Blood Bank Lab 1 Flashcards
what Ag are on a RBC with blood type A
A
what Ag are on a RBC with blood type B
b
what Ag are on a RBC with blood type AB
A and B
what Ag are on a RBC with blood type O
none
what Ab are in plasma with blood type A
anti B
what Ab are in plasma with blood type B
anti A
what Ab are in plasma with blood type AB
none
what Ab are in plasma with blood type O
anti A and anti B
what sugar defines type O blood
fucose
what sugar defines type A blood
N- acetylgalactosamine
what sugar defines type B blood
galactose
what part of the blood is used for ABO blood type testing
RBC and plasma/serum (both required)
what part of the blood is used during forward type testing
RBC
what part of the blood is used during reverse type testing
plasma/ serum
what is the order of blood parts when it is centrifuged (top to bottom)
plasma, WBC & platelets, and RBC
what immunoglobulin is in Anti a reagent
IgM
what color is anti a reagent
blue
what color is anti b reagent
yellow
what causes agglutination in a forward type test
anti ab reacting with ag on pt RBC
Grade: type O blood + anti A (forward rxn)
0
Grade: type O blood + anti b (forward rxn)
0
Grade: type O blood + anti A,B (forward rxn)
0
Grade: type A blood + anti A (forward rxn)
4+
Grade: type A blood + anti b (forward rxn)
0
Grade: type A blood + anti A, b (forward rxn)
4+
Grade: type B blood + anti A (forward rxn)
0
Grade: type B blood + anti b (forward rxn)
4+
Grade: type B blood + anti A,b (forward rxn)
4+
Grade: type AB blood + anti A (forward rxn)
4+
Grade: type AB blood + anti b (forward rxn)
4+
Grade: type AB blood + anti A, b (forward rxn)
4+
Grade: type O blood + A1 cells (reverse rxn)
4+
Grade: type O blood + B cells (reverse rxn)
4+
Grade: type A blood + A1 cells (reverse rxn)
0
Grade: type A blood + B cells (reverse rxn)
4+
Grade: type B blood + A1 cells (reverse rxn)
4+
Grade: type B blood + B cells (reverse rxn)
0
Grade: type AB blood + A1 cells (reverse rxn)
0
Grade: type AB blood + B cells (reverse rxn)
0
how do you label tubes during a ABO blood type test
last 3 digits of pt ID # with A or B
do you use capital or lowercase A and B for labeling the reverse rxn
lowercase
do you add the reagents or RBC last during an ABO blood type test
RBC
T or F: pt’s RBC need to be diluted before ABO testing
T
what color should the RBC be after diluting
similar color to A1 and B cell reagents
does the Rh blood group have naturally occurring abs
no
if you have the rh ag “D” what does this mean
rh pos
if you get a neg rh what has to be done
37 degree C incubation phase and AHG testing phase
what immunoglobulin is rh ab
IgG
what rh ag typing reagent has limited availability; expensive; and lengthy incubation time
saline reactive
can you use saline reactive reagent with a weak D
no
what rh ag typing reagent increase the likelihood of false pos
high protein
what has to be run with a high protein rh reagent
manufacturers control
can you use high protein rh reagent with a weak D
yes
what rh ag typing reagent relaxes ab molecule by breaking disulfide bonds. ab span distance between RBC in low protein medium
chemically. modified
can chemically. modified rh reagent be used with weak d
yes
what rh ag typing reagent hybridize to increase ab production and ab strength
monoclonal
if a pt is weak D pos what are they considered
rh pos
can you give weak d blood to a d neg pt
no
what do expecting mothers need to be tested for
weak d
can you give d neg blood to a weak d pt
yes
if d tube rxn is pos and rh control is neg cell are considered _____
rh pos
if d tube rxn is neg and rh control is neg preform _____ ______
du testing
what are the 2 most important blood group when transfusing
ABO and Rh
what 2 genes make up the lewis system
H and Se
what ag are dectected in saliva
Lea and Leb
what chain are lewis ags expressed on
type 1
lewis ag are passively _____ onto RBCs from ______
absorbed; plasma
what is the most common lewis phenotype
Le (a- b+)
what lewis phenotype has lewis abs
Le (a- b-)
why do pregnant women have lewis abs
they lose their lewis phenotype during pregnancy
what kind of immunoglobulin are lewis abs
IgM
are lewis Ab clinically significant
no
what kind of ab can be induced by. pregnancy and transfusion
anti-K
def? developed ab when exposed to blood
alloantibody
t or f: anti k is rare
t
