Blood bank Flashcards
What does the heavy chains determine?
Ig class (IgG, IgA, IgM, IgD and IgE)
what are the light chains
kappa and lamda
which immunoglobulins can pass the placenta?
IgG because it is the smallest (only one that can do that)
what are the donor testing required?
- ABO/Rh (weak D)
- Antibody screening
- phenotybe (on selecting donations)
- Syphilis (treponema pallidum)
- Hepatitis (A, B and C)
- HIV
- Human T-cell lymphotrohic virus I/II
- west nile virus and chaga’s disease when increase in risk present
after a blood unit has been open how low is it good for?
be used within 24 if stored in fridge and within 4 hours if stored at RT
What temperature is RBC unit stored at?
1-6oC (all blood units are stored like this like irratiated blood except for RBC frozen)
What temperature is frozen RBC stored at?
Less then -65oC (frozen in glycerol)
What temperature is Fresh frozen plasma stored at?
less then -18oC
What temperature is cryoprecipitate stored at?
less then -18oC
What temperature is platelets stored at?
RT
What is the shelf life of RBC?
35 days in CPDA-1, 42 days in adenine, 21 days in the other preservatives
What is the shelf life of frozen RBC?
10 years
What is the shelf life of washed RBC?
24h
What is the shelf life of irradiated RBC?
original expiry date ir 28 days after irradiated
What is the shelf life of Fresh frozen plasma?
frozen 12 months, thawed 24h
What is the shelf life of cryoprecipitate?
frozen 12 months , thawed 4h, thawed and pooled 6h
What is the shelf life of platelets?
5 days or 4 hours after pooled/opened
Why would we give a RBC to a patient?
inadequate tissu oxygenation
Why would we give a washed RBC to a patient?
history of severe allergic reaction
Why would we give a to RBC leukocyte reduced a patient?
history of febrile(fever) reaction
Why would we give a RBC irriadiated to a patient?
immunodefiency, malignancy, bone marrow transplant, etc. prevent graft-host disease
What would you give to a patient with deficiency of coagulation factors?
Fresh frozen plasma
Why would we give a cryoprecipitate to a patient?
fibrinogen and factor XIII deficiencies
What do you give to hemophilia A and Von wille brand patients?
cryoprecipitate
Why would we give a platelets to a patient?
low platelet level(thrombocytopenia) or abnormal plt fonction
which immunoglobin causes transfusion reactions
IgG and IgM (ABO can be IgG or IgM)
which immunoglobin causes MHNN?
IgG
What is the optimum temperature for IgG and IgM?
IgG : 37oC
IgM : 25oC or lower
what is called de difference in charge between RBC surface and positives ions around RBC.
Zeta potential, reducing zeta = RBC move closer together
What does 4+ look like in tube ,gel and solid reaction
tube : one solid agglutination
gel : solid band rbc at top
solid : RBC are diffused
What does negative look like in tube ,gel and solid reaction
tube : no agglutinates
gel : well-defined pellet of unagglutinated RBCs at bottom
solid : buton of RBC in bottom of well
Exemples of phenotype and the genotype to match
phenotype : A genotype: AA, AO
phenotype : B genotype: BB, BO
phenotype : AB genotype: AB
phenotype : O genotype: OO
What is the possible genotype of a baby from a AO mother and a BO father
baby : AB, BO, AO, OO
Which blood type is most common?
O
Which blood type is second most common?
A
Which blood type is third most common?
B
If someone is group O which antibody will be found in serum?
Anti-A and Anti-B
If someone is group AB which antibody will be found in serum?
none
Which antigen is on the red cell in a blood type B
B
what blood type is this person if anti-A= neg, anti-B=neg , A cells=+ and B cells= +
type O
what blood type is this person if anti-A=¸+, anti-B=+ , A cells= neg and B cells= neg
type AB
what blood type is this person if anti-A= +, anti-B=neg , A cells= neg and B cells= +
type A
What can cause all negative reactions in ABO panel?
missing isoagglutinins in group O
What can cause anti-A +, anti-B neg, A1 cells 1+ and B cells 4+ in ABO panel?
A2 with anti-A1
What can cause all positive reactions in ABO panel?
