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bloodbank last test lannamekianov

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alolimmunity
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
D,K,Rh,K,Ss
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
-quantitative
-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
refix
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:http://quizlet.com/create_set/#add-row
acid resistant
KB test: adult hgb is:
dissolved from cells because is is not acid resistant
most common cause of HDN
Anti-D
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
SOP
most important lab document
TJC
college of american pathologists the joint commission
CAP
college of american pathologists
QC reagents how often
every day and when you open a new bottle
middleware
software that converts instrument info into hospital readable data
LIS
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
document
RBC life time
120 days
hemolytic anemia=
decreased RBC survival
warm AIHA reaction
-IgG
-37°C
-DAT positive= adsorption and elution
cold AIHA reaction
-IgM
-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
AABB
american association of blood banks
what do you do to get AIHA to away
prewarm specimen
elution
removing Abs that are bound to RBCs
adsorption
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
FDA
regulates drugs and devices
CDC
makes safety and disease recommendations to OSHA
EPA
environmental protection agency- assesses medical waste
DOT
all transportation except mail
TJC
accrediting agency for hospitals
AABB
accredits bloodbanks
CAP
lab peer review
HCFA
health care financial administration
-determines if a facility can get medicare reimbursement
root cause analysis
why somethin's not working (check for error systematically)
accuracy
correct
precision
re-creatable but not necessarily correct
validation
standardizing - establish that a process produces a specific result
calibration
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