HEALTH, EDUCATION AND COUNSELLING INSTITUTE/HECOININTERNATIONAL DIPLOMA IN PHLEBOTOMY TECHNICIAN

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FOR HECOIN STUDENTS ONLY!!!

PHLEBOTOMY QUESTIONS AND ANSWERS

Question Answer

What is the first vein of choice? Median Cubital Vein

What is the second vein of choice? Cephalic Vein

What is the third vein of choice? Basilic Vein

What is near the Basilic Vein? Brachial Artery and Median Nerve

What will a properly tied tourniquet do?Allow Arterial blood to flow, and Venous blood to slow and pool.

How far above the site should the tourniquet be tied?

3-4 inches

What does palpate mean? To examine by touch

What is the bevel of a needle?The opening of the needle, which should always be facing up.

What is the shaft of a needle? This is the gauge of the needle.

What is the hub? Where the needle threads into the adapter

What is the rubber sleeve?This prevents blood from leaking when tubes are removed

What is the adapter? Aids in the placement and removal of tubes

What is the Patient Bill of Rights?Not a legal document, but an accepted statement of principle a patient must understand their rights.

What does HIPAA stand for?Health Insurance Portability and Accountability Act

What are DRG's?Diagnosis Related Groups, government decides payment of patient care regardless of length of stay

What are reference laboratories?Large independent labs that have contracts with other facilities to preform both routine and highly specialized tests

What are ICD-9 codes?

International Classification of Diseases-Ninth Edition. What will be paid by insurance companies and Medicare depending on the diagnosis code provided by the doctor

What is the CDC and what do they do?Center for Disease Control, responsible for tracing and preventing the spread of disease

What is OSHA and what do they do?Occupational Safety and Health Administration, regulates workplace safety

Define infection Occurs when a pathogen invades the body

Define Systemic Infection Throughout the whole body

Define Local Infection Restricted to a small area of the body

Define pathogenThe organism that causes the disease (bacteria, fungus, virus)

What is a Nosocomial Infection?Infections that are contracted by a patient after admission to the hospital.

How many links make up the chain of infection?

Six

Define Causative Agent It is a bacteria, fungus, virus or protozoa

Define Reservoir Host Where the causative organism can survive

Define Exit Pathway How the infection leaves their host

Define Means of TransmissionThe method by which microorganisms can be transmitted from one hos to another

Define Entry PathwayHow the microorganism enters the susceptible host

Define Susceptible HostA person with a compromised immune system

How many Means of Transmission are there?

Five

Define the two subcategories of Contact transmission

Direct- skin to skin and Indirect- exposing a susceptible host to a pathogen by the means of an inanimate object (fomite)

Which means of transmission can only travel less than 3 feet and cannot remain suspended in air?

Droplet Transmission

Which means of transmission are generated by talking, coughing, and sneezing, can travel more than 3 feet and

Airborne Transmission

remain suspended on dust particles?

Which means of transmission carries causative agents through contaminated food, water, medications, and blood?

Vehicle Transmission

Which means of transmission carries infections through flies, fleas, ticks, mosquitoes, and rats?

Vector Transmission

What's the difference between TB disease and TB infection?

TB disease is active TB, while TB infection is when the bacteria is present but the carrier is not contagious

How do you break the chain of infection? Washing your hands

Which vaccination is required by federal law to be available free of charge to all employees that have occupational risk?

Hepatitis B Vaccination

What are PPE's? Personal Protective Equipment

What are the 5 types of Isolation?Strict, contact, respiratory, blood and body fluids, and reverse or protective isolation

Define Universal Precautions

Designed to prevent the transmission of blood borne pathogens. All blood and most body fluids that contain blood are considered potentially infectious. Regardless of diagnosis all patients are considered potentially infectious

Define Body Substance Isolation

was designed for the body fluids UP did not cover, regardless if there was blood present or not, stated that hand washing after glove removal was not needed

Define Standard Precautions

Combine UP and BSI into a single set of precautions to be used for the care of all patients when coming into contact with body fluids regardless if there is blood present

Define Transmission Based PrecautionsUsed when a patient has a known or suspected infection

A Biologic Hazard is an infectious agent

Any materials that are harmful to health are

Biohazards

Needles, lancets and broken glass all go into which category of objects that can cause blood borne infections?

