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These are Antibodies that DO NOT react with antigens present on the RBC's of the antibody producer
Alloantibodies (Non-self)
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Alloantibodies are formed against the RBC antigens of who?
another individual
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These are antibodies that react with antigens present on the RBC's of the antibody producer.
Auto antibodies (self)
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"By testing the serum with each of the cells in the panel, a pattern of reactivity will be established," is the principle of what procedure?
Antibody Identification
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The Antibody Identification procedure is based on a pattern from _________ and ___________ reaction seen in the antigram.
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Antibody Identification is used to ID what three types of non-ABO antibodies?
- unexpected
- Atypical
- Irregular
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What is the class of antibody that is stimulated by pregnancy or transfusion?
Immune antibodies (IgG)
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What is the class of antibody that has an unkown stimulus?
Naturally occuring (IgM)
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a history of what five items is useful in antibody ID.
- Pregnancy
- Transfusion
- Pt diagnosis
- Pt drug therapy
- Recent RhIg
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A history or recent RhIg will cause a false positve for what reagent?
Anti-D
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What are six problems that indicate the presence of unexpected antibodies?
- incompatible crossmatch
- ABO discrepancy
- Positive IAT
- Positive DAT
- HDN
- Transfusion Reaction
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Serum or plasma for Antibody ID must be used within how many hours if refrigerated?
72hrs
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Why must Serum or plasma be used within 72 hours if refrigerated?
antibodies degrade with time
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Hemolysis causes what type of false result on Antibody ID?
positive
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Serum separator will causes what type of false result in Antibody ID?
positive
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what are the two tubes that Antibody ID can be collected in?
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An antibody panel is usually only done when other procedure indicates the presence of what?
atypical antibody
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What are three procedures that can indicate a need for antibody panel?
- IAT
- DAT
- Crossmatch incompatibility
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An antibody panel contains _____ separate vials of commercially prepared red cells.
10-16
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What blood type is used in comercially prepared red cell reagents for antibody ID?
O cells
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Who indicates what antigens are on cells of each reagent vial in antibody ID?
manufacturer
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what size of disposable glass tubes should be used for antibody ID?
12x75
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in other than optimal conditions such as the field, fleet hospitals, and power outages blood products are stored how?
on ice in boxes
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in other than optimal conditions ABO/Rh is preformed using what method?
finger stick and slide method
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in other than optimal conditions, blood is issued under _________ status.
emergency only
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Compatibility in other than optimal conditions is based on what?
donor and recipient ABO/Rh match only
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Antibody panel is tested in what three phases?
- Saline phase (IS)
- 37oC phase (LISS or Albumin phase)
- AHG or coombs phase
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In the saline phase suspension of red cells are mixed at what temperature?
room temp
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Saline phase detects what class of antibodies?
IgM
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What are the seven IgM antibodies?
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What is the phase where red cells and serum are incuated with enhancement media?
37oC phase
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What are the IgG antibodies detected in the 37oC phase?
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what are the occasional IgM antibodies detected in the 37oC phase?
- Anti-LeaAnti-LebSome Ss antibodies
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AHG detects what eight IgG antibodies?
- Rh
- Kell
- Duffy
- Kidd
- Lewis
- Lutheran
- MNSs
- Xg
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in what phase are reactions read microscopically if macroscopically negative/
AHG
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reactions should be read Macroscopically for ____________ and/or __________ in each phase.
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True or flase
Seological properties of the antibody are used only as a guide.
true
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what are the two hemolytic antibodies?
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what system antibodies are capable of reacting in all phases and temps?
lewis
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this may resemble agglutination due to increased serum protein.
Rouleaux
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Rouleaux is detected only in what phases?
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how are Rouleaux resolved?
saline replacement
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This is when serum contains anti-caprylate antibodies?
albumin agglutinating phenomenon
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ALL red cells are agglutinated in albumin stabilized with caprylate only in what phase?
