Review Cards - Immunohematology Flashcards

Question

Donor deferrals (AABB) - malaria, or from an area endemic for malaria

Answer 1

indefinite

Answer 2

indefinite

Answer 3

indefinite

Answer 4

indefinite

Answer 5

indefinite

Answer 6

indefinite

Answer 7

aseptic method, e.g., povidone-iodine scrub & prep solution

Answer 8

450 mL +/- 10% or 500 mL +/- 10%, depending on collection bag

Answer 9

10.5 mL of blood per kg of donor's weight, including samples for testing

Answer 10

-300-404 mL in 450 mL bag OR -333-449 mL in 500-mL bag -labeled "low volume" -RBCs may be transfused, but plasma and platelets from "low volume" unit should be discarded

Answer 11

-63 mL anticoagulant for 450-mL collection -70 mL for 500-mL collection

Answer 12

-usually <10 minutes -if >15-20 minutes, unit may not be suitable for preparation of platelets or plasma

Answer 13

from diversion pouch or by 2nd phlebotomy

Answer 14

20*-24*C if platelets are to be prepared; otherwise 1*-6*C

Answer 15

automated blood collection system that allows removal of 1 or more components of blood & return of remainder to donor

Answer 16

-allows collection of larger volumes of specific components -can reduce number of donors to which patient is exposed

Answer 17

vary with procedure

Answer 18

-2 units can be collected at same time from donors who are larger & have a higher HCT -16 weeks between donations

Answer 19

-plateletpheresis -can collect HLA matched for patients who are refractory to random platelets -can be leukoreduced during collection -contain >=3 x 10^11 platelets

Answer 20

plasmapheresis

Answer 21

-leukapheresis -not widely used to date

Answer 22

-for bone marrow reconstitution in patients with cancer, leukemia, lymphoma -autologous or HLA matched

Answer 23

(plasma exchange) used to remove abnormal plasma proteins & replace with crystalloid, albumin, or FFP

Answer 24

used to remove cellular elements, such as an exchange transfusion for sickle cell patients, leukemic WBCs, lymphocytes (to induce immunosuppression)

Answer 25

-ABO -Rh (including weak D)

Answer 26

antibody screen

Answer 27

antibodies to *Treponema pallidum* or nontreponemal serological test for syphilis, e.g., RPR

Answer 28

-HBsAg -Anti-HBc -Anti-HCV -HCV RNA (nucleic acid testing [NAT])

Answer 29

-Anti-HIV-1/2 -HIV-1 RNA (NAT)

Answer 30

-Anti-HTLV-I/II -West Nile virus RNA (NAT) -Anti-*Trypanosoma cruzi* (FDA recommends 1-time donor screening) -Zika virus (FDA recommends testing pooled donations)

Answer 31

culture of platelets or FDA-approved rapid test (e.g., Pan Genera Detection [PGD] test)

Answer 32

Citrate - prevents coagulation by chelating calcium Dextrose - (glucose) supports ATP generation

Answer 33

Citrate - prevents coagulation by chelating calcium Dextrose - (glucose) supports ATP generation

Answer 34

-high pH preserves 2,3-DPG better -better oxygen delivery

Answer 35

contains 100% more glucose than CPD

Answer 36

-Adenine - increases ADP, which increases synthesis of ATP -contains more glucose to sustain cells during longer storage

Answer 37

extend shelf life of RBCs to 42 days

Answer 38

-glucose for energy -adenine to support ATP levels

Answer 39

-plasma expressed from whole blood 100-110 mL additive transferred from attached satellite bag to RBCs within 72 hours of collection or per manufacturer's instructions

Answer 40

55-65% (HCT of RBCs without additive: 65-80%)

Answer 41

-Adsol (AS-1) -Nutricel (AS-3) -Optisol (AS-5)

Answer 42

-seal on unit is broken to attach external transfer bag -exposure to air poses threat of bacterial contamination

Answer 43

-components stored at 1-6*C must be used within 24 hours after system is open -components stored at 20-24*C must be used within 4 hours

Answer 44

-sterility maintained though use of attached satellite bags or sterile connecting device that welds tubing from 1 bag to another -no exposure to air

Answer 45

-separated from whole blood by centrifugation or sedimentation any time before the expiration date of whole blood, OR -collected by apheresis

Answer 46

35 days in CPDA-1

Answer 47

inadequate tissue oxygenation

Answer 48

should have HCT <=80%; otherwise not enough preservative to support RBCs

Answer 49

1 unit should increase HGB 1 g/dL or HCT 3%

Answer 50

additive solution added to RBCs following removal of most plasma

Answer 51

inadequate tissue oxygenation

Answer 52

RBCs adenine, saline added

Answer 53

-frozen in glycerol within 6 days of collection -high glycerol (40%) method most commonly used

