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1
Q

is the study of blood group antigens and antibodies, HLA antigens and antibodies, pretransfusion testing, identification of unexpected alloantibodies, immune hemolysis, autoantibodies, drugs, blood collection, blood components, cryopreservation of blood, transfusion transmitted viruses, tissue banking and organ transplantation, blood transfusion practice, safety, quality assessment, records, blood inventory management, and blood usage review.

A

Immunohematology

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2
Q

foreign molecules that bind specifically to an antibody or a T-cell receptor.

A

Antigen

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3
Q

ells or tissue from a genetically different individual.

A

Allogeneic

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4
Q

cells or tissue from self.

A

Autologous

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5
Q

small-molecular-weight particle that requires a carrier molecule to be recognized by the immune system

A

Hapten

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6
Q

study of blood group antigens and antibodies.

A

Immunohematology

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7
Q

lymphocytes that mature in the bone marrow, differentiate into plasma cells when stimulated by an antigen, and produce antibodies.

A

B lymphocytes (B cells)

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8
Q

lymphocytes that mature in the thymus and produce cytokines to activate the immune cells including the B cell.

A

T lymphocytes (T cells)

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9
Q

secreted proteins that regulate the activity of other cells by binding to specific receptors. They can increase or decrease cell proliferation, antibody production, and inflammation reactions.

A

Cytokines

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10
Q

B cells produced after the first exposure that remain in the circulation and can recognize and respond to an antigen faster.

A

Memory B cells

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11
Q

antibody-producing B cells that have reached the end of their differentiating pathway.

A

Plasma cells

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12
Q

sites on an antigen that are recognized and bound by a particular antibody or T-cell receptor (also called epitopes).

A

Antigenic determinants

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13
Q

single antigenic determinants; functionally, they are the parts of the antigen that combine with the antibody.

A

Epitopes

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14
Q

family of cells or organisms having genetically identical constitution.

A

Clone

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15
Q

antigen in its role of eliciting an immune response.

A

Immunogen

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16
Q

simple sugars, such as monosaccharides and starches (polysaccharides).

A

Carbohydrates

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17
Q

fatty acids and glycerol compounds.

A

Lipids

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18
Q

is an antigen that provokes the immune response. Not all antigens are immunogens.

A

immunogen

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19
Q

glycoprotein (immunoglobulin) that recognizes a particular epitope on an antigen and facilitates clearance of that antigen.

A

Antibody

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20
Q

antibody; glycoprotein secreted by plasma cells that binds to specific epitopes on antigenic substances.

A

Immunoglobulin

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21
Q

larger polypeptides of an antibody molecule composed of a variable and constant region; five major classes of heavy chains determine the isotype of an antibody.

A

Heavy chains

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22
Q

smaller polypeptides of an antibody molecule composed of a variable and constant region; two major types of light chains exist in humans (kappa and lambda).

A

Light chains

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23
Q

one of five types of immunoglobulins determined by the heavy chain: IgM, IgG, IgA, IgE, and IgD.

A

Isotype

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24
Q

one of the two types of light chains that make up an immunoglobulin.

A

Kappa chains

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25
Q

one of the two types of light chains that make up an immunoglobulin.

A

Lambda chains

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26
Q

one of the two types of light chains that make up an immunoglobulin.

A

Lambda chains

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27
Q

amino-terminal portions of immunoglobulins and T-cell receptor chains that are highly variable and responsible for the antigenic specificity of these molecules.

A

Variable regions

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28
Q

non-variable portions of the heavy and light chains of an immunoglobulin.

A

Constant regions

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29
Q

variable part of an antibody or T-cell receptor; the antigen-binding site.

A

Idiotope

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30
Q

portion of the immunoglobulin heavy chains between the Fc and Fab region; provides flexibility to the molecule to allow two antigen-binding sites to function independently.

A

Hinge region

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31
Q

red cell destruction by phagocytes residing in the liver and spleen usually facilitated by IgG opsonization.

A

Extravascular hemolysis

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32
Q

number of epitopes per molecule of antigen.

A

Valency

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33
Q

red cell lyses occurring within the blood vessels usually by IgM activation of complement.

A

Intravascular hemolysis

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34
Q

having a combining power of two.

A

Bivalent

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35
Q

condition caused by destruction of fetal orneonatal red cells by maternal antibodies.

A

Hemolytic disease of the fetus and newborn

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36
Q

immune response induced by initial exposure to the antigen.

A

Primary immune response

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37
Q

method is necessary to detect antigen-antibody complexes involving IgG antibodies in vitro.

