Immunohematology

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pineset
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Immunohematology
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2010-05-25 05:12:06
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Blood bank flashcards
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Blood Bank & Hematology
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  1. What is the minimum age one must be to donate blood?
    17
  2. What is the temp and bood pressure one must have to donate blood
    • 37c or 99.5 F
    • 180/100
  3. What must the hct and hgb of one who wants to donate blood be?
    • > or = to 38g% hct
    • >or = to12.5g% hgb
  4. WHAT SHOULD THE PULSE AND WEIGHT BE OF ONE WHO WANTS TO DONATE BLOOD?
    • 50-100
    • 110lb/50kg
  5. Name the common blood anticoagulants & the the expirations for each?
    • CPD-(citrate, phosphate, dextroxse) 21day expiration
    • CPDA-1 (adenine added) 35 day expiration
  6. what is antologous donations?
    donations for self
  7. What is the hct and hgb of the antologous donor?
    • Hct 33%
    • Hgb 11g
  8. Define absorption(one of the methods for hemaphersis/apheresis collectiion)?
    the removal of only a selected constituent of plasma with reinfusion of plasma after constituent removed
  9. why is whole blood rarely used for transfusion?
    Due to the increased use and availabilty of components
  10. When is whole blood given?
    in cases of shock needing the rbc's for oxygen and the plasma for volume
  11. How is plasma removed from rbc's?
    by successive saline washes
  12. what do washed red cells prevents?
    allergic response to plasma proteins and anaphylactic shock in IgA deficient pts. with anti-IgA
  13. Where is Iga found?
    in normal plasma
  14. What is the preferrred way for wbc's prepared?
    by filtration and washing will remove wbcs too
  15. How must frozen cells be thawed?
    37C
  16. When do frozen cells expire?
    10 yrs.
  17. What is the storage of frozen cells?
    at -65C or colder; 1-6C for 24hrs. after deglycerolizing
  18. What is the expiration of fresh frozen plasma?
    • 1 yr. from date of collection when stored at < or equal to -18C or colder or 7yrs. stored at<or equal to
    • -65C
  19. When do thawed FFP expire?
    in 24 hrs. if kept at 1-6C
  20. What must be FFP be compatible with?
    ABO compatible with recipient cells
  21. What forms when FFP frozen within 8hrs. of whole blood collection is thawed at 1-6C ?
    a cold insoluble portion of plasma forms called CRYO(cryoprecipitate)
  22. When should CRYO be transfused?
    within 6hrs of thawing; 4hrs after pooling
  23. What is cryoprecipitate used for?
    fibrinogen and factor XIII deficiencies severe von Willebrand disease topical fibrin sealant
  24. What is CRYO seldom used for?
    hemophilia because of factor VIII concentrates which have little or no risk of viral infection transmission
  25. From what are platelets prepared and tell the temp for storage?
    whole blood and stored at 20-24C prior to processing
  26. Explain the prepartion procedure of platelets
    first spin lightly to remove rbc then spin heavy to spin down platelets and wbcs the supernatant plasma expressed in another bag and may be frozen the remaining plasma, platelets, amd wbcs=platelet concentrate
  27. What should one unit of platelet raise the platelet count to?
    5,000-10,000 in an average size adult
  28. What should you not transfuse platelets through?
    mircroaggregate filter
  29. What should platelets be checked for before issuing?
    bacteria
  30. What is the coagulation factor in intrinsic pathway that APTT is not a screening test for
    factor XIII
  31. Coagulation factor decreased in Hemophilla A?
    Factor VIII
  32. Coagulation factor decreased in Hemphillia B?
    Factor IX
  33. Temp of FFP for performance for coag.
    37C (35-38C)
  34. Factors that may lose activity and least stable in vitro at room temp after 4-8hrs.
    Factor V & VIII
  35. the length of time APTT specimen can be held at room temp
    no more than 4 hrs.