Answer 54

-frozen in high glycerol (40%): <=65*C -after removing glycerol (washing in decreased concentration of saline): 1-6*C

Answer 55

-frozen: 10 years -after removing glycerol fix: 24 hours (unless a closed system used)

Answer 56

inadequate tissue oxygenation

Answer 57

osmolality

Answer 58

all plasma, anticoagulant, WBCs, and platelets

Answer 59

IgA-deficient patients

Answer 60

store rare cells

Answer 61

RBCs washed with saline

Answer 62

24 hours after washing

Answer 63

history of severe allergic reaction (e.g., IgA, other plasma proteins)

Answer 64

leukoreduced RBCs

Answer 65

leukoreduced RBCs

Answer 66

filtration or apheresis processing

Answer 67

-closed system: 35 days in CPDA-1 -open system: 24 hours

Answer 68

-closed system: 35 days in CPDA-1 -open system: 24 hours

Answer 69

history of febrile reaction

Answer 70

irradiation at 2,500 cGy

Answer 71

original outdate or 28 days from irradiation, whichever comes first

Answer 72

-immunodeficiency -immunocompromised patients -hematopoietic stem cell transplantation (HSCT) patients -bone marrow transplant -blood from blood relative -intrauterine & neonatal transfusions

Answer 73

graft-vs.-host disease

Answer 74

donor T cells

Answer 75

plasma separated from whole blood & frozen within 8 hours of collection

Answer 76

-frozen: <=-18*C -after thawing: 1-6*C

Answer 77

-frozen: 12 months -after thawing: 24 hours

Answer 78

deficiency of coagulation factors

Answer 79

all coagulation factors

Answer 80

30-37*C or by FDA-approved microwave

Answer 81

prepared by thawing FFP at 1-6*C, removing plasma, & re-freezing within 1 hour

Answer 82

Frozen: <=-18*C After thawing: room temperature

Answer 83

Frozen: 12 months After thawing: single units 6 hours; pools 6 hours if sterile connecting device used; otherwise 4 hours

Answer 84

fibrinogen & factor XIII deficiencies

Answer 85

used for hemophilia A and von Willebrand disease ONLY if factor VIII concentrate or recombinant factor preparations are not available

Answer 86

>=80 IU of factor VIII and >=150 mg of fibrinogen

Answer 87

-centrifugation of whole blood at RT within 8 hours of collection -1st soft spin yields platelet-rich plasma -2nd hard spin separates platelets from plasma

Answer 88

-5 days from collection, with agitation -after pooling: 4 hours

Answer 89

severe thrombocytopenia or abnormal platelet function

Answer 90

-40-70 mL plasma ->=5.5 x 10^10 platelets -pH >=6.2

Answer 91

should increase platelets by 5,000-10,000/uL in 75-kg patient

Answer 92

5 days with agitation

Answer 93

severe thrombocytopenia or abnormal platelet function

Answer 94

>=3.0 x 10^11 platelets (equivalent to 4-6 units)

Answer 95

exposes recipient to fewer donors

Answer 96

WBCs removed by filtration or during apheresis processing

Answer 97

open system: 4 hours apheresis: 5 days

Answer 98

-recurrent febrile reaction -decrease risk of CMV transmission or HLA alloimmunization

Answer 99

4-6 ABO-identical platelets pooled using closed system

Answer 100

5 days from collection

Answer 101

-recurrent febrile reaction -decrease risk of CMV transmission or HLA alloimmunization

Answer 102

to decrease WBCS to decrease febrile nonhemolytic transfusion reactions, transmission of CMV, & HLA alloimmunization

Answer 103

-by apheresis processing -by filtration during manufacture of components or after storage; prestorage leukocyte reduction is most effective; WBCs removed before they release cytokines -use of filter during infusion

Answer 104

-lactic acid -plasma K+ -plasma hemoglobin -microaggregates

Answer 105

-ATP -2,3-diphosphoglycerate (2,3-DPG) -pH -glucose -viable cells -coagulation factors (the plasma has been removed)

Answer 106

shift to left (increased HGB/O2 affinity, decreased O2 delivery to tissues)

Answer 107

1st exposure to antigen

Answer 108

days to months

Answer 109

IgM at first - may switch to IgG after 2-3 weeks (isotype switching)

