HEMA OSMOTIC FRAGILITY TEST Flashcards

1
Q

Red blood cells are surrounded by a
selectively permeable membrane that
allows the exchange of ___ and ___.

A

Osmotic Fragility Test
- gases
- electrolytes.

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2
Q

If the RBCs are placed in a ____, osmotic equilibrium will be established by drawing water into the cells, which then swell.

Pathologically,___ of the RBC membrane leads to the accumulation of water within the cell, and finally the escape of _____ through the widened pores of the cell membrane

A

Osmotic Fragility Test
- hypotonic saline solution
- increased permeability
- hemoglobin

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3
Q

Used for definitive diagnosis or traditional screening test of ____
in combination with other tests such as
blood indices.
Test that demonstrates ______
>RBCs that have decreased surface
area-to-volume ratio (such as ___)

A

Osmotic Fragility Test
- hereditary spherocytosis
- increased RBC fragility
- spherocytes

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4
Q

Causes of Decreased Surface Area-to-volume ratio

A

Hereditary spherocytosis
Warm autoimmune hemolytic anemia

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5
Q

Caused by lack of vertical interaction
of the RBC membrane as a result of
_____

A

Hereditary spherocytosis
spectrin deficiency

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6
Q

RBCs are sensitized by antibodies
known as IgGs that are pitted in the
spleen resulting in ____
formation

A

Warm autoimmune hemolytic anemia
spherocyte

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7
Q

OFT lacks ____ and ____ because it cannot differentiate whether the cause of spherocyte formation is due to HS or WAIHA

A

specificity and sensitivity

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8
Q

OFT Principle
Whole blood is added to varying
concentrations of _____, that being buffered ____ and allowed to incubate at room temperature.

A

hypotonic solution
sodium chloride solution

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9
Q

Precautions in performing OFT

A
  • Blood sample should be obtained with
    minimum stasis and trauma.
  • The test should be set up as soon as
    possible.
  • The sizes of the drops of blood must be
    uniform.
  • Blood should fall directly into the saline
    solution and not on the sides of the tubes.
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10
Q

Rejection criteria of OFT

A

hemolyzed specimen

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11
Q
  1. Prepare _____
  2. Arrange _____ and label the tubes from _____
  3. To each tube, add _____
  4. The number of drops should correspond to the _____
  5. Add ____ to each tube. The number of drops should bring the total volume in each tube to __. Mix.
  6. Deliver a drop of ____ into each tube. Mix gently
  7. Allow the tubes to stand for __ at ____.
  8. Examine the tube for initial and complete hemolysis.
A

Griffin-Sandford Method
0.5% NaCl solution (0.5g NaCl dissolved
100 mL d.H2O).
12 Wassermann tubes
25 down to 14(left to right)
drop by drop 0.5% NaCl
number labeled on each tube
distilled water
25
freshly drawn blood
2 hours
Room temp

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12
Q

Griffin-Sandford Method
Computation: _____
Normal value:
Initial hemolysis - _____
Complete hemolysis _____

A

Tube number x 0.02 = %
0.44 +/- 0.02% (0.42-0.44%)
0.32 +/-0.02% (0.32-0.34%)

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13
Q

Hemolysis are partial if the fluid(supernatant) turns faintly pink
Sediment or red cells or cell button still present
starts at test tube ___ and ___ in normal biconcave RBC

A

Initial Hemolysis
22
21

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14
Q

Complete when the fluid (supermatant) is red with no sediments
Sediments or red cell button is not present
Starts at test tube __,___ in normal biconcave RBC

A

Complete hemolysis
16
17

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15
Q

no hemolysis yet in test tube ___,____,___

A

25,24,23

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16
Q

Erythrocyte Osmotic Fragility Curve

A

B
C
A

17
Q

Normal biconcave RBC

A

B

18
Q

Increased OFT/ Shift to the left
___ and ___

A

C
Spherocytosis
Older red cells

19
Q

Decreased OFT/ Shift to the right

A

A
Thalassemia and hemoglobinopathies
Target cells
Younger red cells - reticulocytes

20
Q

Factors that affect OFT

A
  1. Shape of red cells
  2. Functional state of cell membrane
  3. Surface-to-volume area
  4. Chemical purity of sodium chloride
  5. Accuracy of sodium chloride solution
  6. Tonicity of solution
  7. pH must be 7.4 - a change of pH by 0.1 is equal to the change of tonicity by
    0.01%
  8. A temperature rise will increase fragility - 5 degrees Celsius change is equal to a change of tonicity of about 0.01%
21
Q

Increased Osmotic Fragility

A

Decreased Resistance
Hemolytic anemias
Hereditary spherocytosis,
Whenever spherocytes are found

22
Q

Decreased Osmotic Fragility

A

Increased Resistance
Splenectomy
In liver disease,
Sickle cell anemia,
Iron-deficiency anemia,
Thalassemia and
Polycythemia Vera,
Conditions in which target cells are present

23
Q

Hypertonic

A

shrink/ crenate

24
Q

Hypotonic

A

swell/ lysis -> Hemolysis