Quiz 4

Question 0

Major Crossmatch Definition

Answer 0

Patient serum with donor RBC

Question 1

What is the purpose of a crossmatch?

Answer 1

1. Prevention of transfusion reactions

2. Assurance of maximum benefit to the patient from the transfused cells or component

Question 2

What does a major crossmatch test for?

Answer 2

• *Detects antibodies in patient serum that may react with donor’s RBC antigen
• *Detect some errors in ABO, labelling, and identification of donor and recipient

Question 3

Minor Crossmatch Definition

Answer 3

Patient RBC with donor serum

Question 4

Minor Crossmatch tests for…

Answer 4

• *Detects donor antibody in plasma that may react with patient RBC antigen
• *Detects some major blood group errors
• *Detects a positive DAT of patient cells which may help in the diagnosis

Question 5

What are the reasons for a crossmatch?

Answer 5

1. Intrauterine and exchange transfusion
2. Newborns
3. Emergency
4. Multiple transfusions
5. Chronic transfusions
6. Biological crossmatch

Question 6

The crossmatch will NOT…

Answer 6

1. Guarantee normal RBC survival once it is transfused
2. Prevent patient from producing antibodies
3. Detect all ABO group errors
4. Detect all Rh errors unless D(-) with an anti-D
5. Detect all clerical errors
6. Detect antibody unless specific for donor antigen
7. Detect antibody to platelets or white blood cells

Question 7

O
A. First choice
B. Second Choice
C. Third Choice

Answer 7

A. O
B. -
C. -

Question 8

A

1. First choice
2. Second Choice
3. Third Choice

Answer 8

1. A
2. O
3. –

Question 9

B

1. First choice
2. Second Choice
3. Third Choice

Answer 9

1. B
2. O
3. –

Question 10

AB

1. First choice
2. Second Choice
3. Third Choice

Answer 10

1. AB
2. A or B
3. O

Question 11

A with anti-H

1. First choice
2. Second Choice
3. Third Choice

Answer 11

1. A
2. –
3. –

Question 12

A with anti-A

1. First choice
2. Second Choice
3. Third Choice

Answer 12

1. A
2. O
3. –

Question 13

A2 with anti-H

1. First choice
2. Second Choice
3. Third Choice

Answer 13

1. A2B
2. A2 or B
3. –

Question 14

A2B with anti-A2

1. First choice
2. Second Choice
3. Third Choice

Answer 14

1. A2B
2. A2 or B
3. –

Question 15

Troubleshooting the problem crossmatch

Answer 15

1. Human error: clerical or technical
2. Patient medical history
3. Initial test results
4. Refer to compatibility diagrams
5. Drugs
6. WBC antigens shared with RBC
7. Bacteria/virus

Question 16

Elution

Answer 16

Process by which antibody is attached to RBC in vivo and elution removes antibody from RBC

Question 17

Transfusion Reactions (most common)

Answer 17

1. Intravascular hemolysis
2. Extravascular hemolysis
3. Febrile, nonhemolytic

Question 18

Intravascular hemolysis

Answer 18

• Hemolysis activated by complement in the bloodstream
• ABO blood group incompatibility
• Immediate reaction

Question 19

Extravascular hemolysis

Answer 19

• Seen in the spleen or liver
• Complement not activated
• Delayed reactions (days later)
• IgGs usually

Question 20

When conducting a transfusion reaction investigation, what five specimens are needed?

Answer 20

1. Pre-transfusion recipient specimen
2. Post-transfusion recipient specimen
3. Donor pilot sample
4. Transfused pack with blood
5. Post-transfusion urine

Question 21

Whole Blood

Answer 21

1. Patient hemorrhage
2. 42 days
3. 1C to 6C

Question 22

Packed Red Blood Cells

Answer 22

1. Hemorrhage or anemia or surgical blood loss
2. 42 days
3. 1C to 6C

Question 23

Buffy-coat Poor Red Cells

Answer 23

1. Anemia with sensitivity to WBC
2. 42 days
3. 1C to 6C

Question 24

Washed Red Cells

Answer 24

1. Anemia with sensitivity to WBC and/or plasma components
2. 24 hours
3. 1C to 6C

Question 25

Frozen Red Blood Cells

Answer 25

1. Anemia with sensitivity to WBC
2. 10 years
3. < -65C

Question 26

Thawed Deglycerolized Red Blood Cells

Answer 26

1. Anemia with sensitivity to WBC; transfusion to people with rare blood types
2. 2 weeks
3. 1C to 6C

Question 27

Irradiated RBCs

Answer 27

Help prevents graft versus host disease

Question 28

Albumin

Answer 28

1. Volume expander; burn patient
2. 3 years
3. Room temperature

Question 29

Immune Serum Globulin

Answer 29

1. Hepatitis; agammaglobinemia; hypogammaglobinemia
2. 3 years
3. Room temperature

Question 30

Platelets

Answer 30

1. Thrombocytopenia; bleeding
2. 5 days
3. 20C to 24C

Question 31

Fresh Frozen Plasma

Answer 31

1. Coagulation deficiencies
2. 1 year
3. -18C

Question 32

Cryopercipitate

Answer 32

1. Hemophiliacs, Factor VIII, DIC
2. 1 year
3. -18C

Question 33

Leukocyte Concentrate

Answer 33

1. Severe Leukopenia
2. 24 hours
3. 20C-24C

Question 34

What is the most common incompatibility of hemolytic disease of a newborn?

Answer 34

ABO blood group

Question 35

What is the symptom of HDN when there is an ABO incompatibility?

Answer 35

*Mild anemia

*

Question 36

What are the clinical features of HDN?

Answer 36

• Jaundice
• Anemia
• Edema
• Death
• Kernicterus

Question 37

What tests are done to detect HDN?

Answer 37

• ABO
• Rh
• DAT (cord/eluates)
• Bilirubin
• Hemoglobin

Question 38

What are the treatments for HDN?

Answer 38

• Exchange transfusion
• Transfusion
• Phototherapy
• Intrauterine transfusion
• Early induction of labor
• RhoGAM therapy within 72 hours

Question 39

Who is NOT a RhoGAM candidate?

Answer 39

1. Rh negative mother who has anti-D
2. Rh negative mother with Rh negative baby
3. Rh positive women or D positive women

Question 40

MicroRhoGAM

Answer 40

Prevents antibody formation after miscarriage or abortion up to 12 weeks

Question 41

Rh immune globulin (RhoGAM)

Answer 41

Artificial passive immunization with anti-D immunoglobulin