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Mercy CLS: Comprehensive Study > Blood Bank > Flashcards

Blood Bank Flashcards

1
Q

WB donation interval

A

8 weeks

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2
Q

platelet apheresis donation interval

A

every 48 hr
24 per year

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3
Q

must collect blood from donor within ——-

A

15 min

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4
Q

autologous donation interval

A

no more than 72 hours between donations and before procedure

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5
Q

directed donor requirement if blood relative

A

irradiated

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6
Q

examples of fractionation products

A

RhIg
IVIg
albumin

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7
Q

ensures blood products are consistently manufactured to a quality appropriate for their intended use

A

cGMP

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8
Q

platelet product QC

A
  • bacterial contamination
  • absolute plt count
  • pH
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9
Q

leukocyte reduced blood QC

A
  • absolute wbc count
  • rbc recovery
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10
Q

most blood group antigens are expressed as ————

A

codominant

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11
Q

amorphic gene with no detectable product

A

O gene

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12
Q

L-fucose

A

H antigen

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13
Q

N-acetylgalactosamine

A

A antigen

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14
Q

D-galactose

A

B antigen

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15
Q

hh genotype
anti-H

A

Bombay

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16
Q

states that if an individual has an antigen, they will not have the antibody

A

Landsteiner’s rule

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17
Q

most common blood group

A

O

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18
Q

Se gene

A

secretor
A & B antigens are found in secretions

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19
Q

GI problem
sugar cleaved off of A antigen

A

acquired B antigen
found in A group people

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20
Q

weak reverse group

A

infants
elderly
immune deficient

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21
Q

ABO discrepancy caused by transfusion, transplant or subgroup

A

mixed field

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22
Q

resolve weak reverse testing

A

extended incubation

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23
Q

C is trans to D in Dce/dCe haplotype

A

weak D

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24
Q

most severe cause of HDFN

A

Rh system

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25
Q

anti-D,C
present with D or C

A

G antigen

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26
Q

c and e in cis position

A

f antigen

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27
Q

give ——— blood to a person who has anti-f

A

c=

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28
Q

normal circulating blood volume

A

5 L

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29
Q

cause platelet refractoriness

A

HLA Ab and platelet Ab

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30
Q

nucleated RBC in fetal circulation from increased production due to hemolysis

A

erythroblastosis fetalis

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31
Q

mildest HDFN

A

ABO

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32
Q

HDFN that does not reflect alloimmunization in mother

A

ABO

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33
Q

blood requirements for IUT

A

O neg
antigen neg for mom’s Ab
CMV=
irradiated
filtered
washed
<5 days old
sickle =

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34
Q

blood requirements for infant exchange transfusion

A

compatible with mom & baby’s type
FFP compatible with unit & baby
CMV=
sickle =
irradiated
filtered
< 7 days old

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35
Q

qualitative test for fetal-maternal hemorrhage

A

fetal rosette test

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36
Q

quantitative test for fetal-maternal hemorrhage

A

kleihauer betke

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37
Q

based on the principle that fetal hgb is resistant to acid elution

A

KB test

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38
Q

irradiation prevents…

A

GVHD

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39
Q

leukocyte reduction prevents…

A

HLA alloimmunization
CMV infection
febrile rxns

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40
Q

possible causes for ABS+

A
  • Ab to specific Ag
  • passive anti-D
  • cold agglutinins
  • cold or warm autoAb
  • rouleaux
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41
Q

when to do AHG XM

A
  • ABS+ at IS
  • previously detected clinically significant Ab
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42
Q

possible causes for incompatible XM

A
  • wrong sample
  • wrong ABO type
  • Ab present (allo, auto, low-freq)
  • DAT+ unit (discard)
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43
Q

antibodies that will not be detected at ABS, but will be during XM

A

anti low-freqs

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44
Q

when do neonates start making AB?

A

4-6 months

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45
Q

pretransfusion testing for neonate

A
  • ABO forward
  • Rh
  • ABS/ABID on mother’s specimen
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46
Q

when to use a selected cell panel for ABID

A
  • previously ID’d antibody
  • rule-outs after a full panel
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47
Q

antigen is acquired from the plasma, onto the RBC surface

A

Lewis

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48
Q

DAT detects…

A

in vivo sensitization of rbcs with Ig and/or C’

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49
Q

enzymes used in blood bank

A

ficin
papain

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50
Q

Ag typing sera made from plants

A

lectins

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51
Q

Dolichos biflorus

A

A1 lectin

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52
Q

used in BB to remove Ab from the serum

A

adsorption

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53
Q

autoadsorption can only be performed if…

A

pt has not been transfused in the last 3 months

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54
Q

maternal titrations for RBC Ab begun when and performed when?

