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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
What disease states does a DAT help determine?
hemolytic transfusion reactions, hemolytic disease of the fetus and newborn, autoimmune hemolytic anemia, and drug-induced immune hemolysis
26
What does the DAT vs IAT detect?
DAT: detects the antibodies or complement proteins attached to the RBCs IAT: detects antibodies produced against foreign RBCs
27
What components of the blood is used in a DAT vs IAT?
DAT: washed RBCs without plasma IAT: serum
28
When is a DAT vs IAT performed?
DAT: to detects autoimmune hemolytic anemia IAT: used prior to blood transfusions and prenatal testing of pregnant women
29
What type of autoantibodies typically causes a positive DAT and Autocontrol?
Cold C3d
30
What disease states can cause a positive DAT and auto control due to cold antibody?
1. Mycoplasma pneumonia (anti-I) 2. Some cases of anemia 3. Infectious mononucleosis 4. Drug interactions
31
What drug can cause cold antibodies and why?
Darzalex for multiple myeloma which is anti- Cd38, coating the cell in bound complement
32
How does a cold vs warm antibody appear on a panel?
Cold: weak and "scratchy" reactions Warm: pan-reactivity
33
When the auto control is positive and a cold antibody is detected what steps should be performed?
warm specimen and all reagents up to 37 C then retest
34
what disease commonly forms warm antibodies?
Warm autoimmune hemolytic anemia
35
Is a cold or warm antibody positive screen typically sent out to reference labs and what is performed there?
warm antibodies to perform elution and/or adsorption techniques
36
define elution
disassociated IgG antibody from the RBCs by means of temperature shock or by lowering the pH
37
define adsorption
disassociates IgG antibodies by means of antigen positive RBCs
38
What test result is commonly seen in patient with multiple myeloma and why?
rouleax and pan-reactivity which causes a false agglutination due to cells already being clumped together
39
what is Darzalex (daratumumab and how does fit affect testing?
medication to treat multiple myeloma which coats cells in anti-CD38 (IgG antibody) which reacts during any procedure where IgG is added
40
Is a DAT positive or negative in multiple myeloma patients with rouleax/pan-reactivity?
weak to negative
41
What is polyethylene glycol (PEG) and what does it do?
it is an enhancement method which concentrates the antibody
42
What are the enzymes used as enhancement methods and what do they do?
ficin and papain which removes negative charge from RBC surface and denatures some antigens
43
Which antigens are enhanced vs destroyed vs unaffected by ficin and papain?
Destroyed: MNS, Duffy, Lutheran Enhanced: Rh, Kidd, ABO-related Unaffected: Kell, Diego, Colton
44
What is low ionic strength saline (LISS) and what does it do?
enhancement method which increases rate if antibody uptake
45
What is the #1 cause of transfusion reactions and how does it occur?
clerical errors: patient misidentification and unit mislabeling
46
What are febrile reactions caused by?
antibodies that agglutinate leukocytes in the donor/leukocyte antigens (HLA antigens) in the recipient
47
Febrile reaction symptoms
1. fever and chills 2. headache 3. nausea and emesis 4. hypotension
48
What causes allergic reactions in transfusions?
allergy to preservatives or plasma proteins in the unit
49
What causes anaphylaxis in transfusions?
due to IgA deficiency and anti-IgA
50
Allergic reaction symptoms in blood transfusions
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
What causes transfusion associated circulatory overload (TACO)?
Caused by excessive volume transfused
52
TACO symptoms
1. headache 2. chest tightness 3. fevers and chills 4. increased blood pressure 5. shortness of breath
53
What causes a bacterial infection in blood transfusions?
bacterial contamination of blood products
54
symptoms of a bacterial infection due to transfusion
1. high fever 2. nausea, vomiting, and diarrhea 3. hypotension
55
what causes an acute hemolytic reaction to a blood transfusion and how fast does it occur?
antibody incompatibility (typically ABO systems) which occurs within a few minutes to a few hours from the start of a transfusion
56
What causes a delayed hemolytic reaction in transfusions and when does it occur?
Caused by newly formed alloantibodies as a result of a transfusion (typically Kidd system) and occurs 7-10 days after transfusion
57
Symptoms of hemolytic reactions
1. pain in lower back/legs 2. fever and chills or rigors 3. chest tightness 4. hypotension 5. hematuria 6. tachycardia
58
What is TRALI and what causes it?