A

antiglobulin test

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38
Q

process of somatic mutations in the immunoglobulin gene causing the formation of variations in the affinity of the antibody to the antigen. B cells with the highest affinity are “selected” for the best fit, and the resulting antibody is stronger38. Secondary
immune response: immune response induced after a second exposure to the antigen, which activates the memory lymphocytes for a quicker response.

A

Affinity maturation

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39
Q

secondary immune response. Multiple stimulations of the immune system with the same antigen produce antibodies with increased binding strength as a result of affinity maturation.

A

Anamnestic response

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40
Q

complex of one or more antibody molecules bound to an antigen.

A

Immune complex

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41
Q

strength of the binding between a single antibody and an epitope of an antigen.

A

Affinity

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42
Q

overall strength of reaction between several epitopes and antibodies; depends on the affinity of the antibody, valency, and noncovalent attractive forces.

A

Avidity

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43
Q

compounds containing carbohydrate and protein molecules.

A

Glycoproteins

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44
Q

compounds containing carbohydrate and lipid molecules.

A

Glycolipids

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45
Q

visible clumping of particulate antigens caused by interaction with a specific antibody.

A

Agglutination

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46
Q

antibodies with specificities other than self; stimulated by transfusion or pregnancy.

A

Alloantibodies

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47
Q

test to determine the presence of alloantibodies.

A

Antibody screen test

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48
Q

group of serum proteins that participate in an enzymatic cascade, ultimately generating the membrane attack complex that causes lysis of cellular elements.

A

Complement system

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49
Q

C5 to C9 proteins of the complement system that mediate cell lysis in the target cell.

A

Membrane attack complex

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50
Q

lysis or rupture of erythrocytes.

A

Hemolysis

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51
Q

activation of complement that is initiated by antigen-antibody complexes.

A

Classical pathway

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52
Q

activation of complement that is initiated by foreign cell-surface constituents.

A

Alternative pathway

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53
Q

complement split products (C3a, C4a, and C5a) that mediate degranulation of mast cells and basophils, which results in smooth muscle contraction and increased vascular permeability.

A

Anaphylatoxins

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54
Q

products such as histamines released by basophils, mast cells, and platelets that act on the endothelium and smooth muscle of the local vasculature.

A

Vasoactive amines

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55
Q

movement of cells in the direction of the antigenic stimulus.

A

Chemotactic

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56
Q

substance (antibody or complement protein) that binds to an antigen and enhances phagocytosis.

A

Opsonin

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57
Q

molecules on the cell surface that have a high affinity for a particular ligand.

A

Receptors

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58
Q

system of mononuclear phagocytic cells, associated with the liver, spleen, and lymph nodes, that clears microbes and damaged cells.

A

Mononuclear phagocyte system

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59
Q

binding of antibody or complement components to a red cell.

A

Sensitization

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60
Q

combination of antibody and a multivalent antigen to form cross-links and result in visible agglutination.

A

Lattice formation

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61
Q

ratio of antigen on the red cell to antibody in the serum.

A

Serum-to-cell ratio

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62
Q

interpretation of agglutination reactions immediately after centrifugation and without incubation.

A

Immediate-spin

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63
Q

electrostatic potential measured between the red cell membrane and the slipping plane of the same cell.

A

Zeta potential

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64
Q

number of binding sites of multivalent antigen and antibody are approximately equal.

A

Zone of equivalence

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65
Q

excess antibody causing a false-negative reaction.

A

Prozone

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66
Q

excess antigen causing a false-negative reaction.

A

Postzone

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67
Q

fluid above cells or particles after centrifugation.

A

Supernatant

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68
Q

unresponsiveness to platelet transfusions owing to HLA-specific or platelet-specific antibodies or platelet destruction from fever or sepsis. Responsiveness is measured by posttransfusion platelet counts.

A

Refractoriness

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69
Q

set of linked genes inherited together because of their close proximity on a chromosome.

A

Haplotype

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70
Q

different forms of a gene present at a particular chromosomal locus.

A

Alleles

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71
Q

genetic system that expresses several possible alleles at specific loci on a chromosome.

A

Polymorphic

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72
Q

antibody destruction of a newborn’s platelets caused by antibodies formed from prior pregnancies and directed to paternal antigens.

A

Neonatal alloimmune thrombocytopenia

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73
Q

antibodies with specificities other than self; stimulated by transfusion or pregnancy.

A

Alloantibodies

74
Q

antibody destruction of platelets after transfusion.

