Summarize the following text to main points and sub-points and make detailed explain for them:

lection 
using a syringe). 
3. As a result of aspirating Para venous blood after inaccurate 
puncture of the vein. 
B. Hemolysis causes elevated potassium concentrations and an 
Increase in the activity of LDH, ALT, AST, and acid 
phosphatase. Additional band due to hemoglobin may be seen in 
serum protein electrophoresis. 
C. Hemolysis is visible to the naked eye if the hemoglobin 
concentration exceeds 0.2 g/l 
 
A
 
B
 
 
30 
 
2. PHLEBOTOMY 
ﻜﺮﺘﻳﻮﻟﻮﺟﻲ
 
ﺍﺧﺘﺼﺎﺹ
ﻟﻴﺚ 
 
ﺷﺎﻛﺮ
 
ﺟﺎﺳﻢ
 
ﺭﺋﻴﺲ
 
ﻜﺮﺘﻳﻮﻟﻮﺟﻲ
 
ﻓﺎﻃﻤﺔ
 
ﺳﻌﺪ
 
ﺳﻠﻴﻢ
 
 
 
 
 
 
 
 
 
 
Figure (1-22): Hemolysis blood sample 
1.19 Differences between capillary and venous blood 
Venous blood and capillary blood are not quite the same. 
In capillary blood, the following are higher: 
a. Haemoglobin concentration (Hb) 
b. Packed cell volume (PC) 
c. Red cell count (RBC) 
d. Total WBCs, neutrophils and monocytes. 
In venous blood, the platelet count is higher. 
1.20 Specimen Storage 
a. Samples need to be stored either because the analysis 
b. cannot be directed immediately 
c. Or for the purpose of retesting the sample after the analysis if we 
need. 
d. Specimens can be stored without being affected by significant 
alterations, set the following guidelines. 
1. Serum or heparinized plasma for the determination of 
enzymes and substrates for one week at 4-8 Co 
 
31 
 
2. PHLEBOTOMY 
ﻜﺮﺘﻳﻮﻟﻮﺟﻲ
 
ﺍﺧﺘﺼﺎﺹ
ﻟﻴﺚ 
 
ﺷﺎﻛﺮ
 
ﺟﺎﺳﻢ
 
ﺭﺋﻴﺲ
 
ﻜﺮﺘﻳﻮﻟﻮﺟﻲ
 
ﻓﺎﻃﻤﺔ
 
ﺳﻌﺪ
 
ﺳﻠﻴﻢ
 
2. Platlate-poor citrated plasma for prothrombin time test and 
activated partial thromboplastin time (APTT) test for up to 8 
h at room temperature. 
3. EDTA blood for the determination of complete blood count 
different, but including a platelet count) 24h at room 
temperature. 
Preanalytical phase 
1. Variable biological factors include nutrition, fasting, alcohol, 
body weight, muscle mass, physical activity, posture, climate, 
altitude, diurnal rhythm, therapeutic drugs. 
2. Invariable biological factors are gender, age, race, and hereditary 
factors. 
Analytical phase 
Which cover the following : 
1. Checks the test method, the reagents, standards, and control 
materials. 
2. Checks the equipment and instruments used perform the test 
and calculate the results. 
Post-analytical phase 
Which cover the following Reporting the test result which must 
include: 
1. Test name and type of specimen analyzed. 
2. Test results clearly. 
3. The measurement unit and reference range (Review the range with 
the age and sex). 
4. The comment if found, Interpretation of test results to follow if the 
result is seriously abnormal or unexpected. 
 
