Sample Lesson – Coombs (Indirect vs. Direct) Labs and Vignettes


Next Step: Make Cards on the Automatic Key Concepts, and Vignettes

Remember, the more you automatically know what each sentence means on your test, the better you will do. There are 4 stages in making interpretation more automatic:

  • Stage 1: Unable to Make Pathophysiologic Chronologies in Either Timed or Untimed setting
  • Stage 2: Basic Pathophysiologic Chronologies, but with Significant Gaps
  • Stage 3: Detailed Pathophysiologic Chronology Without Time, but Unable to Consistently Generate PC During Timed Setting
  • Stage 4: Consistent Pathophysiologic Chronologies in Timed Setting

My goal with these vignettes is to help you reach Stage 4. How do you do so?

  • With the Automatic Key Concept cards, you can master the underlying information to move past Stages 1 + 2.
  • Then, with the Vignette/Pathophysiologic Chronology cards, you can teach yourself to make these connections on your exam.

summary of key concepts:


labs interpretation:


Explain the relationship between the Direct Coombs test, hemoglobin, and bilirubin. Which bilirubin is most prominent?

Direct Coombs positive = RBCs coated with antibodies. In this context, it indicates autoimmune hemolytic anemia → RBC destruction → hemoglobin ↓ / production of bilirubin ↑ → indirect bilirubin >> direct bilirubin

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