Blood bank Flashcards
1
Q
What does the heavy chains determine?
A
Ig class (IgG, IgA, IgM, IgD and IgE)
2
Q
what are the light chains
A
kappa and lamda
3
Q
which immunoglobulins can pass the placenta?
A
IgG because it is the smallest (only one that can do that)
4
Q
what are the donor testing required?
A
- 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
5
Q
after a blood unit has been open how low is it good for?
A
be used within 24 if stored in fridge and within 4 hours if stored at RT
6
Q
What temperature is RBC unit stored at?
A
1-6oC (all blood units are stored like this like irratiated blood except for RBC frozen)
7
Q
What temperature is frozen RBC stored at?
A
Less then -65oC (frozen in glycerol)
8
Q
What temperature is Fresh frozen plasma stored at?
A
less then -18oC
9
Q
What temperature is cryoprecipitate stored at?
A
less then -18oC
10
Q
What temperature is platelets stored at?
A
RT
11
Q
What is the shelf life of RBC?
A
35 days in CPDA-1, 42 days in adenine, 21 days in the other preservatives
12
Q
What is the shelf life of frozen RBC?
A
10 years
13
Q
What is the shelf life of washed RBC?
A
24h
14
Q
What is the shelf life of irradiated RBC?
A
original expiry date ir 28 days after irradiated
15
Q
What is the shelf life of Fresh frozen plasma?
A
frozen 12 months, thawed 24h
16
Q
What is the shelf life of cryoprecipitate?
A
frozen 12 months , thawed 4h, thawed and pooled 6h
17
Q
What is the shelf life of platelets?
A
5 days or 4 hours after pooled/opened
18
Q
Why would we give a RBC to a patient?
A
inadequate tissu oxygenation
19
Q
Why would we give a washed RBC to a patient?
A
history of severe allergic reaction
20
Q
Why would we give a to RBC leukocyte reduced a patient?
A
history of febrile(fever) reaction
21
Q
Why would we give a RBC irriadiated to a patient?
A
immunodefiency, malignancy, bone marrow transplant, etc. prevent graft-host disease
22
Q
What would you give to a patient with deficiency of coagulation factors?
A
Fresh frozen plasma
23
Q
Why would we give a cryoprecipitate to a patient?
A
fibrinogen and factor XIII deficiencies
24
Q
What do you give to hemophilia A and Von wille brand patients?
A
cryoprecipitate
25
Why would we give a platelets to a patient?
low platelet level(thrombocytopenia) or abnormal plt fonction
26
which immunoglobin causes transfusion reactions
IgG and IgM (ABO can be IgG or IgM)
27
which immunoglobin causes MHNN?
IgG
28
What is the optimum temperature for IgG and IgM?
IgG : 37oC
| IgM : 25oC or lower
29
what is called de difference in charge between RBC surface and positives ions around RBC.
Zeta potential, reducing zeta = RBC move closer together
30
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
31
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
32
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
33
What is the possible genotype of a baby from a AO mother and a BO father
baby : AB, BO, AO, OO
34
Which blood type is most common?
O
35
Which blood type is second most common?
A
36
Which blood type is third most common?
B
37
If someone is group O which antibody will be found in serum?
Anti-A and Anti-B
38
If someone is group AB which antibody will be found in serum?
none
39
Which antigen is on the red cell in a blood type B
B
40
what blood type is this person if anti-A= neg, anti-B=neg , A cells=+ and B cells= +
type O
41
what blood type is this person if anti-A=¸+, anti-B=+ , A cells= neg and B cells= neg
type AB
42
what blood type is this person if anti-A= +, anti-B=neg , A cells= neg and B cells= +
type A
43
What can cause all negative reactions in ABO panel?
missing isoagglutinins in group O
44
What can cause anti-A +, anti-B neg, A1 cells 1+ and B cells 4+ in ABO panel?
A2 with anti-A1
45
What can cause all positive reactions in ABO panel?
Rouleaux or cold antibody
46
What is the name of Anti-A1 serum?
Dolichos biflorus lectin
47
# 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
48
# 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
49
In the Fisher-race antigen which one is the most common?
antigen e (98% have it)
50
Dce is most common in which race?
black
51
What happen if the Anti-D is + and the Rh controle is +
invalid, Rh controle needs to be neg
52
When can cause a false Rh +
rouleaux, cold agglutinate, contaminated or wrong reagent, reaction to reagent
53
When can cause a false Rh negative
failure to add reagent, suspension to high or incorrect reactive
54
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
55
what is the method of a week D test?
incubate Rh typing tubes at 37oC for 15-60min and carry to AHG
56
What Rh blood type can someone with week D can have?
Rh pos or neg
57
What Rh blood type can someone with Rh negative can have?
Rh neg only, especially women of childbearing age
58
what is the most common antigen? (not fisher race)
k (99.8% white and 100% black)
59
what is the least common antigen? (not fisher race)
K (9% white and 2 % black)
60
Which antigen is common in cord cells
anti-i (adult cells = I)
61
warm antibodies
Rh, Kell, Duffy, Kidd
62
cold antibodies
M, N and P1
63
What are the naturally occuring antibodies
ABO, Lewis, P1, MN, Lua
64
What are the clinically significant antibodies
ABO, Rh, Kell, Duffy, Kidd, SsU
65
which antibodies react with AHG
Kell, Duffy and Kidd
66
antibodies enhanced by enzymes
Rh, Lewis, Kidd and P1
67
antibodies eliminated by enzymes
M, N , S and Duffy
68
antibody enhanced by acidification
M
69
antibody that cause anamnestic response (delayed transfusion reaction)
Kidd
70
antibody that cause paroxysmal nocturnal hemoglobinuria
anti-P
71
antibody that cause cold agglutinine disease
anti-I
72
antibody that cause mycoplasma pneumoniae infections
anti-I
73
antibody that cause infectious mononucleosis
anti-i
74
what is the % of alb in the albumine reagent?
