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Lab Med > Immunohematology > Flashcards

Immunohematology Flashcards

1
Q

the study of antigens, antibodies, and their reactions, as pertaining to blood

A

immunohematology

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2
Q

the process of collecting, separating and storing blood products, and ensuring that these products are safe for therapeutic use

A

blood banking

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3
Q

what is the most frequently performed and most important test in the blood bank?

A

ABO grouping

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4
Q

blood type refers to _____ present on the RBC membrane

A

antigens

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5
Q

A and B genes correspond with A and B _____, respectively

A

antigens

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6
Q

the O gene is _____, producing no antigen

A

amorph

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7
Q

what is the mendelian genetics of A and B genes?

A

codominant

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8
Q

what is the mendelian genetics of O gene?

A

autosomal recessive

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9
Q

genetic composition inherited from parents

A

genotype

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10
Q

observable expression of the blood type

A

phenotype

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11
Q

develop after 6 months of age in response to antigens not present on the RBC membrane

A

ABO antibodies

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12
Q

blood type A has which antibodies present?

A

B antibodies

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13
Q

blood type B has which antibodies present?

A

A antibodies

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14
Q

blood type AB has which antibodies present?

A

no antibodies

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15
Q

blood type O has which antibodies present?

A

A and B antibodies

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16
Q

refers to the presence or absence of the D antigen

A

Rh antigens

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17
Q

D antigen present on RBC membrane =

A

Rh +

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18
Q

D antigen absent from RBC membrane =

A

Rh -

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19
Q

how do Rh antibodies most commonly develop?

A

from exposure to foreign RBC antigens through pregnancy or blood transfusion

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20
Q

what can occur since Rh antibodies readily cross the placenta?

A

hemolytic disease of the newborn (HDN)

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21
Q

what is the most common and most important pretransfusion test performed?

A

blood typing

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22
Q

detects in vivo coating of RBC with antibody, and identifies immune-mediated hemolytic anemia and hemolytic disease of the newborn

A

Direct antiglobulin/Coombs test (DAT)

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23
Q

detects in vitro coating of RBC with antibody, and is used for antibody screening and compatibility testing

A

Indirect antiglobulin/Coombs test (IAT)

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24
Q

what does a positive antibody screen indicate?

A

unexpected antibody is present and must be identified before transfusion

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25
Q

in which patients does a higher rate of alloimmunizations occur?

A

those who have received multiple transfusions

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26
Q

blood banker identifies the specific antibody present that is responsible for the positive screen

A

antibody identification

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27
Q

testing donor blood with patient serum for compatibility

A

crossmatch

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28
Q

what sample is a crossmatch performed on?

A

packed RBCs only

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29
Q

what is the leading cause of M&M related to blood transfusion?

A

clerical errors

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30
Q

what tube is anticoagulant blood preferred in?

A

EDTA (lavender)

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31
Q

what is required to confirm ABO?

A

collection of a second sample from a different time

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32
Q

ordered when a patient is losing blood rapidly and there is little time to complete required pretransfusion testing

A

crash blood

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33
Q

what blood type will be given to patients with unknown BT history?

A

O

34
Q

RBC separated from whole blood through centrifugation and suspended in residual plasma and additive solution (preservatives and nutrients)

A

packed RBCs

35
Q

used in immunocompromised patients

A

leukocyte-reduced packed RBCs

36
Q

PRBCs are treated with gamma radiation to prevent T lymphocyte activation; used for immunocompromised patients

A

irradiated PRBCs

37
Q

occurs when viable T lymphocytes are transplanted into an immune compromised patient and mounts an immune response due to differences between donor and recipient HLA antigens

A

graft-vs-host disease (GVHD)

38
Q

removes plasma proteins, which are responsible for most allergic reactions; also removes WBCs and platelets

A

washed PRBCs

39
Q

which blood product is indicated for patients with a history of severe allergic transfusion reactions?

A

washed PRBCs

40
Q

contains all blood components and indicated for anemia and emergency traumas

A

whole blood

41
Q

what makes whole blood safe to use in emergencies?

A

low titer (limited A and B antibodies)

42
Q

what patients are platelets not indicated for?

A

patients with PLTs less than 1,000

43
Q

indicated to treat nonspecific coagulation deficiency in bleeding patients with liver failure, DIC, vit K deficiency, warfarin overdose, or in a massive transfusion protocol

A

fresh frozen plasma

44
Q

concentrate of fibrinogen, factors VIII, XIII, vWF, and fibronectin

A

cryoprecipitate

45
Q

what is cryoprecipitate primarily used in?

