26 January 2020 (Sunday) - BTLP-TACT Excercise

It was time for another BTLP-TACT exercise. I logged on and was presented with two cases.

68902 – a twenty-five year old woman in A&E requiring two units of blood tomorrow

04701 – a forty-year old woman in the haematology clinic also requiring two units of blood tomorrow (irradiated blood)

  

Case 68902

This grouped as O Rh(D) Negative with a positive antibody screen. The panel showed anti-C and anti-D and could not rule out anti-Cw

Two units of O Neg D Neg C Neg were selected

Case 04701

This grouped as A but with what looked like a weak D reaction. I called it A Rh uninterpretable. The weak D needs further investigation.

This one also had a positive antibody screen which looked to be anti-D but anti-Cw cold not be ruled out.

I gave O Neg irradiated because of the iffy Rh group…

I got the green light. I was pleased about that…

24 January 2020 (Friday) - Look At This...

I saw this in a blood film today, and fetched everyone to come and have a look

MOUSE M              D1234567           01.02.33 M TW12   Dr D Duck R,20.3005334.Q       R 24.01.20  Clinical details  UGI bleed, possible pneumonia​             HBM   WBCM    PLT    HCT   RBCM   MCVM   MCHM  MCHCM    RDW      N 220120 F     97  10.41    125  0.289   2.88  100.3   33.7    336   18.6   8.29 230120 F     90   9.16    117  0.267   2.58  103.5   34.9    337   19.1   7.44 230120 F     90   9.40    132  0.276   2.69  102.6   33.5    326   19.2   7.92 240120 F     94   7.59    134  0.285   2.74  104.0   34.3    330   19.3   6.18               L      M      E      B   NRBC    ESR     GF 220120 F   1.10   0.89   0.09   0.04   0.05               230120 F   0.78   0.83   0.08   0.03   0.07               230120 F   0.62   0.72   0.09   0.05   0.08               240120 F   0.54   0.79   0.05   0.03   0.06

What’s caused the basophilic stippling in this case? I don’t really know. But from this link https://www.ncbi.nlm.nih.gov/pubmed/6202140 and this link https://en.wikipedia.org/wiki/Basophilic_stippling​ (good old wikipedia!!) basophilic stippling would seem to be a rather non-specific finding, and has been replaced by more specific tests in cases of suspected lead poisoning.

23 January 2020 (Thursday) - Bcr-Abl tyrosine-kinase inhibitors

The subject of Bcr-Abl tyrosine-kinase inhibitors came up at work today. I’m not going to pretend that I had the faintest idea, so I looked it up. As always Wikipedia gave the most concise description to the layman.

I won’t pretend that I understood it all, but I understand more than I did, and (as I always say) a day when you learn nothing is a day wasted…