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Blood Bank > Blood Bank Unit 2 Exam > Flashcards

Blood Bank Unit 2 Exam Flashcards

1
Q

What is the antiglobulin test (Coombs Test) used for?

A

to detect RBCs sensitized with IgG antibodies and/or complement components

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2
Q

In vitro Coombs Test

A

Indirect (IAT)

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3
Q

In vivo Coombs test

A

Direct (DAT)

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4
Q

How are monoclonal reagents made?

A

spleen lymphocytes from immunized mice are fused with myeloma cells

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5
Q

Monoclonal reagents - specificity (eg. how many antibodies are made)

A

multiple of ONE type of antibody is made that reacts with one specific epitope

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6
Q

How are polyclonal reagents made?

A

by injecting animals with human globulin components and collecting the antihuman antibodies

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7
Q

Polyclonal reagents - specificity (eg. how many antibodies)

A

reacts with multiple epitopes, less specific with a giant mix of antibodies

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8
Q

What can a positive DAT tell us (diagnosis)?

A
  • Hemolytic Disease of the Newborn (in pregnant women)
  • Autoimmune hemolytic anemia (autoimmune diseases)
  • Transfusion reaction
  • Drug/anti-drug complexes
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9
Q

What is the purpose of the DAT?

A

To demonstrate in vivo sensitization of red cells with IgG and/or Complement

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10
Q

What is the purpose of the IAT?

A

To demonstrate in vitro sensitization of red cells with antibody and/or complement

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11
Q

What is the IAT used for?

A

Antibody screening
Antibody identification
Crossmatches
Antigen Typing

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12
Q

Describe the test procedure for the DAT (tube used, suspension, how many washes, etc)

A
  • Collect in EDTA blood bank tube
  • 3-5% RBC suspension with 0.9% saline
  • one drop of suspension washed 3 times
  • 2 drops AHG
  • centrifuge and read (clumping = positive)
  • add indicator cells to negative reactions
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13
Q

When should you add indicator cells? What should the result be? What if the results are not what they should be?

A

Indicator cells should be added to negative reactions only.
Indicator cells should then be positive.
If they are negative, you must repeat everything.

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14
Q

Describe the procedure for the IAT

A
  • 2 drops serum/plasma + 1 drop red cell reagent
  • read at initial spin
  • 2 drops enhancement media (LISS/PEG)
  • incubate 37C for 15 min
  • centrifuge and read
  • wash 3 times
  • add 2 drops AHG reagent
  • centrifuge and read
  • add check cells to negative tubes
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15
Q

Polyspecific Reagent

A
  • green reagent used primarily for DAT that contains both IgG and C3 (cannot differentiate between which one it is binding, agglutination could be either)
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16
Q

Anti IgG reagent

A

monospecific reagent that can detect IgG binding RBC

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17
Q

Anti-Complement reagent

A

monospecific reagent that can only detect Anti C3 complement binding RBC

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18
Q

False Negative sources of error in AHG testing (low sensitivity)

A
  • inadequate washing
  • under centrifugation
  • loss of reagent activity
  • inappropriate RBC concentration
  • failure to add regents
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19
Q

False Positive sources of error in AHG testing (decreased specificity)

A
  • over centrifugation
  • dirty glassware (contamination from bacteria or other patient)
  • agglutination prior to washing in IAT
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20
Q

What are check cells?

A

O positive cells coated with anti-D that serve as cross-linking supplement when AHG added, making sensitization visible

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21
Q

Antithetical

A

antigens that are products of allelic genes (Duffy, Kidd, Rh)

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22
Q

Type

A

the test for ABO and Rh (specifically D) phenotype

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23
Q

Screen

A

The test to determine if there are any antibodies present in the patients plasma

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24
Q

Front Type

A

“what you are” - unknown patient cells tested with known anti-serum

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25
Q

Back/Reverse Type

A

“what you are not” - known cells tested with unknown antibodies

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26
Q

Crossmatch

A

test to see if blood is compatible with pt - mixing of donor blood with pt plasma

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27
Q

IS/Immediate Spin Crossmatch

A

add donor RBC and pt plasma together and immediately spin them and read reaction

28
Q

Extended Crossmatch/AHG crossmatch

A

add pt plasma and donor RBC and incubate 37C for 15 min
add AHG, centrifuge, read
check cells for neg reactions

