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blood bank > Finals - RBC autoantibodies > Flashcards

Finals - RBC autoantibodies Flashcards

1
Q

(T/F) AIHA and DIHA are inherited abnormalities

A

false

are acquired

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2
Q

____ when there is production of abs to a drug or

antibody-drug complex

A

drug induced HA

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3
Q

which of the ff is not true about RBC autoab?

a. may sensitize autologous RBCs without causing their destruction
b. autoab production is result of breakdown in immune regulation
c. characterized by DAT neg
d. can explain decrease RBC survival and unexplained anemia

A

C

DAT +

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4
Q

(T/F) presence of autoabs may be indicated by a pos DAT or pos autocontrol in ab screening

A

T

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5
Q

which of the ff evidences does not apply to the diagnosis of AIHA?

a. ↑ reticulocyte count
b. ↑ unconjugated bilirubin
c. ↑ Lactate Dehydrogenase (LDH)
d. ↑ haptoglobin levels

A

D

levels are ↓↓

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6
Q

which of the ff is not a possible (other) reason for RBC destruction?

a. G6PD deficiency
b. hereditary spherocytosis
c. thrombocytopenic purpura
d. hemoglobinopathies

A

C

this involves platelets, the rest must be excluded for diagnosis of AIHA

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7
Q

(T/F) AIHA is a cell mediated destruction of RBCs

A

false

antibody mediated!

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8
Q

which of the ff is false about the diagnostic test for cold AIHA?
a. some cases of hemolytic anemia autoabs cannot be detected
b. IgG are found to sensitize RBC is rare cases
c. AHG tests contain only anti-
IgG and anti-C3b + C3d or anti C3d
d. if RBCs are coated with other Igs the DAT will be negative

A

B

IgAs and IgMs

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9
Q

which of the ff is false about cold autoantibodies?

a. Anti-I and anti-i are examples
b. are harmful
c. IgMs are involved
d. may activate compliment in vitro

A

B

benign

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10
Q

which of the ff doesn’t apply to benign cold auto ab?

a. will not be detected with enzyme treatment
b. detection is enhanced with albumin
c. Anti-I is mostly involved
d. not clinically significant

A

A

detection is enhanced

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11
Q

which of the ff doesn’t apply to pathologic cold auto ab?

a. is secondary to viral infections
b. reactive at >30C
c. Anti-I is mostly involved
d. not clinically significant

A

D

duh

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12
Q

(T/F) pathologic titers for cold autoab are generally high compared to benign cold auto ab

A

true

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13
Q

___ the reagent that can remove/elute cold auto IgM from RBCs

A

DTT

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14
Q 
which of the ff is not a common specificity of cold auto ab?
a. Anti-IH
b, Anti-i
c. Anti-H
d. Anti-Pr
A

D

this is rare. also anti-En(a)

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15
Q

which of the ff conditions does not commonly contribute to pathological cold autoab?

a. Mycoplasma pneumoniae
b. Cold Hemagglutinin Disease (CHD)
c. Paroxysmal Cold Hemoglobinuria (PCH)
d. Infectious mononucleosis

A

C

this is a rare cause

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16
Q

which of the ff about PCH is false?

a. cold IgG autoab
b. has anti-I specificity
c. a biphasic hemolysin
d. ab+complement bind to RBCs at low temps

A

B

anti-P specificity

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17
Q

____ the diagnostic test for PCH

A

Donath-Landsteiner (D-L) test

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18
Q

which of the ff is not a symptom of PCH intravascular hemolysis?

a. Hemoglobinemia
b. Hemoglobinuria
c. RBC hemolysis
d. Bilirubinemia

A

all are symptoms

duh

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19
Q

which of the ff is false about warm AIHA?

a. can be IgM or IgA
b. secondary to surgery or pregnancy
c. spherocytes are involved
d. fragmented or nucleated RBCs may be seen

A

A

20
Q

which of the ff diseases is not associated with warm AIHA?

a. CLL
b. PCH
c. collagen diseases
d. ulcerative colitis

A

B

this is for cold

21
Q

which of the ff subclass is arranged in order in terms of wAIHA rbc destruction (most to least)?

a. IgG1> IgG3>IgG2
b. IgG2> IgG3>IgG1
c. IgG3> IgG1>IgG2

A

C

22
Q

macrophages have receptors to these molecules except:

a. C3b
b. C3d
c. IgG1
d. IgG3

A

B

23
Q

(T/F) Phagocytosis of IgG + C3b coated RBCs are more rapid than IgG or C3b, alone

A

true

24
Q

which of the ff is not a characteristic of warm auto ab?

a. lead to difficulties in RBC typing
b. strong agglutination of sensitized RBC in the presence of potentiator
c. DTT is used as treatment for agglutinated RBCs
d. macrophages are not involved

A

D

they are!

