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Immunohematology (Blood Bank and Serology) > Final Exam > Flashcards

Final Exam Flashcards

1
Q

Which immunoglobulin class is associated with the primary response?

A

IgM

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2
Q

Which immunoglobulin class is associated with the secondary (anamnestic) response?

A

IgG

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3
Q

Which immunoglobulin class is also known as incomplete or blocking antibodies?

A

IgG

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4
Q

Which immunoglobulin class is the predominant class found in the Rh system?

A

IgM

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5
Q

Explain Landsteiner’s Law.

A

antibodies will only be present in the serum/plasma if the corresponding antigens are not present on the red cells

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6
Q

What is the difference between a genotype and a phenotype?

A

the genotype is the actual genetic coding, while the phenotype is the outward expression of those genes

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7
Q

Where are the antigens and antibodies found in the body?

A

antigens are on the red cells, antibodies are in the serum/plasma

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8
Q

What antibodies naturally occur in group A blood?

A

anti-B

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9
Q

What antibodies naturally occur in group B blood?

A

anti-A

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10
Q

What antibodies naturally occur in group O blood?

A

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

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11
Q

What antibodies naturally occur in group AB blood?

A

none

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12
Q

What antibodies naturally occur in the blood of Bombay individuals?

A

anti-A, anti-B, anti-A,B, anti-H

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13
Q

What is the amount of H substance demonstrated on red cells in order of decreasing reactivity?

A

O > A2 > B > A2B > A1 > A1B

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14
Q

What is demonstrated in forward blood typing?

A

which blood group antigens are present on the red cells, including Rh status

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15
Q

What is demonstrated in reverse blood typing?

A

which blood group antibodies are present in the serum/plasma

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16
Q

What is the purpose of performing an adsorption, and what is the difference between auto- and alloadsoprtion?

A

binds antibody to the red cells in order to remove them from the serum/plasma and better analyze what is left behind; autoadsorption removes autoantibody using the patient’s own red cells; alloadsorption removes certain alloantibodies using non-self red cells, usually as a means of resolving multiple antibodies

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17
Q

What are the five main factors influencing antigen-antibody reactions?

A

concentration and kind of electrolyte present; pH; temperature; agitation/centrifugation; time

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18
Q

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

A

B

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19
Q

Why don’t labs perform reverse blood grouping on newborns?

A

blood group antibodies are absent in newborn plasma/serum

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20
Q

What are the antisera used in ABO/Rh typing?

A

anti-A, anti-B, anti-D

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21
Q

Anti-A1 is most often found in individuals of what blood group?

A

A2

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22
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 group?

A

anti-A1 lectin

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23
Q

Describe the two types of AHG.

A

polyspecific/broad spectrum - contains anti-IgG and anti-complement; monospecific - contains only one of either anti-IgG or anti-complement

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24
Q

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

A

Ulex europaeus

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25
Q

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

A

removes any unbound IgG or other unbound protein that could potentially interfere with testing

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26
Q

The lectin from which plant is used to distinguish between A1 and subgroup A red cells?

A

Dolichos biflorus

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27
Q

What is the difference between and IAT and a DAT?

A

IAT (indirect antiglobulin test, indirect Coomb’s, antibody screen) detects whether red cells are coated with IgG antibody in vitro (outside the body); DAT (direct antiglobulin test, direct Coomb’s) detects whether red cells are coated with IgG antibody and/or complement in vivo (inside the body)

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28
Q

How can cold agglutinins be excluded from a crossmatch?

A

using the prewarming technique

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29
Q

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

A

used to type received donor blood, and to detect A and B subgroups

30
Q

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

A

DAT or elution (particularly Lui Freeze-Thaw)

31
Q

What type of antibody does the DAT detect?

A

IgG

32
Q

Which rare blood type produces natural anti-H antibodies?

A

Bombay (hh, Oh)

33
Q

What procedure can be used to remove Rouleaux?

A

saline replacement

34
Q

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

A

hemolytic disease of the fetus and newborn (HDFN)

35
Q

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

A

weak-D testing

36
Q

When is Rh immunoglobulin (RhoGam, RhIG) given to Rh= mothers?

