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Transfusion > Trans Lecture 9 > Flashcards

Trans Lecture 9 Flashcards

1
Q

What does DAT positive indicate?

A

Membrane modification DAT positive for IgG or Complement.

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2
Q

When does DAT positivity usually occur after treatment begins?

A

7–10 days.

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3
Q

How long can DAT stay positive after the drug is withdrawn?

A

Up to 2 years.

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4
Q

What is the recommended treatment for hemolytic anemia caused by drugs?

A

Withdraw the drug.

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5
Q

How do you differentiate sensitivity reaction to drug from hemolysis?

A

Rash/hypotension vs Jaundice/other signs of hemolysis.

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6
Q

What is the treatment for severe cases of drug-induced hemolytic anemia?

A

Transfusion and steroids (Prednisone).

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7
Q

Name some examples of drugs that can cause hemolytic anemia.

A

Penicillin family, Aldomet (α-methyldopa), Cephalosporin, Quinidine.

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8
Q

What are the lab findings in hemolytic anemia caused by drugs?

A

Decreased Hb/Hct, normal or slightly elevated MCV, increased Bilirubin and LD, decreased Haptoglobin.

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9
Q

What are the manifestations of intravascular hemolysis in transfusion reactions?

A

Hemoglobinemia, hemoglobinuria, and hemosiderinuria.

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10
Q

What is the most common cause of transfusion reactions?

A

Human error in blood compatibility.

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11
Q

What are the signs and symptoms of immediate transfusion reaction?

A

Chills, fever, hives, tachycardia, nausea/vomiting, chest and back pain, shock, anaphylaxis, pulmonary edema, congestive heart failure.

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12
Q

What are the lab findings in immediate transfusion reaction?

A

Hemoglobinemia and/or hemoglobinuria, increased Bilirubin and LD, decreased haptoglobin.

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13
Q

What are the morphological features seen in immediate transfusion reaction?

A

Spherocytes, increased polychromasia, and may have schistocytes.

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14
Q

What is the treatment for immediate transfusion reaction?

A

Stop the transfusion immediately, treat for bleeding/shock, and maintain renal circulation.

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15
Q

When do signs and symptoms of delayed transfusion reaction appear?

A

Days to weeks after blood transfusion.

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16
Q

What can be the causes of delayed transfusion reaction?

A

ABO, Rh, Kell, Fya antibodies, or graft-vs-host reaction.

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17
Q

What are the symptoms of delayed transfusion reaction?

A

Jaundice, mild fever and chills, slight anemia, hemoglobinuria, shock, and renal failure.

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18
Q

What are the lab findings in delayed transfusion reaction?

A

Increased Bilirubin and LD, decreased haptoglobin.

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19
Q

What are the morphological features seen in delayed transfusion reaction?

A

Spherocytes and increased polychromasia.

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20
Q

What is the treatment for delayed transfusion reaction?

A

Support renal function, reduce possibility of hypertension, and may need blood products if coagulation issues arise (DIC).

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21
Q

What is the most common antigen responsible for hemolytic disease of the newborn (HDN)?

A

Rh blood group antigen D.

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22
Q

When can Rh HDN occur?

A

When the mother is Rh negative and the father is Rh positive.

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23
Q

How does a mother become sensitized to Rh?

A

Through previous pregnancy or fetal-maternal bleed during delivery.

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24
Q

What happens in the first pregnancy of an Rh-negative mother with an Rh-positive fetus?

A

The mother forms antibodies (anti-D/IgG) from exposure to Rh during the pregnancy.

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25
Q

What allows anti-D IgG antibodies to cross the placenta?

A

The size of IgG allows it to cross the placenta.

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26
Q

What can happen in subsequent pregnancies if the mother is sensitized to Rh?

A

Anti-D IgG antibodies can cross the placenta and attack an Rh-positive fetus.

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27
Q

What is another term for hemolytic disease of the newborn due to Rh incompatibility?

A

Erythroblastosis Fetalis.

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28
Q

What can be the severity of hemolytic disease of the newborn?

A

It can range from mild to severe.

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29
Q

What are the symptoms of hemolytic disease in neonates with Rh incompatibility?

