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Immunohematology > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

This method is used to
screen for unexpected
antibodies in the clincial lab
prior to transfuion.

A

Antibody Screen

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2
Q

In addition to meeting the
rule of 3, you must also
perform this test on the
patient’s own RBCs to
confirm the antibody
specificity

A

Phenotyping the patients
RBCs for the corresponding
antigen

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3
Q

After identifying an
antibody, you determine it
does NOT meet the ‘rule of
3’, what does this mean?

A

95% confidence that the correct antibody has NOT been identified

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4
Q

Describe what makes an
antibody clinically
significant.

A

Allo-antibody that causes decreased survival of RBCs with target
antigen
Usually IgG, reacting at 37C or AHG

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5
Q

List 3 different things you
might see in an antibody
panel to indicate multiple
antibodies in a patient’s
serum

A
  1. Pattern not fitting
    single antibody
  2. Variation in the
    phase of reaction
  3. Variation in the
    strength of antibody
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6
Q

This type of unit cannot
crossover into the general
blood bank if not used, and
is often associated with a
higher cost.

A

An autologous donation

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7
Q

After pregnancy, a donor is
deferred from donating for
this time period

A

6 weeks post pregnancy

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8
Q

List the parts of the ‘pre-
donation screening.

A

Pre-donation Screening
Includes:
-Registration
-Medical/Donor History
Questionnaire (DHQ)
-Physical Exam

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9
Q

This is the deferral period
for a person that donates a
‘double red’ or ‘power red’
via apheresis

A

16 weeks

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10
Q

This is the different between
the processing of whole
blood in the US vs Canada

A

Canada & Uk > Buffy coat method > 1 hard spin & pool
US > PRP (platelet rich plasma method > light spin, hard spin

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11
Q

This list of questions is
given to screen prospective
blood donors to for
infectious risks, and the
order CANNOT be changed
by collection facilites.

A

Donor History Questionnaire

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12
Q

Following treatment and
recovery from malaria, a
person is deferred from
donating blood for this time
period

A

3 years

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13
Q

This has been largly
responsible for the most
recent decrease of the
‘window period

A

Nucleic Acid Testing (NAT)

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14
Q

List the required hbg & hct
values for a male & a female
to donate a unit of whole
blood

A

Female: 12.5 g/dL & 38%
Male: 13.0 g/dL & 39%

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15
Q

The procedure that is
performed when a previous
donor of a blood product,
tests positive for an
infectious disease marker,
not present in previous
donation

A

Donor Lookback

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16
Q

These two crossmatching
procedures will only be able
to detect ABO
incompatibilites.

A

Immediate Spin (IS) & Computer
Crossmatch

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17
Q

After transfusion, the donor
sample & pre-transfusion
recipent sample must be
kept for this long

A

7 days

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18
Q

A ‘type & screen’ includes
these types of tests

A

ABO & Rh, Antibody Screen & ID if +

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19
Q

A patient has an anti-K that
was identified back in 1965.
If she is getting a unit of
pRBCs the blood bank can
perform this kind of XM

A

AHG Crossmatch only!!!

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20
Q

Define ‘massive transfusion’

A

8-10 RBC units in <24 hours
4-5 RBC units, in less than 1 hour

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21
Q

Patients who are IgA
deficient should be
transfused with this special
kind of RBCs

A

Washed RBCs!

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22
Q

A unit of RBCs collected 1
week ago and irradiated
today has this shelf life.

A

28 days (or the expiration date of unit- whichever is sooner)

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23
Q

Thawed cryoprecipitate has
a shelf life of

A

6 hours!  at what temperature??
Room Temperature!!

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24
Q

This product is the most
appropriate for a patient
with a multiple coagulation
factor deficiency

A

Fresh frozen plasma

25
Q

As RBCs age in storage, this
molecule decreases, which
causes hgb’s affinity for
oxygen to increase

A

2, 3 DPG Left Shift

26
Q

This process is performed on
pRBC units to prevent
immunocompetent donor T-
lymphocytes from engrafting
in an immunocompromised
recipient

A

Irradiation

27
Q

This is the most likely
reason frozen,
deglycerolized RBCs would
be transfused

A

A patient with antibodies to a high-frequency antigen

28
Q

This is the expected
outcome after the
transfusion of 1 unit of
packed RBCs.

