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Blood Bank > Mid-Term: Week 1-3.5 > Flashcards

Mid-Term: Week 1-3.5 Flashcards

1
Q

Packed RBC Storage Temperature

A

1-6 C

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2
Q

Platelets Storage Temperature

A

20-24 C

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3
Q

Whole blood storage temperature

A

1-6 C

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4
Q

Fresh Frozen Plasma Storage

A

<-18 (frozen)

1-6 (thawed)

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5
Q

Cryoprecipitate Storage Thawed and Frozen

A

<-18 (frozen)

20-24 (thawed)

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6
Q

Granulocytes Storage Temperature

A

20-24 C

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7
Q

Packed RBC components and indications

A

RBCs

Anemia, major surgeries, radiation therapy

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8
Q

Platelet Components and indications

A

Platelets suspended in plasma

Aid in formation of platelet plug, low platelet count due to radiation therapy, post-operative bleeding

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9
Q

Whole blood components and indications

A

all components together

Massive bleeds/traumas, pediatric surgeries

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10
Q

Fresh Frozen Plasma components and indications

A

All coagulation factors

Abnormal, coagulation assays, factory deficiencies

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11
Q

Cryoprecipitate components and indications

A

concentrated coagulation factors separated from plasma

factor deficiencies, fibrinogen deficiency due to hemorrhage, fibrinogen insufficiency due to liver disease

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12
Q

Granulocyte components and indications

A

Leukocytes, platelets, RBCs

Neutropenia with infection not responding to antibiotics

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13
Q

Most common and least common blood type

A

Most: O+
Least: B-

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14
Q

Which type of D deficiency is quantitative and cannot produce Anti-D?

A

Weak D as it is a normal D but fewer quantities

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15
Q

What type of D deficiency is qualitative and is capable of producing anti-d?

A

Partial/partial-weak D since the structure is altered

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16
Q

In emergencies what blood type should you provide for women, men, and children?

A

type O uncross-matched
Rh - for women
Rh + for men
Rh -, CMV -, irradiated for children

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17
Q

Testing policy for massive transfusion

A

Current type and screen within <72 hours, only need to crossmatch
If patient doesn’t have a type and screens send uncross-matched blood and crossmatch the saved unit segments once testing can be completed

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18
Q

What does PUBS stand for and what is it used for?

A

percutaneous umbilical blood sampling for intrauterine transfusions

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19
Q

What blood is given for intrauterine transfusions and what is cross matched?

A

O NEG, CMV NEG, and irradiated RBCs
Hg S negative and antigen negative if Indicated
Crossmatched to the mother’s blood

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20
Q

What blood is given for neonatal transfusions and how is the volume determined?

A

O negative, CMV negative RBCs
Antigen negative if indicated
Volume is based on weight

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21
Q

What is Rhogam, when is it indicated, and what does it do?

A

It is a purified anti-D injection which is given to Rh negative mothers which gives passive anti-D

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22
Q

What antibody reacts on immediate spin vs 37 C vs AHG enhancement?

A

IS: IgG
37 C: Strong IgM/IgG
AHG enhancement/IAT: IgG

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23
Q

Which antibodies show dosage?

A

Duffy, Kidd, Rh, and MNS

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24
Q

Why are DATs performed?

A

To determine if RBCs have been coated in-vivo with IgG or complement (C3d), or both.

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25
Q

What disease states does a DAT help determine?

A

hemolytic transfusion reactions, hemolytic disease of the fetus and newborn, autoimmune hemolytic anemia, and drug-induced immune hemolysis

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26
Q

What does the DAT vs IAT detect?

A

DAT: detects the antibodies or complement proteins attached to the RBCs
IAT: detects antibodies produced against foreign RBCs

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27
Q

What components of the blood is used in a DAT vs IAT?

A

DAT: washed RBCs without plasma
IAT: serum

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28
Q

When is a DAT vs IAT performed?

A

DAT: to detects autoimmune hemolytic anemia
IAT: used prior to blood transfusions and prenatal testing of pregnant women

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29
Q

What type of autoantibodies typically causes a positive DAT and Autocontrol?

A

Cold C3d

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30
Q

What disease states can cause a positive DAT and auto control due to cold antibody?

A
  1. Mycoplasma pneumonia (anti-I)
  2. Some cases of anemia
  3. Infectious mononucleosis
  4. Drug interactions
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31
Q

What drug can cause cold antibodies and why?

A

Darzalex for multiple myeloma which is anti- Cd38, coating the cell in bound complement

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32
Q

How does a cold vs warm antibody appear on a panel?

A

Cold: weak and “scratchy” reactions
Warm: pan-reactivity

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33
Q

When the auto control is positive and a cold antibody is detected what steps should be performed?

