Immunohematology

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Author:
ncrook
ID:
213017
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Immunohematology
Updated:
2013-05-11 00:53:29
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Other Blood Group Systems Reagents Methods DAT ID Alloantibodies Pretransfusion Testing
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Description:
Other Blood Group Systems, Reagents and Methods, DAT, ID of Alloantibodies, Pretransfusion Testing
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  1. What type of antibody is Kell blood group system?
    IgG
  2. What antigen:
    IgG
    Optimal reaction temp is 37 degrees celcius
    Optimal reaction phase is AHG
    Can cause hemolytic transfusion reactions and HDN
    No effect with enzymes
    • Kell blood group system
    • K
  3. Name some antigens associated with Kell blood group system and which ones are more common
    • K
    • k
    • Kpa
    • Kpb
    • Kpc
    • Jsa
    • Jsb
    • Ku
  4. What phenotype occurs when RBCs lack the Kell antigens but have the Kx antigen?
    Kellnull
  5. What is produced by a gene located on a different chromosome than the Kell system genes
    Is inherited independently from the Kell antigens
    Appears to be required for the expression of the Kell system antigens
    Kx antigen
  6. What phenotype:
    Individuals have an alteration of the allele producing Kx on the X chromosome lack Kx on the RBC
    Greatly decreased expression of Kell antigens
    Decreased RBC survival
    RBC morphologic and functional abnormalities
    McLeod phenotype
  7. What Blood group system:
    IgG
    Optimal temp: 37 degrees
    Reaction phase: AHG
    Enzyme treatment: destroys Fya and Fyb
    Can cause HTR and HDN
    • Duffy Blood Group system
    • Fy
  8. What phenotype is more resistant to malarial infections by Plasmodium vivax?
    Fy(a-b-)
  9. What antigens are included in the Duffy blood group system?
    • Fya
    • Fyb
  10. What blood group system:
    IgG
    Optimal temp: 37 degrees
    Reaction phase: AHG
    Enzyme treatment: enhances agglutination
    Can cause HTR and mild HDN
    Ability to bind complement
    • Kidd Blood Group system
    • Jk
  11. What antigens are included in the Kidd Blood Group system?
    • Jka
    • Jkb
    • Jk3
  12. What blood group system:
    Can be IgM or IgG - depending on the antigen
    Optimal temp: 4 degrees or 37 degrees - depending on antigen
    Reaction phase: Room Temp or AHG - depending on antigen
    Some antigens associated with HTR and HDN
    • Lutheran Blood Group System
    • Lu
  13. What antigens are included in the Lutheran Blood Group system?
    • Aua
    • Aub
    • 18 in total
  14. What antibodies are associated with the Lutheran Blood Group system?
    • Lua: IgM
    • Lub: IgG
  15. What blood group system:
    IgM
    Optimal temp: Most often 4 degrees, sometimes 37 degrees
    Reaction phase: Room temp, 37 degrees, and AHG
    Enzyme treatment: enhances agglutination
    Not clinically significant
    Sometimes antibodies are formed during pregnancy but weaken and disappear after delivery
    • Lewis Blood group system
    • Le
  16. What antigens are included in the Lewis Blood group system?
    • Lea
    • Leb
  17. What blood group system:
    IgM
    Optimal temp: 4 degrees
    Reaction phase: IS and occasionally 37 degrees
    Enzyme treatment: enhances agglutination
    Not clinically significant but can be associated with Mycoplasma pneumoniae infection
    I Blood Group System
  18. What blood group system:
    IgM
    Optimal temp: 4 degrees
    Reaction phase: IS, 37 degrees, AHG
    Enzyme treatment: enhances agglutination
    Not clinically significant if alone but together is an IgG clinically significant antibody
    • P Blood Group
    • P1
  19. What antibody is:
    Donath-Lansteiner antibody
    Naturally occurring biphasic antibody associated with paroxysmal cold hemoglobinuria
