(M) Week 9: Special test for diagnosis of certain RBC membrane defects Flashcards
Tests can be used to classify anemia
a. CBC
b. ESR
C. PBS
d. a and b
e. a and c
e
An erythrocyte sedimentation rate (ESR) is a blood test that that can show if you have inflammation in your body
T or F
Polycythemia can also be detected using special hematology laboratory tests
t
test used to diagnose hereditary spherocytosis
Erythrocyte Osmotic Fragility test
a genetic membrane defect associated with deficiency or abnormal molecular structure of either the alpha or beta chain of spectrin
hereditary spherocytosis
What are the defective peripheral proteins associated with hereditary spherocytosis
ankyrin
protein band 3
protein band 4.2
characteristics of rbc membrane in hereditary spherocytosis
loose and fragile
RBC of patients with hereditary spherocytosis have this defect on its membrane
blebs
RBC blebs are removed by ________________ from the spleen , decreasing the red cell membrane which forms a small and _________ shaped red cell instead of a disc shaped
macrophages
sphere
Spherocytes have a low surface to area volume ratio, measuring <5um in diameter resulting to
(low/high) MCV
(low/high) MCHC
low MCV and high MCHC
which test principle is this?
subjecting the red cells into different concentration of salt starting from hypertonic solution (1.0% NaCl) or isotonic solution (0.90-0.85% NaCl) and identify at what salt concentration shows the initial and complete hemolysis
Erythrocyte osmotic fragility test
for hereditary spherocytosis
normal red cell _______________ at hypertonic solution
shrinks
normal red cell will _____________ in isotonic solution
will not lyse
normal red cell will ___________ at hypotonic solution
eventually lyse
a normal red cell without any defect on its membrane can withstand up to ___________ solution without lysis
0.5% NaCl hypotonic solution
partial hemolysis will only happen on _____________ of NaCl solution
0.40 -0.45%
hemolysis will only occur to normal rbc at ___________ NaCl solution
0.30 -0.35%
In hereditary spherocytosis, the red cells are lysed higher than _________ NaCl solution
0.5%
these are abnormal red cells that shares the same result with spherocytes if subjected to EOFT
elliptocytes
macrocytes
ovalocytes
(EMO, tore my life (hemolysis) into pieces this is my last desire ~)
What are the non lysing red cells in EOFT
hypochromic red cells
sickle cells
target cells / codocytes
(hay, so tibay)
hay = hypochromic red cells
so = sickle cells
tibay = target cells
In Manual EOFT procedure, what is the formula to get the concentration of the test tube?
Tube No. that showed partial/complete hemolysis x 0.02
o For example, Test Tube 21
o To get concentration of the test tube:
- IH: 21 x 0.02 = 0.42%
Manual EOFT procedures: Interpret the results
From glass tube 25 to 12, obtain the following results:
First test tube that contains Initial Hemolysis is Test tube 14. While, test tube 12 contains complete hemolysis.
Abnormal, presence of non-lysing RBCs
This test is used to confirm the diagnosis of paroxysmal nocturnal hemoglobinuria or PNH
ham test / acidified serum test
confirmatory or screening test for PNH?
Ham’s test
diagnostic
confirmatory or screening test for PNH?
acidified serum test
diagnostic
confirmatory or screening test for PNH?
sugar water test
bonus: its both
screening daw talaga yan but other text books say na it’s also diagnostic)
manual says na screening lang
confirmatory or screening test for PNH?
flow cytometry
diagnostic/confirmatory
PNH is associated with deficiency of which protein
guanidine phosphate inositol linked protein
which cd markers are decreased / absent in the genetic deficiency of guanidine phosphate inositol linked protein
protective gear
CD 55 and CD-59
55 (decaying accelerating factor)
59 (membrane inhibitor reactive lysis)
CD 55 AKA
Decaying Accelerating factor
CD 59 AKA
Membrane inhibitor reactive analysis
What are the three types of PNH?
type 1
type 2
type 3
which PNH type shows a mild loss of the gpi-proteins
type 1
which PNH type exhibits moderate and complete absence of gpi-proteins
type 2 and 3
red cells without CD 55 and CD 59 are prone to ________________________ specially if the blood pH is slightly acidic
spontaneous complemented mediated hemolysis
what are the three different types of serum prepared in Ham’s test
normal serum
patient’s serum
inactivated serum
iactivated serum is prepared by heating the serum at _____ for ______
56 deg celsius for 20 minutes
30*
which complement proteins are deactivated in the preparation of inactivated serum
C4 and C2
what reagent is used in ham’s test
0.2 N HCl
___ ul of defibrinated blood is placed on each serum preparations in Ham’s test and incubated for _____ hour at _____ temperature
20
1 hour
37 deg celsius / water bath temp
Ham’s test
in normal patients, which serum tube/s will show hemolysis?
positive for PNH
patient’s serum and normal serum
this is positive for PNH
Ham’s test
in normal patients which tube/s will not show hemolysis
inactivated serum
what other hematological disorder may show a positive test result in Ham’s test
CDA type II or HEMPAS
Hereditary spherocytosis sin
in patients with CDA type II / HEMPAS, which tubes show hemolysis when subjected to Ham’s test?
normal and inactivated serum
sample of patients with hereditary spherocytosis show mild hemolysis when subjected to Ham’s test
all of them
this test is a screening test for the assessment of PNH
it is sensitive but not specific to PNH
sugar water test
this test principle belongs to which type of test?
the patient’s whole blood will be mixed with sugar water solution at room temperature and allow it to stand for 10 minutes, then after which check the mixture for hemolysis.
Sugar water test
what is a positive result for sugar water test
hemolysis in the mmixture
what is a negative result for sugar water test
no hemolysis
this test uses an isotonic sucrose solution normal ABO compatible serum from where the patient’s rbc will be placed
sucrose hemolysis test
________ will lyse and _________ will not in the sucrose hemolysis test
PNH red cell = hemolysis
normal red cells = will not lyse
what other conditions show a positive result in sucrose hemolysis test
leukemia and myelosclerosis
