ASCP BB MT Test Study
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| 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) |
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
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
Created by:
anb060708
Popular Laboratory Science sets