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Phlebotomy Training Specialists Intelvio
Phlebotomy Training Specialists Intelvio
200 terms
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Flashcards
200 cards
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Practice quiz
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Questions
200
Answers
1
There are how many blood types
4
8
10
6
2
What is a hematoma?
Raised red welts on the skin
Bruising
An accumulation of blood between the skin tissue
Broken red blood cells
3
Which organ does HBV affect?
Lungs
Heart
Kidneys
Liver
4
As a phlebotomist, we can give results to the patients.
True
False
5
What is the medical term for fainting due to a blood draw?
Viral syncope
Vaginal syncope
Viagra syncope
Vasovagal syncope
6
The three layers of the blood vessels are Tunica intama, tunica media and
Tunica adderall
Tunica address
Tunica advocates
Tunica Adventitia
7
How much glucola is given to someone doing a 3 hour OGTT?
300 g
125 g
100 g
25 g
8
What is the TJC?
The janitor closet
The jail committee
The Joint Commission
Tail jumping committee
9
The lipid panel is what kind of specimen?
Twisting and turning
Heated and warmed
Broken and bent
Fasting and chilled
10
What is the universal donor blood type
A-
O-
O+
AB+
11
What does HIV stand for?
Hugs intended violence
Herpes infection virus
Human Immunodeficiency virus
Hepatitis D
12
The microtainer collection order of draw
Ethlene, high tops, abrasion, sodium
EDTA, heparin, any other additive, serum
Sodium citrate, solid additive, liquid additives
Tiger/gold top, red top tube, light blue, lavender
13
Put the following gauge sizes in largest to smallest 21, 16, 18, 23,
18, 16 23, 21
23, 21, 18, 16
16, 18, 21, 23
21, 23, 16, 18
14
How do you properly identify your patient ?
Last name, blood type drivers license
Their address and doctors name
By wristband only
Full name, Date of birth, Government ID or wrist band
15
What is polycythemia vera
High amounts of ammonia
Too many red blood cells
Holding too much iron
High amounts of bilirubin
16
What is the correct order of removal of PPE?
Glove, goggle, mask, gown
Gloves, gown, goggles, mask
Mask, goggle, gloves, gown
Gloves, goggles, gown, mask
17
How much blood is usually drawn for a therapeutic blood donation?
450-500 mL
750 mL
5-10 mL
25-200 mL
18
Which tube requires a discard tube prior?
Pink top tube
Light blue top tube
Gray top tube
Red top tube
19
Persistent and offensive conduct is?
Harboring
Harassment
Harnessing
Endangering
20
All specimen should be noted in military time.
False
True
21
What is the basal state?
No exercise all week
No water for the day
No sleep the night before
Fasting and no exercise
22
The ditch or impression of the elbow is called?
Cephalic
Armpit
Inner elbow
antecubital fossa
23
The breakdown and removal of a clot is what step in hemostasis?
Asepsis
Electrophoresis
Hemoconcentration
Fibrinolysis
24
The three layers of the heart include, myocardium and epicardium and
Episiotomycardium
Endocardium
Perplexicardium
Eveningcardium
25
What is aerobic?
Potassium
Carbon dioxide
With oxygen
Without oxygen
26
The state of being free from contaminants preventing contact with microorganisms
Antisemitism
Antique
Antiseptic
Asepsis
27
When would the plasma/serum appear greenish/brownish after spinning in the centrifuge?
Extra iron
Free hemoglobin floating around
Fat in the blood
High amounts of bilirubin
28
What blood type is the universal recipient?
O+
AB+
O-
Rh factor
29
For a hand draw with a butterfly we enter in at
Flat no degree angle
15-35 degree angle
7 degree angle
5-10 degree angle
30
What does the clsi do?
Identify and create guidelines on laboratory testing, quality, efficiency
Identify who is a part of health care industry
Creating life changing instruments to aid in recovery
Recreate simulations for educational purposes
31
What is anaerobic?
Carbon dioxide removed
With oxygen
Added water
Without oxygen
32
The most common nosocomial infection for lab employees is…
HIV (human and immuno deficiency virus)
RSV (Respiratory Syncytial Virus)
HBV (hepatitis B virus)
Common flu (influenza A or B)
33
Which tube is known as a plain vacuum tube?
