Antibody ID Flashcards

1
Q

Do you phenotype auto-Ab positive or negative?

A

Only auto-Ab negative can be phenotyped

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2
Q

Haplotype

A

Antigens inherited together on same chromosome

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3
Q

Clinically significant Ab

A
  • React at body temp and can cause HDN and/or HTR (some type of immune response)
  • Can destroy transfused Ag-pos RBCs
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4
Q

Allo-antibody

A
  • Preventable
  • Patient missing Ag
  • Treat by transfusing compatible cells
  • Same species but diff person from you
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5
Q

Auto-antibody

A
  • Unrelated to transfusion
  • Patient has the antigen
  • Treat by transfusing only as necessary
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6
Q

Auto-control

A
  • self vs self
  • Pt RBCs 3% solution against Pt plasma
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7
Q

Phenotype (referring to protocol)

A
  • Self vs antibody
  • antibody is known reagent
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8
Q

Antibody ID

A
  • Self vs cell
  • Pt plasma vs known screen cells
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9
Q

Low-incidence Ag

A

Less than 10% of population

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10
Q

Give examples of low-incidence Ag

A
  • Cw
  • V
  • Kpa
  • Jsa
  • Lua
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11
Q

High-incidence Ag

A

Greater than 90% of the population

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12
Q

Give examples of high-incidence Ag

A
  • Kell sellano (k)
  • Kpb
  • Jsb
  • Lub
  • Leb
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13
Q

HTLA stands for

A

High Titer Low Avidity Antibodies

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14
Q

Describe HTLA

A
  • Weakly reactive but really big titer
  • May block other Ab from being detected
  • Do not cause HDN/HTR, so clinically insignificant
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15
Q

How do you diagnose HTLA?

A
  • Antibody Titer: You serially dilute the antibody and test to see if it’s still there at super dilute levels
  • HTLA will be present no matter how dilute
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16
Q

Give two examples of HTLA

A
  • Chido/Rogers
  • JMH
17
Q

How do you remove Chido/Rogers if it’s causing HTLA disturbance?

A

Neutralize with plasma

18
Q

How do you remove JMH if it’s causing HTLA disturbance?

A

Destroy with enzyme

19
Q

What do HTLA titer results look like?

A

The bottom row shows HTLA

20
Q

List all steps for finding compatible blood from start to finish

A
  1. ABO blood type fwd + rvs
  2. Ab Screen
  3. Ab panel (big screen) + auto-control
  4. Select cells
  5. Phenotype
  6. Find compatible blood
  7. AHG crossmatch
21
Q

Antibody screen procedure start to finish GO!

A
  1. 2 drops pt plasma + 1 drop screen cells I/II/or III and do IS reaction grade
  2. Add 2 drops of LISS
  3. 15 min inc at 37°C and do reaction grade
  4. Wash 4x
  5. Add 2 drops anti-IgG
  6. AHG reaction grade
  7. Add 1 drop check cells to negative reactions only
22
Q

Rule of 3 is for

A

Rule in only

23
Q

T/F
Auto-control results may indicate if a patient was transfused or not

A

True

24
Q

How many points for 1 homozygous rule out?

A

2

25
Q

How many points for 1 heterozygous rule out?

A

1

26
Q

Which antigen systems are exceptions to the rule of 3 and why?

A
  • Kidd and Duffy because high dosage
  • Homozygous rule outs only
27
Q

T/F
Always phenotype patient blood

A

False
Always phenotype donor blood

28
Q

When do you phenotype patient blood?

A
  • New antibody found
  • Patient not previously typed for antigen
29
Q

When do you NOT phenotype patient blood?

A
  • Auto-control has mixed-fixed field
  • Recent transfusion (past 2-4 wk)
  • Already phenotyped for antigen
30
Q

When do you NOT phenotype donor blood?

A
  • Ab is non-specific and/or antisera for Ag doesn’t exist
  • Ab clinically insignificant
  • Ab is auto-antibody
31
Q

If auto-control is positive in the IS phase, where will you see issues?

A

ABO typing

32
Q

If auto-control is positive in the AHG phase, where will you see issues?

A

Phenotype testing

33
Q

An auto-control gives a mixed-field result. Is this valid?

a. Yes, the result shows the patient has an auto-Ab
b. Yes, the patient has probably been recently transfused
c. No, the panel cells cannot give mixed field results, something is wrong with the test system
d. No, the control has failed, the test must be repeated until it gives valid results

A

b. Yes, patient has probably been recently transfused

34
Q

What is phenotype testing?

A

After you have ID’d the Ab, you want to prove yourself right by testing patient RBCs against known antisera (for Ab you ID’d) and expect no agglutination because patient should not have the antigen it has made an antibody against