Transfusion related acute lung injury caused by activated neutrophils which damage endothelial cells
59
TRALI symptoms
1. dyspena 2. hypoxemia 3. bilateral chest infiltrates
60
#1 cause of transfusion associated death
TRALI
61
Why do we test for weak D and who specifically do we test?
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
Is IAT or DAT used for weak D testing?
Typically IAT but also DAT for partial and partial weak D
63
What are antigens and where are they found?
Protein molecules on RBC surface
64
What are antibodies and where are they found?
proteins found in the plasma
65
Are kell system antibodies IgG or IgM?
IgG
66
Are Duffy system antibodies IgG or IgM?
IgG
67
Are Kidd system antibodies IgG or IgM?
IgG, sometime IgM
68
Are MNS system antibodies IgG or IgM?
IgM, sometimes IgG
69
Are cold auto/Anti-I IgG or IgM?
IgM
70
Are warm antibodies IgG or IgM?
IgG
71
Are Rh antibodies IgG or IgM?
IgG
72
which antibody is produced in a primary response?
IgM
73
which antibody can cross the placenta?
IgG
74
does IgG or IgM react best at room temperature?
IgM
75
Are ABO antibodies typically IgG or IgM?
IgM
76
which antibody activate complement and why?
IgM because it is very large and contributes to direct agglutination
77
is 70-80% of serum IgG or IgM?
IgG
78
Is IgM found is an acute or chronic/previous infection
acute
79
What causes autoimmune hemolytic anemia, how does it present in the lab, and what must be done prior to RBC typing?
cause: RBCs sensitized with autoantibody presentation: decreased hemoglobin and positive DAT solution: chemically remove bound IgG prior to RBC typing
80
What causes the Bombay phenotype and what does it result in?
nonfunctional FUC1 genes (aka homozygous hh) which causes RBCs to lack H and ABO antigens
81
In blood compatibility testing, what is tested in the recipient vs donor?
recipient antibodies tested for compatibility w/donor antigens
82
In plasma compatibility testing, what is tested in the recipient vs donor?
donor antibodies are tested for compatibility with recipient antigens
83
A patient who is on Daratumab for multiple myeloma needs a blood transfusion, what type of units must they receive and why?
they just receive K negative units because DTT destroys kell system antigens
84
what type of antibodies are associated with lupus/carcinoma?
warm antibodies
85
why types of antibodies are associated with pneumonia
cold antibodies
86
what antibodies are associated with sickle cell disease?
multiple allo/autoantibodies
87
What antibody is common in black populations?
anti-Jsb
88
What results can you expect to find in a recently transfused patient and what explains the result of the DAT?
positive auto-control and negative DAT (due too low affinity antibodies)
89
What factors and disease states are associated with decreased ABO antibodies?
- newborn - elderly - multiple myeloma - bone marrow transplant - immunosuppressive therapy - agammaglobulinemia - hypogammaglobulinemia - chronic lymphocytic leukemia
90
What patient history is expected in group A with acquired B antigen discrepancies, what causes it, and what is the laboratory presentation?
Patient Hx: lower GI disease and gram negative septicemia Cause: bacterial deacetylating enzyme Presentation: AB group
91
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?
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
Why can a bacterial infection cause polyagglutination in B(A) phenotype?
it exposes a hidden antigen
93
What causes a mixed field and what can it be due to?
Cause: presence of two distinct cell populations Due to: recent non-ABO identical transfusion, hematopoietic progenitor transplants, A3 phenotype, Tn-polyagglutinable RBCs
94
How does group A2 w/anti-A1 present?
extra ABO reaction w/A1
95
How do RBC appear in rouleax?
like stacked coins
96
How does rouleax affect lab results?
produces false positive agglutination
97
what causes rouleax?
Increased serum protein concentration
98
what disease cause increased serum protein concentration?
multiple myeloma and waldenstrom macroglobulinemia
99
When rouleax is present in the lab what should be performed?
saline replacement therapy to remove excess proteins
100
List the cold antibodies
- Anti-M - Anti-N - Anti-P1 - Anti Le (a+b) - Anti-A1
101
List the ABO related antibodies
- ABO/H - Lewis - I - P

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