Sharps

When a substance has a risk of causing a possible exposure to toxic, or carcinogenic substance it is a?

Chemical Hazard

Anything with electricity running through it is a potential?

Electrical Hazard

Bunsen burners, oxygen and chemicals can all be what type of hazard?

Fire or Explosive

Lifting incorrectly, bending and running are all examples of

Physical Hazards

What is the Needle Stick Safety and Prevention Act?

Any new equipment that is brought into the facility must be first used by the employees, and after a trial period employees will be asked about the equipment

What is a Class A fire?Ordinary combustibles like wood, paper and cloth.

What is a Class B fire?Flammable liquids like grease, gasoline, paints and oils.

What is a Class C fire? Electrical equipment, motors and switches

What is a Class D fire? Flammable metals

What does P.A.S.S. stand for? Pull pin, Aim nozzle, Squeeze trigger, Sweep nozzle

What does R.A.C.E. stand for? Rescue, Alarm, Confine, Extinguish

What are the principles involved in radiation safety?

Distance, Shielding, and Time

What is the OSHA HazCom Standard?"The right to know law"meaning all dangerous chemicals must be labled

What is an MSDS?Material Safety Data Sheets, contains information for all chemicals

Pale cold clammy skin, rapid weak pulse, increased shallow breathing, and expressionless face and staring eyes are symptoms of?

Shock

What are the 5 steps to providing first aid for shock?

1. Maintain an open airway, 2. call for help, 3. Lie the victim down and elevate the feet, 4. Attempt to control bleeding or other cause of shock, 5. Keep the victim warm

Superior means Upper

Inferior means Below

Anterior means Front or Ventral

Posterior means back or dorsal

Medial means toward the middle

Lateral means toward the side

Proximal means Towards the point of attachment

Distal means Away from the point of attachment

Prone means face down

Supine means Face up

Frontal Plane divides the body into front and back portions

Sagittal Plane divides the body into right and left portions. Midsagittal is equal

Transverse Plane divides the body into upper and lower portions

Dorsal cavity includes which 2 cavities? Cranial (Brain) and Spinal (spinal cord)

The Ventral Cavity includes which 3 cavities?

Thoracic (lungs heart ribs) Abdominal (digestive system) and Pelvic (reproductive organs)

Define Metabolismall the chemical reactions that happen within the body

Define Anabolism create needed product

Define Catabolism break down of products

Cells are? The smallest living unit

A group of cells that have the same shape and function create a..?

Tissue

Two or more types of tissues that have the same shape and function create a..?

Organ

A group of organs that have the same functions create an..?

Organ system

What are the four (4) types of tissues? Epithelial, Connective, Muscle, Nervous

Every living organism is in a constant process of maintaining a "steady state" or balance. This is called

Homeostasis

The skeletal system consists of? Bones, cartilage, ligaments, and tendons

Ligaments connect.. Bone to bone

Tendons connect.. Muscle to bone

What are the 4 classifications of bones? Flat bones, Irregular bones, Long bones and

Short bones

Synovial joints contain.. Synovial fluid

What is Gout and what test is used to check for it?

A metabolic disease caused by deposits of Uric Acid in the joints becoming full of crystals. Its a Uric Acid test, drawn in an SST and sent to Chemistry

What is Osteoporosis?Imbalance between the breaking down of bone

What is Osteomyelitis?Inflammation of the bone caused by bacterial infections

What is Alkaline Phosphatese (ALP) drawn in?

