Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
ASCP MT BB
ASCP BB MT Test Study
| Question | Answer |
|---|---|
| Antibody Characteristics: Naturally Occurring | ABO, Lewis, P1, MS, Lua |
| Antibody Characteristics: Clinically Significant | ABO, Rh, Kell, Duffy, Kidd |
| Antibody Characteristics: Warm Antibodies | Rh, Kell, Duffy, Kidd |
| Antibody Characteristics: Cold Antibodies | M, N, P1 |
| Antibody Characteristics: Usually only react in AHG | Kell, Duffy, Kidd |
| Antibody Characteristics: Can react in any phase of testing | Lewis |
| Antibody Characteristics: Enhanced by enzyme treatment | Rh, Lewis, Kidd, P1 |
| Antibody Characteristics: Not detected by enzyme treatment | M, N, Duffy |
| Antibody Characteristics: Enhanced by acidification | M |
| Antibody Characteristics: Show dosage | Rh (other than D), MNS, Duffy, Kidd |
| Antibody Characteristics: Bind complement | I, Kidd, Lewis |
| Antibody Characteristics: Cause in vitro hemolysis | ABO< Lewis, Kidd, Vell, some P1 |
| Antibody Characteristics: Labile in vivo & in vitro | Kidd |
| Antibody Characteristics: Common cause of anamnestic response (delayed transfusion reaction | Kidd |
| Antibody Characteristics: Associated w paroxysmal nocturnal hemoglobinuria | Anti-P1 |
| Antibody Characteristics: Associated w cold agglutinin disease & Mycoplasma pneumoniae infections | Anti-I |
| Antibody Characteristics: Associated w infectious mononucleosis | Anti-i |
| Ag-Ab Enhancement: Albumin | 22% bovince serum albumin. Reduces net neg charge of RBCs, allows them to come closer together |
| Ag-Ab Enhancement: Low ionic strength solution (LISS) | Lowers IS of suspending medium >allows ags &abs to move closer together more rapidly. Reduce inc time for IAT |
| Ag-Ab Enhancement: Polythyleneglycol (PEG) | Inc ab uptake. Used for detection & ID of weak IgG abs. |
| Ag-Ab Enhancement: Enzymes | Ficin & Papain most common. Reduce RBC surface charge by cleaving sialic acid molecules. M, N, S, Fya, Fyb ag destroyed |
| Antigens destroyed by enzymes | M, N, S, Fya, Fyb |
| DAT | Direct Antiglobulin Testing. Detects in vivo sensitization of RBC's by IgG ab. EDTA red cells. Application: HDFN, tf rxn, autoimmune hemolytic anemia, drug-induced hemolytic anemia. |
| DAT: False Positives | Complement binding in vitro (RBCs from red top tube & broad-spec AHG) Septicemia Contamination of specimen Wharton's jelly in cord blood Over-reading Overcentrifugation |
| DAT: False Negatives | Interruption in testing Contamination, improper storage, or outdating of AHG Failure to add AHG Neutralization of AHG from inadequate washing Dilution of AHG by residual saline Over- or undercentrifugation |
| IAT | Indirect Antiglobulin Testing. Detects in vitro sensitization of RBCs by IgG ab. Serum, Plasma, RBCs Application: Ab screen, xmatch, RBC phenotyping, weak D testing |
| IAT: False Positives | Cells w pos DAT Overcentrifugation |
| IAT: False Negatives | Interruption in testing Contamination, improper storage, or outdating of AHG Failure to add AHG Neutralization of AHG from inadequate washing Dilution of AHG by residual saline Over- or undercentrifugation Over- or underincubation |
| Incom. XM Reactions: Neg ab screen, incom IS | Possible Cause: ABO incompatibility (retype donor & recipient. XM w ABO-compatible donor.) |
| Incom. XM Reactions: 1 ab screening cell & 1 donor pos in AHG | Possible Cause: Alloantibody (Identify ab. XM units neg for corresponding ag.) |
| Incom. XM Reactions: Ab screening cells & all donors except 1 neg at 37*C & in AHG. 1 donor pos in AHG only | Possible Cause: Positive DAT on donor (perform DAT on unit. If pos, return to collecting facility.) |
| Incom. XM Reactions: Ab screening cells, donors, & autocontrol pos in AHG | Possible Cause: Warm autoantibody (Best not to tf. If unavoidable, find 'least incompatible' unit. May require in vivo XM.) |
| Incom. XM Reactions: Ab screening cells, donors & autocontrol pos at 37*C, neg in AHG | Possible Cause: Rouleaux (saline replacement technique) |
| Transfusion-Associated Infections | Testing: HIV, Hep B, Hep C, HTLV-I and -II, Syphilis Hx: Malaria (Plasmodium RBCs), Babesiosis (Babesia RBCs), Chagas' disease (Tryppanosoma cruzi RBCs) Selected donor testing: Cytomegalovirus (LRP or CMV= for at risk pts. Testing & Hx: Sepsis |
| Acute Immunologic Transfusion Reactions: Hemolytic, intravascular | Signs: Fever, chills, shock, renal failure, DIC, pain (chest, back, flank) Cause: Immediate destruction of donor RBCs by recipient ab Other: HGB in urine & serum, mixed field DAT |
| Acute Immunologic Transfusion Reactions: Febrile | Signs: Temp up 1*C/2*F Cause: Anti-leukocyte abs or cytokines Other: Common. May premedicate with antopyretics (aspirin, acetaminophen). |