    Binds to the antigen on the patients RBCs in the cold and fixes complement
    RBCs then lyse when temp reaches 37 degrees
    Anti-P
  20. What blood group system and which specific antigens:
    IgM or IgG
    Optimal temp 4 degrees or 37 degrees
    Reaction phase: IS, 37 degrees, or AHG
    Enzyme treatment: destroys antigens
    Clinical significance: only if IgG
    Associated with glycophorin A
    • MNS Blood Group system
    • Specifically M and N antigens
  21. What blood group system and which specific antigens:
    IgG
    Optimal temp: 37 degrees
    Reaction phase: AHG
    Enzyme treatment: variable
    Associated with glycophorin B
    Causes HTR and HDN
    • MNS Blood Group system
    • Specifically S and s antigens
  22. What antibody:
    Can cause HTR and HDN
    Rare
    Occurs in S-s-U- people
    Anti-U
  23. What other miscellaneous blood group systems are high incidence antigens?
    • Diego
    • Cartwright
    • Scianna
    • Dombrock
    • Colton
    • Chido/Rodgers
    • Gerbich
    • Cromer
    • Knops
    • Cost
    • Vel
    • John Milton Hagen
    • Sid
  24. Who has a higher chance of having XG antigens?
    Females have a higher chance of Xga
  25. What is significant about Anti-Vel?
    • Hemolytic
    • Clinically significant antibody
  26. What type of reagent antisera has many B cell clones produce antiboies against antigens?
    Polyclonal
  27. What type of reagent antisera has a single B cell clone produce antibody against the antigen?
    Monoclonal
  28. What potentiating reagent increases antibody uptake  of antigen?
    LISS
  29. What potentiating reagent allow sensitized cell to come close together to form agglutination lattices?
    Bovine albumin
  30. What potentiating reagent concentrates antibodies and creates a low ionic solution to allo greater antibody uptake?
    PEG
  31. What potentiating reagent:
    Enhances Rh, Kidd, Le blood group systems
    Destroys M, N, S, Xga, Fya, Fyb
    • Papain
    • Ficin
    • Bromelin
  32. What test is ordered to detect IgG and/or complement proteins attached to RBCs in autoimmune hemolytic anemia, HDN, a drug related mechanism, or a transfusion reaction?
    DAT (direct antiglobulin test)
  33. What is the autocontrol used to detect?
    Autoantibodies
  34. What antibodies are produced against antigens that occur in at least 98% of the population?
    Antibodies to High Frequency Antigens
  35. Name the low frequency antigens
    • Cw
    • Lua
    • Kpa
    • Wra
    • V
    • Bga
    • VS
    • Cob
  36. What antibodies:
    Can be detected by a positive DAT or positive autocontrol
    Produced in response t drugs, cold autoimmune disease, pneumonia, warm autoimmune disease, infectious mononucleosis
    Autoantibodies
  37. What antibodies:
    Have cold antibodies that are not usually significant but can mask significant antibodies
    If reacts at 37 degrees, it can be clinically significant
    Alloantibody
  38. Name the most common cold autoantibodies
    • Anti-I
    • Anti-H
    • Anti-IH
  39. What are the 3 types of elution techniques?
    • Intact RBC antibody removal: uses buffers to remove the antibody from the RBC without destroying the RBC
    • Digitonin: releases the antibody by destroying the RBCs
    • Lui freeze-thaw: is used to remove IgM antibodies (usually A or B) present on newborn RBCs
  40. What is the term for a total blood volume replacement within 24 hours (approximately 10-12 units)?
    Massive transfusion
  41. How is a crossmatching infants who are less than 4 months old performed?
    • Pretransfusion testing is only ABO and Rh (forward only)
    • If alloantibodies are detected in the mother's or infant's serum, the infant is transfused with units negative for the corresponding antigens (baby doesn't develop antibodies until 4-6 mths of age)
  42. How does Hemolytic Disease of the Newborn (HDN) happen?
    • Maternal IgG antibodies cross the placenta and destroy the baby's RBCs
    • Hgb from the lysed RBCs is metabolized into unconjugated bilirubin
  43. What clinical conditions can result from HDN?
    • Fetus becomes anemic from RBC destruction
    • Cardiac failure and/or hydrops fetalis may result from anemia
    • After birth, bilirubin accumulates in the baby - leading to jaundice, deafness, mental retardation, kernicterus (brain damage due to bilirubin accumulation), or death
  44. What can be used to determine HDN caused by other IgG antibodies (Kidd, Kell, etc...) and repeated on positive mothers at 16 and 22 weeks, then ever 1-4 weeks until delivery?
