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% Document Info
\author{ressentie}
\pdfinfo{
  /Title (sem-chemistry.pdf)
  /Creator (Cheatography)
  /Author (ressentie)
  /Subject (SEM-CHEMISTRY Cheat Sheet)
}

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\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{C}
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    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{SEM-CHEMISTRY Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{ressentie} via \textcolor{DarkBackground}{\uline{cheatography.com/163647/cs/34331/}}}
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\noindent
\begin{multicols}{3}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}ressentie \\
  \uline{cheatography.com/ressentie} \\
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Not Yet Published.\\
   Updated 24th September, 2022.\\
   Page {\thepage} of \pageref{LastPage}.
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  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
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\begin{document}
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\begin{multicols*}{2}

\begin{tabularx}{8.4cm}{x{3.12 cm} x{4.88 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{PATIENT PREPARATION}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{EXERCISE}} & - increased in lactate, fatty acid, ammonia, ALT, AST, CPK, LD \{\{nl\}\}- increased in growth hormone, prolactin, testosterone, leutenizing hormone. \{\{nl\}\} - elevated levels of proteins in urine (proteinuria) \{\{nl\}\} - vigorous hand exercise (fist clenching) increases potassium, lactate and phosphate. \tn 
% Row Count 13 (+ 13)
% Row 1
\SetRowColor{white}
{\bf{FASTING}} & - 8-16 hrs is required for glucose, lipids and LPP.\{\{nl\}\}- {\bf{Serum bilirubin}} may increase after 48 hrs of fasting\{\{nl\}\}- {\bf{Plasma triglyceride}} increases after 72 hrs of fasting\{\{nl\}\}{\bf{Basal state collection}} — glucose, cholesterol, triglyceride and electrolytes. \tn 
% Row Count 25 (+ 12)
% Row 2
\SetRowColor{LightBackground}
{\bf{DIET}} & - metabolic products of food can increase in venous blood (High CHON diet — increases urea) \{\{nl\}\}- {\bf{Serotonin}} = will increase the urinary excretion of 5-hydroxyindole acetic acid\{\{nl\}\}- {\bf{Caffeine}} = increases the concentration of glucose, {\bf{releases catecholamines from adrenal medulla and brain tissue}}. \{\{nl\}\}- Increases turbidity or lactescence = triglyceride levels exceed 400 mg/dL\{\{nl\}\}-Contributes to degree of ictericia (bilirubin) — 25.2 mg/L\{\{nl\}\}-Icteric samples interfere with albumin, cholesterol, glucose and total protein tests. \tn 
% Row Count 49 (+ 24)
\end{tabularx}
\par\addvspace{1.3em}

\vfill
\columnbreak
\begin{tabularx}{8.4cm}{x{3.12 cm} x{4.88 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{PATIENT PREPARATION (cont)}}  \tn
% Row 3
\SetRowColor{LightBackground}
{\bf{POSTURE}} & - patient should be seated/supine for at least 20 min before blood collection to prevent hemodilution or hemoconcentration. \{\{nl\}\}- {\bf{changing from supine to sitting or standing position}} causes constriction of blood vessels and reduction of plasma volume — inc levels of albumin, enzymes and calcium. \{\{nl\}\}- {\bf{changing from sitting to supine}} causes shifting of water and electrolytes into tissue causing hemoconcentration — inc levels of proteins, lipids, BUN, iron and calcium. \{\{nl\}\}- {\bf{changing from standing to supine}} causes extravascular water to transfer to the vascular system and dilutes nondiffusable plasma constituents — decreased levels of cholesterol triglycerides and LPP. \tn 
% Row Count 30 (+ 30)
\end{tabularx}
\par\addvspace{1.3em}

