2ND TRINAL Flashcards
Republic act no. 7719
National Blood Services Act of 1994.
Republic act no. 7719 was Enacted into law on
April 2, 1994
Republic act no. 7719 was approved on
May 5, 1994
Republic act no. 7719 was approved by
former president Fidel V. Ramos
Repealing R.A. No. 1517
Blood Blanking Law of 1956
the old blood banking law
Repealing R.A. No. 1517 (Blood Blanking Law
of 1956)
the old blood banking law was approved on
May 15, 1994
the old blood banking law was approved by
President Fidel V. Ramos.
the old blood banking law was Published in the official gazette on
August 18, 1994
the old blood banking law Took effect on
August 23, 1994
TWO MAJOR AGENCIES
Philippine National Red Cross (PNRC)
Philippine Blood Coordinating Council (PBCC)
RULES AND REGULATIONS IMPLEMENTING
REPUBLIC ACT No. 7719
Administrative Order No. 9, Series of 1995
the date promulgated by the
Secretary of the Department of Health (DOH).
April 28 1995.
AIDS was first described in
1979.
the first occurrence of AIDS was
described in an infant.
1982,
First case of HIV infection in the
Philippines was reported in
1984
ISBT
– International Society of Blood
Transfusion.
Revising the Blood Banking Law Guidelines
ADMINISTRATIVE ORDER NO. 57, SERIES OF
1989
- institutionalizing National Blood Services
Program (NBSP)
ADMINISTRATIVE ORDER NO. 118-A (1992)
- RULES AND REGULATIONS GOVERNING THE
REGULATION OF BLOOD SERVICE FACILITIES
ADMINISTRATIVE ORDER NO. 2008-0008
* May 2, 2008
Commercial Blood Banks paid donors
varying rates around
50-150 pesos.
NATIONAL VOLUNTARY BLOOD SERVICES
PROGRAM
PNRC
PBCC
government agencies
non-governmental organizations
– a unit, agency, or institution that provides blood products.
Blood Service Facility (BSF)
– substances derived from
whole blood or plasma are also called blood
components.
Blood Products
Blood Products
o Whole blood
o Packed red blood cells
o Granulocytes
o Plasma
o Platelets
o Cryoprecipitates
o Cryosupernates
- Blood collected within 24 hours
- Stored in a blood bag with the appropriate
anticoagulant. - Provides red blood cells (RBC), plasma, and
platelets. - After 48 hours, it is called whole blood (WB)
and contains the red cells and plasma
component of donor blood.
FRESH WHOLE BLOOD (FWB)
- Also called red cell concentrate, concentrated
red cells, or plasma-reduced cells) - Prepared by allowing blood to separate under
the influence of gravity overnight in a
refrigerator at a temperature of +2oC to +6oC
or by centrifuging the blood pack in a special
refrigerated centrifuge.
PACKED RED BLOOD CELLS
- Red cells washed with 0.9% sterile isotonic
saline using manual method to remove the
majority of plasma proteins, antibodies, and
electrolytes. - Depleted of plasma, platelets, and leukocytes.
WASHED RED CELLS
- Granulocytes collected through automation
(i.e., apheresis) - Apheresis (basophil, eosinophil, neutrophil)
GRANULOCYTES CONCENTRATE
- Blood component without most of its plasma
using a third-generation filter, either at the BSF
or at the patient’s bedside. - Red cells filtered most of its leukocytes.
- Leukocytes (basophil, eosinophil, neutrophil,
lymphocyte, monocyte)
LEUKOCYTE-DEPLETED (FILTERED) RED CELLS
- Also called random donor platelets
- Suspended in a small quantity of plasma
derived from whole blood within eight hours of
collection. - Platelet concentrates should be stored at a
temperature of between +20OC and +24OC
with continuous agitation.
PLATELET CONCENRATE
- Also referred as cryoprecipitate pool, cryo, or
pooled cryo. - Contains the cryoglobulin fraction of plasma
- Thawing one unit of FFP between 1OC – 6OC
and recovering the cold insoluble precipitate. - The cryoprecipitate is refrozen within one hour.
CRYOPRECIPITATE
- Also known as cryo-poor plasma
- Supernate plasma removed during the
preparation of cryoprecipitate. - It contains most clotting factors.
CRYOSUPERNATE
- Non-cellular fluid portion of the blood
separated from whole blood within 6 to 8
hours. Rapidly frozen and maintained at all times at a temperature of 30OC or lower.
