RECALLS

By
Ma’am Leah Navarro

Isolation techniques:
1. Prevent spread of infection from patient to hospital personnel
2. Prevent spread of infection from patient to other patients
3. Protect infection prone patient from pathogens
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STRICT ISOLATION: Gown, mask and gloves
ENTERIC ISOLATION: Gown and gloves
RESPIRATORY ISOLATION: Mask, gloves
WOUND AND SKIN ISOLATION: Gown and gloves
PROTECTIVE ISOLATION: Gown, mask, gloves, shoe coverings

SENSITIVITY: the probability that an individual with the disease will have a positive test result;
no false negatives
SPECIFICITY: the probability that an individual without disease will have a negative test result;
no false positives
 HEMATOLOGY
Platelet satellitosis (platelet encircling the peripheral borders of neutrophils) is seen in a rare patient
whose blood is anticoagulated with EDTA. This phenomenon is thought to be due to a serum factor
which reacts in the presence of EDTA.

PLATELET ACTIVATION PATHWAYS

1. Eicosanoid synthesis pathway, alternatively called the prostaglandin, cyclooxygenase, or
thromboxane pathway
2. Inositol Triphosphate–Diacylglycerol Activation (IP3-DAG) Pathway

SIGNAL AMPLIFICATION Branched DNA

Hybrid Capture Assays
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TARGET AMPLIFICATION
Polymerase Chain Reaction
Transcription-Based Amplification
Strand-Displacement Amplification
Loop-Mediated Amplification
Helicase-Dependent Amplification
Nicking Endonuclease Amplification
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PROBE AMPLIFICATION
Cleavase/Invader Technology

Viral load may be used to monitor effectiveness of therapy

DIC, although characteristically identified through its hemorrhagic symptoms, is classified as a
THROMBOTIC DISORDER

ACUTE DIC (UNCOMPENSATED): PT, PTT, and thrombin time are prolonged; the fibrinogen level is
reduced to less than 100 mg/dL; and fibrin degradation products, including D-dimers, are significantly
increased
CHRONIC DIC (COMPENSATED): Only elevated test result may be the D-dimer assay value, a hallmark of
unregulated coagulation and fibrinolysis

Plasma transports at least 16 procoagulants, also called coagulation factors.

Plasma transports at least 16 procoagulants, also called coagulation factors. Nearly all are
glycoproteins synthesized in the liver, although monocytes, ECs, and megakaryocytes produce a few.
Eight are enzymes that circulate in an inactive form called zymogens. Others are cofactors that bind,
stabilize, and enhance the activity of their respective enzymes.

The plasma procoagulants may be serine proteases or cofactors, except for factor XIII, which is a
transglutaminase.

Serine proteases are synthesized as inactive zymogens consisting of a single peptide chain. Activation
occurs when the zymogen is cleaved at one or more specific sites by the action of another protease
during the coagulation process.

Fibrinogen, which has been implicated as a primary risk factor for thrombotic disorders, increases
approximately 10 mg/dL per decade in the elderly (65 to 79 years) and Per decade 10 mg/dL

Definitive diagnosis of VWD

Depends on the combination of a personal and family history of mucocutaneous bleeding and the
laboratory demonstration of decreased VWF activity.
INITIAL WORK_UP FOR vWD: A CBC is necessary to rule out thrombocytopenia as the cause of
mucocutaneous bleeding, and PT and PTT, which assess the coagulation system, are part of the initial
VWD workup. No longer recommended are the bleeding time test and the PFA-100 or other automated
functional platelet assays.

BLOODBANK AND SEROLOGY

B lymphocytes are stimulated to produce antibodies to HIV, which can usually be detected in the host’s
serum by 6 weeks after primary infection. The first antibodies to be detected are directed against the
gag proteins such as p24, followed by production of antibodies to the envelope, pol, and regulatory
proteins.

HIV
SEXUAL CONTACT 12 MONTHS DEFERRAL
CLOSE CONTACT NO DEFERRAL
Women who have had sex with men who have had sex with another man, even once since 1977, should
be deferred for 12 months. There is no tangible evidence of HIV being transmitted by close contact
(living in the same house, working with, shaking hands, kissing, etc.); therefore, potential donors who
meet the definition of being in close contact with someone with AIDS or an HIV-positive individual need
not be deferred
HEPATITIS
SEXUAL CONTACT AND CLOSE CONTACT 12 MONTHS DEFERRAL
Sexual contact or living with a person (“close contact”) who has acute or chronic hepatitis B (test
positive for HBsAg or HBV) or who has symptomatic hepatitis C or other hepatitis virus requires a 12-
month deferral following discontinuation of the “close contact.” FDA defines “living with” as residing in
the same dwelling (house, apartment, or dormitory).

VALIDATION OF BLOOD UNITS PRIOR TO ISSUANCE

The following information requires validation before the blood or blood components is cleared for
issuance:
Result of TTI screening tests
Results of ABO and Rh grouping
Complete data on the blood unit label
Confirmation, if for autologous transfusion, when applicable
The two (2) authorized Medical Technologists on duty shall validate the above information by
crosschecking the laboratory forms with the appropriate logbooks.

PROCEDURE OF PATIENT IDENTIFICATION

Bedside check is a vital step in preventing transfusion error and staff must be vigilant in checking the
patients identification details match those on the blood transfusion prescription or report form and the
compatibility label attached to the blood pack. At least two member of staff, at least one must be a
doctor or a registered nurse, should be responsible for carrying out identify check of the patient and the
unit of blood at the patients’ bedside. (BCSH, 1999) (Grade A; Level 3) A blood transfusion compatibility
report form and/or the blood transfusion prescription sheet must be signed by the member of the staff
carrying out the identify check and the date and time of the commencement of the transfusion of each
unit of blood or blood component indicated on both.