PHLEBOTOMY NOTES

HEMATOLOGY (Lavander Top) Total BIlirubin

Complete Blood Count TBIL/DBIL/
Platelet Count TPAG
Hgb/Hct Total Protein
ESR 24° CREA CLEARANCE
Abo Typing ENZYMES
Rh Typing SGOT/AST
ClottingTime/BleedingTime SGPT/ALT Liver Function Test, Yellow top
WBC Differential Count Alkaline Phosphatase
Protime- citrate Acid Phosphatase
APTT- citrate Amylase
Peripheral Blood Smear GGT
Reticulocyte Count LDH
CLINICAL MICROSCOPY Lipase
Routine Urinalysis ELECTROLYTES(Red top)
Routine Fecalysis Total Calcium
AFB Ionized Calcium
Gram Stain Chloride
KOH Magnesium
Occult Blood Sodium
Pregnancy Potassium
Sperm Analysis Phosphorous
Urobilinogen THYROID FUNCTION TEST ( Yellow Top)
Ketone /Acetone FSH
Sugar T3
Body Fluids T4
Cell Differential Count FT3
 Sugar FT4
 Protein
SEROLOGY Microtainer (Small Lavander Tube)
ANA Titer 1. CBC
Dengue Titer 2.Platelet
Typhidot- Yellow Top, for typhoid fever caused by Salmonella typhi 3.Dengue Duo
bacteria EDTA 3mL
H. Pylorl 1. ESR
RPR/VDRL 2. HBAIC
HBSAg (Screening)
Eg: CBC & . HBAIC- 3mL EDTA
HEPATITIS (Yellow Top)
ALL TEST ARE YELLOW TOP OR RED TOP TUBE
Anti- HAV IgG
EXCEPT…yellow talaga pig gagamit ninda
Anti HAV IgM
Anti HCV  CBC
HBeAg- Yellow Top, 3 CC syringe  ESR Lavander tube
Anti HBS  HBA1C
HBSAg (Confirmatory)  PROTIME
Antí Hbc igG  APTT Citrate tube
Anti Hbc IgM FBS/RBS-for sugar, 6 to 8 hrs fasting
Hepatitis Profile If there is FBS & Lipid Profile Test- 12 hrs fasting
Hepatitis B Profile For Urinalysis( Always tell the patient to catch on the
CHEMISTRY(Yellow Top)
middle not on the first ihi )
FBS/RBS
OGCT For Fecalysis (Peasized only)
OGTT If the request have a Urinalysis and Drug Test tell the
HBAIC- for managing diabetes mellitus patient to go to information area
Total Cholesterol Protime test- citrate tube( 4 inversion), use 3CC
Triglycerides Lipid Profile-10 to 12 hrs Bilirubin test- Yellow/Red top( cover the test tube
HDL (fasting) with paper before extracting)
LDL
BUN (Blood Urea Nitrogen) If ONLY RBS & Blood typing- pricking, use lancet
Creatinine Kidney Function For Hepa B test for student-use red top
BUA (Blood Uric Acid) Test 1 CC- small tube( microtainer0
Albumin 3 CC- Small tube + 3mL tube
SeTrarum iron/TIBC 5 CC-3mL + 3mL
 SEROLOGY AND HEPATITIS NOTES
Typhoid - 1 drop( Sample),2 drop (Buffer) 20 minutes
( sa test kit may nakalaag duman C,G,M)
Results Interpretation:
Positive Result:
 Control Line (C) + G Line (IgG) = Past
infection (the person has had typhoid 2 .Dispense 4 drops of assay diluent into the round assay
before). diluent well.
 Control Line (C) + M Line (IgM) =
Recent/current infection.
Negative Result: Only the control line appears, 3. Using micropipette, dispense 5 pl of serum or plasma
indicating no current or past infection. into the specimen well.
HBSAg- 2 drops, 20 minutes
Reported as REACTIVE & NON REACTIVE
Drug Test-2-3 drops, 5 minutes
Positive-no line
Negative-have a line
HAV- mixed 5Ml of serum on the buffer
-2-3 drops (20 minutes)
4. Interpret test results at 20 minutes. Reading after 20
 Read the test procedure
minutes can yield false results.
 POSITIVE: Distinct color lines appears
Caution: Do not read test results after 20 minutes.
 NEGATIVE: Only one color
 INVALID: There is a line in the letter T
NSI- for active/ infection of dengue CLINICAL MICROSCOPY NOTES
ANTI HAV IgG/IgM
Test procedure
For Fecalysis
1. Bring all kit compunents and specimens to reach a
