Clinical Lab Block 3

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Blood banking

blood banking is regulated by...


blood is classified as a...


goals of the FDA in blood banking are...

safety for blood supply, donor, recipient, hc workers

GMPs are...

good manufacturing practices

donating blood for donor's own use...


community donation, unknown donor and recipient is...

allogenic donation

donation for a specific recipient is...

directed donation

apheresis donation is...

automated collection procedure where blood is separated, centrifuged, and the remainder is returned to donor

blood is collected (before separation into components) as...

whole blood

packed RBCs are known as...

packed RBCs

components are...

parts that are separated out from blood

a sterile system of blood collection is...

closed system

open system is...

when collection is exposed to air - decreasing expiration date

apheresis platelet is also known as...

single donor platelets

physical assessment for blood donation includes...

arm check, age (16 or 17), weight (110+), temp (99.5), Hg (12.5+), BP <180/100, pulse 50-100 (45 - athlete)

autolous donations have relaxed requirements...

Hg - 11, weight >100, no age requirement (over 75 - MD clearance)

individuals disqualified from donation is called...

deferral (temporary or permanent)

infectious diseases tested for at blood donation include...

HBV, HCV, HIV, RPR (Syphilis), NAT (nucleic acid amplification testing for HIV), Trypsinoma cruzi, West Nile

people who need fibrinogen (and fibrin blue) are given...


% of RBCs compared to the total volume is...


anemia - inadequate producrion is...


excessive breakdown anemia is...


lack of sufficient iron is...

iron deficiency anemia

abnormal Hg anemia is...

sickle cell

one unit of RBC can raise pt hematocrit by...


plasma can be stored frozen for...

1 year

plasma exchange is done by...


cryoprecipitate is...

cold insoluble portion of FFP

primary immune response includes...


secondary immune response includes...


father of blood banking is...

Karl Landsteiner

what happens when we mix group ABO groups with the wrong ones?

agglutination (climping) - dangerous clinical consequences

ABO groups are unique, having...

codominant expression

antigens in ABO groups represent...

sugar expressed on the genes

phenotype is...

genes expressed on the red cell

genotype is...

specific genes inheritted

4 A's of specimen collection are...

appropriate, adequate, aseptic, before antibiotics

lab should be notified of a dog or cat bite/ scratch to look out for...

pasturella (& Bartonella henselae)

which disease should be tested for in a patient who was in Mexico eating oysters?


which stage of disease will the virus be greatest in number?


a procedure where a tube is placed down the throat w another one inside it to avoid contamination of normal flora is...

doublelumen bronchoscopy

how would one release the media into a culturette tube?

crush the ampule (c = crush)

how would we release media into a pledgett?

push all the way down (p=push)

for specimens that are aerobes, which tubes do we use?

plastic (breathes)

anaerobes (pathogens) require which type of tube?

glass tube to keep out the oxygen

which immunoglobulin type reacts in Rh rxns?


Rh allantibodies can lead to...

transfusion rxn, hemolytic disease of the newborn

O bloodtype is representative of which gene?

H gene

antigens are expressed on...

red cells

antibodies are found in...


which blood groups can AB receive from?


which groups can O type receive donations from?

only O

how does an Rh (-) mom create antibodies against Rh?

she is exposed to Rh antigens in a previous pregnancy

explain IAT - indirect antiglobulin test (indirect Coombs test)...

detects RBCs sensitized with IgG antibodies in vitro

what is the DAT - direct antiglobulin test (direct Coombs test)?

it detectd RBCs sensitized w IgG antibody in vivo

the antigen referred to as Rh- is the...

D (big D)

Rh immune globulin is given to expecting women when?

28 weeks gestation, 72 hours postpartum, and in case of trauma, ectopic pregnancy, amneocentesis, abortion, misscariage

risk to the fetus in HDFN - hemolytic disease of fetus and newborn is...

cardiac failure due to uncompensated anemia

what happens to billirubin that is usually metabolized by the mother which accumulates in newborn (in HDFN) after birth?