Gold top tube
Red top tube
Gray top tube
Lavender top tube
34
If exposure to an airborne contaminant is possible make sure you wear an N 95 respirator mask.
False
True
35
If the sample is hemolyzed, when it is centrifuged it will appear…
Greenish bluish
Yellow
Orange
Pink or red
36
What is the difference between plasma and serum?
Clotting factors
The color when centrifuged
Everything
Where it’s drawn from on the patient
37
What are the three main stool specimens we deal with?
Fecal fat, stool quaiac and O&P ova and parasite
Fecal stool, upside down turn over, buccal swab stool.
Fecal fat analysis, creative protein, and judicial stool
TJC, over haul, dump truck sample
38
What is battery
Injuring someone
A charging device
Poking the patient more than 2 times
Touching someone without permission
39
What does PASS stand for from our fire section?
Pen, adrenaline, squeeze, shoot
Page, attending, several, sessions
Poke, address, surpass surprise
Pull the pin, Aim, Squeeze the trigger and Sweep the base.
40
What type of patient should you be drawing and OGTT on?
Sleeping/resting
Young or younger
Post-prandial
Fasting/basal state
41
We do not give patients results or explain what the test look for.
False
True
42
When drawing blood from the arm with straight stick needle you should enter at
10-40 degrees
15-30 degrees
5-15 degrees
5 degrees
43
Where do you poke someone with an IV?
You can’t draw on them
Next to the IV
Above the IV
Below the IV
44
If the sample is hemolyzed, it will appear purple.
True
False
45
The breaking of red blood cells is called
Homolysis
Heterosexual
Hemostasis
Homosexual
46
The two key nerves of the arm are?
Brachial and radial
Femoral and arterial
Peripheral nervous system and CNS
Musculocutaneous nerve and radial nerve
47
Whole blood consists of what percentage of plasma?
None
45%
90%
55%
48
What does the stool guaiac test look for
Watery diarrhea stool
Hidden (occult) blood in the stool
Urine contaminated stool
Bowel obstruction
49
How many times do you need to invert the light blue top tube?
8-10x
5-6x
3-4x
None
50
What percent of communication is nonverbal?
90%
80%
10%
50%
51
What is the additive and what will it yield in the light blue top tube?
Sodium citrate, serum
Lithium heparin, plasma
Sodium citrate, plasma
Sodium heparin, serum
52
For the electrolyte testing I use the ——- tube
Light gray top
Light green top
Dark Green top
Lavender top
53
What specimen is needed to be protected from light?
QNS
Ammonia
Bilirubin
Urine UA
54
It is the phlebotomist job to make sure the patient has followed all of the requirements for the tests needed
True
False
55
LIS stands for
Later in significance
Laboratory insurance statistics
Ladies in sight
Laboratory information systems
56
How much blood is in the average adult body weighing about 155 pounds?
8 liters
3-4 liters
5-7 liters
10+ liters
57
What are the 3 main veins used for venipuncture in the AC area?
Basilic, brachial, femoral
Radial, cephalic, ulnar
Median cubital, basilic and cephalic
Media, basement, ceiling
58
Why would a patient be on hemodialysis?
They are in liver failure
They just had brain surgery
They have cancer
Kidneys aren’t functioning in the way they’re supposed to
59
The capillary order of draw is the same as the venipuncture order of draw
False
True
60
What does RACE stand for from our fire section?
Replace, administer, create, erase
Rescue, Attract, confine, eliminate
Reach, attach, cascade and escape
Rescue, Alarm, Confine, Extinguish
61
An ABG draw must be ran within 15 min of collection.
False
True
62
What is an AV fistula?
A process to enlarge a vein sewn next to an artery
Significant changes within hormones
The process by which they put arterial blood into a vein
A machine that cleans and purifies the blood
63
When a patient tells you to stop the draw, you finish the draw quickly then end.
True
False
64
What is your first step after an exposure?
Wash the area immediately for 15 minutes
Report it to your supervisor and follow the steps they tell you
Stop drop and roll, then wipe your eyes
Referred to the MSDS and fill out the exposure report form
65
What should you do if your draw is QNS?
Tell the patient they don’t have enough blood in their system
Hydrate the patient
Send it in anyway
Redraw the patient
66
Where should an unused cracked vacutainer be placed?
