Certified Medical Assistant (CMA AAMA)Procedures, Examinations and DiagnosticsHard

A medical assistant is drawing a coagulation study and must fill a light blue-top tube. Why is it essential that this tube be filled to its exact volume mark?

  1. ATo maintain the correct 9:1 ratio of blood to sodium citrate anticoagulant
  2. BTo ensure enough serum separates during centrifugation
  3. CTo prevent glycolysis from falsely lowering glucose results
  4. DTo prevent hemoconcentration from a prolonged tourniquet application
Show answer & explanation

Correct answer: A. To maintain the correct 9:1 ratio of blood to sodium citrate anticoagulant

Light blue-top tubes contain sodium citrate anticoagulant in a fixed volume, and they must be filled completely to maintain the correct 9:1 blood-to-anticoagulant ratio; underfilling causes an excess of citrate relative to blood, which can falsely prolong coagulation results such as PT/PTT.

Why the other options are wrong

  • B. Serum separation applies to serum tubes, not sodium citrate (plasma) tubes.
  • C. Glycolysis concerns relate to gray-top glucose tubes, not coagulation tubes.
  • D. Hemoconcentration relates to tourniquet time, not tube fill volume.

Sodium Citrate Ratio (Light Blue-Top)

Light blue-top tubes must be filled to the exact volume mark to maintain the required 9:1 ratio of blood to sodium citrate anticoagulant for accurate coagulation testing.

  • 9:1 blood-to-citrate ratio required
  • Underfilling causes falsely prolonged PT/PTT results
  • Used for coagulation studies like PT and PTT

Memory trick: '9 parts blood, 1 part citrate — fill it right or throw a fit'

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