A

Anemia, splenomegaly, hepatomegaly, high bilirubin levels, low haptoglobin levels.

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30
Q

What is the primary cause of death in neonates with Rh incompatibility?

A

Hepatocellular damage and hepatic obstruction.

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31
Q

How can Rh incompatibility be monitored and prevented during pregnancy?

A

Maternal antibody screening, monitoring bilirubin levels in amniotic fluid, and administration of Rhogam (Rh immune globulin).

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32
Q

What is the treatment for hemolytic disease of the newborn due to Rh incompatibility?

A

Injection of fetal compatible blood into the umbilical cord vein or exchange transfusion after delivery.

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33
Q

What is the most common cause of jaundice in the first day of life in newborns?

A

Hemolytic disease of the newborn due to ABO incompatibility.

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34
Q

What is ABO HDN and how common is it?

A

Hemolytic disease of the newborn due to ABO incompatibility. It occurs in about 25% of all pregnancies.

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35
Q

What antibodies are present in mothers with group “O” blood and what antigens can be present in their babies?

A

Mothers with group “O” blood have Anti-A and Anti-B antibodies, while their babies can have group “A”, “B”, or “AB” antigens.

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36
Q

What is the role of placenta in conjugating bilirubin in ABO HDN?

A

In utero, the placenta contributes to conjugating bilirubin.

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37
Q

What happens when the antibodies from a mother with group “O” blood attach to fetal tissues?

A

The severity of the hemolytic disease is reduced, leading to less hemolysis and less anemia.

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38
Q

What is the clinical presentation of hemolytic disease of the newborn due to ABO incompatibility?

A

Rare hepatosplenomegaly, possible jaundice.

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39
Q

What are the recommended treatments for ABO HDN based on severity?

A

No treatment for mild or no anemia/jaundice, phototherapy for jaundice, and exchange transfusion for severe cases.

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40
Q

What is the cause and mode of transmission of Malaria?

A

Malaria is caused by blood infection of tiny parasites originating from an infected Anopheles mosquito.

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41
Q

Where is Malaria typically seen?

A

Malaria is typically seen in subtropical countries.

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42
Q

How many people are infected with Malaria each year and how many die from the disease?

A

About 290 million people are infected with Malaria each year and 400,000 die from the disease.

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43
Q

Why is testing for Malaria typically done in triplicate at three different time periods?

A

Fever associated with Malaria is episodic, so multiple tests increase the chances of detection.

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44
Q

What can happen if Malaria species lie dormant in the body?

A

Some Malaria species can lie dormant in the body for years, leading to recurring infections.

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45
Q

In determining the species of Malaria in the blood, what information is useful to know?

A

Knowing where the patient has traveled can be helpful in determining the species of Malaria present in the blood.

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46
Q

What pH range is ideal for the appearance of pink in the presence of G?

A

pH 7.0-7.2

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47
Q

How are thin films made for malaria testing?

A

Like a regular peripheral blood film

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48
Q

How should the size of a thick film drop of blood be spread?

A

Spread out to about the size of a dime

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49
Q

What is the purpose of drying the smears completely before staining?

A

To prevent flaking off during staining

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50
Q

How are thin films fixed before staining?

A

In methanol

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51
Q

Which stain is considered ideal for malaria testing?

A

Giemsa

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52
Q

What is the recommended staining time for thick and thin slides?

A

45-60 minutes

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53
Q

What can be done for rapid staining of thick and thin slides?

A

Use a more concentrated preparation of Giemsa stain and stain for 10 minutes

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54
Q

What can a routine blood film stained with W-G provide?

A

Rapid presumptive identification

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55
Q

Why is fresh stain made for each patient processed?

A

To ensure no carry over or contamination from wash off

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56
Q

What quality control measures are recommended for thick and thin preparations?

A

Both positive and negative controls

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57
Q

What type of blood can be used as a negative control for thick and thin film preparations?

A

Random fresh blood with normal CBC results

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58
Q

How can a positive control slide be prepared for thick and thin films?

A

Make large batch slide preparations from previously identified positive patient sample

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59
Q

What is the recommended storage time for wrapped, unfrozen thick and thin slides?

A

Up to 6 months

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60
Q

How should a thawed slide be handled before examination?