Use if for your next draw
In the biohazard sharps container
In your scrub pocket
In the trash
67
There are 5 types of consent are: expressed, HIV, informed parental and …
Vector borne Consent
Correct consent
Implied consent
STD/STI Consent
68
If the patient is complaining of a tingling or numb feeling you should
Yank the needle out asap
Finish the draw quickly
Tell them they are ok and complete the draw
End your draw by TTCC
69
What is HBV?
Healthy balanced vaccine
Human bodily vitals
Hepatitis B Virus
Herpes, Botulism virus
70
The process by which blood vessels repair after injury and four stages is called…
Hemostasis
Hemoconcentration
Hemoglobinemia
Homolysis
71
What is the most common injury due to phlebotomy?
Contamination
Hematoma
Hemophilia
Bruising
72
What protects patient information saved electronically
CMP (complete metabolic panel)
PRP (platelet Rich plasma)
PHI (Protected health information)
CDC (center for disease, control, and prevention)
73
What are the 7 types of hazards in the work place? There is biologic, sharps, chemical and…
electrical, fire or explosive, physical, allergic
Slips, vector, springs, rolling
Blood, non-intact skin, TJC, droplet precautions
Laboratory, lights, sight, checking
74
The main blood vessels, except for capillaries are comprised of three layers
Tunica arterioles, tunica median, tunica input
Tunica addressed, Tunica mycoplasma, tunica endothelial
Tunica adventitia, Tunica Media, Tunica Intama
Tunica Reynold, tunica, versatile, tuna intimate
75
What recommendation will cleaners need to meet to be used to clean a work areas?
EPA registered tuberculocidal
Medical asepsis
FDA approved oversight
Deep cleaner
76
What is the main difference between arterial and venous blood?
How fast the blood moves through
Arteries carry blood away from the heart and veins carry blood to the heart
The color of it, Blue and red
Arteries empty the heart veins fill the heart
77
What is a centrifuge?
And ice bath for the specimens
A machine that spins specimens down for separation
A tachometer for generalizing
A really cold fridge for specific specimens
78
It is OK for you to turn off IV fluids when needing to draw blood from a patient.
False
True
79
Warmed specimens are drawn in
Pre-warmed gold top tubes
Pre-warmed red top tubes
Pre-warmed lavender tubes
Warmed gray top tubes
80
Who draws an ABG?
Me, you and my sister
The receptionist or ultrasound tech
The parents of the patient
Respiratory therapist, nurse or physician
81
Under the patient’s “bill of rights” they can…
Draw their own blood with supervision
Give away their time for others
Order their own tests
Refuse or decline part or all of the treatment
82
What is a warmed specimen
A specimens sound down fresh of the centrifuge
A specimen that is prewarmed and kept warm until testing
The test results of a specimens sent in
A specimen with fresh blood
83
The largest organ in the body is
Tongue
Liver
Skin
Brain
84
What are considered mucous membranes?
Eyes, ears mouth and nose
Hair, ear wax, pores
Head shoulders knees and toes
Hands, bottom of feet, and inside of wrists
85
What is the first PPE that should be removed to prevent cross-contamination?
Gloves
Gown
Goggles
Google
86
Early bloodletting was done to rid the body of excess fluids believed to be infected.
False
True
87
What type of test the the H Pylori?
Saliva spit test
Blood in stool test
Finger stick test
Breath test
88
How often should a centrifuge be calibrated?
It doesn’t need to be
Every year
Every day
Every six months
89
What does TTCC mean and refer to?
Train, tanning, collection, corporation
Telephone tracing connection community
Tourniquet, tube, cotton, cap
Tune town corporate cash
90
What are the two key nevers in the arm?
Nerve fibers and nerve bundles
Radial and musculocutaneous nerve
Rapid and brachial nerves
Ulnar and brachialis nerves
91
What does HIPAA stand for?
Health insurance Portability and accountability act
Health insurance petition accepted access
Health information prepared adrenaline act
Health insurance practice agency act
92
Serum is the clear yellow liquid part of ——— blood.
Capillary
Unclotted
Medial
Clotted
93
A Ph range of 6.5-7.5 is considered?
Neutral
Basic or alkaline
Wrong
Acidic
94
The dermis layer of skin has its own blood supply.
False
True
95
Following an exposure how long should you wash the area?
Don’t wash the area
15 minutes
20 seconds
3-5 minutes
96
What do you do if your patient faints?