what is the most common kell phenotype
K- k+
what kind of immunoglobulin is anti- K
IgG
is anti- K clinically significant
yes
does anti- K bind to C’
no
what ags are the most important in routing blood bank serology
duffy
what are the 2 Duffy ags
Fya and Fyb
what ags are developed as early as 6 weeks gestational age and fully developed at birth
duffy
what kind of Duffy phenotype is resistant to malaria
Fy(a- b-)
what kind of malaria are Fy(a-b-) resistant to
P. vivax
what is the most common Duffy ab
anti-Fya
what kind of immunoglobin are Duffy abs
IgG
what kind of ab shows dosage (3)
duffy, MNS, and kidd
what kind of HTR are associated with Duffy abs
acute and delayed
what are the ags of the Kidd system
Jka and Jkb
T or F: Kidd ags are not very immunogenic
T
what kind of alleles are Jka and Jkb
codominate allleles
T or F: Kidd abs are very common
F
what kind of immunglobin are Kidd abs
IgG
if someone has a delayed HTR to Kidd abs what color will their plasma be
smokey gray
T or F: Kidd abs cause HDFN
F
what special ab do people with Jk(a-b-) phenotype have
anti-Jk3
which one of the Kidd ab can cause HTR and HDFN
anti-Jk3
where are M and N ags found
on glycophorin A
where are S and s ags found
glycophorin B
what sytem do these ags belong to M, N, S, and s
MNS
T or F: MNS ags are well developed at birth
T
what MNS abs are naturally occurring
anti-M
what immunoglobin is the most common form of anti-M
IgM
what MNS ab is more common in children and pts with bacterial infections
anti-M
what ab is made from M+N-
anti-N
what is the most common form of anti-N
IgM
what kind of immunoglobulins are anti-S/s
IgG
what test has this principle: based on antihuman globulins obtained from immunized non-human species bind to human globulins
Coombs/antiglobulin test
what does the Coombs test detect
sensitized RBC
what is polyspecific reagent contain
human IgG and C3d
what is monospecific reagent contain
either anti-IgG or anti-C3b/d
what will occur if the RBC are not washed properly during the Coombs test
false neg
what kind of antiglobilin test detects in vivo sensitized RBC
direct
what kind of antiglobilin test detects in vitro sensitized RBC
indirect
what does a varied reaction strength suggest during Ab testing
more than 1 ab is present or dosage
what are the 3 types of Ab id methods
tube test, column agglutination, and solid phase
T or F: you can use different Ab id methods for initial and ab detection tests
F
what does a neg auto control mean in an ab id test
suggest alloantibody is present
what does a pos auto control mean in an ab id test
suggest transfusion rxn or autoantibody.
what is the exception to the rule if anti-D is present
exclude anti-C and anti-E
when is a X match done on a pt
when they need a transfusion
what does the donor questioner ask
healthy? info correct? pregnant? mediation? traveled? vaccines?
how much does someone have to weigh to donate blood
greater than 110 lbs
how often can you donate blood
every 2 months
how often can you donate platelets
every 7 days
why does the donor questioner ask if you have traveled
they want to know if you have gone anywhere where malaria is prevalent
if you are a prostitute or gay can you donate blood
no
once a donor fills out the q’s what happens
they go into a screening room to go over q’s and do a slight physcical
what is tested during the slight physical (4)
hemoglobin, blood pressure, pulse, and temp
what does your hemoglobin have to be for women
12.5 or higher
what does your hemoglobin have to be for men
13 or higher
how long does it take for your blood to be taken
10-15 min
how long are RBC good for
35-42 days
what affects how long RBC are good for
anticoagulent
how long are platelets good for
5-7 days
what temp are platelets stored at
room temp
why are platelets only good for a short period of time
activity and bacteria grows at room temp
where does your blood go if you volunteer
to anyone
where does your blood go if you are a direct donor
specific person
why is it best to sometimes get volenteer blood
there is no conflict of interest
where does your blood go if it is an autologous donation
yourself
what diseases are screened for prior to donation (7)
hep b, hep c, HIV, West Nile virus, HTLV virus, and syphilis
what must the platelet conc be
3.01 * 10 ^11
Which is not included on a properly labeled specimen?
