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Ch6 Immunohematology
Flashcards made directly from the Success! in Clinical Laboratory Science book
| Question | Answer |
|---|---|
| a woman wants to donate blood. Her physical exam is as follows: weight - 110lbs, pulse - 73bmp, b/p - 125/75, hematocrit 35%. What could possibly exclude the prospective donor? | hematocrit is too low |
| a potential donor has no exclusions, but she weighs only 95 lbs. What is the allowable amount of blood (including samples) that can be drawn? | 454 mL the calculation is no more than 10.5 mL/kg of their body weight. 95lb/2.2kg=43.2kg ~ 43.2kgx10.5mL/kg= 453.6 mL |
| donors who have received blood or blood products within 12 months of when they desire to donate are deferred to protect the recipient because the | blood could have transmitted hepatitis (HBV or HCV) or HIV |
| Which of the following viruses resides exclusively in leukocytes? | CMV |
| A donor indicates that he has taken two aspirin tablets per day for the last 36 hours. The unit of blood.... | may be used for pooled platelet concentrate preparation |
| A pooled sera product from 16 donors has a repeatedly positive nucleic acid test NAT) for HCV. The next action that should be taken is to | test each donor in the pool for HCV |
| blood needs to be prepared for intrauterine transfusion of a fetus with severe HDN. The red blood cell unit selected is compatible with the mother's serum and has been leuko-depleted. An additional step that must be taken is to | irradiate the RBCs before infusion |
| the addition of adenine in an anticoagulant-preservative formulation aids in | maintaining ATP levels for red cell viability |
| the pilot tubes for donor unit #3276 break in the centrifuge. You should... | remove sufficient segments to complete donor processing procedures |
| when 2,3-BPG levels drop in stored blood, which of the following occurs as a result? | red blood cell ability to release O2 decreases |
| the last unit of autologous blood for an elective surgery patient should be collected no later than ___?___ hours before surgery | 72 |
| it has been determined that a patient has post transfusion hepatitis and received blood from eight donors. there is nothing to indicate that these donors may have been likely to transmit hepatitis. What action must be taken initially? | Notify the donor center that collected the blood |
| the temperature range for maintaining red blood cells and whole blood during shipping is | 1-10 degrees Celsius |
| platelets play an important role in maintaining hemostasis. one unit of donor platelets derived from whole blood shout yield _________?___________ platelets | 5.5x10^10 |
| The pH of 4 platelet concentrates is measured the day of expiration.The pH and plasma volumes are as follows: pH6.0,45mL; pH5.5,38mL; pH5.8,40mL; pH5.7,41mL.What corrective action is needed in product prep to meet AABB standards for platelet production? | increase the final plasma volume of platelet concentrates |
| during preparation of platelet concentrate, the hermetic seal of the primary bag is broken. The red blood cells must..... | be labeled with a 24-hour expiration date |
| the blood bank procedures manual must be reviewed | annually by an authorized individual |
| previous records of patients' ABO and Rh types must be immediately available for comparison with current test results | indefinitely |
| in order to meet the current AABB standards for leukocyte reduction to prevent HLA alloimmunization or CMV transmission, the donor unit must retain at least _____ of the original red cells and leukocytes must be reduced to less than ____ | 80%, 5X10^6 |
| a 70 kg man has a platelet count of 15,000 uL and there are no complicating factors such as fever or HLA sensitization. If he is given a platelet pool of 6 units, what would you expect his post transfusion count be? | 45,000-75,000 uL |
| Temperature for storing Red Blood Cells, liquid | 1-6 degrees Celsius |
| Temperature for storing Red Blood Cells, frozen | -65 degrees Celsius |
| Temperature for storing Fresh-Frozen plasma and cryoprecipitate | -18 degrees Celsius |
| Temperature for storing platelet concentrate | 20-24 degrees Celsius |
| Shelf life of red blood cells in CPDA-1 | 35 days |
| shelf life of fresh frozen plasma and cryoprecipitate | 1 year |
| shelf life of fresh frozen plasma, thawed | 24 hours |
| shelf life of platelet concentrate in PL-732 (with agitation) | 5 days |
| shelf life for CPD (citrate phosphate dextrose) blood for transfusion therapy | 21 days |
| shelf life for CPDA-1 (citrate phosphate dextrose adenine) blood for transfusion therapy | 35 days |
| shelf life for AS-1 (adsol) blood for transfusion therapy | 42 days |
| shelf life for EDTA blood for transfusion therapy | not an approved anticoagulant |
| what type of blood component would patients with warm autoimmune hemolytic anemia (AIHA) due to alpha-methyldopa with hemoglobins of 8.5 g/dL or above get? | transfusion not indicated |
| What type of blood component would patients requiring transfusion with RBC that will not transmit cytomegalovirus (CMV) get? | leukocyte reduced RBCs |
| what type of blood component would patients with normovolemic anemia get? | RBCs |
| what type of blood component would patients who are thrombocytopenic secondary to the treatment of acute leukemia get? | platelet concentrate |