Answer 110

rises slowly, peaks, then declines

Answer 111

subsequent exposure to antigen

Answer 112

rises faster & higher, stays elevated longer

Answer 113

IgG: monomer IgM: pentamer

Answer 114

IgG: 2 IgM: 10

Answer 115

IgG: immune (adaptive) IgM: naturally occurring

Answer 116

IgG: 37*C IgM: 25*C or lower

Answer 117

IgG: no IgM: yes

Answer 118

IgG: yes IgM: no

Answer 119

IgG: moderate IgM: strong

Answer 120

IgG: yes IgM: not usually , except ABO

Answer 121

IgG: yes IgM: no

Answer 122

IgG: yes IgM: no

Answer 123

IgG: yes IgM: no

Answer 124

IgG: no IgM: yes

Answer 125

attachment of antibody to antigen

Answer 126

clinically significant antibodies react best at 37*C

Answer 127

most antibodies react at pH 5.5-8.5

Answer 128

reducing ionic strength of medium facilitates interaction of antibody with antigen (e.g., low ionic strength solution [LISS])

Answer 129

-too much antibody can cause prozone (false negative) -optimum serum-to-cell ratio is 80:1 -usually 2 drops serum to 1 drop of 2-5% RBCs

Answer 130

-depends on medium -usually 10-30 minutes

Answer 131

formation of the lattice-type structure composed of the antigen-antibody bridges

Answer 132

IgM is larger, can span distance between RBCs more easily

Answer 133

affects ease of attachment of antibodies

Answer 134

-difference in charge between negatively-charged RBC surface & cloud of positive ions that surround RBCs -reducing zeta potential allows RBCs to move closer together -commercially available enhancement media reduces the zeta potential, allowing positively charged antibodies to get closer to negatively charged RBCs & increasing the RBC agglutination by IgG molecules

Answer 135

glass test tubes

Answer 136

-antibodies attach to corresponding antigens on RBCs, forming bridges between cells -RBCS agglutinate

Answer 137

agglutinated RBCs or hemolysis

Answer 138

no agglutinated RBCs or hemolysis

Answer 139

plastic microtube containing dextranacrylamide gel

Answer 140

-antigen-antibody reaction results in agglutinated RBCs -gel acts as sieve -large agglutinates can't pass through, remain at top -small agglutinates pass into gel -unagglutinated cells go to bottom

Answer 141

-agglutinated RBCs suspended in gel -position indicates strength of reaction -large agglutinates at top

Answer 142

button of unagglutinated RBCs in bottom of microtube

Answer 143

microplate with RBC membranes bound to surface of wells

Answer 144

-antibodies in sample attach to RBC antigens on surface of wells -after incubation, unbound antibody removed by washing -anti-IgG-labeled indicator RBCs added -attach to antibodies bound to reagent RBC antigens during centrifugation

Answer 145

indicator RBCs adhere diffusely to surface of well

Answer 146

-no adherence of RBCs -button of RBCs in bottom of well

Answer 147

-standardized -more sensitive than tube testing -reaction stable for 2 days

Answer 148

-standardized -more sensitive than tube testing -reaction stable for 2-3 days; can be captured electronically -antihuman globulin (AHG) tests don't require washing or control cells

Answer 149

Tube: one solid agglutinate Column: solid band of agglutinated RBCs at top

Answer 150

Tube: several large agglutinates Column: band of agglutinated RBCs near top with a few staggered below

Answer 151

Tube: medium-sized agglutinates, clear background Column: agglutinates throughout

Answer 152

Tube: small agglutinates, turbid background Column: agglutinates predominantly in lower half of column with some RBCs at bottom

Answer 153

Tube: some agglutinated RBCs in sea of free RBCs Column: layer of agglutinated RBCs at top & pellet of unagglutinated RBCs at bottom

Answer 154

Tube: no agglutinates Column: well-defined pellet of unagglutinated RBCs at bottom

Answer 155

-European ancestry: 45% -African ancestry: 49% -Hispanic ancestry: 57% -Asian ancestry: 40%

Answer 156

-European ancestry: 40% -African ancestry: 27% -Hispanic ancestry: 31% -Asian ancestry: 27%

Answer 157

-European ancestry: 11% -African ancestry: 19% -Hispanic ancestry: 10% -Asian ancestry: 25%

Answer 158

-European ancestry: 4% -African ancestry: 4% -Hispanic ancestry: 2% -Asian ancestry: 7%

Answer 159

-antigen(s) on RBC: neither -antibody(s) in serum: anti-A, anti-B

Answer 160

-antigen(s) on RBC: A -antibody(s) in serum: anti-B

Answer 161

-antigen(s) on RBC: B -antibody(s) in serum: anti-A

Answer 162

-antigen(s) on RBC: A and B -antibody(s) in serum: none

Answer 163

Possible cause: missing isoagglutinins in group O Resolution: -incubate reverse grouping at RT for 30 minutes -if still negative, incubate at 4*C for 15-30 minutes -include controls: patient RBCs in 4% albumin, patient serum with O cells

Answer 164

Possible cause: A2 with anti-A1 Resolution: -type RBCs with anti-A1 (*Dolichos biflorus* lectin) -test serum with several additional A1, A2, & O cells

