The nice people at the Fritsma Factor sent
their update today. This time there’s quite a bit of stuff which went over
my head. Perhaps it shouldn’t… which is why I do CPD…
This is (supposed to be) a reflective diary by a (not very) anonymous biomedical scientist who works somewhere in the south of England. One day this diary may well be submitted to the Health and Care Professions Council as evidence of ongoing continual professional development....
2 June 2026 (Tuesday) - BTLP-TACT Exercise
I’m always getting prompts to do more
BTLP-TACT exercises, I’ve walked the dogs, and it is raining outside anyway…
I was given two cases:
I was given two cases:
33586 – a thirty-year-old woman with appendicitis needing group and save.She grouped as O Rh(D) Positive with a negative antibody screen.15253 – an eight-one-year-old woman needing four units of blood for a pancreatectomy.She grouped as B Rh(D) Positive with an antibody screen positive in cells 2 & 3.I performed antibody panels.The enzyme and IAT panels were positive in cells 1, 3, 4, 6 & 7 corresponding with anti Jk(a) but not excluding anti-Cw.I scared up four units of various compatible ABO and RH groups that were Jk(a) Negative
I got it wrong…
Anti-Cw *could* have been excluded from the screening panel. Dur !!!
But if that was the only hiccup I’m content. Better to err on the side of caution, eh?
1 June 2026 (Monday) - VEXAS Syndrome
I saw a diagnosis today: VEXAS syndrome.
A new one on me – it is an adult-onset, severe autoinflammatory and blood
disorder caused by a random, acquired mutation in the UBA1 gene. It primarily
affects men over fifty. The name is an acronym outlining its core
characteristics:
· Vacuoles in bone marrow cells
· E1
enzyme malfunction
· X-linked
genetic origin
· Autoinflammation
(immune system attacking healthy tissue)
· Somatic mutation (not inherited)
Here’s a link about it.
31 May 2026 (Sunday) - Slide Saturday Challenge
At first sight I agreed with the people who’d said it was some sort of haemoglobinopathy… OK there were target cells there. But in a haemoglobinopathy the red cells are a tad more uniform. These ones are all over the place. Massive anisopoikilocytosis with cell fragments, tear drop cells, spherocytes…
That’s some sort of microangiopathic haemolytic condition…
27 May 2026 (Wednesday) - Westgard QC Update
The nice people at Wesgard QC sent their update today. You can read it by clicking here. I did. I’d suggest you do to, but I’ve got a degree in maths and I found it heavy going.
The headline “Has hematology quality
bled out?” caught my eye, but has it? I’d have to take Mr. Westgard’s word
for it if he says it has. The British Prime Minister Benjamin Disraeli was believed
to have ranted about "Lies, damned lies, and statistics" when
describing the deceptive power of numbers to bolster weak arguments. He might
have a point here, he might not. I don’t know.
Looking back in time to yesterday I
think I might have made my own (albeit informal) Westgard rule… due to a
minor problem the details of which are irrelevant here we had to leave
non-urgent blood films over the bank holiday weekend, and yesterday I spent the
afternoon catching up. A few patients who were clinically stable had blood
films made every day (the reasons for which are irrelevant here), and as
I reviewed the blood films I noticed that the results didn’t change much from
day to day. That’s not a bad QC measure, is it?
27 May 2026 (Wednesday) - BTLP-TACT Exercise
I’ve got half an hour before I need to
go to the late shift…
I was presented with two cases:
37192 – a twenty-one year-old woman in maternity needing group and saveHer ABO group was indeterminate, but she was Rh(D) Positive with a negative antibody screen46614 – a ninety-six year-ol d chap needing four untits of FFP for bleeding varices.He grouped as O Rh(D) Positive with antibody screen positive on cells 1 & 3. I performed antibody panels.The enzyme panel was negative throughout. The IAT panel was positive in cells 1, 3, 6, 9 and 10 corresponding with anti-Fy(a)FFP is NOT recommended for bleeding varices https://pubmed.ncbi.nlm.nih.gov/33969607/ so I didn’t issue any
I got the green light…
25 May 2026 (Monday) - Found on the Internet
I found this on one of the Facebook groups I follow this morning… It’s
not bad really…
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