bbquick Flashcards
3 bacteria implicated in contamination of blood, 1 thats not3 parasites transmitted by blood
Yersinia, Citrobacter, Pseudomonas-these are the books answer-possibly staph/strepE.Coli has notPlasmodium, Trypanosoma(cruzi), Babesia
Primary resonse Ig, time appears…Secondary response Ig, time appears…% get immunizied to blood grp ag
Primary IgM, 7-14 daysSecondary IgG 1-2 days1-4%
ABO labels versus dyes colors-A,B,O,AB-A,B,D/A1B
Labels:-A: yellow-B: pink-O: blue-AB: black/gray/whiteDye:-A: blue-B: yellow-D/A1B: clear
anti -A1 made from…anti-H made from…
anti -A1 made from…Dolichos biflorusanti-H made from…Ulex europeus
Potentiators:-which one decreases incubation-which one books says increases sensitivity-shortens incubation, increases speed/sensitivity, decreases zeta, phosphate buffered saline/glycine-increases sensitivity for IAT, longer incubation-increases sensitivity, removes water increasing concentration of ab, enhances warm auto-eliminate rxns, can enhance coldwarm auto-reduce disulfide bonds, eliminates Kell
Potentiators:-decreasse incubation LISS-increase sensitvity albuminLISS low ionic strenght sln-shortens incubation, increases speed/sensitivity, decreases zeta, phosphate buffered saline/glycineBSA/albumin-increases sensitivity for IAT, longer incubationPEG-increases sensitivity, removes water increasing concentration of ab, enhances warm autoProteolitic enyzmes-eliminate rxns, can enhance coldwarm autoDTT, dithiothreitol-reduce disulfide bonds, eliminates Kell
Reaction grading…which one is caused by transfusion, some agg with sea of free rbc…which one is microscopic/cloud…4+3+2+1+MFWPNeg
Reaction grading…4+ solid button,clear3+ lrg clump, clear2+ med clumps, clear1+ sml agg, turbidMF some agg, sea of free(transfusion)WP microscopic cloudyNeg no agg,cloudy
Allogenic Donor reqs:Age:Temp/C/F:Wt:Hmg/Hct: femalemaleBP:Pulse:
Allogenic Donor reqs:Age: >=16Temp/C/F: 37.5C/99.5FWt: >=110lb/50kgHmg/Hct: 12.5/38%female 12.5/38%male 13/39BP: 90-180/50-100Pulse: 50-100
Autologous donor req…Age..Hmg/HCT..other…
Autologous-no age req-Hmg/HCT 11/33%-no bacterimia-collect >72hrs before-ABO/Rh testing
Vaccine defferments..TB skin pos…measles/mumps/rubeola/polio no symptoms..Hep B…Germen measles/chicken pox/ West Nile….
Vaccine defferments..TB skin pos…no defferal if all else normalmeasles/mumps/rubeola/polio no symptoms..2 wksHep B…3 wksGermen measles/chicken pox/ West Nile….4 wks
Wait time for plasmapheresis donor to wait before donate WB…Wait time for WB donor to donate plasmapheresis…
Wait time for plasmapheresis donor to wait before donate WB…48hrsWait time for WB donor to donate plasmapheresis…72hrs-need to test TP if >1x/2mths at 4mth intervals
Main reason to be defered for 1yrs…3 random…
exposure to hepatitis, malaria, HIV-had sex/living with, tatoo/trans, hep B immuneglobulin, mucous/skin->72hrs in jail-completed syphillis/gonn treatment or reactive STS-bitten by dog
Reason to be deffered 3yrs
asymptomatic from endemic area of malaria or had malaria before/completed treatment
Permnament deferral main reasons…random reason…
Permnament..-definete disease, habits high risk for hep/malaria/CJD,Babeosis,T.cruzi, HIV, HTLV-Viral hep after age 11-drug-human growth hormone
Main testing for products…
ABO/Rh, ab screen-Syphillis/RPR-Hepatitis(HBsAg,antiHBc, antiHCV)-HIV(anti1/2)-HTLV(anti1/2)-T.cruzi, WN, Zika, Babesia