Patient’s home address
How many days before a pretransfusion specimen expires?
3 days
How many days must a pretransfusion specimen and donor unit segments be retained post-transfusion?
7 days
If a blood type cannot be resolved, what ABO group should be selected for a red blood cell transfusion?
O blood
Which antibody specificity is not required in antibody detection tests?
Cw
A patient has a history of anti-Jk a . The antibody screen is negative. Which red blood cell unit should be selected, and what type of crossmatch should be performed?
Jk(a-) red blood cells, antiglobulin crossmatch
Which is not true of rouleaux formation?
Can be seen in the antiglobulin test
A patient’s blood type is AB-negative, but there are no AB-negative red blood cell units available. What donor units could be selected?
A- neg
A patient requires 15 units of thawed plasma for an apheresis procedure. The patient’s blood type is O-negative. What donor units could be selected? (3)
O-negative, AB-positive, A-negative
The American College of Surgeons recommends transfusion of red blood cells, thawed plasma, and platelets in what ratio for a massive transfusion?
1 unit of red blood cells to 1 unit of thawed plasma to 1 unit of platelets
A patient’s antibody screen was positive and an anti-c was identified. Antiglobulin crossmatches were performed with c-negative units and 1 of the 6 units was incompatible. What should be performed to resolve the incompatible crossmatch?
Retype the incompatible unit for the c antigen, Perform a DAT on the incompatible unit, Perform additional identification testing to include low-specificity antigens
A mother, 30 weeks’ pregnant, has anti-K with a titer of 32. An intrauterine red blood cell transfusion is indicated. The donor unit selected should be all of the following except :
Positive for sickling hemoglobin
A patient with sickle cell disease is B-positive with a pos antibody screen. The antibody identified is anti-D, and the autocontrol is negative. What is a possible explanation?
Patient possesses the partial D phenotype
what kind of unit needs x match testing
RBC
what kind of sample is used in x match
pt plasma
if there is agglutination during a X match what does this mean
donor blood is NOT compatible with pt blood
if there is no agglutination during a X match what does this mean
donor blood is compatible with pt blood
does HDFN occur in utero or ex-utero
both
what causes HDFN
baby has RBC ags that are foreign to mom –> mom makes abs that attack baby RBC
T or F: if the mom is pregnant w/ her 1st child and she is RH neg and the baby is RH pos. the baby will not be harmed
T
what is the most common ab that cause HDFN
anti-D
how is the baby transfused while still in the mom
sonar
if titer is high what does this mean for the chance of HDFN
increased
what kind of sample is used for a DAT on a fetus
cord blood
why does cord blood need to washed 3x during a DAT
worton jelly contaminates
what is given to an RH neg mom w RH pos baby
RHIG
if more than 5 rosettes are seen during a fetal screen what does this mean
maternal hemarage
how many doses of IgG should be given to an Rh neg mom with less than 5 rosettes
1
what test tells you how much fetal blood is in the mothers circulation
kleihauer betke test
what plasma is compatible with O blood
O, A, B, AB
what plasma is compatible with A blood
A and AB
what plasma is compatible with B blood
B and AB
what plasma is compatible with AB blood
AB
what specific antibody classes are specific to anti A and anti B
IgM
Incompatibility of what blood type causes the most serious transfusion reaction
ABO or O blood
what kind of sample is used for a DAT
pt RBC
what kind of sample is used for a IAT
pt serum
what specific type of test is used for weak D testing
Du test
how is the weak D test preformed
after D testing wash tube 3x –> add AHG, spin, read
rh ab are apart of what antiglobin class
IgG
if someone is Rh pos what is there Weiner phenotype
D
Weiner phenotype: Dce
R0
Weiner phenotype: DCe
R1
Weiner phenotype: DcE
R2
Weiner phenotype: DCE
Rz
Weiner phenotype: dce
r
Weiner phenotype: dCe
r’
Weiner phenotype: dcE
r’’
Weiner phenotype: dCE
ry
what clinical conditions would have a pos DAT
TRXN, lupus, anemia, HDN
principle of antiglobin test
antihuman globulin (AHG) antibodies combine with RBCs coated with human immunoglobulin or complement
which rh ab is association HDFN
Rh neg
what blood group can receive FFP
O
