Blood Banking Flashcards
1
Q
Who did the First Blood Transfusion
A
Pope Innocent VII (1942)
2
Q
Discovered Sodium Phosphate for blood preservation
A
Braxton Hicks (1869)
“**18 **yrs old ka na mag Bra ka Na Pho”
3
Q
Discovered the ABO Blood Group and first man to do forward typing
A
Karl Landsteiner (1901)
4
Q
Discovery of fourth blood group AB blood group
A
Alfred von Decastillo and Adriano Sturli (1902)
5
Q
Vein to vein transfusion using multiple syringes and a special cannula
A
Edward Lindemann (1913)
6
Q
Direct transfusion using sodium citrate as an anticoagulant
A
Albert Hustin (1914)
7
Q
Determined the minimum amount of sodium citrate for anticoagulatio
A
Richard Lewisohn (1915)
8
Q
Use of glucose as preservative
A
Rous and Turner (1916)
9
Q
Acid Citrate Dextrose
A
Loutit and Mollison (1943)
10
Q
Citrate-Phosphate Dextrose
A
Gibson (1957)
11
Q
Refers not only to genetically encoded Ag in erythrocytes but also in other blood constituents including leukocytes, platelets, and plasma
A
Blood Group Ag
12
Q
Characteristics of Ag
A
1.Chemical composition - proteins are best immunogens
2. Complexity - number of available epitopes
3. Molecular size - MW > 10,000D
13
Q
Ranking of the Immunogenecity of Blood group antigens
A
- A and B antigens
- RhD
- K
- Fya and common Rh antigens
14
Q
Antibody directed against antigens not present on yourself
A
Alloantibodies
15
Q
Antibodies directed against own antigens
A
Autoantibodies
16
Q
Antibodies that are present in the serum of individuals that have never been previously exposed to RB antigens by transfusion, injection, or pregnancy
A
Naturally Occuring Antibodies
17
Q
Naturally Occurring Antibodies are usually _ antibodies
A
IgM (mostly insignificant)
18
Q
The Naturally Occuring Antibodies (IgM)
A
LIPMAN (Lewis, Lua, li, P, MN, AB)
19
Q
Antibodies found in the serumf of individuals who have been transfused or who are pregnant
A
Rich Daring Kidd can Kill (Rh, Duffy, Kidd, Kell, Ss, Lub)
20
Q
Anti-I can be neutralized by what
A
Mother’s milk
21
Q
Anti-H can be neutralized by what
A
Saliva
22
Q
Anti-Sdᵃ can be neutralized by what
A
Guinea Pig Urine
23
Q
Anti-Chido, Anti-Rodgers can be neutralized by what
A
Plasma/Serum
24
Q
Anti-Lewis can be neutralized by what
A
Secretor saliva, plasma/serum
25
Anti-P1 can be neutralized by what
Hydatid cyst fluid
26
Most common reaction in Blood Bank
Hemagglutination
27
Clumping of rbcs due to formation of Ag-Ab bridges bet RBC Ag and Ab.
Hemagglutination
28
Development of an insoluble Ag-Ab complex from reactio of soluble Ag and Ab
Precipitation
29
Opposite of Hemagglutination and is used in secretory studies where positive is no agglutination
Agglutination Inhibition
30
Complement-mediated RBC lysis due to Ag-Ab reaction
Hemolysis
31
**One solid** aggregate
| grading and scoring of Hemagglutination Tube method
4+ | 10
32
Hemolysis
| grading and scoring of Hemagglutination Tube method
H | 10
33
**Several medium** to large aggregates
| grading and scoring of Hemagglutination Tube method
3+ | 8
34
**Medium** aggregates with clear background
| grading and scoring of Hemagglutination Tube method
2+ | 5
35
**Small** aggregates with turbid background
| grading and scoring of Hemagglutination Tube method
1+ | 3
36
**Few small** aggregates with many unagglutinated cells
| grading and scoring of Hemagglutination Tube method
w+ | 1
37
**No** agglutination or hemolysis
| grading and scoring of Hemagglutination Tube method
0 | 0
38
Mixed field
| grading and scoring of Hemagglutination Tube method
mf | NA
39
Rouleaux
| grading and scoring of Hemagglutination Tube method
R | NA
40
Non specific aggregation appearing like stack of coin
Rouleaux
41
How to correct Rouleaux formation
Saline wash
42
Who developed Gel Technology method
| Hemagglutination Reaction
Dr Yves Lapierre
43
Advantages of Gel Technology
1. No washing needed
2. Control cells are not needed
3. More stable endpoint
4. More reproducible result
5. Standardization
6. Smaller Sample Volume
7. Enhanced Sensitivity and Specificity
44
Disadvantage of Gel Technology
Need for special Equipment
45
Incubation time of Gel Technology
15 mins
## Footnote
"In"cubation - Fif"teen"
46
Centrifugation time of Gel Technology
10 mins
## Footnote
"Cen"trifugation - "Ten"
47
Agglutinated cells from a cell layer at the **top** of the gel media
| Grading in Gel Technology
4+
48
Agglutinated cells begin to disperse into gel media and are **concetrated near the top** of the tube
| Grading in Gel Technology
3+
49
Agglutinated cells disperse into the gel media and are **observed throughout the length** of the tube
| Grading in Gel Technology
2+
50
Agglutinated cells disperse throughout the gel media and may **concentrate toward the bottom** of the tube
| Grading in Gel Technology
1+
51
All cells pass through the gel media and form a **cell button at the bottom** of the tube
| Grading in Gel Technology
Negative
52
Agglutinated cells form a layer at the **top** of the gel media and unagglutinated cells pass to the **bottom** of the tube
| Grading in Gel Technology
Mixed Field
53
Brings reactants closer together by increasing the gravitational forces on the reactants
Centrifugation
54
Undercentrifugation of specimen
| Factors that influence Ag-Ab reaction
False Negative
55
Overcentrifugation of specimen
| Factors that influence Ag-Ab reaction
False Positive
| > 10minss
56
What zone when there is Excess Ab
Prozone
| False Negative
57
What zone when there is Excess Ag
Postzone
| False Negative
58
How to correct Prozone
Dilution
59
How to correct Postzone
Repeat the other day, wait to create more antibody.