Answer 165

Possible cause: Rouleaux Resolution: -use washed RBCs suspended in saline for forward grouping -perform saline replacement technique in reverse grouping Possible cause: AB with cold alloantibody Resolution: -perform antibody panel at RT -if cold alloantibody identified, repeat reverse grouping with A1 & B cells that lack corresponding antigen

Answer 166

Possible cause: A2B with anti-A1 Resolution: -type cells with anti-A1 (*Dolichos biflorus* lectin) -test serum with additional A1, A2, & O cells

Answer 167

Possible cause: acquired B antigen Resolution: -check medical history for infection by GI bacteria (some have enzymes that convert A antigen to B-like antigen) -retype RBCs with different monoclonal anti-B or acidified human anti-B (pH 6.0; doesn't react with acquired B antigen)

Answer 168

-Weiner: Rho -Rosenfield: Rh1

Answer 169

-Weiner: rh' -Rosenfield: Rh2

Answer 170

-Weiner: rh" -Rosenfield: Rh3

Answer 171

-Weiner: hr' -Rosenfield: Rh4

Answer 172

-Weiner: hr" -Rosenfield: Rh5

Answer 173

-European ancestry: 85% -African ancestry: 92%

Answer 174

-European ancestry: 68% -African ancestry: 27%

Answer 175

-European ancestry: 29% -African ancestry: 22%

Answer 176

-European ancestry: 80% -African ancestry: 96%

Answer 177

-European ancestry: 98% -African ancestry: 98%

Answer 178

-antigens: Dce -European ancestry: 4% -African ancestry: 44% -Asian ancestry: 3%

Answer 179

-antigens: DCe -European ancestry: 42% -African ancestry: 17% -Asian ancestry: 70%

Answer 180

-antigens: DcE -European ancestry: 14% -African ancestry: 11% -Asian ancestry: 21%

Answer 181

-antigens: DCe -European ancestry: <=0.01% -African ancestry: <=0.01% -Asian ancestry: 1%

Answer 182

-antigens: dce -European ancestry: 37% -African ancestry: 26% -Asian ancestry: 3%

Answer 183

-antigens: dCe -European ancestry: 2% -African ancestry: 2% -Asian ancestry: 2%

Answer 184

-antigens: dcE -European ancestry: 1% -African ancestry: <=0.01% -Asian ancestry: <=0.01%

Answer 185

-antigens: dCE -European ancestry: <=0.01% -African ancestry: <=0.01% -Asian ancestry: <=0.01%

Answer 186

-think: "big" -rh' = C

Answer 187

-think: "little" -hr' = c

Answer 188

-think: presence of D -Rh1 = DCe

Answer 189

-think: absence of D -rh' = dCe

Answer 190

-think: C (if no 1 or ', then c) -examples: --Rh1 = DCe --rh' = dCe -Rho = Dce

Answer 191

-think: E (if no 2 or ", then e) -examples: --Rh2 = DcE --rh" = dcE --Rho = Dce

Answer 192

-think: c + e -Rho = Dce

Answer 193

-think: C + E -rh^y = dCE

Answer 194

prepared from pools of human sera (immunized Rh-negative individuals)

Answer 195

-same ingredients as reagent, except no anti-D -should be purchased from same manufacturer as anti-D

Answer 196

more false positives than low-protein reagents, e.g., RBCs with positive direct antiglobulin test (DAT)

Answer 197

mixture of monoclonal IgM & monoclonal or polyclonal IgG

Answer 198

-any negative typing reaction serves as control, e.g., negative reaction with anti-A or anti-B -when RBCs react with all antisera (i.e., AB positive), run control recommended by manufacturer -(usually patient RBCs with autologous serum or 6% or 8% albumin)

Answer 199

-most widely used -lower rate of false positives with Ig-coated RBCs

Answer 200

negative* *test for weak D if donor or infant of mother being evaluated for RhIG

Answer 201

-warm or cold autoagglutinins -rouleaux -polyagglutinable RBCs -nonspecific agglutination due to ingredient or reagent, e.g., dye, preservative -contaminated or incorrect reagent

Answer 202

-failure to add reagent -RBC suspension too heavy -resuspending cell button too vigorously -contaminated or incorrect reagent -blocking of antigen sites by antibodies, e.g., severe HDFN due to anti-D

Answer 203

when anti-D & Rh control are negative in Rh typing of donor or infant of mother being evaluated for RhIG

Answer 204

not all anti-D reagents are appropriate for use -refer to manufacturer's package insert

Answer 205

incubate Rh typing tubes at 37*C for 15-60 minutes indirect antibody test (IAT)* *RBCs with positive DAT will react in any IAT test

Answer 206

Rh positive

Answer 207

Rh negative

Answer 208

Rh positive OR Rh negative

Answer 209

Rh positive OR Rh negative, depending on the weak D phenotype

Answer 210

Rh negative only, especially women of childbearing age (If Rh positive must be given in emergency, RhIG can be given to prevent immunization)

