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Hematology 2 PPT > Automation Part 2 > Flashcards

Automation Part 2 Flashcards

1
Q

utilize various end-point detection techniques.

A

POC coagulation analyzers

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2
Q

Newer versions feature of POC:

A

○ Touch screen interface
○ Wireless transmission of results in real-time
○ Micro-blood volumes

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3
Q

Examples of Common POC Tests:

A

ACT
PT/INR

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4
Q

Introduced in 1966 for heparin monitoring during cardiac surgery

A

Whole Blood Activated Clotting Time (ACT):

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5
Q

Monitoring oral anticoagulant therapy, such as Coumadin.

A

Prothrombin Time/International Normalized Ratio (PT/INR):

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6
Q

Point-of-care coagulation testing offers rapid and convenient testing options, but__________________________________________ for accurate clinical decision making.

A

careful validation and understanding of differences between POC and central laboratory results are essential

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7
Q

Validations and Considerations

A

○ POC device results validated against plasma-based assays in central laboratories.
○ Differences in instrumentation, reagents, and specimens may impact correlation between POC and central laboratory results.
○ Clinical decisions reliant on accurate understanding of differences between POC and central laboratory results

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8
Q

Thromboelastography was developed in

A

1948

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9
Q

Used the viscoelastic property of blood clotting

A

Thromboelastography

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10
Q

Provides information on the entire kinetic process of whole blood clot formation

A

Global Hemostasis Assessment ( thromboelastogrphy)

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11
Q

Global Hemostasis Assessment
specimen

A

Whole blood

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12
Q

Allows evaluation of interactions of platelets, erythrocytes, leukocytes, plasma coagulation factors, and plasma proteins

A

Global Hemostasis Assessment (Thromboelastography)

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13
Q

Assesses both bleeding and thrombosis risk

A

Global Hemostasis Assessment Thromboelastography

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14
Q

Provides an evaluation of fibrinolysis and a hypercoagulable state

A

Global Hemostasis Assessment

Thromboelastography

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15
Q

TEG Thromboelastograph Hemostasis Analyzer System form Haemonetics specimen

A

Nonanticoagulated or citrated WB

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16
Q

TEG Thromboelastograph Hemostasis Analyzer System form Haemonetics
REAGENT

A

Kaolin

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17
Q

TEG Thromboelastograph Hemostasis Analyzer
System form Haemonetics principle

A

As the blood clots, the resulting pin torque generates an electrical signal from the torsion wire.

The signal is plotted as a function of time to produce a TEG
tracing

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18
Q

The TEG tracing determines

A

○ Speed, strength, and stability of clot formation
○ Downstream of fibrinolysis

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19
Q

A new version of thromboelastography

A

Rotational Thromboelastometry (ROTEM)

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20
Q

based on the original instrument design

A

TEG Thromboelastograph Hemostasis Analyzer
System form Haemonetics

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21
Q

ROTEM Enhancements

A

○ Not sensitive to vibrations
○ Has four test channels
○ Touch screen
○ Automated pipettor

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22
Q

Pin (rotates) and cup (stationary)

