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Serologic Testing Flashcards

1
Q

Pre-transfusion testing - Autologous Donation

A

ABO
Rh

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2
Q

Pre-transfusion testing of Allogenic Transfusion

A

ABO, Rh
Antibody Screen
Crossmatching

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3
Q

Serum within 3 days

A

Specimen for pre-transfusion testing procedures

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4
Q

7 days

A

Retain patient specimen and segment after transfusion

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5
Q

Universal Donor RBCs

A

Type O

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6
Q

Universal Recipient RBCs

A

Type AB

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7
Q

Universal Plasma Donor

A

Type AB

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8
Q

Universal Plasma Recipinet

A

Type O

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9
Q

Current mandated test for Pretransfusion sample - ABO
* Forward
* Reverse

A

Current mandated test for Pretransfusion sample - ABO
* Forward - Anti-A, Anti-B
* Reverse - A1 and B cell

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10
Q

DAT/Direct Coomb’s Test

Direct Antiglobulin Test

A

Detect clinical conditions due to IN VIVO sensitization of RBCs

HTR, HDFN, AIHA, DIHA

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11
Q

DAT Specimen

A

EDTA

avoid in viotro activation of C’

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12
Q

IAT/Indirect Coomb’s Test

A

Detect IN VITRO sensitization of RBCs used in various serologic tests

Antibody screening, Antibody identification, Weak D testing, Crossmatch

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13
Q

IAT Specimen

A

Serum

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14
Q

Composition of Polyspecific AHG

Green in color

A

Anti-IgG
Anti-C3d
Ant-kappa and lambda chains (IgG, IgM)
Anti-C3b, Anti-C4b, Anti-C4d

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15
Q

Composition Monospecific AHG

Colorless

A

Either Anti-IgG or Anti-C3d

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16
Q

AHG Sources of Error - False Positive

A

AHG Sources of Error - False Positive

* Improper Specimen - Refrigerated/Clotted/Used Serum (DAT)
* Cold autoantibody
* Bacterial contamination
* Overcentrifugation

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17
Q

AHG Sources of Error - False Negative

common are technical probelms

A

AHG Sources of Error - False Negative

  • Inadequate washing
  • Fail to add AHG
  • Neutralization of AHG
  • Prozone/Prozone phenomenon
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18
Q

Check cells/Coomb’s cells

A

detect if added and with reactive AHG and adequate washing

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19
Q

Check Cell Interpretation
* (+) Agglutination
* (-) No agglutination

A

Check Cell Interpretation
* (+) Agglutination - FREE AHG (AHG is added & reactive)
* (-) No agglutination - nonreactive AHG, NSS, fail to add AHG

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20
Q

Final Check for Compatibility

A

Crossmatching

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21
Q

Major Crossmatch

A

Test if patients antibodies from antigens of doors red cells

PSDR

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22
Q

Minor Crossmatch

A

dtects if donor serum has antibody for patients red cells

DSPR

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23
Q

Replaced Minor crossmatch

A

Antibody screening

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24
Q

Can transfuse even in ABO-incompatible patients

A

Plateltets

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25
Q

Only needs Crossmatching

A

RBCs

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26
Q

Phases of Antibody detection

  • IS (RT)
  • Thermophase (37C)
  • AHG Phase
A

Phases of Antibody detection

  • IS - IgM, ABO antibodies, Clerical errors
  • Thermophase (37C) - Agglutinating IgG
  • AHG Phase - non-agglutinating antiobodies, alloantibodies
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27
Q

Interpretation of Compatibility Tests
Antibody screen: (+)
Compatibility: (-)

A

Possible Compatible

phenotype donor to confirm compatibility

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28
Q

Interpretation of Compatibility Tests
Antibody screen: (+)
Compatibility: (-)

A

Possible Compatible

phenotype donor to confirm compatibility

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29
Q

Interpretation of Compatibility Tests
Antibody screen: (-)
Compatibility: (+)

A

Not Compatible

Ab reacts to low incidience antigen
(+) DAT
Technical Error

30
Q

Interpretation of Compatibility Tests
Antibody screen: (-)
Compatibility: (-)

A

Compatible

No antibody detected

31
Q

Interpretation of Compatibility Tests
Antibody screen: (-)
Autocontrol: (-)
Compatibility: (+)

A
  • ABO Grouping Error
  • DONOR unit = DAT (+)
  • Donor with alloantibodies to low incidence antigen
32
Q

Interpretation of Compatibility Tests
Antibody screen: (+)
Autocontrol: (-)
Compatibility: (+)

A

Patient has alloantibodies to donors antigen

33
Q

Interpretation of Compatibility Tests
Antibody screen: (+)
Autocontrol: (+)
Compatibility: (+)

