Midterm

Question 1

Patient has colon cancer and a lower GI bleed
Anti-A : 4+
Anti-B : 1+
Anti-D : 4+
A1 : 0
B : 4+
What is the discrepancy? What is the blood type? What caused the discrepancy? What can be safely transfused?

Answer 1

Probable acquired B phenotype
A pos blood type
Discrepancy caused by GI bleed
Can receive A+, A=, O= and O+

Question 2

Patient has pre-op labs before hysterectomy
Anti-A : 4+
Anti-B : 0
Anti-D : 4+
A1 : 2+
B : 4+
What is the discrepancy? What additional testing should be done? What is the blood type? What blood should be on hold?

Answer 2

A subgroup
A1 lectin
A2 pos
O+ AHG crossmatched

Question 3

Patient has multiple myeloma
Anti-A : 4+
Anti-B : 4+
Anti-D : 4+
A1 : 1+
B : 1+
What discrepancy? How to resolve?

Answer 3

Rouleaux or cold auto antibody
Wash RBCs and repeat test, test for cold autoantibodies

Question 4

Why is a history of multiple myeloma significant for blood bank?

Answer 4

it can cause rouleaux

Question 5

What drug prescribed for multiple myeloma causes problems with antibody testing and Why? What would the screen and panel look like?

Answer 5

Darzalex is often mistaken as autoantibody or alloantibody and causes pan-reactivity. The DAT can be positive

Question 6

Chimerism and how it affects blood typing

Answer 6

Chimerism is a mixture of donor and recipient cell populations after hematopoetic stem cell transplants. This determines if there was a successful transplant and if further testing in needed

Question 7

R0

Answer 7

cDe

Question 8

R1

Answer 8

CDe

Question 9

R2

Answer 9

cDE

Question 10

Rz

Answer 10

CDE

Question 11

r

Answer 11

cde

Question 12

r’

Answer 12

Cde

Question 13

r’’

Answer 13

cdE

Question 14

ry

Answer 14

CdE

Question 15

A x B possible phenotypes

Answer 15

A, B, AB, O

Question 16

AB x AB possible phenotypes

Answer 16

A, B, AB

Question 17

B x B possible phenotypes

Answer 17

B, O

Question 18

O x O possible phenotypes

Answer 18

O

Question 19

Rr x rr possible phenotypes

Answer 19

Rr, rr

Question 20

A x O possible phenotypes

Answer 20

A, O

Question 21

AB x A possible phenotypes

Answer 21

A, B, AB

Question 22

AB x O possible phenotypes

Answer 22

A, B

Question 23

Why do we test for weak D?

Answer 23

To make sure the patient in negative and to see if patient is a candidate for Rhogam, and to make anti-D transfusion decisions

Question 24

What testing method is used to test for weak D?

Answer 24

IAT

Question 25

Why is it important to run a control sample along with the patient sample?

Answer 25

To make sure anti-sera is working and to make sure patient cells are not already coated with IgG

Question 26

Weak D

Answer 26

Quantitative change in D antigen expression, Rh positive

Question 27

Partial D

Answer 27

Qualitative change in D antigen usually from recombination wit C/E gene locus, can test as Rh positive but more alloantibodies to D antigen, transfuse with Rh negative blood and give RhD immune globulin to prevent hemolytic disease of the newborn

Question 28

What does in vivo mean?

Answer 28

The antibodies are bound to the RBCs inside the body

Question 29

What further testing does a positive adult DAT require?

Answer 29

monospecific DAT with Anti-IgG and anti-C3d

Question 30

What does the further testing in a positive adult DAT tell us?

Answer 30

If a person has autoimmune hemolytic anemia

Question 31

Elution

Answer 31

process that dissociates antigen-antibody complexes on RBCs, freed IgG antibody is tested for specificity

Question 32

Adsorption

Answer 32

technique using RBCs to remove RBC antibodies from a colution

Question 33

#1 cause of transfusion reactions

Answer 33

Clerical errors

Question 34

HLA cause what kind of reaction?

Answer 34

Febrile

Question 35

ABO incompatibility causes what kind of reaction?

Answer 35

Acute hemolytic

Question 36

Alloantibody cause what kind of reaction?

Answer 36

Delayed hemolytic

Question 37

Transfusion of large volumes cause what kind of reaction?

Answer 37

TACO

Question 38

IgA deficiency cause what kind of reaction?

Answer 38

Anaphylactic

Question 39

O+ is compatible with

Answer 39

O+ and O=

Question 40

A+ is compatible with

Answer 40

A+, A=, O=, O+

Question 41

B+ is compatible with

Answer 41

B+, B=, O=, O+

Question 42

AB+ is compatible with

Answer 42

AB+. AB=, A+, A=, B+, B=, O+, O=

Question 43

O= is compatible with

Answer 43

O=

Question 44

A= is compatible with

Answer 44

A =, O=

Question 45

B= is compatible with

Answer 45

B=, O=

Question 46

AB= is compatible with

Answer 46

AB=, A=, B=, O=

Question 47

O plasma is compatible with

Answer 47

O, A, B, AB

Question 48

A plasma is compatible with

Answer 48

A, AB

Question 49

B plasma is compatible with

Answer 49

B, AB

Question 50

AB plasma is compatible with

Answer 50

AB

Question 51

How does a Rhogam injection affect patient panels?

Answer 51

Gives a passive anti-D

Question 52

Where are antigens located?

Answer 52

RBCs

Question 53

Where are antibodies located?

Answer 53

Serum

Question 54

Rh (D, C, E...)

Answer 54

IgG, dosage, warm, enzyme enhanced, HDFN

Question 55

Kell

Answer 55

IgG, no dosage, warm, HDFN

Question 56

Duffy

Answer 56

IgG, dosage, warm, enzyme suppressed, HDFN

Question 57

Kidd

Answer 57

IgG, dosage, warm enzyme enhanced, HDFN

Question 58

MNS

Answer 58

IgG or IgM, dosage, cold, enzyme suppressed

Question 59

Cold Auto/Anti-I

Answer 59

IgM, no dosage, cold, activate complement, may be seen at AHG phase if strong

Question 60

Warm Auto

Answer 60

IgG, no dosage, warm, pan-reactivity, associated with autoimmune disorders and certain drugs