\vfill
\columnbreak
\begin{tabularx}{8.4cm}{x{3.12 cm} x{4.88 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{PATIENT PREPARATION (cont)}}  \tn
% Row 4
\SetRowColor{LightBackground}
{\bf{TOURNIQUET APPLICATION}} & - 1 minute application is recommended \{\{nl\}\}- prolonged tourniquet application results to:  \{\{nl\}\} \{\{fa-check\}\} hemoconcentration (venous stasis)\{\{nl\}\}\{\{fa-check\}\} anaerobiosis \{\{nl\}\}- the pressure from the tourniquet causes biological analytes to leak from the tissue cells into the blood. \{\{nl\}\}Increased levels: proteins, enzymes, lactate, cholesterol, potassium and ammonia \tn 
% Row Count 16 (+ 16)
% Row 5
\SetRowColor{white}
{\bf{TOBACCO SMOKING}} & - inc in plasma non-esterified fatty acid (NEFA) concentration. \{\{nl\}\}- inc in plasma catecholamines and serum cortisol \{\{nl\}\}- inc in glucose, growth hormone, cholesterol, triglyceride and urea. \tn 
% Row Count 25 (+ 9)
% Row 6
\SetRowColor{LightBackground}
{\bf{ALCOHOL INGESTION}} & - inc plasma concentration of urate and triglyceride \{\{nl\}\}- inc GCT concentration \{\{nl\}\}- it causes hypoglycemia (chronic alcoholism) \tn 
% Row Count 31 (+ 6)
\end{tabularx}
\par\addvspace{1.3em}

