Final Exam Flashcards
When discussing IgG or IgM, which of these would best describe the following:
A. Main Ig in primary response
B. Main Ig in secondary response
C. Also known as incomplete or blocking antibodies
D. The predominant Ig type found in the Rh system
A: IgM
B:IgG
C:IgG
D:IgG
Briefly explain Landsteiner’s Law.
Ab are present in plasma only when the corresponding Ag is not present on the RBCs.
Explain the difference between genotype and phenotype
Genotype: total sum of genes present on the chromosomes with the respect to the one or more characteristics, regardless of whether or not they produce detectable products
Phenotype: the detectable products of genes only discovered through the description of observed traits or the result of direct testing (Ph-physical trait)
Explain where antigens and antibodies are found
Antibodies found in plasma
Antigens are on surface of RBC
List below the antibodies one would expect to find in someone with each of the following blood groups:
a. Group A
b. Group B
c. Group O
d. Group AB
a. Anti B
b. Anti A
c. Anti A Anti-B Anti-AB
d. None
Explain the difference between alloantibodies and autoantibodies.
ALLO-formed antibodies in response to an antigen from outside the body
AUTO-antibodies to self antigens
The amount of H substance demonstrated on the cells in order of decreasing reactivity is as follows:
O,>A2,>B>A2B,>A1>A1B
Forward ABO grouping and the reverse grouping when typing blood demonstrates what in terms of antigens and antibodies present?
Forward detects Ag on cells
Reverse detects Ab in plasma
(They should be opposite of each other)
What is the purpose of performing an absorption?
to bind and remove some of the Ab to better analyze the Abs left behind.
Give some examples of factors that could influence antigen-antibody reactions.
temp, pH, Centerfiguation, time, concentration, size, incubation time, proximity sites of antigen cites on RBC membrane, ionic strength of surrounding medium
If 2 homozygous B adults have children, what blood type would their offspring be?
B
Why don’t labs perform reverse blood groupings on newborn infants?
because there antibodys arnt well develpoed
Name the antisera used in in an ABO/Rh.
Anti-A
Anti-B
Anti-D
Anti-A1 is found occassionally in individuals of this blood group
A2
What is one of the best ways to test a patient to see if they have a subgroup or variant of the A blood type
test plasma or serum with A1 cells
Describe the 2 types of AHG: what are they called and what is contained in each?
Polyspecific: has both Anti IgG and C3D
Monospecific has one or other
The lectin from which plant has a specificity for anti-H?
Ulics Uropeous
What is the main purpose of washing red blood cells used for testing in an antiglobulin test?
to prevent neutralization of AHG in the blood sample
The extract from what plant is used to distinguish type A1 cell from other type A cells?
Dolichos biflorus
The weakest agglutination would be seen with anti-A with which of the following:
A1B A1 A3 O
A3
What is the difference between an IAT and a DAT and what do they each indicate
DAT: in VIVO red cells coated in the body with gamma and betta globulins
IAT: in VITRO cells are coated in the test tube
How can cold agglutinins be excluded in a crossmatch?
pre-warming
but the auto control is cold
What is the purpose of anti-A1 lectin? What is the purpose of anti-A,B antisera?
A1 lectin-demonstrate the presence of A1 Antigen
A,B antisera-detects subgroups of A weaker than A2
What type of test would demonstrate that group A or B fetal cells have been coated with maternal group O antibodies?
DAT(direct coombs)
What type of antibodies does an antiglobulin test detect?
IgG, blocking antibodies or in-completed
Which rare blood type produces natural anti-H antibodies?
Bombay
Name a procedure you could perform in the blood bank to remove rouleaux formation.
Saline replacement technique
ABO and Rh antibodies are most often implicated in what serious condition that affects newborns and fetuses?
HDFN (HDN)
What must be done to a donor unit to firmly establish that it is indeed Rh negative?
Weak D testing (DU)
When is Rh immunoglobulin (Rhogam) given to Rh negative mothers?
28 weeks and with in 72 hours of delivery
What causes kernicterus in newborns?
accumulation of Biliruben in the brain which is uncongiguated
What type of blood bank testing is used to detect weak D (Du)?
IAT (indirect anti-humanglobulen test)
Before testing, what must be done to all cord cells and why?
wash, to remove wartons jelly because it can interfere with blood typing
What causes HDFN
maternal cells lack antigen that fetal cells have. causes sensitization
What substances do the following individuals secrete into their saliva in terms of ABO?
A secretors- A, H
B secretors- B, H
O secretors- H
AB secreats AB,H (if they are a secreator and have the BIG H )
How must an individual inherit the Lewis, secretor, and H genes in order to secrete Leb substance
at least one dominant gene
You have a patient that has developed Lewis antibodies. What type of donor blood would you want to give them?
