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BOC Study Cards (From success book/Polansky) > Blood Bank Polansky Review > Flashcards

Blood Bank Polansky Review Flashcards

1
Q

AABB criteria for whole blood donors

age allogenic

A

> 16 or allowed by state

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2
Q

Criteria for whole blood donors HGB/HCT allogenic

A

hgb >12.5g/dl

Hct >38%

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3
Q

Temperature of whole blood donation criteria allogenic

A

<99.5 f or 37.5c

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4
Q

Autologous whole blood donation requirements

age
hgb/hct
temperature

A

age determined by director

hgb >11g/dl
hct >33%

bacteremia is cause for deferral in temperature

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5
Q

aspirin deferral (if donor is sole source of platelets)

A

2 days

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6
Q

measels/rubeola, mumps, polio, yellow fever vaccine deferral

A

2 weeks

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7
Q

rubella, chicken pox (varicella zoster) vaccine deferral

A

4 weeks

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8
Q

pregnancy deferral

A

6 weeks

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9
Q

whole blood donation deferral

A

8 weeks

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10
Q

syphillis, gonorrhea, skin penetration, hepatitis contact, high risk HIV, Iraq travel…etc deferral

A

12 mos

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11
Q

malaria or endemic region deferral

A

3 years

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12
Q

permanent deferrals

A

parenteral drug use
CJD
GH treatment
hepatitis after 11yrs
Hep B
Chagas/bebesiosis

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13
Q

volume of blood collected routinely

A

450 - 500ml

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14
Q

Time of collection of whole blood

A

<10min, if >15-20min unit may not be suitable for prep of platelets or plasma

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15
Q

apheresis explanation

A

removal of 1 or more components of blood from donor and return of remainders to donor

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16
Q

advantages of apheresis

A

allows collection of larger volumes of specific components, reduces number of donors pt is exposed to

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17
Q

Donor testing required by AABB/FDA

A

Type ABO/Rh (weak D)
Ab Screen

Syphilis
Hep
HIV
HTLV
WNV
bacterial cultures

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18
Q

ACD-A anticoag

A

acid citrate dextrose

21 day life

chelates calcium, apheresis

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19
Q

CPD anticoag

A

citrate phosphate dextrose

21 days

higher pH , better 02 delivery

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20
Q

CP2D anticoag

A

citrate phos double dextrose

21 days

contains 100% more glucose than CPD

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21
Q

CPDA-1 anticoag

A

citrate phos dextrose w adenine

35 days

increases ATP, longer cell storage

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22
Q

additive solution purpose

consituents

lowers?

A

extends shelf life of rbcs to 42 days

glucose for energy, ATP

lowers viscosity

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23
Q

Examples of rbc additive solutions

A

AS-1, AS-3 AS-5

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24
Q

Open system

A

seal on unit is broken to attach external transfer bag, exposure to air poses bacterial contam

used w/in 24hr after opened, stored within 4 hr

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25
Q

closed system

A

sterilty maintained through satellite bags or device, welds tubing from one bag to another, no air exposure

no change in expiration

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26
Q

RBC storage temp
shelf life
indications
Hct

A

centrifuge to separate out WBC

store 1-6c

35 days in CPDA-1

inadequate tissue oxygenation

HCT >80%

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27
Q

how much does one unit of rbcs change HCT/HGB

A

1 unit increases Hgb 1g/dl
Hct 3%

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28
Q

Rbcs adenine, saline added storage
shelf

A

removal of most plasma
1-6c
42 days
mOST COMMONLY USED PRODUCT

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29
Q

frozen rbcs
storage
shelf

A

frozen in glycerol w/in 6 days
<65c after deglyc 1-6c

10yrs, after thaw 24hr

safe for IgA def patients, used to store rare cells

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30
Q

washed rbcs
storage
shelf
indications

A

washed with saline
1-6c

expires 24hr after wash

hxt of severe allergic rxn

not sub for wbc reduced rbcs

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31
Q

RBC leukoreduced
storage
shelf
indications

A

filtration/apheresis method
1-6c
history of febrile rxn

85% original rbcs must be retained
<5x10^6 wbc

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32
Q

irradiated rbcs
storage
shelf
indications

A

cGy irradiation
1-6c
origninal out date or 28 days from irradiation

immunodef,malignancy

prevention of GVH, kills donor t cells

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33
Q

FFP
storage
shelf

A

plasma sep from wb and frozen w/in 8 hr

frozen: <-18c
after thaw 1-6c

frozen: 12mos
thaw: 24hr

coag factor def, contains all coag factors

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34
Q

Cryoprecipitate
prep
storage
shelf
indications

A

thaw FFP at 1-6c, remove plasma, refreeze w/in 1hr

frozen: <-18c
after thaw: RT

frozen: 12mos
thaw: single unit 6hr, pool 6hr if sterile device (4hr regular)

factor I and vIII deficiencies

hemophilia A/VWD

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35
Q

Platelets
prep
strorage
shelf

A

centrifuge w/in 8hr

1st soft spin, (rich plasma) 2nd hard spin (separates plts)