  36. What indicates loss of precision with increase in SD and coefficient of variation?
    shift, trends, increased scatter on quality control plot
  37. If new lot of controls for PT has a mean of 12.2; SD of 0.4 sec what is the control ranges?
    11.4 to 13.0 sec
  38. what is itthe cause of Clumping of wbcs and platelets on wright stain peripheral blood smear
    smear made from 1hr. old heparinized blood
  39. What Adjustment is made when specimen has very low hematocrit
    increase angle of spreader slide higher than normal 30-45 angle results in thcker slide
  40. A cause of black purplish precipitate over slide
    insufficient rinsing of stain and buffer mixture
  41. formula for MCV (mean corpusucular vol.)
    • HCT x 10
    • RBC
  42. Formula for MCHC (mean cell hemoglobin concentration)
    • hgb x100
    • Hct
  43. Miller Disc calculation for retic # count
    • total retics in square A x100
    • total retics in square B x 9
  44. RPI (retic production index) calculation
    • Retic % x pt. hct/normal hct(0.45)
    • maturation time in peripheral blood(2)
  45. most likely Conditions seen when schizocytes seen blood smear
    severe burns megaloblastic anemia mircoangiopathic hemolytic anemia
  46. RBC morphology on peripheral blood smear of alcoholic with cirrhosis
    • Pseudomacrocytosis acanthocytes codocytes
    • (seen in alcoholic cirrhosis)
  47. What cell has single nucleolus marked cytoplasmic granularity cytoplasmic blembs and may be seen in myeloproliferative disorders(CML, AMM, etc.)?
    micromegakaryocytes
  48. What cells have the background of peripheral blood smear stained Rommawsky that appear very blue eccentric nucleus and perinuclear
    plasma cells
  49. Test used for differentation of HBF and HbA doesn't migrate in S region
    Alkali denaturation
  50. Test in useful procedure for fractionation of various hemoglobins?
    acid electrophoresis
  51. Test for sickling hgb nd don't differentiate between those and hgb S
    Hgb solubility
  52. Cells seen in falsely elevated G6PD assay using flourescent spot test seen in these types of pts.
    presence of reticulocytes
  53. identifies abnormal hgb such as S & C
    hgb electrophoresis
  54. Screening test for PNH (paroxysmal nocturnal hemoglobinuria)
    sucrose hemolysis test
  55. test that identifies some rbc enzyme deficiencies
    fluorescent spot tests
  56. test that identifies pts with a minority population of spherocytes
    incubated osmotic fragility test
  57. Define hematopoiesis
  58. where is excess iron stored
    tissues and body organs
  59. the iron transport protein
    transferrin
  60. define ferritin
    the major iron storage form
  61. define hemosiderin
    water insoluble iron storage form (long term)
  62. the color & what is responsible for color seen in porphyrias
    purple pigment is responsible for the wine red colr of porphyrin in urine
  63. test tube # for gross examination cell count morphology
    #3
  64. test tube for microbial examination
    #2
  65. test tube for chemical and serological examination
    #1
  66. gross examinatiion findings fo CSF and its diagnosis:
    Increased fibriongen
    subarachnoid hemmorrhage
    subarchnoid hemmorhage more than 12hrs. after bleed
    pleocytosis
    • gel formation
    • grossly bloody specimen
    • xanthochromia (yellow color)
    • cloudy and turbid
  67. microscopic findings with its conditions:
    Lymphocytosis
    increased segmented neutrophils PMNs
    macrophages
    extremely elevated wbc count in CSF
    normal WBC reference range for CSF
    • viral infection
    • bacterial infection
    • CNS leukemia or lymphoma
    • intraventricular rupture of brain abscess
    • 0-5 x106L
  68. covers abodominal walls and viscera of abdomen
  69. covers the lungs
  70. A fibrous sac around the heart
  71. condition associated with pleural effusion
    viral pneumonia
  72. Male production structures and their constituents:
    Testicle
    seminal vesicles
    prostate
    cowper's glands
    • sperm
    • fructose/prostagladins
    • p30glycoprotein
    • unknown
  73. sperm motility can become decreased if specimen is