A

Remain in the tinfoil until it reaches room temperature

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61
Q

Why is a test slide processed with each patient batch?

A

To ensure proper staining of the parasites

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62
Q

What is the reporting time requirement for identifying Malaria?

A

Preliminary report within 1 hour of received/prepared blood/smears

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63
Q

Why should 2 MLTs usually examine smears together?

A

For time efficiency and consistency in reporting

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64
Q

What is the purpose of 10X scan during examination of blood films?

A

To look for larger gametocyte forms, especially banana shaped gametocytes specific to p. Falciparium

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65
Q

What must not be skipped during the examination of thick films?

A

Scanning the entire thick film

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66
Q

What is the purpose of a 40X scan during examination of blood films?

A

To further examine the smears for parasites

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67
Q

What must be done if an agg is unable to clear completely the RBC, HCT and all indices?

A

TNP and a comment must be reported.

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68
Q

What must be done if the warm smear shows signs that agglutination is still present?

A

A warm plasma replacement must be performed.

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69
Q

What is used as an isotonic diluent on the Sysmex analyzer?

A

Prewarm Saline or Cell Pack.

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70
Q

How much sample should be removed into a fully labeled tube for incubation?

A

Approximately 2mLs.

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71
Q

How long should the sample be centrifuged for?

A

10 minutes at 2500 rpm.

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72
Q

How much plasma should be removed from the sample at a time?

A

Between 100uL and 200uL.

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73
Q

What must be done to avoid disturbing the buffy coat when aspirating the plasma?

A

Care must be taken to not disturb the buffy coat.

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74
Q

How much plasma should be aspirated without going too close to the buffy coat?

A

As much as possible.

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75
Q

What should be done after aspirating all the plasma?

A

Replace with the warmed saline/cell pack and mix well.

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76
Q

How long should the blood be incubated after replacing with warmed saline/cell pack?

A

At least 10 minutes.

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77
Q

What should be done after returning the blood to the incubator?

A

Mix well and remake a new blood film and label it as ‘warm PR’.

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78
Q

What should be done if there is no evidence of agglutination in the warm plasma replacement blood film?

A

Complete the blood film review as normal and add the messages ‘Agglutination present’ and ‘Agglutination dispersed following warm plasma replacement’ to the RBC morphology.

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79
Q

What should be included in the first CBC parameter on the final report if warm plasma replacement was done?

A

The message ‘CBC parameters corrected for the presence of Cold Agglutination’ and ‘CBC parameter obtained following plasma replacement at 37oC’.

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80
Q

What parameter can be used as an accuracy control for the plasma replacement?

A

Platelet count.

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81
Q

What may be seen in the morphology if significant numbers of spherocytes are present?

A

MCHC may stay between 360-370 g/L after warm correction.

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82
Q

What may accompany the presence of spherocytes?

A

An increase in polychromasia.

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83
Q

What should be done if Paroxysmal Cold hemoglobinuria is suspected?

A

Supportive care and avoid cold.

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84
Q

What is the most common cause of Paroxysmal Cold hemoglobinuria?

A

Viral infections.

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85
Q

What treatment options are usually ineffective for Paroxysmal Cold hemoglobinuria?

A

Corticosteroids and splenectomy.

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86
Q

What is the mechanism of drug-induced immune hemolytic anemia?

A

Drug invokes antibody reaction to the drug through complement fixation.

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87
Q

What can some drugs do to the red cell membrane?

A

Alter it, allowing IgG and complement attachment.

88
Q

What can some drugs elicit?

A

An autoimmune antibody reaction to self-antigens.

89
Q

What are the complications associated with Pure Red Cell Aplasia (PRCA)?

A

AML, MDS, Squamous cell carcinoma, Diamond-Blackfan anemia (DBA)

90
Q

What does PRCA primarily affect?

A

Differentiated stem cell precursors, specifically proerythroblasts

91
Q

What are the symptoms of PRCA?

A

All symptoms of anemia

92
Q

What are the possible causes of secondary PRCA?

A

Autoimmune disease, Thymoma, Viral infection, Lymphoproliferative disorders, Idiopathic, Drugs

93
Q

What is Diamond-Blackfan Anemia (DBA) also known as?

