MEDT 4600
Blood Bank Review
Case Gaze
Affected person Title: Mindy Jones
Affected person MR #: 001521098
A newly identified sickle cell patient has been admitted to the clinical institution in disaster. Mindy Jones is a 3 -yr
inclined female who presented to the emergency room with excessive abdominal grief and grief in her lower left
leg. Lab values indicated a critically low hemoglobin (6.5 g/dL) and Hematocrit (19%). Her peripheral
blood smear showed moderate polychromasia, gentle to moderate drepanocytes, gentle target cells, and 8
nRBCs/100 WBCs counted. Additional phenomenal findings encompass her chemistry panel with elevated LDH
(450 IU/L) and sing bilirubin (2.5 mg/dL). Her physical exam printed splenomegaly and gentle
respiratory hurt. The of us each and each indicated that she had by no approach been hospitalized or treated with
transfusions. The admitting doctor ordered the next extra labs: Reticulocyte depend,
Hemoglobin Electrophoresis, Form and Display camouflage, and a Crossmatch for 1 unit.
Q1. What elevate out the distinctive hematology and chemistry lab values and clinical exam expose in regards to the
patient’s fresh hematology clinical image?
Q2. Why did the doctor philosophize every of the extra labs mentioned?
Q3. The patient’s absolute reticulocyte depend modified into as soon as elevated at 90.3 x 10^9/L. What does the info
contribute to the hematologic image?
Q4. The hemoglobin electrophoresis printed 90% HbSS, 7% HbF, and 3% HbA2. Does this confirm the
customary diagnosis? How did you reach your conclusion?
The doctor wrote an disclose to transfuse the patient with one unit of pRBCs and initiate 15mg/kg per day
hydroxyurea. Her hemoglobin answered accurately and she or he perceived to be responding positively to
treatment. On her fourth day of admission, he ordered for one extra unit of pRBC to be transfused earlier than
discharge. The blood financial institution requested one more form and display camouflage camouflage.
Q5. Why did the blood financial institution ask one more sample?
An hour after receiving the sample, the blood financial institution known as the bottom informing them that there shall be
a extend due to a definite antibody display camouflage camouflage. Discuss with the pdf attachment with patient outcomes. Complete
the ID and reply the next questions.
Q6. How did the patient change into sensitized to kind an antibody?
Q7. What antibody did you name?
Q8. Own been you ready to rule-out all varied antibodies with two “double-dose” cells?
Q9. What cells did you use to rule-in in accordance with the three×3 rule?
Q10. Why are cells #1, 6, and 11 weaker than the more than a few definite reactions on Panocell-16?
Q11. What data does the auto-retain watch over chase as “PC” on the Panocell-16 provide touching on the
kind of antibody that that the patient is exhibiting? Why is this indispensable?
Q12. The blood financial institution modified into as soon as ready to search out a esteem minded unit for the patient. What particular necessities
must this patient include real looking when deciding on the most productive unit for transfusion? Rob into consideration
each and each her diagnosis and antibody position.
Q13. The doctor determined to add Mindy Jones to their clinical institution’s Sickle Cell Transfusion Protocol.
Which sample must the bloodbank resolve to construct an prolonged phenotype, the one drawn on
3/9/16 or the second one drawn on 3/13/16?
Q14. What kind of panel cell must be chosen for a definite retain watch over for the anti-sera passe to construct
the prolonged phenotype? Single- or double-dose? Why is this indispensable?
Q15. What is the motive of finding phenotype-matched blood for chronically transfused patients?
Q16. Referring to the linked phenotype, elevate out these outcomes confirm the identified antibody?
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