22% bovine serum alb
75
what is the alb reagent used for ?
reduces net charge of RBC cells
76
what does Low ionic strengh solution LISS do?
lowers ionic strengh of suspension (allow antigen and antibody move closer together more rapidly)
77
What does polythyleneglycol PEG do?
used for detection of week IgG antibody
78
What enzymes are most commonly used for antigen panel?
ficin and papain
79
What contains in a polyspecific antihuman globulin serum AGH?
IgG and C3D
80
what is the polyspecific AGH used for?
used for direct antiglobulin test DAT
81
What contains in a monospecific antihuman globulin serum AHG?
IgG or C3d (one or the other)
82
what is C3d AHG used for?
investigation of immune hemolytic anemia
83
what is IgG AHG used for?
Detects clinically significant antibodies
84
Which test is used for in vivo sensitization?
DAT
85
Which test is used for in vitro sensitization?
IAT (indirect antiglobulin testing)
86
what part of the specimen is used for DAT?
red cells
87
what part of the specimen is used for IAT?
serum, plasma , rbc
88
Crossmacth is a DAT or IAT
IAT
89
MHNN is a DAT or IAT
DAT
90
week D testing is DAT or IAT
IAT
91
What can cause a false IAT
positive DAT or overcentrifuge
92
What can cause a false DAT?
Wharton's jelly in cord blood
93
What can cause a false negative for DAT and IAT
problem with AGH , not added, contamination or outdated
94
What would cause all positive cells with AHG and positive in autocontrol
warm autoantibody
95
What would cause all cells positive for 37oC, neg for AHG and autocontrol positive?
rouleaux
96
What would cause all cells positive for AHG and negative for autocontrole
multiple antibodies or antibody to high antigen frequency
97
What would cause positives in different phases of the anitbody panel
combination of warm and cold antibodies
98
What would cause variant strengh in antibody panel?
multiple antibody
99
What would cause same strengh and in 1 phase only in antibody panel?
single antibody
100
If you cant eliminate some antibodies, should we use homozygote cells or heterozygote cells?
homozygotes cells are preferred to avoid missing weak antibodies.
101
How many negative and positive we need to confirm antibody
3 pos and 3 neg
102
What do we use for the crossmatch
donor's blood and recipient's serum
103
when do we do AHG crossmatch
if recipient has or had clinically significant antibody, AGH must be negative
104
What happens if you do a AHG crossmatch and the AHG is positive? (also autocontrole positif)
present of warm antibody
105
What plasma type can a person group O can receive
O, A, B, AB
106
What plasma type can a person group B can receive
B, AB
107
What plasma type can a person group AB can receive
AB
108
in a trama if typing does not allow what do you give?
O-neg (physician must sign release form)
109
why would not do reverse grouping
baby blood , =invalide
110
Quel ingredient dans le sérum-test anti-B peut causé un faux positif?
Acroflavine (donne couleur jaune)
111
Le gène H est présent chez ?% de la population
99.99% on forme homozygote HH ou hétérozygote Hh
112
Pourquoi le substance H est augmenter chez les groupes O?
Le H n'est pas transformée en antigène A ou B
113
Réactivité avec le réactif anti-H lectine (groupe ABO de plus réactif au moins)
1. O
2. A2
3. B
4. A2B
5. A1
6. A1B
114
Ces quoi l'autre nom du anti-H lectine?
Ulex Europeus
115
Quoi fait quelqu'un bombay?
Personne est h homozygote (hh)
, donc pas enzyme fucosyltransférase et pas attachement L-fucose
116
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
117
Can lewis cause MHNN
no, IgM
118
Développement de l'antigène lewis
Naissance : Le(a-b-)
10 jours : Le(a+b-)
Après : Le(a-b+)
119
homo ou hetero?
1. Élimination ac : controle positif
2. Confirnation absence ag : controle positif
1. Homozygote
| 2. Heterozygote
120
Quoi est toxique pour le bébé après la naissance ? Victime du MHNN
Bilirubine indirect
121
Ces quoi la formule?
#unité/%ag négatif
122
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
123
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
124
On donne quoi à une mère qui est Rh- avec un bébé Rh+?
WinRho/RhoGam
125
Tranfusion reactions : cause hemolytic intravascular
immediate destruction of donor RBC by recipient antobody (most serious reaction)
126
Tranfusion reactions : cause febrile(fever)
anti-leukocyte antibodies or cytokines (common)
127
Tranfusion reactions : cause allergic rx
foreign plasma proteins (common)
128
Tranfusion reactions : cause anaphylactic
anti-IgA in IgA deficient recipient (pulmonary edema)
129
Tranfusion reactions : cause TRALI
unknown, accumulation of fluid in lungs (most common cause of transfusion reaction death)
130
Tranfusion reactions : cause sepsis
bacterial contamination (gram +)
131
Tranfusion reactions : cause TACO
too large a volume or too rapid transfusion
132
how can we treat anaphylatic transfusion rx
epinephrine
133
Tranfusion reactions : cause nonimmune hemolysis
destruction of RBC due to extremes of temp
134
Tranfusion reactions : cause hypothermia
rapid infusion of large amounts of blood
135
what does RhIg do?
prevent immunization D
136
what happens transfusion associated graft-vs-host diease?
viable T lymphs in donor blood attack recipient