    stored at room temp and in a plastic container for more than 1hr, examined after 2hrs. of storage
  74. normal value ranges of sperm cells is
    60-150 x 10L
  75. what do arthrocentesis test for
    tests for infectious disease
  76. name the abnormal crystals
    cystine, cholesterol, leucine, tyrosine
  77. Tell what color urine will one see if pt has the following substance:

    HgB, myoglobin, rbcs, beets, PSP dye, food with dyes
    bilirubin or medication and normal color
    pyridium
    normal
    melanin, methemoglobin, methydopa, or homogentic acid
    Pseudomonas spp (pigment producing bacteria)
    BSP dye
    • Red
    • yellow brown to amber
    • orange
    • yellow
    • brown
    • blue green
    • bright or dark blue
  78. The major functional unit of the kidneys
    nephron
  79. Takes place in the kidneys
    reabsorption
  80. Refigeration of urine may result in the precipitation of what crystal
    amorphous
  81. Urine should sit for a minimum of __________ in order to come to room temperature
    15 minutes
  82. The fruity odor in urine is most likely indicative of the presence of
    ketones
  83. the normal specific gravity of urine
    1.002-1.005
  84. the largest most frequent seen epithelial cells
    squamous
  85. the normal sperm count #'s
  86. fluid analyzed for fetal lung maturity(FLM)
    amnoitic
  87. tests which is most valuable assay for the assessment of fetal pulmonary maturity
    L/S lecithin sphingomyelin ratio
  88. body fluid used to diagnose cystic fibrosis
    sweat
  89. describes pink orange or yellow coloring of CSF
    xanthochromia
  90. Diazo reaction used to produce blusish purple color for which element of urine
    ketones
  91. the principle dipstick reaction for nitrate
    gressis's
  92. mature fetal lungs reflect a L/S ratio of
    >2.0
  93. T3 and T4 are produced in the
    thyroid
  94. Hgb A1C used to monitor the average glucose over a period of
    2 months
  95. the urobilinogen's principle that uses paradiamethylaminobenzaldehyde in acid buffer which reacts with itself to produce a peach to pink color is called
    ehrlich's
  96. Crystals that are 3 dimensional forms are
    CPPD crystals
  97. Increased % of segmented neutrophils PMNs) is characteristic of
    basic calcium phosphate crysals
  98. Identify the crystal that goes with the following disorders:
    Chronic renal disease
    chronic rheumatoid effusions
    Acute and chronic arthritis
    Acute gouty arthirtis
    • calcium oxalate
    • cholesterol
    • lipid liquid Maltose cross
    • monosodium urate
  99. Disorders that can be diagnosed definitvely by synovial fluid analysis are
    gout CPPD deposition disease and septic arthiritis
  100. Aspiration sites for synovial fluid
    posterior iliac crest
  101. if a synovial fluid aspirate is very turbid and septic arthiritis is suspected a ________ should definitely be performed
    gram stain and culture
  102. normal CSF contains these cells
    lymphocytes and ependymal cells
  103. cell count on CSF specimen should be performed within _________ of collection
    one hour
  104. Clotting in CSF may be caused by
    increased protein concentration
  105. increase total WBC count in CSF specimen can be caused by
    bacterial meningitis and intravascular rupture of a brain abscess
  106. increase in lymphocytes in CSF specimen can be caused by
    mutiple sclerosis, viral meniagoencephalitis, fungal meningitis
  107. characteristic of effusion
    abnormal accumulation of fluid can be a transduate or exudate
  108. transudate description
    specific gravity <1.016 PH 7.4-7.5 lactic dehydrogenase <200 IU/L
  109. Exudate apperance of disorders:
    Empyema
    infectious process
    anaerobic bacterial infection
    chylothorax
    malignancy in the absence of trauma
    • clearly visible pus
    • yellow and turbid
    • foul odor
    • milky
    • bloody
  110. the pleural fluid can have white supernatant fluid after centrifugation owing to
    presence of chylomicons
  111. extremely elevated wbc concentration in pleural fluid is typically associated with
    empyema
  112. cells seen in pleural fluid
    LE cells mononuclear phagocytes mesothelial cells