60
Weak expression of antigen on RBCs due to heterozygous inheritance of genotypes
Dosage Effect
61
Anitgens that exhibits dosage effect
Rh except D, MNSs, Kidd, Duffy, Lutheran
62
Most Ab react best at what pH
| (optimum pH)
6.5-7.5
| (except anti M which reacts stronger below pH 6.5)
63
IgM reacts best at what temperature
Room temperature
64
IgG reacts best at what temperature
37 deg C
## Footnote
except auto anti-P for it also reacts at Room temp also even though it is also an IgG.
65
Auto anti-P is also known as _ and is present in _
Donath Landsteiner Ab | PCH (Paroxysmal Cold Hemoglobinuria)
66
Zeta potential depends on _ _ and _
1. Electronegativity of the RBC
2. Dielectric constant
3. Ionic strength
67
Purpose of the enhancement media
Decreases the zeta potential
68
It increases the dielectric constant which reduces zeta potential
Protein Media
69
Incubation time of PEG (Polyethylene glycol)
10-30 mins
70
Benefits of using PEG
1. Increased sensitivity
2. More specific - reduces false-positive results
3. More effective in detection of weak antibodies
71
It **decreases** the **ionic strength** of a reaction medium which reduces the zeta potential
LISS (Low Ionic Strength Solution)
72
Most commonly used Enhancement media
LISS
| (but prone to false-positive results)
73
Incubation time of LISS
5-15 mins
74
Enhancement media that is used in detection and identification of blood group antibodies
Proteolytic Enzymes
75
Proteolytic enzymes enhances what blood groups
PRIKLe (P, Rh, I antigens, Kidd, Lewis)
76
Proteolytic enzymes enhances what blood groups
Duffy, MN antigens
| Kell is unaffected
77
Ficin is from
fig plants
78
Papain is from
Papaya
79
Trypsin is from
pig stomach
80
Bromelin is from
pineapple
81
The anti IgG reagent
AHG reagent
82
Who introduced the AHG reagent
Coombs, Mourant, and Race
83
Purpose of AHG reagent
Used to detect weak or incomplete Ab ( IgG )
84
First Blood Group System reported after Coomb's test was introduced
Kell Blood Group
85
It detects **in vivo** sensitization of RBC with Ab or complement
## Footnote
Specimen: Whole Blood
Direct AHG Test (DAT)
## Footnote
Uses of DAT
1. HDN - Maternal Ab coating fetal RBCs
2. HTR - recipient Ab coating donor RBCs
86
It detects **in vitro** sensitization of RBCs
## Footnote
Specimen : Serum
Indirect AHG Test (IAT)
## Footnote
Uses of IAT
1. Crossmatching
2. Ab detection and identification
87
2 Types of AHG reagents
1. Polyspecific
2. Monospecific
88
AHG reagent that contains anti-IgG **and **anti-C3d
## Footnote
Sensitive and useful in detection of anti-Jka
Polyspecifc AHG reagent
89
AHG reagent that contains anti-IgG **or** anti-C3d
## Footnote
Specific
Monospecific AHG reagent
90
Mixture of Ab of different specificites produced from **different B cell clones** and are from **rabbits**
Polyclonal
91
Antibodies of the same specificity produced from a **single B cell clone** and are from **mice**
Monoclonal
92
A **Group O Rh-positive RBC** sensitized with Anti-D (IgG) that is used to **confirm negative AHG results**
Coomb's Check Cell
93
Designed to group antigens which are biochemically, genetically, or serologically similar but **genetic basis has not yet been discovered**
Collections (200)
94
**Most important** of all blood group system and **most immunogenic**
ABO Blood Group system
95
Most common cause of HDN
| (Blood group system)
ABO Blood Group system
96
Landsteiner rule
1. Antigen on RBC determines the blood group
2. If an individual lacks ABO antigen in their red cells, they posses the corresponding antibody in their serum
97
Blood Group A
| What Ag on RBC and what Ab o serum
A antigen | Anti-B
98
Blood Group B
| What Ag on RBC and what Ab o serum
B antigen | Anti-A
99
Blood Group O
| What Ag on RBC and what Ab o serum
None | Anti- A, Anti-B, Anti- A,B
100
Blod group that is high risk of ulcer
O
101
Blood Group AB
| What Ag on RBC and what Ab o serum
AB antigen| None
102
In ABO blood group which is the most common to least common
O > A > B > AB
103
Blood group that is high risk of gastric carcinoma
A & AB
104
It detects the **antigen** on the surface of RBC
| Sample: **Patient Red Cell**
Reagent: **Known anti-sera/ab**
Forward Typing
## Footnote
Color of antisera:
1. Anti-A - Blue
2. Anti-B - Yellow
3. Anti-D - Color
105
It detects the ABO antibodies in the serum
| Sample: **Serum**
Reagent: **4-5% Red Cell Suspension**
Reverse/Serum Typing
| * confirms forward typing
* not required in infants <4months old
106
What relationship is there bet forward and reverse typing
Inverse reciprocal relationship
| If not then there is discrepancy in result
107
ABO gene is found where