Splash water on their face
Get the needle out of their arm
Lay them on the ground
Finish the draw they won’t feel it anyway
97
What is the hematocrit test looking for?
The color of plasma
The blood type of the patient
The amount of serum in the blood
The percentage of red blood cells
98
Which three tests are done in the pink top tube?
CBC, comprehensive metabolic panel, gases
Type and screen ratio, cross match and Rh factor
Blood bank, hematology, chemistry
Serum pregnancy, cross match, OGTT
99
What are you trying to create with a blood smear?
Glass shield
Feathered edge
Spiral
Pinpoint
100
Who defines the order of the draw?
OSHA
CLIA
TJC
CLSI
101
The intentional touching of another without their consent is…
Libel
Battery
Assault
Mismanagement
102
What is an example from OSHA blood born pathogen standards
Blowing you nose
Removing one or both or part of your glove before the end of your draw
Using hand sanitizer
Not wearing a gown
103
Dark green top tube is most commonly used for ammonia and it is a chilled specimen.
False
True
104
You discard your first glove before removing your second glove.
False
True
105
What are the three components of a urine analysis?
Plain, visual, taste
Physical, chemical, microscopic
Template, rigidity and shape
Amount, floating, color
106
What is an Arteriovenous graft?
A graft that becomes an artificial vein used for repeated needle placement
When an artery and a vein are sharing blood
Removing a tendon from the wrist
A fake vein with fake blood
107
What is the number one biggest mistake a phlebotomist can make?
Tying the tourniquet 3-4” above the draw site
Missing the vein
Misidentify or Not identifying your patient
Bevel upside down
108
How fast does a semen sample have to reach the lab with in?
Over night
Within 20 min
Within 6 hrs
With in 1 hr
109
What vein do we try not to redirect in?
All of the above
All of them
Basilic
Median cubital
110
Plasma contains no clotting factors and serum contains all the clotting factors.
True
False
111
What is the proper way to end your venipuncture?
CDCC
TTCC
PMDD
POCT
112
White blood cells are also called?
Wikipedia
Leukopenia
Differential
Leukocytes
113
What is the machine used for POCT testing regarding PT/INR
Hemophilia
Hypothesis programmed
Hematuria
Hemochron signature elite
114
What does OSHA stand for?
Occupational Safety and Health Administration
Outdoor safety and health admissions
Office safety and Hygiene admissions
Ocean Safety and health administration
115
What are the two needles we use for drawing blood?
Butterfly and straight needles
Short and long
Geriatric and pediatric
Hypodermic needle
116
There are about 70,000 muscles in the human body.
True
False
117
Another name for the mitral valve is the bicuspid valve
False
True
118
Postprandial refers to…
After a meal
No exercise
No water
Basal state
119
What are the tiny non-raised red dots from the tourniquet being on too long or too tight?
Eucharia
Ulcer
Allergy
Petechiae
120
What is universal precautions?
Washing your hands
Hemochron signature elite
Treating everything as if it is infected
The same through out the nation
121
The pink top tube goes to what part of the lab for testing?
Coagulation
Hematology
Chemistry
Blood bank
122
Neonatal or neonate is the term for what?
Baby monkey still in the womb
Miscarriage
Human Newborn within the first month of life
A baby in the NICU
123
If using bleach for cleaning, what ratio must it meet for medical asepsis?
100%
9:1
3-4
10% bleach 1:10
124
How many days can hepatitis B virus survive in dry blood?
10 days
2 days
12 days
7 days
125
There are three layers of skin. The last two are dermis and subcutaneous layers. What is the first layer?
Epidermis
Flesh
Foreskin
Jugular
126
Having the HBV vaccines immunized you to other types of hepatitis.
False
True
127
If a sample is lipemic, it will appear…
Pink
Milky/white
Greenish/brownish
Clear
128
Why do we invert our tubes?
To mix the blood and additives
To keep our hands busy
Because I say so
You don’t need to
129
If the patient is allergic to latex just finish quickly.
False
True
130
What is the difference between the lavender and pink top tubes additives?
Lavender has to come from a finger poke
Pink is a larger tube
Pink has potassium EDTA lavender and regular EDTA
There is no difference
131
How many times can you poke a patient?
Until you are successful
Once
4 times out of
2 times
132
What are the raised red welts that can appear on the skin during an allergic reaction?