29
Q

Anti-sera

A

manufactured monoclonal/polyclonal antibody

30
Q

Reagent cells

A

manufactured human RBC that have known antigens

31
Q

Panels

A

Set of reagent cells that allow you to identify antibodies

32
Q

Positive Reaction in blood bank

A

any agglutination or hemolysis that occurs (depends on the test)

33
Q

Negative reactions in blood bank

A

No agglutination or hemolysis occurs (depends on the test)

34
Q

Cell button

A

the clump/pellet of red cells after centrifugation

35
Q

Hemolysis

A

destruction of RBC

36
Q

FFP

A

fresh frozen plasma - contains all clotting factors

37
Q

pRBCs

A

packed red blood cells (red blood cell portion of whole blood)

38
Q

PLTs

A

platelets suspended in a little plasma

39
Q

CRYO

A

a concentrated source of coagulation factor VIII that also contains fibrinogen, factor XIII and VWF.

40
Q

LK

A

leukoreduced - filtered to remove the major of WBC

41
Q

IRR

A

irradiated - gamma radiation of a cellular blood product for protection against graft vs host disease

42
Q

4 types of BB reagents

A

commercial RBCs
Antisera
Antiglobulin reagents
Potentiators

43
Q

Polyclonal vs. Polyspecific Reagents

A

Polyclonal - AHG with IgG and IgM

Polyspecific - AHG with IgG and C3b

44
Q

What is the most specific type of commercial antibodies??

A

Monoclonal antibodies

45
Q

Advantages/Disadvantage of monoclonal antibodies

A

Advantage - highly specific

Disadvantage - very expensive

46
Q

Positive Agglutination reactions for each blood type in FORWARD TYPE reaction

A

A - positive reaction with anti-A
B - positive reaction with anti-B
AB - positive reaction with both anti-A and anti-B
O - no agglutination will occur

47
Q

what color is anti-A reagent

A

blue

48
Q

what color is anti-B reagent

A

yellow

49
Q

what color is anti-D reagent

A

clear

50
Q

what color is anti-A,B reagent

A

clear

51
Q

Forward Typing reactions for D antigen

A

D-positive - positive reaction with anti-D

D-negative - no positive reaction

52
Q

What is a low-protein anti-D reagent?

A

6% bovine albumin that have replaced high protein reagents

53
Q

What should controls show during ABO testing?

A

The control should show no agglutination

54
Q

When is a separate control used?

A

When RBCs agglutinate with all ABO anti-sera (eg. AB+)

A separate control is not needed if there is any negative result in the forward type

55
Q

What procedures use commercial RBCs?

A
  • ABO serum testing (reverse type)
  • screening tests
  • antibody identification
56
Q

What are the reagent RBCs?

A

A1 and B cells

57
Q

Positive agglutination reactions for each blood type during REVERSE TYPING

A

A - positive reaction with reagent B cells
B - positive reaction with reagent A1 cells
AB - no positive reactions
O - positive reaction with both reagent A1 and B cells

58
Q

T/F: A1 and B cells are positive for Rh antigens.

A

False; they are negative for Rh antigens

59
Q

Screening cells

A

Used in antibody screen. Available in sets of 2-3 vials; pt serum added to screening cells to see if antibody/antigen complexes form

60
Q

Panel Cells

A

Similar to screening cells but are 10+ vials

61
Q

LISS

A

increases rate of antibody uptake

62
Q

Potentiators/Enhancement medias

A

LISS, PEG, proteolytic enzymes, BSA

63
Q

what does PEG do

A

Concentrates the antibody in the test environment in LISS

64
Q

what do proteolytic enzymes do

A

removes negative charges from the red cell membrane to reduce zeta potential; denatures some red cell antigens

65
Q

what does BSA do

A

Reduces the repulsion between cells but does not shorten incubation time

66
Q

solid phase positive vs negative reaction

A

positive reaction - no cell button (cells adhere to the sides of the well)
negative reaction - cell button (cells settle to the bottom of the well)

67
Q

Column Agglutination Technology (0-4+)

A 
0 - cells on bottom of tube 
1+ - cells mostly on bottom of tube but towards the middle too 
2+ cells evenly distributed throughout 
3+ cells mostly towards the top 
4+ all cells at the top

Blood Bank (7 decks)

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