A

begun at 16-22 weeks
performed every 1-4 weeks

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55
Q

used to diminish or destroy IgM reactivity to reveal IgG reactivity

A

thiol reagents (DTT, 2-ME)

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56
Q

dithiothreitol

A

DTT —used to destroy IgM reactivity and reveal IgG

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57
Q

destroys Kell antigens

A

DTT
2-ME

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58
Q

DDT + ficin

A

ZZAP
removes IgG & C3 from DAT+ rbcs

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59
Q

removes antibody from DAT+ cells

A

ZZAP
chloroquine diphosphate
EGA

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60
Q

samples in BB expire after —– days, and are kept for —– days after last possible transfusion

A

3
7

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61
Q

transfusion trigger

A

<7 g/dL Hgb or actively bleeding

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62
Q

platelet transfusion trigger

A

<50,000 plt count

63
Q

room temp return requirement for blood products

A

≤6° C
no time limit

64
Q

blood products must be transfused within ——— of issue

A

4 hours

65
Q

normal RhIg dosage
protects against…

A

300 μg
30 mL WB, 15 mL packed cells

66
Q

prenatal RhIg begins at — weeks

A

28

67
Q

postpartum RhIg must be given within —– of birth

A

72 hours

68
Q

intraoperative blood salvage cannot be used during ——— surgery

A

abdominal

69
Q

indicated for volume expansion

A

albumin

70
Q

1 pRBC ↑ Hgb by…

A

1.0 g/dL

71
Q

1 WBD platelet ↑ plt by…

A

5-10 x 10^3

72
Q

1 apheresis plt = —- WBD platelets

A

6

73
Q

massive transfusion

A

8-10 units within 24 hours
4-5 units within 1 hour

74
Q

TRALI

A

transfusion related acute lung injury

75
Q

TACO

A

transfusion associated circulatory overload

76
Q

course of action after trxn (in the BB)

A
  • clerical check
  • examination for hemolysis
  • ABO/Rh and DAT on post specimen
  • additional tests as required by results
77
Q

anamnestic response to RBC antigens after transfusion
Hgb does not ↑

A

delayed hemolytic trxn

78
Q

calculation to find compatible blood products

A

units needed/%compatibility for antigen = units to XM

1 - frequency = compatibility
multiply compatibilities for multiple Ags

79
Q

calculate RhIg dose

A

(% fetal cells on KB)(5000) = fetal bleed in mL
(fetal bleed in mL/30 → round) + 1 = vials of RhIg

80
Q

BP for donors

A

systolic: 90-180
diastolic: 50-100

81
Q

hemoglobin for donors

A

≥12.5 (♀)
≥13.0 (♂)

82
Q

hematocrit for donors

A

≥38% (♀)
≥39% (♂)

83
Q

body temp for donors

A

≤37.5°
(99.5°)