A

Increase the hemoglobin by 1 g/dL and the hematocrit
by 3%

29
Q

Give one example why you
would use an absorption

A

To remove an AUTO-antibody from a patient’s plasma
(process of removing antibodies from serum, by incubating with
corresponding antigen)

30
Q

Describe the reason why
specimens on patients
recently
transfused/pregnant should
be used < 3 days after
collection.

A

Recent pregnancy or transfusion may stimulate antibodies that are not detectable
at the time of collection

31
Q

An antibody screen & panel have revealed the presence of an allo-antibody in the patient’s plasma.
What would be the next step to find compatible units for the patient

A

Antigen type patient’s cells & donors unit to be crossmatched for the corresponding antigen

32
Q

Incompatibilities can be seen with the Immediate Spin (IS) crossmatch for all the following reasons
EXCEPT

A

Correct ABO unit selected for the patient

33
Q

Samples of the blood donor and recipient, used in crossmatching must be stored in the blood bank for a minimum of how many days after transfusion

A

7 days

34
Q

What is an antibody screen?

A

2-3 reagent cells with known antigens on them. If there is agglutination in any of the stages then move to the panel.

35
Q

Rule of three

A

Confirms antibody presence with a 95% confidence. If not enough cells to satisfy the rule then extend the panel and use a few more cells.

36
Q

Selected Cells

A

When you pick cells specifically to test for one antibody (confirmation)

37
Q

Neutralization

A

Commercial substances that bind antibodies to create no reaction when tested with reagent cells.

38
Q

Proteolytic enzymes

A

Can be used to enhance and destroy antigens

39
Q

Sulfhydryl reagents

A

differentiate between IgG and IgM. Breaks disulfide bond in IgM. DDT

40
Q

ZZAP

A

Enzymes and DDT

41
Q

Cold Autoantibody

A

Reacts at RT with most panel cells, and positive autocontrol.

42
Q

Warm Autoantibody

A

more common, +DAT. Rh is main target, can cause hemolytic anemia

43
Q

Adsorption is

A

the process of removing auto Ab by incubating plasma with corresponding antigen (patient cells)

44
Q

T/F autoantibodies can hide clinically significant alloantibodies

A

True

45
Q

Immediate spin crossmatch

A

preformed if there is no detection or history of clinically significant antibodies

46
Q

Antiglobulin crossmatch

A

preformed when there is a clinically significant Ab has been ID or theres a history

47
Q

Steps to donor selection

A

Registration, medical history, physical exam, informed consent, collection of blood, post-donation testing and component separation

48
Q

How often can you collect blood?

A

8 weeks

49
Q

US separation

A

Platelet rich plasma

50
Q

Canada+Europe separation

A

Buffy Coat Method

51
Q

Apheresis

A

Blood donation that separates one component of the blood to be collected while giving back the other components

52
Q

Plateletpheresis frequency

A

every 7 days up to 24x a year

53
Q

Plasmapheresis frequency

A

serial donors=2x a week
regular=every 4 weeks

54
Q

Double Reds

A

deferred for 16 weeks
female has to be taller than 5’5” and over 150lb
Male has to be taller than 5’1” and over 130lb

55
Q

Donor lookback protocol

A

When a donor tests positive for a viral marker
-notify donor
-notify blood product recipients
-find additional components
-quarantine previous units, additional testing, desstory previous units if pos

56
Q

RBC storage times

A

42 day fridge
10yr freeze

57
Q

Plasma storage

A

1 yr freeze
7yr deep freeze
freeze within 8 hrs of collection

58
Q

Cryo

A

prepared from FFP. Storage at -18 for 1 year, must be used within 6 hr of thaw

59
Q

What is it important to do if someone has an IgA deficiency?

A

Wash the RBC

Immunohematology (2 decks)

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