A

warm specimen and all reagents up to 37 C then retest

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34
Q

what disease commonly forms warm antibodies?

A

Warm autoimmune hemolytic anemia

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35
Q

Is a cold or warm antibody positive screen typically sent out to reference labs and what is performed there?

A

warm antibodies to perform elution and/or adsorption techniques

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36
Q

define elution

A

disassociated IgG antibody from the RBCs by means of temperature shock or by lowering the pH

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37
Q

define adsorption

A

disassociates IgG antibodies by means of antigen positive RBCs

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38
Q

What test result is commonly seen in patient with multiple myeloma and why?

A

rouleax and pan-reactivity which causes a false agglutination due to cells already being clumped together

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39
Q

what is Darzalex (daratumumab and how does fit affect testing?

A

medication to treat multiple myeloma which coats cells in anti-CD38 (IgG antibody) which reacts during any procedure where IgG is added

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40
Q

Is a DAT positive or negative in multiple myeloma patients with rouleax/pan-reactivity?

A

weak to negative

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41
Q

What is polyethylene glycol (PEG) and what does it do?

A

it is an enhancement method which concentrates the antibody

42
Q

What are the enzymes used as enhancement methods and what do they do?

A

ficin and papain which removes negative charge from RBC surface and denatures some antigens

43
Q

Which antigens are enhanced vs destroyed vs unaffected by ficin and papain?

A

Destroyed: MNS, Duffy, Lutheran
Enhanced: Rh, Kidd, ABO-related
Unaffected: Kell, Diego, Colton

44
Q

What is low ionic strength saline (LISS) and what does it do?

A

enhancement method which increases rate if antibody uptake

45
Q

What is the #1 cause of transfusion reactions and how does it occur?

A

clerical errors: patient misidentification and unit mislabeling

46
Q

What are febrile reactions caused by?

A

antibodies that agglutinate leukocytes in the donor/leukocyte antigens (HLA antigens) in the recipient

47
Q

Febrile reaction symptoms

A
  1. fever and chills
  2. headache
  3. nausea and emesis
  4. hypotension
48
Q

What causes allergic reactions in transfusions?

A

allergy to preservatives or plasma proteins in the unit

49
Q

What causes anaphylaxis in transfusions?

A

due to IgA deficiency and anti-IgA

50
Q

Allergic reaction symptoms in blood transfusions

A
  1. urticarial rash
  2. flushing
  3. angioedema
  4. nausea and emesis
  5. wheezing
  6. throat and chest tightness
  7. hypotension
  8. tachycardia
  9. shock
51
Q

What causes transfusion associated circulatory overload (TACO)?

A

Caused by excessive volume transfused

52
Q

TACO symptoms

A
  1. headache
  2. chest tightness
  3. fevers and chills
  4. increased blood pressure
  5. shortness of breath
53
Q

What causes a bacterial infection in blood transfusions?

A

bacterial contamination of blood products

54
Q

symptoms of a bacterial infection due to transfusion

A
  1. high fever
  2. nausea, vomiting, and diarrhea
  3. hypotension
55
Q

what causes an acute hemolytic reaction to a blood transfusion and how fast does it occur?

A

antibody incompatibility (typically ABO systems) which occurs within a few minutes to a few hours from the start of a transfusion

56
Q

What causes a delayed hemolytic reaction in transfusions and when does it occur?

A

Caused by newly formed alloantibodies as a result of a transfusion (typically Kidd system) and occurs 7-10 days after transfusion

57
Q

Symptoms of hemolytic reactions

A
  1. pain in lower back/legs
  2. fever and chills or rigors
  3. chest tightness
  4. hypotension
  5. hematuria
  6. tachycardia
58
Q

What is TRALI and what causes it?

A

Transfusion related acute lung injury caused by activated neutrophils which damage endothelial cells

59
Q

TRALI symptoms

A
  1. dyspena
  2. hypoxemia
  3. bilateral chest infiltrates
60
Q

1 cause of transfusion associated death

A

TRALI

61
Q

Why do we test for weak D and who specifically do we test?

A

To determine who should receive RhoGam to prevent alloimmunization; Newborns of Rh negative mothers are tested for Rh D and weak Rh D, and Rh Ig is recommended for mothers of Rh D positive or weak Rh positive

62
Q

Is IAT or DAT used for weak D testing?

A

Typically IAT but also DAT for partial and partial weak D

63
Q

What are antigens and where are they found?

A

Protein molecules on RBC surface

64
Q

What are antibodies and where are they found?

A

proteins found in the plasma

65
Q

Are kell system antibodies IgG or IgM?

