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Blood Bank Exam 1 Flashcards

1
Q

RBC Membrane is freely permeable to

A
  • Water
  • Anions
  • O2 and CO2
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2
Q

RBC Membrane is NOT freely permeable to

A
  • Na+
  • K+
  • Ca2+
    Active transport is required, using energy (ATP)
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3
Q

RBCs get their energy from

A
  • 90% from Anaerobic Glycolysis
  • 10% from Monophosphate Shunt
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4
Q

Minimum Requirement for pRBC unit viability

A

75% survival of transfused RBCs after 24 hours

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5
Q

RBC storage temp

A

1-6°C

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6
Q

One Unit pRBC contains

A

405-495 mL of blood
63 mL anticoagulant/preservative

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7
Q

WB (Whole Blood) Storage temp

A

1-6°C

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8
Q

Plasma (FFP) Storage temp

A

-18°C or below

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9
Q

Platelets Storage temp

A

20-24°C

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10
Q

Two Stages of Agglutination

A

1: Sensitization
2: Lattice formation

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11
Q

AHG

A

Anti-human globulin, added to assist with lattice formation

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12
Q

PEG

A

Polybrene & Polyethylene Glycol

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13
Q

Zeta Potential

A

Net negative charge on surface of RBCs. Pushes each other away, resisting lattice formation

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14
Q

ABO Forward Reactions

A

Using reagent antisera to test for patient antigens

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15
Q

ABO Reverse Reactions

A

Using reagent cells to test for patient antibodies in serum

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16
Q

ABO Gene Locus

A

Chromosome 9

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17
Q

Hh Gene Locus

A

Chromosome 19

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18
Q

Sese Gene Locus

A

Chromosome 19

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19
Q

Where are blood type antigens found?

A

On RBCs, epithelial cells and in soluble form in the plasma

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20
Q

“H” gene codes for

A

fucosyltransferase, adds fucose to CHO (“carbohydrate”) chain, forming the H antigen

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21
Q

h/h Genotype

A

Bombay blood. No fucose added, no H antigen, no A/B phenotype possible. “Oh” phenotype.

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21
Q

Two types of CHO precursors

A

Type 1 - Body Fluids, 1-4 linkage
Type 2 - RBCs, 1-3 linkage

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22
Q

“A” gene codes for

A

N-acetylgalactosaminyl transferase, adds N-acetylgalactosamine to fucose chain, forming the A antigen

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23
Q

“B” gene codes for

A

Galactosyl transferase, adds galactose to the end of the fucose chain, forming the B antigen

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24
"O" gene codes for
No enzyme (amorph). Fucose remains terminal on the CHO chain, displaying the H antigen
25
Test for Bombay blood
Anti-H lectin
26
"Se" gene codes for
Secretion of H, A, and B antigen (in saliva, tears, bile, milk, etc.)
27
ABO Antibody class from immune exposure
IgG
28
ABO Antibody class that is naturally occurring
IgM
29
Antibody productions starts at what age?
3-6 months of life, ignore reverse reactions on cord blood
30
Discrepancy
When the forward reaction doesn't match the reverse reaction
31
In type A and B patients, antibodies to the opposite tend to be
IgM
32
In type O patients, antibodies to A and B tend to be
IgG
33
Type A vs Type A2
- Type A has A1 and "A" (A2) antigens - Type A2 has A2 antigens only
34
Mixed Field Reaction
Obvious agglutination with a cloudy (unagglutinated) background
35
Group I Discrepancies
Weakly reacting or missing antibody reactions - Age - Immunodeficiency
36
Group II Discrepancies
Weakly reacting or missing antigens; extra antigens - disease-related - acquired B antigens - Rare antibodies
37
Group III Discrepancies
Protein/plasma abnormalities - increased globulins - increased fibrinogen - plasma expanders - Wharton's Jelly
38
Group IV Discrepancies
Miscellaneous - Polyagglutination - Cold reactive antibodies - Warm autoantibodies - Unexpected antibodies - Unexpected Ag-Ab complexes - cis AB phenotype
39
DAT Testing Detects
IN VIVO coating of RBCs with Antibody or C'
40
IAT Testing Detects
IN VITRO reactions of serum and reagent RBCs (hunting for antibodies)
41
IgG 1 is best at
crossing the placenta
42
IgG 4 is least likely to
activate complement
43
Which AHG reagent isn't used in routine testing
Anti-C3d,C3b
44
Common complement binding antibodies
- Anti-A - Anti-B - Anti-Jka - Anti-Lea
45
Check Cells are added to
negative AHG tubes to confirm it as a true negative (both DAT and IAT)
46
Rh control is used when
albumin (high protein) reagent is used
47
Rh control is positive when
DAT is positive
48
If Check Cells are negative
likely error in wash steps
49
3 Phases of IAT testing
- RT - detect "cold antibodies" (IgM) - 37C - detect "warm antibodies" (IgG) - AHG - detects sensitized cells
50
Why are albumin reagents falling out of fashion?
Prone to spontaneous agglutination
51
If you have the D antigen, you are Rh
positive
52
HDN
Hemolytic Disease of the Newborn
53
Where is the D antigen found
on RBCs only (integral membrane component)
54
5 most common Rh antigens
D, C, c, E, e
55
Tippet/Rosenfield
Rh naming system, is primarily used for research
56
Fisher Race
Rh naming system, most used, 3 closely linked loci inherited as a unit
57
Genotype that strengthens expression of D antigen
R2 (cDE)
58
Cis effect
E antigen weakens when on the same haplotype as D
59
Trans effect
E and C antigens weaken when on opposite haplotypes from D
60
Weak D notation
Du
61
Who is tested for weak D
- Blood donors - Mom/Baby testing
62
Anti-G
Anti-C,D; expressed by D neg individuals
63
LW Antigen
Separate from D antigen, but weaker in D neg individuals
64
Rh Null
No Rh Antigens (d/d, deletion of C/c and E/e). Very rare
65
Antibodies to Rh antigens result from
exposure
66
Rh Antigen Immunogenicity
e < C < E < c < D
67
Enhancement Media for Rh antibody testing
PEG or LISS
68
Concomitant Antibodies
Antibodies which often occur together (E and c due to common R1 genotype)
69
Protein % in albumin reagent
20-24%
70
Rhi antigen
C,e compound antigen found on DCe haplotype cells (R1 gene)
71
f antigen
c,e antigen that occurs when c and e are in the same haplotype (Dce)
72
Frequency of D vs d phenotype
85% D, 15% d
73
Frequency of C, c, e
70%
74
Frequency of E
30%
75
Most common Rh haplotypes
DCe (white, native, asian), dce (white, black), Dce (black)
76
Most common Rh genotypes for Caucasians
DCe/dce - 33% DCe/DCe - 18% dce/dce - 15%

MLS (18 decks)

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