A

ROTEM

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23
Q

Pin

A

Rotates

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24
Q

Cup

A

Stationary

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25
ROTEM Principle
● Upon clot formation, the increased tension from fibrin binding the cup to the pin is detected by sensors. ● The tracing is recorded as clot evolves over time
26
Clot signature of ROTEM and TEG is the _______
Same
27
TEG and ROTEM Results are available within
10-20 minutes
28
TEG AND ROTEM Disadvantages
○ The assay results are operator dependent ○ Require training ○ Demand a certain level of skill to perform a quality assay ○ Result interpretation requires skill, knowledge, and experience
29
TEG AND ROTEM Clot initiation or clotting time
TEG - R (reaction time) ROTEM- CT (clotting time)
30
TEG AND ROTEM Clot kinetics
TEG- K ROTEM- CFT ( clot formation time)
31
Time of initial fibrin
Clot of initiation time or clotting time
32
A measure of the speed to reach a specific level of clot strength
Clot kinetics
33
Measure the rate of clot formation, reflects the rate of fibrin formation and cross linking
Angle
34
Measure of the strength of the clot
Clot strength
35
TEG AND ROTEM Clot strength
TEG - MA (maximum amplitude) ROTEM- MCF (maximum clot firmness)
36
TEG AND ROTEM Clot stability
TEG- Lys30 (lysis at 30 minutes as a ratio of MA) ROTEM- CLI (clot lysis index)
37
Measure of the rate of amplitude reduction
Clot stability
38
The demand increased due to the need to monitor the efficacy of antiplatelet therapy
Platelet function testing
39
Preoperative evaluation of platelet function is important in hemostatic management, particularly if the patient has a _____________________ or if the ___________________
History of bleeding Anti platelet medication
40
Classic platelet aggregometry developed by
Born in 1962
41
Classic platelet aggregometry developed by Born in 1962 measures _________________
light transmission induced by various agonists.
42
New devices detect platelet aggregation based on
Whole blood impedance Luminescence Light scatter
43
Examples of Platelet Aggregometers:
PAP-8E from BioData Chrono-Log Whole Blood/Optical Lumi Aggregation System Multiplate Analyzer from Diapharma AggRAM from Helena
44
Uses the light transmittance principle by Born
Classic Platelet Aggregometry
45
Measure the increase light transmission that occurs in direct proportion to platelet aggregation
Classic Platelet Aggregometry
46
Induced by various agonists
Classic Platelet Aggregometry
47
Upon activation, platelets become sticky and adhere to metal sensor wires (electrodes)
Whole Blood Aggregation by Impedance
48
Platelet Aggregometers ● Three calculated parameters:
○ Maximum percentage aggregation ○ Area under the curve ○ Velocity
49
Is an eight-channel platelet aggregometer with a touch screen and on-screen procedure templates
PAP–8E from BioData
50
Uses LTA and a low sample volume
PAP–8E from BioData
51
PAP–8E from BioData sample
PRP
52
Has a whole blood/optical lumi–aggregation system
Chrono-Log
53
Chrono-Log sample
WB OR PRP
54
Provides for platelet aggregation (impedance) and measures platelet secretion (optical density) response
. Chrono-Log
55
Also called Whole–Blood Multiple Electrode Platelet Aggregometer (MEA)
Multiplate Analyzer from Diapharma
56
Monitors platelet function by impedance
Multiplate Analyzer from Diapharma
57
Correlate well with LTA in testing therapeutic efficacy
Multiplate Analyzer from Diapharma
58
A modular system for platelet aggregation and ristocetin cofactor testing
AggRAM from Helena
59
Use laser diode measuring at a wavelength of 650 nm
AggRAM from Helena
60
Platelet Aggregometers
PAP–8E from BioData Chrono-Log Multiplate Analyzer from Diapharma AggRAM from Helena
61
Platelet Function Analyzers
Siemens PFA-100 Platelet Function Analyzer Verify Now from Accriva Diagnostics Plateletworks Platelet Function Assay (Helena)
62
Automated instrument that provides rapid results on quanti- and qualitative platelet abnormalities
Siemens PFA-100 Platelet Function Analyzer
63
Siemens PFA-100 Platelet Function Analyzer Test cartridges stimulate platelet aggregation using _________________ or __________________.
collagen/epinephrine or collagen/ADP.
64
Measures the time for a platelet plug to occlude a microscopic aperture.
Siemens PFA-100 Platelet Function Analyzer
65
Successful in detecting von Willebrand disease and assessing aspirin therapy efficacy
Siemens PFA-100 Platelet Function Analyzer
66
Optical detection system measuring platelet aggregation by microbead agglutination.
Verify Now from Accriva Diagnostics
67
Uses disposable cartridges with fibrinogen-coated beads and platelet agonists.
Verify Now from Accriva Diagnostics
68
Provides aspirin assay, glycoprotein IIb/IIIa inhibitor assay, and P2Y12 inhibitor assay.
Verify Now from Accriva Diagnostics
69
Suitable for near-patient testing
Verify Now from Accriva Diagnostics
70
Can be run on any standard impedance cell counter
Plateletworks Platelet Function Assay (Helena)
71
Aggregation results based on platelet count before and after activation
Plateletworks Platelet Function Assay (Helena)
72
Blood collected via venipuncture directly into tubes provided in the kit.
Plateletworks Platelet Function Assay (Helena)
73
ideal for presurgical screening and antiplatelet therapy monitoring.
Plateletworks Platelet Function Assay (Helena)
74
offer advantages over conventional platelet aggregation studies.
Flow cytometry assays
75
Whole blood testing provides a more physiologic evaluation.
Flow Cytometry
76
Requires minimal specimen volumes, suitable for pediatric and difficult-to-draw patients.
Flow Cytometry
77
Able to measure multiple cellular activation-dependent changes related to platelet function.
Flow cytometry
78
Available for the diagnosis of heparin-induced thrombocytopenia (HIT), but currently laboratory developed tests (LDTs).
Flow cytometry
79
revolutionized the diagnosis of thrombophilia and related disorders
Molecular testing in the coagulation laboratory
80
Molecular testing in the coagulation laboratory Commonly tested gene mutations include
Factor V Leiden Prothrombin G20210A Methylenetetrahydrofolate reductase (MTHFR).
81
widely used for their accuracy in detecting point mutations and single-nucleotide polymorphisms
Polymerase chain reaction (PCR)-based assays
82
while less common, is another method for analyzing PCR product
Restriction fragment-length polymorphism (RFLP) analysis
83
like the Invader assay offer high-throughput capabilities and allele-specific hybridization.
Non-PCR-based methods
84
Molecular testing provides
high sensitivity and specificity without interference from anticoagulants or inhibitors.

Hematology 2 PPT (12 decks)

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