In the long arms of **chromomsome 9**
108
It controls the presence or absence of ABH antigens on the RBC
H gene
109
Pattern of Inheritance in ABO Blood Groups
Codominant
| O gene is considered amorph
110
It controls the presence or absence of ABH antigens in secretions
Se gene
111
N acetylglucosamine in beta **1 → 3 linkage** and precursor substace in **secretions**
Type 1 Precursor substance
112
Enzyme in the H gene
L-fucosyl transferase
| Immunodominant sugar: L-fucose
113
N acetylglucosamine in **beta 1 → 4 linkage **and precursor substace in **red blood cells**
Type 2 Precursor substance
114
Enzyme in A gene
N-acetylgalactosaminyl transferase
| Immunodominant sugar: N-acetyl-D-galactosamine
115
Enzyme in B gene
D-galactosyltransferase
| Immunodominant sugar: D-galactose
116
Enzyme in O gene
None
| Immunodominant sugar: None
117
Enzyme in Se gene
L-fucosyl transferase
| Immunodominant sugar: L-fucose
118
Amount of H antigen from Greatest to Least in ABO
O>A2>A2B>A1>A1B
119
AA/Hh/SeSe
| ABH Substance in RBC | ABH in Secretion
A, H | A, H
120
BB/Hh/Sese
| ABH Substance in RBC | ABH in Secretion
B, H| B, H
121
AB/HH/Sese
| ABH Substance in RBC | ABH in Secretion
A, B, H | A, B, H
122
OO/Hh/Sese
| ABH Substance in RBC | ABH in Secretion
H | H
123
AB/Hh/sese
A, B, H | None
124
AA/ hh/ Sese
| ABH Substance in RBC | ABH in Secretion
None | A, H
125
Bombay phenotype first reported by
Bhende in Bombay India
126
Patient is "A" secretor
Saliva + Anti-A + A cell = Agglu or no agglu
Saliva + Anti -B + B cell = Agglu or no agglu
| Agglutination Inhibition
No agglutination
Agglutination
127
Patient's genotype is AB/Hh/sese
Saliva + Anti-A + A cell =
Saliva + Anti-B + B cell =
Both with agglutination
| Patient is a nonsecretor "sese"
128
Ag and Ab seen in Bombay phenotype
No antigen | anti-A, anti-B, anti-AB, anti-H
129
An accused rapist is group B. During the investigatio a semen sample from the victim was taken and agglutination showed the following reactions:
Semen + Anti-A + A cell = Agglutination
Semen + Anti-B + B cell = Agglutination
Semen is Anti-H + O cell = No agglutination
Do the results suggest that the accused man is really the rapist? Why?
No because the specimen was from a group O secretor and the accused rapist was a group B.
130
Phenotype of Bombay phenotype
Blood group O
| But Type O has no anti-H antibody which Bombay have
131
Bombay phenotype can receive what blood type
Bombay phenotype only
132
It is used to differentiate ABO subgroups and alternative to antisera
ABH Lectins
133
Lectins used for the A1 antigen
*Dolichus biflorus*
| Diff. A1 and A2 (agglutination on A1)
134
Lectins used for B antigen
*Griffonia simplicifolia*
| Diff. True B vs Acquired B (agglutination on True B)
135
Lectins used for H antigen
*Ulex europaeus*
| Diff. Type O vs Bombay (agglutination on Type O)
136
Most common type of discrepancy in ABO discrepancies
Group 1 discrepancy
| (Newborn, Elderly patients, immunosuppressive drugs|check px history)
## Footnote
Discrepancy in **reverse** grouping due to reacting or missing **antibodies**
137
Least frequently encountered ABO discrepancy
Group 2 discrepancy
| (Subgroups of A or B, Leukemia,Acquired B phenomenon)
## Footnote
Missing reactions in **forward** typing due to weakly reacting or missing **antigen**
138
Discrepancies bet forward and reverse groupings due to **plasma abnormalities** and result rouleaux formation
Group 3 Discrepancy
| (Multiple myeloma, Elevated Fibrinogen | Saline wash to correct)
139
RHD and RHCE is found where
Chromosome 1
140
RHAG gene is found where
Chromosome 6
| A co-expressor of RH blood group
141
Discrepancies bet forward and reverse grouping due to miscellaneous problems
Group 4 Discrepancy
| (Cold reactive autoantibodies, Unexpected alloantibodies)
142
States that antigens of the system were produced by **3 closely linked** sets of alleles (D, C, and E genese)
| Theory
Fisher-Race Theory
143
"d" denotes _
| Fisher Race
Absence of D antigen
144
It states that **two genes** control the expression of Rh antigens (RHD and RHCE)
| Theory
Tippet Theory
145
States that a **single** gene produces a single product that contains separately recognizable factors
| Theory
Wiener Theory
146
Discovered Rh Blood Group
Levine and Stetson
147
Most important blood group system associated with HDN
RH Blood Group
| RH gene: RHD and RHCE
148
Most widely accepted Genetic Inheritance Theory
Tippet Theory
149
*Rh⁰*
| Blood Factor | Fisher Race Antigens
## Footnote
Wiener RH-HR Terminology
Rh₀hr'hr'' | Dce
150
*Rh²*
| Blood Factor | Fisher Race Antigens
## Footnote
Wiener RH-HR Terminology
Rh₀hr'rh'' | DcE
151
*rh'*
| Blood Factor | Fisher Race Antigens