SST and sent to Chemistry

What is a Calcium (Ca) test drawn in? SST and sent to Chemistry

What is a Phosphorus (P) test drawn in? SST and sent to Chemistry

What is a Vitamin D test drawn in? SST and sent to Chemistry

What are the three types of muscles?Skeletal (Striated), Smooth (Non-striated), and Cardiac (lightly striated)

Which Muscles are under voluntary control, and which are involuntary

Voluntary- Skeletal Involuntary- Cardiac and Smooth

What is a Creatine Phosphokinase (CK/CPK) or CPK/CK Iso enzymes drwan in for STAT and routine tests?

STAT- Green and sent to Chemistry Routine- SST and sent to Chemistry

What is a Lactic acid drawn in and what are the special procedures?

Gray top tube, with NO tourniquet and NO fist, must be transported on ice to Chemistry

What is a Lactic Dehydrogenase (LD/LDH) drawn in?

SST and sent to Chemistry, STAT is Green

What is a Myoglobin test drawn in? SST and sent to Chemistry

What is Aspartate Aminotransferase (AST) (GOT) (SGOT) drawn in?

SST and sent to Chemistry STAT Green

What is a Creatine Kinase MB (CK-MB) drawn in?

SST and sent to Chemistry

What is Muscle Atrophy? Decrease in size due to inactivity

What is Muscular dystrophy?Genetic disease in which muscles waste away

What is the outermost layer of the Integumentry system?

Epidermis

What is the Stratum Corneum?dead cells, outermost layer, where Keratin is produced

What is the Stratum Germinativum?live cells, innermost layer of Epidermis, where melanin is produced

Which layer is also called the "true skin"? Dermis

The dermis contains 2 glands, what are they and what do they produce?

Sebaceous gland- produces oil called sebum Sudoriferous gland- produces sweat

What is the Subcutaneous Layer?Lies underneath the Dermis and is composed of Fat and loose connective tissue, and insulates deep tissue

What is Kaposis Sarcoma?A form of skin cancer found in patients with AIDS. Characterized by numerous bluish red lesions on the skin

Define AcneInflammatory disease of the sebaceous glands and hair follicles

Define Impetigo Staph or strep infection

What is Psoriasis?Chronic skin condition of unknown origin characterized by clearly defined red patches of scaly skin

What does the Central Nervous System include?

Brain and Spinal Cord

What is the largest part of the brain? Cerebrum

Which part of the brain plays an important part in motor control and in Latin also means "little brain"?

Cerebellum

Which is the brains link to the Endocrine System?

Hypothalamus

What connects the spinal cord to the brain and manages messages going between the brain and the rest of the body?

Brain Stem

What are Meninges?Membranes that surround the Central Nervous System

What is the Pia Mater?Inner layer of meninges, adheres to the surface of the brain

What is the Arachnoid Mater? Middle layer of the meninges

What is the Dura Mater?outermost layer of meninges that surrounds the skull

What does the Peripheral Nervous System consist of?

All the nerves that project from the brain and spinal cord

What are the 2 main nerves associated with the Peripheral Nervous System, and what do they do?

Motor- efferent nerves carry impulses from the CNS Sensory- afferent nerves carry impulses to the CNS

What is a Neuron? Specialized cells that direct impulses

What is the brain of a cell? Nucleus

What do the Dendrites do? Carry impulses to the nucleus

What is the Axon?A fiber optic highway that extends from the cell body, carrying impulses away from the cell body

What is the Myelin Sheath? Protective layer over the Axon

What is a Synapse?A small space separating the neurons from the next set of dendrites

What is epilepsy? Seizure disorder

What is Meningitis?Inflammation of the membranes of the spinal cord and brain

What is Multiple Sclerosis?Disease that causes destruction of the Myelin Sheath

What is Shingles? Adult onset Chicken Pox

What is a Dilantin test drawn in? SST and sent to Toxicology

What is Seratonin drawn in? SST and sent to Toxicology

What does a Cerebral Spinal Fluid test consist of?

