Blood Bank Exam 1

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Blood Bank Exam 1
2011-02-25 16:06:53
Blood Bank Exam

Blood Bank Exam 1
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  1. Acquired Immunity
    In acquired (adaptive immunity) a specific response is enlisted. The cells involved have the ability to recognize the specific agent and mount a powerful response
  2. Innate Immunity
    • Innate (natural immunity) is nonspecific and provides the first line of defense against invading pathogens
    • skin
    • mucous membranes
    • pH in skin
    • acid in stomach
  3. Primary Response
    • Elicited on first exposure to a foreign antigen
    • Lag phase of 5-7 days before antibody can be detected in the host
    • Following the lag period, antibody levels rise, plateau, and then decline
    • IgM antibodies are produced first then IgG are producted
  4. Secondary Response
    Also called anamnestic response because there are memory cells

    Happens within 1-2 days of Ag exposure with significant amount of antibody production

    Principal antibody is IgG, unlike primary response in which IgM is the principal antibody

    1,000 times more antibody and slow decline
  5. What Influences Ag-Ab Binding
    • Goodness of fit
    • Strength and rate of reaction
    • Size, Shape, and Charge
    • Affinity: The strength of binding between a single antibody and epitope of an antigen
    • Avidity: The overall strength of reactions between several epitopes and antibodies

    Epitope made of sugar and lipids
  6. Prozone
    The concentration of antibody exceeds the antigen concentration
  7. Zone Of Equivalence
    • Maximum agglutination occurs when the concentrations of antigen and antibody are in the zone of equivalence
    • Same amout of antibody and antigen
  8. Postzone
    The concentration of antigen exceeds antibody concentration
  9. Why is the concentration of the red cell suspension important and what is a good percent?
  10. Red cell agglutination grading
    • 4+ red cell button is a solid agglutinate, with a clear supernatant background
    • 3+ red cell button breaks into several large agglutinates, with a clear background
    • 2+ red cell button breaks into many medium sized agglutinated, clear background, no free RBC
    • 1+ red cell button breaks into many small clumps barely visible macroscopically, background is turbid with many unaggutinated red cells
    • 0 no agglutinated red cells visible, red cells are observed flowing off the red cell button during the process of grading
  11. IgM
    First class of antibodies produced by B cells or plasma cells when an Ag is encountered

    Pantamer shape, 5 units held together by J chains

    Can agglutination of red cells in saline at room temp

    Constitutes 5%-10% of total serum antibody
  12. IgG
    Consists of a single four chain unit

    Does not agglutinate red cells in saline

    Reacts optimally at 37 degrees C

    Can cross the placenta and cause HDFC

    Makes up 80% of Ab concentration in the serum
  13. Antibody Molecule
    Heavy chain constant region has the function of the class. The variable region is unique and gives it specificity
  14. Antiglobulin Test
    Detect IgG antibodies on the red cell. Differ between direct and indirect
  15. Direct Antiglobulin Testing (DAT)
    • Identify red cells that have been sensitized to IgG or complement in vivo
    • cells must be washed to remove excess antibody so it doesn't neutralize the AHG (Coombs) reagent
    • No incubation necessary because the reaction has already occured in vivo
  16. Indirect Antiglobulin Test (IAT)
    • Designed to detect in vitro sensitization of red cells
    • Two step method by which serum is incubated at body temp (37 degrees) with a red cell source allowing for binding of antibody
    • Excess antibody is thoroughly washed and the AHG reagent is added
    • Aggulitination indicates a positive result
  17. Alloantibody
  18. Monoclonal
    • A created clone that contains antibodies of a defined specificity
    • Monoclonal antibody is produced in vitro
  19. Polyclonal
    • Usually derived from the injection of animals or humans with purified antigens
    • Polyclonal product contains several clones of B-cell antibody
  20. Reagents that will enhance a reaction
  21. ABO typing sera
  22. Rh control
    • If a high protein anit-D is used then a Rh control required
    • This is to verify positive reaction
    • Make sure it is not caused by some additive or reagent
    • This is the reason to use monoclonal
    • If there is a positive reaction with anti-D and the D control is also positive then the test is invalid
  23. Antiglobulin reagents
    Polyspecific AHG reagents are used primarily in direct antiglobulin testing (DAT) and contain antibodies to both IgG and C3d

    Monospecific reagents are preparedd by separating the polyspecific products into either IgG, AHG, or C3d AHG

    AHG is commercially available as polyclonal or monoclonal serum based
  24. Reverse typing cells
  25. Screening cells
    • Used in antibody screen tests
    • Obtained from type O individuals
    • Available as two or three vial sets
    • FDA requires that the cells detect the most clinically significant antibodies
  26. Panel cells
  27. Phenotype
    Serologic testing determines the presnece or absence of antigens on red cells

    The phenotype is the physical expression of inherited genes

    More specifically the antigens found on red cells
  28. Genotype
    The actual genes inherited from each parent

    Can be inferred only from the phenotype

    Family studies are required to determine the actual genotype

    Predicting the genotype from a phenotype is important in paternity studies or when determining a fetus' probable phenotype
  29. Pedigree charts
    • Examination of family history
    • Allows the important elements of patterns to become more visibly apparent
    • Can illustrate the difference between genotype and phenotype
  30. Punnett squares
    Illistrate the probabilities of phenotypes from known or inferred genotypes

    Figuring out blood types
  31. Alleles
  32. Haplotype
  33. Mitosis
  34. Recessive
  35. Amorphic gene
  36. Codominant gene
  37. Polymorphic
  38. Heterozygous
    Refers to different blood system alleles from each parent (AO)
  39. Homozygous
    Both parents contributed the same gene, giving a double dose of antigen (AA, BB)
  40. Crossing over
    Exchange of genetic material during meiosis between chromosomes
  41. FDA
    Food and Drug Administration
    • Ensures the safety and efficiency of blood, blood components, and testing reagents
    • Requires licensing of manufactureres and products
    • Regulates labeling and facilities
    • Penalties for violation
    • FDA inspections
  42. OSHA
    Occupational Safety and Health Administration
    • OSHA passed by congress in 1970
    • Defines biosafety levels based on potential exposure to infectious material
    • Ensures a safe, healthful work environment
    • All accidents must be reported
  43. CDC
    Centers for Disease Control and Prevention
    • Introduced in 1987
    • Introduced to reduce the risk of occupational exposure to blood borne disease
    • Treat all substances are potentially infectious
  44. EPA
    Environmental Protection Agency
    Became involved in the assessment of medical waste in 1988

    Required to determine types, numbers, and sizes of generators of medical waste in the US

    Examines present or potential threat of medical waste to human health and the environment
  45. DOT
    Department of Transportation
    DOT regulates diagnostic materials and etiologic agents shipped between states and foreign countries

    Governs all ground transportation
  46. TJC
    The Joint Commission
    Accrediting agency by which orginizations elect to be inspected and accredited

    Blood bank included in inspection

    Safety requirements incorporate general safety, hazardous chemicals, and equipment
  47. AABB

    Standards for blood bank and transfusion services, provides the basis for inspection and accreditation

    High standards

    Safety is a large component of the inspection process
  48. CAP

    • Provides peer reviewed accreditation for labs
    • Recognizes accreditation by CAP as equivalent to it's standards
    • Includes inspection and observation of safety compliance
    • Uses comprehensive checklist
  49. HCFA
  50. NFPA