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MEDT 420 FINAL

Terms in this set (104)

cold reacting (IgM) ab
Lewis, MN O P
destroyed by enzymes
Duffy, K, MNSs
Enhanced by enzymes
P, I, Kidd, lewis, Rh
unaffected by enzymes
lutheran, K (ficin and papain)
frequencies of
e
D
c
C
E
K
98, 85, 80, 70, 30, 9
NO DOSAGE
K lewis p
SHOW DOSAGE
Lutheran duffy MNSs Kidd rh
malaria is caused by what ag
DUFFY antigens (Fya Fyb)
***Not destroyed by enzymes
anti-e
G ANTIGEN
anti C + D
DOSAGE is stronger with what types of cells
stronger with homozygous and weaker with heterozygous
B antigen is associated with what part of the body
colon
If a patient forward types as A and reverse types as O- Anti-A1 lectin and the A2 cells come back negative- negative antibody screening

What is most likely to cause her ABO discrepancy?And what type of blood would you give her?
A2 making anti-a1

she has a weaker reaction against the A1 cells
- her anti-A1 lectin comes back negative which means she is not an A1 individual

- She also has no reaction with the A2 cells which means she is not making an Anti-A2- We would give her type O because it is harder to find A2 cells
Group 3- Unexpected Reactions due to abnormal plasma proteins cause this

How to resolve rouleaux
saline replacement
what is the most common group error
reverse grouping
AHG which one doesn't require wash step
gel filtration
- there is no was step needed before AHG step (unlike SPRCA)- no check cells needed- there is also a more stable end point - agglutination is evident for days- 25/50 microliter pipettes and .8% cell suspension
GEL FILTRATION
Bromeline
pineapple
can still work with lipemic and hemolyzed samples (advantage)- it is very sensitive and may detect weak autoantibodies (disadvantage)- AHG REQUIRES wash step (unlike gel technology)- Check cells are NEEDED (unlike geL technology)
SPRCA
one most responsible for DHTR
Kidd
ABSORBED ON RBC
LEWIS
Le (a+b-)
results from the lack of inheritance of the secretor gene, person is a non secretor (sese)
Which of the following statements is true for Anti-Sda?
A.It is always clinically significant
B.It causes HDFN
C.It can be neutralized by guinea pig urine or pooled human urine
D.It can be neutralized by hyatid cyst fluid, pigeon droppings, or earthworm extracts
c
What is not reccomended for people who have been recently transfused
autoabsorbtion (warm reagent)
Weak non specific reactions are

- Ex: Pt has a recent hx of transfusion, types as A in the forward, but O in the reverse, has a positive Ab screening and you ID an anti-M → transfuse the pt with A blood
transfused
LEWIS AG questions on paper

IgG AND IgM allo ab
Anti-E
Anti Lewis
Ab titration with anti-E
...
DAT look for in vivo or vitro
vivo
INCREASE LDH AND DECREASE HAPTOGLOBIN
INTRAVASCULAR HEMOLYSIS (SORTA BOTH)
SPECIFIC FOR --> Cold Agglutinin Syndrome/Disease
COLD AUTO- ANTI I
MIXED TYPE AIHA on dat
Polyspecific +, IgG +, C3bC3d +
Paroxysmal Cold Hemoglobinuria (PCH)
DONATH LANDSTEINER TEST WITH ANTI-P
WHICH ONE WILL STILL CONTINUE IF THE DRUG IS STOPPED
IMMUNE COMPLEXES
CCI for PLT transfusion results
(Absolute PLC increment/uL) x body surface area (m^2) / # PLC transfused (10^11)

Absolute PLC increment= posttransfusion - pretransfusion
2 in a row have to be <10,000 PLC for patient to be refractory

Titer/score for maternal titers during pregnancy

(post-pre x bsa )/ 6 TRANSFUSED x .55
Kb
Kb% x 50/30

if over 2.2 then give 3 vials
KNOW TITERS AND SCORE CALCULATIONS
- Titer scores→
- 4+ = 12
- 3+ = 10
- 2+=8
- 1+=5
- weak= 2

- Clinically significant findings
- A titer of 16 or greater (a titer of 8 or greater)

- Any two fold increase in titer or increase in the titer score of 10
What kind of non-invasive procedure can you do with baby still inside you
MCA-PV
KB IS QUAL OR QUAN
QUANTITATIVE
FETAL SCREEN IS QUAL OR QUAN
QUALITATIVE
FFP/Frozen Plasma/Cryo reduced WHEN FROZEN is stored at
-18 C
FFP/Frozen Plasma/Cryo reduced THAWED is stored at
1-6 C
RDPlatelets is stored at
20-24 C
whole bloods is stored at
1-6
Cryoprecipitated AHF Thawed/Pooled stored at
20-24 C
WHEN is digitoin elution used
dat + polyspecific + igg+ and recent sensitizing event
IRRADIATION
JANUARY 7TH 2020

