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immunohematology > final exam > Flashcards

final exam Flashcards

1
Q

Main Ig in primary response

A

IgM

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2
Q

main Ig in secondary response

A

IgG

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3
Q

also known as incomplete or blocking antibodies

A

IgG

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4
Q

the predominant Ig type found in the Rh system

A

IgG

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5
Q

briefly explain landsteiner’s rule

A

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

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6
Q

explain the difference between genotype and phenotype

A

G- individuals actual genetic makeup (AA, AO, etc)

P- outward expression of genes

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7
Q

explain where antigens and antibodies are found

A

antigens are found on RBC surface

antibodies found in plasma

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8
Q

What antibodies are found in Group A

A

anti-B

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9
Q

what antibodies are found in Group B

A

anti-A

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10
Q

what antibodies are found in Group O

A

anti-A/anti-B/anti-A,B

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11
Q

what antibodies are found in Group AB

A

none

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12
Q

explain the difference between alloantibodies and autoantibodies

A

allo-production after exposure to genetically different Ag from same species
auto- production to self Ag (usually have autoimmune disease)

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13
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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14
Q

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

A

forward typing- test Ag on patient RBC with antisera

reverse- check patient serum/plasma for Ab with check cells

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15
Q

what is the purpose of performing an absorption

A

remove Abs

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16
Q

Give 5 examples of factors influencing antigen-antibody reactions

A
  • incubation time
  • proximity of Ag sites on RBC membranes
  • ionic strength
  • Ph
  • temperature
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17
Q

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

A

B

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18
Q

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

A

they don’t have well formed Abs until 6 months

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19
Q

name the antisera used in an ABO/Rh

A

anti-A
anti-B
anti-D

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20
Q

Anti-A1 is occasionally found in individuals of this blood group;

A

A2

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21
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/serum with A1 cells

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22
Q

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

A

polyspecific- anticomplement (anti-C3D) anti-IgG

monospecific- has only one or the other of polyspecific

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23
Q

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

A

ulex europeaus

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24
Q

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

A

prevent neutralization of AHG by globulins

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25
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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26
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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27
Q

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

A

IAT- in vivo, used for XM in tube

DAT- in vitro, determines if sensitization has occured in body from by gamme/beta globulins

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28
Q

how can cold agglutinins be excluded in a crossmatch?

A

prewarm

AC not warmed

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29
Q

what is the purpose of anti-A1 lectin?

A

to confirm A1 antigen on the RBC

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30
Q

what is the purpose of anti-A,B antisera?

A

detections of subgroups of A weaker than A2

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31
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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32
Q

what type of antibodies does an antiglobulin test detect?

A

IgG/ blocking/ incomplete

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33
Q

which rare blood type produces natural anti-H antibodies?

A

bombay

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34
Q

name a procedure you could perform in the blood bank to remove rouleaux formation?

A

saline replacement

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35
Q

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

A

HDFN

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36
Q

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

A

D+w test

Du

37
Q

when is Rh immunoglobulin (rhogam) given to Rh negative mothers?

A

at 28 weeks gestation and within 72 hours after birth

38
Q

what causes kernicterus in newborns?

A

build up of unconjugated bilirubin

39
Q

what type of blood bank testing is used to detect weak D

A

IAT (indirect coombs)

40
Q

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

A

need to b washed to remove wharton’s Jelly (could interfere with blood typing)

41
Q

what causes HDFN?

A

maternal cells lack Ag that fetal cells have

42
Q

what substances do A blood group secretors secrete into saliva in terms of ABO

A

A,H

43
Q

what substances do B blood group secretors secrete into saliva in terms of ABO

A

B,H

44
Q

what substances do O blood group secretors secrete into saliva in terms of ABO

A

H

45
Q

what susbstances do AB blood group nonsecretors secrete into saliva in terms of ABO

A

nothing *nonsecretor

46
Q

how must an individual inherit the lewis, secretor, and H genes in order to secrete Leb substance?