A

Congenital Hypoplastic Anemia

94
Q

What type of inheritance does DBA exhibit?

A

Autosomal inheritance, both recessively and dominantly

95
Q

What areas of the body does DBA affect primarily?

A

Bone marrow

96
Q

At what age is DBA typically diagnosed?

A

Infancy, with most cases by 6 months

97
Q

What are some physical features associated with DBA?

A

Short stature, altered or missing thumb, low birth weight, head and facial abnormalities, eye complications, delayed puberty, kidney abnormalities

98
Q

What are the laboratory results for DBA?

A

Anemia but no pancytopenia, increased MCV, decreased retic count, thrombocytopenia or thrombocytosis, lack of RBC precursors in bone marrow

99
Q

What is the treatment for DBA?

A

Transfusion for anemia, small doses of steroids after 1 year, lifelong transfusion if steroids are not effective, bone marrow transplant (if no iron overload)

100
Q

What is anemia of renal disease characterized by?

A

Hypoproliferative anemia due to decreased Erythropoietin (EPO)

101
Q

What are some diseases or conditions associated with anemia of renal disease?

A

Malignant hypertension, glomerulonephritis, acute renal cortical necrosis, amyloidosis, diabetic nephropathy, secondary to hyperparathyroidism, dialysis

102
Q

What are the laboratory results for anemia of renal disease?

A

Decreased Hb/Hct, normal MCV/MCH/MCHC, increased reticulocytes (if EPO is unaffected), may have thrombocytopenia, presence of burr cells, acanthocytes, and schistocytes in morphology, erythroid hypoplasia in bone marrow

103
Q

How is anemia of renal disease treated?

A

Treating underlying conditions, improving renal function to increase RBC production, supplementing with recombinant EPO, potentially treating with iron, close monitoring of Hb levels, monitoring iron stores

104
Q

What can happen if Hb levels are above 120 g/L in anemia of renal disease?

A

Venous thrombosis and myocardial infarction (MI), potentially leading to death

105
Q

What must also be monitored in anemia of renal disease treatment?

A

Iron stores to ensure availability for matching EPO levels

106
Q

What is the occurrence rate of spontaneous remission in DBA?

A

25% of cases, reason unknown

107
Q

What is the most common area to see tsetse flies?

A

Sub-Saharan Africa

108
Q

Which two species of Trypanosoma are most concerning for human infections?

A

Trypanosoma Brucei vs cruzi

109
Q

What are the three types of filaria infections?

A

Lymphatic filaria, subcutaneous filaria, or serous filaria

110
Q

Which mosquito species can transmit Loa loa?

A

Anopheles (Malaria) and Aedes (Dengue and Zika)

111
Q

What are the distinguishing features of Wuchereria bancrofti?

A

Sheath, no nuclei in the tip of the tail

112
Q

What are the distinguishing features of Brugia malayi?

A

Sheath, 2 distinct nuclei in the tip of the tail

113
Q

What are the distinguishing features of Loa loa?

A

Sheath, nuclei extending to the tip of the tail

114
Q

What are the distinguishing features of Onchocerca volvulus?

A

No sheath, no nuclei in the tip of the tail

115
Q

What are the distinguishing features of Mansonella perstans?

A

No sheath, nuclei extending to the tip of the tail

116
Q

What are the distinguishing features of Mansonella ozzardi?

A

No sheath, no nuclei in the tip of the tail

117
Q

What are the distinguishing features of Mansonella streptocerca?

A

No sheath, nuclei extending to the tip of the hooked tail

118
Q

What type of bacteria is Clostridium perfringens?

A

Gram positive rods

119
Q

What is a complication resulting from Clostridium perfringens infection?

A

Acute hemolysis

120
Q

What is the median survival time from onset of symptoms in Clostridium perfringens infection?

A

6 hours

121
Q

What is the delayed TAT of Hb in Clostridium perfringens infection due to?

A

Correction for hemolysis

122
Q

What are the symptoms of Bartonella bacilliformis infection?

A

Fever, headache, muscle and joint pain, enlarged lymph nodes, and severe anemia

123
Q

What stain is used to demonstrate Bartonella bacilliformis in a blood film?

