final exam Flashcards
Main Ig in primary response
IgM
main Ig in secondary response
IgG
also known as incomplete or blocking antibodies
IgG
the predominant Ig type found in the Rh system
IgG
briefly explain landsteiner’s rule
Ab are present in plasma only when the corresponding Ag is not present on RBC
explain the difference between genotype and phenotype
G- individuals actual genetic makeup (AA, AO, etc)
P- outward expression of genes
explain where antigens and antibodies are found
antigens are found on RBC surface
antibodies found in plasma
What antibodies are found in Group A
anti-B
what antibodies are found in Group B
anti-A
what antibodies are found in Group O
anti-A/anti-B/anti-A,B
what antibodies are found in Group AB
none
explain the difference between alloantibodies and autoantibodies
allo-production after exposure to genetically different Ag from same species
auto- production to self Ag (usually have autoimmune disease)
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 typing- test Ag on patient RBC with antisera
reverse- check patient serum/plasma for Ab with check cells
what is the purpose of performing an absorption
remove Abs
Give 5 examples of factors influencing antigen-antibody reactions
- incubation time
- proximity of Ag sites on RBC membranes
- ionic strength
- Ph
- temperature
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?
they don’t have well formed Abs until 6 months
name the antisera used in an ABO/Rh
anti-A
anti-B
anti-D
Anti-A1 is occasionally found 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/serum with A1 cells
describe the 2 types of AHG: what are they called and what is contained in each?
polyspecific- anticomplement (anti-C3D) anti-IgG
monospecific- has only one or the other of polyspecific
the lectin from which plant has a specificity for anti-H?
ulex europeaus
what is the main purpose of washing red blood cells used for testing in an antiglobulin test?
prevent neutralization of AHG by globulins
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?
IAT- in vivo, used for XM in tube
DAT- in vitro, determines if sensitization has occured in body from by gamme/beta globulins
how can cold agglutinins be excluded in a crossmatch?
prewarm
AC not warmed
what is the purpose of anti-A1 lectin?
to confirm A1 antigen on the RBC
what is the purpose of anti-A,B antisera?
detections of 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/ incomplete
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
ABO and Rh antibodies are most often implicated in what serious condition that affects newborns and fetuses?
HDFN
what must be done to a donor unit to firmly establish that it is indeed Rh negative?
D+w test
Du
when is Rh immunoglobulin (rhogam) given to Rh negative mothers?
at 28 weeks gestation and within 72 hours after birth
what causes kernicterus in newborns?
build up of unconjugated bilirubin
what type of blood bank testing is used to detect weak D
IAT (indirect coombs)
before testing, what must be done to all cord cells and why?
need to b washed to remove wharton’s Jelly (could interfere with blood typing)
what causes HDFN?
maternal cells lack Ag that fetal cells have
what substances do A blood group secretors secrete into saliva in terms of ABO
A,H
what substances do B blood group secretors secrete into saliva in terms of ABO
B,H
what substances do O blood group secretors secrete into saliva in terms of ABO
H
what susbstances do AB blood group nonsecretors secrete into saliva in terms of ABO
nothing *nonsecretor
how must an individual inherit the lewis, secretor, and H genes in order to secrete Leb substance?
atleast one Le
atleast one Se
any H— Hh, hh, HH
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 presentage oft he caucasian population are secretors?
80%
what are components used for testing in a major crossmatch and what is the purpose of this testing?
donor RBC recipient plasma
acceptable survival , safe transfusion
which antibodies can show up as cold agglutinins?
I/MN/P1/lewis
which antibodies belong to the Kidd blood group systems
jka
jkb
which antibodies are known for showing dosage when reacting with heterozygous red cells?
duffy kidd MN Ss Rh except D lutheran
what antigen is known to be sex-linked
Xga
the i antigen is most prevalent in what type of population
newborns
which antibodies are most known for delayed HTR
kidd
why is the transfusion of specific blood components preferable to the use of whole blood?
- less chance of circulatory overload
- many people can be treated with single donation
- concentrated form of what’s needed for adminstration
name some of the routine testing generally performed on donor blood
ab panel ABO/rh viral - Hiv hep CMV SYPHILIS weak D testing
whats the biggest difference between autlogous dontations and directed donations
autologous- any donation of blood reserved for donors own use (ex. hard blood types _ bombay)
directed- donation for specific person
what is emergency release
when there is not enough time to do XM before transfusion so doctor releases O- blood
name and describe the main components that can be taken when separating whole blood into individual blood products
1- packed RBC; concentrated / small amount of plasma
2) FFP
3) platelets - concentrated/ small amount of plasma
4) CRYO- insoluble portion of plasma when FFP is thawed
give the normal temperature and storage requirements for these blood components
1) 35 days in CPDA-1 at 1-6C
2) 1 year at -18 C – FFP and CRYO
3) 5 days at 20-24 C on rotators with continuous gentle agitation
FROZEN RBC 10 YEARS -65,-125
what is therapeutic phlebotomy and why is it used and name two conditions that might be associated
removal of blood to help treat patient symptoms
polycythemia
hemochromatosis
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 RBC 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 5C
to reserve the viability of 70% of RBC post transfusion
know the reasons a person may be deferred from donating blood permanently
butt loving
iv drug usage
hemophiliacs
viral hepatitis
what is plasmapheresis
removal of plasma while returning the other components of blood
what is the most common of all transfusion reactions
febrile or allergic
what usually causes febrile reactions to occur
leukocyte antibodies
cytokines or pyrogens
platelet abs
know two acceptable methods for thawing FFP
FDA approved microwave
waterbath 30-45 before administration at 30-37 C
which government agency is the regulatory agency for providing licensure for blood banking reagents
FDA
whats the expiration of packed RBC and the hermetic seal has been broken but the unit has been refrigerated
24 hours
whats the expiration of the six units of platelets that have been pooled together in an open system
4 hours
state the expiration of FFP that has been thawed and refrigerated
24 hours
what is the temperature limit for shipping packed red cells
1-10C
what does refractory mean? and which blood component is it associated with
patient is unresponsive to platelet transfusion
why are patients specimens kept in the lab after testing is completed and for how long?
in case of more testing needed
7 days
name the methods of good record keeping at the blood bank how long are most blood bank records kept in the lab
NO GEL PENS non smearing ink record right things right place if you make a mistake single line and initial date 12 months
what is the number one source of error in blood banking
clerical
what blood component is needed factor 8 deficiency
CRYO
what blood component is needed marked thrombocytopenia
plateletes
what blood component is needed factor 5 deficiency
FFP
what blood component is needed for exchange transfusion
whole blood especially fresh
what blood component is needed for severe burns
albumin human serum
what blood component is needed for chronic anemia
packed RBC
what blood component is needed for acute blood loss
whole blood
what blood component is needed for hemophilia
CRYO
