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Hematology 1 > (M) Week 9: Special test for assessing certain hemoglobin disorders > Flashcards

(M) Week 9: Special test for assessing certain hemoglobin disorders Flashcards

1
Q

screening test to evaluate the presence of Hgb S in the patient’s blood

A

Dithionite solubility test

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2
Q

an unstable hemoglobin where point mutation of a single amino acid occurs in the beta globin chain

A

Hgb S

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3
Q

Hgb S is a genetic defect that causes the substitution of glutamic acid with _________ on the ___ position of amino acid in either one or two beta globin chains of the hemoglobin

A

valine on the 6th position

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4
Q

Hgb S causes the hemoglobin to ___________ within the red cells that changes the appearance of RBCs from disc to __________

A

precipitate
sickle shaped

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5
Q

Shape change to sickle may be triggered by the following factors:

A

hypoxia
acidosis
dehydration

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6
Q

What are the three forms of hemoglobin defect

A

sickle cell anemia = Hgb SS
sickle cell trait = Hgb AS
sickle cell disease = Hgb SC, SG, SD, SE, S-Beta thalassemia

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7
Q

which test principle is this:

The red cells are placed in a solution containing saponin and sodium dithionite reagent.

A

dithionite solutbility test

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8
Q

What is the action of the saponin reagent in the dithionite solubility test?

A

lyses the red cell, liberating the hemoglobin

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9
Q

What is the action of the sodium dithionite reagent if Hgb S is presnet

A

Hgb S is oxidized and forms tactoids / precipitates

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10
Q

Which diseases cause a positive result in the dithionite solubility test

A

Hgb SS / Hgb AS

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10
Q

What is the positive test result for dithionite solubility test

A

precipitates that causes turbidity

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11
Q

Which diseases causes a negative result on the dithionite solubility test?

A

sickle cell diseases

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12
Q

Used as a screening test for Hgb S

A

sickling test / sodium metabisulfite

+ dithionite solubility test

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13
Q

What shape does RBCs turb into when there is a presence of Hgb SS or As after being incubated with sodium metabisulfite

A

holly leaf appearance

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14
Q

a technique used to identify the specific type of hemoglobin present on an individual’s blood

A

Hgb electrophoresis

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15
Q

What blood disorders do Hgb electrophoresis confirm?

A

thalassemia and other hemmoglobinopathy

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16
Q

What are the two types of Hgb electrophoresis

A

cellulose acetate Hgb electrphoresis
citrate Hgb electrophoresis

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17
Q

what is the pH environment of cellulose acetate Hgb electrophoresis

A

8.0

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18
Q

what is the pH environment of citrate Hgb electrophoresis

A

6.0-6.2

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19
Q

What are the Hgb standards used for Hgb electrophoresis

A

Hgb A1
Hgb F
Hgb S
Hgb C

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20
Q

what is the order of migration in cellulose acetate Hgb electrophoresis (fastest to slowest)

A

Hgb A1
Hgb F
Hgb S
Hgb C

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21
Q

to which direction do the Hgb standards in cellulose acetate Hgb electrophoresis migrate to?

A

toward the anode (positive charge)

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22
Q

what is the order of migration in citrate Hgb electrophoresis (fastest to slowest)

A

Hgb C
Hgb S
Hgb F
Hgb A1

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23
Q

to which direction do the Hgb standards in citrate Hgb electrophoresis migrate to?

A

Hgb C and S = anode area (positive)
Hgb F and A1 = cathode area (negative)

24
Where do Hgb D and G migrate when using the cellulose acetate Hgb electrophoresis
same point as Hgb S
25
Where do Hgb E, O-Arab, and Hgb A2 migrate using the cellulose acetate medium
same point as Hgb C
26
Where do the Bart's Hgb, Hgb I, and Hgb H migrate to using the cellulose acetate medium?
goes to the same area where Hgb A1 but faster
27
where do the Hgb A2, D, G, E, and O-Arab migrate to in the citrate medium?
same point as Hgb A1 (cathode)
28
Test to determine the degree of distribution of the red cell containing Hgb F in a given specimen
Acid elution test
29
which disorders are characterized to have a high Hgb F level
Hereditary persistence of fetal hemoglobin (HPFH) fetal red cells in maternal circulation
30
which test principle is this: blood smears are fixed with ethyl alcohol and then incubated in a citric acid solutioni
Acid elution test
31
Blood sample for acid elution test can be from either one of the following:
finger stick or EDTA sample (less than 6 hrs old)
32
RBC with Hgb F (will/will not) be lysed when subjected to an acid solution
will not be
33
What are the stains used for the blood smears in acid elution test?
hematoxylin stain erythrosin B
34
Acid elution test hematoxylin is used to stain what?
WBC nuclei
35
Acid elution test erythrosin B is used to stain what?
RBCs
36
how many fields should the medical technologist view in the stained slides for acid elution test?
20-25
37
what is the formula for the number of Hgb F / field
Hgb F RBC / field - # intact RBC counted / # of field counted | then multipled to 100
38
What is the formula for the % of Hgb F
% of RBC with Hgb F = # Hgb F RBC /field divided by the ave # of RBC / field x 100
39
In Hereditary persistent fetal hemoglobin, the amount of Hgb F is even in all red cells which makes it stained (consistently/ inconsistently)
consistently
40
disorders where Hgb f is variable
thalassemia acquired aplastic anemia sickle cell other hemoglobinopathies
41
This may resist elution by the acid and may cause confusions and discrepancy in the laboratory report for acid elution test
reticulocytes
42
test used to quantify the concentration of Hgb F in a given specimen
alkali denaturation test
43
normal levels of Hgb F in newborns
60-90%
44
normal Hgb F level for 4 month old babies
10%
45
what should be the Hgb concentration for 6-12 month olds
2%
45
what is the Hgb F level in hereditary persistent fetal hemoglobin
above 15%
46
what is the Hgb f level in sickle cell anemia
normal to 20%
47
what is the Hgb F levels in beta thalassemia minor
2-5%
48
what is the Hgb F levels in beta thalassemia major
15-95%
49
high or low Hgb F levels are observed in the following: acquired aplastic anemia megaloblastic anemia PNH myelofibrosis leukemia refractory anemia pregnancy
high
50
what are the two methods of alkali denaturation test
Betke method Singer method
51
what reagent is used in the Betke method of alkali denaturation test
sodium hydroxide
52
what reagent is used in the singer method of alkali denaturation test
potassium hydroxide
53
Which test is this the principle of: red cell hemolysate is incubated with an alkali solution which allows the denaturation of all forms of hemoglobin except Hgb F
alkali denaturation test
54
the denatured hemoglobin will be precipitated with what reagent?
ammonium sulfate
55
T or F Hgb F is precipitated in the solution after the addition of ammonium sulfate
F (it is left in the solution) whats eluted is other forms of HGB
56
What is used after the alkali denaturation test to determine the optical density of the filtrate
cyanmethemoglobin test
57
what is the formula to calculate the precent concentration of Hgb F
%Hgb F = (OD of Hgb F / OD of total Hgb x 10) 100

Hematology 1 (32 decks)

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