  113. characteristics of malignant cells
    smooth chromatin
  114. the cellular abnormality encountered in pleural and peritoneal and its disorders is
    acute bacterial inflammation
  115. condition seen when many lymphocytes, mesothelial cells, histocytes and plasma cells
    viral infection
  116. in a pleural effusion the % of __________ is extremely high in pneumonia and % of _______ is extremely high in viral peritonitis
    segmented neutrophils
  117. abnormal appearing peritoneal effusion can be caused by
    tuberculous peritonitis
  118. conditon that goes with the following peritoneal effusion colors is:
    pale yellow
    straw colored
    bloody
    • normal
    • congestive heart failure
    • pulmonary infarct
  119. extemely high wbc concentration in peritoneal fluid can be caused by
    bacterial peritonitis
  120. the following abnormalities may cause an increase in what cell:

    chronic peritoneal dialysis
    conjestive heart failure
    cirrhois and nephrotic syndrome
    turberculous peritonitis
    • eosionophils
    • lymphocytes
    • mesothelial cells
  121. match the various types and causes of pericardial effusion:

    infectious agents
    collagen vasular disease
    no plastic disease
    • coxsackie group viruses
    • rheumatic disease
    • mesothelioma
  122. a cause of an increase concentration of cells in pericardial fluid
    microbial infection and malignancy
  123. what is the plasma changes during storage (1-6)
    increase potassium and ammonia and decrease pH and sodium
  124. tranport temp of blood and components:
    red cells
    platelets and granulocytes
    frozen components
    • 1-10
    • 20-24
    • kept frozen
  125. Expiration of blood and components when seal is broken
    • products stored at 1-6c=24hrs
    • products stored at 2-24c=4hrs.
  126. blood components and the storage temp and amt. of time
    rbcs(packed cells)
    wbc reduced cells
    frozen red cells
    FFP
    platelets, single donor
    platelets, pheresis
    granulocytes
    • 1-6 21 days (closed); 24 hrs open
    • 1-6
    • 10yrs. -65C
    • 12 months < or equal to -18C
    • 3/5 days
    • 4hrs, 20-24C
    • 5 days 20-24C
    • 24 hrs. 20-24C
  127. what is the expiration of pooled components
    • platelets 4 hrs (open)
    • cryoprecipitate 4 hrs (open)
  128. when can unit of blood not be reused or reissued
    if >10c (15 or 30 min.)or if seal disturbed
  129. in the ABO system what are the subgroups of A
    A1 (aggluntinated) and A2(not aggluntiated)
  130. define lectin
    plant or seed extract diluted to agglutinate specific human blood group antigens
  131. when there is lack of H this is genetically________
    hh (Bombay phenotype)
  132. what problems might one see in ABO grouping
    • rouleaux-failure to wash cells
    • mixture of cell types ex. A or B transfused with O cells
    • subgroups ex. A2 with or without Anti-A1
    • unusual genotypes ex. bombay
    • disease process-ex. leukemia or bacteria
  133. what problems might one see with ABO grouping with serum
    • rouleux- due to increased serum proteins ex Waldenstrom's or Muptiple Myeloma
    • room temp or cold reacting antibody reacting with their corresponding antigens on reverse cells
    • age-elderly (antibody production decreased) or newborn (antibody production hasn't reached optimm level); missing antibodies
    • compromised immune system-ex. A/hypohgammaglobulinemia
  134. what are the cold reacting antibodies
    H, I, M, N, P1, or Lewis
  135. describe rouleaux
    a stack of coins apperance when observed under microscope occurs when the serum in the test mixture is replaced with saline, and the cells dissociate; it is associated with mutiple myeloma and Waldenstrom's macroglobulinema
  136. in the Rh system what are the antigens
    D C E c e
  137. what is the most immunogenic of all blood group antigens
    D
  138. what is the D grouping (RH type) based on
    presence or absence of D when tested with anti-D
  139. Describe weak D
    it is D reactive at antiglobulin phase only, weak D considered D positive, testing for weak D required on donors aned OB pts.