 
32 
 
2. PHLEBOTOMY 
ﻜﺮﺘﻳﻮﻟﻮﺟﻲ
 
ﺍﺧﺘﺼﺎﺹ
ﻟﻴﺚ 
 
ﺷﺎﻛﺮ
 
ﺟﺎﺳﻢ
 
ﺭﺋﻴﺲ
 
ﻜﺮﺘﻳﻮﻟﻮﺟﻲ
 
ﻓﺎﻃﻤﺔ
 
ﺳﻌﺪ
 
ﺳﻠﻴﻢ
 
Prolonged Tourniquet Application 
1. The primary effect is hemoconcentration of nonfilterable elements 
such as proteins. The hydrostatic pressure causes some water and 
filterable elements to leave the extracellular space and enter the 
venous blood. 
2. Significant increases can be found in total protein, aspartate 
aminotransferase (AST), total lipids, cholesterol, and iron. 
3. Affects packed cell volume and other cellular elements 
1.21 Summary of types of blood sample used in laboratory 
Table (1-3): Types of blood sample used in laboratory
 
Specimen type 
Collection method 
Description 
Use 
Cotted blood  
Venipuncture 
No anticoagulant added. 
For separation to use 
the serum portion. 
Serum 
Venipuncture 
Clotted blood is allowed to 
stand for 20 to 30 minutes 
and then centrifuged. The 
upper portion is termed 
serum and does not contain 
fibrinogen. 
Chemistry testing. 
Serological testing. 
Blood banking. 
Whole blood 
Venipuncture 
Obtained by using a 
collection tube containing 
anticoagulant which 
prevents the blood from 
clotting. Whole blood 
includes all cellular 
material and plasma. 
For use in hematology 
testing and for 
separation by 
centrifuging to use the 
plasma portion. 
Plasma 
Venipuncture 
Whole blood containing 
anticoagulant is centrifuged 
and the upper portion is 
termed plasma. Plasma 
contains fibrinogen. 
Coagulation studies. 
Plasma chemistries. 
 
Capillary blood 
Finger stick or heel 
stick 
A combination of venous 
blood, arterial blood, and 
tissue fluid obtained by a 
skin puncture. 
Used in children and 
infants, or where 
Venipuncture cannot 
be performed. 
Specimens may be 
processed for serum, 
plasma, whole blood, 
or applied to special 
filter paper cards and 
used as dried blood 
spots. 
 
 
33 
 
2. PHLEBOTOMY 
ﻜﺮﺘﻳﻮﻟﻮﺟﻲ
 
ﺍﺧﺘﺼﺎﺹ
ﻟﻴﺚ 
 
ﺷﺎﻛﺮ
 
ﺟﺎﺳﻢ
 
ﺭﺋﻴﺲ
 
ﻜﺮﺘﻳﻮﻟﻮﺟﻲ
 
ﻓﺎﻃﻤﺔ
 
ﺳﻌﺪ
 
ﺳﻠﻴﻢ
 
1.22 Most common errors in specimen collection  
Table (1-4): Most common errors in specimen collection:
 
Possible causes
 
Invalid specimen
 
Quantity of blood not sufficient for testing 
(QNS)  
Filter paper circles incompletely filled or not 
saturated/not all circles filled.  
Blood applied with needle or capillary tube.  
Contamination of surface of filter paper 
circle before or after specimen collection by 
gloved or ungloved hands, or by substance 
such as hand lotion or powder, etc.  
Blood spots appear scratched or abraded  
Blood applied improperly using capillary 
tube or other means (blotter has been 
damaged or torn by device).  
Blood spots wet  
Specimen not properly dried before mailing.  
Blood spots appear supersaturated  
Excess blood applied (usually with capillary 
tube or needle).  
Blood applied to both sides of filter paper.  
Blood spots appear diluted, discolored, or 
contaminated  
Puncture site squeezed or “milked.”  
Exposure of blood spots to direct heat.  
Contamination of filter paper before or after 
specimen collection by gloved or ungloved 
hands, or by substances such as alcohol, 
formula, water, powder, antiseptic solutions, 
or hand lotion.  
Contamination during transit.  
Blood spots exhibit “serum rings”  
Alcohol not wiped off puncture site before 
skin puncture is made.  
Filter paper has come into contact with 
alcohol, water, hand lotion, etc.  
Puncture site squeezed excessively.  
Specimen dried improperly.  
Blood applied to the filter paper with a 
capillary tube.  
Blood spots appear clotted or layered  
Same filter paper circle touched to a blood 
drop several times.  
 