A

atleast one Le
atleast one Se
any H— Hh, hh, HH

47
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-)

48
Q

an individual genotypes as le, se and h. these genes are said to be ____ or ___

A

recessive

amorphic

49
Q

what presentage oft he caucasian population are secretors?

A

80%

50
Q

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

A

donor RBC recipient plasma

acceptable survival , safe transfusion

51
Q

which antibodies can show up as cold agglutinins?

A

I/MN/P1/lewis

52
Q

which antibodies belong to the Kidd blood group systems

A

jka

jkb

53
Q

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

A 
duffy
kidd
MN
Ss
Rh except D 
lutheran
54
Q

what antigen is known to be sex-linked

A

Xga

55
Q

the i antigen is most prevalent in what type of population

A

newborns

56
Q

which antibodies are most known for delayed HTR

A

kidd

57
Q

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

A
  • less chance of circulatory overload
  • many people can be treated with single donation
  • concentrated form of what’s needed for adminstration
58
Q

name some of the routine testing generally performed on donor blood

A 
ab panel
ABO/rh
viral - Hiv hep CMV
SYPHILIS
weak D testing
59
Q

whats the biggest difference between autlogous dontations and directed donations

A

autologous- any donation of blood reserved for donors own use (ex. hard blood types _ bombay)
directed- donation for specific person

60
Q

what is emergency release

A

when there is not enough time to do XM before transfusion so doctor releases O- blood

61
Q

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

A

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

62
Q

give the normal temperature and storage requirements for these blood components

A

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

63
Q

what is therapeutic phlebotomy and why is it used and name two conditions that might be associated

A

removal of blood to help treat patient symptoms
polycythemia
hemochromatosis
porphyrias

64
Q

how long should someone wait between whole blood donations?

A

8 weeks

65
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

66
Q

when transfusing packed RBC what is the total amount +/- 10 % that is routinely transfused

A

280 ml

67
Q

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

A

to reserve the viability of 70% of RBC post transfusion

68
Q

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

A

butt loving
iv drug usage
hemophiliacs
viral hepatitis

69
Q

what is plasmapheresis

A

removal of plasma while returning the other components of blood

70
Q

what is the most common of all transfusion reactions

A

febrile or allergic

71
Q

what usually causes febrile reactions to occur

A

leukocyte antibodies
cytokines or pyrogens
platelet abs

72
Q

know two acceptable methods for thawing FFP

A

FDA approved microwave

waterbath 30-45 before administration at 30-37 C

73
Q

which government agency is the regulatory agency for providing licensure for blood banking reagents

A

FDA

74
Q

whats the expiration of packed RBC and the hermetic seal has been broken but the unit has been refrigerated

A

24 hours

75
Q

whats the expiration of the six units of platelets that have been pooled together in an open system

A

4 hours

76
Q

state the expiration of FFP that has been thawed and refrigerated

A

24 hours

77
Q

what is the temperature limit for shipping packed red cells

A

1-10C

78
Q

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

A

patient is unresponsive to platelet transfusion

79
Q

why are patients specimens kept in the lab after testing is completed and for how long?

A

in case of more testing needed

7 days

80
Q

name the methods of good record keeping at the blood bank how long are most blood bank records kept in the lab

A 
NO GEL PENS
non smearing ink
record right things right place
if you make a mistake single line and initial date 
12 months
81
Q

what is the number one source of error in blood banking

A

clerical

82
Q

what blood component is needed factor 8 deficiency

A

CRYO

83
Q

what blood component is needed marked thrombocytopenia

A

plateletes

84
Q

what blood component is needed factor 5 deficiency

A

FFP

85
Q

what blood component is needed for exchange transfusion

A

whole blood especially fresh

86
Q

what blood component is needed for severe burns

A

albumin human serum

87
Q

what blood component is needed for chronic anemia

A

packed RBC

88
Q

what blood component is needed for acute blood loss

A

whole blood

89
Q

what blood component is needed for hemophilia

A

CRYO

immunohematology (4 decks)

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