Answer 211

-European ancestry: 9% -African ancestry: 2%

Answer 212

-European ancestry: 99.8% -African ancestry: 100%

Answer 213

-European ancestry: 68% -African ancestry: 13%

Answer 214

-European ancestry: 80% -African ancestry: 23%

Answer 215

-European ancestry: 76% -African ancestry: 92%

Answer 216

-European ancestry: 74% -African ancestry: 48%

Answer 217

-European ancestry: 79% -African ancestry: 74%

Answer 218

-European ancestry: 70% -African ancestry: 75%

Answer 219

-European ancestry: 55% -African ancestry: 30%

Answer 220

-European ancestry: 90% -African ancestry: 92%

Answer 221

-European ancestry: 22% -African ancestry: 23%

Answer 222

-European ancestry: 72% -African ancestry: 55%

Answer 223

-European ancestry: 79% -African ancestry: 94%

Answer 224

Adult cells: much Cord cells: trace i adult cells: trace

Answer 225

Adult cells: trace Cord cells: much i adult cells: much

Answer 226

-ABO -Lewis -P1 -MN -Lu^a

Answer 227

-ABO -Rh -Kell -Duffy -SsU

Answer 228

-Rh -Kell -Duffy -Kidd

Answer 229

-Kell -Duffy -Kidd

Answer 230

-Rh -Lewis -Kidd -P1

Answer 231

-M -N -Duffy

Answer 232

-Rh other than D -MNS -Duffy -Kidd

Answer 233

-I -Kidd -Lewis

Answer 234

-ABO -Lewis -Kidd -Vell -some P1

Answer 235

22% bovine serum albumin -reduces net negative charge of RBCs, allowing them to come closer together

Answer 236

-reduces ionic strength of suspending medium (lowers zeta potential), allowing antigens & antibodies to move closer together more rapidly -reduces incubation time for IAT

Answer 237

-increases antibody uptake -used for detection & ID of weak IgG antibodies

Answer 238

-ficin & papain most commonly used -reduce RBC surface charge by cleaving sialic acid molecules -M, N, S, Fya, Fyb antigens destroyed

Answer 239

monospecific sera used for follow-up testing

Answer 240

may detect complement-binding antibody more readily

Answer 241

reaction due to complement binding by clinically insignificant cold antibody

Answer 242

routine compatibility tests & antibody ID

Answer 243

detects clinically significant antibodies

Answer 244

complement

Answer 245

complement

Answer 246

immune hemolytic anemia

Answer 247

in vivo sensitization of RBCs by IgG antibody

Answer 248

EDTA red cells preferred

Answer 249

none required

Answer 250

-HDFN -transfusion reaction -autoimmune hemolytic anemia -drug-induced hemolytic anemia

Answer 251

-complement binding in vitro if RBCs are taken from red-top tube & broad-spectrum AHG used -septicemia -contamination of specimen -Wharton jelly in cord blood -overcentrifugation

Answer 252

-interruption in testing -contamination, improper storage -failure to add AHG -neutralization of AHG from inadequate washing -dilution of AHG by residual saline -undercentrifugation

Answer 253

in vitro sensitization of RBCs by IgG antibody

Answer 254

serum, plasma, RBCs

Answer 255

-serum or plasma with reagent RBCs OR -RBCs with reagent antiserum

Answer 256

-antibody screen -crossmatch -RBC phenotyping -weak D testing -antibody ID

Answer 257

-cells with positive DAT -overcentrifugation

Answer 258

-interruption in testing -contamination, improper storage -failure to add AHG -neutralization of AHG from inadequate washing -dilution of AHG by residual saline -undercentrifugation -underincubation

Answer 259

suggestive of single antibody

Answer 260

-multiple antibodies -antigens exhibiting dosage

Answer 261

-combination of warm & cold antibodies -antibody with wide thermal range

Answer 262

-multiple antibodies -antibody to high frequency antigen

Answer 263

warm autoantibody

Answer 264

1. On row of antigens at top of antigram, cross out those that are present on cells that didn’t react in any phase. 2. Circle antigens that aren’t crossed out. An antibody to 1 or more of these may be present. 3. Look for matching patterns, e.g., if serum only reacted with cells #3 & #5, and E antigen is only on cells #3 and #5, the antibody is most likely anti-E An antibody will react with all cells that possess the corresponding antigen (except for weak antibodies that only react with homozygous cells). An antibody won’t react with any cells that lack the corresponding antigen.

Answer 265

If other antibodies can’t be ruled out, further testing with selected cells might be required. Cells selected for testing should be positive for only 1 antigen corresponding to antibodies in question, e.g., if pattern reactivity matches anti-Jka, but anti-K and anti-S can’t be ruled out, serum should be tested with cells of the following type: *Jk(a-), K+, S- *Jk(a-), K-, S+ *Jk(a+), K-, S- Homozygous cells are preferred to avoid missing weak antibodies that demonstrate dosage.