Rouleaux or cold antibody
What is the name of Anti-A1 serum?
Dolichos biflorus lectin
Translate the fisher-race to weiner
- Dce
- DCe
- DcE
- DCE
- dce
- dCe
- dcE
- dCE
- Dce : Rho
- DCe : Rh1
- DcE : Rh2
- DCE : Rhz
- dce : rh
- dCe : rh’
- dcE : rh’’
- dCE : rhy
Translate the fisher-race to rosenfield
- Dce
- DCe
- dce
Rosenfield = 1, 2, 3, 4, 5
- Dce : 1, -2, -3, 4, 5
- DCe : 1, 2, -3, -4, 6
- dce : -1, -2, -3, 4, 5
In the Fisher-race antigen which one is the most common?
antigen e (98% have it)
Dce is most common in which race?
black
What happen if the Anti-D is + and the Rh controle is +
invalid, Rh controle needs to be neg
When can cause a false Rh +
rouleaux, cold agglutinate, contaminated or wrong reagent, reaction to reagent
When can cause a false Rh negative
failure to add reagent, suspension to high or incorrect reactive
When to preformed a week D test?
when anti-D and Rh control are neg in Rh typing of donor or infant of mother being evaluated for RhIg
what is the method of a week D test?
incubate Rh typing tubes at 37oC for 15-60min and carry to AHG
What Rh blood type can someone with week D can have?
Rh pos or neg
What Rh blood type can someone with Rh negative can have?
Rh neg only, especially women of childbearing age
what is the most common antigen? (not fisher race)
k (99.8% white and 100% black)
what is the least common antigen? (not fisher race)
K (9% white and 2 % black)
Which antigen is common in cord cells
anti-i (adult cells = I)
warm antibodies
Rh, Kell, Duffy, Kidd
cold antibodies
M, N and P1
What are the naturally occuring antibodies
ABO, Lewis, P1, MN, Lua
What are the clinically significant antibodies
ABO, Rh, Kell, Duffy, Kidd, SsU
which antibodies react with AHG
Kell, Duffy and Kidd
antibodies enhanced by enzymes
Rh, Lewis, Kidd and P1
antibodies eliminated by enzymes
M, N , S and Duffy
antibody enhanced by acidification
M
antibody that cause anamnestic response (delayed transfusion reaction)
Kidd
antibody that cause paroxysmal nocturnal hemoglobinuria
anti-P
antibody that cause cold agglutinine disease
anti-I
antibody that cause mycoplasma pneumoniae infections
anti-I
antibody that cause infectious mononucleosis
anti-i
what is the % of alb in the albumine reagent?
22% bovine serum alb
what is the alb reagent used for ?
reduces net charge of RBC cells
what does Low ionic strengh solution LISS do?
lowers ionic strengh of suspension (allow antigen and antibody move closer together more rapidly)
What does polythyleneglycol PEG do?
used for detection of week IgG antibody
What enzymes are most commonly used for antigen panel?
ficin and papain
What contains in a polyspecific antihuman globulin serum AGH?
IgG and C3D
what is the polyspecific AGH used for?
used for direct antiglobulin test DAT
What contains in a monospecific antihuman globulin serum AHG?
IgG or C3d (one or the other)
what is C3d AHG used for?
investigation of immune hemolytic anemia
what is IgG AHG used for?
Detects clinically significant antibodies
Which test is used for in vivo sensitization?
DAT
Which test is used for in vitro sensitization?
IAT (indirect antiglobulin testing)
what part of the specimen is used for DAT?
red cells
what part of the specimen is used for IAT?
serum, plasma , rbc
Crossmacth is a DAT or IAT
IAT
MHNN is a DAT or IAT
DAT
week D testing is DAT or IAT
IAT
What can cause a false IAT
positive DAT or overcentrifuge
What can cause a false DAT?