Newborn can't metabolize it (missing glycuronyl transferase) so it binds to albumin and forms jaundice > deafness, menatl retardation, kernicterus, eventually could cause brain damage and death

at what levels of billirubin do we take action?

at 15 we get blood ready for transfusion - probably use Billy-lights (phototherapy) - 20 is critical #

most severe Rh antibody reaction (HDFN) is from...


RhIG (Rhogam) is given to Rh- mom to...

prevent mom from making Anti-D antidodies to baby's D+ fetal cells

standard blood bank tests done at birth on baby (cord blood) - (forward typing) include...

ABO/Rh, DAT, chemistry - Billirubin

What does the DAT show?

if there is any blood antigen-antibody rxn - will be HDFN

describe an amniocentesis...

ultrasound guided test where amniotic fluid is obtained from insertion of needle through mom's abdominal wall, ans uterus and extract from amniotic sac

what does the amniocentesis show about HDFN?

fluid is measured spectrophotometrically - observing levels of billirubin to measure RBC destruction

Liley graph is used to...

predict severity of HDFN during pregnancy by evaluating amniotic fluid

how does the Liley graph measure?

at 450 wavelength it measures the change in level - Billirubin bulge

Which zones in Liley graph are worse?

higher #s - zone IV (higher level III) is the worst

in severe cases of HDFN what might be done?

intrauterine transfusion

if early labor is induced, what must be checked?

FLM - fetal lung maturity

hospital blood bank is also known as...

transfusion service

a sample of pleural fluid or CSF contains a minute amount of bacterial infection - is this significant?

yes b/c there should not be any bacteria in these fluids (so we use sterile containers to collect these specimens)

what sort of collection kits are used for parasitology?

O&P, formalin, PVA

the parasite enterobius vermicularis is known as...


how do we collect pinworm specimen?

not stool - use scotch tape method or pinworm paddle

genital cultures can be transported with...

transport swabs, jembec plates, DNA probes for N. Gonorrhea and Chlamydia

describe Staph aureus histologically...

gram + clusters of cocci/ catalase and coagulase +

where is the Staph aureus carried in a human?

nasal cavity

T or F staph epidermitis is normal flora and safe...

False - it is normal flora, but is opportunistic and can lead to infection

what is significance of staph saprophyticus?

community acquired uti in young women - aside from E. coli (second most common)

differentiate between staph epidermitis and saprophyticus...

staph sapro is resistant to novobiocin, s epidermitis isn't

what dangerous form can group A strep (pyogenes) cause?

necrotizing fasciitis

what is the danger of strep b - strep agalactiae?

neonatal meningitis (colonized in vagina - can transfer to fetus in delivery)

enterococcus faecalis is..

normal bacteria in stool - can cause UTI or biliary tract infection, endocarditis

strep pneumoniae...

lancet shaped diplococci - cause pneumonia upper resp - can lead to meningitis

strep mutans - viridans - are a problem when?

MVP - dental carries

niesseriae meningitidis...

gram (-) kidney bean - can cause meningitis - spreads by resp droplets

n. gonorrhea...

gonorrhea and baby can get conjuctivitis during delivery

bacillus anthracis - anthrax is...

gram + spore forming bacilli; habitat is soil; transmission - sharing wool, bio terrorism agent

bacillus cereus is...

food poisoning - rice sitting for too long - gram + bacilli

Clostridium tetani is...

anaerobic, spore-forming rods, habitat is soilenters through trauma to skin, vaccines (boosters 10 yrs)

clostridium botulinum is...

botulism - anaerobic spore formers, habitat - soil, improperly preserved food (canned) - potential bioterror

clostridium perfingens...

food poisoning

clostridium difficle...

normal flora SI, but if active produces toxins; pseudomembranous colitis - AB wipes out normal flora and this goes wild

cornybacterium diptheriae...

diptheria - can be fatal - resp occlussion - vaccines are highly successful

listeria monocytogenes...

food poisoned, can become meningitis and fatal, transmits across placenta in delivery - gram + rod

