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Clinical Lab Block 3
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
good manufacturing practices
donating blood for donor's own use...
community donation, unknown donor and recipient is...
donation for a specific recipient is...
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...
packed RBCs are known as...
parts that are separated out from blood
a sterile system of blood collection is...
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...
one unit of RBC can raise pt hematocrit by...
plasma can be stored frozen for...
plasma exchange is done by...
cold insoluble portion of FFP
primary immune response includes...
secondary immune response includes...
father of blood banking is...
what happens when we mix group ABO groups with the wrong ones?
agglutination (climping) - dangerous clinical consequences
ABO groups are unique, having...
antigens in ABO groups represent...
sugar expressed on the genes
genes expressed on the red cell
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...
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?
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?
antigens are expressed on...
antibodies are found in...
which blood groups can AB receive from?
which groups can O type receive donations from?
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?
if early labor is induced, what must be checked?
FLM - fetal lung maturity
hospital blood bank is also known as...
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?
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?
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
lancet shaped diplococci - cause pneumonia upper resp - can lead to meningitis
strep mutans - viridans - are a problem when?
MVP - dental carries
gram (-) kidney bean - can cause meningitis - spreads by resp droplets
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
normal flora SI, but if active produces toxins; pseudomembranous colitis - AB wipes out normal flora and this goes wild
diptheria - can be fatal - resp occlussion - vaccines are highly successful
food poisoned, can become meningitis and fatal, transmits across placenta in delivery - gram + rod
gram - rods, UTI, sepsis, traveler's diarrhea, habitat in human colo, transmits to neonate at birth - meningitis
gram - rods, food poisoning - fecal-oral route, raw meat, eggs
gram - rods, causes dysentery (troops in poor conditions) - no animal carriers
gram - rods, can cause dehydration - deadly
vibrio parahemolyticus and vulnificus...
gram - rods, watery diarrhea, eating contaminated raw seafood
peptic ulcers - gastric duodenitis (can lead to cancer - GI) if untreated
gram - rods, normal flora, but can cause resp and UTI
hospital acquired - normal flora
gram - rods, wound infections, UTI, nosocomial - burns, cystic fibrosis
normal stool flora, can cause sepsis, pertonitis, abdominal abscess
gram - cocobacili - resp issues
waterborne disease - air vents - aerosol
small gram (-) rods, brucellosis - undulent fever - potential bioterrorism agent
very deadly - tuleremia from rabbits, deer, rodents - caution handling - bioterror
cat or dog bite, cellulitis
the plague bubonic and pneumonic - wild rodents, prarie dogs, rats - flea bite, bio-terror
how long can you store platelets?
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?
treatments for AIDS include...
protease inhibitors, fusion inhibitors, nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors
lyme disease is caused by...
lyme disease is transmitted by...
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...
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?
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?
which bacteria is a major concern in a pregnant female w gram + chains - even low amount?
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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