Rash
Urticaria
Pin pricks
Goosebumps
133
What does OGTT stand for?
Original game that takes
Organic garden tents turned
Oral glucose tolerance test
Old gray total tipsy
134
The bevel of the needle should be facing?
Doesn’t matter
Up
To the side
Follow the packaging instruction
135
Which is NOT a common vein for venipuncture?
Basilic
Cephalic
Median cubital
Brachial
136
There are five types of WBC.
True
False
137
You should always have an aerobic and anaerobic bottle when performing blood cultures on an adult patient.
True
False
138
What is hemostasis?
Blown veins repairing themselves
Blood vessels repair after injury in four stages
Repair after injury in three stages
Blood vessels reparing in 6 stages
139
What are the four stages of hemostasis?
Bleeding, clotting,agglutination , spreading
Price, treatment, breathing, pouring
Written, expressed, implied, eminent
Vascular, platelet, coagulation, fibrinolysis
140
What is the primary role of the phlebotomist?
To bring the patients back to a room and take vitals
To complete intake and gather history
To collect blood by venipuncture or dermal stick techniques
Stop the blood flow for testing
141
Which tubes yield serum?
Gold and tiger (SST), red, royal blue with red stripe
Lavender, light green Tiger
Gold, dark green, gray
Lt blue, gold, red
142
Urine is the most common non-blood specimen we use as phlebotomist
True
False
143
What are the 2 main circulations in the body?
Rounding and spreading circulations
Plastic and glass circulations
Arteries and veins circulations
Systemic and pulmonary circulations
144
How many test can you runoff a single tube?
6 depending
14 or more depending
Only 1
2-3 depending
145
Which tube has an anti glycolic agent in it?
Gray
SST
Pink
Lavender
146
When blood is found in the urine it is called what?
Occult fecal
Hemoglobin
Hematuria
Hydrolysis
147
The pulmonary circulation takes the blood from
The heart to the lungs to be oxygenated back to the heart
From the lungs to the arterials
To the heart from the groin for the brain
From the heart to the capillaries for exchange
148
Red blood cells enter in as immature…
Leukocytes
Amber lights
Nitrates
Reticulocytes
149
What does POCT stand for
Point of catheter test
Point of care testing
Point of correction testing
Point of care tasks
150
What does QNS stand for?
Quality not Sufficed
Quality never Suspended
Quality Not Sought
Quantity Not Sufficient
151
What does without stasis mean?
Without tying a tourniquet
Blind poke
No additive in the tube
No food or drink including water
152
What test is ordered to detect the presence of pathogenic microorganisms in the blood stream?
CMP
Vector borne
Blood cultures
Bacterial
153
A PKU test is done within the first
Year of baby’s life
72 hours of life
Has to be drawn from an artery
The day they are born
154
What is the most important step in a capillary puncture?
Place the tourniquet above
Wipe away the first drop of blood
Only use the thumb
Use a cotton ball or bandaid
155
What does TJC do?
Changes the program
Comes up with new tests
Joins the committee for each department
Looking out for the rights of patients
156
What tube is an OGTT drawn in?
SST
Lavender
Green
Gray
157
What is a nosocomial infection?
Sharing blood through hand shake
Infection given purposefully
Healthcare setting contrived infection
The flu
158
Another name for red blood cells is?
Sedimentation
Microliter
Infection, chemotherapy
Erythrocytes
159
I CAN centrifuge a CBC in a lavender tube
False
True
160
The RH factor was discovered in
Type O blood
Human baby
Otters
The Rhesus monkey
161
What is the most important thing to remember in a semen COLLECTION?
Always use a condom
Must be done with a partner
The phlebotomist has to collect it
No spermicides or detergents
162
Who controls universal precautions?
CLIA
CDC
CLSI
CDL
163
What test is drawn without stasis? And what color tube?
Bilirubin in SST
Ammonia in green
Lactic Acid in gray
Lactic acid in lavender
164
Which arteries carry deoxygenated blood to the lungs to be oxygenated?
Femoral arteries
Radial arteries
Pulmonary arteries
Ulnar arteries
165
Within 10 days of employment, your employer must offer you the HBV vaccines.
True
False
166
What does HIPAA do?
