AlliedHelper

Biochemistry 1st.year supplymentry





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Biochemistry & Anatomy 2nd yr supplymentry 2k23

TYPES OF TUBES:
1. THE PURPLE ONE:
These bottles are generally used for hematology tests where whole blood is required for analysis.
This tube contains EDTA(ethylenediaminetetraacetic acid), which acts as a
potent anticoagulant by binding to calcium in the blood.
COMMON TESTS:
o full blood count(FBC)
o erythrocyte sedimentation rate (ESR)
o blood film for abnormal cells or malaria parasites
o reticulocytes
o red cell folate
o Monospottest for EBV
o HbA1C for diabetic control
o parathyroid hormone (PTH)

2. THE PINK ONE:
The pink bottles work in the same way as the purple ones, but are specifically used only for whole blood samples being sent to the transfusion lab.
This tube also contains the anticoagulant EDTA.
COMMON TESTS:
o group and save (G&S)
o crossmatch (XM)
o direct Coomb’s test (aka direct antiglobulin test) for autoimmune haemolytic anaemia

3. THE BLUE ONE:
The blue bottle is used for haematology tests involving
the clotting system, which require inactivated whole blood for
analysis. This contains buffered sodium citrate, which acts as
a reversible anticoagulant by binding to calcium ions in the blood and subsequently disrupting the clotting cascade
COMMON TESTS:
o coagulation screen including bleeding time for platelet
function, prothrombin time (PT)for extrinsic pathway, activated partial thromboplastin time (APTT) for intrinsic pathway, and thrombin time (TT) or fibrinogen assay for the final common pathway
o D-dimer for thrombosis e.g. due to DVT or PE
o INR for monitoring patients on warfarin (this is calculated from the prothrombin time
o activated partial thromboplastin ratio (APTR) for monitoring patients on IV heparin infusions (this is calculated from the APTT)
o anti-Xa assay for monitoring patients on high-dose low molecular weight heparins like tinzaparin.

4. THE YELLOW ONE:
These bottles are used for a huge variety of tests requiring
separated serum for analysis, including biochemistry, endocrinology, oncology, toxicology, microbiology and immunology.
This tube is known in the lab as the SST (serum separating tube). It contains two agents; silica particles and a serum separating gel. The silica particles work to activate clotting and cause the blood cells to clump together.
COMMON TESTS:
o biochemistry tests are the ones you will encounter most commonly:
o urea and electrolytes (U+E) – this includes urea, creatinine, sodium and potassium
o C-reactive protein (CRP)
o liver function tests (LFTs) – this includes bilirubin, ALP, AST/ALT, GGT, total protein and albumin
o amylase assay
o bone profile – this includes calcium, phosphate, ALP and albumin
o magnesium assay
o iron studies – this includes serum iron, ferritin, transferrin saturation and total iron binding capacity
o lipid profile – this includes cholesterol, LDL, HDL and triglycerides
o thyroid function tests (TFTs) – this includes TSH, free T4 +/- free T3
o vitamins e.g. vitamin B12
o troponins – this requires 2 samples to be taken at different times to assess the acute trend
o creatine kinase (CK)
o urate
o serum osmolality – this requires a urine sample to be taken at the same time
o endocrinology: beta-hCG, calcitonin*, cortisol, EPO, s*x hormones,
growth hormone, IGF-1
o tumour markers: PSA, CEA, CA-125, CA19-9, AFP, lactate
dehydrogenase (LDH)
o toxicology: ethanol, cannabis, opiates, benzodiazepines, other drugs e.g. co***ne, amphetamines
o drug levels: paracetamol, salicylates (aspirin), digoxin, lithium, gentamicin, carbamazepine
o microbiology/virology: serology for a wide variety of bacterial, viral, fungal and parasitic infections including HIV and viral hepatitis
o immunology: immunoglobulins, complement, autoantibody screen, rheumatoid factor, thyroid antibodies, α1AT, ACE

5. THE GREY ONE:
The grey bottle is only used fo two tests, so compared to the yellow one it’s fairly easy to remember! It is used for biochemistry tests requiring whole blood for analysis.
This contains two main agents. Sodium fluoride acts as an antiglycolytic agent to ensure that no further glucose breakdown occurs within the sample after it is taken. Potassium oxalate acts as an anticoagulant.
COMMON TESTS:
o glucose – this can be fasting or non-fasting, or part of a glucose tolerance test (GTT)
o lactate

6. THE RED ONE:
The red bottle is less common – it is used for biochemistry tests requiring serum which might be adversely affected by the separator gel used in the yellow bottle.
This contains silica particles which act as clot activators.
COMMON TESTS:
o the use of this bottle varies greatly – some hospitals use it for many sensitive tests, including hormones, toxicology, drug levels, bacterial and viral serology and antibodies, whereas others seem to only use it for a few very specific purposes and use the yellow bottle for most things.
o my hospital definitely uses it for ionised calcium, but not much else

7. THE DARK GREEN ONE:
This less commonly used bottle is for biochemistry tests which
require heparinised plasma or whole blood for analysis.
This contains sodium heparin, which acts as an anticoagulant.
COMMON TESTS:
o ammonia*
o insulin*
o renin and aldosterone

8. THE LIGHT GREEN ONE:
This rare species of bottle is used for biochemistry tests
requiring separated heparinised plasma. I have never actually used one but have seen them on the dermatology ward.
This bottle is known as the plasma separator tube (PST). It
contains lithium heparin, which acts as an anticoagulant, and a plasma separator gel similar to that used in the yellow bottle, which acts to separate out the plasma layer.
COMMON TESTS: it can be used for routine biochemistry, but most hospitals seem to use the yellow bottle for this. It can also be used for blood ethanol provided the sample is not for legal purposes.

OTHER ONES
o white – used for molecular diagnostics such as PCR and DNA
amplification studies
o black – for paediatric ESR





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