Patient Title: Mindy Jones
Patient MR #: 001521098
A newly recognized sickle cell affected person has been admitted to the health facility in disaster. Mindy Jones is a 3-twelve months
worn female who equipped to the emergency room with extreme stomach anguish and anguish in her decrease left
leg. Lab values indicated a critically low hemoglobin (6.5 g/dL) and Hematocrit (19%). Her peripheral
blood smear confirmed life like polychromasia, light to life like drepanocytes, light target cells, and eight
nRBCs/100 WBCs counted. Additional irregular findings consist of her chemistry panel with elevated LDH
(450 IU/L) and yell bilirubin (2.5 mg/dL). Her bodily examination published splenomegaly and light-weight
respiratory damage. The opposite people both indicated that she had never been hospitalized or treated with
transfusions. The admitting doctor ordered the next additional labs: Reticulocyte depend,
Hemoglobin Electrophoresis, Kind and Mask, and a Crossmatch for 1 unit.
Q1. What manufacture the fresh hematology and chemistry lab values and clinical examination shroud in regards to the
affected person’s fresh hematology clinical image?
Q2. Why did the doctor repeat every of the additional labs talked about?
Q3. The affected person’s absolute reticulocyte depend became elevated at 90.3 x 10^9/L. What does the recordsdata
make a contribution to the hematologic image?
Q4. The hemoglobin electrophoresis published 90% HbSS, 7% HbF, and 3% HbA2. Does this verify the
normal prognosis? How did you reach your conclusion?
The doctor wrote an repeat to transfuse the affected person with one unit of pRBCs and originate 15mg/kg per day
hydroxyurea. Her hemoglobin spoke back precisely and she perceived to be responding positively to
treatment. On her fourth day of admission, he ordered for yet yet any other unit of pRBC to be transfused sooner than
discharge. The blood financial institution requested one other kind and shroud.
Q5. Why did the blood financial institution quiz one other pattern?
An hour after receiving the pattern, the blood financial institution called the bottom informing them that there might presumably well be
a extend ensuing from a obvious antibody shroud. Refer to the pdf attachment with affected person results. Total
the ID and acknowledge the next questions.
Q6. How did the affected person change into sensitized to develop an antibody?
Q7. What antibody did you establish?
Q8. Were you in a situation to rule-out all other antibodies with two “double-dose” cells?
Q9. What cells did you make use of to rule-in in step with the 3×3 rule?
Q10. Why are cells #1, 6, and 11 weaker than the opposite obvious reactions on Panocell-16?
Q11. What recordsdata does the auto-protect watch over flee as “PC” on the Panocell-16 present in regards to the
form of antibody that that the affected person is exhibiting? Why is this important?
Q12. The blood financial institution became in a situation to search out a admire minded unit for the affected person. What particular requirements
might presumably well devour to this affected person devour taken into consideration when selecting the fully unit for transfusion? Rob below consideration
both her prognosis and antibody deliver.
Q13. The doctor made up our minds to add Mindy Jones to their health facility’s Sickle Cell Transfusion Protocol.
Which pattern might presumably well devour to the bloodbank resolve to manufacture a long phenotype, the one drawn on
3/9/16 or the second drawn on 3/13/16?
Q14. What form of panel cell must be chosen for a obvious protect watch over for the anti-sera former to manufacture
the extended phenotype? Single- or double-dose? Why is this important?
Q15. What’s the explanation of discovering phenotype-matched blood for chronically transfused patients?
Q16. Referring to the attached phenotype, manufacture these results verify the known antibody?
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