Blood Bank Flashcards
1
Q
WB donation interval
A
8 weeks
2
Q
platelet apheresis donation interval
A
every 48 hr
24 per year
3
Q
must collect blood from donor within ——-
A
15 min
4
Q
autologous donation interval
A
no more than 72 hours between donations and before procedure
5
Q
directed donor requirement if blood relative
A
irradiated
6
Q
examples of fractionation products
A
RhIg
IVIg
albumin
7
Q
ensures blood products are consistently manufactured to a quality appropriate for their intended use
A
cGMP
8
Q
platelet product QC
A
- bacterial contamination
- absolute plt count
- pH
9
Q
leukocyte reduced blood QC
A
- absolute wbc count
- rbc recovery
10
Q
most blood group antigens are expressed as ————
A
codominant
11
Q
amorphic gene with no detectable product
A
O gene
12
Q
L-fucose
A
H antigen
13
Q
N-acetylgalactosamine
A
A antigen
14
Q
D-galactose
A
B antigen
15
Q
hh genotype
anti-H
A
Bombay
16
Q
states that if an individual has an antigen, they will not have the antibody
A
Landsteiner’s rule
17
Q
most common blood group
A
O
18
Q
Se gene
A
secretor
A & B antigens are found in secretions
19
Q
GI problem
sugar cleaved off of A antigen
A
acquired B antigen
found in A group people
20
Q
weak reverse group
A
infants
elderly
immune deficient
21
Q
ABO discrepancy caused by transfusion, transplant or subgroup
A
mixed field
22
Q
resolve weak reverse testing
A
extended incubation
23
Q
C is trans to D in Dce/dCe haplotype
A
weak D
24
Q
most severe cause of HDFN
A
Rh system
25
anti-D,C
present with D or C
G antigen
26
c and e in cis position
f antigen
27
give --------- blood to a person who has anti-f
c=
28
normal circulating blood volume
5 L
29
cause platelet refractoriness
HLA Ab and platelet Ab
30
nucleated RBC in fetal circulation from increased production due to hemolysis
erythroblastosis fetalis
31
mildest HDFN
ABO
32
HDFN that does not reflect alloimmunization in mother
ABO
33
blood requirements for IUT
O neg
antigen neg for mom's Ab
CMV=
irradiated
filtered
washed
<5 days old
sickle =
34
blood requirements for infant exchange transfusion
compatible with mom & baby's type
FFP compatible with unit & baby
CMV=
sickle =
irradiated
filtered
< 7 days old
35
qualitative test for fetal-maternal hemorrhage
fetal rosette test
36
quantitative test for fetal-maternal hemorrhage
kleihauer betke
37
based on the principle that fetal hgb is resistant to acid elution
KB test
38
irradiation prevents...
GVHD
39
leukocyte reduction prevents...
HLA alloimmunization
CMV infection
febrile rxns
40
possible causes for ABS+
- Ab to specific Ag
- passive anti-D
- cold agglutinins
- cold or warm autoAb
- rouleaux
41
when to do AHG XM
- ABS+ at IS
- previously detected clinically significant Ab
42
possible causes for incompatible XM
- wrong sample
- wrong ABO type
- Ab present (allo, auto, low-freq)
- DAT+ unit (discard)
43
antibodies that will not be detected at ABS, but will be during XM
anti low-freqs
44
when do neonates start making AB?
4-6 months
45
pretransfusion testing for neonate
- ABO forward
- Rh
- ABS/ABID on mother's specimen
46
when to use a selected cell panel for ABID
- previously ID'd antibody
- rule-outs after a full panel
47
antigen is acquired from the plasma, onto the RBC surface
Lewis
48
DAT detects...
in vivo sensitization of rbcs with Ig and/or C'
49
enzymes used in blood bank
ficin
papain
50
Ag typing sera made from plants
lectins
51
Dolichos biflorus
A1 lectin
52
used in BB to remove Ab from the serum
adsorption
53
autoadsorption can only be performed if...
pt has not been transfused in the last 3 months
54
maternal titrations for RBC Ab begun when and performed when?
begun at 16-22 weeks
performed every 1-4 weeks
55
used to diminish or destroy IgM reactivity to reveal IgG reactivity
thiol reagents (DTT, 2-ME)
56
dithiothreitol
DTT — used to destroy IgM reactivity and reveal IgG
57
destroys Kell antigens
DTT
2-ME
58
DDT + ficin
ZZAP
removes IgG & C3 from DAT+ rbcs
59
removes antibody from DAT+ cells
ZZAP
chloroquine diphosphate
EGA
60
samples in BB expire after ----- days, and are kept for ----- days after last possible transfusion
3
7
61
transfusion trigger
<7 g/dL Hgb or actively bleeding
62
platelet transfusion trigger
<50,000 plt count
63
room temp return requirement for blood products
≤6° C
no time limit
64
blood products must be transfused within --------- of issue
4 hours
65
normal RhIg dosage
protects against...
300 μg
30 mL WB, 15 mL packed cells
66
prenatal RhIg begins at --- weeks
28
67
postpartum RhIg must be given within ----- of birth
72 hours
68
intraoperative blood salvage cannot be used during --------- surgery
abdominal
69
indicated for volume expansion
albumin
70
1 pRBC ↑ Hgb by...
