How would the technologist differentiate between a traumatic specimen collection tap and a cerebral hemorrhage? Provide at least three macroscopic and three microscopic findings
What will be an ideal response?
nswer:
Macroscopic findings: traumatic tap
Decreasing gross blood in subsequent tubes; highest concentration of gross blood typically present in Tube 1with subsequent decreasing numbers in the remaining tubes
The presence of a clot in the sample; trauma to the body introduced by specimen collection, activating the coagulation cascade
The absence of xanthochromia. Xanthochromia indicating hemoglobin breakdown
Macroscopic findings: cerebral hemorrhage
Equal concentration of blood in all four tubes
No clot present in the sample
Presence of xanthochromia in the sample
Microscopic findings: traumatic tap
Intact RBCs in high numbers
No ingestion of RBCs by phagocytic cells
No hematoidin/hematin crystals present
No hemosiderin crystals present
Microscopic findings: cerebral hemorrhage
RBCs fragments often seen
Erythrophagocytosis present
Hemosiderin present
Hematoidin/hematin crystals present
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