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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
in which patients does a higher rate of alloimmunizations occur?
those who have received multiple transfusions
26
blood banker identifies the specific antibody present that is responsible for the positive screen
antibody identification
27
testing donor blood with patient serum for compatibility
crossmatch
28
what sample is a crossmatch performed on?
packed RBCs only
29
what is the leading cause of M&M related to blood transfusion?
clerical errors
30
what tube is anticoagulant blood preferred in?
EDTA (lavender)
31
what is required to confirm ABO?
collection of a second sample from a different time
32
ordered when a patient is losing blood rapidly and there is little time to complete required pretransfusion testing
crash blood
33
what blood type will be given to patients with unknown BT history?
O
34
RBC separated from whole blood through centrifugation and suspended in residual plasma and additive solution (preservatives and nutrients)
packed RBCs
35
used in immunocompromised patients
leukocyte-reduced packed RBCs
36
PRBCs are treated with gamma radiation to prevent T lymphocyte activation; used for immunocompromised patients
irradiated PRBCs
37
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
graft-vs-host disease (GVHD)
38
removes plasma proteins, which are responsible for most allergic reactions; also removes WBCs and platelets
washed PRBCs
39
which blood product is indicated for patients with a history of severe allergic transfusion reactions?
washed PRBCs
40
contains all blood components and indicated for anemia and emergency traumas
whole blood
41
what makes whole blood safe to use in emergencies?
low titer (limited A and B antibodies)
42
what patients are platelets not indicated for?
patients with PLTs less than 1,000
43
indicated to treat nonspecific coagulation deficiency in bleeding patients with liver failure, DIC, vit K deficiency, warfarin overdose, or in a massive transfusion protocol
fresh frozen plasma
44
concentrate of fibrinogen, factors VIII, XIII, vWF, and fibronectin
cryoprecipitate
45
what is cryoprecipitate primarily used in?
fibrinogen deficiency
46
what antigens are present on lymphocytes?
HLA and MHC antigens
47
how are HLA genes inherited?
one from each parent
48
what test is important in determining organ transplant compatibility?
HLA testing
49
destruction of transfused RBCs due to antibody-mediated incompatibility
acute hemolytic transfusion reaction
50
a patient presents with fever, chills, hypotension, pain at infusion site/ flanks/ chest/ or abdomen. what are they likely experiencing?
acute hemolytic transfusion reaction
51
when does acute hemolytic transfusion reaction occur?
less than 24 hrs after transfusion
52
what can acute hemolytic transfusion reaction lead to?
acute kidney injury
53
positive DAT 24 hours to 28 days after a transfusion, with newly identified alloantibody, and evidence of hemolysis
delayed hemolytic transfusion reaction
54
a patient presents with acute respiratory distress (dyspnea, tachypnea, and hypoxemia). what could it be?
transfusion-related acute lung injury (TRALI)
55
when must TRALI occur?
within 6 hours of transfusion
56
what would a radiograph of TRALI show?
bilateral pulmonary edema
57
the presence of 3 or more signs of fluid overload occurring within 6 hours of transfusion
transfusion-associated circulatory overload (TACO)
58
a patient presents with acute respiratory failure from pulmonary edema due ton increased intravascular tone. what is this?
TACO (transfusion-associated circulatory overload)
59
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
febrile nonhemolytic transfusion reaction
60
what is febrile nonhemolytic transfusion reaction related to?
product storage time
61
what is the most common reaction seen with platelet and plasma transfusions?
allergic transfusion reactions (ATR)
62
a patient presents with hives, urticaria, and no fever. what is this?
allergic transfusion reaction (ATR)
63
what are 2 reasons transfusion-associated graft vs host disease can occur?
1. recipient is immunocompromised 2. partial HLA matching in WBCs (relatives)
64
what procedure can be done to confirm transfusion-associated graft vs host disease?
tissue biopsy
65
severe and sudden drop in platelet count occurring 5-10 days after transfusion; patient has counts <10 and bleeding of mucous membranes
post-transfusion purpura
66
what is the treatment for post-transfusion purpura?
steroids IV immunoglobulins
67
what should a patient with a known history of post-transfusion purpura be given?
washed units
68
what is the first step if any transfusion reaction is suspected?
stop the transfusion immediately
69
an individual donates blood for their own use
autologous donation
70
in what procedure is autologous donation, in which blood is collected intraoperatively and returned to circulation, common in?
cardiac procedures
71
blood is collected for transfusion to a known recipient
directed donation
72
blood withdrawal performed as treatment for a medical condition
therapeutic phlebotomy
73
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
hemapheresis
74
the destruction of fetal or neonatal RBCs by maternal antibodies
hemolytic disease of newborn (HDN)
75
fetal hematopoietic tissue increases production of RBCs to compensate for reduced fetal RBC survival in HDN
erythroblastosis
76
in unable to compensate for HDN, severe anemia develops with subsequent high output cardiac failure and intrauterine death. what is this called?
hydrops fetalis
77
what is administered to Rh- mothers at 28 weeks and after birth to reduce Rh HDN?
rhogam
78
condition due to anti-A or anti-B in type O mothers
ABO HDN
79
what is the leading cause of HDN?
ABO incompatibility
80
what blood type in mother and neonate most commonly leads to ABO incompatibility?
type O mothers with type A, B, or AB neonates

Lab Med (19 decks)

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