FRESH FROZEN PLASMA (FFP)
BSFs may be classified as to:
o Ownership
o Institutional character
o Service capability
OWNERSHIP
Government BSFs
Private BSFs
o Owned, established, and operated by an
individual, corporation, association, or
organization.
Private BSFs
o Operated and maintained, partially or
wholly, by the:
▪ national government
▪ LGU (province, city, or municipality)
▪ Any other political unit or any
department, division, board, or
agency.
Government BSFs
INSTITUTIONAL CHARACTER
- Hospital-based
- Non-hospital-based
o Located within the premises of a hospital
Hospital-based
o Can be a government- or PRNC-owned BSF
located outside the premises of a hospital.
Non-hospital-based
- other hospitals and PNRC chapters rendering
blood services not classifies as BB/BC or BCU - regulated by the BRL
BLOOD STATION (BS)
- organized and established by Blood
Bank/Centers
BLOOD COLLECTION UNIT (BCU)
- Storage and issuance of whole blood and
blood components obtained from a BC
BLOOD BANK (BB)
- Hospital based
- Non-hospital based
- Commercial
- Testing of units of blood for transfusion
transmissible infections (TTIs
BLOOD BANK/CENTER
The TTIs screened by BCs are:
o Human Immunodeficiency Virus (HIV)
(determination of anti-HIV 1/2)
o Hepatitis B (determination of HBsAg)
o Hepatitis C (determination of anti HCV)
o Malaria
o Syphilis
Hospital-based blood stations
o must be managed by a ___________
certified by PSP
pathologist
Non-hospital-based blood stations
o ____________ formal
training in basic blood banking by a DOH-recognized training provider.
Physician with at least 3 months
Non-hospital-based BCUs, BS, and BS/BCU
___________________ in basic
blood banking provided by a DOH-recognized training provider
o Physician with formal training
BCs and blood banks is supervised by a
pathologist
hematologist
is an official permit issued by the
DOH to an individual, corporation,
partnership, or association to a BCU or BU
Authority to Operate (ATO)
is a formal authority issued by the
DOH to an individual, corporation
License to Operate (LTO)
are tasked to inspect and monitor BSF
the HFSRB and CHD
Person who gives blood freely and
voluntarily without payment
voluntary, non-remunerated blood donor
Licensed hospital that can perform
compatibility testing
End-Use Hospital
Non-hospital health facility that can
perform compatibility testing
End-User Non-hospital health facility
R.A. 9165
“Comprehensive Dangerous
Drugs Act of 2002”
This law mandates the Department of Health
to license, accredit, establish, and maintain a
drug test network and laboratory, initiate,
conduct, and support scientific research on
drugs and drug control
R.A. 9165 Comprehensive Dangerous
Drugs Act of 2002”
the date the DOH promulgated the
Implementing Rules and Regulations
Governing the Accreditation of Drug Testing
Laboratories in the Philippines
July 11, 2003
the date they designed a computer-based
system called Interim Drug Test Operations
and Management Information System
(IDTOMIS)
October 2003
– IDTOMIS was initiated
April 2006
is an integrated system that
captures data for accrediting DTLs and
rehabilitation centers, drug testing operations
at different levels of implementation,
verification of pending transactions, and
monitoring and evaluation of standards,
systems, and performance
Interim Drug Test Operations
and Management Information System
(IDTOMIS)
– DOH started the nationwide
implementation of IDTOMIS.
January 5, 2009
Comprehensive Dangerous Drugs Act of 2002
was Approved on
June 7, 2003
Comprehensive Dangerous Drugs Act of 2002
was signed by
Former President Gloria Macapagal-Arroyo
Repealed R.A. No. 6425, otherwise known as
the
Dangerous Drugs Act of 1972
Dangerous Drugs Act of 1972 consists of how many sections
102
is a private or government facility that is capable of testing a specimen to determine the presence. Of dangerous drugs therein
DTL – Drug Testing Laboratories
A DTL may be classified as
Ownership
Institutional Character
Service Capability
Service Capability
Screening Laboratories
Confirmatory Laboratories
Institutional Character
Institution-based DTLs
Freestanding DTLs
Ownership
Government DTLs
Private DTLs
are capable of performing screening tests.
Screening Laboratories
are capable of performing qualitative and
quantitative examinations of
dangerous drugs from the specimen.
Confirmatory Laboratories
R.A. No. 10586, otherwise known as
“Anti-Drunk and Drugged Driving Act of 2013.