1. Write the name and date in the form
temperature between 15 C and 30°C pior to testing
2. Spray Lysol around before opening the container
2. Remove the test device from foil pouch and place it on a
3. Place stool container on plastic or tissue to avoid mes..
flat, dry surface. Label the test device with a patiet
4. State the color and consistency of stool
identifier.
3. [Using a capillary pipette]  F-form
Dispense 5 uL serum or plasma specimen drawn into the  S-semifom
square specimen well.
 W-watery
Or,
[Using a micropipette]  L-loose
Dispense 5 uL of serum or plasma specimen into the Color Possible Causes Consistency Notes
Brown ✅ Normal— bile and Formed to soft Most common and
square specimen well. bilirubin breakdown healthy color
4. Dispense 4 drops of assay diluent into the round assay Dark High protein/iron diet, Formed or Still normal unless
Brown dehydration, slow transit hard black/tarry or with
diluent well. other symptoms
Green Rapid transit, green Soft to loose Often harmless unless
5. Interpret test results at 20 minutes veggies, iron supplements, persistent
Caution : Do not read test results after 20 minutes. antibiotics
Yellow Fat malabsorption, celiac Greasy, foul- Suggests steatorrhea
Reading after 20 minutes can yield false results. disease, Giardia smelling (fat in stool)
Black Upper GI bleeding, iron Sticky, tar-like ✅ Urgent evaluation
Other notes: (Tarry) supplements, bismuth may be needed
(Pepto-Bismol)
1. Label the test kit Red Lower GI bleeding Varies Check if from diet or
2. Get the” capillets lookalike” ,press it to get the sample (hemorrhoids, colon), red bleeding
foods
3. Place in the sample well Pale / Bile duct obstruction, liver Soft, putty-like Indicates lack of bile;
Clay- disease may be serious
4. Place the sample in ______________ colored
Orange Carrots, beta-carotene, Formed Usually dietary
5.Wait for 20 mins medications (rifampin)
1. Using a capillary pipette, dispense 5 pl of serum or
plasma into the specimen well. 5. Place 1 drop of Iodine and NSS on slide then using
applicator stick, spread the stool on the slide
6. Dispose the stool in the waste bin and also the stick
7. Then examine microscopically 2. While removing the strip from the urine, run the edge of
8. Discard slide and write what you have observed the strip against the rim of the urine container to remove
excess urine. Hold the strip in a horizontal position and
NOPS-(No Ova or Parasite seen)
bring the edge of the strip into contact with an absorbent
LPO- for parasite( Ascaris, trichuris,hookworm) material (e.g. a paper towel) to avoid mixing chemicals
HPO-for parasite ( Amoeba, Giardia,enterobius, from adjacent reagent areas and/or soiing hands with urine.
trichimonas) See illustration 2 below.
FOCT-Fecal Occult Blood Test 3. Compare the reagent areas to the corresponding color
-means” hidden” uses buffer to detect . blocks on the canister label at the specified times. Hold the
For Urinalysis strip close to the color blocks and match carefully. See
LPO- Epithelial, mucus, cast, amorphous illustration 3 below.
urates(acidic), amorphous phosphates (acidic) Note: Results may be read up to 2 minutes after the
HPO-Puss cell, RBC, Bacteria,Yeast ,crystals, specified times.
Results may also be read using the Insight Urine Analyzers.
Refer to the Instruction
Manual for details.
QUANTITATIVE