E. coli...

gram - rods, UTI, sepsis, traveler's diarrhea, habitat in human colo, transmits to neonate at birth - meningitis

salmonella typhi...

gram - rods, food poisoning - fecal-oral route, raw meat, eggs


gram - rods, causes dysentery (troops in poor conditions) - no animal carriers

vibrio cholerae...

gram - rods, can cause dehydration - deadly

vibrio parahemolyticus and vulnificus...

gram - rods, watery diarrhea, eating contaminated raw seafood

campylobacter jejuni...

food poisoning

h. pylori...

peptic ulcers - gastric duodenitis (can lead to cancer - GI) if untreated

klebsiella pneumoniae...

gram - rods, normal flora, but can cause resp and UTI

serratia marcescens...

hospital acquired - normal flora

Proteus vulgaris...

UTI, sepsis

Pseudomonas aeruginosa...

gram - rods, wound infections, UTI, nosocomial - burns, cystic fibrosis

bacteroides fragilis...

normal stool flora, can cause sepsis, pertonitis, abdominal abscess

haemophilus influenzae...

gram - cocobacili - resp issues

bordatella pertusis...

whooping cough

legionella pneumophilia...

waterborne disease - air vents - aerosol


small gram (-) rods, brucellosis - undulent fever - potential bioterrorism agent

francisella tularensis...

very deadly - tuleremia from rabbits, deer, rodents - caution handling - bioterror

pasturella multocida...

cat or dog bite, cellulitis

yersinia pestis...

the plague bubonic and pneumonic - wild rodents, prarie dogs, rats - flea bite, bio-terror

how long can you store platelets?

5 days

what is cryoprecipitated anti-hemolytic factor (cyro) used for?

fibrinogen deficiency and fibrin glue

which antibody is anamnestic - has remembering response?

IgG (secondary response)

which antibody comes in first response?


what kind of replacement transfusion would you give to a burn victim?


which rxn is faster - precipitation or agglutination?


what is ELISA and how does it work?

A sensitive immunoassay that uses an enzyme linked to an antibody or antigen as a marker for the detection of a specific protein, especially an antigen or antibody

what does a titer measure?

agglutination rxn - with serial dilution of antibody: the titer is the highest dilution showing agglutination

main causative agent of chronic fatigue syndrome is...

Epstein Barr virus - EBV

Sx of EBV include...

fever, sore throat, enlarged lymph nodes and tonsils, spenomegaly, hepatomegaly, elevated LFTs

decreased levels of which hormone in early pregnancy indicate inadequate development of fetus and inreases incidence of spontaneous abortion?


what info can be gleaned from HCG assays?

confirmed pregnancy, ectopic p, threat of spontaneous abortion, diagnosis of various tumors (& follow of treatment)

which form of Hepatitis is likely to present with fever and malaise?


which test is an advance marker (often years in advance) of risk for heart disease and MI?

C-reactive proteins

treatments for AIDS include...

protease inhibitors, fusion inhibitors, nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors

lyme disease is caused by...

borrelia burgdorferi

lyme disease is transmitted by...

deer tick

cold agglutinins are used to diagnose...

primary atypical (walking) pneumonia

a motile amoebae producing diarrhea and dehydration, contracted through drinking contaminated spring - mountain water is...

giarida lamblia

hx of swimming in a lake, infected with meningoencephalitis could be from...

nigleria fowleri (motile amoebae)

common STD - vaginal discharge is...


diabetic w necrotic foot may have which infection?

clostridium perfingens

members of which sex can be diagnose w N gonorrhea by gram stain alone?


which patients with salmonella would be treated with AB?

children, elderly, immunocompromised

why would we isolate a pt positive for toxins of clostridium difficile?

spore former

which bacteria is a major concern in a pregnant female w gram + chains - even low amount?

strep agalactae

is a finding of lactobacillus in urine significant?

no - it belongs (normal flora) in vaginal tract - got mixed up

a very low amnt of bacteria found in CSF or pleural fluid - is it significant?

yes - should be 100% sterile

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