## Footnote
Wiener RH-HR Terminology
rh'hr'' | Ce
152
*Rh^ᶻ* or *Rh^ʸ*
| Blood Factor | Fisher Race Antigens
## Footnote
Wiener RH-HR Terminology
Rh₀rh'rh'' | DCE
153
1. R = _
2. r = _
3. 1 or ' = _
4. 2 or " = _
5. Z or y = _
6. absence of 1 or ' = _
7. absence of 2 or " = _
| Wiener Terminology
1. D
2. d
3. C
4. E
5. CE
6. c
7. e
154
*Rh¹*
| Blood Factor | Fisher Race Antigens
## Footnote
Wiener RH-HR Terminology
Rh₀rh'hr'' | DCe
155
*rh*
| Blood Factor | Fisher Race Antigens
## Footnote
Wiener RH-HR Terminology
hr'hr'' | ce
156
*rhʸ* or *rh^ᶻ*
| Blood Factor | Fisher Race Antigens
## Footnote
Wiener RH-HR Terminology
rh'rh'' | CE
157
Wiener : r⁰R²
Fisher-Race: | Rosenfield:
dce/DCE | 1, 2, 3, 4, 5
158
*rh''*
| Blood Factor | Fisher Race Antigens
## Footnote
Wiener RH-HR Terminology
hr'rh'' |cE
159
Wiener : R¹r¹
Fisher-Race: | Rosenfield:
DCe/dCe | 1, 2, -3, -4, 5
160
Wiener : rr^ᶻ
Fisher-Race: | Rosenfield:
ce/CE | -1, 2, 3, 4, 5
161
Wiener : R'r"
Fisher-Race: | Rosenfield:
DCe/dcE | 1, 2, 3, 4, 5
162
Rh positive or negative depends on the presence of the _
D antigen
| Rh + = Have D antigen
Rh - = No D antigen
163
Most Immunogenic to least for DCEce
D>c>E>C>e
164
What type of typing is used in Rh typing
Forward typing
| They are not naturally occurring Ab
165
It is required for the weak D detection
IAT (Indirect AHG test)
166
RHD genes code for a weakened expression of D antigen. **D antigens are complete but fewer in number**
Genetic weak D
167
**Positional effect** or gene interaction effect. **Arrangement of the C antigen in relationship to the D antigen** appears to **interfere w/ expression of D antigen**.
C in Trans to RHD
168
One or more D epitopes is either missing or altered where the Rh positive with **anti-D to the missing part.**
Partial D/D Mosaic
| **Rh- blood should be transfused**
169
Weak D
as Patient is typed as _
as Donor is typed as _
Rh -
Rh +
170
The individuals lack all Rh antigens on their RBC
RHnull
| Associated with Stomatocytosis
## Footnote
Meaning they produce all Rh antibodies since they lack all antigens
171
Reduced expression of all Rh antigens
RHmod
172
Type of RHnull where is a mutation in the RHAG gene
Regulator-type RH null
173
Type of RHnull where is a mutation in the RHCE and RHD genes
Amorphic type RHnull
174
RH antibodies most are _ and reacts best at _
IgG | 37c
175
RH antibodies causes _ hemolysis
extravascular
| also causes HDFN and do not bind coplement
176
Most severe HDFN
RH HDFN
| mother is Rh negative and fetus ir Rh positive
176
Most common HDFN
ABO HDFN
| where mother is type O and fetus is type A or B
177
It is done to check fetal distress and fetal lung maturity
Amniocentesis
177
The use of whole blood or equivalent to replace the neonate's circuating blood to prevent **kernicterus**
Exchange Transfusion
177
Purpose of Intrauterine Transfusion
Transfusion of pRBC to fetus to correct anemia; maintain Hb>10g/dL
## Footnote
*Sample crossmatching using Mother's serum because fetus still has no antibodies*
178
Criteria for Exchange and Intrauterine Transfusion
1. Group O Rh- neg blood
2. <7 days old (reduces risk of hyperkalemia)
3. CMV negative
4. Leukoreduced
5. Irradiated
6. HbS negative
179
Safest blood for baby
Group O Rh- negative blood
180
It competes with the mother's antibodies for the Fc receptors on the macrophage in the infant's spleen
Intravenous Immune globulins
181
It is administered to prevent immunization to D antigen
Rhogam
182
Criteria for RhIg administration
1. Mother is Rh- negative
2. Baby is Rh-positive or Rh-unknown
3. Mother is not previously immunized and has nto formed anti-D
| It is given **72 hours** after birth
183
Regular dose of vial is sufficient to protect against _ mL _ or _ mL _
15mL pRBC or 30mL WB
184
Screening Test before Rhogam administration
Rosette Test
| it checks the fetomaternal hemorrhage
185
Quantitative test done to know how many vial is to be administered
| determines the approximate vol. of Fetomaternal bleed
Kleihauer Betke Acid Elution Test
## Footnote
Ghost Cell: Mother's Cell
Intact Cell: Fetal Cell
2000 cells are counted
186
FMH 2 formulas
1. %fetal cell = (# of fetal cells / 2000 ) * 100
FMH = %fetal cell x 50
2. FMH = (Number of fetal cells * Maternal blood volume) / Number of maternal cells
| estimated maternal blood is 5000mL
187
Number of vials of rhogam to be administered formula
Number of vials = FMH / 30
(Then add one vial to the rounded calculated answer)
| Since the kleihauer betke is an estimate
188
A Kleihauer-Betke acid elution test identifies 50 fetal cells in 2,500 maternal redcells. How many full doses of RhIg are indicated?