Ensure healthy and safe work environment
Protects the employee
Properly identifies patients
Protect patients privacy
167
The urinary system is also referred to as the excretory system.
True
False
168
Another name for platelets is?
Hemostasis
Formed cellular elements
Reticulocytes
Thrombocytes
169
What is hemochromatosis?
Enlarged liver
Holding too much iron in your system.
Holding too much ammonia and grease in your system
Hepatitis disease
170
What is protective/reverse isolation?
Wrapping the patient in bubble wrap
Protecting the patient from the outside world
Covering you face with a mask and face shield
Hiding the patient
171
There are 6 main PPE to know face shield, mask, gloves, gown, goggles and
Hair net
Apparatus suit
Resuscitation mask
N95 Respirator mask
172
What type of needle should you use on pediatric patients?
25 gauge needle
Catheter needle
Small
Winged infusion set/butterfly needle
173
What three things should be included on a sharps injury log?
Address, physician name, date
device used, where it happened, explanation of what happened
Make and model, color and how it happened
Name, date of birth, signature
174
What is a syncope episode
Fainting or passing out
The act of removing their bandage
Back talking
Synchronize dance
175
When drawing an alcohol blood levels, you clean the site with 70% isopropyl alcohol.
True
False
176
What does HCG test look for?
Broken white blood cells
Pregnancy in a woman
High amounts of lipids in the blood
Blood in the stool
177
What do you do if you notice an overflowing sharps container?
Open the container to move some of the used supplies to another container
Cover it so patients don’t see it
Report it to your supervisor and then take care of it
Push the supplies down to make more room
178
Where should the tourniquet be placed?
6” above
3-4” above
1-3” above
3-4” below
179
The easiest and most effective way to break the chain of transmission is
Blowing your nose with a tissue
Wearing gloves
Washing your hands
Blowing your hands dry
180
—— is a warmed specimen
Stool guaiac test
Cold Agglutinins
Bilirubin
Lactic acid
181
I’ve just been hired at a new job. I can sign a declaration form to not have to get the hepatitis B vaccines.
False
True
182
What requirements does the disinfectant need to meet for medical asepsis?
CLIS approved
Deep cleaning
State mandated
EPA registered tuberculocidal
183
Which tube does NOT yield plasma?
Gray
Gold/Tiger/SST
Lavender
Greens
184
Nitrile or vinyl gloves can be used instead of latex
False
True
185
How often is a sputum test collected?
3 consecutive days
Once every three days
Once a week
Morning, mid day, night
186
According to the CLSI order of draw does the pink top tube or lavender top go first
Doesn’t matter
Pink
Lavender
Royal blue with lavender strip
187
When was the needle stick and prevention act passed?
December 1994
November 6 of 2000
January 2020
November 1 of 2006
188
The additives in the SST tubes (gold and tiger) is
Silicone
Silliness and thixotropic gel
Sodium citrate with thixotropic gel
Silica and thixotropic gel
189
How many chambers are in the heart
2
8
3
4
190
Another name for white blood cells is
Reticulocytes
Leukocytes
Hemochromatosis
Particular sites
191
What is a direct OSHA violation?
Standing for long periods of time
Calling your supervisor in an emergency
Eating in the lab
Wearing a dress to work
192
Diurnal variations refers to the daily cyclic variations within our body.
False
True
193
Reverse/protective isolation
Isolating the employees
Removing all animals from surrounding
Sheer your needles to be more blunt
Special air handling and precautions are taken to protect the patient
194
The accession number is a unique tracking number different for each sample.
False
True
195
There are 4 OSHA compliance inspections imminent danger, complaint, fatality/accident and…
Programmed inspection
Yearly inspection
Randomized inspection
The inspection
196
Which two fingers are most used for dermal sticks
Third and fourth fingered of the non-dominant hand
Any of them
Only use the thumb
Pointer and pinky fingers only
197
What additive is in the glass red top tube?
None
Sodium
All of the additives
Thixotropic gel
198
What does PKU test for
A stool, blood and urine type of test
Genetic disease that causes mental retardation and brain damage
Often found in geriatric patients through blood and stool
A DNA test ran on parents and animals
199
Another name for thrombocytes is
Red blood cells
White blood cells
Vessels
Platelets
200
What does the CDC stand for?
Checked Daily Chart
Certainly doesn’t change
Center deserving carving
Center for disease control and prevention