A

fibrinogen deficiency

46
Q

what antigens are present on lymphocytes?

A

HLA and MHC antigens

47
Q

how are HLA genes inherited?

A

one from each parent

48
Q

what test is important in determining organ transplant compatibility?

A

HLA testing

49
Q

destruction of transfused RBCs due to antibody-mediated incompatibility

A

acute hemolytic transfusion reaction

50
Q

a patient presents with fever, chills, hypotension, pain at infusion site/ flanks/ chest/ or abdomen. what are they likely experiencing?

A

acute hemolytic transfusion reaction

51
Q

when does acute hemolytic transfusion reaction occur?

A

less than 24 hrs after transfusion

52
Q

what can acute hemolytic transfusion reaction lead to?

A

acute kidney injury

53
Q

positive DAT 24 hours to 28 days after a transfusion, with newly identified alloantibody, and evidence of hemolysis

A

delayed hemolytic transfusion reaction

54
Q

a patient presents with acute respiratory distress (dyspnea, tachypnea, and hypoxemia). what could it be?

A

transfusion-related acute lung injury (TRALI)

55
Q

when must TRALI occur?

A

within 6 hours of transfusion

56
Q

what would a radiograph of TRALI show?

A

bilateral pulmonary edema

57
Q

the presence of 3 or more signs of fluid overload occurring within 6 hours of transfusion

A

transfusion-associated circulatory overload (TACO)

58
Q

a patient presents with acute respiratory failure from pulmonary edema due ton increased intravascular tone. what is this?

A

TACO (transfusion-associated circulatory overload)

59
Q

a patient presents with fever >100.4 F / a change >1.8 F from pretransfusion temp occurring during or within 4 hours of the transfusion

A

febrile nonhemolytic transfusion reaction

60
Q

what is
febrile nonhemolytic transfusion reaction
related to?

A

product storage time

61
Q

what is the most common reaction seen with platelet and plasma transfusions?

A

allergic transfusion reactions (ATR)

62
Q

a patient presents with hives, urticaria, and no fever. what is this?

A

allergic transfusion reaction (ATR)

63
Q

what are 2 reasons transfusion-associated graft vs host disease can occur?

A
  1. recipient is immunocompromised
  2. partial HLA matching in WBCs (relatives)
64
Q

what procedure can be done to confirm transfusion-associated graft vs host disease?

A

tissue biopsy

65
Q

severe and sudden drop in platelet count occurring 5-10 days after transfusion; patient has counts <10 and bleeding of mucous membranes

A

post-transfusion purpura

66
Q

what is the treatment for post-transfusion purpura?

A

steroids
IV immunoglobulins

67
Q

what should a patient with a known history of post-transfusion purpura be given?

A

washed units

68
Q

what is the first step if any transfusion reaction is suspected?

A

stop the transfusion immediately

69
Q

an individual donates blood for their own use

A

autologous donation

70
Q

in what procedure is autologous donation, in which blood is collected intraoperatively and returned to circulation, common in?

A

cardiac procedures

71
Q

blood is collected for transfusion to a known recipient

A

directed donation

72
Q

blood withdrawal performed as treatment for a medical condition

A

therapeutic phlebotomy

73
Q

process in which a donor or patient’s whole blood is removed, separated into components, the desired component is collected and recombined components are returned to circulation

A

hemapheresis

74
Q

the destruction of fetal or neonatal RBCs by maternal antibodies

A

hemolytic disease of newborn (HDN)

75
Q

fetal hematopoietic tissue increases production of RBCs to compensate for reduced fetal RBC survival in HDN

A

erythroblastosis

76
Q

in unable to compensate for HDN, severe anemia develops with subsequent high output cardiac failure and intrauterine death. what is this called?

A

hydrops fetalis

77
Q

what is administered to Rh- mothers at 28 weeks and after birth to reduce Rh HDN?

A

rhogam

78
Q

condition due to anti-A or anti-B in type O mothers

A

ABO HDN

79
Q

what is the leading cause of HDN?

A

ABO incompatibility

80
Q

what blood type in mother and neonate most commonly leads to ABO incompatibility?

A

type O mothers with type A, B, or AB neonates

Lab Med (19 decks)

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