| most blood group antibodies are what immunoglobulin classes? | IgG and IgM |
| If a person has the genetic makeup Hh, AO, LeLe, sese, what substance will be found in the secretions? | Le^a substance |
| lectins are useful in determining the cause of abnormal reactions in blood bank serology. These lectins are frequently labeled as anti-H, anti-A1, etc.The nature of these lectins is that what kind of substance reacts chemically with certain RBC antigens? | Plant substances |
| What sugar must be present on a precursor substance for A and B antigenic activity to be expressed? | L-Fucose |
| An antigen-antibody reaction alone does not cause hemolysis. What is required for red blood cell lysis? | complement |
| A white female's red blood cells gave the following reactions upon phenotyping D+ C+ E- c+ e+ what is the most probable Rg genotype? | DCe/dce |
| An individual of the dce/dce genotype given dCe/dce blood has an antibody response that appears to be anti-C plus anti-D. What is the most likely explanation for this? | the antibody is anti-G |
| If a patient has the Rh genotype of DCe/DCe and receives a unit of red blood cells from a DCe/dce individual, what Rg antibody might the patient develop? | Anti-c |
| If a D-positive person makes an anti-D this person is probably | Partial D |
| A serum containing anti-K is not frequently encountered. This is because | People who lack the k antigen are rare |
| The Xga antigen has a higher frequency in ___?____ than ___?___ | Women, men |
| Testing needs to be done with an anti=serum that is rarely used. The appropriate steps to take in using this antiserum include following the manufacturer's procedure and | testing a cell that is negative for the antigen and one that is heterozyfous for the antigen |
| What antibody system is often implicated in delayed hemolytic transfusion reactions? | Kidd system |
| A patient had an anti=E identified in his serum 5 years ago. His antibody screening test is now negative. To obtain suitable blood for transfusion, what is the best procedure to use? | Type the donor units for the E antigen an crossmatch the E-negative units. |
| A recently transfused patient's serum has a positive antibody screen. The panel performed at IS, in LISS at 37 degrees Celsius, and at AHG shows a strong anti-Fya and a weak possible anti-C. To conform the anti-C you would perform an | Enzyme panel |
| Which set of antibodies could you possibly find in a patient with no history of transfusion or pregnancy? | Anti-P1, Anti-Lea, Anti-I |
| Lymphocytotoxicity testing can be used to detect the presence of antibodies to | HLA antigens |
| The antibody produced during the secondary response to a foreign antigen is usually | present at a higher titer than after a primary response |
| What is the process of removing an antibody from the red blood cell membrane called? | elution |
| At the end of an antiglobulin test, IgG-coated control cells are added to the negative atests and centrifuged. What does it mean if no afflutination occurs? | cells were not washed properly |
| The cross match is performed using | donor's red cells and recipient's serum |
| A resident physician hand-delivers a blood sample, drawn by the attending physician, for pretransfusion testing from a patient who is difficult to draw. The sample is unlabeled. One Should.... | discard the sample and request that the resident obtain a new sample, adhering to proper guidelines for labeling |
| a specimen of blood is received in the blood bank with request slips initialed by the phlebot. the tube has the patient's first and last name and MRN on the label. What else must be on the tube label as required by AABB standards? | date of phlebotomy |
| a physician calls the blood bank and wants an additional unit of RBC crossmatched for a patient.Several specimens from that patient have been drawn over the past month. which one is appropriate?1 day old,4 days old,1 week old,or 1 month old? | 1 day |
| A patient has a hemoglobin value of 8.1g/dL. the surgeon wants to raise the hemoglobin to 10 g/dL before surgery. How many units of RBC need to be administered to this patient to raise the hemoglobin to the required level? | 2 units |
| A patient with an anti-K and an anti-Jka in her plasma needs 2 units of RBC for surgery. How many group-specific units would need to be screened to find 2 units of RBC? Jk(a+) frequency is 77%. the K+ frequency is 10% | 10 units |
| If 98% of the red blood cells are viable in a unit of RBC at the time of transfusion, what percentage of red cells will remain viable 28 days post transfusion? | 70% |
| What is the component of choice for someone who needs a RBC transfusion when there is a history of febrile transfusion reactions? | leukocyte-reduced RBCs |
| A patient is group A. Which cryoprecipitate units would most appropriately be used to treat this patient? | Group A and Group AB |
| What is the component of choice when a physician is concerned about restoring or maintaining oxygen-carrying capacity? | red blood cells |
| the serum of a patient contains an antibody that reacts with all random donor cells and panel cells that have been tested. The best possibility to find compatible blood would be to test what kind of relatives? | siblings |
| four units of FFP have been ordered to correct factor V deficiency in a group O patient. One should thaw and issue... | Any blood group available |
