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CCHS SBB > Antibody Identification > Flashcards

Antibody Identification Flashcards

1
Q

agency that controls blood bank reagents

A

Bureau of Biologics of FDA

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2
Q

types of blood bank reagents

A

high protein, monoclonal, chemically modified, human-derived

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3
Q

ABO reagents

A

commercially prepared anti-A, anti-B, anti-A,B, anti-A1, A1 and B cells

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4
Q

RH reagents

A
  • monoclonal IgM antibody reactive at room temp

- monoclonal polyclonal blend includes IgG antibody for weak D detection

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5
Q

uses of indirect antiglobulin test

A 
antibody screen/panel
crossmatch
weak D testing
leukocyte and platelet antibody test
detection of autoantibodies
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6
Q

uses of direct antiglobulin test

A

detection of autoantibodies
HDFN
transfusion reactions
RBC sensitization by drugs

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7
Q

examples of enhancement media

A 
LISS
PEG
22% bovine serum albumin
gel column agglutination
solid-phase technology
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8
Q

what should be suspected if autocontrol is positive but DAT is negative?

A

antibodies to LISS and PEG enhancement media ingredients

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9
Q

mechanism: LISS

A

low ionic strength saline; reduced ionic strength in comparison to normal saline

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10
Q

which enhancement media(s) is used to enhance reactivity and decrease incubation time for antibody identification?

A

LISS, PeG

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11
Q

which enhancement media may enhance autoantibodies?

A

LISS

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12
Q

mechanism: PeG

A

polyethylene glycol; linear polymer that is water-soluble; steric exclusion of water molecules in the diluent

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13
Q

what enhancement may enhance warm autoantibodies?

A

PEG

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14
Q

what enhancement enhances detection of clinically significant antibodies along with decreasing detection of clinically insignificant antibodies?

A

PEG

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15
Q

mechanism: 22% bovine serum albumin

A

helps reduce repulsive charges between red cells during antibody detection, promoting agglutination

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16
Q

what enhancement may enhance cold autoantibodies?

A

22% bovine serum albumin

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17
Q

principle use of enhancement media

A

reduce incubation time and increase reaction strength

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18
Q

what media enhances linked lattice formation by reducing net negative charge of red cells, allowing the cells to come closer together?

A

albumin

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19
Q

what media enhances antibody uptake by reducing zeta potential and allowing increased attraction between positively charged antibodies and negatively charged red cells?

A

LISS

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20
Q

what media enhances antibody-antigen binding by excluding water from around the red cells, effectively concentrating the antibody and favoring binding to its target antigen?

A

PEG

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21
Q

what media enhances linked lattice formation by decreasing the net negative charge of the red cells by removing sialic acid residues to allow the red cells to come closer together?

A

enzyme treatment

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22
Q

what media enhances formation of the linked lattice by neutralizing the negative charges of the sialic acid residues on the red cells, allowing red cells to get closer together?

A

polybrene

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23
Q

media that can enhance reactivity of weak Kidd and Duffy antibodies

A

PEG

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24
Q

enhancement that may not pick up IgM antibodies such as ABO or Lewis

A

PEG

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25
Q

enhancement that can result in spontaneous agglutination

A

polybrene

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26
Q

avidity

A

speed at which standardized endpoint is attained (strength)

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27
Q

titer

A

reciprocal of greatest dilution that gives 1+ agglutination (amount)

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28
Q

requirements at reagent arrival

A

dated and stored at optimal temp

expiration date and appearance noted and recorded

29
Q

QC of antigen typing sera

A

heterozygous positive control

negative control

30
Q

naturally occurring antibody common class

A

IgM

31
Q

immune stimulated antibody common class

A

IgG

32
Q

antibodies to substances in the environment that are antigenically similar to red cell antigens are ___ (naturally occuring or immune stimulated)

A

naturally occurring

33
Q

definition: clinically significant antibody

A

causes HDFN or HTR or noticeable decrease in transfused red cell survival

34
Q

preanalytical patient medical history considerations in antibody identification

A

transfusion, pregnancy, disease, drugs, rare phenotype

35
Q

analytical considerations in antibody identification

A

specimen requirements, reagents, serological procedures, factors affecting antibody identification

36
Q

p value requirement of antibody identification

A

<0.05

37
Q

causes of positive autocontrol

A

autoantibodies (Warm and cold)
recent transfusion/DHTR
drug-induced issues
passively acquired antibodies

38
Q

source of ficin

A

figs

39
Q

source of papain

A

papaya

40
Q

source of trypsin

A

pig stomach

41
Q

source of bromelin

A

pineapple

42
Q

antigens destroyed by enzyme treatment

A

M, N, Fya, Fyb, Xga, JMH, Ch, Rg

43
Q

antigens enhanced by enzyme treatment

A

Rh, Lewis, Kidd, P, I

44
Q

mechanism of enzyme treatment

A

cleave membrane glycoproteins and sialic acid residues that link amino acid chains together

45
Q

antigens unaffected by enzyme treatment

A

Kell
Diego
Colton

46
Q

mechanism of thiol reagents

A

disrupt disulfide bonds that connect J chain of IgM molecule; denatures IgM molecules so they can’t agglutinate or bind complement

47
Q

thiol reagents

A

DTT
2-ME
AET

48
Q

reagent used to distinguish IgM from IgG

A

thiol

49
Q

what enzyme denatures CD38 antigen

A

thiol

50
Q

antibody seen in Dara patients

A

anti-CD38

51
Q

thiol reagent effect on Kell antigens

A

destroys

52
Q

mechanism of ZZAP

A

denatures DTT sensitive antigens along with antigens that are sensitive to enzymes

53
Q

mechanism of chloroquine diphosphate

A

dissociate IgG from red cell membrane; weakens class I HLA antigen expression along with other antigens including Rh

54
Q

reagent used to remove bound antibody so cells can be antigen typed using antisera that require IAT testing

A

glycine acid/EDTA, chloroquine diphosphate

55
Q

what antibodies can be enhanced by lowering pH to 6.5

A

anti-M, some anti-U

56
Q

how to lower pH to 6.5

A

1 volume 0.1N HCl to 9 volumes serum

57
Q

lowering pH to <6.0 can decrease or diminish reactivity of what blood groups

A

Rh, Duffy, Kidd

58
Q

Lewis inhibition substance

A

saliva of individual with Lewis gene

59
Q

P1 inhibition substance

A

hydatid cyst fluid, pigeon eggs

60
Q

Sda inhibition substance

A

urine from Sda positive individual

61
Q

Chido and Rodgers inhibition substance

A

plasma from Ch+Rh+ individual

62
Q

what is required to interpret results from inhibition techniques?

A

overall test result is nonreactive and dilution control is negative

63
Q

mechanism: adsorption

A

antibodies removed from patient serum by adsorbing onto red cells which express the corresponding antigen

64
Q

normal serum:cell ratio for adsorption

A

1:1

65
Q

mechanism: elution

A

bound antibody is released by changing of thermodynamics to recover bound antibody into usable form

66
Q

heat/freeze-thaw elution use

A

ABO incompatibility from ABO HDFN

67
Q

acid/organic solvent elution use

A

warm autoantibodies and alloantibodies

68
Q

mechanism: titration

A

testing twofold serial dilutions of patient’s serum with preselected red blood cells to provide relatively how much antibody is present in patient’s serum or given strength of red blood cell antigen expression

CCHS SBB (40 decks)

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