A

Gram stain

124
Q

What is the incubation period of Bartonella bacilliformis infection?

A

About 20 days

125
Q

How is Bartonella bacilliformis infection diagnosed?

A

PCR or serology

126
Q

How does Bartonella bacilliformis adhere to red blood cells?

A

To the outside of the red blood cells

127
Q

What are the three reasons for hemolytic anemia?

A

Spleen overwork, hepatomegaly, skeletal changes

128
Q

What are the characteristics of intravascular hemolysis?

A

Free hemoglobin in serum, marked increase in LD and bilirubin

129
Q

What are the characteristics of extravascular hemolysis?

A

No free hemoglobin in serum, Hb reading on automated instruments must be corrected for free hemoglobin

130
Q

What are the different types of immune hemolytic anemia?

A

Autoimmune Hemolytic Anemia, Drug-induced Immune Hemolytic Anemia, Alloimmune Hemolytic Anemia

131
Q

What are the characteristics of autoimmune hemolytic anemia (AIHA)?

A

Production of antibodies against self antigens, can be caused by IgG or IgM

132
Q

What are the causes of warm antibody AIHA?

A

Most commonly caused by IgG, more common in middle-aged women

133
Q

What are the characteristics of extravascular hemolysis in AIHA?

A

RBC coated with IgG, macrophages in the spleen remove the antibody from the cell membrane

134
Q

What are the causes of warm antibody AIHA?

A

Idiopathic, malignancies, autoimmune conditions, medications, viral infections

135
Q

What are the characteristics of cold antibody AIHA?

A

Typically anti-i or anti-I, dependent on complement activation, optimal at about 40C

136
Q

What are the most common causes of cold antibody AIHA?

A

Idiopathic, viral infections, B-cell lymphoma

137
Q

What are the characteristics of cold agglutination?

A

Low grade intravascular hemolytic anemia, may have increased bilirubin and LD, acrocyanosis

138
Q

What are the CBC findings in autoimmune hemolytic anemia?

A

Decreased RBC, increased MCV and MCH/MCHC

139
Q

What is the characteristic finding on blood smear in AIHA?

A

Agglutination that can be resolved by warming the blood sample

140
Q

How can you differentiate warm and cold antibody AIHA on blood smear?

A

Spherocytes on warm smear for warm antibody AIHA

141
Q

What are the characteristics of complement-mediated AIHA?

A

Extravascular: RBC coated with C3b, Intravascular: RBC coated with a lot of complement C5-C9

142
Q

What is the osmotic environment of the RBC in complement-mediated intravascular hemolysis?

A

Osmotic environment of the RBC is affected

143
Q

How long does it take for recombinant EPO to take effect?

A

8-12 weeks

144
Q

What are the two types of anemia categorized as normochromic normocytic anemia?

A

Aplastic Anemia and Anemia of Renal Disease

145
Q

What is the normal value for the Reticulocyte Production Index (RPI) in underproduction anemia?

A

RPI<2.5

146
Q

What are the causes of extrinsic hemolytic anemia?

A

Antibodies (warm and cold reacting), hemolytic disease of the newborn, infectious agents (microorganisms or parasitic), mechanical damage

147
Q

Name three infectious agents that can cause extrinsic hemolytic anemia.

A

Malaria, Babesiosis, Clostridial Sepsis

148
Q

What are the causes of intrinsic hemolytic anemia?

A

Cell shape abnormalities, erythrocyte enzyme deficiencies, hemoglobinopathies, abnormal porphyrin metabolism, paroxysmal nocturnal hemoglobinuria

149
Q

What is the definition of hemolysis?

A

Premature destruction of RBCs with a shortened life span (<120 days)

150
Q

How does the bone marrow respond to hemolysis?

A

Marrow response cannot compensate for the increased loss of RBCs, leading to uncompensated anemia

151
Q

What is the difference between intrinsic and extrinsic causes of hemolysis?

A

Intrinsic causes are from factors inside the RBCs, while extrinsic causes are from factors outside the RBCs

152
Q

What is the difference between intravascular and extravascular hemolysis?

