor that converts fibrinogen to fibrin

VERGARA, ELYSSA DOMINIQUE THE GREAT L.

Anticoagulants

 Prevents blood from clotting

 EDTA, citrate, and oxalate remove calcium needed for clotting by forming insoluble calcium salts
 Heparin prevents clotting by binding to anti-thrombin in the plasma and inhibiting thrombin and activated coagulation
factor X
 To ensure proper mixing, it must be gently inverted immediately after collection according to manufacturer’s
directions
 Tubes with anticoagulant are either tested as whole blood or are centrifuge to yield plasma
Antiglycolytic agent

 Inihibits the metabolism of glucose by blood cells

 Necessary if testing for the glucoses level is delayed
 Sodium fluoride – most commonly used antiglycolytic agent
 Tubes containing sodium fluoride alone yield serum
 Tube containing sodium fluoride and an anticoagulant (EDTA or oxalate) yield plasma
 Anticoagulant blood can be centrifuged immediately to obtain plasma for testing, thus decreasing the specimen
preparation time.
Separator gel

 an inert material that undergoes a temporary change in viscosity during the centrifugation process
 serve as a separation barrier between the liquid (serum or plasma) and cells
 this gel may interfere with some testing, serum or plasma from these tubes cannot be used with certain instruments
or for blood bank procedures
8. What are the sources of error in venipuncture? Classify as pre-analytical, analytical or post-analytical.
PRE-ANALYTICAL

 Test orders
 Test request forms
 Stat orders and timeliness
 Turnaround time
 Specimen collection
 Specimen transport
 Specimen management
 Site of collection
ANALYTICAL

 Quality of reagents, machines, and equipment

 Quality of specimen
 Knowledge and skills of the medical technologists
 Instrumentation, calibration, and maintenance
POST-ANALYTICAL

 Results and data review

 Reports
 Interpretation of results
 Delta checks
 Reference intervals according to age and gender
VERGARA, ELYSSA DOMINIQUE THE GREAT L.
9. What causes the following?
a. Hemolysis
 Too small needle during a difficult draw
 Drew the blood through an existing hematoma
 Pulled back too quickly on the plunger of the syringe
 Forced blood into a tube from a syringe by pushing the plunger
 Mixed a tube too vigorously
 Contaminated the specimen with alcohol or water at the venipuncture site or in the tube
 Physiologically, result of hemolytic anemias
b. Hematoma
 Needle goes through the vein or when the bevel of the needle is only partially in the vein
 Phlebotomist fails to remove the tourniquet before removing the needle
 Does not apply enough pressure to the site after venipuncture
 Inadvertent puncture of an artery
c. Absence of blood in the needle hub
 Vein is missed because of improper positioning
d. Bulging of the vein
 Too much pressure
 Needle irritates or injured the vein
e. Formation of bubbles during venipuncture
 The needle in not securely attached in the syringe

VERGARA, ELYSSA DOMINIQUE THE GREAT L.