Color of Urine:
C-Clear
LY-Light Yellow
DY-Dark Yellow
Other notes for Urinalysis
A-Amber
1.Put the urine in the tube
B-Brown
2.Put the reagent strip
R-Red
3.Blot in the tissue
Transparency :
4 Put in the machine
Term Description Possible Causes 5. Centrifuge the urine
Clear No visible particles; Normal
6.Decant
transparent
Hazy Slightly cloudy; may Mucus, epithelial 7.Examine microscopically
still be readable cells, amorphous
through crystals HEMATOLOGY NOTES
Cloudy Noticeably opaque, WBCs, RBCs,
harder to read through bacteria, crystals, Differential count
mucus 1. Monocyte
Turbid Very cloudy or opaque; Heavy bacteria, pus
2.Lymphocyte
cannot see through (WBCs), fat, chyle
Milky White, thick Chyluria, lipids, 3.Neutrophil
appearance pyuria (pus in urine) 4.Basophil
P-PUSS 5.Eosinophil
R-RBC In WBC, it should be total of 100
E-EPITHELIAL For 3 parts machine- babangaon so mid( Eosinophil,
M-MUCUS Basophil,Monocyte) it should be total na 100
B-BACTERIA Do not include/compute the WBC in differential
A-AMORPHOUS count
Nitrate-Bacteria For ESR- Itutusok,dapat dae sya nahihiro kasi….
Blood-RBC  For every 10-degree tilt from vertical:
Test Procedure  The ESR can increase by about 30%.
Allow the strip, urine specimen, and/or controls to reach  So for a 30-degree tilt:
room temperature (15-30°C) prior to testing.  The ESR result may increase by up to
1. Remove the strip from the closed canister and use it as ~90%.
soon as possible. Immediately close the canister tightly Probe- so nag s-suck sa sample
after removing the required number of strip(s). Completely Zybio- name of the machine, the reagents are on the
immerse the reagent areas of the strip in fresh, well-mixed top of it.
urine and immediately remove the strip to avoid dissolving
the reagents. See illustration 1 below.
  Ensure all materials (test device, buffer, etc.) are
CLINICAL CHEMISTRY NOTES at room temperature.
2. Power on the SP BIOSENSOR Machine
For Creatinine  Let it initialize and prepare for testing.
1. Place the sample in the centrifuge for 5 minutes( if there 3. Get the Buffer Solution
is chylus ) centrifuge again for 5 minutes  Shake or flick the buffer tube gently if the
2. Place the sample in the machine (cobas 111) solution is stuck at the top or sealed (some
buffers settle or get trapped near the cap).
3.Click the ‘order’ 4. Add the Sample to Buffer
4. Click the’ <!>’
 Pipette 100 µL of serum (patient’s sample) and
5.Type the name add it to the buffer tube.
6. Click ‘>>’  Mix thoroughly by gently flicking or vortexing.
7.Click ‘Crea’ 5. Load the Sample onto the Cartridge
8.Click ‘check’ then put the sample in the no. 1 within 10  Pipette 100 µL of the mixed buffer+serum
seconds,then click <!> solution.
For Sodium/Potassium  Dispense it into the sample well of the test
1. Place the sample in the probe to get the serum cartridge.
2. Click ‘Yes’ 6. Run the Test
3. Wait for 60 seconds  Insert the cartridge into the SP BIOSENSOR
4.Then the machine will input the result machine.
Air Sensor- if mag ka problema and probe  Start the timer as instructed by the kit (usually
automatic after insertion).
 Wait for the result.
For OGTT
PART 2 NOTES
Preparation:
CHEMISTRY
 Patient must fast for hours before the test. Water A. Order of Draw
is allowed, but no food, coffee, or juice.
 Blood Culture Bottles – Sterile (yellow or glass bottle)
 Test is ideally done in the morning to avoid
 Light Blue – Sodium Citrate (coagulation studies)
interference from circadian glucose variations.
Step-by-Step Instructions:  Red / Gold / SST – No additive or with clot activator
1. Fasting Blood Sample (1st "tusok"): (serology/chemistry)
o Collect the first blood sample to  Green – Heparin (plasma chemistry)
measure fasting blood glucose (FBS).  Lavender / Pink – EDTA (hematology/blood bank)
2. Glucose Drink:  Gray – Sodium fluoride/potassium oxalate
o Give the patient a solution containing (glucose/lactate)
75 grams of glucose. B. Color of each test
o Instruct them to drink the solution
within 5 minutes.
3. Start the Timer for 1 hour:
o The moment the patient finishes the
drink, start timing.
4. 1-Hour Blood Sample (2nd "tusok"):
o Exactly 1 hour after the patient
finishes the drink, collect the second
blood sample.
5. 2-Hour Blood Sample (3rd "tusok"):
o Exactly 2 hours after finishing the
glucose drink, collect the third and
final blood sample.
Important Notes:
 If both the 1st (FBS) and 2nd (1-hour) results
are high, this may indicate gestational diabetes.
 If the 1st result is low but the 2nd result is high,
the result may be invalid and the test may need to
be repeated.
C. Carbohydrates
1.FBS: fasting: 8-10 hrs
TUMOR MARKERS NOTES
2.OGTT: fasting: 8-10 hrs
Glucose Load: 75g
1. Prepare the PSA FIA Kit
3.HBA1C- No fasting; it is to reflects the average blood 2.BUN
sugar level over the past 2 to 3 months. 3. CRF
4. Fructosamine: reflects the amount of sugar in the blood 4. BUA
that has attached to proteins, especially albumin, over the 5. TRIGLYCERIDES
past 2 to 3 weeks — like sugar that’s already in your 6.TOTAL CHOLESTETOL
hands, but hasn’t been used up yet. 7.HDL
D. Principle of each test 8.LDL
9.ALT
10,AST
HEMATOLOGY
1. RBC INDICES