  140. what is the most common cause of a positve D control
    there is a positve DAT
  141. for D negative grouping to be valid what must the D control be
    negative
  142. name the unusual phenotypes
    • RH null- no D, C E c or e antigens
    • deleted cells (-D-)
  143. Are RH antibodies IgG or Igm significant
    IgG
  144. how may RH antibodies aggulinate
    at 37c and AHG
  145. which RH antibodies react stronger with enzyme treated cells
    Anti C c E e
  146. name all the IgM cold antibodies
    anti I i M N P1 Lea Leb H
  147. name all the IgG antibodies
    anti D C c E e M(some) K k Fya Fyb Jka Jkb
  148. what is the second most immunogenic antigen
    K (kell) antigen
  149. Describe Lewis blood group
    • plasma antigens that absorb onto rbcs
    • not on cord cells
    • antibodies don't cause HDN but can be hemolytic
  150. Describe I, i blood group
    • absent or weak on cord cells
    • i converts to I as infant matures due to branching of carbohydrate chains
    • infants i pos. I neg and adults I pos i neg
    • the antibodies: react with all adult cells (except rare i adults)
    • may mask clinically significant alloantibody
  151. describe P blood group
    • antigen strength deteriorates upon storage
    • antibodies: anti P1 can be neutralized to reveal other significant alloantibodieis
    • anti P found in PCH (paroxysmal cold hemoglobinuria and reacts with all P or P1 positive cells
  152. describe MNS
    • M&N are codominant alleles with no HDN will not react with enzyme treated cells
    • (are destroyed by enzymes)
    • anti M:may be IgG and cause HDN may require acidification of serum to identify
    • Anti U: is IgG and formed by black individuals who lack S or s and U
  153. describe Kell
    • K&k are codominant
    • 91% are K neg.
  154. describe Kidd
    • Jka & Jkb condominant
    • react stronger with enzyme treated cells
    • associated with delayed transfusion reactions
  155. describe Duffy
    • Fya & Fyb are condominant
    • 68% of african americans are Fy(a-b-)
    • antigens detroyed by enzymes and
    • antigen typing -Fy(a t b-) white- homozygous for Fya (FyaFya) blacks-proabably heterozygous for Fya(FyaFy-)-dosage problem
    • antibodies- weak ex. may show dosage and neg. reaction with enzyme treated cells
  156. what is a direct exclusion of determining paternity
    marker present in child but absent from father and mother
  157. what is indirect exclusion
    in paternity the child lacks a marker that the alleged father do(must) transmit ex. father has anti K but child and mother doesn't but child and mother has anti k but father doesn't
  158. is the father excluded if from the test below
    father: KK
    mother: kk
    child:Kk
    no father is not excluded
  159. Screening cells contain ____ different cells and panels contain ___________ cells
    • 2-3
    • 10-20
  160. describe panel and screening cells
    • commerically prepared group O red cells with specific distribution of blood group antigens
    • pt. serum added to the cells and tested at various temps, different enhancement media, with antiglobulin reagent(IAT)
  161. what is autocontrol
    pt. serum tested against own cells to determine the presence of autoantibody
  162. describe low ionic strength saline(LISS) & enzymes
    • increases antibody uptake allowing decrease in incubation time
    • removes sialic acid that decreases neg. charge and promotes cells aggluntination
    • increase reactivity of RH kidd and lewis antibodies
    • usually increases warm and cold autoantibodies
    • destroys M, N S and dufffy antigens
  163. describe IAT
    • indirect antiglobulinr testing
    • the antibody that attaches to corresponding antigen on red cells at 37c
    • the excess serum/antibody removed by saline washes
    • antiglobulin is added and bind to antibody on the cells
  164. in IAT what may failure to adequately wash cells cause
    false neg.-human globulins antibodiesl proteins, not wash away will neutralize the AHG
  165. what is a pos. reaction indicative of in the IAT
    aggluntination or decrease in size of button due to hemolysis at 37c
  166. what should check cells (IgG sensitized cells ) be in IAT
    positive indicating AHG was actually added in the final step and not neutralized
  167. Name the enhanced and detroyed enzyme treated antibodies
    • Enhanced: Kidd, I and some Rh (not D)
    • Destroyed: duffy, MN and S
  168. most panels with 1+ or 3+ reactions are indicative of
    two different antibodies
  169. what may be indicative if autocontrol is pos.