A

Intravascular hemolysis happens within the blood vessels, while extravascular hemolysis happens in the liver, spleen, lymph nodes, or bone marrow

153
Q

List three causes of intravascular hemolysis.

A

Complement, enzyme macroangiopathic hemolytic anemia, microangiopathic hemolytic anemia

154
Q

What are the common symptoms of hemolytic anemia?

A

Symptoms of anemia, jaundice, splenomegaly, pulmonary hypertension, thrombosis

155
Q

What lab features indicate hemolytic anemia?

A

Increased bilirubin, increased urobilinogen, increased LD, decreased haptoglobin, increased reticulocytes, hemoglobinuria

156
Q

What is the common morphology seen in hemolytic anemia?

A

Spherocytes, increased polychromasia, schistocytes in intravascular hemolysis

157
Q

What are the clinical features of extravascular hemolysis?

A

Pale/tired, fatigue, dizziness, exercise intolerance, jaundice, splenomegaly

158
Q

What are the two types of normocytic normochromic anemia?

A

Aplastic anemia and anemia of renal disease, ACD

159
Q

What is the Reticulocyte Production Index (RPI) value for underproduction type normocytic normochromic anemia?

A

RPI<2.5

160
Q

What is the Reticulocyte Production Index (RPI) value for increased destruction type normocytic normochromic anemia?

A

RPI>2.5

161
Q

What are the two types of macrocytic anemia?

A

Disruption in proliferation and/or differentiation of stem cells and renal disease with reduced EPO production

162
Q

What are the symptoms of aplastic anemia?

A

Pale, fatigue, headache, angina or heart mummer, shortness of breath on exertion

163
Q

What is pancytopenia?

A

Depression of all three cell lines (RBCs, WBCs, and platelets)

164
Q

What causes leukocytopenia (agranulocytosis) in aplastic anemia?

A

Infection

165
Q

What are the symptoms of thrombocytopenia in aplastic anemia?

A

Spontaneous or mucosal bleeding (petichae, purpura, echymoses)

166
Q

What can cause aplastic anemia?

A

Inherited factors, radiation, drugs/toxins/chemo, viruses (HIV, EBV parvo B19), immunological factors, PNH, pregnancy

167
Q

What are the laboratory results for aplastic anemia?

A

Decreased RBCs, decreased Hb/Hct, normal/ increased MCV, decreased reticulocytes

168
Q

What is the treatment for aplastic anemia?

A

Stop drug/chemical, hematopoietic stem cell transplant, immunosuppression, androgens, synthetic EPO/G-CSF, packed red blood cells

169
Q

What is Fanconi’s anemia?

A

Autosomal recessive disorder affecting marrow development, most common cause of inherited aplastic anemia

170
Q

What are the physical features associated with Fanconi’s anemia?

A

Short stature, deafness and low set ears, radial bone abnormalities, hyperpigmentation on trunk and neck, microcephaly, broad nose, structural kidney abnormalities, testicular atrophy

171
Q

What are the laboratory results for Fanconi’s anemia?

A

Pancytopenia, macrocytic, increased HbF levels

172
Q

What are the four species of malaria?

A

P. falciparum, P. vivax, P. malariae, P. ovale

173
Q

Which regions are included in Oceania?

A

Papua New Guinea, Samoa, Tonga, Fiji, French Polynesia

174
Q

Which regions are included in the Americas?

A

Central and South America

175
Q

How can malaria be transmitted?

A

Through blood transfusion, sharing of needles, and from mother to unborn child

176
Q

What are the symptoms of malaria?

A

Fever, chills, general feeling of discomfort, headache, nausea and vomiting, diarrhea, abdominal pain, muscle or joint pain, fatigue, rapid breathing, rapid heart rate, cough

177
Q

Who is at higher risk of serious disease from malaria?

A

Young children and older adults

178
Q

Where do more than 90% of malaria deaths occur?

A

Africa

179
Q

What are the critical symptoms of malaria?

A

Seizures, brain damage, trouble breathing, organ failure, hemolytic crisis

180
Q

What can happen if malaria is not treated?

A

It can lead to severe complications and be fatal

181
Q

What is the recommended treatment for malaria?

A

ASAP at first sign of fever and use of antimalarial drugs

182
Q

What are some preventive measures for malaria?

