CCCC Clinical Study Guide Flashcards
What antibodies have been implicated in HDFN?
ABORh, Kell, Duffy (uncommon), Kidd, anti-S, anti-s, anti-U, anti-M (in IgG form; this is rare)
What antibodies have been implicated in HTR?
Kell, Duffy, Kidd, anti-S, anti-s, anti-U, rare form of anti-P1 reactive at 37 degrees
How can cold agglutinins be excluded from testing?
perform the antibody screen (and panel is necessary) using the prewarm technique
How can Rouleaux be excluded from testing?
perform the saline replacement technique
What antibodies does the immediate spin phase of tube testing detect?
M, N, P, ABORh, Ii
What phases other than immediate spin do anti-P and anti-I/i react at?
room temperature and 4 degrees Celsius
What antibodies does the 37 degree phase of tube testing detect?
M and N
What antibodies does the AHG phase of testing detect?
Kell, Duffy, Kidd, MN, Ss, and Lutheran (which can also react at room temperature)
How much time must pass between each donation of blood products?
whole blood, RBCs, WBCs - once every 8 weeks; platelets - no more than twice a week or 24 times a year, provided platelet count is at least 150,000/uL and at least 48 hrs. between donations; plasma - no more than twice every 7 days, with 48 hrs. between donations
What are the hemoglobin and hematocrit values acceptable for blood donation?
Hgb: >/= 12.5 g/dL, Hct: >/= 38%
What is the total volume of blood drawn in a single donation setting?
routine amount drawn is 450 mL +/- 10%; maximum bleed is 525 mL (including 2-4 tubes for testing)
What conditions would permanently defer someone from donating blood products?
use of intravenous drugs (even once); man who has had sex with another man since 1977 (even once); hemophilia; + antibody test for HIV; man or woman who has had sex for drugs or money since 1977; had viral hepatitis; cancer (except in situ basal cell carcinoma or in situ cervical cancer if successfully treated); multiple sclerosis; had coronary artery bypass surgery; had a stroke; history of babesiosis (Chagas disease); take or have taken Tegison for psoriasis; history of Creutzfeld-Jakob disease in donor or donor family members; clinical/laboratory evidence of human T-cell lymphotrophic virus (HTLV); recipient of dura mater or pituitary growth hormone; clotting or other blood disorder; sickle cell disease or other hemoglobinopathies; sexual contact with anyone who was born or lived in Africa; have been to Africa; used clotting factor concentrates; had malaria*; spent 5 or more years in Europe since 1980; received a blood transfusion in the UK or France since 1980
How much must a donor weigh?
> /= 110 lbs.
What special circumstances apply to deferrals related to malaria?
if donor has been asymptomatic after the diagnosis of malaria, the deferral time is 3 years
Give the probable genotype for the following Rh type: R(zero)
cDe
Give the probable genotype for the following Rh type: R1
CDe
Give the probable genotype for the following Rh type: R2
cDE
Give the probable genotype for the following Rh type: Rz
CDE
Give the probable genotype for the following Rh type: r
cde
Give the probable genotype for the following Rh type: r’
Cde
Give the probable genotype for the following Rh type: r”
cdE
Give the probable genotype for the following Rh type: ry
CdE
List the guidelines and blood selection for emergency transfusions and alternate blood selection.
- Always obtain a sample for crossmatching regardless of whether it can be done before units are sent out. 2. If there is time for a TNS, perform one and issue ABO compatible units; if there is no time, issue O= units, and switch to ABO compatible once the TNS has been performed. 3. All transfusion tickets MUST be stamped with “Compatibility Testing Not Completed” in red ink, and an emergency release form MUST be signed by the attending physician. 4. Perform the crossmatch ASAP, and notify the nurse or physician if: the crossmatch is complete and there are compatible units available; if an antibody has been detected; if the emergency release units were found to be incompatible with the patient. 5. In the event that emergency units are found to be incompatible, notify the medical director or the pathologist on call, and complete a blood product deviation form.
At what temperature do commonly encountered antibodies react?
37 degrees Celsius