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Blood bank 7 > Test 7 > Flashcards

Test 7 Flashcards

1
Q

What group of antibodies is the most frequent cause of HDN

A

ABO

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2
Q

Which antibody is the most common cause of HDN

A

Anti-A,B

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3
Q

Is ABO HDN usually severe

A

No

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4
Q

What group of antibodies is the most frequent cause of severe HDN

A

Rh antibody

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5
Q

Is cord blood mom or baby blood

A

Baby

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6
Q

What hematological changes are seen with HDN

A

Increased retic and NRBC

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7
Q

What chemistry changes are seen in HDN

A

Increased indirect bilirubin

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8
Q

In HDN why does baby’s bilirubin rise even more after birth

A

Mothers liver not there to compensate and baby’s lover takes 3 days to reach total function

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9
Q

Which bilirubin is more dangerous for the baby

A

Indirect

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10
Q

Unconjugated bilirubin had affinity for what tissue

A

CNS

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11
Q

What is kernicterus

A

Bilirubin precipitates in baby brain cells

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12
Q

Which children are at greatest risk for kernicterus

A

Acidotic, hypoxic, premature birth, low serum albumin

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13
Q

Objectives of exchange transfusion

A

Decrease bilirubin
Remove baby Ab coated RBCs
Provide RBCs w/ O2 carrying capacity
Decrease level of incompatible Ab in baby

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14
Q

What will simple transfusion help with

A

Providing O2 carrying capable RBCs

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15
Q

Samples that can be used for cross match on baby

A

Mothers serum
Eluate from baby cells
Baby’s serum

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16
Q

How long is it acceptable to use mothers sample for crossmatch

A

4 months

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17
Q

Serological test commonly used to predict severity of HDN

A

Antibody titer

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18
Q

When doing titers what is done to avoid discrepancy

A

Run previous specimen alongside current

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19
Q

How does monitoring OD of amniotic fluid help predict worsening of disease

A

OD usually declines after 2nd trimester

HDN causes it to stay the same or increase

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20
Q

What does cord blood testing usually include

A

ABO, Rh and DAT

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21
Q

Cord blood testing is usually ordered on infants of what mothers

A

O or Rh negative mom

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22
Q

Test of choice to screen for FMH in Rh negative no there’s with Rh positive babies

A

Rosette test

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23
Q

If rosette test is negative what will be done

A

Give 1 vial RhIg

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24
Q

If rosette test is positive what will be done

A

Quantitative test such as flow cytometry or K-Betke

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25
Q

What type of test is K-Betke

A

Staining technique used to detect fetal Hgb

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26
Q

Test of choice to screen of FMH of Rh positive moms

A

Quantitative test

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27
Q

Test of choice to screen for FMH in Rh negative moms with weak D positive babies

A

Quantitative test

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28
Q

How to calculate vials of RhIg

A

Number fetal cells/ number adult cells100= % fetal cells
%fetal cells50= FMH
FMH/30= vials
Vials+1

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29
Q

Anemia that results when an individual forms an antibody against RBC antigens

A

Autoimmune hemolytic anemia

30
Q

Term for anemia that results when an individual forms an antibody against drug

A

Drug induced autoimmune hemolytic anemia

31
Q

Autoimmune hemolytic anemia classified into what categories

A

Warm autoimmune hemolytic anemia

Cold hemagglutinin disease

32
Q

Which AIHA is more common

A

WAIHA

33
Q

What temp do antibodies seen in WAIHA react best

A

37C

34
Q

Extra vascular hemolysis occurs where

A

Liver and spleen

35
Q

Cells carrying low levels of IgG are cleared in what organ

A

Spleen

36
Q

Cells sensitized by complement or higher levels of IgG cleared by what organ

A

Liver

37
Q

Lab findings associated with intravascular hemolysis

A

Hemoglobin in plasma and urine
Increased bilirubin
Decreased haptoglobin

38
Q

Lab findings associated with extra vascular hemolysis

A

Increased bilirubin

Urobilinogen

39
Q

Test to determine if circulating antibody and the antigens on RBCs have bound

A

DAT

40
Q

When a DAT is positive what will RBCs most likely be coated with

A

Both IgG and complement

41
Q

If only one protein is coating RBC surface in DAT what is it likely

A

IgG

42
Q

To remove protein coating patient RBCs what procedure will be done

A

Elution

43
Q

Why shouldn’t patients with WAIHA be transfused

A

AutoAb makes finding compatible blood and identifying alloAB difficult
Auto AB shortens life of transfused cells

44
Q

Does presence of ab in serum indicate mild or severe disease

A

Severe

45
Q

Procedure used to remove autoantibody from patients cells so they can be type

A

Chloroquine diphosphate for IgG

Think reagent for IgM

46
Q

Procedure used to remove AutoAb from patients serum

A

Adsorption

47
Q

Procedure used to remove AutoAb from patients serum

A

Adsorption

48
Q

What determines if autologous or homologous cells are used for adsorption

A

If patient has been recently transfused

49
Q

Type of treatment will WAIHA usually receive

A

Glucocorticoid steroid
Splenectomy
Cytotoxic drugs

50
Q

Age group and disease state usually seen with chronic CHD

A

Over 50

Lymphoproliferative disorders

51
Q

Age group and disease state usually seen in transient CHD

A

Adolescents

Infections

52
Q

Cold reactive AutoAb that react at what temp are clinically significant and why

A

28-31C can cause ongoing hemolysis at room temp

53
Q

In CHD what protein should be seen coating cells when DAT is performed

A

Complement

54
Q

Titer of cold reactive antibody usually associated with what

A

Thermal amplitude

55
Q

Infections associated with CHD

A

Mycoplasma pneumoniae

Infectious mono

56
Q

Auto anti-P in PNH is called what

A

Doneth-Landsteiner

57
Q

Treatment for CHD

A

Keep warm

Folic acid

58
Q

What temp is EDTA tube for cold agglutinin test kept at and why

A

37C

So antibody comes off of RBCs to perform testing

59
Q

What cells are used to perform cold agglutinin test

A

Patient cells with screening cells,

Best tracing cell is used in overnight test

60
Q

Significant titer rise

A

> 128

61
Q

True drug induced hemolytic anemias caused by what

A

Methyldopa/aldomet

62
Q

In true drug induced hemolytic anemia what type of cells will eluate react with

A

All RBCs

63
Q

What type of drug is usually involved in anemia resulting from drug adsorption

A

IV penicillin

64
Q

What are the only type of cells eluate from patient with drug adsorption mechanisms

A

Penicillin coated RBCs

65
Q

What differentiates drug adsorption mechanism from drug dependent mechanism

A

Drug dependent may bind drug at any site in body

Drug adsorption only destroys cells with drug on surface

66
Q

Another term for drug dependent mechanism

A

Immune complex mechanism

Innocent bystander mechanism

67
Q

What cells will eluate of patient with drug dependent mechanism react

A

None

68
Q

What differentiates membrane modification mechanism from drug adsorption and drug dependent mechanism

A

It does not cause RBC destruction

69
Q

In membrane modification mechanism what will DAT demonstrate

A

IgG
Complement
Or both

70
Q

In membrane modification mechanism with what cells will eluate react

A

None

71
Q

What is HDN

A

Immune destruction of fetal or newborn RBCs due to sensitization by maternal IgG

Blood bank 7 (1 decks)

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