5
189
Difference of the M and N antigen
M antigen : 1st amino acid in Serine and 5th is Glycine
N antigen : 1st Leucine and 5th is Glutamic acid
| MN antigen both easily degraded by enzymes
189
Anti M reacts best at pH _
6.5 pH
| And it is a naturally occurring antibody (IgM)
190
Antibody that is seen in renal patients who were dialyzed on equipment sterilized with **formaldehyde**
| Other blood group systems
Anti-N
| an IgM
190
Disease Associated with the GPAᴹ
Receptor for pyelonepgrogenic strains of E. coli
190
Disease associated with GPA and GPB
Receptor for Plasmodium falciparum
| P. falciparum -deadliest causative agent of malaria
190
Associated disease with Anti-P1
Echinococcus granulosis and Fascioliasis
190
Antibody that was first describe in the serum of **Mrs. Jay** a p individual
Anti-Tja/Anti-PP1Pk
190
Associated abortion with Anti-Tja/Anti-PP1Pk
Spontaneous abortion
190
Associated abortion with Alloanti-P
Habitual early abortion
190
Pᵏ antigen disease associated
Shiga toxin and E.coli associated with HUS
190
Disease associated with P antigen
Parvovirus B19
190
Prevalenc of Lutheran phenotype
Lu(a-b+) > Lu(a+b+) > Lu(a+b-) > Lu(a-b-)
## Footnote
Homozygous B > Heterozygous AB > Homozygous A > Null
190
The First Blood Group System discovered ater introduction of AHG
Kell Blood Group
| **Antigens are found only on RBCs**
## Footnote
Expression of the Kell antigen is **dependent on Xk protein**
190
Absence of Xk protein
McLeod Phenotype
| associated with CGD and acanthocytosis
190
Most common antibody after ABO and Rh antibodies
Anti-K
| IgG | Implicated in HTR and HDFN
191
2 antigen of the Lewis blood group
Leᵃnd Leᵇ
191
Where is Le gene located
chromosome 19
| must be preset for a precursor substance to Leᵃ
191
Phenotype of Non secretor Lewis BGS | secretor | cord blood, pregnant mother
Le(a+b-) | Le(a-b+) |Le(a-b-)
191
Leᵇ disease associated with
receptor of H.pylori and Norwalk virus
191
Leᵃᵇ disease associated with
marker for Reedsternberg cell
| Seen in Hodgkin's lymphoma
191
Le (a-b-) disease associated with
increased susceptibility to Candida and Uropathogenic E. coli
191
Duffy antigens
Fya, Fyb
| destroyed by enzyme
191
Fy(a-b-) disease association
Resitance to P.vivax and P.knowlesi
191
Which blood group system is associated with resistance to Plasmodium vivax and Plasmodium knowlesi
Duffy blood group
191
Blood group antigens that are Microbial Receptors
1. MNS
2. Duffy
3. P
4. Lewis
5. Cromer
6. Ok
| Mom, Dad, Palo CROMER, Ok?