Answer 266

Conclusive ID requires testing sufficient numbers of cells that are positive and negative for the corresponding antigen, e.g., 3 positive & 3 negative. Some labs use other combinations that provide the same probability (*p*) value of <=0.05 (I.e., 95% confidence level that the antibody ID is correct). Once the antibody is identified, type patients RBCs for corresponding antigen. Should be negative.

Answer 267

-only found in subgroups of A -agglutinates A1 and A1B cells, but not A2 or O.

Answer 268

-agglutinates all adult cells, except i adult -doesn’t agglutinate cord cells

Answer 269

agglutinates cord cells more strongly than adult cells

Answer 270

-most common in A1 and A1B -agglutinates O cells most strongly, followed by A2 and B; least likely in A1B

Answer 271

-most common in A1 and A1B -agglutinates cells that possess both I and H -agglutinates adult O cells most strongly -weaker reaction with A1 cells -doesn’t agglutinate cord cells

Answer 272

recipient serum & donor RBCs

Answer 273

7 days (kept at 1-6*C)

Answer 274

recipient serum + donor RBCs tested through AHG

Answer 275

if recipient has or had clinically significant antibody

Answer 276

recipient serum + donor RBCs tested in IS only

Answer 277

if recipient doesn't have & never had clinically significant antibody

Answer 278

ABO incompatibility

Answer 279

computer check of donor ABO & Rh type AND recipient ABO & Rh type

Answer 280

if recipient doesn't have & never had clinically significant antibody

Answer 281

ABO incompatibility

Answer 282

-detect ABO incompatibility -detect most antibodies against donor cells

Answer 283

-detect all ABO typing errors -detect most Rh typing errors -detect all antibodies -detect platelet or leukocyte antibodies -prevent immunization -ensure normal survival of RBCs

Answer 284

Possible cause: ABO incompatibility Resolution: retype donor & recipient; crossmatch with ABO-compatible donor

Answer 285

Possible cause: Alloantibody Resolution: ID the antibody; crossmatch units negative for corresponding antigen

Answer 286

Possible cause: positive DAT on donor Resolution: perform DAT on unit; if positive, return to collecting facility

Answer 287

Possible cause: warm autoantibody Resolution: important to detect any underlying clinically significant alloantibodies prior to transfusion; Adsorption testing is typically required; if patient situation is life-threatening, consult with medical director and provide transfusion.

Answer 288

Possible cause: rouleaux Resolution: saline replacement technique

Answer 289

RBC type patient can receive: O only Plasma type patient can receive: O, A, B, AB

Answer 290

RBC type patient can receive: A, O Plasma type patient can receive: A, AB

Answer 291

RBC type patient can receive: B, O Plasma type patient can receive: B, AB

Answer 292

RBC type patient can receive: AB, A, B, O Plasma type patient can receive: AB

Answer 293

yes -can be electronic crossmatch if negative antibody screen & no record of previously detected antibodies

Answer 294

no -must be ABO compatible with recipient RBCs

Answer 295

no -all ABO groups acceptable; Rh type not considered

Answer 296

No* *for apheresis platelets containing >2 mL RBCs, ABO compatibility & crossmatch required -any ABO group acceptable; compatible with recipient RBCs recommended; ABO-identical preferred

Answer 297

-maintained at 1-10*C -closure wasn't broken -at least 1 sealed segment remains attached to unit -unit is inspected before release -records indicate that blood has been inspected & is acceptable for reissue

Answer 298

-if time allows for typing, give ABO & Rh compatible; otherwise give O-neg RBCs -label must indicate that crossmatch wasn't completed -physician must sign emergency release -routine testing must be completed & physician notified immediately of any incompatibility

Answer 299

donor testing

Answer 300

1 in 1,467,000 transfusions

Answer 301

donor testing

Answer 302

1 in 280,000 transfusions

Answer 303

donor testing

Answer 304

1 in 1,149,000 transfusions

Answer 305

donor testing

Answer 306

rare in the US

Answer 307

donor testing

Answer 308

-limited risk in refrigerated or frozen components - spirochetes cannot survive the cold -HIGHEST risk from platelets

Answer 309

donor testing

Answer 310

*Plasmodium* is transmitted in RBCs

Answer 311

donor testing

Answer 312

*B. microti* is transmitted in RBCs

Answer 313

donor testing

Answer 314

*Trypanosoma cruzi* is transmitted in blood. -potential risk in donors from Central & South America

Answer 315

-selected donor testing (not routine) -use of CMV-neg or leukoreduced components for patients at risk