Freestanding
screening DTLs must
be headed by:
- A pathologist; or
- a licensed physician
Confirmatory DTLs
must be headed by:
- a pathologist; or
- a chemist with
master’s degree in
chemistry or
biochemistry
Institution-based
screening DTLs must
be headed by a:
- Licensed physician;
- Chemist;
- medical technologist;
- pharmacist; or
- chemical engineer
A licensed physician is allowed to supervise at least
10 DTLs.
is a member of the laboratory personnel who collects specimens from a patient, client, or subject.
authorized specimen collector
shall have either a
full-time licensed chemist, medical
technologist, pharmacist, or chemical engineer with appropriate training in screening test procedures for dangerous drugs.
screening laboratory
shall have a full-time
licensed chemist who has successfully
completed extensive, and appropriate training in chromatography, spectroscopy, and either a medical technologist, pharmacist, or chemical
engineer with appropriate training.
confirmatory laboratory
NRL of Toxicology, including Drug testing is
East Avenue Medical Center.
Screening DTL Floor Area Work Area
20 sqm
Confirmatory DTL Floor Area
60 sqm
Screening DTL Work Area
10 sqm
Confirmatory DTL Work Area
30 sqm
refers to the formal authorization
issued by the DOH to an individual,
partnership, corporation, or association which has complied with all the licensing and
accreditation requirements
Accreditation
is the most common type of specimen
submitted for drug test mainly because of it is readily available.
Urine
refers to procedures to
account for each specimen by tracking
handling and storage from point of collection
to final disposal.
Chain of custody
The following specimens may be submitted for drug test:
urine
blood
fingernails
saliva (oral fluid)
scalp hair
sweat (patch)
tissue.
Urine specimen collected must be at
least ________ if a single container
60 mL
Urine specimen collected in two separate containers for split specimens
30 mL
After proper collection of the specimen it is
then endorsed to a
drug analyst
o Qualitative test
o Refers to a test to eliminate negative
specimens from further consideration
and to identify the presumptively
positive specimens that require
confirmatory testing
Screening test
o Quantitative test
o Refers to the analytical procedure used
to identify and quantify the presence of
a specific drug or metabolite,
Confirmatory test
– these methods are
used for preliminary screening, based
on antibody-antigen reactions. The
following are examples
Immunoassay
– the separation of a
mixture is the main outcome of the
chromatographic method.
Chromatography
– a combination
of two sophisticated technologies
Hyphenated technique
the two most abused prohibited drugs in the
Philippines are
shabu and marijuana.
- Also called as meth, crank, crystal,
crystal meth, or speed
Shabu
Identified the stimulant
Ephedrine from the ephedra
plant
Shabu
active metabolite of shabu
Methamphetamine hydrochloride
also known as cannabis or pot.
Marijuana –
indian hemp
Cannabis sativa L.
the active metabolite of Marijuana
Tetrahydrocannabinol (THC)
Confirmatory Laboratory COA – valid for
2 years
Screening Laboratory COA – valid for
1 year
has the authority to monitor
accredited DTLs.
HFSRB or CHD
is authorized to conduct a PT for all screening and confirmatory DTLs
National Reference Laboratory (NRL)
is the only disease that has its own law
AIDS
believed to have originated in the
Democratic Republic of Congo, and this virus was transmitted from chimpanzees to humans in the early 1900s
HIV
HIV testing became a mandatory pursuant to A.O. No. 57, Series of 1989
1989-
- PNAC was created by virtue of E.O. No. 39 series of 1992
December 3. 1992
was tasked to provide comprehensive
approach to the prevention and control of HIV/AIDS in the Philippines
PNAC-
- R.A. No. 8504 other known as Philippine AIDS Prevention and Control Act of 1998 came into law
February 13, 1998
REPUBLIC ACT NO. 11166 Known as
Philippine HIV and AIDS Policy Act
REPUBLIC ACT NO. 11166 Known as Philippine HIV and AIDS Policy Act was approved and became law on
December 20, 2018
Strengthens the Philippine Comprehensive policy on HIV and AIDS prevention, treatment, care, and support
REPUBLIC ACT NO. 11166 Known as Philippine HIV and AIDS Policy Act
is a retrovirus that infects cells of the human’s immune system
HUMAN IMMUNODEFICIENCY VIRUS
- The transfer of HIV from one infected person
to an uninfected individual
HIV TRASMISSION
major Route of HIV
- Sexual intercourse
- Mother to child
- Parenteral inoculation
Route of HIV through Sexual intercourse
o Vaginal
o Oral
o Heterosexual transmission
Route of HIV through Non-sexual:
o Needle prick
o Blood transfusion
o Mother to child
o Menstruation
o Hemophilia treatment
Route of HIV through Non-sexual: infectious
Breastfeeding
o Blood
o Vaginal secretion
o Semen
Route of HIV through Non-sexual: non-infectious
o Saliva
o Sweat
o Urine
o Feces
o Tears
- Refers to a health condition wherein a deficiency in HIV makes an individual susceptible to opportunistic infections
ACQUIRED IMMUNODEFICIENCY SYNDROME
- refers to diseases caused by various organisms many of which do not cause illness in persons with a healthy immune system, such as tuberculosis
Opportunistic infections
- refers to choices and behaviors adopted by a person to reduce risk of HIV transmission
Safe sex practices
- associated virus discovered by Luc Montagnier
Lymphadenopathy
the right to privacy of individuals with HIV shall be guaranteed; Enacted into law on
April 2, 1994
- HIV positive who has multiple partners
High-Risk Behavior
- voluntary agreement of a
person; at least 15 years of age can give consent
Informed Consent
virus cannot be detected; can be detected after 6 months
Window Period-
- refers to concept enshrined in article 5, a minor who is at least 15 years but less than 18 years of age
Evolving capacities of the child
- the legal principal that recognizes the capacity of some minors to consent independently to medical procedures
Mature Minor Doctrine
- also known as Gillick
Principle or Gillick Competence, which was decided in a 1996 case by the English House of Lords
Mature Minor Principle
- refers to any facility based, mobile medical procedure, or community-based screening to determine the presence or absence of HIV in a person’s body
HIV Testing
2 aspects of HIV testing
o Screening test
o Confirmatory test
- serologic test to determine to
presence of antibodies against HIV 1 and HIV
2
Screening test
to ensure than results are
true positive
Confirmatory test-
- the interpersonal and dynamic communication process between a client and a trained counselor
HIV counseling
2 phases of HIV counseling
o Pre-Test Counseling
o Post-Test Counselling
after collection/result
o Post-Test Counselling-
Before testing
Pre-Test Counseling-
refers to the treatment that stops or
suppresses the replication of HIV
ANTI-RETROVIRAL THERAPHY
- the private and public hospitals accredited by DOH to have the capacity and facilities to provide treatment, case and services to PLHIV, it includes:
Treatment hubs
- use of prescription drugs as a prevention of HIV infection by people who don’t have HIV/AIDS
Pre-exposure prophylaxis
- preventive medical treatment started immediately after exposure to pathogen
Post-exposure prophylaxis
RA No. 8553-
The Anti-Rape Law of 1997
Penalties for violations of confidentiality shall suffer the penalty of imprisonment for
six (6) months to 4 years
- R.A. No. 11166 defines it as an unfair or unjust treatment on any ground such as sex, gender, age, sexual orientation, gender identity and expression, economic statues, disability, ethnicity, and HIV status
DISCRIMINATION
- refers to the way a person communicates gender identity to others
Gender expression
- refers to the personal sense of identity as characterized, may have male or female identity with the physiological characteristics of opposite sex
Gender identity
- refers to the direction of
emotional, sexual attraction or conduct towards of the same sex (homosexual) or both sexes (bisexual) or towards people of the opposite sex (heterosexual) or to the absence of sexual attraction (asexual)
Sexual orientation
- the dynamic devaluation and
dehumanization of an individual in the eyes of others
STIGMA
A severe or repeated cause of
reasonable fear of physical or emotional harm or damage to one’s property
BULLYING-
- Agency attached to the DOH that is tasked to ensure the implementation of the country’s response to HIV and AIDS situation
Philippine National AIDS Council (PNAC)
Philippine National AIDS Council (PNAC) has how many members
26
- Aims to prevent deaths and developmental
disorders among Filipino children
NEWBORN SCREENING ACT OF 2004
- the Philippine Newborn
Screening Project was initiated in the Phil
june 27, 1996
- DOH issued A.O. No. 1-A,
series of 2000 stating the Policies for the
Nationwide Implementation of Newborn
Screening
January 3, 2000
Newborn Screening, panel of disorders included;
o Congenital Hypothyroidism
o Congenital Adrenal Hyperplasia
o Galactosemia
o Phenylketonuria
- DOH issued A.O. No. 121,
series of 2003 Strengthening Implementation
of the National Newborn Screening System
December 9, 2003
-when did former President Gloria
Macapagal Arroyo issued proclamation No.
