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Immunohematology > Final Exam > Flashcards

Final Exam Flashcards

1
Q

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

A: IgM
B:IgG
C:IgG
D:IgG

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2
Q

Briefly explain Landsteiner’s Law.

A

Ab are present in plasma only when the corresponding Ag is not present on the RBCs.

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3
Q

Explain the difference between genotype and phenotype

A

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)

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4
Q

Explain where antigens and antibodies are found

A

Antibodies found in plasma

Antigens are on surface of RBC

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5
Q

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

a. Anti B
b. Anti A
c. Anti A Anti-B Anti-AB
d. None

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6
Q

Explain the difference between alloantibodies and autoantibodies.

A

ALLO-formed antibodies in response to an antigen from outside the body
AUTO-antibodies to self antigens

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7
Q

The amount of H substance demonstrated on the cells in order of decreasing reactivity is as follows:

A

O,>A2,>B>A2B,>A1>A1B

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8
Q

Forward ABO grouping and the reverse grouping when typing blood demonstrates what in terms of antigens and antibodies present?

A

Forward detects Ag on cells
Reverse detects Ab in plasma
(They should be opposite of each other)

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9
Q

What is the purpose of performing an absorption?

A

to bind and remove some of the Ab to better analyze the Abs left behind.

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10
Q

Give some examples of factors that could influence antigen-antibody reactions.

A

temp, pH, Centerfiguation, time, concentration, size, incubation time, proximity sites of antigen cites on RBC membrane, ionic strength of surrounding medium

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11
Q

If 2 homozygous B adults have children, what blood type would their offspring be?

A

B

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12
Q

Why don’t labs perform reverse blood groupings on newborn infants?

A

because there antibodys arnt well develpoed

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13
Q

Name the antisera used in in an ABO/Rh.

A

Anti-A
Anti-B
Anti-D

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14
Q

Anti-A1 is found occassionally in individuals of this blood group

A

A2

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15
Q

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

A

test plasma or serum with A1 cells

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16
Q

Describe the 2 types of AHG: what are they called and what is contained in each?

A

Polyspecific: has both Anti IgG and C3D

Monospecific has one or other

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17
Q

The lectin from which plant has a specificity for anti-H?

A

Ulics Uropeous

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18
Q

What is the main purpose of washing red blood cells used for testing in an antiglobulin test?

A

to prevent neutralization of AHG in the blood sample

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19
Q

The extract from what plant is used to distinguish type A1 cell from other type A cells?

A

Dolichos biflorus

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20
Q

The weakest agglutination would be seen with anti-A with which of the following:
A1B A1 A3 O

A

A3

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21
Q

What is the difference between an IAT and a DAT and what do they each indicate

A

DAT: in VIVO red cells coated in the body with gamma and betta globulins
IAT: in VITRO cells are coated in the test tube

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22
Q

How can cold agglutinins be excluded in a crossmatch?

A

pre-warming

but the auto control is cold

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23
Q

What is the purpose of anti-A1 lectin? What is the purpose of anti-A,B antisera?

A

A1 lectin-demonstrate the presence of A1 Antigen

A,B antisera-detects subgroups of A weaker than A2

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24
Q

What type of test would demonstrate that group A or B fetal cells have been coated with maternal group O antibodies?

A

DAT(direct coombs)

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25
Q

What type of antibodies does an antiglobulin test detect?

A

IgG, blocking antibodies or in-completed

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26
Q

Which rare blood type produces natural anti-H antibodies?

A

Bombay

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27
Q

Name a procedure you could perform in the blood bank to remove rouleaux formation.

A

Saline replacement technique

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28
Q

ABO and Rh antibodies are most often implicated in what serious condition that affects newborns and fetuses?

A

HDFN (HDN)

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29
Q

What must be done to a donor unit to firmly establish that it is indeed Rh negative?

A

Weak D testing (DU)

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30
Q

When is Rh immunoglobulin (Rhogam) given to Rh negative mothers?

A

28 weeks and with in 72 hours of delivery

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31
Q

What causes kernicterus in newborns?

A

accumulation of Biliruben in the brain which is uncongiguated

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32
Q

What type of blood bank testing is used to detect weak D (Du)?

A

IAT (indirect anti-humanglobulen test)

33
Q

Before testing, what must be done to all cord cells and why?

A

wash, to remove wartons jelly because it can interfere with blood typing

34
Q

What causes HDFN

A

maternal cells lack antigen that fetal cells have. causes sensitization

35
Q

What substances do the following individuals secrete into their saliva in terms of ABO?

A

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 )

36
Q

How must an individual inherit the Lewis, secretor, and H genes in order to secrete Leb substance

A

at least one dominant gene

37
Q

You have a patient that has developed Lewis antibodies. What type of donor blood would you want to give them?