Answer 316

CMV transmitted in WBCs

Answer 317

risk to CMV-neg immunocompromised patients & premature infants of CMV-neg mothers

Answer 318

donor testing

Answer 319

-no confirmed transfusion-transmission cases of Zika in the US, but Brazil has reported platelet transfusion transmission

Answer 320

donor testing

Answer 321

used to screen all prospective donors in the US - most people are unaware they are infected

Answer 322

-donor screening (history, temp) -aseptic technique -use of diversion pouches (1st 30-45 mL of blood goes into pouch so that skin plug doesn't enter unit) -tests to detect bacterial contamination of platelets (e.g., culturing 24 hours after collection)

Answer 323

platelets - due to RT storage

Answer 324

-fever -chills -shock -renal failure -DIC -pain in chest, back or flank

Answer 325

immediate destruction of donor RBCS by recipient antibody

Answer 326

-post-transfusion specimen: --HGB in urine & serum --mixed field DAT (unless donor cells are all destroyed) --decreased haptoglobin, HGB, & HCT

Answer 327

transfusion of ABO-incompatible blood

Answer 328

temperature increased >=1*C or 2*C during or shortly after transfusion, with no other explanation

Answer 329

anti-leukocyte antibodies or cytokines

Answer 330

multiply transfused patients or women with multiple pregnancies

Answer 331

leukoreduced components

Answer 332

antipyretics (aspirin, acetominophen)

Answer 333

-hives (urticaria) -wheezing

Answer 334

foreign plasma proteins

Answer 335

antihistamines

Answer 336

-pulmonary edema -bronchospasms

Answer 337

anti-IgA in IgA-deficient recipient

Answer 338

epinephrine

Answer 339

washed cellular blood products

Answer 340

-fever -chills -coughing -respiratory distress -fluid in lungs -decreased blood pressure within 6 hours of transfusion LIFE THREATENING

Answer 341

-unknown -possibly donor antibodies to WBC antigens

Answer 342

infusion of plasma -all components have been implicated

Answer 343

reduced use of plasma from female donors

Answer 344

-fever -chills -decreased BP -cramps -diarrhea -vomiting -muscle pain -DIC -shock -renal failure

Answer 345

bacterial contamination

Answer 346

-positive gram stain & culture on unit -positive blood culture on patient

Answer 347

-coughing -cyanosis -difficulty breathing -pulmonary edema

Answer 348

too large a volume or too rapid rate of infusion

Answer 349

-children -cardiac & pulmonary patients -elderly -patients with chronic anemia

Answer 350

destruction of RBCs due to extremes of temperature, addition of meds to unit

Answer 351

-hemoglobinuria -hemoglobinemia

Answer 352

cardiac arrhythmia

Answer 353

rapid infusion of large amounts of cold blood

Answer 354

use blood warmer for rapid infusions

Answer 355

-fever -anemia -mild jaundice -2-14 days after transfusion

Answer 356

donor RBCs sensitized by recipient IgG antibody & removed from circulation

Answer 357

-increased bilirubin -mixed-field DAT -decreased haptoglobin -decreased HGB & HCT -positive antibody screen

Answer 358

anamnestic response

Answer 359

usually NO

Answer 360

none, unless subsequently exposed to same foreign antigens

Answer 361

development of antibodies to foreign RBCs, WBCs, platelets, plasma proteins following transfusion

Answer 362

-antibody to RBCs detected in antibody screen -others require specialized testing

Answer 363

leukoreduced components

Answer 364

-rash -nausea -vomiting -diarrhea -fever -pancytopenia USUALLY FATAL

Answer 365

viable T lymphocytes in donor blood attack recipient

Answer 366

irradiate components for: -premature infants -intrauterine or exchange transfusion -stem cell or bone marrow transplants -recipients of blood from a 1st-degree relative -immunocompromised -patients with leukemia or lymphoma

Answer 367

-diabetes -cirrhosis -cardiomyopathy

Answer 368

build-up of iron in body

Answer 369

increased serum ferritin

Answer 370

patients receiving repeated transfusions over long period of time, e.g., patients with thalassemia, sickle cell anemia, other chronic anemias

Answer 371

-fever -chills -respiratory distress -hyper- or hypotension -back, flank, chest, or abdominal pain -pain at site of infusion -hives (urticaria) -jaundice -hemoglobinuria -nausea/vomiting -abnormal bleeding -oliguria/anuria

Answer 372

-pre-transfusion blood -post-transfusion blood -post-transfusion urine -segment from unit -blood bag with administration set & attached IV solutions

Answer 373

-stop transfusion -check all IDs & labels -repeat ABO on post-transfusion sample -visual check of pre- & post-transfusion samples for hemolysis -DAT on post-transfusion sample; if positive, perform on pre-transfusion sample