ADD 28 DAYS TO DATE
WHAT DO U DO BEFORE PRETESTING-
A.PULSE
B. BP
C.TEMP
ALL OF THE ABOVE
Immediate HTR
MOST PREVENTABLE
therapy for FEBRILE non hemolytic anemia
- FNHTR
ANSWER IS TYLENOL
Allergic Urticarial-Hives
Hives - allergic reaction
receiving leuko reduced blood cells know how to prepare them for transfusion
- RBC's Leukoreduced
- Quality Control: WBC count <5x106 and must contain at least 85% of the original RBC mass
Case study - where he had NO fever the answer is
anaphylactic
Most common allergic transmitted disease are
ALLERGIC AND FEBRILE
Which hepatitis is NOT routinely tested is
HEV
when HGB IS LESS THAN 7 GIVE
pt's hgb is <7 g/dL
1 RBC
Aliquot/exchange transfusion
...
What panel is seen in newborns - one with no ab do its all
0 reaction in the reverse group
Babys blood type if babys A and reacting with A,B
mom has anti- ???
"Look-back" system
Notify donor of blood/components involved in reaction
Facilities and Safety risks
biological, chemical, radiation
Process Control: ensure quality of products and processes carried out in controlled environment

SOPS
Change SOPs
Proficiency testing
QC
Sterility
involved in
Organization→ structure clearly identified as well as responsibilities for the provision of blood, components, products, services
Executive management
Compliance→ establish and maintain quality standards
Often "reactive"
ALL OF THE ABOVE
"reactive"
issue has occurred, now need to investigate and decide how to prevent future error
TQM→
prevention-maintain standards to prevent issues
most common cause of Transfusion transmitted disease death
Bacterial contamination
TRALI--WBC emboli in lungs
NO FFP DONATED TO MULTI-PAROUS FEMALES
TACO
CHF and pulmonary edema, too much transfused too fast
Rh immune globulin is indicated for prenatal mothers who are
Rh negative with no immune anti-D
DIC
<10,000 / uL
FFP must be frozen within
8 hrs
SPRCA rbc is
attached to cell walls
In Gel technology rbc agglutination
is trapped in or above the gel column
Blood selected for red blood cell exchange transfusion for a newborn must be
ANTIGEN NEG FOR ANTIGENS CORRESPONDING TO MATERNAL ANTIBODIES
Acquired B antigen forward and reverse is
AB the A
Bombay Phenotype (hh)
- No A, B, or H Antigens
- Types as an O person, but the pt's RBCs will not react with Anti-H lectin (Ulex europaeus)
- ABSC is positive
- Autocontrol is negative
- ABSC positive and autocontrol negative→
underlying alloantibody
- ABSC negative and autocontrol positive→
underlying autoantibody
Group 2- Errors in the Forward Grouping most common in
elderly
Group 3- Unexpected Reactions due to abnormal plasma proteins can cause _______________ use ___________ _____________ to resolve
- multiple myeloma
- hodgkins disease
-whartons jelly
rouleax saline replacement
if 30 weeks pregnant and forward is B and reverse is O and has ABSC+ and ABID+ she
formed a Lewis autoAb due to Lewis Ag depression during pregnancy
How should you proceed if Ab screening is positive and Ab ID is negative?
a. Record as positive
b. Record as negative
c. Repeat Ab screening cells
d. Look for low incidence Ag on screen cells lacking on Ab ID panel
c
How would you enhance an Ab that would have enhanced reactivity against enzyme treated cells? (opposite to destroy)
a. Use homozygous cells
b. Use heterozygous cells
c. Treat with enzyme
b
How would you find an Ab that would have Dosage?
a. Use homozygous cells
b. Use heterozygous cells
c. Treat with enzyme
A
What class of immunoglobulins are anti-Le antibodies?
A.IgG
B.IgA
C.IgM
D.IgE
c
A person who is Lele sese would have which phenotype?
A.Le(a+b-)
B.Le(a-b+)
C.Le(a+b+)
D.Le(a-b-)
a
What are the 3 reasons when it would be helpful to run an Ab prewarmed screen panel?
1)Weak reactions mixed with strong reactions
2)No obvious specificity
3)Need to evaluate / eliminate weak cold Abs
What reagent is used for cold adsorption when a patient is recently transfused?
RESt adsorption
What type of gel undergoes centrifugation in gel technology?
dextran acrylamide gel
forward AB reverse A and forward reaction transcrepency
Aquired B antigen
Aquired B antigen can be transfused with
O or A
forward AB reverse B then...
A2B making anti-A1
after autocontrol then do Anti-A1 lectin and if positive then
A1 individual
if Anti-a1 lectin negative then
A2 or other A subgroup
A3 and A end are what type of agglutination
mixed
Ax agglutination only with
anti A,B neg wit anti- A1
Am Ay Ael require
adsorbtion/ elution to detect A
Wouldnt react with anti-a1 lectin!
A2 pos with anti-A1
A2B pos with anti-a1
If negative with Anti-A1 lectin then....
A2
High incidence antigens:
e, k, Kpb, Jsb, Lub
the classical pathway requires what
calcium
what top chelates calcium and binds to it in complement system
Lavender tops
no EDTA to bind calcium in red top
Red top tubes
Cryoprecipitate:
concentrated source of Factor V, VIII, vWF, XIII, fibrinogen
most common cause of TTD death: transmitted disease death
Bacterial contamination
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