| Acute Immunologic Transfusion Reactions: Allergic | Signs: Hives (urticaria), wheezing Cause: Foreign plasma proteins Other: Common. Treat w antihistamines, Tf Rxn not required. |
| Acute Immunologic Transfusion Reactions: Anaphylactic | Signs: Pulmonary edema, bronchospasms Cause: Anti-IgA in IgA-deficient recipient Other: Rare, but dangerous. Treat w epinephrine. Tx w washed products. |
| Acute Immunologic Transfusion Reactions: Transfusion-Related Acute Lung Injury (TRALI) | Signs: Fever, chills, coughing, respiratory distress, fluid in lungs, decrease BP within 6 hr of tf. Life Threatening. Cause: Unknown. Possible donor abs to WBC ags. Other: Most common cause of tf-related deaths in US. Reduce F plasma donors. |
| Acute Nonimmunologic Transfusion Reactions: Sepsis | Signs: Fever, chills, dec BP, cramps, diarrhea, vomiting, muscle pain, DIC, shock, renal failure Cause: Bacterial contamination Lab: Pos gram stain & culture on unit |
| Acute Nonimmunologic Transfusion Reactions: Transfusion-associated circulatory overload (TACO) | Signs: Coughing, cyanosis, diff breathing, pulmonary edema Cause: Too lg volume or too rapid rate of infusion Lab: None Other: Problem in children, cardiac & pulmonary patients, elderly, & those w chronic anemia |
| Acute Nonimmunologic Transfusion Reactions: Nonimmune hemolysis | Signs: Variable Cause: Destruction of RBCs due to extremes of temp, addition of meds to unit Lab: Hemoglobinuria, hemoglobinemia Other: |
| Acute Nonimmunologic Transfusion Reactions: Hypothermia | Signs: Cardiac arrhythmia Cause: Rapid infusion of lg amts of cold blood Lab: None Other: Use blood warmer for rapid infusions |
| Delayed Transfusion Reactions (Immunologic): Hemolytic, extravascular | Signs: Fever, anemia, mild jaundice 2-14 days after tf Cause: Donor RBCs sens by rec IgG ab & removed from circulation Lab: Inc bili, m-f DAT, d hapto, d Hgb & Hct, pos ab screen Other: Maybe due to anamnestic resp. Kidd ab most com. Not life threat. |
| Delayed Transfusion Reactions (Immunologic): Alloimmunization | Signs: None, unless subs exposed to same foreign ag Cause: Develop abs to for. RBC, WBC, PLT, FFP proteins after tf Lab: Ab to RBC detected in ABSC. Others need special testing Other: Use LRP for patients with WBC abs. |
| Delayed Transfusion Reactions (Immunologic): Transfusion-associated graft-vs-host disease (TA-GVHD) | Signs: Rash, nausea, vomiting, diarrhea, fever, pancytopenia. Usually fatal Cause: Viable T lymphs in donor blood attack rec Lab: None Other: IRR - for babies, fetus, immunocompromised, transplants, blood from relatives, leukemia/lymphoma |
| Delayed Transfusion Reactions (Nonimmunologic): Iron overload | Signs: Diabetes, cirrhosis, cardiomyopathy Cause: Build up of Iron in body Lab: Inc Serum Ferritin Other: Problem for pts rec repeated tf over long time (pts w thalassemia, sickle cell anemia, other chronic anemias) |
| TRXN Investigation: Signs and Symptoms | TRXN Investigation: Fever, chills, resp distress, hyper/hypo tension, pain (back, flank, chest, abdom), pain at site of infusion, hives (urticaria), jaundice, hemoglobinuria, nausea/vomiting, abn bleeding, oliguria/anuria |
| TRXN Investigation: Specimens Needed | TRXN Investigation: Pre-tf blood, post-tf blood, post-tf urine, segment from unit, blood bag with admin set & attached IV solutions |
| TRXN Investigation: Immediate Steps | TRXN Investigation: Stop TF, Check all IDS and labels, Repeat ABO on post tf blood, visual check pre and post blood for hemolysis, DAT on Post tf blood (if POS, DAT on Pre) |
| TRXN Investigation: Signs of Hemolytic Rxn | TRXN Investigation: Hemolysis in post but not pre (repeat post draw avoiding mechanical hemolysis). M-F agglutination in DAT on Post but not on Pre. |
| TRXN Investigation: Further steps if possible hemolytic rxn | TRXN Investigation: Check HGB in 1st voided urine post tf. Repeat ABO & Rh on pre, post, and unit. Repeat ABSC on pre & post. AHG XM w pre & post. |
| TRXN Investigation: Addtl tests that may be performed | TRXN Investigation: Haptoglobin (dec w hemolysis), gram stain & culture of unit, bilirubin 5-7 hrs after tf (sign of extravascular hemolysis), BUN & creatinine (sign of renal failure). |
| TRXN Investigation: Reporting of Transfusion-related fatalities | TRXN Investigation: Must be reported to FDA Center for Biologics Evaluation & Research (CBER) by phone or e-mail ASAP |
| Neonate Testing (<4 months) | ABO & Rh: ASBC: XM: |
| Hemolytic Disease of the Fetus and Newborn (HDFN) |
Created by:
toothteet
Popular Laboratory Science sets