37oC
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This is a mixutre of patient red cells and serum/plasma that is tested in parallel with other tubes through various phases and temps.
Autologous control (Auto control)
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Auto control most often has what result?
negative
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What are four situations that can cause positive auto control?
- cold autoantibodies (Anti-I and anti-H)
- Rouleaux
- albumin agglutinating phenomena (anti-caprylate antibodies)
- warm autoantibodies
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non-reactive in all phases of antibody ID is considered to be what result?
negative
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In antibody ID tubes that have what reaction should be reviewed?
negative
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In atibody ID, antigens present in vial that is ________ are ruled out (crossed off).
negative
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After the ruling out process of antibody ID antigens remaining match what?
pattern of reactivity
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Antibodies are identified in antibody ID provided that it meets what three criteria?
- vials containing antigen are positve
- vials reacting have that anitgen
- vials lacking antigen are negative
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after the ruling out process in antibody ID, if more than one antigen remains there is a possibility of what?
multiple anitbodies
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This is used when testing additional cells is necessary in antibody ID.
custom panel
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In a custom panel, each additonal cell must ____ one of the antigens but _____ the other.
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true or false
custom panels are tested in all phases.
true
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if only one antigen remains in a custom panel, the serum has only ____ antibody.
one
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if more than one antigen remains in a custom panel serum may have ______ antibodies.
multiple
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this is done after antibody identification to determine if anitbody present is allo or auto.
phenotype patient red cells for corresponding antigen
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in Antibody ID, patient should lack antigen unless what?
- auto antibody (DAT positve)
- antigens from donor cells.
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what are the five special serological test procedures?
- cold panel
- adsorption
- elution
- enzyme
- neutralization/inhibition
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in a cold panel incubating at refigerator temperature is used to do what?
enhance reactions of cold agglutinins
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what is the antibody that could mask other significant antibodies in a cold panel?
Anti-I
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This is the removal of antibody from serum by reacting that antibody with the specific antigen on red cells.
Adsorption
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Adsorption is used to __________ and __________ antibodies.
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In adsorption antigens ______ to corresponding antibody on red cells.
bind
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In adsorption, an equal volume of serum and washed packed red cells, is centrifuged to separate serum and cells, red cells are saved and panel is preformed on adsorbed _______.
serum
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what two things can cause inaccurate test results on adsorption?
- incorrect ratio of serum to cells
- incorrect incubation time or temperature
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This is the removal and recovery of an antibody that is attached to a red cell surface.
elution
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Elution is used to ________ anitbody, and _________ bound antibody.
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what are the four basic procedures for elution?
- heat
- ether
- digitonin (acid)
- lui-freeze thaw
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in elution we are interestin in what antibodies?
antibodies bound to red cell membrane
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how do you know the eluate is ready for antibody studies?
eluate will be hemolyzed
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what two things can cause inaccurate test results on elution?
- improper wasing
- improper incubation time or temperature
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This is used to pretreat red blood cells to modify antigens.
enzyme
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Do enzyme modify anitgen or RBC's?
antigen
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what are the four enzymes?
- ficin
- papain
- bromelin
- trypsin
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enzyme enhances reactivity of what five antibodies?
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what are the three antigens destroyed by enzyme?
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what two things can cause inaccurate test results on enzyme?
- destruction or enhancement of incorrect antibody
- tested for incorrect antibody
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this is used so antibodies are unable to react with antigens.
neutralization/inhibition
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in neutralization/inhibition antibody binds to antigen substance, and antigen substance _______ reactivity of suspect antibody.
inhibits
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What is used to neutralize lewis?
saliva of persons with Se genes
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what is used to neutralize P1?
- hydatid cyst fluid
- pigeon egg reagent
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what is used to neutralize Sda?
Urine (body fluids)
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What two things can cause inaccurate test results in neutralization/inhibition?
- used incorrect blood group antigen
- tested for incorrect antibody
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