    • Antibody titration
    • A twofold rise in the titer indicates a serious situation and invasive procedures or an exchange transfusion may be necessary
  45. How is HDN prevented?
    Prenatal Rh immune globulin (RhIG) administered to D-negative mothers at 28 weeks and then again at childbirth
  46. What is a screening method to detect fetomaternal bleeds >15 mL?
    Fetal screen (Rosette test)
  47. What test is used to determine the amount of a fetomaternal hemorrhage?
    Kleihauer-Betke (KB) acid elution
  48. What is the calculation for determining the number of RhIG (RhoGAM) needed to give a mother with a fetomaternal hemorrhage?


    For every ratio interval of 0.0045, 1 additional RhoGAM is needed
  49. What type of donation is a donation of blood given by a person to be used for transfusions on themselves at a later date?
    Autologous
  50. Name the 4 types of autologous donation
    • Preoperative: collected prior to surgery
    • Intraoperative hemodilution: 1-2 units of blood removed at beginning of surgery and replaced with volume expanders
    • Intraoperative collection: blood lost in the abdominal cavity is collected by a machine, washed and given back to the patient
    • Postoperative collection: Collects blood from surgical drains, must be transfused within 6 hours
  51. What type of donation occurs when patients choose their own donors?
    Directed donations
  52. What is the term for only WBCs removed from donor blood?
    Leukopheresis
  53. What is the term for only plts removed from donor blood?
    Plateletpheresis
  54. What is the term for when only plasma is removed from donor blood?
    Plasmapheresis
  55. What is the term for when only RBCs are removed from donor blood?
    Red cell pheresis
  56. What is an electronic instrument that takes blood from a donor, separates the desired component, and returns the remaining components to the donor?
    Apheresis instrument
  57. How often can someone perform plateletpheresis, according to AABB?
    • Plt count of 150,000/micro-L
    • 48 hrs required in between donations
  58. How often can someone perform Leukopheresis, according to AABB?
    Not more than twice a week
  59. How often can someone perform Plasmapheresis, according to AABB?
    • Every 4 weeks
    • Total protein, IgG, and IgM are monitored
  60. How often can someone perform Red cell pheresis, according to AABB?
    Every 16 weeks
  61. What is performed when:
    One unit of blood is removed from a paitent in a specified time interval
    To treat patient symptoms in polycythemia, hemochromatosis, and prophyria
    Therapeutic phlebotomy
    • POSS AB WITH COLD AGGLUTININ
    • TEST PT SERUM AGAINST FETAL CORD CELLS (COLD IS NEG)
    • COULD ALSO BE A SUBGROUP OF A OR NON-SPECIFIC ANTIBODIES
    • POSSIBLE ROULEAUX 
    • ELDERLY OR NEWBORN W/ A LACK OF ANTIBODY ACTIVITY
    • ADD 3 DROPS OF SERUM TO TUBES
    • IF STILL NEG, INCUBATE FOR 15 MIN AT ROOM TEMP
    • ACQUIRED B ANTIGEN
    • RETEST PT RBC WITH:
    • ANTI-B LECTIN (ACQUIRED IS NEG)
    • ANTI-B LECTIN THAT HAS BEEN ACIDIFIED TO PH OF 6.0 W/ 0.1N HCL (ACQUIRED IS NEG)
    • PLASMA FROM TYPE A (ACQUIRED B IS NEG)
    • PROBABLY A2 WITH ANTI-A1 ANTIBODY
    • TEST PT RBC’S WITH ANTI-A1 LECTIN (A2 IS NEG)
    • TEST PT SERUM WITH REAGENT A2 CELLS (A2 IS NEG)
    • MIXED FIELD REACTIONS
    • PT MAY HAVE BEEN TRANSFUSED WITH LARGE AMOUNT OF DONOR BLOOD
    • VERIFY TRANSFUSION
  62. Name the 37 Degree/AHG Antibodies
    • D
    • C c E e f
    • V
    • CW
  63. Name the AHG Antibodies
    • KELL (K k Kpa Kbb Jsa Jsb)
    • DUFFY (Fya Fyb)
    • KIDD (Jka Jkb)
  64. Name the Cold reacting antibodies
    • M N
    • S s
    • M N S s ARE SIG IF REACT AT 37°C
    • I
    • P
  65. Name the Room Temperature Antibodies
    • LEWIS (Lea Leb)
    • LUTHERAN (Lua, Lub)
    • Often produces mixed Field reactions

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