CSF (not drawn by us) Glucose, Protein, cell count, and culture

What does the Endocrine System Produce?

Hormones

Which is the master gland that secretes hormones to stimulate other glands?

Pituitary Gland

Which hormone stimulates the adrenal glands to secrete Cortisol? What tube and department?

Adrenocorticotropic Hormone (ACTH) SST to Chemistry

Which hormone stimulates the Kidneys to reabsorb water? What tube and department?

Anti-diuretic Hormone (ADH) SST to Chemistry

Which hormone stimulates the development of Ova and Sperm? What tube and department?

Follicle Stimulating Hormone (FSH) SST to Chemistry

Which hormone stimulates growth? What tube and department?

Growth Hormone (GH) SST to Chemistry

Which hormone controls Thyroid Activity? What tube and department?

Thyroid Stimulating Hormone (TSH) SST to Chemistry

Which gland is located in the middle of the brain and calcifies after puberty?

Pineal Gland

Which hormone effects sleep and wake cycles? What tube and department?

Melatonin. SST to Chemistry

Which is the largest gland in the body? Thyroid gland

Which hormone regulates calcium in the blood? What tube and department?

Calcitonin SST to Chemistry

Which hormone accelerates metabolic rate in the tissues? What tube and department?

Thyroxine (T4) SST to Chemistry

Which hormone maintains normal heart rate and development of bone and muscle tissue? What tube and department?

Triidothyronine (T3) SST to Chemistry

Which small glands are located posterior the Thyroid gland

Parathyroid glands

Which hormone regulates blood calcium levels, increases blood calcium levels, and regulates P metabolism? Which tube and department?

Parathyroid Hormone (PTH) SST to Chemistry

Which gland is active in immune response?

Thymus gland

Which hormone is active in the development of lymphocytes? What tube and department?

Thymosin Hormone SST to Chemistry

Which glands are located on top of each Kidney?

Adrenal glands

Which hormone is active in fight or flight response? Which tube and department?

Adrenal Medulla Hormone. SST to Chemistry

Which hormones are produced by the Adrenal Cortex?

Corticosteroid hormones and Androgens and estrogens

What is the name of the cluster of cells found within the Pancreas?

Islets of Langerhans

What does insulin do? Needed for movement of glucose into the

cells and decreases blood glucose levels

Which word means secreting too little? Hyposecretion

Which word means secreting too much? Hypersecretion

Which disorder is characterized by the over growth of hands, feet and face caused by excessive Growth Hormone in adult hood?

Acromegaly

Which form of diabetes causes increased thirst and urine production?

Diabetes Insipidus

Which disorder is characterized by swollen "moon shaped" face and redistribution of fat to abdomen and back of neck caused by excess Cortisone?

Cushing Syndrome

What is Diabetes Mallitis? What is the blood test called, and what is the tube and department?

Deficiency of Insulin. Hemoglobin A1C (Hgb A1C) Lavender to Chemistry

Name the six organs of the Gastrointestinal tract.

Mouth, Pharynx, Larynx, Esophagus, Stomach, Small Intestines, Large Intestines

What does the Liver do?Manufactures bile, detoxifies harmful substances, stores vitamins, and makes Thrombin and Fibrinogen

What does the Gallbladder do? Stores bile

What does the Pancreas do?Secretes insulin, produces digestive enzymes; Amalayse, Lipase, and Trypsin

What is inflammation of the Gallbladder called?

Cholecytitis

What is inflammation of the stomach lining called?

Gastritis

Hepatitis means? Inflammation of the liver

What is inflammation of the Pancreas called?

Pancreatitis

What is an occult blood test? Blood in stool

Where is an Ova and Parasites test sent?Microbiology section of Chemistry Department

What is the tube and department for an Ammonia test?

Green top to Chemistry. Don't forget to transport on ICE!

Which is the primary filtering organ of the Kidneys

Urinary system?

What is the main filtering unit of the Kidneys?