191
Kidd blood group 3 antigens
Jka, Jkb, Jk3
| Antibodies : Anti-Jka and Anti-Jkb
191
Most common cause of the Delayed Hemolytic Transfusion Reaction (DHTR)
Kidd Blood Group System
| Delayed ang pag iisip ng bata kaya DHTR
191
At birth RBCs are rich in _ antigen and in adult RBCs are rich in _ antigen
| I or i
i | I
| only trace amount of i antigen in adult
191
Adult i antigens is associated with
Congenital cataracts in Asians
## Footnote
*Conditions assocaited with increased i antigen:
Dyserythropoiesis and HEMPAS (Hereditary Erythroblastic Multinuclearity w/ a Positive Acidified Serum Test)*
191
It consists of strong IgM agglutinins reacting up to 30-32deg C and associated with M.pneumoniae
Pathologic autoanti-I
191
Anti-i is associated with what disease
Infectious mononucleosis
191
Donates blood for own use and safest blood to be transfused
Autologous Donor |autologous blood
| For patients with rare blood type
192
Collection of whole blood with the concurrent infusion of crystalloid or colloid solutions
Acute Normovolemic Hemodilution
192
Ratio for crystalloids and colloids
| Acute Normovolemic Hemodilution
3:1 | 1:1
192
Collecting shed blood from the surgical site, processing the blood, and reinfusing the blood immediately
Intraoperative Collection
192
Collecting of blood from a drainage tube placed at the surgical site where the blood is **dilute, partially hemolyzed, and defibrianted**
Post Operative Salvage
| Blood must be reinfused within 6 hrs
192
3 Types of allogenic donors
1. Voluntary Non-Remunerated Donors
2. Directed Donors - yellow tag (if blood relative unit is irradiated to prevent GvHD)
3. Paid Donors
193
Allogenic Donation age and weight requiremet
16 year old | 50kg/110lbs
193
Autologous Donation age and weight requiremet
No age/weight requirement
193
Temp for Blood donation
upper limit is 37.5 deg C / 99.5deg F
193
Pulse rate for Autologous and Allogenic Donation
50-100bpm (athletes can be <50bpm)
193
Blood Pulse for Autologous and Allogenic Donation
Systolic 90-180 mmHg Diastolic 50-100mmHg
193
Autologous Donation Heomglobin requirement and Hematocrit on both Male n Female
11 g/dL | 33%
193
Allogenic Donation Hemoglobin and Hematocrit Female
12.5 g/dL & 38%
193
Allogenic Donation Hemoglobin and Hematocrit for Male requirement
13.0 g/dL & 39%
193
In autologous donation what is the formula for volume to collect when donor's weight is <50kg
Volume tocollect = (donors weight in kg/50)x450mL
Or if pounds then
Volume to collect = (donors weight in lbs/110)x450mL
193
What label when volume to collect in Autologous is 300-405 mL
Low volume
193
If volume to collect is less than 300mL then what formual to get amount of sol. to use
Reduced volume of anticoagulant = (volume to collect/450) x 63
Then amount of sol'n to be removed = 63mL - reduced volume of anticoagulant
194
Donor is unable to donate blood for a limited period of time
Temporary Deferral
194
Donor is unable to donate blood for someone else for an unspecified period of time due to current regulatory requirement
Indefinite Deferral
194
Donor will never be eligible to donate blood for someone else
Permanent Deferral
| May donate autologous blood
194
Causes of Permanent Deferrals
1. HIV (+)
2. HBsAg(+)
3. HCV
4. Bovine Insulin
5. Dura mater graft
6. Tegison
7. Heophiliacs
8. Babesiosis
9. Chaga's Disease
10. Leukemia
11. Growth Hormone administration
194
Causes of Temporary Deferrals for 1 year
1. Travelers to malaria endemic areas (Pampanga)
2. Surgery
3. Received blood units
4. Tatto, body piercing
5. Needle Prick
6. Sexual contact with a prostitute with AIDS, Hepatitis, with hemophiliacs, or with IV drug users
7. Treated with gonorrhea or syphilis
8. Rabies vaccination
9. Rape victim
10. In prison for more than 3 days
11. HBIg
194
Causes of Temporary Deferrals for 3 years
1. Immigrant from malaria endemic area
2. Soriatane
3. Diagnosed with malaria
194
Causes of Temporary Deferrals for 1 month
1. Accutane
2. Proscar
3. Vaccines
-German measles (Rubella)
-Chickenpox
194
Causes of Temporary Deferrals for 2 weeks
Vaccines
* Measles (Rubeola)
* Mumps
* Polie(sabin)
* Typhoid
* Yellow fever
194
Causes of Temporary Deferrals for 48 hrs
1. Apheresis donation
2. Aspirin and aspirin containing drugs
195
Causes of Temporary Deferrals for 8weeks / 2months
Blood Donation
| If double blood donation 16 weeks or 4 months
195
Childbirth length of deferral
9 months
195
1st ad 2nd trimester abortion or miscarriage length of deferral
no deferral
195
Men who had sex with men length of deferral
12 months
196
Small vaccination length of deferral
14 - 21 days or until the scab has fallen off
196
Clopidogrel and Ticlopidine length of deferral
14 days
196
Double Red Cell Apheresis length of deferral
16 weeks
196
Intake of Alcohol length of deferral
12 hours
196
Feldene length of deferral
2 days for platelet donation
196
In aseptic technique if allergic to iodine what is the alternative
Chlorhexidine gluconate and Isopropyl alcohol
196
Collection of specific blood component and returning remaining whole blood components back to the patient
Apheresis
| The only effective method in **collecting leukocytes and stem cells**
## Footnote
Anticoagulant is citrate
196