RBC temps etcstorage…transport..open good for…Frozen RBC temp, time-% glycerol, thaw at, store at, good for1 unit raises hmg/hct by
RBC nonfrozen-store 1-6C-transport 1-10-open=24hrsFrozen: -65C, 10yrs-40% glycerol, thaw at 37C, store 1-6, good for 24hrsraise 1g/3%(rbcx3=hct)
FFP storage:-shorest time, longest time-thaw temp, store at, time-good for..Cryo storage-2 main things contain-good for once thawed, kept at-thawed/open time
FFP coag def-1 yr at -18-7yrs at -65-thaw at 30-37, store 1-6, 24hrsCryo fibrinogen, F8-1 yr at -18-6hrs thawed, leave at RT-4hrs thawed/pooled
PLTS:-days, temp, with-open: pooled, apheresisGranulocytes/washed-time good for with no-washed preventsIrradiated -days -prevents
PLTS-light spin removes rbc, heavy spins down wbc/plts-5 days, 20-24 w/agitation-4 hrs plts pooled open-24hrs aphresis openGranulocytes: 24hrs, 20-24,no agitationwashed rbc: 24hrs, prevents allergy to plasma proteins in IgA defIrradiated: 28 days, prevents GVHD
additivesshorest to longest…
rejuvenating sln: restores 2,3DPG/ATP-store 1-6C, use w/in 24hrsACD/CPD/CPD2: 21 days-anticoag citrate dextrose, -citrate phosphate dextroseCPDA1: 35 days, has adenine at endADSOL/AS/additives: 42 days
Storage of blood changes
Decreased:-pH (lactic acid)-Na (moves into cells while K moves out)-2-3DPGIncreased: -K(moves out while Na moves in)-NH4
Backbone of sugars is…O gene is…H is…-H gene codes for/what is glycosyltransferase/sugar A gene codes for..B gene codes for..
Backbone is Gal with Fuc off bottomGenes add onto Gal to the left…O gene is inactive, H is unmodifiedhas fuco-syl-transferase/fucoseA has N-acetyl-galac(NAC)B has D-galac
Bombay phenotype is..antibodies in serum..Phenotype with absense of Rh…
absense of ABO ag, Ohhas A,B,H-type as O-not agg w/anti-H, no HRhnull is absense of Rh ag
H ag greatest to leastgreatest, least
greatest H is O, least is Oh(none)A2>B>A2B>A1>A1BO>A2>B>A2B»A1>A1B>Oh-A2>B-more A, B less H so A2>A2B-A2>A1
Se: expression ABO ag in BF, secretor status-dominant, 80% have Se geneSe codes for these three…-need….to have A or B-Se doesn’t code forLe: adsorbed onto red cell, in saliva/plasma-need Le to make…-need.. to make…
Se codes for H, then A and B, doesn’t code for SeLe:-need Le to make Lea-need Lea to make Leb
ABO frequency greatest to least/%
O>A>B>ABO 46A 41B 9AB 4
Subgroups:-MF with antiA, neg with antiA1 lectin…-A1 cell pos, antiA1 lectin neg-antiA 3+, antiB 3+, A1 cells 2+, antiA1Lectin neg
Subgroups:A3 is mixed field w/antiA1Ax isnt mixedMF with antiA, neg with antiA1 lectin: A3-barely any A=MF,-antiA1 lectin neg=no A1 ag=not A1A1 cell pos, antiA1 lectin neg=Ax-A1 cell pos=has antiA1-antiA1 lectin neg=not A1antiA 3+, antiB 3+, A1 cells 2+, antiA1Lectin neg: A2B-antiA,anti B 3+=AB-A1 cells 2+=has antiA1=not A1-antiA1 lectin neg=not A1=A2
Autoab that is IgG, donath landsteiner, PCHab that is IgM, cold agg disease, Mycoplasma pneumonia, blacks…ab seem infants, infectious mono…
P: Autoab that is IgG, donath landsteiner, PCHI: ab that is IgM, cold agg disease, Mycoplasma pneumonia, blacks…i: ab seem infants, infectious mono…
5 naturally occuring ab
ABOLewis, P, MCw
Rh null…Oh…
Rh null no Rh agOh no ABO ag
Tja part of..Cw/f part of…U part of…
Tja/PP1PK part of PCw/f part of RhU part of MNS
D how many have…K, k how many have…
D 85% haveK only 9% hask 99% has
most little letters has 90-100% frequencys,e,k
s=90e=98k=99
most others have 70-85%…except these 3….