Answer 374

-hemolysis in post-transfusion sample, but NOT in pre-transfusion sample -mixed field agglutination in DAT on post-transfusion sample, but NOT on pre-transfusion sample

Answer 375

-check HGB in first voided urine after transfusion -repeat ABO & Rh on pre- & post-transfusion samples & unit -repeat antibody screen on pre- & post-transfusion samples -AHG crossmatch with pre- & post-transfusion samples

Answer 376

-haptoglobin (decreased with hemolysis) -gram stain & culture of unit -bilirubin 5-7 hours after transfusion (sign of extravascular hemolysis) -BUN & creatinine (sign of renal involvement)

Answer 377

must be reported to FDA Center for Biologics Evaluation & Research (CBER) by phone or email ASAP, followed by submission of a written report within 7 days

Answer 378

cord blood, capillary, or venous blood

Answer 379

no, ABO forward grouping only

Answer 380

serum or plasma of mother OR baby

Answer 381

serum or plasma from mother OR baby

Answer 382

perform AHG crossmatch on units negative for corresponding antigen

Answer 383

crossmatch not required

Answer 384

ABO: usually group O Rh: Rh negative

Answer 385

ABO: yes Rh: not usually

Answer 386

ABO: common Rh: uncommon

Answer 387

ABO: mild Rh: can be severe

Answer 388

ABO: weak pos or neg Rh: strong pos

Answer 389

ABO: yes Rh: rare

Answer 390

ABO: no Rh: yes (maternal antibody screen)

Answer 391

ABO: no Rh: yes (RhIG)

Answer 392

-ABO & Rh (weak D not required) - if Rh positive, woman isn't candidate for RhIG -Antibody screen (confirm patient has not received prenatal RhIG, which may be detected in antibody screen) - if positive, ID antibody; if anti-D present, woman isn't candidate

Answer 393

ABO & Rh, including weak D, on baby: --if baby is Rh neg = mother isn't candidate --if baby is Rh pos, draw mother's blood after delivery & perform rosette test to screen for fetal blood ---Mother's RBCs incubated with anti-D ---Anti-D coats fetal D-pos RBCs ---indicator D-pos RBCs added ---attach to anti-D on fetal D-pos RBCs, forming rosettes --If rosette test pos, quantitate fetal bleed by flow cytometry or Kleihauer-Betke acid-elution test; fetal cells resist acid elution and stain pink; adult cells lose HGB and appear as "ghosts"

Answer 394

anti-D derived from pools of human plasma

Answer 395

prevent immunization to D

Answer 396

-Antepartum: to Rh neg woman at 28 weeks of gestation -Postpartum: within 72 hours of delivery when Rh-neg woman delivers Rh-pos baby -Other obstetric events: to Rh-neg woman after spontaneous or therapeutic abortion, ectopic pregnancy, amniocentesis, chorionic villus sampling, antepartum hemorrhage, or fetal death Note: May also be administered to Rh-neg recipients of Rh-pos blood or components

Answer 397

1 dose per 15 mL of D-pos fetal RBCs (30 mL of fetal whole blood) Calculating dose: --if # to right of decimal point is >=0.5, round up to next whole # & add 1 vial, e.g., 1.6 vials calculated = 2 + 1 = 3 --if # to right of decimal point is <0.5, don't round up; just use whole # & add 1 vial, e.g., 1.4 vials calculated = 1 + 1 = 2

Answer 398

system for continuous temp monitoring & audible alarm

Answer 399

system for continuous temp monitoring & audible alarm

Answer 400

compare against thermometer daily; calibrate as necessary

Answer 401

check high & low temp of activation quarterly

Answer 402

check temp daily

Answer 403

check temp daily; periodically check each well

Answer 404

-determine optimum speed & time for different procedures upon receipt, after repairs, & periodically -check timer every 3 months, RPM every 6 months (with tachometer)

Answer 405

check tube fill level daily, AHG volume monthly; verify time & speed quarterly

Answer 406

calibrate quarterly

Answer 407

test with pos & neg controls each day of use; use heterozygous cells for pos controls

Answer 408

-check for hemolysis -test each day of use with pos & neg controls

Answer 409

-check for hemolysis -test each day of use with pos & neg controls

Answer 410

check anti-IgG activity each day of use by testing Rh-pos cells sensitized with anti-D

Answer 411

C. 37*C incubation and IAT

Answer 412

C. Anti-M and anti-N

Answer 413

D. All of the above

Answer 414

B. Citrate-phosphate-dextrose with adenine

Answer 415

C. O negative only

Answer 416

A. Wash the blood product

Answer 417

D. All of the above

Answer 418

C. Reaction with all cells at 37*C, neg in AHG, autocontrol positive

Answer 419

B. Travel to area endemic for malaria

Review Cards - Immunohematology Flashcards

(523 cards)