20-24c

5 days from collection, after pooling 4hr

severe tp or abn plt function

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36
Q

Platelet component requirements

A

> 5.5 x 10^10 plts
ph >6.2
incs plts by 5000-10,000 in one unit

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37
Q

apheresis plt
storage temp
shelf life
plt count

A

20-24c
5 days with agitation
>3.0 x 10^11plts

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38
Q

Leukoreduced plt components
storage
shelf
indications

A

wbc removed,
20-24c
open system 4hr
apheresis 5 days

recurrent febrile rxn, decrease risk of CMV/HLA

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39
Q

prestorage pooled plts
prep
storage
shelf

A

ABO identical plts pooled in closed system

20-24c
5 days from collection

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40
Q

Leukoreduction purpose
wbc count
methods

A

to dec wbcs to dec febrile rxn, CMV, HLA

<5 x 10^6 wbcs

apheresis, filtration, filters

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41
Q

RBC storage lesion

A

INC: Lactic acid, Plasma K, Hgb, Aggregates

Decreased: ATP, 2,3BPG, pH, glucose, viable cells, labile coag factors

shift to the left of curve (inc oxy affinity, decreased oxy to tissues)

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42
Q

Primary response
stimulous
lag phase
ab
titer

A

1st exposure to ag
days to mos lag
IgM first, IgG after 2wk
titer is slow, peaks then declines

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43
Q

Secondary response (anamnestic)
stimulous
lag phase
ab
titer

A

subsequent ag exposure
lag phase hours
IgG first
titer rises faster and higher, stays elevated longer

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44
Q

Clin sign ab react at what temperature

A

37c

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45
Q

pH of most ab rxns

A

5.5-8.5

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46
Q

ionic strength

A

reducing ionic strength facilitates interaction of ab with ag (LISS)

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47
Q

optimum serum to cell ratio

A

80:1

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48
Q

what does reducing zeta potential do

A

allows rbcs to move closer together

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49
Q

Gel testing

A

more sensative than tube, rxn stable for 2-3days

AHG doesnt require washing or control cells

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50
Q

Type O frequencies
Whites
blacks
hispanic
asian

A

white 45%
black 49%
hispanic 57%
asian 40%

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51
Q

A frequency
w,b,h,a

A

40, 27, 31, 27

52
Q

B frequencies
W,B,H,A

A

11, 19, 10, 25

53
Q

AB frequency
W,B,H,A

A

4,4,2,7

54
Q

Group O
ags on rbc
antibodies in serum

A

no ags on rbcs
Anti-A, Anti-B in serum

55
Q

Group AB
ag on rbcs
ab in serum

A

A and B ag
no Anti-A or Anti-B

56
Q

ABO discrepency
missing rxns

A

missing agglut in group O
inc reverse RT for 30 min
or 4c

57
Q

Fisher race Rh ag

A

DCEce

58
Q

Weiner Rh ag

A

Rh0
rh’
rh’’
hr’
hr’’

59
Q

Rosenfield Rh ag

A

Rh1
Rh2
Rh3
Rh4..etc

60
Q

Rh frequency
W/B
D

A

85% w
92% b

61
Q

C frequency

A

68% w
27%B

62
Q

E frequency

A

29% W
22% B

63
Q

c frequency

A

80% w
96% b

64
Q

e frequency

A

98% w
98% b

65
Q

most common Rh genes

A

DCe, Dce, DcE, dce

66
Q

r before h

A

BIG
rh’ = C

67
Q

h before r

A

little
hr’ = c

68
Q

R

A

presence of D
Rh1 = DCe

69
Q

0

A

c+e
Dce
Rh0

70
Q

Z or Y

A

C+E
rhy
dCE

71
Q

rh typing
high protein Anti-D

A

pools of human sera
no anti-D
more false pos

rbcs w pos DAT

72
Q

Low protein anti-D

A

monoclonal igM or igG
most used, lower rate of false pos with ig coated rbcs

73
Q

False pos Rh typing

A

warm/cold auto
rouleax
poly rbcs
nonspec agglut
contamination

74
Q

false negative rh type

A

no rgnt added
rbc suspension too heavy
resuspension too vigorous
contamination
blocking of ag sites by ab