Le (a-b-)
An individual genotypes as le, se, and h. These genes are said to be __________________ or ___________________.
recessive; amorphic
What percentage of the Caucasian population are secretors?
80%
What are components used for testing in a major crossmatch and what is the purpose of this testing
donor red cells and recipient plasma, to ensure the safety of the transfusion
Which antibodies can show up as cold agglutinins?
Anti I Anti M Anti N Anti P1 Anti Le a b
Which antibodies belong to the Kidd blood group system?
anti Jk a b
Which antibodies are known for showing dosage when reacting with heterozygous red cells?
Kidd, Duffy, M,N S, Rh(not D), Lu a b
What antigen is known to be sex-linked
Xg a
The i antigen is most prevalent in what type of population?
Newborns
Which antibodies are most known for delayed hemolytic transfusion reactions?
Kidd
Why is the transfusion of specific blood components preferable to the use of whole blood?
reduces risk of circulatory overload, not as wasteful, administer concentrated form of what is needed by the PT with the blood components, less reactions, many PT can be effectively treated with a single donation
Name some of the routine testing generally performed on donor blood
ABORh, Antibody, Syphilis, HEP, AID ,Rh-
What is the difference between autologous donations and directed donations? What is the biggest advantage of autologous donations?
Autologous: self donation
Direct: specific recipient
- some one who is rare blood type like Bombay
What is emergency release?
physician signs for NON XM BLOOD
Name and describe the main components that can be taken when separating whole blood into individual blood products.
packed cells with a small amount of plasma,
Plasma (FFP),
Platelets,
Cryo(the insoluble portion of plasma that remains after thawing FFP)
Give the normal temperature and storage requirements for these blood components: pRBC w/ CPDA1 Frozen RBC Cryo/FFP Platelet
packed red cells with CPDA1 35days
Frozen red cells will keep for 10 years
Cryo/FFP keep for 1yr @ -18deg
Platelet: 5 days RT for 5 days
What is therapeutic phlebotomy?
Why is it used?
blood letting used to remove blood to treat pts with Polycythemia vera Hemachromotosis Porphyrias
How long should someone wait between whole blood donations?
8 weeks
How often should a new sample be collected on a blood recipient when a series of transfusions are to be administered over a period of time?
every 3 days
When transfusing packed red cells, what is the total amount (±10%) that is routinely transfused?
280 ml
Why is there a storage limit of 21 days put on CPD blood stored at 5°C?
to preserve the viability of at least 70% of Red cells post transfusion
Know the reasons a person may be permanently deferred from donating blood
HIV, Drug Abuse, HEP
What is plasmapheresis?
removing blood and plasma from the body, separate and re-infuse the red cells
What is the most common of all the transfusion reactions?
Febral, Allergic Reaction
What usually causes febrile reactions to occur?
leukocytes, pyrogens, platelet antibodies
Name 2 acceptable methods for thawing FFP.
FDA Microwave, Water bath
Which government agency is the regulatory agency providing licensure for blood banking reagents?
FDA
State the expiration of the following units under the following conditions:
A. Packed red cells and the hermetic seal has been broken but the unit has been refrigerated:
24 hrs
State the expiration of the following units under the following conditions:
b. Six units of platelets have been pooled together in an open system:
4 hrs
State the expiration of the following units under the following conditions:
c. FFP has been thawed and is being kept refrigerated:
24 hrs
What is the temperature limit for shipping packed red cells
1-10
What does refractory mean and which blood component is it associated with?
non responsive to platelet transfusion
Why are patient specimens kept in the lab after testing is completed and for how long?
in case you need to retest
7 days
Name the methods of good record keeping in the blood bank. How long are most blood bank records kept in the lab
Not Indelible Ink (not gel pens)
recording data in app log book, good record keeping
12 months
What is the number one source of error in blood banking?
clerical errors
Name the blood component of choice for the following conditions:
Factor VIII deficiency
Cryo
Name the blood component of choice for the following conditions:
Marked thrombocytopenia
Platelets
Name the blood component of choice for the following conditions:
Factor V deficiency
FFP
Name the blood component of choice for the following conditions:
Exchange transfusion
Whole Blood especially fresh
Name the blood component of choice for the following conditions:
Severe burns
Human Serum Albumin (protein)
Name the blood component of choice for the following conditions:
Chronic anemia
Pac red cells
Name the blood component of choice for the following conditions:
Acute blood loss
Whole Blood
Name the blood component of choice for the following conditions:
Hemophilia
Cryo