To separte cells this is done in Apheresis Technique by their densities
Centrifugation
196
It is where there is a single puncture and blood is processed in batches or cycles
| Methods of Centrifugation
Intermittent Flow Centrifugation
196
It has two puncture sites where the blood withdrawal, processing, and reinfusion are performed simultaneously
| Methods of Centrifugation
Continuous Flow Centrifugation
196
Donor deferral for frequent Plasmapheresis
2days/48 hours
196
Donor deferral for Infrequent Plasmapherisis
4 weeks / 1 month
196
Deferral for Plateletpheresis
7 days or 1 week
196
A sedimenting agent used in Leukapheresis to engance separation fo RBC from WBC
HES (Hydroxyethyl Starch) and GCSF (Granulocyte Colony Stimulating Factor)
197
Weight guideline for Double RBC Pheresis
Male : Minimum of 130lbs
Female: minimum of 150 lbs
198
Height guideline for Double RBC Pheresis
Male : 5'1
Female : 5'5
199
Hematocrit guideline for Double RBC Pheresis
Male and Female : >40%
200
FDA requirement for Blood preservation
75% RBC survival in 24 hrs
201
Shelf life of blood with Acid-Citrate Dextrose (ACD)
21 days
202
Shelf life of blood with Citrate Phosphate Dextrose (CPD)
21 days
203
Shelf life of blood with Citrate Phosphate Double Dextrose (CP2D)
21 days
204
Shelf life of blood with Citrate Phosphate Adenine (CPDA-1)
35 days
205
Shelf life of blood with CPDA-2
42 days
206
Anticoagulant, chelates calcium
| Component of Blood Preservative
Citrate
207
Substrate for ATP production
| Component of Blood Preservative
Dextrose
208
Prevents caramelization
| Component of Blood Preservative
Citric Acid
209
Maintains pH during storage
| Component of Blood Preservative
Monobasic Sodium Phosphate
210
Production of ATP (Extends shelf life)
| Component of Blood Preservative
Adenine
211
Additives that prolongs the pRBC for 42 days
1. Adsol
2. Nutricel
3. Optisol
4. SOLX
212
Decreased in RBC
| RBC storage lesions
1. % viable cell
2. Glucose
3. ATP
4. pH
5. 2,3 DPG
213
Increased in RBC
| RBC storage lesions
1. Plasma Potassium
2. Plasma Hemoglobin
3. Lactic Acid
214
Oxygen Dissociation Curve
| RBC storage lesions
Shift to the left
215
Reviving expired RBC up to 3 days only
Rejuvenation
| It regenerates ATP and 2,3 -DPG
216
The only FDA approved rejuvenation solution
Rejuvesol
## Footnote
Contais PIPA : Phosphate, Inosine, Pyruvate, Adenine
217
Blood group systems associated with the Complement Component pathway
KCCC (Knops, Cromer, Chido Rogers, CD59)
218
Complement component associated with Chido antigen
C4b
219
Complement component associated with Rogers antigen
C4a
220
Speed and time for Hardspin
5000g / 3600 rpm for 5mins
221
Speed and time for Lightspin
3200 rpm for 2-3mins
222
It provides the oxygen carrying capacity (RBC) and blood volume expansion
Whole Blood Transfusion
| For acute blood loss
223
Whole bood temperature for storage
1-6deg C
224
Whole bood temperature for transport
1-10 deg C
225
1 unit increases _ Hgb ; _ Hct
1g/dL Hgb ; 3 Hct
| in whole blood and pRBC
226
Unit given especially if patient is at risk for circulatory overload. It restores oxgen carrying capacity (RBC mass) of the patient
| For normovolemic patients
pRBC (packed Red Blood Cell)
227
If pRBC or Whole blood is on an open system then its shelf life is _
24 hours
228
It is done for a prolonged storage of rare blood types and autologous units
Frozen and Deglycerolized RBC
229
the Most commonly used cryoprotective agent
Glycerol
| penetrating
230
Storage Temperature for High Glycerol Frozen RBC
-65deg C
| Allows slow freezing
231
Storage temperature of Low Glyerol Frozen RBC
-120deg C
232
Frozen RBC Shelf-life
10 years
233
Deglycerolization Process
* Thaw at 37deg C
* Wash in decreasing concentration of saline
12%, 1.6% then 0.09 w/ 0.2% Dextrose
* If with sickle cell trait, omit 1.6% because it will cause lysis of blood
234
Frozen RBC shelf life after deglycerolization in Open system
24 hours
235
Frozen RBC shelf life after deglycerolization in Closed system
14 days
236
Washed RBC storage temperature and shelf-life
1-6degC : 24 hrs
237
Washed Platelet storage temperature and Shelf-life
20-24C; 4 hours
238
Leukoreduced RBC/Platelet must be prepared within _ hrs of collection
Storage of RBC | Platelet
6 hrs
1-6 degC | 20-24deg C
239
Leukoreduced RBC Open system shelf life | Close system shelf life
24 hours | Original exp date
240
Leukoreduced RBC shelf life in Open system | Close System
4 hours | 5 days
241
Quality Control of Leukoreduced RBC
[5.0x106 residual WBC; ]
85% RBC mass
242
Leukoreduced Platelet Quality Control random donor
8.3 x 105 residual WBC
243
Leukoreduced Single Donor Platelet Quality Control
5.6 x 106 residual WBC
244
Blood components for patients at risk at TA-GVHD or Immunocomporised patients
Irradiated RBC
245
Storage temperature for Irradiated RBC
1-6deg C
246
Shelf-Life of Irradiated RBC
Till original expiration or 28 days from the date of irradiation
| whichever expiration is sooner
## Footnote
Irradiation of platelets does not affect the shelf life of platelet product
247
Radiactive source of Irradiated RBC
Cesium-137 or Cobalt-60
248
Minimum dose of radiation in Irradiated RBC
Central portion: 25Gy
Any part of the blood unit: 15Gy