A

Posttransfusion purpura

75
Q

First time a blood transfusion was recorded in history.

A

Pope Innocent VII

76
Q

Sodium phosphate

A

Braxton Hicks

77
Q

ABO blood groups

A

Karl Landsteiner

78
Q

Vein to vein transfusion

A

Edward E. Lindemann

79
Q

Syringe-valve apparatus

A

Unger

80
Q

Sodium citrate

A

Hustin

81
Q

Minimum amount of citrate needed for anticoagulation

A

Lewisohn

82
Q

Citrate dextrose solution

A

Rous and Turner

83
Q

Techniques in blood transfusion and blood preservation

A

Dr. Charles Drew

84
Q

Introduced the formula for the preservative acid-citrate dextrose

A

Loutit and Mollison

85
Q

Introduced citrate-phosphate dextrose

A

Gibson

86
Q

The amount of whole blood in a unit has been______of blood

A

450 mL +/- 10%

87
Q

For a____donor, a maximum of_____ can be collected

A

110 lb, 525 mL

88
Q

Total blood volume for most adults

A

10 to 12 pints

89
Q

Donors can replenish the fluid lost from the donation of

A

1 pint in 24 hours

90
Q

The donor’s red cells are replaced within_____after donation.

A

1 to 2 months

91
Q

A volunteer donor can donate blood every, every what week?

A

8 weeks

92
Q

What are the units of the whole blood can be separated into three components?

A

Packed red blood cells, platelets, and plasma

93
Q

The plasma can be converted by_______to a clotting factor concentrate that is rich in antihemophilic factor.

A

cryoprecipitation

94
Q

A unit of whole blood-prepared RBCs may be stored for

A

21 to 42 days

95
Q

THE DONATION PROCESS

Educational material that contains information on the risks of infectious diseases transmitted by blood transfusion, including the symptoms and sign of AIDS, is given to each prospective donor to read.

A

Step 1: Educational Materials

96
Q

A uniform donor history questionnaire, designed to ask questions that protect the health of both the donor and the recipient, is given to every donor. The health history questionnaire is used to identify donors who have been exposed to diseases that can be transmitted in blood.

A

Step 2: The Donor Health History Questionnaire

97
Q

The abbreviated physical examination for donors includes blood pressure, pulse, and temperature readings; hemoglobin or hematocrit level; and the inspection of the arms for skin lesions.

A

Step 3: The Abbreviated Physical Examination

98
Q

Syphilis

A

1950’s

99
Q

Hepatitis B surface antigen (HbsAg)

A

1971

100
Q

Hepatitis B core antibody (anti-HBc)

A

1986

101
Q

Hepatitis C virus antibody (anti-HCV

A

1990

102
Q

Human immunodeficiency virus antibodies (anti- HIV-1/2)

A

1992

103
Q

Human T cell lymphotropic virus

A

19972

104
Q

NAT-nucleic acid amplification testing, **Initially under IND starting in

A

1999

105
Q

Anti-HIV-1 testing implemented

A

1985

106
Q

Anti-HTLV testing implemented

A

1988

107
Q

Three areas of RBC biology are crucial for normal erythrocyte survival function:

A
  1. Normal chemical composition and structure of the RBC membrane
  2. Hemoglobin structure and function
  3. RBC metabolism
108
Q

main lipid component of the membrane, arranged in a bilayer structure comprising the framework in which globular proteins traverse and move.

A

Phospholipids

109
Q

The biochemical composition of the RBC membrane is approximately

A

52% protein, 40% lipid, and 8% carbohydrate.

110
Q

The loss of RBC membrane is exemplified by the formation of spherocytes (no central pallor) and bite cells.

A

Deformability

111
Q

Human immunodeficiency virus (HIV-1) (NAT)

Hepatitis C Virus (HCV) (NAT)

A

1999

112
Q

Hepatitis C Virus (HCV) (NAT)

A

2004

113
Q

Trypanosoma cruzi antibody (anti-T. cruzi)

A

2007

114
Q

Hepatitis B virus (HBV) NAT

A

2009

115
Q

Babesia microti antibody and NAT (recommended)

A

2012

116
Q

Zika virus NAT

A

2016

117
Q

The RBC membrane is freely permeable to water and anions.
* The RBC membrane is relatively impermeable to cations such as sodium and potassium
* The erythrocyte intracellular-to- extracellular ratios for Na+ and K+ are 1:12 and 25:1, respectively

A

Permeability

118
Q

Goal of Blood preservation: To provide viable and functional blood components for patients requiring blood transfusion.
* To maintain optimum viability, blood is stored in the liquid state between 1oC and 6oC for a specific number of days, as determined by the preservative solution(s) used.
* The loss of RBC viability has been correlated with the “lesion of storage” which is associated with various biochemical changes.