A

Taking antimalarial medications, avoiding outdoor activities during high mosquito activity, using repellents with DEET, wearing treated clothing with long sleeves and pants, and using netting

183
Q

What is the first-ever vaccine for malaria prevention?

A

A vaccine that targets P. falciparum and has 75% efficacy

184
Q

How is the malaria vaccine administered?

A

It requires four injections

185
Q

What can rapid tests detect for malaria identification?

A

Plasmodium histidine-rich protein antigens present in infected RBCs

186
Q

What are the advantages of lateral flow immunochromatographic assay for malaria identification?

A

Quick screening test, can be used in areas without trained laboratory professionals, and mostly reliable with minimal false negatives

187
Q

What is required for laboratories to perform thick and thin film examinations to identify malaria?

A

A licensing code

188
Q

Which stain is better for identifying malaria on routine smears?

A

Wrights Giemsa

189
Q

What is the pH of the phosphate buffer solution used in Giemsa stain for malaria staining?

A

pH 6.8

190
Q

What may cause color variation of the parasites in different stains during malaria staining?

A

The difference in pH between stains

191
Q

What is the treatment for Cold reacting AIHA and PCHU?

A

Supportive treatment and avoiding the cold.

192
Q

What are the treatment options for Warm reacting AIHA?

A

Immunosuppression (steroids), splenectomy, and other drugs.

193
Q

What does the Direct Coombs test detect?

A

Antibodies and/or complement on the RBC cell surface.

194
Q

What is the purpose of the Indirect Coombs test?

A

To detect antibodies in the serum.

195
Q

When is the Direct Coombs test used?

A

For autoimmune hemolysis (warm or cold), drug-induced hemolysis, and alloimmune hemolysis.

196
Q

How is Pseudo Macrocytosis identified in the lab?

A

By observing agglutination and an MCV usually >125 fL.

197
Q

What MCHC value indicates intravascular hemolysis?

A

MCHC >360 g/L.

198
Q

How should blood samples with strong agglutination be handled in the lab?

A

Do not run them on the analyzer, make a blood film, warm the blood to 37oC, and stain the smear.

199
Q

What should be done when MCHC >360 g/L in the lab?

A

Examine the PBF immediately for spherocytes/hemolysis and then prioritize accordingly.

200
Q

What should be done if agglutination is observed with no spherocytes?

A

Drop priority to routine and correct the sample by warming it to 37oC.

201
Q

What is the message for RBC morphology in the lab when agglutination is present?

A

“Agglutination present” and “Agglutination disperses at 37oC”.

202
Q

What should be done if there is no sign of agglutination on the warm smear?

A

Accept the analyzer results and report the morphology from the warm slide.

203
Q

What objective is used for quick scanning of the entire thick film?

A

10X

204
Q

At what power can intermediate stages be easier to find on the film?

A

10X

205
Q

What is the purpose of using a 50X OI objective?

A

To improve the efficiency of scanning

206
Q

At what power are the entire readable area of thin films and the entire smear of thick films examined?

A

100X OI

207
Q

What is the main focus initially when examining a routine smear or a Giemsa smear for malaria?

A

Identifying any positive malaria - is it falciparium or non falciparium

208
Q

Which species of malaria is the most aggressive and infectious?

A

Plasmodium falciparium

209
Q

What confirms the presence of Plasmodium falciparium?

A

Banana gametocytes

210
Q

What are some symptoms of babesia infection?

A

Fever, chills, muscle aches, low blood pressure, severe headache, liver problems, abdominal pain, nausea, kidney failure

211
Q

What is the cause of Lyme disease?

A

Four species of Borrelia sp. bacterium

212
Q

What is the vector for anaplasmosis?

A

Black-legged tick

213
Q

What type of blood cells does Anaplasma phagocytophilum target?

A

Neutrophils

214
Q

What organism causes Chaga’s disease?

A

Trypanosoma cruzi

215
Q

What is the most common route of transmission for Trypanosoma cruzi?

A

Insect vector

216
Q

Which continent is Sleeping Sickness prevalent?

A

Africa

217
Q

What is the mode of transmission for Trypanosoma brucei?

A

Animal to human

Transfusion (7 decks)

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