249
Blood given to correct thrombocytopenia, dysfunctional, PLT, DIC
Platelet conccetrate (Random Donor)
| Must be prepared within 4 hours of whole blood collection
250
Blood components given to patients unresponsive to Random Donor Platelet due to HLA alloimmunization
Single Donor Platelet Concentrate
| Must be prepared within 4 hours of whole blood collection
251
Platelet concentrate storage temp and pH
20-24C with continuous agitation
pH >6.2
252
Platelet concentrate Shelf-life
5 days
| FDA standards define the expiration is at midnight of day 5
## Footnote
when opened: 6 hours at RT
253
Pooled platelet shelf life
4 hours
254
Prepooled platelet concentrate shelf life
5 days
255
Quality Control of Random Donor Platelet
. >5.5x10¹⁰ platelets
256
Quality Control of Single Donor Platelet
. >3.0 x 10¹¹
257
Used for multiple coagulation factor deficiency (liver damage, vit K deficiency)
FFP (Fresh Frozen Plasma)
| Must be prepared within 8 hours collection
258
Shelf life when temperature is
-18C | -65C
1 year | 7 years
259
Shelf life after thawing of fresh frozen plasma on 1-6 C
24 hours
260
Same composition with FFP but with slightly reduced level of Factor VIII
PF24
261
This is the plasma that is held at 4C prior to freezing withing 8 to 24 hours
PF24
262
Plasma held at Room temp within first 8 hours then is frozen
PF24RT24
263
Thawed plasma can be maintened at 1-6C for up to _ days
4 days
264
It is used for treatment of fibrinogen deficiency, hemophilia A, von Willebrand disease and Factor XIII deficiency
Cryoprecipitate
265
Storage and Shelf-life of Cryoprecipitate
-18C | 1 year
## Footnote
Thawed 20-24C (6 hours)
Pooled 4 hrs
266
Given to patients with Neutropenia, Granulocyte dysfunction, unresponsive to antibiotics and myeloid hypoplasia
Granulocyte concentrate
266
Storage and Shelf life of Granulocyte Concentrate
20-24C | 24 hours
267
Granulocyte Concentrate Quality control
. >1.0 x 10¹⁰
268
Blood label Yellow
Blood type A
269
Blood label Pink
Blood tpye B
270
Blood label White
AB
271
Blood label Blue
Blood type O
272
Blood label Tan
Hold for further testing
273
Blood label Gray
Not for transfusion
273
Blood label Orange
Green
For emergency use only
For autologous use only
274
Blood label
Purple | Red
Irradiated | Biohazard
275
Blood label Chartreuse
From therapeutic phlebotomy
275
Specimen must have at least _ unique patient identifiers
| Pretransfusion
2
px identifiers: Full name and Date of birth or medical record.
275
Blood label Yellow, salmon
For directed donation
276
Hemolyzed specimen is acceptable
| True | False
False
276
Specimen must be kept for _ days post transfusion
7
277
Lipemia is not a cause for rejection
| True | False
True
277
Age of specimen < 4 days old
| T | F
False
| . < 3 days old
278
Pretransfusion test performed
1. ABO typing
2. Rh Typing
3. Ab screening and Id
278
Additional technique in Ab identification which dissociates the Ab from the RBC surface to allow for identification
Elution
278
Universal recipient of pRBC
AB
## Footnote
1st choice: AB
2nd: A
3rd: B
4th: O
278
Universal donor of pRBC
O
279
Final check of ABO compatibility between donor and px, to a lesser extent, detection of unidentified Ab
Crossmatching
280
Compatibility testing of donor red cell and recipient plasma/serum
Major Crossmatching
| MARS (Major Recipient plasma/serum)
281
Compatibility testing of donor plasma/serum and recipient red cell
Minor Crossmatching
| MIDS (Minor Donor serum)
282
Used only for patients who have no currently detected clinically significant Ab or history of alloantibodies
Computer Crossmatch
283
For emergency transfusion, ABO specific blood shoud be given if not known then give _
O Rh-negative blood
## Footnote
Rh positive blood can be used for male patients or female above childbearing age
284
Transfusion of 10 units of blood within 24 hours
Massive Transfusion
## Footnote
Diluting fluid: 0.9% saline, 5% albumin
285
Adverse effects of Transfusion where signs and symptoms are seen within 24 hours of transfusion
Acute/Immediate
286
Adverse effects of Transfusion where signs and symptoms are seen after 24 hours of transfusion
Delayed
287
Most common Acute Immune adverse reaction in Transfusion
Febrile Non-Hemolytic Transfusion Reaction
| 1C increase in body temperature
288
It is the 2nd most common Transfusion reaction
Mild allergic Reaction
| Due to Ab to allerges (IgE)
289
Anti-IgA ab from IgA deficient patient causes Anaphylactic reaction
Sever Allergic Reaction
| Give washed RBC without IgA
290
Is defined as IgA level less than 0.05 mg/dL
Absolute IgA deficiency
291
It shows Post-transfution to Pre-transfusion BNP ratio of 1.5
Transfusion Associated Circulatory Overload (TACO)
| Physician Induced
292
Most common bacterial isolate found in RBCs
Y. enterocolitica
293
Second most common Bacterial contaminant in RBCs
Pseudomonas
294
It shows unexpected drop in hemoglobin or hematocrit
Delayed HTR
295
Most common cause of Delayed HTR
anti-Kidd antibody
296
Chelating agent used to prevent Iron overload
Deferoxamine
297
Most common parasitic complication of transfusion
Plasmodium species
298
Most common cause of Disease Transmission in Transfusion Reaction
HBV
299
300
301
302
303