\vfill
\columnbreak
\begin{tabularx}{8.4cm}{x{3.12 cm} x{4.88 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{PATIENT PREPARATION (cont)}}  \tn
% Row 7
\SetRowColor{LightBackground}
{\bf{STRESS}} (anxiety) & - affects adrenal hormone secretion \{\{nl\}\}- also associated with inc levels of albumin, glucose, insulin, lactate and cholesterol \tn 
% Row Count 6 (+ 6)
% Row 8
\SetRowColor{white}
{\bf{DRUGS}} & - TDM specimen collection should be schedule according to the last time of the last dose.\{\{nl\}\}- medications affecting plasma volume can affect protein, BUN, iron and calcium concentrations.\{\{nl\}\}- hepatotoxic drugs can elevate liver function enzymes \{\{nl\}\}- diuretics can decrease plasma sodium and potassium levels. \tn 
% Row Count 20 (+ 14)
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\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{4 cm} x{4 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{BLOOD COLLECTION PROCEDURES}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{PATIENT IDENTIFICATION}} & -Ask the patient to state his or her full name \{\{nl\}\}-Check the patient's ID band/bracelet bearing the patient's name and hospital ID number \tn 
% Row Count 7 (+ 7)
% Row 1
\SetRowColor{white}
{\bf{SLEEPING PATIENTS}} & -Wake the person gently and properly identify the patient \tn 
% Row Count 10 (+ 3)
% Row 2
\SetRowColor{LightBackground}
{\bf{UNCONSCIOUS PATIENTS, YOUNG, MENTALLY INCOMPETENT OR NON-ENGLISH SPEAKING PATIENTS}} & -Ask a relative or the patient's nurse or physician to identify the patient \tn 
% Row Count 15 (+ 5)
% Row 3
\SetRowColor{white}
{\bf{NEONATES \& OTHER INFANTS}} & -ID band \{\{nl\}\}-Ask the attending nurse, relative or guardian \tn 
% Row Count 19 (+ 4)
% Row 4
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{\bf{OUTPATIENT}} & -Ask the patient to state his/her name; ID card \tn 
% Row Count 22 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{BLOOD COLLECTION}}  \tn
% Row 0
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\mymulticolumn{1}{x{8.4cm}}{{\bf{SKIN PUNCTURE}}} \tn 
\mymulticolumn{1}{x{8.4cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}- a sharp lancet is used to pierce the skin and a capillary tube \{\{nl\}\}- Outer area of the bottom of the foot (heel stick)\{\{nl\}\}- Fleshy part of the middle of the third/fourth finger (finger stick)} \tn 
% Row Count 6 (+ 6)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{{\bf{ARTERIALIZED CAPILLARY BLOOD}}} \tn 
\mymulticolumn{1}{x{8.4cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}For blood gas analysis (NB and infants) — measures pH and pCO2 but not PO2 \{\{nl\}\}{\bf{Earlobe}} — preferred site due to vascularity \{\{nl\}\}{\bf{Lateral plantar heel surface}} — most commonly used site} \tn 
% Row Count 12 (+ 6)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{{\bf{INDICATIONS}} \newline -NO accessible veins \{\{nl\}\}-For POCT procedures such as glucose monitoring\{\{nl\}\}-Obtaining blood from infants or children \{\{nl\}\}-For Newborn Screening}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{SKIN PUNCTURE}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{8.4cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/ressentie_1664010539_Untitled picture1.png}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Not in the center arch of the heel because of the bone.}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{THE VASCULAR SYSTEM}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{{\bf{Arterial Blood}}} \tn 
\mymulticolumn{1}{x{8.4cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}- Has a larger concentration of oxygen than carbon dioxide \{\{nl\}\}- Pumped by the heart to the body cells} \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{{\bf{Venous Blood}}} \tn 
\mymulticolumn{1}{x{8.4cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}- Has a larger concentration of carbon dioxide \{\{nl\}\}- Pumped by the heart to the lungs} \tn 
% Row Count 7 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{BLOOD COLLECTION}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{{\bf{PHLEBOTOMY OR VENIPUNCTURE}}} \tn 
\mymulticolumn{1}{x{8.4cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}It is the act of obtaining a blood sample from a vein using a needle attached to a syringe or evacuated tube} \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{{\bf{ANTECUBITAL VEIN OF THE ARM}}} \tn 
\mymulticolumn{1}{x{8.4cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}It is the most frequent site for venipuncture} \tn 
% Row Count 6 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{VENIPUNCTURE}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{8.4cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/ressentie_1664010300_Untitled picture.png}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{{\bf{Median}} - 1st choice \newline {\bf{Cephalic}} - 2nd choice \newline {\bf{Basilic}} - Last choice due to nerve endings}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{3.04 cm} x{4.96 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{CAPILLARY PUNCTURE}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{MICROHEMATOCRIT TUBES}} & Hold {\bf{50-75ul}} of blood \{\{nl\}\}{\bf{RED/GREEN BAND}} - Heparin tubes \{\{nl\}\}{\bf{BLUE BAND}} - Nonadditive tubes \tn 
% Row Count 5 (+ 5)
% Row 1
\SetRowColor{white}
{\bf{ORDER OF DRAW}} & EDTA \{\{nl\}\}Other additives \{\{nl\}\}Serum specimens \tn 
% Row Count 7 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{CAPILLARY PUNCTURE STEPS}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{1. Review test requisition  \{\{nl\}\}2. Approach, identify and prepare patient  \{\{nl\}\}3. Verify diet restriction and latex sensitivity  \{\{nl\}\}4. Sanitize hands and put on gloves  \{\{nl\}\}5. Position patient  \{\{nl\}\}6. Select the puncture/ incision site  \{\{nl\}\}-{\bf{Adults/ children \textgreater{} 1 yr}} - palmar surface of the middle or ring finger of the nondominant hand  \{\{nl\}\}-{\bf{Infants}} - heel puncture (\textless{} 2 mm)  \{\{nl\}\}7. Warm the site if applicable  \{\{nl\}\}-with cloth/towel/diaper moistened w/ warm water for 3-5 min  \{\{nl\}\}-Must not exceed 42 deg cel  \{\{nl\}\}8. Clean and air-dry site  \{\{nl\}\}-70\% isopropanol  \{\{nl\}\}9. Prepare Equipment  \{\{nl\}\}10. Puncture the site and discard the lancet/incision devise  \{\{nl\}\}11. Wipe away first drop of blood  \{\{nl\}\}12. Fill and mix the tubes/container in order of draw  \{\{nl\}\}13. Place gauze and apply pressure  \{\{nl\}\}14. Label the specimen  \{\{nl\}\}15. Dispose contaminated materials  \{\{nl\}\}16. Thank patient, remove gloves and sanitize hands  \{\{nl\}\}17. Transport specimen to the lab} \tn 
% Row Count 21 (+ 21)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{TYPES OF SAMPLES}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{{\bf{WHOLE BLOOD}}} \tn 
\mymulticolumn{1}{x{8.4cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}BOTH the liquid portion of the blood (plasma) + cellular components (RBC, WBC, platelets)} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{{\bf{PLASMA}}} \tn 
\mymulticolumn{1}{x{8.4cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}fluid portion of an anticoagulated blood} \tn 
% Row Count 5 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{{\bf{SERUM}}} \tn 
\mymulticolumn{1}{x{8.4cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}fluid portion of coagulated blood} \tn 
% Row Count 7 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}


% That's all folks
\end{multicols*}

\end{document}