A

Le (a-b-)

38
Q

An individual genotypes as le, se, and h. These genes are said to be __________________ or ___________________.

A

recessive; amorphic

39
Q

What percentage of the Caucasian population are secretors?

A

80%

40
Q

What are components used for testing in a major crossmatch and what is the purpose of this testing

A

donor red cells and recipient plasma, to ensure the safety of the transfusion

41
Q

Which antibodies can show up as cold agglutinins?

A 
Anti I
Anti M
Anti N
Anti P1
Anti Le a b
42
Q

Which antibodies belong to the Kidd blood group system?

A

anti Jk a b

43
Q

Which antibodies are known for showing dosage when reacting with heterozygous red cells?

A

Kidd, Duffy, M,N S, Rh(not D), Lu a b

44
Q

What antigen is known to be sex-linked

A

Xg a

45
Q

The i antigen is most prevalent in what type of population?

A

Newborns

46
Q

Which antibodies are most known for delayed hemolytic transfusion reactions?

A

Kidd

47
Q

Why is the transfusion of specific blood components preferable to the use of whole blood?

A

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

48
Q

Name some of the routine testing generally performed on donor blood

A

ABORh, Antibody, Syphilis, HEP, AID ,Rh-

49
Q

What is the difference between autologous donations and directed donations? What is the biggest advantage of autologous donations?

A

Autologous: self donation
Direct: specific recipient
- some one who is rare blood type like Bombay

50
Q

What is emergency release?

A

physician signs for NON XM BLOOD

51
Q

Name and describe the main components that can be taken when separating whole blood into individual blood products.

A

packed cells with a small amount of plasma,
Plasma (FFP),
Platelets,
Cryo(the insoluble portion of plasma that remains after thawing FFP)

52
Q 
Give the normal temperature and storage requirements for these blood components:
pRBC w/ CPDA1
Frozen RBC
Cryo/FFP
Platelet
A

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

53
Q

What is therapeutic phlebotomy?

Why is it used?

A 
blood letting 
used to remove blood to treat pts with 
Polycythemia vera
Hemachromotosis
Porphyrias
54
Q

How long should someone wait between whole blood donations?

A

8 weeks

55
Q

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?

A

every 3 days

56
Q

When transfusing packed red cells, what is the total amount (±10%) that is routinely transfused?

A

280 ml

57
Q

Why is there a storage limit of 21 days put on CPD blood stored at 5°C?

A

to preserve the viability of at least 70% of Red cells post transfusion

58
Q

Know the reasons a person may be permanently deferred from donating blood

A

HIV, Drug Abuse, HEP

59
Q

What is plasmapheresis?

A

removing blood and plasma from the body, separate and re-infuse the red cells

60
Q

What is the most common of all the transfusion reactions?

A

Febral, Allergic Reaction

61
Q

What usually causes febrile reactions to occur?

A

leukocytes, pyrogens, platelet antibodies

62
Q

Name 2 acceptable methods for thawing FFP.

A

FDA Microwave, Water bath

63
Q

Which government agency is the regulatory agency providing licensure for blood banking reagents?

A

FDA

64
Q

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:

A

24 hrs

65
Q

State the expiration of the following units under the following conditions:

b. Six units of platelets have been pooled together in an open system:

A

4 hrs

66
Q

State the expiration of the following units under the following conditions:

c. FFP has been thawed and is being kept refrigerated:

A

24 hrs

67
Q

What is the temperature limit for shipping packed red cells

A

1-10

68
Q

What does refractory mean and which blood component is it associated with?

A

non responsive to platelet transfusion

69
Q

Why are patient specimens kept in the lab after testing is completed and for how long?

A

in case you need to retest

7 days

70
Q

Name the methods of good record keeping in the blood bank. How long are most blood bank records kept in the lab

A

Not Indelible Ink (not gel pens)
recording data in app log book, good record keeping
12 months

71
Q

What is the number one source of error in blood banking?

A

clerical errors

72
Q

Name the blood component of choice for the following conditions:

Factor VIII deficiency

A

Cryo

73
Q

Name the blood component of choice for the following conditions:

Marked thrombocytopenia

A

Platelets

74
Q

Name the blood component of choice for the following conditions:

Factor V deficiency

A

FFP

75
Q

Name the blood component of choice for the following conditions:

Exchange transfusion

A

Whole Blood especially fresh

76
Q

Name the blood component of choice for the following conditions:

Severe burns

A

Human Serum Albumin (protein)

77
Q

Name the blood component of choice for the following conditions:

Chronic anemia

A

Pac red cells

78
Q

Name the blood component of choice for the following conditions:

Acute blood loss

A

Whole Blood

79
Q

Name the blood component of choice for the following conditions:

Hemophilia

A

Cryo

Immunohematology (5 decks)

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