| What type of IV fluid is appropriate to be given with a blood transfusion? | 0.9% saline |
| Hemolytic transfusion reactions are the most serious type of reactions to blood transfusion. The majority of hemolytic transfusion reactions are caused by ______?______ errors | clerical |
| What type of transfusion reaction is often diagnosed by a positive DAT and a gradual drop in the patient's hemoglobin level? | delayed hemolytic |
| What antibody, labile both in stored serum and the patient's plasma, is a frequent cause of delayed hemolytic transfusion reactions? | Anti-Jka |
| Occasionally, Patients have an anaphylactic reaction to a specific immunoglobulin class during a transfusion. Which immunoglobulin class is most often implicated? | IgA |
| Although use of autologous blood transfusions generally has several advantages, which of the following is not avoidable? Transmission of disease, Clerical error, Allergic reactions, or Graft-versus-host disease? | clerical error |
| The serum of a patient transfused 2 weeks ago reacts 3+ on IS and 1+ at the AHG phase of testing with all reagent red cells except for the ii cell. The autocontrol reacts similarly to the panel cells. In order to crossmatch this patient, one should | use the prewarmed technique |
| von Willebrand disease and hypofibrinogenemia would require what blood component for treatment? | cryoprecipitate |
| Factor V deficiency and Liver disease would require what blood component for treatment? | fresh-frozen plasma |
| Hemorrhagic episode during intensive chemotherapy would require what blood component for treatment? | platelet concentrate |
| In which of the following blood group systems may the red blood cell typing change during pregnancy? P, MNS, Lewis, Duffy | Lewis |
| Which of the following is not considered a useful predictor of hemolytic disease of the newborn during the gestational period? Anti-A. Anti-D, Anti-Fya, Anti-U. | Anti-A |
| Which is the class of the immunoglobulin uniquely associated with hemolytic disease of the newborn? IgA,IgD, IgE, IgG | IgG |
| A newonate with a positive DAT indicates that there was an incompatibility between a mother and her fetus. The system that is most associated with an incompatibility is | ABO |
| a newborn is goup O, D-pos and has a 3+ DAY. The mother's antibody screening test is negative. Assuming the antibody detection is valid, onw should consider HDN due to an antibody directed against a | low- incidence antigen |
| The most conclusive way to demonstrate the antibody that is causing a positive DAT in a newborn is to perform an antibody | panel using an eluate from the baby's red cells |
| A massive fetomaternal hemorrhage in a D-neg woman who had a D-pos infant should be suspected if the | Weak-D test on the maternal blood shows a mixed-field reaction microscopically |
| What is the principle of the Kleihauer-Betke stain? | Adult hemoglobin is more soluble in acid buffer than fetal hemoglobin |
| Which of the following antibodies present in a multitransfused obstetric patient would be most likely to cause HDN in her infant? Anti-Lea, Anti-c, Anti-P, Anti-K1 | Anti-c |
| The specificity of the antibody in Warm autoimmune hemolytic anemia (WAIHA) is most often associated with which of the following blood group systems? ABO, Kell, Kidd, Rh | Rh |
| What is the most important consideration in patient suffering from life-threatening anemia and whose serum contains warm autoantibodies? | Exclude the presence of alloantibody(ies) |
| the serum and eluate from a male patient with a 3+ DAT on alpha-methyldopa therapy demonstrates anti-e specificity.The patient denies knowledge of having received blood transfusions. To determine whether the anti-e is an auto- or alloanti-body, one should | Type the patient's red cells with a low-protein anti-e reagent |
| A patient has a 2+ mf DAT with anti-IgG. He was transfused 1 week ago with 2 units of RBCs during surgery. His eluate would most likely contain | an alloantibody |
| How is cold hemagglutinin disease (CHG) different from paroxymal cold hemoglobinuria (PCH)? | The offending antibody in PCH is an IgG antibody unlike the IgM antibody in CHD |
| If during a Donath-Landsteiner test there is hemolysis in both the test and control tubes at the conclusion of the test, this indicates that the test is | invalid |
| A patient has a positive DAT due to cephalosporin therapy and a negative antibody screening test result. Two units of RBCs have been ordered. In order to crossmatch this patient, one should crossmatch with | Untreated patient's serum and untreated donor cells |
| A patient being treated with alpha-methyldopa has a 4+DAT result. You would expect an eluate from his red cell to react most likely with | All the untreated panel cells tested |
| A patient wit a drug-induced hemolytic anemia has the following DAT results: Polyspecifitc AHG=3+, Anti-IgG=3+, Anti-C3d=0. Which of the following drugs is most likely the cause? Phenacetin, Quinidine, Penicillin,Tolmetin | Penicillin |
| A patient with cold hemagglutinin disease (CHD) has a positive DAT when tested with a polyspecific AHG. Which of the following would most likely be detected on her red cells? IgM, IgG, IgA, C3? | C3 |
| If a patient's red blood cells are DAT+ due to penicillin antibody, the... | eluate will react with penicillin coated red cells |
Created by:
Mwortman
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