Methods In Haem & Hb Associated Disorders

Question 1

What is a blood count/blood film? What do automated analysers detect?

Question 2

List the 3 RBC indices, and what can be calculated from them.

Answer 2

1. Mean Cell Volume(MCV); Packed cell volume/RBC
2. Mean Cell Hemoglobin(MCH); Hb/RBC
3. Mean Cell Hemoglobin Concentration(MHCH); Hb/packed cell volume

Most laboratory analyzers measure the root measurements stated above. Three other indices (Hct, MCH, MCHC, and RDW) is calculated using said measurements.

• Mean corpuscular hemoglobin (MHC); is a calculation of the amount of oxygen-carrying haemoglobin inside your RBCs.
• Mean corpuscular concentration (MCHC); is a calculation of the condition of haemoglobin side the RBCs.
• Red cell distribution width (RDW); is a calculation of the variation in the size of your RBCs.

Question 3

Define erythrocyte sedimentation rate.

Answer 3

The erythrocyte sedimentation rate is the rate at which red blood cells in anticoagulated whole blood descend in a standardized tube over a period of one hour. It is a common hematology test, and is a non-specific measure of inflammation.

Question 4

Brief notes on Blood Smears.

Question 5

Outline some hematinic assays.

Question 6

Discuss the ELISA in DETAIL. (Illustrations may help)

Answer 6

The ELIZA uses specialized enzymes that attaché to antibodies in the blood. The substrate then reacts with the enzyme and produce a colorimetric product.
1. Plate well coated with antibody specific for protein being measured.
2. Plate washed
3. Plasma is added as source of protein being measured, which binds to antibody
4. Plate is washed
5. Addition of antibody that’s conjugated to an enzyme. Antibody binds to captured protein.
6. Plate washed
7. Substrate is reacted with the enzyme to produce colored product.

Question 7

Discuss the LIA. (Draw also)

Answer 7

Latex beads contain the antibody of interest. Adding plasma causes agglutination of beads to which the degree is measured by light scatter. Usually detection of serum markers; ferritin.

Question 8

Define and explain all aspects of haemostasis.

Question 9

Explain contact activation.

Question 10

List/outline some molecular techniques.

Answer 10

International sensitivity index; the sensitivity of thromboplastin to oral anti-coagulant therapy relative to WHO.
International normalised ratio; the time ratio of blood plasma to clot compared with that of warfarin.

Question 11

What is the role of references ranges and control samples?

Question 12

What is the role of RBCs?

Question 13

Describe the main constituents of blood and their primary roles including the main cell types, their abundance, and primary function. (Draw the tree)

Answer 13

RBC; carries oxygen, nutrients, waste by-products etc.
WBC; functions primarily as defence mechanism against infection. (Cell types include eosinophil, neutrophil ,basophil, NKC, b&t-lymphocytes)
RBC and WBC make up 45% of blood
Platelets; primarily prevents blood loss by process of coagulation and clotting via activation and cascade.
Plasma; is a transport medium for nutrients and plasma proteins, growth and clotting factors.
Make up 55% of blood

Question 14

Define Anemia and list the normal Hb levels.

Question 15

What are the 2 types of defects in production, with respect to anemia?

Question 16

List the symptoms of anemia.

Question 17

Discuss/Notes on the Classification of Microcytic Hypochromic Anemia + Treatment.

Question 18

Discuss/Notes on the Classification of Macrocytic Hypochromic Anemia + Treatment.

Question 19

Discuss/Notes on the Classification of Normocytic Normochromic Hypochromic Anemia + Treatment.

Question 20

Briefly outline/describe + draw the uptake of iron.

Question 21

Explain/illustrate haem synthesis.

Question 22

List the causes of deficiency.

Question 23

Brief Notes on Pernicious Anemia (PA)

Question 24

Brief Notes on Sideroblastic Anemia (PA)

Question 25

Brief Notes on Haemochromatosis

Question 26

Describe how B12 and folate are required for DNA synthesis.

Question 27

Define and compare the inflammatory tests: ESR, C-reactive protein, and plasma viscosity.

Answer 27

ESR; inexpensive, quick, simple and account for a variety of factors however is not sensitive.
C-reactive; this tests for inflammation within the body by detecting C-reactive protein levels. This test is rapid, wide-ranged, and expensive.
Plasma; this tests the viscosity of plasma within the body, but this test is unaffected by anaemia, expansive and not widely available.

Question 28

Explain how flow cytomtery work with the aid of diagrams. (…detection of CD4+ lymph?)

Answer 28

Basically, individual cells are passed through a laser beam and light is scattered according to size and complexity. Automatic count cells within regions(or gates).

Question 29

Describe the change in proportions of cell types identified in the three subtypes of anaemia, any specific characteristics that can be associated with the Pathogenesis and treatments? (Describe the key destructive features for each and the potential causative factors)