Screening, reagents, and nomenclature for blood typing
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| What is the purpose of the blood bank? | recruit donors; collect, store, process, dispense blood/blood components; type, screen, and prep patient and donor blood for xfusion; detect/ID unexpected Abs in recips/preg women; paternity testing; tissue type; database questionable donors
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| Autosomal genes | Found on non-sex chromosomes
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| Immunohematology | Study of blood related antigens, antibodies, and other related factors
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| Phenotype | How the genetic information manifests itself or how it appears.
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| Genotype | the alleles that contribute to the phenotype (dominant or recessive traits)
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| Homozygous | the genotype contains either both dominant or both recessive alleles (not a mixture of genotypes)
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| Heterozygous | the genotype contains both the recessive and dominant alleles
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| Antigen | Foreign substance that combines with with an antibody and causes an immune response in immonocompetent hosts.
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| antibody | a large protein molecule formed in response to an antigen. Interacts specifically with the antigen and is found in blood plasma and body fluids like tears, saliva, and breast milk
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| alloantibody | produced after exposure to geneticcally different (nonself) antigens
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| autoantibody | antibodies produced in response to self antigens
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| affinity | the strength of the bond between antibodies and antigens at a single combining site
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| avidity | the overall strength of several epitopes and antibodies. This is dependent on the affinity, valency, and noncovalent attractive forces.
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| Complement | a series of proteins in the circulation that disrupt cell membranes using either the classical or alternative pathway when sequentially activated
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| agglutination | the clumping together of RBCs or particulates as a result of interaction between antibodies and their corresponding antigens.
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| hemolysis | destruction of red blood cells.
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| potentiators | enhancement media used to adjust the test environment to promote agglutination and enhance ag/ab complex formation
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| What is Landsteiner's rule? | Normal healthy individuals possess ABO antibodies to the ABO blood group antigens absent from their red cells.
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| What is the purpose of red blood cells in transfusion? |
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| What is the job of the blood bank? | recruit donors; collect, store, process, dispense blood/blood components; type, screen, and prep patient and donor blood for xfusion; detect/ID unexpected Abs in recips/preg women; paternity testing; tissue type; database questionable donors
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| dominant genes | a trait or characteristic that will be expressed in the offspring even though it is carried on only one of the homologous chromosomes
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| recessive genes | a trait or characteristic that will not be expressed in heterozygotes, expression only occurs when inherited in the homozygous state
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| codominant genes | a pair of genes which neither is dominant over the other so they are both expressed.
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| Bombay phenotype | this is hh also known as Hnull or Oh.
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| What is the defect in the Bombay phenotype? | Classical lack the H antigen while para have a very weak form of A and B which can only be detected via special procedures
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| Rank H substance from greatest to least H substance in ABO systems | O>A2>B>A2B>A1>A1B
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| Translate D gene (Fisher-Race) to Wiener | R = dominant, r = no D gene (also seen as d)
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| Translate DCe to wiener | R1
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| Translate dCe to wiener | r'
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| Translate DcE to Wiener | R2
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| Translate dcE to Wiener | r"
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| Translate DCE to Wiener | Rz
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| Translate dCE to Wiener | ry
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| Translate Dce to Wiener blood factor symbols | Rh0hr'hr"
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| Translate DCe to Wiener blood factor symbols | Rh0rh'hr"
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| Translate DCE to Wiener blood factor symbols | Rh0rh'rh"
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| Translate DcE to Wiener blood factor symbols | Rh0hr'rh"
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| Translate dce to Wiener blood factor symbols | hr'hr"
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| Translate dCe to Wiener blood factor symbols | rh'hr"
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| Translate dCE to Wiener blood factor symbols | rh'rh"
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| Translate dcE to Wiener blood factor symbols | hr'rh"
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| What to reactions are you looking for to determine if an antigen-antibody reaction occurred? | Agglutination and hemolysis
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| What is in the Rh control anti-sera? | Rh control anti-sera has the same constituents as anti-D anti-sera, except the anti-D components have been removed.
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| What is the purpose of the Rh control? | Makes sure that there is no agglutination taking place independent of the D antigens.
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| What can be used in place of the Rh control anti-sera if it is unavailable? | Saline works as a reagent for the Rh control if the anti-sera is unavailable.
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| When is weak D testing performed? | in neonates (determines whether the mother needs RhIg) and when donor red cells do not directly agglutinate with anti-D reagents.
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| What is Anti-A1 lectin made from? | Dolichos biflorus
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| What is Anti-H lectin made from? | Ulex Europaeus
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| What is Anti-N lectin made from? | Vicia graminea
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| What is Anti-M lectin made from? | Iberis amara
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| What are the 10 quality essentials in blood banking? | Organization, Personnel, Equipment, Supplier Issues, Process Control, Docs and records, Occurrence Management, Internal Assessment, Process Improvement, Facilities and Safety
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| What is differential DAT testing? | monospecific AHG used to determine whether patients' red cells are sensitized with IgG, complement, or both.
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| What blood type is the "Universal Donor"? | O Negative (this blood can go to ANYONE)
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| What blood type is the "Universal Recipient"? | AB Positive
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| What is Low Ionic Strength Solution? | LISS is a potentiator that can cells can be incubated with to increase the rate of antibody binding to specific antigen receptors on the red blood cells
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| What is Bovine Serum Albumin? | BSA is a potentiator that allows antibody sensitized red cells to come closer together than is possible in saline medium.
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| What is Polyethylene glycol? | PEG is a potentiator that removes water molecules in the test environment to allow a greater probability of collision between antigen and antibody. Can only be used in indirect antiglobulin testing and only with Anti-IgG.
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| What are proteolytic enzymes? | These are potentiators that modify RBC membranes by removing the negatively charged molecules, reduce zeta potential and enhance agglutination. Enhances Rh, Kidd, and Lewis
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| What are potentiators? | Potentiators are reagents that enhance the detection of antibodies by adjusting the in vitro test environment to promote agglutination
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| What does DAT stand for? | Direct Antigen Test
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| What does IAT stand for? | Indirect Antigen Test
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| What is IAT? | a test to determine in vitro sensitization of RBC used to detect incomplete antibodies to potential donor RBCs or screening cells in serum, determine RBC phenotype using known antisera, and titrate incomplete antibodies.
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| What is anti-I? | A common group IV ABO discrepancy that causes cold autoantibodies.
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| Group I discrepancies | occur due to weak reacting or missing antibodies meaning the patient had decreased or absent antibody production.
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| How is group I discrepancy resolved? | incubate reverse grouping (plasma) at RT or 1-6 C for 5 mins or add 2 more drops of plasma.
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| Group II discrepancies | occur due to weak reacting or missing antigens (not common)
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| How are group II discrepancies resolved? | use anti-A1 lectin, check the Dx (hodkins or leukemia may affect it), or wash the cells
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| Acquired B antigen | A group II discrepency caused by intestinal disorders and resolved by acidifying anti-B reagent to pH of 6.
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| Group III discrepancies | occur due to protein or plasma abnormalities or increased levels of globulin (cause rouleaux)
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| How are Group III discrepancies resolved? | wash the cells extra times or add 1-2 drops of saline to plasma
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| Group IV discrepancies | caused by polyagglutination RBCs coated with antibody, additives to antisera, unexpected isoagglutinins, Cis-AB, unexpected antibodies, and cold autoantibodies
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