    a delayed transfusion reaction or if along with all panel cells autoantibody indicated
  170. name the enzymes
    bromelin ficin papain trypsin
  171. name the antigen dosages
    MNS Rh(other than D) kidd duffy(weak ex. mahy show dosage)
  172. the enhanced enzymes
    kidd RH lewis I
  173. destroyed enzymes
    Duffy MNSs
  174. antigens that are absent and present on cord cells
    • present i
    • absent I Lewis Sda
  175. name the RH antibodies and the class
    anti D C E c e; IgG
  176. Igm are what type of antibodies
    warm 37c antibodies
  177. IgG are whatg type of antibodies
    Cold antibodies
  178. name the IgM using polyspecific antibodies
    complement binding anitbodies: anti I anti Lea and Leb
  179. 37c IgG uses what enhancement
    LISs/albumin or AHG
  180. cold IgM antibodies uses what enhancement
    saline
  181. what antibodies can be seen directly at 37c (IgG)and which ones must see when using antiglobulin testing
    • RH antibodies
    • Kell Duffy and Kidd
  182. what do EDTA chelates
    Calcium preventing complement activation by plasma antibody causing a false pos. DAT
  183. describe DAT
    • direct antiglobulin testing
    • antiglobulin added to washed red cells
    • if cells coated in vivo the antiglobulin reacts with the IgG antibody or complement(depends on AHG used)
  184. how many times do you wash red cells(blood) before adding AHG
    4x
  185. when do you add check cells in DAT procedure
    add to all negative antiglobulin tests in antibody detection and compatibilty testing
  186. what are the autoimmune hemolytic anemia conditions
    • warm autoantibodies WAIHA
    • cold hemagglutinin disease CHD
    • mixed type AHA
    • paroxysmal cold hemoglobinuria PCH
  187. what are the drug induced hemolytic anemia DIHA conditions in alloimmune hemolytic anemia
    • HDN hemolytic disease of the Newborn
    • tranfusion reaction
  188. name the AHG reagents -mono/polycolonal
    • polyspecific anti IgG & anti C3d
    • anti IgG
    • anti complement
  189. when should you avoid refrigerating a red top and why?
    before performing the DAT due to anti I may attach to antigen I present on red cells and cause false pos. DAT and will also cause false neg. cold aggluntinin titer since the test measures anti I (cold aggluntinin) in serum
  190. antibodyto human IgG and C3d component of complement
    polyspecific
  191. antibody to IgG or to C3b, C3d
    monospecific
  192. why perform DAT with polyspecific-monspecific
    • To screen
    • to characterize the globulin
  193. why perform IAT with monospecific anti IgG
    TO avoid cold complement binding antibodies
  194. when do you use check cells
    To confirm all neg. antiglobulin tests in antibody detection and compatibility testing when using anti-IgG ; confirms AHG added and not neutralized (insuffcient removal of serum proteins prior to addition of AHG)
  195. define antologous
    pts. own serum and cells
  196. when is absorption used
    • to separate mutiple antibodies
    • remove autoanitbody-reveal alloantibody masked by autoantibody
    • confirm antigen exsistence on RBC
    • confirm antibody specificity
  197. in gel testing if the cells settle at bottom what type of reaction do you have
    neg.
  198. in gel testing if the cells settle at top what type of reaction is this
    pos.
  199. name the pretransfusion tests
    • ABO & D grouping
    • antibody screens
    • crossmatch
    • autocontrol
  200. describe the procedure for crossmatch
    • the patient serum reacts with donor RBCs
    • observe for aggluntination or hemolysis
    • demonstrate ABO compatibilty
    • carry through 37c incubation with AHG if current antibody screen positive or history of clinically significant antibodies
  201. in antigen typing pts. with clinically significant antibodies should recieve what type of units
    antigen neg.
  202. how dou you confirm antigen neg. status
    by reacting cells with commericial preparations of the antibody
  203. what is the appropiate controls for antigen typing of heterozygous cells(ex. anti-K tested with a Kk)
    pos.
  204. what appropiate control is used in antigen control for the cell without antigen
    (ex. anti-K tested with a kk cell)
    neg.
