With the results below, do you think the patient requires a transfusion? Using current guidlines to support your answer , explain your reason. Investigation Result (normal range - female) Haematology Red cell count (x 1012/L) 4.0 (3.8 – 5.8) Haemoglobin (g/L) 123 (115 – 165) White cell count (x 109/L) 8.1 (3.6 – 11.0) neutrophils 2.9 (1.8 – 7.5) lymphocytes 4.5 (1.0 – 4.0) monocytes 0.62 (0.2 – 0.8) eosinophils 0.10 (0.1 – 0.4) basophils 0.02 (0.02 – 0.1) Platelets (x 109/L) 138 (140 – 400) Prothrombin Time (s) 20 (10 – 14) Activated Partial Thromboplastin Time (s) 45 (22 – 36) Biochemistry Serum Bilirubin (µmol/L) 50 (≤21) Serum ALP (IU/L) 300 (30 – 130) Serum AST (IU/L) 527 (≤32) Serum ALT (IU/L) 650 (10 – 35) Serum albumin (g/L) 37 (35 – 50) Urine: Microscopy Faeces: Microscopy WBC <5 per ml No Cryptosporidium seen RBC <5 per ml No ova cysts or parasites seen in wet prep Epithelial cells – moderate numbers No ova cysts or parasites seen in concentrate Culture Faeces: Culture No significant growth No Salmonella, Shigella, Campylobacter, E. coli O157 or Vibrios isolated Hepatitis test Test result HBsAg Positive Anti-HBc Positive IgM Anti-HBc Borderline Anti-HBs Negative Forward group Antibody Screen IAT 37°C Anti-A Anti-B Anti-D Cell I Cell II Cell II Patient cells 0 4 4 0 0
With the results below, do you think the patient requires a transfusion? Using current guidlines to support your answer , explain your reason.
|
Investigation |
Result (normal range - female) |
|
Haematology |
|
|
Red cell count (x 1012/L) |
4.0 (3.8 – 5.8) |
|
Haemoglobin (g/L) |
123 (115 – 165) |
|
White cell count (x 109/L) |
8.1 (3.6 – 11.0) |
|
neutrophils |
2.9 (1.8 – 7.5) |
|
lymphocytes |
4.5 (1.0 – 4.0) |
|
monocytes |
0.62 (0.2 – 0.8) |
|
eosinophils |
0.10 (0.1 – 0.4) |
|
basophils |
0.02 (0.02 – 0.1) |
|
Platelets (x 109/L) |
138 (140 – 400) |
|
Prothrombin Time (s) |
20 (10 – 14) |
|
Activated Partial Thromboplastin Time (s) |
45 (22 – 36) |
|
Biochemistry |
|
|
Serum Bilirubin (µmol/L) |
50 (≤21) |
|
Serum ALP (IU/L) |
300 (30 – 130) |
|
Serum AST (IU/L) |
527 (≤32) |
|
Serum ALT (IU/L) |
650 (10 – 35) |
|
Serum albumin (g/L) |
37 (35 – 50) |
|
Urine: Microscopy |
Faeces: Microscopy |
|
WBC <5 per ml |
No Cryptosporidium seen |
|
RBC <5 per ml |
No ova cysts or parasites seen in wet prep |
|
Epithelial cells – moderate numbers |
No ova cysts or parasites seen in concentrate |
|
Culture |
Faeces: Culture |
|
No significant growth |
No Salmonella, Shigella, Campylobacter, E. coli O157 or Vibrios isolated |
|
Hepatitis test |
Test result |
|
HBsAg |
Positive |
|
Anti-HBc |
Positive |
|
IgM Anti-HBc |
Borderline |
|
Anti-HBs |
Negative |
|
|
Forward group |
Antibody Screen IAT 37°C |
||||
|
|
Anti-A |
Anti-B |
Anti-D |
Cell I |
Cell II |
Cell II |
|
Patient cells |
0 |
4 |
4 |
0 |
0 |
0 |
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