75
Q

Weak D testing

A

mother/infant being eval for RhIG

inc tubes at 37c for 15-60min through AHG

76
Q

I system
adults

A

I, trace amounts of i

77
Q

I system cord cells

A

trace I, lots of i

78
Q

Naturally occuring antibodies

A

ABO, Lewis, P1, MN, Lua

79
Q

Clinically significant antibodies

A

ABO, Rh, Kell, Duffy, KIdd, SsU

80
Q

Warm antibodies

A

Rh, Kell, Duffy, Kidd

81
Q

Cold Ab

A

M,N P1

82
Q

Usually only react in AHG ab

A

Kell, Duffy, Kidd

83
Q

can react in any phase of testing Ab

A

lewis

84
Q

detection enhanced by enzyme treatment

A

Rh, Lewis, Kidd, P1

85
Q

not detected with enzymes/destroyed

A

Duffy, M, N

86
Q

enhanced by acidification

A

M

87
Q

Shows dosage

A

Rh other than D
MNS
Duffy
Kidd

88
Q

Binds complement

A

I, Kidd, Lewis

89
Q

Causes in Vitro hemolysis

A

ABO, Lewis, kidd, Kell, P1

90
Q

Labile in vivo and vitro

A

Kidd

91
Q

Associated with PNH paroxymal nocturnal hemoglobinuria

A

Anti-P

92
Q

Assoc w cold agg disease, Myco pneumoniae infections

A

Anti-I

93
Q

assoc with infectious mono

A

Anti-i

94
Q

Albumin

A

22% bovine, reduces zeta potential/net charge of rbcs, allows rbcs to get closer together

95
Q

LISS

A

lowers ionic strength, ag/ab moves closer together more rapidly, reduces incubation time for IAT

96
Q

PEG

A

increases Ab uptake, detects weak IgG abs

97
Q

Enzymes

A

ficin and papain, reduce rbc surface charge by cleaving silaic molevules

M,N,S, Duffy destroyed

98
Q

Polyspecific antihuman globulin serum

A

igG C3d
DAT

99
Q

Monospecific antihuman globulin serum

A

IgG
routine compatibility/ID
clin sign ab detection

100
Q

Anti-C3d or Anti-c3b-c3d

A

complement
immune hemolytic anemias

101
Q

DAT antiglobulin test

A

in vivo sensitization of rbcs by ab

HDFN,tf rxn, AHA

102
Q

IAT

A

in vitro sensitization of rbcs by ig

ab screen, xm, phenotype, weak D

103
Q

same strength and 1 phase only

A

suggestive of single ab

104
Q

all cells in AHG and autocontrol negative

A

multiple ab possible, ab to high frequency ag

105
Q

all cells in AHG, autocontrol pos

A

warm autoab possible

106
Q

all cells at 37c, neg AHGm autocontrol pos

A

Rouleaux

107
Q

Anti-A1

A

cold ab
found only in A subgroups

agglut A1 and A1B but not A2 or O

108
Q

Anti-I

A

cold ab
agg all adult cells except adult i, doesnt agg cord cells

109
Q

Anti-i

A

agg cord cells more strongly than adult cells

110
Q

Anti-H

A

most common in A1 and A1B, agg O most, A1B least

111
Q

Compatibility testing

A

spec collected within 3 days
retain for 7 days after transfusion

112
Q

antiglobulin xm

A

recipient serum and donor rbcs

if recipient has/had clin sign ab

113
Q

IS XM

A

recipient serum/donor rbcs

no clin sign ab, detects ABO incomp, must be taken through AHG

114
Q

what type of plasma can O person recieve

A

O, A, B , AB

115
Q

Pretransfusion testing
what specimens need to be crossmatched?
which dont?

A

rbcs yes
plt/plasma/cryo no xm

116
Q

Acute TFXN
hemolytic intravascular

A

fevers, chill, shock, DIC
backpain

immediate rbc destruction

dec Hgb/Hct haptoglobin

MOST SERIOUS, ABO incompatible

117
Q

Febrile acute TFXM

A

inc temp >1c or 2c
anti-leukocyte wbc

common, multiple transfusion pt, or mult preg

give tylenol or aspirin

118
Q

Allergic TFRXN

A

hives, wheezing

foreign plasma proteins

antihistamines
investigation not required

119
Q

anaphylactic TFRXN

A

pulmonary edema, bronchospamsa

Anti-igA def recipient

dangerous, epi injection, washed products

120
Q

TRALI

A

fever, chills, cough, dec BP,
WBC ag
most common cause of tf assoc death

reduced use of plasma from female donors

121
Q

Sepsis rxn

A

dec Bp, cramps, DIC, fever, rigors, shock

bacteria

122
Q

TACO

A

cough, cyanosis, pulmonary edema

too large volume at rapid rate
children, cardiac pt, elderly/anemia

123
Q

Non immune hemolysis rxn

A

rbc destruction due to temp/medications
hemoglobinuria/emia

124
Q

hypothermia rxn

A

cardiac arrythmia
rapid infusion of cold blood

use blood warmer

125
Q

Delayed hemolytic rxn

A

fever, jaundice after

inc bili, DAT
dec hapto,hgb and hct

Kidd

126
Q

TA-GVHD

A

rash, nausea, pancytopenia,

viable t lymphs attack recipient

irradiate components

127
Q

iron overload

A

delayed transfusion rxn
diabetes, cirrhosis, cardiomyo

inc serum ferritin

repeated transfusion,m sickle cells or anemias

BOC Study Cards (From success book/Polansky) (9 decks)

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