34 
 
2. PHLEBOTOMY 
ﻜﺮﺘﻳﻮﻟﻮﺟﻲ
 
ﺍﺧﺘﺼﺎﺹ
ﻟﻴﺚ 
 
ﺷﺎﻛﺮ
 
ﺟﺎﺳﻢ
 
ﺭﺋﻴﺲ
 
ﻜﺮﺘﻳﻮﻟﻮﺟﻲ
 
ﻓﺎﻃﻤﺔ
 
ﺳﻌﺪ
 
ﺳﻠﻴﻢ
 
Circle filled from both sides of the filter 
paper.  
Blood will not elute from the blotter paper  
Blood specimen has been heat-fixed.  
Blood specimen is too old (more than two 
weeks between collection and receipt by the 
screening laboratory). 
 
 
 
35 
 
 
3. COMPLETE BLOOD COUNT (CBC) ﺩ.ﻣﺤﻤﺪ ﻣﻴﺴﺮ ﺍﻟﻨﻌﻴﻤﻲ
 
ﻋﺰﻳﺰ ﺣﺴﻴﻦ ﺍﺑﺘﺴﺎﻡ.ﺩ 
 
2.1  Complete  blood  count  (CBC)  =  Full  blood  count  (FBC)  = 
Complete blood picture (CBP) 
A complete blood count is one of the most ordered lab tests and includes red 
blood cell count, white blood cell count with differential, platelet  count,  
hemoglobin,  hematocrit,  red  cell  indices  (mean corpuscular volume, red blood 
cell distribution width, mean corpuscular hemoglobin, etc.) and reticulocyte count. 
2.1.1 Benefits of the test 
This is a simple test and can help detect infections, inflammatory diseases, 
some malignancies, anemia and some other disorders. The CBC test can be 
applied manually or automatically instruments 
2.1.2 Special consideration before the test: Specimen 
Whole venous blood, uncentrifuged, anticoagulated with EDTA (Purple or 
lavender cap) see table (1-2). 
2.1.3 Sample storage 
The test is done within 6-8 hours of taking the sample at room temperature; 
however, it can be stored for 24 hours at 4℃. 
2.2 Manual blood count 
1.  Hemoglobin concentration: (Hb) 
Hb is a metal protein found in the RBC Haemoglobin plays a very important 
in the body, since it's primarily responsible for carrying oxygen to all parts of the 
body see table (2-1). 
 
 
36 
 
 
3. COMPLETE BLOOD COUNT (CBC) ﺩ.ﻣﺤﻤﺪ ﻣﻴﺴﺮ ﺍﻟﻨﻌﻴﻤﻲ
 
ﻋﺰﻳﺰ ﺣﺴﻴﻦ ﺍﺑﺘﺴﺎﻡ.ﺩ 
 
Procedure: The Hb conc. is done by special solution (Drabkin's Reagent is used 
for the quantitative, colorimetric determination of hemoglobin concentration in 
whole blood at 540 nm. 
In test tube put 5 ml of Drabkin’s R. then add 20µl of well mixed EDTA 
blood, Mix well and allow standing for at least 15 minutes at room temperature 
(18–26 °C). And read by spectrophotometer at 540 nm. 
Normal value (N.V.): Male: 12.5-17.0 g/dl 
                                   Female: 11.5-16.0 g/dl. 
- Hb decreased in: anemia (various types) & bone marrow failure. 
- Hb increased in: Polycythemia & congenital heart disease 
2.  Packed cell volume (PCV) / haematocrit (Hct): the percentage of blood that 
is represented by the packed red cells. 
Procedure: draw blood from EDTA tube or finger-tip to the capillary tube to 
about 75% of the tube then seal one end with clay or by heat. Then put it in micro-
centrifuge for 5 min. at speed 9000-10000 RPM as shown in figure (2-1). 
 
 
 
 
Figure (2-1): Steps of packed cell volume analysis 
Measure the proportio

Summary :