70-85% -Fya/Fyb, Jka/Jkb-M/N, P1-Lebexceptions…Lea=22E=29S 55
Fy…-Ig, temp-dosage/enzymes?-Fya-b-, seen in, %, resistance to-most common ab
Fy-IgG, 37/AHG-dosage/destroyed by enzymes-Fya-b- blacks, 68%, resist vivax/knowlesi-Fya ab more common
3 groups that dont cause HDN
lewis, lutheranM/N
Kidd…Jka/Jkb/Jk3Ig, temp, dosage/enzymes, seen in
IgG, 37/AHG, show dosage, enhanced by enzymes, seen in delayed trans rxn
Kell: next to D, 2nd most potent ag-% lackIg, temp, enzymes, dosageTwo systems in K, which one low/highwhich one Mcleod, xlinked males, Ko genesk: cellano-how many have
Kell: no one has, no dosage/no enzyme-90% lack, antibody common easy to find units-IgG,37/AHG, unffected by enzymes/no dosage-Kpa/Jsa is low-Kpb/Jsb is high-Kx: 100% have, ones that don’t are McLeod,males-K0/nullk/Cellano: 99 have
System with MF, RT/saline, no HDN destroyed by enzymes
Lutheran
Grp IgM, common in all esp blacks, cold reactive, not on infant, cold agg disease, M.pneumo
I
Rh..Ig, temp, dosage enzymes% have D…most common rh neg genotype…most common cause of HDN next to D…weak D common in…
Rh-IgG, 37/AHG, dosage/enzymes-85% have, weak D blacks-genotype: cde/cde-most common HDN after D is c
IgM, enhanced by enzymes, naturally occuring, neutralized by hydatid cyst
P1
IgG, 37/AHGpart of M/N, if you have this you have UU neg is seen in…and resistant to…
S/spart of M/N, have S, have UUneg blacks, resistant to ficin
Dosage…4 grps
-Kidd, Fy, Rh-M/N/Skidd and duffy the rh monkey eat lots of MNS
Enyzmes destroy…all but….are enhanced…
enzymes destroy-Fy, M/N/Sall but Kell are enhanced
QCfridge, freezer..temp, how oftencheck alarm…chartstemp…waterbath/heat…centrifuge…how often
fridge 1-6, freezer -18 dailycharts weeklycentrifuge 6mthsalarm 3x mthtemp w/NIST yearlywaterbath/heat 37
Polyspecific AHG has…color…how to check reagent…type of cells, rxnIf CC agg, means these 3 things
IgG and C3d (not b), greencheck with check cells, grpO, WPCC agg means-ahg added-washed well-ahg didnt react with PT red cells
AHG testing..false pos..false neg…
false pos:-pos DAT/complement fixed-over centrifuging/reading-septicemia/bacteria -Whartons jelly in cordfalse neg:-inadequate washing: ahg neutralized, ab eluted-prozone-dilution w/saline, didn’t add reagent-over/under centrifugation/incubation
IAT time, tempDAT temp
IAT 15-60min (w/out LISS) at 37, washDAT wash cells first, then add poly, IS-if neg sit RT
3 drugs that cause false pos DAT1 drug doesn’t
penicillin, cephalothinmethyldopaaspirin wont
Common Rh antigen that warm autoab directed against
e
Ab screen/ID rxns…-same strength in 1 phase…-varying strength…-rxn diff phases…-all cells in AHG, AC pos…-all cells in AHG AC neg…-all cells at 37, neg AHG, AC pos….-no rxn in screen/ab panel but xmatch incompatible….-only rxn in AHG and PT anemic, AC pos….
Ab screen/ID rxns…-same strength in 1 phase…single ab-varying strength…multiple ab-rxn diff phases…warm, cold-all cells in AHG, AC pos…warm auto-all cells in AHG, AC neg…high frequency ag-all cells at 37, neg AHG, AC pos….rouleaux-no rxn in screen/ab panel but xmatch incompatible….low freq ab-only rxn in AHG and PT anemic, AC pos….warm auto HA
Procedure to remove ab bound to sensitized rbc…cannot remove….Procedure to separate multiple ab…
elution, cannot remove complementmultiple=adsorption
AET/DTT, ZZAP, 2ME all are….and….
sulfhydrl reagents, inactivate