  205. who can O rbc's be given to?
    any blood group
  206. what blood groups can AB group recieve
    A, B and O rbc's
  207. when do D neg. individual get D pos. blood
    in an emergency if no D neg. available
  208. what is the procedure when ABO identical is not available for Rbcs
    • decide what antibody is in pts plasma
    • transfused cells must lack corresponding antigens
    • EX. O recieve O A B AB
    • B recieve B or AB
    • AB recieve AB
  209. what is the procedure when ABO identical is not available for plasma
    • decide what antigen is on the pts. RBCs
    • transfused plasma should lack the corresponding antibody
    • ex.O recieve O
    • A recieve O or A
    • AB recieve O A B AB
  210. ABO grouping is not required unless what?
    giving ABO type not compatible with mother
  211. when is crossmatch not necessary
    if intial antibody screen is neg. using infant or maternal serum or plasma and group O is given
  212. when is repeating test for crosmatch not required
    for infants less than 4 months for any one hospital admission
  213. when should blood products with reduced risk of CMV transmission be used for infants
    If infants are <1200 g at birth and the mother is CMV neg. or CMV status is unknown
  214. A group B pt. needs blood but ABO identical blood is unavailabe what group may be used and why
    group O since B individuals have anti-A and O units have no A antigens or B antigens
  215. A group AB pt. needs blood but ABO identical unavailable what group should be given a and why
    any blood group red cells since AB individuals have no ABO antibodies
  216. what type of blood should not be given for pretransfusion testing
    whold blood
  217. A group O pt. was crossmatched with group B red cells will this incompatibility be defected and why or why not?
    yes the pt. serum contains anti A B AB and will show aggluntination when added to the group B cells
  218. A group B needs FFP which blood group would be acceptable and why or why not?
    a group B pt has B antigens on his red cells no group with anti B will be acceptabe. group B(has anti-A) or AB(has no ABO antibodies) will be fine
  219. A group B neg needs 3 untis of red cells and 1 unit of FFP no B neg rbcs or FFP are available what would be the choice for both components and why
    O neg red cells is the appropriate emergency and no B neg or O neg is available B pos or O pos would be used. The FFP should be AB since group O and A contain anti-B.
  220. four units of O neg rbcs are issued on emergency release to the ER after blood is issued a blood sample and a request for 4 more units is recieved the 4 additional units of O neg rbcs are issued and the type and crossmatch started. the pt. turns out to be A pos. with a neg. antibody screen. the crossmatch with the first 8 O neg units are compatible and the antibody screen neg. the ER calls requesting more units. what ABO/RH group should these next 6 units be?
    pt. should be switched to D pos. blood now; a new sample can be requested and tested for ABO antibodies either with an immediate spin crossmatch or a crossmatch carried through the AHG to detect ABO antibodies
  221. what can be the cause for delayed transfusion reactions
    • hrs. to days after transfusion
    • indicated by no rise or decrease in hemoglobin after transfusion
    • positive DAT
    • often due to Kidd antibodies
  222. what might be the cause of febrile nonhemolytic in transfusion(temp rise )
    • recipient performed antibodies reacting with donor lymphocytes granulocytes or platelets
    • infusion or cytokines in donor bag from storage
    • wbc reduced blood components; prestorage leukoreduction prevents cytokine buildup
  223. what is the single most important diagnostic test after birth for the diagnosis of HDN
    DAT
  224. when is antepartum administration given in RH immune globulin(concentrated anti-D)
    at 28 weeks to all D neg. women and again with 72 hrs. of delivery to D neg. women with D pos. infants
  225. what are the 2 prepartions of RHIg
    intramuscular IM injection only- 1 vial neutralized 30 ml whole bloood (15 ml rbcs) fetal maternal hemorrhage and IM or intravenous- 1 vial neutralizes 17 ml RBCS
  226. what terst is usually used for screeningf on all RHIg candidates to determine if more than one vial necessary
    rosette test
  227. what happens if rosette test pos.
    Kleihauer Betke acid elution will quantiate fetal maternal bleed
  228. what is the second in importance to ABO for long term survival of transplanted solid organs and the most important in hematopoietic progenitor cell transplantation
    HLA SYSTEM -Human leukocyte antigens

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