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Blood Bank Test 3b > Chapter 8 > Flashcards

Chapter 8 Flashcards

1
Q

Landsteiner was the first too

A

perform ABO testing

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2
Q

Ottenberg stressed the important of

A

crossmatch before transfusions

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3
Q

When are cold reactive antibodies significant?

A

Hypothermia

Dropping OR Temp

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4
Q

Alloantibodies that react at 37 degrees/AHG are capable of

A

causing decreased survival of transfused RBCs

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5
Q

Alloantibodies are formed by

A

exposure to foreign RBCs by previous transfusion and/or pregnancy

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6
Q

When are alloantibodies clinically significant?

A

When they cause HTR or HDNF

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7
Q

What is the purpose of AHG testing?

A

To detect RBCs sensitized by IgG alloantibodies, IgG autoantibodies, and/or complement

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8
Q

How does the AHG reagent work?

A

Any cells coated with antibody will be complexed with AHG, and clumps will form (macro or microscopically)

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9
Q

What are the two type of AHG tests

A

Direct Antiglobulin Test (DAT)

Indirect Antiglobulin Test (IAT)

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10
Q

Polyspecific AHG reagent contains

A

anti-IgG and and anti-C3d (complement)

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11
Q

Monospecific AHG reagent contains

A

EITHER
anti-IgG or
anti-C3d

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12
Q

This test detects in vivo sensitization of RBCs w/ IgG and/or complement (like a snapshot of what is happening in the body right now )

A

Direct Antiglobulin Test (DAT)

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13
Q

This test detects in vitro sensitization of RBCs (like a what if scenario)

A

Indirect Antiglobulin Test (IAT)

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14
Q

The DAT test is used for

A

HDN
HTR
AIHA

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15
Q

The IAT test is used for

A

Compatibility testing, antibody screen, antibody ID, RBC phenotyping

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16
Q

Coombs control check cells usually have avery potent anti-___.

A

anti-D

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17
Q

What are Coombs Control Cells used for?

A

To ensure that AHG was not accidently omitted or inactivated.

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18
Q

If CCC cells are negative the test is

A

invalid and must be repeated

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19
Q

What is a major crossmatch?

A

Testing a recipient serum against donor RBCs

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20
Q

What is a minor crossmatch?

A

Testing of the recipients RBCs against donor serum.

NO LONGER PERFORMED (per AABB standards)

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21
Q

What are the elements of Pre-transfusion testing?

A 
ABO Forward
Rh
ABO Revese
Antibody Screen
Crossmatch
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22
Q

Gel technology require serum/plasma?

A

Plasma

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23
Q

Tube testing works better with serum/plasma?

A

Serum

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24
Q

What can be used to break up small clots from anticoagulated patients on heparin?

A

Thrombin or protamine sulfate

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25
Q

What must be included on the label of patient blood samples?

A 
2 uniques identifiers
Date of Collection
Phlebotomists name/ID
Legible
Indelible Ink if handwritten
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26
Q

Which antibodies are known to cause hemolysis?

A 
ABO
P
Lewis
Kidd
Vel
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27
Q

Lipemic blood samples may be

A

rejected

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28
Q

How long can a blood sample be pre-transfusion tested before the transfusion?

A

3 days if:
The patient has been transfused in the last 3 months
The patient has been pregnant in the last 3 months
The history is uncertain or unavailble

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29
Q

Blood samples should be stored after a transfusion

A

1-6 degrees C for a minimum of 7 days after transfusion along with segments

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30
Q

Reviewing previous records for previously detected antibodies helps in avoiding

A

amnestic response

possible delayed hemolytic sequellae

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31
Q

What is the goal of the antibody type and screen?

A

To detect antigen-antibody interaction

32
Q

What is GEL negative and GEL positive?

A

Negative: button of cells at the bottom
Positive: clump of cells at the top
1+, 2+, 3+ in middle

33
Q

What is microplate positive and negative?

A

Negative: no adherance
Positive: Adherance to cell wall

34
Q

What type of technolody do microplates use?

A

Solid phase technology

35
Q

What types of reagents should be used for Rh control?

A

Commerical Rh control

6% albumin

36
Q

The Rh control should always be positive/negative

A

Negative

37
Q

Why is an Rh control necessary?

A

To ensure a spontaneous agglutination that could yield a false positive is not present

38
Q

The combination of screening cells used must contain antigenic expressions of

A

D, C, c, E, e, K, k, P1, M, N, S, s, Le^a, Le^b, Jk^a, Jk^b, Fy^a, Fy^b

39
Q

Why do some labs not do the IS reading or room temperautre reading?

A

Antibodies found in these phases tend to be of no clincial signifiance

40
Q

What is the risk of not reading after the 37 degree incubation?