Nephrons

After the Nephrons, waste then travels to the _________________, inside this, the blood vessels get smaller and the tiny tufts of capillaries are called the ________ which make it possible to filter waste

Glomerular Capsule (Bowmans Capsule), Glomerulus

What do the Renal tubules do?Where what is needed by the body gets absorbed back into the bloodstream

From the kidneys, urine travels down the _______ and into the ______

Ureters, Bladder

The Urethra is..? How urine leaves the body

What are Renal Calculi? Kidney Stones

What is External Respiration?The actual act of breathing and getting the needed oxygen to the tissue cells

What is Internal Respiration?Exchange of gases between the tissue cells and the blood

Which is the main organ of your respiratory system?

Lungs

What is the glottis and epiglottis?Glottis is the slit in the larynx; Epiglottis is the flap of skin that covers the larynx during swallowing

Which structure of the respiratory system splits into smaller tubes which extend to each lung?

Trachea

What are the Bronchi?Two man branches if the Trachea that go into the lungs

What are the smaller divisions of the Bronchi called?

Bronchioles

What is the name of the hollow sacs at the end of the Bronchioles where gas exchange takes place?

Alveoli

What is the partial pressure of oxygen?How high hemoglobin is in the lungs, and how low carbon dioxide is in the lungs

What is the Partial Pressure of Carbon Dioxide?

how low hemoglobin is in the lungs

What is Apnea A temporary cessation of breathing

What is Asthma?difficulty breathing accompanied by wheezing, caused by spasm or swelling in bronchioles

What is Emphysema? chronic obstructive pulmonary disease

What is Hypoxia? Deficiency of oxygen

What is Pulmonary Edema? Accumulation of fluid in the lungs

What is the Endocardium? Inner layer of the heart

What is the Myocardium? Middle layer of the heart

What is the Epicardium?Outer layer of heart where Coronary arteries are located.

What do the coronary arteries do? Supply the heart with oxygenated blood

What is the sac that holds the Heart in place?

Pericardium

What does the Right Atrium do?Receives deoxygenated blood from the Superior and Inferior Vena Cava

After the right atrium the deoxygenated blood flows through the..?

Tricuspid (Atrioventricular) Valve

After the Tricuspid (AV) valve, the deoxygenated blood moves to the..?

Right Ventricle.

from the R Ventricle, the deoxygenated blood moves through the _____ and into the ______.

Pulmonary valve, Pulmonary artery

The pulmonary artery brings the deoxygenated blood where? And what happens there?

Lungs. The exchange of gases occurs. Blood becomes oxygenated, and leaves Carbon Dioxide

The Oxygenated blood enters the ______ through the ________

Left Atrium, Pulmonary Veins

From the L Atrium, the oxygenated blood moves through the ______ and into the ______

Bicuspid (Mitral) Valve, Left Ventricle

From the L Ventricle, the oxygenated blood moves through the _____ and into the _____

Aortic Valve, Aorta

From the Aorta, blood then goes where? To the rest of the body

The Pulmonary Artery is the only artery that transports what?

deoxygenated blood

The Pulmonary Veins are the only veins in the body that transports what?

Oxygenated blood

Which is the biggest artery in the body? Aorta

Which is the largest vein in the body? Superior/Inferior Vena Cava

Define Systole

Ventricular Contraction, Atria are filling with blood and blood is being forced into the pulmonic and aortic valves. BP is higher, and is top number on BP

Define DiastoleVentricular relaxation. Ventricles fill with blood, BP is at its lowest and is the bottom number on a BP

What is the Sinoatrial Node? (SA Node)

Body's pacemaker, located in the right atrium, and starts the electrical impulse that spreads throughout the heart and will eventually cause ventricles to contract

After the SA Node, the impulses are then picked up by.?

The Atrioventricular (AV) node

After the AV Node, the Impulse travels to the ___________ and then to the little bundle of fibers that branch off that called the ___________

Bundle of His, Purkinje Fibers

Both the Bundle of His and the purkinje Fibers are located where?

