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comes from someone else

HDN description

mom is alloimmunized from baby's RBCs and mom makes antibodies to baby RBCs and starts lysing the baby cells.
-results in erythroblastosis fatalis

IgG antibodies


other than ABO& RH, the Ab that causes HDN the most is

ABO and Rh, then Kell is next

when prenatal testing detects mom antibodies, what do you need to do next

an antibody ID panel

If IgM is detected on an antibody ID panel and IgM is detected, is that clinically significant?

no- only if IgG is detected

what test is used to assess fetal maternal bleeds

rosette test

if a babies Rh positive blood mixes with a mothers Rh negative blood how do you remove the baby's cells?

add anti-D to mom's cells and rosettes will form (qualitative). Because the anti-D will bind with the baby cells.

Kleiheiuer-Betke test facts

-stains hgb F
-uses acid buffer on slide
-can count hgb F cells
moms hgb A shows as ghost cell

if a pregnant woman is injured and intrauterine bleeding occurs, what needs done?

-intrauterine transfusion
-O neg blood less than 7 days old
-CMV neg blood
-blood neg for hgb's

How do you prevent HDN?

Use rogam 72 hours after delivery if baby is RH pos (1st baby)
for second pregnancy, rogam at 28 weeks and after birth if baby is Rh pos

how do you determine if there is an internal bleed in a pregnant woman?

draw mom's blood and perform a rosette test

KB test: what specimen is NOT suitable for testing fetal-maternal hemorrhage

cord blood
(used for QC purposes only)

KB test: maternal specimen storage

2-8°C for up to 2 weeks

KB test: what is used for QC

EDTA male blood or cord blood

KB test: do not do what to slides


KB test: slide storage

in freezer for several weeks but use at room temp

KB test: stain

citrate-phosphate buffer

KB test: slides to use

positive and negative control

KB test: what stains hot pink

-fetal cells
-lymphocytes (nucleated or granulocytic)
-platelets (small)

KB test: adult cell morphology

ghost cells

KB test: result

percentage of fetal to adult counted cells from slide

KB test: fetal hgb is:

acid resistant

KB test: adult hgb is:

dissolved from cells because is is not acid resistant

most common cause of HDN

Anti K
Anti C
Anti Fy

KB test: used for what

do determine how much rogham needs to be given

2 reasons to do cord blood testing:

1. if mom is O+
2. if mom is Rh neg

after giving birth to an Rh positive infant, a mom who previously tested Rh negative may test weak D pos. Why?

baby's blood crossed over into mom's blood and she developed antibodies

a mother has an anti-D and an infant who has HDFN symptoms. the infant tests are Rh neg. what may cuase a false neg Rh test in the infant?

Mom's blood crossed over into baby's blood so mom's antibodies are being detected in baby


most important lab document


college of american pathologists the joint commission


college of american pathologists

QC reagents how often

every day and when you open a new bottle


software that converts instrument info into hospital readable data


lab info system

LIS benefits

-reduced paperwork
-store data
-immediate access to data
-barcodes reduce misidentification
-good reports from data

minimum requirements of lab instruments

-access code for security
-unique accession numbers
-unique file for each assay
-record date, time and collector
-store and print bar codes
-interface with current system

the most important thing to do when solving a problem


RBC life time

120 days

hemolytic anemia=

decreased RBC survival

warm AIHA reaction

-DAT positive= adsorption and elution

cold AIHA reaction

-PCH- auto anti-P and donath landsteiner Ab
-DAT pos due to C3d
-adsorption may be necessary

drug induced reaction

-increase doses of IV penicillin
-second generation cefalosporin
-stop drug= stop reaction


american association of blood banks

what do you do to get AIHA to away

prewarm specimen


removing Abs that are bound to RBCs


add specific Ag to remove Ab from serum

Why do we elute serum

so Ags in serum won't get in the way of tests. We can get it out of the way and continue searching for what we are looking for.

DAT (direct antiglobulin test) does what

tests for in vivo coating of RBCs with Ab

pos DAT can tell us:

-if pt has been transfused, they may have an alloantibody coating the transfused cells
-if pt hasn't been transfused, they may have an autoantibody coating their own cells

what causes paroxismal cold hemoglobinurea

donath landsteiner


regulates drugs and devices


makes safety and disease recommendations to OSHA


environmental protection agency- assesses medical waste


all transportation except mail


accrediting agency for hospitals


accredits bloodbanks


lab peer review


health care financial administration
-determines if a facility can get medicare reimbursement

root cause analysis

why somethin's not working (check for error systematically)




re-creatable but not necessarily correct


standardizing - establish that a process produces a specific result


standardizing to a known value

quality control

assesses precision and accuracy

proficiency test

assesses proficiency of techs, instruments and tests (COLA,CAP)

competency assessment

know that techs are capable and skillful

preventative maintenance

equipment care to maximize it's duration

change control

old procedures to new ones

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