A

Clinically signifianct antibodie in the Rh system might be missed

41
Q

If CCC are negative, what are some possible causes?

A

Protein is present
You forgot to add the reagent
Inactive vial of AHG reagent

42
Q

If the antibody screen is negative, what is the likely hood the crossmatch will be compatible?

A

Over 99%

43
Q

What is CMV safe blood and when is it used?

A

Leukocyte reduced

Used in lung transplant patients

44
Q

Patients undergoing a bone marrow transfusion require irradiation to prevent

A

graft-vs-host disease

45
Q

Patients who experience febrile transfusions reactions may benefit from

A

leukoreduced blood

46
Q

If Rh negative units are not available for a patient, you may give Rh+ and

A

RhoIg shot

47
Q

what is an autologous donor?

A

A patient that donates for his/her own surgery

48
Q

What is an allogenic donor?

A

Blood that comes from the general population

49
Q

Order of transfusion donation

A

Autologous
ABO/Rh compatible directed donor
Allogenic

50
Q

What percent of labs use IS crossmatch? What percent use IAT?

A

51% use immediate spin

48% use IAT

51
Q

When a serological crossmatch is performed, the donor blood used for testing must be taken from

A

an integrally attached segment of the donor unit

52
Q

When ca you use the IS crossmatch?

A

When the antibody screen is non-reactive

No history of unexpected antibodies

53
Q

If there is no reaction during IS crossmatch the unit is

A

compatible

54
Q

What are some reasons for an incompatible (agglutinating) crossmatch?

A

Unit may be BO incompatible
Rouleux
Auto/alloantibodies
Tube contamination

55
Q

What are some reasons for an incompatible (agglutinating) cross match if ANTIBODY SCREEN IS NEGATIVE?

A 
Alloantibody in recipient to low incedence antigen on donor RBCs
Positive AHG on donor RBCs
ABO error
Contaminant
Polyagglutinable donor RBC
56
Q

What are some reasons for an incompatible (agglutinating) cross match if ANTIBODY SCREEN IS POSITIVE?

A

Alloantibody direct roward antigen on donor RBC

Contaminant

57
Q

What are some reasons for an incompatible (agglutinating) cross match if ANTIBODY SCREEN IS POSITIVE and AUTOCONTROL POSITIVE?

A

Alloantibody present in recipient who has been transfused
Auto/allo antibody in patient serum
Rouleux

58
Q

IAT may be performed on patients who demonstrate

A

clinically significant antibodies

59
Q

Approximately 1/3 of potention hemolytic alloantibodies are not detected after

A

5 years

60
Q

If you must transfuse incompatible blood in dire emergency and you cannot determine antibody ID you must

A

Medical director and physician decide
Give “least incompatible” by AHG testing
Watch patient

61
Q

Since naturally occuring anti-A and anti-B are not demonstrated until 6 months, infants do not require

A

Reverse typing

62
Q

If enough sample is not collected from an infant, an antibody screen may be performed on

A

maternal sample

63
Q

If an antibody screen is negative, additional testing is not necessary for an infant if

A

Group O cells are used for transfusion

64
Q

If an infant has a negative antibody screen, but recieves blood other than type O you must

A

run an intial crossmatch the include IAT

65
Q

If an infant antibody screen is positive

A

you must identify and give antigen negative blood

66
Q

In infants, it is important to crossmatch with blood that has a

A

stong antigenic expression

67
Q

To transfuse, their must be two determinations of the recipients ABO group, and one determination must be

A

performed on a current sample

68
Q

Ideally, 2 seperate ABO determinations are

A

performed by two different individuals

69
Q

The type and screen is ___% effective in preventing the transfusion of incompatible blood.

A

99.99%

70
Q

What is the frequency of an incompatible IAT crossmatch?

A

0.06-0.08%

71
Q

What is the Maximum Surgical Blood Order?

A

list of an institution’s surgical procedures and the corresponding blood usually available for a particular surgery. Represents a maximum blood order (not a minimum).

72
Q

THE MSBOS allows transfusion services to monitor

A

The ration of crossmatches performed to transfusion givin (C/T) ration

73
Q

What is a Blood Utilization Review?

A

transfusion committee performs review of transfusion practices. Audits in current time (prospective view), previous 12-24 hours time (concurrent audit), and days to months after transfusions (retrospective audit)

74
Q

What is the definition of a Massive Transfusion?

A

the total blood volume of an individual has been replaces with donor blood within 24 hours

75
Q

Massive transfusions diminish the purpose of

A

crossmatch

76
Q

After a massive transfusion, you must continue to give previous antigen nagative blood because

A

a secondary response will be rapid for antibody production

77
Q

In an emergency, if Type O- blood is given without compatibility testing, the unit must be labeled

A

clearly that pretransfusion testing was not complete at the time of issue

Blood Bank Test 3b (3 decks)

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