84
Q

BPM for donors

A

50-100
or 40-49 if athlete, with med director approval

85
Q

weight for donors

A

≥110 lbs

86
Q

must be off aspirin for ——– to donate plts

A

48 hours

87
Q

pregnancy donor deferral

A

6 weeks

88
Q

live vaccination donor deferral

A

2-4 weeks

89
Q

sexual contact questions donor deferral

A

3 months

90
Q

travel to malaria endemic area donor deferral

A

travel: 3 months
had malaria or lived in area: 3 years

91
Q

incarceration donor deferral

A

1 year

92
Q

test performed on donors age 16-18 at risk of losing iron

A

ferritin

93
Q

pRBC shelf life

A

AS: 42 days
CPDA-1: 35 days
CPD: 21 days

94
Q

frozen RBC shelf life

A

10 years

95
Q

thawed deglyc RBC shelf life

A

24 hours

96
Q

washed RBC shelf life

A

24 hours

97
Q

prepared WB shelf life

A

24 hours

98
Q

FFP shelf life

A

1 year

99
Q

thawed FFP/thawed plasma shelf life

A

“thawed FFP”: 24 hours
“thawed plasma”: 5 days

100
Q

frozen cryo shelf life

A

1 year

101
Q

thawed cryo shelf life

A

6 hours
4 hours manually pooled

102
Q

platelet shelf life

A

5-7 days

103
Q

WBD pooled platelet shelf life

A

4 hours

104
Q

irradiated RBC shelf life

A

28 days or original exp date

105
Q

granulocytes shelf life

A

24 hour

106
Q

storage temp for pRBC, thawed RBC, thawed FFP

A

1-6°

107
Q

storage temp for frozen RBC

A

≤ -65°

108
Q

storage temp for FFP

A

≤ -18°

109
Q

storage temp for platelets, granulocytes, thawed cryo

A

20-24°

110
Q

transport temp for RBCs

A

1-10°

111
Q

indication for pRBCs

A

symptomatic anemia

112
Q

indications for washed RBCs

A

IgA def. with anaphylactoid rxns
recurring severe allergic rxns

113
Q

indications for prepared WB

A

exhange transfusion

114
Q

indications for FFP

A

clinically significant deficiency of all coag factors
TTP

115
Q

indications for cryo

A

hypofibrinogenemia
factor XIII, VIII, or vWF def. if concentrates are unavailable

116
Q

indications for plts

A

bleeding due to thrombocytopenia or plt function abnormality

117
Q

indication for granulocytes

A

neutropenia with septicemia not responsive to antibiotics

118
Q

IgG in O type people

A

anti-A,B

119
Q

ABO discrepancy related to GI problems

A

acquired B antigen
reverse like an A, forward like an AB

120
Q

alloantibodies that can cause reverse ABO discrepancies

A

anti-P1
anti-M

121
Q

Fisher-race for R1

A

DCe

122
Q

Fisher-race for r

A

dce

123
Q

Fisher-race for R2

A

DcE

124
Q

Fisher-race for R0

A

Dce

125
Q

Fisher-race for r’

A

dCe

126
Q

Fisher-race for r’’

A

dcE

127
Q

Fisher-race for Rz

A

DCE

128
Q

Fisher-race for ry

A

dCE

129
Q

most common Rh genotype in Black pop.

A

Dce/R0

130
Q

2nd most common Rh genotype in both Black pop. and white pop.

A

dce/r

131
Q

most common Rh genotype in white pop.

A

DCe/R1

132
Q

when is cord blood tested?

A
  • O mom
  • D= mom
  • ABS+ mom
  • problems expected with neonate
133
Q

testing performed on a DAT+ cord blood

A
  • A cell with A baby, or B cell with B baby (detects ABO HDFN)
  • ABS
  • ABS+ (not due to RhIG) → eluate
134
Q

used to ID the antibody coating DAT+ cells

A

eluate

135
Q

RBC antigens with cold Ab

A

Lewis
P1
MN

136
Q

RBC antigens with warm Ab

A

Duffy
Rh
Kidd
Kell
Ss

137
Q

RBC antigens destroyed by enzymes

A

MN
Duffy

138
Q

RBC antigens enhanced by enzymes

A

Rh
Kidd

139
Q

low freqs

A

Cw
V
Kpa
Jsa
Lua

140
Q

high freqs

A

k
Kpb
Jsb
U
P
Lub

141
Q

anti ——- antibodies tend to fade in vivo and in vitro

A

Kidd

142
Q

ABID steps

A
  • perform rule-outs on negative cells with homozygous + antigens (except K, which can be hetero)
  • find most likely antibody using pattern and dosage
  • rule-out others using cells negative for most likely antigen
  • ensure there are 3+ and 3= cells for Ab identified
143
Q

required to give type-specific uncrossmatched blood in an emergency

A

current type + checktype
emergency release form
uncrossmatched tag on unit

144
Q

FFP released in an emergency

A

A or AB, depending on policy

145
Q

give ———— blood after 2 documented febrile rxns

A

leukocyte reduced

146
Q

when are leukoreduced plts indicated?

A

likelihood that patient will receive multiple/further plt transfusions

avoid HLA/plt antibody formation

147
Q

can WBD platelets be provided as leukoreduced?

A

yes, with a bedside reduction filter.

148
Q

these patients are usually phenotyped prior to transfusions to avoid alloimmunization

A

sickle cell

149
Q

process designed to alert blood product recipients when a donor has tested positive for an infectious disease

A

lookback

149
Q

only instance when a transfusion can be continued after a trxn

A

urticarial rxn
give antihistamines

150
Q

infectious disease lookback procedure is used for

A

HIV
HCV
SARS
WNV
smallpox

151
Q

indication for a neonate receiving many lab tests to be transfused

A

“bleeding into the lab” —10% blood loss is an indication for transfusion

especially applies to premature infants

152
Q

equipment used to transfuse infants

A

screw-driven constant rate syringe

Mercy CLS: Comprehensive Study (9 decks)

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