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Hematology 1 > (M) Week 9: Special test for diagnosis of certain RBC membrane defects > Flashcards

(M) Week 9: Special test for diagnosis of certain RBC membrane defects Flashcards

1
Q

Tests can be used to classify anemia

a. CBC
b. ESR
C. PBS
d. a and b
e. a and c

A

e

An erythrocyte sedimentation rate (ESR) is a blood test that that can show if you have inflammation in your body

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2
Q

T or F

Polycythemia can also be detected using special hematology laboratory tests

A

t

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3
Q

test used to diagnose hereditary spherocytosis

A

Erythrocyte Osmotic Fragility test

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4
Q

a genetic membrane defect associated with deficiency or abnormal molecular structure of either the alpha or beta chain of spectrin

A

hereditary spherocytosis

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5
Q

What are the defective peripheral proteins associated with hereditary spherocytosis

A

ankyrin
protein band 3
protein band 4.2

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6
Q

characteristics of rbc membrane in hereditary spherocytosis

A

loose and fragile

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7
Q

RBC of patients with hereditary spherocytosis have this defect on its membrane

A

blebs

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8
Q

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

A

macrophages
sphere

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9
Q

Spherocytes have a low surface to area volume ratio, measuring <5um in diameter resulting to

(low/high) MCV
(low/high) MCHC

A

low MCV and high MCHC

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10
Q

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

A

Erythrocyte osmotic fragility test

for hereditary spherocytosis

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11
Q

normal red cell _______________ at hypertonic solution

A

shrinks

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12
Q

normal red cell will _____________ in isotonic solution

A

will not lyse

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13
Q

normal red cell will ___________ at hypotonic solution

A

eventually lyse

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14
Q

a normal red cell without any defect on its membrane can withstand up to ___________ solution without lysis

A

0.5% NaCl hypotonic solution

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15
Q

partial hemolysis will only happen on _____________ of NaCl solution

A

0.40 -0.45%

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16
Q

hemolysis will only occur to normal rbc at ___________ NaCl solution

A

0.30 -0.35%

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17
Q

In hereditary spherocytosis, the red cells are lysed higher than _________ NaCl solution

A

0.5%

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18
Q

these are abnormal red cells that shares the same result with spherocytes if subjected to EOFT

A

elliptocytes
macrocytes
ovalocytes

(EMO, tore my life (hemolysis) into pieces this is my last desire ~)

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19
Q

What are the non lysing red cells in EOFT

A

hypochromic red cells
sickle cells
target cells / codocytes

(hay, so tibay)

hay = hypochromic red cells
so = sickle cells
tibay = target cells

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20
Q

In Manual EOFT procedure, what is the formula to get the concentration of the test tube?

A

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%

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21
Q

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.

A

Abnormal, presence of non-lysing RBCs

22
Q

This test is used to confirm the diagnosis of paroxysmal nocturnal hemoglobinuria or PNH

A

ham test / acidified serum test

23
Q

confirmatory or screening test for PNH?

Ham’s test

A

diagnostic

24
Q

confirmatory or screening test for PNH?

acidified serum test

A

diagnostic

25
Q

confirmatory or screening test for PNH?

sugar water test

A

bonus: its both

screening daw talaga yan but other text books say na it’s also diagnostic)

manual says na screening lang

26
Q

confirmatory or screening test for PNH?

flow cytometry

A

diagnostic/confirmatory

27
Q

PNH is associated with deficiency of which protein

A

guanidine phosphate inositol linked protein

28
Q

which cd markers are decreased / absent in the genetic deficiency of guanidine phosphate inositol linked protein

protective gear

A

CD 55 and CD-59

55 (decaying accelerating factor)
59 (membrane inhibitor reactive lysis)

29
Q

CD 55 AKA

A

Decaying Accelerating factor

30
Q

CD 59 AKA

A

Membrane inhibitor reactive analysis

31
Q

What are the three types of PNH?

A

type 1
type 2
type 3

32
Q

which PNH type shows a mild loss of the gpi-proteins

A

type 1

33
Q

which PNH type exhibits moderate and complete absence of gpi-proteins

A

type 2 and 3

34
Q

red cells without CD 55 and CD 59 are prone to ________________________ specially if the blood pH is slightly acidic

A

spontaneous complemented mediated hemolysis

35
Q

what are the three different types of serum prepared in Ham’s test

A

normal serum
patient’s serum
inactivated serum

36
Q

iactivated serum is prepared by heating the serum at _____ for ______

A

56 deg celsius for 20 minutes

30*

37
Q

which complement proteins are deactivated in the preparation of inactivated serum

A

C4 and C2

38
Q

what reagent is used in ham’s test

A

0.2 N HCl

39
Q

___ ul of defibrinated blood is placed on each serum preparations in Ham’s test and incubated for _____ hour at _____ temperature

A

20

1 hour

37 deg celsius / water bath temp

40
Q

Ham’s test

in normal patients, which serum tube/s will show hemolysis?

positive for PNH

A

patient’s serum and normal serum

this is positive for PNH

41
Q

Ham’s test

in normal patients which tube/s will not show hemolysis

A

inactivated serum

42
Q

what other hematological disorder may show a positive test result in Ham’s test

A

CDA type II or HEMPAS

Hereditary spherocytosis sin

43
Q

in patients with CDA type II / HEMPAS, which tubes show hemolysis when subjected to Ham’s test?

A

normal and inactivated serum

44
Q

sample of patients with hereditary spherocytosis show mild hemolysis when subjected to Ham’s test

A

all of them

45
Q

this test is a screening test for the assessment of PNH

it is sensitive but not specific to PNH

A

sugar water test

46
Q

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.

A

Sugar water test

47
Q

what is a positive result for sugar water test

A

hemolysis in the mmixture

48
Q

what is a negative result for sugar water test

A

no hemolysis

49
Q

this test uses an isotonic sucrose solution normal ABO compatible serum from where the patient’s rbc will be placed

A

sucrose hemolysis test

50
Q

________ will lyse and _________ will not in the sucrose hemolysis test

A

PNH red cell = hemolysis
normal red cells = will not lyse

51
Q

what other conditions show a positive result in sucrose hemolysis test

A

leukemia and myelosclerosis

Hematology 1 (20 decks)

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