A

RBC PRESERVATION

119
Q

RBC Storage Lesion

CHARACTERISTIC

% Viable Cells

Glucose

ATP

Lactic Acid

pH

2,3-DPG

Oxygen Dissociation Curve

Plasma K+

Plasma hemoglobin

A

CHANGE OBSERVED

Decreased

Decreased

Decreased

Increased

Decreased

Decreased

Shift to the Left

Increased

Increased

120
Q

Adenine supplemented blood can be stored at

A

1 to 6 degrees Celsius for 35 days

121
Q

chelates calcium; prevents clotting 2.

A

Citrate

122
Q

maintains pH during storage

A

Monobasic sodium phosphate

123
Q

Substrate for ATP production

A

Dextrose

124
Q

Production of ATP

A

Adenine

125
Q

Acid Citrate-Dextrose
(formula A)*

A

ABBR. STORAGE TIME (DAYS)

ACD-A 21

126
Q

Citrate-phosphate dextrose

A

ABBR. STORAGE TIME (DAYS)
CPD 21

127
Q

Citrate-phosphate-double
dextrose

A

ABBR. STORAGE TIME (DAYS)
CP2D 21

128
Q

Citrate-phosphate-dextrose adenine

A

ABBR. STORAGE TIME (DAYS)
CPDA-1 35

129
Q

Preserving solutions that are added to the RBCs
after removal of the plasma with or without
platelets.

A

ADDITIVE SOLUTIONS

130
Q

In additive solutions, how many hematocrit will decrease?

A

70% to 85% to around 50% to 60%

131
Q

What are the benefits of RBC Additive Solutions?

A
  1. Extends the shelf-life of RBCs to 42 days by
    adding nutrients
  2. Allows for the harvesting of more plasma and
    platelets from the unit
  3. Produces an RBC concentrate of lower
    viscosity that is easier to infuse
132
Q

Used for autologous units and storage of rare
blood types.
* It involves the addition of a cryoprotective agent
to RBCs that are less than 6 days old
* Currently, the FDA licenses frozen RBCs for a
period of 10 years from the date of freezing; that
is, frozen RBCs may be stored up to 10 years
before thawing and transfusion.

A

RBC FREEZING

133
Q

Rejuvenation of RBCs is the process by which ATP
and 2,3-DPG levels are restored or enhanced by
metabolic alterations.
* FDA-approved rejuvenation solution contains
phosphate, inosine, and adenine
* RBCs may be prepared up to three days after
expiration when stored in CPD, CPDA-1, and AS-
1 storage solutions.

A

RBC REJUVENATION

134
Q

currently the only FDA approved
rejuvenation solution sold in the US.

A

Rejuvesol

135
Q
  • Platelets are involved in the blood coagulation
    process and are given to treat or prevent
    bleeding. They are given either therapeutically to
    stop bleeding or prophylactically to prevent
    bleeding.
  • Platelets are intimately involved in primary
    hemostasis, which is the interaction of platelets
    and the vascular endothelium in halting and
    preventing bleeding following vascular injury.
  • The role of platelets in hemostasis includes:
    1. initial arrest of bleeding by platelet plug
    formation
    2. stabilization of the hemostatic plug by
    contributing to the process of fibrin formation
    3. maintenance of vascular integrity.
A

PLATELET PRESERVATION

136
Q

Platelets are stored at 20°C to 24°C with
maintaining continuous gentle agitation
throughout the storage period of 5 days
* The loss of platelet quality during storage is
known as the platelet storage lesion.

A

Platelet Storage Lesion

137
Q

Factors to be considered when using 5-day plastic
storage bags

A
  1. Temperature control of 20°C to 24°C is critical
    during platelet preparation and storage.
  2. Careful handling of plastic bags during expression
    of platelet-poor plasma helps prevent the platelet
    button from being distributed and prevents
    removal of excess platelets with the platelet-poor
    plasma.
  3. Residual plasma volumes recommended for the
    storage of platelet concentrates from whole blood
    (45 to 65 mL).
  4. For apheresis platelets, the surface area of the
    storage bags needs to allow for the number of
    platelets that will be stored.
138
Q

A platelet concentrate should contain a minimum
of

A

5.5 X 1010/L platelets in a volume routinely
between 45 and 65 mL that is sufficient to
maintain a pH of 6.2 or greater at the conclusion
of the 5-day storage period.