1.0 g/dL
71
1 WBD platelet ↑ plt by...
5-10 x 10^3
72
1 apheresis plt = ---- WBD platelets
6
73
massive transfusion
8-10 units within 24 hours
4-5 units within 1 hour
74
TRALI
transfusion related acute lung injury
75
TACO
transfusion associated circulatory overload
76
course of action after trxn (in the BB)
- clerical check
- examination for hemolysis
- ABO/Rh and DAT on post specimen
- additional tests as required by results
77
anamnestic response to RBC antigens after transfusion
Hgb does not ↑
delayed hemolytic trxn
78
calculation to find compatible blood products
**units needed/%compatibility for antigen = units to XM**
1 - frequency = compatibility
multiply compatibilities for multiple Ags
79
calculate RhIg dose
(% fetal cells on KB)(5000) = fetal bleed in mL
(fetal bleed in mL/30 → *round*) + 1 = vials of RhIg
80
BP for donors
systolic: 90-180
diastolic: 50-100
81
hemoglobin for donors
≥12.5 (♀)
≥13.0 (♂)
82
hematocrit for donors
≥38% (♀)
≥39% (♂)
83
body temp for donors
≤37.5°
(99.5°)
84
BPM for donors
50-100
or 40-49 if athlete, with med director approval
85
weight for donors
≥110 lbs
86
must be off aspirin for -------- to donate plts
48 hours
87
pregnancy donor deferral
6 weeks
88
live vaccination donor deferral
2-4 weeks
89
sexual contact questions donor deferral
3 months
90
travel to malaria endemic area donor deferral
travel: 3 months
had malaria or lived in area: 3 years
91
incarceration donor deferral
1 year
92
test performed on donors age 16-18 at risk of losing iron
ferritin
93
pRBC shelf life
AS: 42 days
CPDA-1: 35 days
CPD: 21 days
94
frozen RBC shelf life
10 years
95
thawed deglyc RBC shelf life
24 hours
96
washed RBC shelf life
24 hours
97
prepared WB shelf life
24 hours
98
FFP shelf life
1 year
99
thawed FFP/thawed plasma shelf life
"thawed FFP": 24 hours
"thawed plasma": 5 days
100
frozen cryo shelf life
1 year
101
thawed cryo shelf life
6 hours
4 hours manually pooled
102
platelet shelf life
5-7 days
103
WBD pooled platelet shelf life
4 hours
104
irradiated RBC shelf life
28 days or original exp date
105
granulocytes shelf life
24 hour
106
storage temp for pRBC, thawed RBC, thawed FFP
1-6°
107
storage temp for frozen RBC
≤ -65°
108
storage temp for FFP
≤ -18°
109
storage temp for platelets, granulocytes, thawed cryo
20-24°
110
transport temp for RBCs
1-10°
111
indication for pRBCs
symptomatic anemia
112
indications for washed RBCs
IgA def. with anaphylactoid rxns
recurring severe allergic rxns
113
indications for prepared WB
exhange transfusion
114
indications for FFP
clinically significant deficiency of all coag factors
TTP
115
indications for cryo
hypofibrinogenemia
factor XIII, VIII, or vWF def. if concentrates are unavailable
116
indications for plts
bleeding due to thrombocytopenia or plt function abnormality
117
indication for granulocytes
neutropenia with septicemia not responsive to antibiotics
118
IgG in O type people
anti-A,B
119
ABO discrepancy related to GI problems
acquired B antigen
reverse like an A, forward like an AB
120
alloantibodies that can cause reverse ABO discrepancies
anti-P1
anti-M
121
Fisher-race for R1
DCe
122
Fisher-race for r
dce
123
Fisher-race for R2
DcE
124
Fisher-race for R0
Dce
125
Fisher-race for r'
dCe
126
Fisher-race for r''
dcE
127
Fisher-race for Rz
DCE
128
Fisher-race for ry
dCE
129
most common Rh genotype in Black pop.
Dce/R0
130
2nd most common Rh genotype in both Black pop. and white pop.
dce/r
131
most common Rh genotype in white pop.
DCe/R1
132
when is cord blood tested?
- O mom
- D= mom
- ABS+ mom
- problems expected with neonate
133
testing performed on a DAT+ cord blood
- A cell with A baby, or B cell with B baby (detects ABO HDFN)
- ABS
- ABS+ (not due to RhIG) → eluate
134
used to ID the antibody coating DAT+ cells
eluate
135
RBC antigens with cold Ab
Lewis
P1
MN
136
RBC antigens with warm Ab
Duffy
Rh
Kidd
Kell
Ss
137
RBC antigens destroyed by enzymes
MN
Duffy
138
RBC antigens enhanced by enzymes
Rh
Kidd
139
low freqs
Cw
V
Kpa
Jsa
Lua
140
high freqs
k
Kpb
Jsb
U
P
Lub
141
anti ------- antibodies tend to fade in vivo and in vitro
Kidd
142
ABID steps
- 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
required to give type-specific uncrossmatched blood in an emergency
current type + checktype
emergency release form
uncrossmatched tag on unit
144
FFP released in an emergency
A or AB, depending on policy
145
give ------------ blood after 2 documented febrile rxns
leukocyte reduced
146
when are leukoreduced plts indicated?
likelihood that patient will receive multiple/further plt transfusions
avoid HLA/plt antibody formation
147
can WBD platelets be provided as leukoreduced?
yes, with a bedside reduction filter.
148
these patients are usually phenotyped prior to transfusions to avoid alloimmunization
sickle cell
149
process designed to alert blood product recipients when a donor has tested positive for an infectious disease
lookback
149
only instance when a transfusion can be continued after a trxn
urticarial rxn
give antihistamines
150
infectious disease lookback procedure is used for
HIV
HCV
SARS
WNV
smallpox
151
indication for a neonate receiving many lab tests to be transfused
"bleeding into the lab" — 10% blood loss is an indication for transfusion
especially applies to premature infants
152
equipment used to transfuse infants
screw-driven constant rate syringe