A

IgG

66
Q

Are Duffy system antibodies IgG or IgM?

A

IgG

67
Q

Are Kidd system antibodies IgG or IgM?

A

IgG, sometime IgM

68
Q

Are MNS system antibodies IgG or IgM?

A

IgM, sometimes IgG

69
Q

Are cold auto/Anti-I IgG or IgM?

A

IgM

70
Q

Are warm antibodies IgG or IgM?

A

IgG

71
Q

Are Rh antibodies IgG or IgM?

A

IgG

72
Q

which antibody is produced in a primary response?

A

IgM

73
Q

which antibody can cross the placenta?

A

IgG

74
Q

does IgG or IgM react best at room temperature?

A

IgM

75
Q

Are ABO antibodies typically IgG or IgM?

A

IgM

76
Q

which antibody activate complement and why?

A

IgM because it is very large and contributes to direct agglutination

77
Q

is 70-80% of serum IgG or IgM?

A

IgG

78
Q

Is IgM found is an acute or chronic/previous infection

A

acute

79
Q

What causes autoimmune hemolytic anemia, how does it present in the lab, and what must be done prior to RBC typing?

A

cause: RBCs sensitized with autoantibody
presentation: decreased hemoglobin and positive DAT
solution: chemically remove bound IgG prior to RBC typing

80
Q

What causes the Bombay phenotype and what does it result in?

A

nonfunctional FUC1 genes (aka homozygous hh) which causes RBCs to lack H and ABO antigens

81
Q

In blood compatibility testing, what is tested in the recipient vs donor?

A

recipient antibodies tested for compatibility w/donor antigens

82
Q

In plasma compatibility testing, what is tested in the recipient vs donor?

A

donor antibodies are tested for compatibility with recipient antigens

83
Q

A patient who is on Daratumab for multiple myeloma needs a blood transfusion, what type of units must they receive and why?

A

they just receive K negative units because DTT destroys kell system antigens

84
Q

what type of antibodies are associated with lupus/carcinoma?

A

warm antibodies

85
Q

why types of antibodies are associated with pneumonia

A

cold antibodies

86
Q

what antibodies are associated with sickle cell disease?

A

multiple allo/autoantibodies

87
Q

What antibody is common in black populations?

A

anti-Jsb

88
Q

What results can you expect to find in a recently transfused patient and what explains the result of the DAT?

A

positive auto-control and negative DAT (due too low affinity antibodies)

89
Q

What factors and disease states are associated with decreased ABO antibodies?

A
  • newborn
  • elderly
  • multiple myeloma
  • bone marrow transplant
  • immunosuppressive therapy
  • agammaglobulinemia
  • hypogammaglobulinemia
  • chronic lymphocytic leukemia
90
Q

What patient history is expected in group A with acquired B antigen discrepancies, what causes it, and what is the laboratory presentation?

A

Patient Hx: lower GI disease and gram negative septicemia
Cause: bacterial deacetylating enzyme
Presentation: AB group

91
Q

What type of blood group and patient Hx is expected in B(A) phenotype discrepancies, what causes it (physiologically and clinically), and what is the laboratory presentation?

A

Patient: group B who acquired reactivity w/anti-A reagents, recent bacterial infection, mutation, abnormal serum protein concentration
Physiological cause: B gene transfers trace amount of N-galactosamine and D-galactosamine
Clinical cause: Wharton’s jelly, increased serum sensitivity
Presentation: poly-agglutination, serum-suspended RBC aggregation

92
Q

Why can a bacterial infection cause polyagglutination in B(A) phenotype?

A

it exposes a hidden antigen

93
Q

What causes a mixed field and what can it be due to?

A

Cause: presence of two distinct cell populations
Due to: recent non-ABO identical transfusion, hematopoietic progenitor transplants, A3 phenotype, Tn-polyagglutinable RBCs

94
Q

How does group A2 w/anti-A1 present?

A

extra ABO reaction w/A1

95
Q

How do RBC appear in rouleax?

A

like stacked coins

96
Q

How does rouleax affect lab results?

A

produces false positive agglutination

97
Q

what causes rouleax?

A

Increased serum protein concentration

98
Q

what disease cause increased serum protein concentration?

A

multiple myeloma and waldenstrom macroglobulinemia

99
Q

When rouleax is present in the lab what should be performed?

A

saline replacement therapy to remove excess proteins

100
Q

List the cold antibodies

A
  • Anti-M
  • Anti-N
  • Anti-P1
  • Anti Le (a+b)
  • Anti-A1
101
Q

List the ABO related antibodies

A
  • ABO/H
  • Lewis
  • I
  • P

Blood Bank (1 decks)

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