A

Px. Autoantibody
Px. Alloantibody
Rouleaux formation

34
Q

Enhancement medium

Albumin

A

Allows sensitized cell to aggregate or come closer together

35
Q

Enhancement medium

LISS

Low and Messeter

A

Increase antibody uptake and shorten incubation time

lowers zeta potential

36
Q

Enhancement medium

PEG

A

Increase antibody uptake by **removing water **in sorrounding RBCs

37
Q

Enhancement Medium

Proteolytic enzyme

papain, ficin, trypsin

A

cleave RBC membrane to destrog antigen or expose antigens

38
Q

Destroyed by Enzymes

Duffy is watching Yt seX with MNS and Chido/Rogers

A

Fy
Yt
Xg
MNS
Chiso/Rogers

39
Q

Enhanced by Enzymes

Enhanced LIPS kasi Rich Kidd

A

Le
I
P
Rh
Kidd

40
Q

Removes antibody in sensitized RBCs

A

Elution

after a positive DAT

41
Q

Revoves antibody in serum

A

Adsorption

after a positive IAT

42
Q

Heat Elution method

A

detect ABO antibodies of ABO HDN

43
Q

Chloroform elution method

A

For positive DAT assciated with warm reactive (IgG) auto- or unexpected antibody

44
Q

Digitonin

A

remove Ab by destroying RBCs

45
Q

Composition - ZZAP

A

Cysteine activated papain + DTT

used to adsorb and enzyme treatment at the same time

46
Q

AET and DTT

*AET - 2-aminoethilsothioronium bromide ; DTT - Dithiothreitol

A

Create a RBCs negative for all antigens of the Kell blood group (except Kx)

47
Q

Best Eluant

A

Chloroquine diphosphate

dissociate IG from red cell positive DAT so that they may be typed with blood grouping reagents that reuire for IAT

48
Q

Prewarminng technique

A

keep all test components at 37C prior to testing

49
Q

Neutralization

A

inhibit reactivity of antibody, allowing separation

50
Q

Neutralize - AntiSda

51
Q

Neutralize - Autoanti-P

A

Hydatid cyst fluid

52
Q

Neutralize - Human milk

53
Q

Agglutination Reading

4+

Tube method

A

One solid agglutinate, Clear background

54
Q

Agglutionation Grading

3+

A

Large agglutinate, Clear background

55
Q

Agglutination Grading

2+

Tube method

A

Medium agglutinates, Clear background

56
Q

Agglutination Grading

1+

Tube method

A

Small agglutinates, Turbid background

57
Q

Agglutination Grading

w+

Tube Method

A

Tiny agglutinates, Turbid background

58
Q

Composition - Gel Technology

Dr. Yves Lapierre

A

Dextran acrylamide Gel + LISS

59
Q

Specimen - Gel Technology
* Donor’s RBCs
* Patient’s Serum

A

Specimen - Gel Technology
* Donor’s RBCs - 50 ul
* Patient’s Serum - 25 ul

60
Q

Gel Technology Grading

4+

A

Solid band of agglutinate at the top

61
Q

Gel Technology Grading

3+

A

Majority of agglutinated cells at upper half of the gel

62
Q

Gel Technology Grading

2+

A

Agglutinates disperesed throughout the gel

63
Q

Gel Technology Grading

1+

A

Agglutinates in the **lower half **of the gel

64
Q

Gel Technology Grading

Negative

A

Pellet in the bottom

65
Q

Gel Technology Grading

mf

A

Agglitinates in the top and pellet in the bottom

66
Q

Gel Technology
* Centrifugation
* Incubation

A

Gel Technology
* Centrifugation: 10 minutes
* Incubation: 37C for 15 minutes

67
Q

Advantage - Gel Technology

A
  • Standardization (major)
  • Stability (2-3 days)
  • Less sample
  • Increase sensitivity and specificity
68
Q

Disadvantage - Gel Technology

A

Disadvantage - Gel Technology
* Need special equipment
* Not used for Lipemic, Icteric and Hemolysed samples

69
Q

Microplate with RBC membranes bound to surface of wells

A

Solid Phase Red Cell Adherence

70
Q

SPRCA
* Centrifugation:
* Incubation:

A

SPRCA
* Centrifugation: 2 mins
* Incubation: 15 mins

71
Q

SPRCA
* Positive Reaction
* Negative Reaction

A

SPRCA
* Positive Reaction: Adherence - Monolayer of RBCs (Ragged edges)
* Negative Reactin: No adherence - button of RBCs in bottom of the well

IHBB (11 decks)

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