25
Q

(T/F) autoab are sometimes only found on the RBCs

A

true

26
Q

which of the ff does not enhance the detection of autoab?

a. LISS
b. PEG
c. enzymes
d. column agglutinations

A

A

less sensitive to autoab, the rest are the more sensitive

27
Q

____ are the two approaches for identifying underlying ALLOANTIBODIES IN THE PRESENCE of warm autoab; done to release autoab from rbcs and freeing some epitopes

A

Autologous Adsorption

allogenic adsorption - used if recently transfused

28
Q

____ treatment for testing allogenic in autologous adsorption in warm AIHA

A 
warm antibody
removal medium (W.A.R.M™) or ZZAP

Both reagents contain DTT + activated papain or ficin
– Treated RBCs will have more ‘free’ ag sites → increase autoab adsorption

29
Q

which of the ff RBC phenotype are NOT used for adsorption of plasma?

a. R1R1,
b. R2R2
c. R1r
d. rr

A

C

30
Q

(T/F) transfusion can be a treatment for warm AIHA

A

false!!!!

avoided! only given if patient has life threatening anemia

31
Q

(T/F) autoab antigens are honored if patient with wAIHA need to be transfused

A

F

no need to transfuse with antigen negative blood

32
Q

____ a treatment for wAIHA

A

corticosteroid (ex. prednisone)

33
Q

which of the ff is not an action of steroids?

a. increases clearance of ab-coated RBCs
b. ↓ ab production
c. Alter antibody activity
d. Change MØ receptors for IgG and C3

A

A

34
Q

______ list other possible wAIHA treatment

A

splenectomy, Immunosuppressive Drugs (last resort)

35
Q

which of the ff is not true about mixed type autoab?

a. warm and cold ab are present
b. cold ab binds to complement
c. warm autoab are IgGs
d. acute hemolysis is present

A

all is true!

cold IgMs can bind compl in this case

36
Q

which of the ff is not true about DIHA

a. DAT pos
b. ab involve can be IgM or IgG
c. involves cellular mediated hemolysis
d. can be drug dependent or independent

A

C

immune mediated!

37
Q

___ treatment for DIHA

A

stop drug treatment

38
Q

which of the ff is not true about DIHA?

a. involves intravascular hemolysis (drug adsorption type)
b. eluate is non reactive with panel cells
c. DAT is C3d pos for drug dependent type
d. DAT is IgG pos for autoimmune type

A

A

this is for drug dep type

39
Q

which of the ff is not a characteristic of PCH?

a. affects children/young adults
b. ab class is IgM
c. attack occurs in

A

B

is IgG (anti-P)

40
Q

which of the ff is not a characteristic of PCH?

a. condition follows viral infection
b. hemolysis is intravascular
c. indicated by high titers
d. D-L test is positive

A

C

low titers

41
Q

which of the ff is a characteristic of CHD?

a. hemolysis is severe
b. hemolysis is extravascular
c. ab class is IgM
d. auto agglutination occurs at RT

A

A

chronic, rarely severe

42
Q

which of the ff reagents does not help prevent agglutination by warm auto ab during RBC typing ?

a. dithiothreitol
b. Mab reagents
c. EDTA/Glycine Acid (EGA)
d. potentiators

A

D

will cause RBCs to spontaneously agglutinate Igg sensitized RBCs

43
Q

*(T/F) differential adsorption is used to test the patient for underlying alloantibody in the presence of warm auto antibody if recently transfused

A

true!

44
Q

(T/F) cold autoab usually have specificity to Rh antigens whie warm auto ab have specificity to P antigen

A

false

cold = IgM = anti-I, i and P
warm = IgG = anti-D, C, E, c, e
45
Q

(T/F) in DIHA, the antibodies are directed at the drug that is administered

A

true

blood bank (10 decks)

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