Final Review Flashcards
Testing of the last was the last wash in the eluate procedure ensures that:
a) The check cells will work
b) The antibody identified in the eluate is the antibody attached to the red cells
c) The antibody identified in the eluate should be in the patient plasma
d) The pH of the elute is appropriate for panel cell testing
The antibody identified in the eluate should be in the patient plasma
Other than anti-IgG, what is Polyspecific AHG reagent?
a) IgM
b) C9
c) C3d
d) C4
C3d
Which statement is true for allo-adsorption procedure?
a) It is utilized when patients have been recently transfused
b) It removes antibody from patient cells
c) QC for this procedure involves testing of the last was
d) Patient cells are used to remove autoantibody from their own plasma
It is utilized when patients have been recently transfused
alloadsopriton - panaagglutination with immune stimulating event - trans
What test should be done next with the following results?
a) Adsorption
b) Phenotype for M antigen
c) DAT
d) Anemia Studies
Anti- A: 4+
Anti-B: 0
Anti-D: 0
A1 cell: 3+
B cell: 3+
___ IS___37___AHG___CC
SC1: 3+, 1+, 0 , 2+
SC2: 3+, 1+, 0, 2+
Auto: 3+, 3+, 3+, NT
DAT
DAT: Positive auto control; hemolysis evident.
Which DAT results indicate that an elution should be performed?
a) AHG + IgG+ C3d-
b) AHG - IgG - C3d-
c) AHG +IgG - C3d+
d) AHG +IgG- C3d-
AHG +IgG+ C3d-
Which test result differentiates between high incident antibody and autoantibody workup?
a) Elution
b) Auto Control
c) Adsorption
d) DAT
Auto control
auto control - w/antibody Id
Shortness of breath indicates hemolytic anemia, what test differentiates between cold acting antibodies and warm acting antibodies being the cause?
a) Auto control
b) Cold Screen
c) Elution
d) Donath Landsteiner
Cold Screen
Which type of anemia is not often associated with compliment activation?
a) PCH
b) CAD
c) Drug Adsorption
d) WAIHA
Drug Adsorption
-Drugs attach to RBC membrane, direct destruction of rbc, IgG, no compli
PCH - compliment is low
CAD - cold aggluitnin disease - moderate chronic hemolytic anemia
WAIHA - Warm auto immune hemolytic anemia - Autoantibody reacts with patients’ RBC’s in vivo may activate compliment or not.
Which antibody is most likely acting in this cold screen?
___ IS___37___AHG___CC
SC1: 3+, 2+, 0 , 2+
SC2: 3+, 2+, 0, 2+
SC3: 3+, 2+, 0, 2+
Cord: 3+, 2+, 0, 2+
Cell
a) Anti-I
b) Anti-IH
c) Anti-i
d) Anti-M
b) Anti-IH
What test helps differentiate pathologic vs benign CAD?
a) Antibody ID
b) DAT
c) Antibody Titer
d) Donath Landsteiner
Antibody Titer
Which of the following is not a control for the Donath Landsteiner test?
a) Patient cells + normal plasma
b) Samples kept at 37C until test commences
c) Normal plasma + patient plasma
d) Normal plasma
Patient cells + normal plasma
Which of the following diagnoses is NOT reasonable for the following serological results?
Anti- A: 4+
Anti-B: 0
Anti-D: 0
A1 cell: 0
B cell: 3+
___ IS___37___AHG___CC
SC1: 0, 1+, 3+ , NT
SC2: 0, 1+, 3+, NT
Auto: 3+, 3+, 3+, NT
a) WAIHA
b) CAD
c) Aldomet Antibody
d) Transfusion reaction with anti-e
–> CAD
side note: Aldomet(IgG+)
CAD is suspected when there is cold screen with cord cell.
This mechanism of drug related hemolysis is less severe with penicillin and most severe with Cefotetan. Which mechanism is it?
a) Drug Adsorption
b) Immune Complex
c) Membrane Modification
d) Drug-Independent Auto Anti-body
Drug Adsorption
Drugs: Cefotetan, streptomyocin, penicilin
Drug- Adsorption:
- Drugs attach to RBC membrane
- Antibody directed to drug causes destrution of RBC
- IgG no compliment
- Hemolysis yes (tea color in blood)
- extravascular to intravasular
Which transfusion recommendation is appropriately matched to its autoantibody diagnosis?
a) Darzalex - don’t transfuse
b) WAIHA - transfuse with blood warmer
c) CAD - wash the cells
d) Cefotetan - transfuse as normal
Cefotetan - transfuse as normal
Cefotetan usually given during surgery prophylactically.
Hemolysis appears 7-10days laster with anemia <4g. Second does is usally fatal.
Darzalex - chemotherapy drug; transfusing them is perfectly fine. (give them blood all the time)
WAIHA - Warm autoimmune hemolytic anemia - we cannot transfuse, not even with a blood warmer, because its already a warm acting antibody. You have to consult with a pathologist and the doctor and they have to sign a form. B/C any thing you try to give to them will be incompatible, and lysis, and make their system worse!
CAD - Cold agglutinate, we need to warm the blood. We warm before we give it to the patient that way we don’t activate hemolysis.
Cefotetan is a medication reaction, where it cause the tea color in serum, support the transfusion, but stop the drug.
A crossmatch sample collected at 1405 on Monday would expire on which day at midnight?
a) Tuesday
b) Wednesday
c) Thursday
d) Friday
Thursday
When should a transfusions be checking vitals?
a) Before the unit started
b) 15 minutes after unit is started
c) 15 minutes after unit is completed
d) Both a and b
Both a and b