139
Q

When platelet concentrates are pooled using an
open system, the storage time changes

A

to 4
hours.

140
Q

Apheresis components contain

A

4 to 6 times as
many platelets as a PC prepared from whole
blood.

141
Q

Platelet components are stored for

A

up to 5 days
at 20-24 C.

142
Q

When necessary, as during shipping, platelets
can be stored without continuous agitation for up
to

A

24 hours at 20-24oC during a 5-day storage
period

143
Q

Platelets are rarely stored at

A

1 to 6 degrees
Celsius.

144
Q

If a platelet bag is broken or opened, the platelets
must be transfused within

A

4 hours when stored
at 20 to 24 degrees Celsius.

145
Q

System for continuous
temp. monitoring and audible alarm

A

Blood storage refrigerators and freezers,
platelet incubators

146
Q

compare against
thermometer daily. Calibrate as necessary.

A

Temperature recorder

147
Q

Check high and low temp. of activation
quarterly

A

Alarms

148
Q

Check temperature daily

A

Waterbath

149
Q

Check temperature daily.
Periodically check each well

A

Heat blocks

150
Q

Determine optimum speed and
time for different procedures upon receipt, after
repairs and periodically. Check timer every 3
months, RPM every 6 months (with tachometer).

A

Centrifuges

151
Q

Check tube fill level daily, AHG
volume monthly. Verify time and speed quarterly.
Calibrate quarterly

A

Cell washers

152
Q

Calibrate quarterly

A

Pipettes

153
Q

Test with positive and negative
controls each day of use. Use heterozygous cells
for positive controls.

A

Antisera

154
Q

Check for hemolysis. Test each
day of use with positive and negative controls.

A

Reagent Cells

155
Q

Check anti-IgG activity
each day of use by testing Rh-pos cells sensitized
with anti-D.

A

Antihuman globulin

156
Q

Study of transmission of inherited
characteristics.

A

Genetics

157
Q

groups of related RBC antigens
inherited according to Mendelian genetics

A

Blood group systems

158
Q

Physical, observable expression of inherited
traits; detectable products

A

Phenotype

159
Q

Inherited genes; actual genetic makeup

A

Genotype

160
Q

Visual map that displays a family history
and can display inheritance patterns for individual traits

A

Pedigree chart

161
Q

Smallest unit of inheritance

A

Gene

162
Q

Site on chromosome where specific
genes are located

A

Genetic locus

163
Q

Alternative forms of a gene

A

Alleles

164
Q

Opposite form of a gene, different allele

A

Antithetical

165
Q

Having two or more possible alleles at a
locus

A

Polymorphic

166
Q

Equal expression of both alleles in
phenotype

A

Codominant

167
Q

Genes expressed with equal frequency in
males and females, on non-sex
chromosome

A

Autosomal

168
Q

Set of genes inherited via one of the two
parental gametes

A

Haplotype

169
Q

Genes that do not produce a detectable
product

A

Amorph

170
Q

Identical alleles at the same gene locus
from both parents

A

Homozygous

171
Q

Different alleles at the same gene locus
from each parent

A

Heterozygous

172
Q

Agglutination reactions are generally
stronger for homozygous cells and slightly weaker for
heterozygous cells.

A

Dosage Effect

173
Q

Genes are inherited on the same chromosome

A

Cis

174
Q

Genes are inherited on separate chromosomes.
Genes inherited in transposition can weaken the trait’s
expression.

A

Trans

175
Q

states that
factors for different characteristics are inherited in
dependent of each other if they reside on different
chromosomes.

A

Mendel’s law of independent assortment

176
Q

is the process by which somatic cells divide, with
an end result of two identical daughtercells

A

Mitosis

177
Q

is the cell division process that takes place in
germ cells that concludes in the production of haploid
gametes, with an end result of four unique daughter cells.

A

Meiosis

178
Q

refers to any structural alteration of DNA in an
organism (mutant) that is caused by a physical or
chemical agent (mutagen) and can occur spontaneously.

A

Mutations

179
Q

is an enzymatic process whereby genetic
information in a DNA strand is copied into an mRNA
complementary strand.

A

Transcription

180
Q

is the complex process by which mRNA,
which contains a mobile version of the DNA template
encoding the genes for an organism

A

Translation

181
Q
A

BB (4 decks)

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