E. Lipid Profile-fasting 10-12 hrs

2. Polycythemia Vera vs. Secondary Polycythemia

F. Liver Function Test-they are usually enzymes

3. Function of WBC
Neutrophils (Most abundant WBC, 50–70%)
 Primary defense against bacterial infections.
 Act like the "soldiers" of the immune system.
 Perform phagocytosis – they engulf and destroy
bacteria.
 Increase during acute infections, inflammation,
stress, and tissue injury.

Lymphocytes (20–40%)
 Key players in the adaptive immune system.
 Two main types:
o B cells – produce antibodies (humoral
G. Hormones immunity).
CHEM 10 o T cells – destroy infected or abnormal
1. FBS cells (cell-mediated immunity).
 Increase during viral infections, leukemia, and
some chronic infections.

Monocytes (2–8%)
 Largest WBC in size.
  Circulate in the blood and migrate into tissues to - 8–10 hours (no food or drink except water).
become macrophages. Initial Count: Medtech
 Function: phagocytosis of pathogens and dead Final Count: Pathologist
cells.
7. Manual Count (Neubauer)
 Also help present antigens to lymphocytes
(bridge between innate and adaptive immunity).
 Increase in chronic infections like tuberculosis
or in recovery phase of infections.

Eosinophils (1–4%)
 Deal with parasitic infections and allergic
reactions.
 Contain granules with enzymes that kill parasites.
 Also contribute to inflammation in asthma and
allergies.
 Increase in parasitic infestations, asthma, and
eosinophilic disorders.

Basophils (0.5–1%) Clinical Microscopy

 Rarest type of WBC.
 Release histamine and other chemicals during
allergic reactions.
 Involved in hypersensitivity responses like
anaphylaxis.
 Similar to mast cells (but found in circulation, not
tissues).
Abundance: Never Let Monkey Eat Bananas
4. Erythrocyte Sedimentation Rate
- ESR measures how fast RBCs settle in a vertical tube
over a given time. It's usually read at:
 30 minutes (intermediate reading)
 60 minutes (standard reading)
Normal ESR Values (Westergren Method)
Group Normal ESR (mm/hr)
Men 0–15 mm/hr
Women 0–20 mm/hr
Children 0–10 mm/hr
Elderly (≥50 Slightly higher (up to 30 mm/hr may be
y/o) acceptable)

ESR is elevated when

Group ESR (mm/hr)
Men >15 mm/hr
Women >20 mm/hr
Children >10 mm/hr
Elderly >30 mm/hr
5. Dengue Test

6.FBS( Fasting Blood Glucose)

- measures the level of glucose (sugar) in the blood