540, declaring the 1st week of October as
National Newborn Screening Act of 2004
January 20, 2004
REPUBLIC ACT 9288
Newborn Screening Act of 2004
REPUBLIC ACT 9288 Newborn Screening Act of 2004 was Enacted on
April 7, 2004
REPUBLIC ACT 9288 Newborn Screening Act of 2004 was Approved on
July 7, 2004
issued Implementing Rules
and Regulations
October 7, 2004-
- DOH issued Dept. Memo No.
2012-0154 directing the inclusion of maple
syrup urine disease (MSUD)
May 15, 2012
- DOH issued A.O. No.
2014-0045 or the “Guidelines on the
Implementation of the Expanded Newborn
Screening Program
November 19, 2014
- DOH promulgated AO No. 2018-0025 with a subject “National Policy and Strategic Framework on Expanded Newborn Screening for 2017-2030
November 5, 2018
- DOH released AO No. 2014-
0045-A directing that Option 1 (6-test) will be
offered until April 30, 2019
March 29, 2019
- all infants born in accredited
facilities shall be tested for option 2 (ENBS
test) only
May 1, 2019
- The process of collecting a few drops of blood from the newborn onto an appropriate collection card and performing biochemical testing to determine if the newborn has a congenital disorder
NEWBORN SCREENING
- An examination that increases the coverage of the NBS panel from 6-28 types of congenital disorders that fall into various categories
EXPANDED NEWBORN SCREENING (ENBS)
- a child from the time of complete
delivery to 30 days old
Newborn
- is any congenital trait
that can result in mental retardation, physical
deformity, or death if left undetected and
untreated
Heritable condition
Preferred mode of collection in NBS is the
heel prick method
- are defects that
involve errors in the production of endocrine
hormones
ENDOCRINE DISORDERS
ENDOCRINE DISORDERS
a. Congenital hypothyroidism (CH)
b. Congenital adrenal hyperplasia (CAH)
- defects that involve
errors in amino acid metabolism
AMINO ACID DISORDERS
AMINO ACID DISORDERS
a. Homocystinuria (Hcy)
b. Methionine adenosine transferase (MAT)
c. Maple syrup urine disease (MSUD)
d. Phenylketonuria (PKU)
e. Tyrosinemia type I
f. Tyrosinemia type II
- group of autosomal recessive disorders caused by the deficiency or absence of any needed enzymes for beta-oxidation
FATTY ACID OXIDATION DISORDERS
FATTY ACID OXIDATION DISORDERS
a. Carnitine palmitoyltransferase I deficiency
(CPT1D)
b. Carnitine palmitoyltransferase II deficiency
(CPT2D)
c. Cartinine uptake deficiency (CUD)
d. Glutaric acidemia type II (GA2)
e. Long-chain hydroxyacyl
f. Medium chain-Acyl
g. Very long chain-Acyl-CoA dehydrogenase
deficiency (VCLAD)
h. Tri-functional protein deficiency
- group of autosomal
recessive disorders caused by the absence of
the needed enzymes
ORGANIC ACIDURIAS
- an inborn error of metabolism
resulting from the deficiency of arginosuccinate synthetase, an enzyme
present in all tissues
Citrullinemia
a rare genetic metabolic
disorder that is inherited in an autosomal
recessive manner
Galactosemia (Gal)-
- a progressive genetic
disease that causes persistent lung
infections
Cystic fibrosis (CF)
an ambulatory clinic based on a tertiary hospital
Newborn screening continuity clinic
is a health
facility that educates parents about NBS
Newborn Screening Facility
- a facility equipped with an NBS laboratory that complies with the standards established by the NIH
Newborn Screening Center
- a facility
identified by the DOH to be part of the National Comprehensive Newborn Screening System Treatment Network
Newborn Confirmatory Center
- the central facility at the NIH that defines testing and follow-up protocols
Newborn Screening Reference Center
Recall- procedure for locating a newborn with a possible heritable condition
Recall-
o establish NBS Reference Center
o National testing database
o Case registries, training, technical
assistance
NEWBORN SCREENING REFERENCE LAB
* NIH
REPUBLIC ACT 7170 Known as
The Organ Donation Act of 1991
REPUBLIC ACT 7170 Amended by R.A 7885 known as
An Act to Advance Corneal Transplantation in the Philippines
R.A. 7170 known as the
Organ Donation Act of 1991
R.A. 7170 Organ Donation Act of 1991 has how many sections
28
R.A. 7170 Organ Donation Act of 1991 was Approved on
June 19, 1995