A

as an antenatal dose at 28 weeks or at any time during the pregnancy; at delivery of an Rh+, Rh invalid, or Rh unknown baby; any time the mother is suspected to have been exposed to fetal red cells, such as in cases of trauma, fetomaternal hemorrhage, miscarriage, amnicentesis, or cordocentesis

37
Q

What causes kernicterus in newborns?

A

hyperbilirubinemia caused by HDFN

38
Q

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

A

cells must be washed to remove Wharton’s jelly

39
Q

What causes HDFN?

A

antibodies in the mother’s circulation cross the placenta and attack fetal cells; most often due to ABO/Rh incompatibilities

40
Q

What substances do group A secretors secrete into their saliva?

A

A and H substance

41
Q

What substances do group B secretors secrete into their saliva?

A

B and H substance

42
Q

What substances do group O secretors secrete into their saliva?

A

H substance

43
Q

What substances do group AB secretors secrete into their saliva?

A

A, B, and H substance

44
Q

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

A

LeLe or Lele, SeSe or Sese, HH or Hh; phenotype would be Le(a-b+)

45
Q

What is the name of for the genes in an individual who genotypes as le, se, and h?

A

null or recessive

46
Q

What percentage of the Caucasian population are secretors?

A

80%

47
Q

What are the components in a major crossmatch?

A

donor red cells and recipient plasma/serum

48
Q

Which antibodies can show up as cold agglutinins?

A

N, P1, Ii

49
Q

Which antibodies belong to the Kidd blood group system?

A

Jka and Jkb

50
Q

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

A

MNSs, Kidd, Lutheran, Duffy, Rh (Cc, Ee)

51
Q

What antigen is known to be sex-linked?

A

Xga

52
Q

The i antigen is most prevalent in what population?

A

children under the age of 18 months

53
Q

Which antibodies are known to cause delayed hemolytic transfusion reactions (DHTR)?

A

Kidd

54
Q

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

A

allows targeting of the specific problem with the appropriate component, and also allows many patients to be treated with a single donation

55
Q

What is the difference between an autologous donation and a directed donation, and what is the biggest advantage of an autologous donation?

A

an autologous donation is the recipient’s own blood, collected at an earlier date in anticipation of a transfusion, and does not require a crossmatch; directed donations are compatible units that usually come from friends or family members of the recipient, and are collected specifically for that recipient

56
Q

What is an emergency release?

A

blood products that are issued without completing compatibility testing at the physician’s request (the physician takes on full responsibility for any consequences)

57
Q

What is therapeutic phelebotomy and what are two conditions that might require this kind of treatment?

A

the removal of blood as a means of treating a medical condition, such as polycythemia vera or hemachromatosis (iron overload, or any such condition where circulatory overload is a concern

58
Q

How often should a new sample be collected on a blood recipient when a series of transfusions are to be administered over the course of several days?

A

the initial sample should be drawn and tested no more than three days before the first transfusion; the results of this initial test are considered valid for a 72-hour period, after which new samples should be drawn and tested

59
Q

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

A

that is how long CPD can maintain 2,3-diphosphoglycerate levels

60
Q

What is the most common of all transfusion reactions, and what causes it?

A

febrile non-hemolytic transfusion reaction (FNHTR), cause by recipient antibody reacting to donor cells

61
Q

What are the two acceptable methods for thawing FFP?

A

37*C water bath or an FDA approved microwave

62
Q

What is the name of the government regulatory agency providing licensure for blood banking reagents?

A

FDA

63
Q

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

A

unresponsive to treatment; platelets

64
Q

Which blood component would be indicated for Factor VIII deficiency?

A

cryoprecipitate

65
Q

Which blood component would be indicated for marked thrombocytopenia?

A

platelets

66
Q

Which blood component would be indicated for Factor V deficiency?

A

fresh frozen plasma (FFP)

67
Q

Which blood component would be indicated for exchange transfusion?

A

whole blood

68
Q

Which blood component would be indicated for severe burns?

A

plasma products (albumin, plasma protein fraction, synthetic volume expanders)

69
Q

Which blood component would be indicated for chronic anemia?

A

packed red cells

70
Q

Which blood component would be indicated for acute blood loss?

A

whole blood

71
Q

Which blood component would be indicated for hemophilia?

A

cryoprecipitate (hemophilia A), Factor IX complex (hemophilia B)

Immunohematology (Blood Bank and Serology) (15 decks)

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