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Wednesday, January 07, 2009

What will be the appropriate investigation for a 40 female with jaundice and spherocytosis

Question 84
What will be the appropriate investigation  for a 40 female with jaundice and spherocytosis
a.       Osmotic fragility
b.      Coomb's test
c.       Electrophoresis
d.      ??
Answer
b. Coomb’s Test
Reference
Harrison 16th Edition Page 609
QTDF
Harrison
Quality
Reader
Status
New
Discussion
 Hereditary spherocytosis must be distinguished primarily from the spherocytic hemolytic anemias associated with RBC antibodies. The family history of anemia and/or splenectomy is helpful, when present.
Explanation
The diagnosis of immune spherocytosis is usually readily established by a positive direct Coombs test
Comments
Spherocytes are also seen in association with hemolysis induced by splenomegaly in patients with cirrhosis, in clostridial infections, and in certain snake envenomations (due to the action of phospholipases on the membrane). A few spherocytes are seen in the course of a wide variety of hemolytic disorders, particularly glucose-6-phosphate dehydrogenase (G6PD) deficiency
Tips
Many Questions in AIIMS Papers have something called as NESTROF Test. It is nothing but “Naked Eye Single Tube Redcell Osmotic Fragility Test”

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