Wharton’s jelly in cord blood
What can cause a false negative for DAT and IAT
problem with AGH , not added, contamination or outdated
What would cause all positive cells with AHG and positive in autocontrol
warm autoantibody
What would cause all cells positive for 37oC, neg for AHG and autocontrol positive?
rouleaux
What would cause all cells positive for AHG and negative for autocontrole
multiple antibodies or antibody to high antigen frequency
What would cause positives in different phases of the anitbody panel
combination of warm and cold antibodies
What would cause variant strengh in antibody panel?
multiple antibody
What would cause same strengh and in 1 phase only in antibody panel?
single antibody
If you cant eliminate some antibodies, should we use homozygote cells or heterozygote cells?
homozygotes cells are preferred to avoid missing weak antibodies.
How many negative and positive we need to confirm antibody
3 pos and 3 neg
What do we use for the crossmatch
donor’s blood and recipient’s serum
when do we do AHG crossmatch
if recipient has or had clinically significant antibody, AGH must be negative
What happens if you do a AHG crossmatch and the AHG is positive? (also autocontrole positif)
present of warm antibody
What plasma type can a person group O can receive
O, A, B, AB
What plasma type can a person group B can receive
B, AB
What plasma type can a person group AB can receive
AB
in a trama if typing does not allow what do you give?
O-neg (physician must sign release form)
why would not do reverse grouping
baby blood , =invalide
Quel ingredient dans le sérum-test anti-B peut causé un faux positif?
Acroflavine (donne couleur jaune)
Le gène H est présent chez ?% de la population
99.99% on forme homozygote HH ou hétérozygote Hh
Pourquoi le substance H est augmenter chez les groupes O?
Le H n’est pas transformée en antigène A ou B
Réactivité avec le réactif anti-H lectine (groupe ABO de plus réactif au moins)
- O
- A2
- B
- A2B
- A1
- A1B
Ces quoi l’autre nom du anti-H lectine?
Ulex Europeus
Quoi fait quelqu’un bombay?
Personne est h homozygote (hh)
, donc pas enzyme fucosyltransférase et pas attachement L-fucose
Est ce que quelqu’un bombay(Oh) peut recevoir du sang des autres groupe O?
Non, puisqu’il produit du anti-H , besoin donneur bombay
Can lewis cause MHNN
no, IgM
Développement de l’antigène lewis
Naissance : Le(a-b-)
10 jours : Le(a+b-)
Après : Le(a-b+)
homo ou hetero?
- Élimination ac : controle positif
- Confirnation absence ag : controle positif
- Homozygote
2. Heterozygote
Quoi est toxique pour le bébé après la naissance ? Victime du MHNN
Bilirubine indirect
Ces quoi la formule?
unité/%ag négatif
Un patient avec un anti-K et un anti-Jka, on veut 2 unités. Combien unité on doit tester?
77% la population est jka+
9% la population est K+
Donc 23% est jka- et 91% est K-
2 / 23% × 91%
2/ 0.20
= 10 unités
Un patient avec un anti-Jka à besoin 4 unité. Combien unité devrais-je tester?
77% la population est Jka+
23% la population est Jka-
4/23% = 17.4 = 18 unités
Tester 18 unité pour trouver 4 unité sans l’antigène jka
On donne quoi à une mère qui est Rh- avec un bébé Rh+?
WinRho/RhoGam
Tranfusion reactions : cause hemolytic intravascular
immediate destruction of donor RBC by recipient antobody (most serious reaction)
Tranfusion reactions : cause febrile(fever)
anti-leukocyte antibodies or cytokines (common)
Tranfusion reactions : cause allergic rx
foreign plasma proteins (common)
Tranfusion reactions : cause anaphylactic
anti-IgA in IgA deficient recipient (pulmonary edema)
Tranfusion reactions : cause TRALI
unknown, accumulation of fluid in lungs (most common cause of transfusion reaction death)
Tranfusion reactions : cause sepsis
bacterial contamination (gram +)
Tranfusion reactions : cause TACO
too large a volume or too rapid transfusion
how can we treat anaphylatic transfusion rx
epinephrine
Tranfusion reactions : cause nonimmune hemolysis
destruction of RBC due to extremes of temp
Tranfusion reactions : cause hypothermia
rapid infusion of large amounts of blood
what does RhIg do?
prevent immunization D
what happens transfusion associated graft-vs-host diease?
viable T lymphs in donor blood attack recipient
