Blood bank Final Flashcards
1
Q
% of population that is RH/D + vs -
A
+ is 85%
- is 15%
2
Q
What do the sugars that determine the A and B antigen attach to?
A
H antigen
3
Q
Which blood groups show dosage
A
M, N, S,s, Fya, Fyb, jka, Jkb
4
Q
Which blood groups don’t show dosage
A
I, i, Lea, Leb, P1, Lua, Lub, U
5
Q
R2
A
DcE
6
Q
R1
A
DCe
7
Q
R0
A
Dce
8
Q
Rz
A
DCE
9
Q
r1
A
dCe
9
Q
r
A
dce
10
Q
r2
A
dcE
11
Q
ry
A
dCE
12
Q
Characteristics of Rh antibodies
A
IgG, show up after exposure, no binding to C’, optimal temp is 37ºC, can cross the placenta
13
Q
What is reverse grouping
A
Using the patients serum and known antigen to determine which antibodies are present in the patient
14
Q
Where are the various lectins made from
A
Anti A1- Dolichos Biflorus
Anti H- Ulex Europeus
15
Q
Which antibodies are associated with different diseases
A
I- mycoplasma pneumonia
i- Infectious mono
16
Q
Which antibodies are clinically significantly
A
P1, Lub, K, k, S, s, U, Fya,Fyb, Jka,Jkb
17
Q
Which antibodies are not clinically significant
A
I, i, Lea, Leb, Lua, M, N
18
Q
Minimum plt in different types of plt units
A
Random- 5.5 x 10^10
Apheresis- 3.0 x 10^11
18
Q
Minimum amount of factors in a cryo unit
A
150ml of Fibrinogen and 8 IU of VIII
19
Q
How to calculate fetal bleeding and dose of RhiG to give
A
- Stain and count the cells out of 2000 (#/2000= %)
- % x 50ml/30
- Round the calculated dose then add 1 = required RhIG
20
Q
What is immunogenicity
A
Antigen being able to stimulate an antibody response
21
Q
Are ABO antibodies naturally occurring?
A
Yes
22
Q
How many A individuals are A1
A
80%
23
Antibody vs antigen
Antigens are on the RBCs (blood types are determined by the absence or presence of the antigen)
Antibodies are in the patients plasma (confirm blood type)
24
Anti-Jka
IgG, clinically significant, implicated in hemolytic transfusion reactions and HDFN, common cause of delayed HT, Kidd antibodies decline in reactivity
25
What are the steps in transfusion reaction investigation
Clerical check
Visual check- hemolysis
Post ABO
Post DAT
26
Know which sugars go with which antigens (A, etc.)
Antigen A- N-acetylgalactosamine
Antigen B- D- Galactose
Antigen AB – N- Acetylgalactosamine and D- Galactose
Antigen O- none
27
How much should a patient’s plt (platelet) count go up when given one unit of plts? Same with rbcs and hemoglobin and hematocrit.
RBCs- 1 unit increases patient Hgb by 1 g/dL to Hct by 3%
Plts- each dose of Plts should increase the patients count by 27,000-67,000/uL
28
Know about the correct storage temperature for different types of blood products
RBCs- 1 to 6ºc
Plts- 20-24ºC
Cryo and plasma - -18ºC or lower
Plasma thawed is 1-6ºC
Cryo thawed is room temp
29
What are the universal donors for red cells and plasma?
Universal RBC donor is O-
Universal Plasma donor is AB
30
Know about what leukoreduction does
To remove 99.9% of leukocytes from RBCs and Plts
The goal is <5 x 10^6
31
Know about the IAT and DAT
IAT is in vitro looking for free floating antibodies
DAT is in vivo looking for already bound antigens
32
Know differences between ABO HDFN and Rh HDFN
Most common cause of HDFN is ABO and the first pregnancy is usually affected
Most sever HDFN is Rh and first pregnancy isn’t usually affected
33
Understand why you would give each type of blood product (e.g. increase in oxygen carrying capacity)
RBC are given to increase O2 carrying capacity and increase Hgb/Hct
Plts are given to increase plt count
Plasma is given to increase coag factors, treatment of liver disease/failure and treat DIC
Cryo- is used as a fibrinogen replacement and contains factor XIII and is used to treat factor XIII deficiency
34
Understand the difference between homozygous and heterozygous
Homozygous cells give a stronger reaction (CC)
Heterozygous cells give a weaker reaction (Cc)
35
How long is a crossmatch sample good for?
72 hours or 3 days
36
What tests are required on donor blood?
ABO/RH, Antibody screen, HbsAg, Anti-HBc, Anti HCV-NAT, Anti-HIV-1/2and NAT, Anti-HTLV-I/II, WNV RNA, Syphilis, T. Cruzi, plt bacteria detection
37
Most of the population is what 2 blood types
A+ and O +
38
Cold agglutinins
Preform prewarming techniques to fix problems
Paroxysmal Cold Hemoglobinuria- Positive one the Donath-landsteiner test. In children and young adults
Cold hemagglutinin disease- In elderly or middle age adults, negative for the Donath-landsteiner test
Pathological cold antibodies are clinically significant
39
Which antibodies do not react at 37 degrees C or AHG?
I, i, Lea, Leb, P1, Lua, M, N
40
Know about the Donath-Landsteiner test
A test which is used to confirm PCH. The test involves collecting fresh blood from a patient and seperated into 3 sets of 3 tubes mixed with O RBCs that express the P antigen. Tubes A1-C1 and A2-C3 will be positive, tubes A3-C3 will be negative
41
What is the crossmatching protocol for plts and/or plasma?
There is none. Plasma products don’t have RBC antigens. They only have antibodies
42
Why do we do serological testing of blood products?
Type and screen- blood type
Antibody detection and identification
Cross match
43
Why do we irradiate blood products?
To prevent GVHD in immunocompromised or immunosuppressed patients
44
Why do we leukoreduce prbcs?
Prevent graft vs host disease
Prevent febrile non hemolytic transfusion reactions
Prevent or delay the development of HLA antibodies
Reduce the risk of transmission CMV
45
Acute hemolytic transfusion reaction
rapid destruction of RBCs within 24hrs
Hypotension, shock, acute renal failure
46
Transfusion-Associated Sepsis
bacterially contaminated blood
Temp increase >2º, profound hypotension
47
Febrile Non-hemolytic transfusion reaction
Cytokines or WBC cause recipient reaction
1ºC increase in body temp, increase blood pressure
48
Allergic Transfusion reaction
recipient antibodies response to an allergic in the blood components
Weals, erythema, hives
49
Anaphylactic transfusion reaction
IgA deficient patients
Tongue, swelling, bronchoconstriction
50
Transfusion related acute lung injury
Bilateral infiltrates, respiratory distress
51
Transfusion associated circulatory overload
Hypertension, congestive heart failure, renal failure, hepatic cirrhosis
52
What would be the probable genotype of a patient who phenotypes as A Pos, Le(a-b-)?
Lele, Se, A/B/H gene
53
Know criteria for IS crossmatches
Patient plasma and donors RBCS
In minor crossmatch- you need donor serum and patient RBCs
54
Know Bombay phenotype and the genotypes that cause it
Makes the H gene- no H gene = no ABO expression, patient would be Only compatible with other non Bombay individuals