They curve around up towards the Ventricles

What is a Myocardial Infarction? Heart attack

Why do arteries have thick walls?To withstand the pressure from the contraction of the ventricles

Which artery is used to measure a Blood Pressure?

Brachial

Which artery is used to find a pulse? Radial

What are arteries that join with capillaries called?

Arterioles

Veins transport what? Deoxygenated blood

What is the longest vein in the body?Great Saphenous, from the groin to the lower leg

When a capillary joins to a vein it is called?

Venules

What do the capillaries do?Where the exchange of gases and nutrients take place.

How thin are capillaries? only 1 cell thick

What is the Tunica Adventitia or Tunica Externa?

The outer layer of a vessel

What is the middle layer of a vessel called?

Tunica media

What is the Tunica intima? The inner layer of a vessel

The difference between arteries and veins is

Veins have valves to keep the blood flowing in one direction and Arteries do not

What is an Embolism? obstruction by a clot

What is an Embolus A circulating clot

What percent of blood are the formed elements?

45%

What percent of the blood is the plasma and what does it contain?

55% 7% proteins, 91% water, and 2% other solutes

What is an Erythrocyte? A Red Blood Cell (RBC)

What is an Erythrocytes primary function?Transport oxygen from the lungs to the tissues of the bod, and remove carbon dioxide

Immature RBC's are called _______ and contain a _______

Reticulocyte, nucleus

Which type of formed element is the most numerous of the formed elements?

Red Blood Cells

What does hemoglobin do?a protien that gives the RBC's their color, and carries the oxygen

What is a Leukocyte? A White Blood Cell (WBC)

Which type of WBC is the most numerous type that numbers increase during bacterial infections?

Neutrophils

There are 2 types of Lymphocytes, what are they and what do they do?

B-Cell- produces antibodies, T-Cell- fighter cells that attack infected cells

Which is the largest of the WBC's and numbers increase during chronic infections

Monocytes

Which WBC's numbers increase during allergies?

Eosinophils

Which WBC's numbers increase during allergic reactions and inflammatory

Basophils

reactions?

Another name for platelets is..? Thrombocytes

What do the Thrombocytes do? Clotting cells

For a person with Type A blood, which antigen and which antibodies does it contain and where?

RBC has the A antigen, plasma contains the anti-b antibody

For a person with Type B blood, which antigen and which antibodies does it contain and where?

RBC has the B antigen, plasma contains the anti-a antibody

For a person with Type AB blood, which antigen and which antibodies does it contain and where?

RBC has both A and B antigens, plasma has neither A nor B antibodies

For a person with Type O blood, which antigen and which antibodies does it contain and where?

RBC has no antigens, plasma contains both A and B antibodies

Which blood type is the universal donor? Type O

Which blood type is the universal receiver?

Type AB

What does the D-Antigen determine? the Rh factor

Where do you find serum? Its the liquid portion of a clotted specimen

Where do you find plasma It is the liquid portion of whole blood

Which disorder is characterized by abnormal reduction in the number of RBC's in the circulating blood?

Anemia

What is Polycythemia? An abnormal increase in RBC's

What is Thrombocytopenia? a decreased number of platelets

Define Hemostasis the controlling of blood

The first stage of hemostasis is Primary Hemostasis, what happens here?

Vasoconstriction, the damaged vessel will constrict or narrow to slow the flow of blood

Stage 2 of hemostasis is called platelet plug formation, what happens here?

When a vessel is damaged, platelets become activated and release a chemical that causes aggregation, then platelets stick together and adhere to the injured area

Stage 3 of hemostasis is called Secondary hemostasis (Fibron clot formation) What happens here?

Clots are formed from a protein called Fibrin, fibrin then turns to fibrinogen, from the enzyme thrombin, also needed is calcium, which acts as a glue to hold the fibrin to

each other and form a loose mesh work. This stabilized mesh will trap RBC's