1180 Exam 3 (Ch. 9, 10, and 12)
Define the Kleihauer-Betke procedure and how the test is used clinically.
- used to calculate the additional doses of RhIG - KB test detects the two differences: 1) fetal hemoglobin is resistant to acid (retains dye) 2) adult hemoglobin is not resistant to acid (ghost-like)
What tests are included in a routine prenatal screen in Blood Bank?
1) ABO/D Typing 2) Antibody screen 3) if antibody screen is positive, identify antibody 4) antibody titration for IgG antibodies to establish baseline
When is RhIG administered?
1) before birth: 1 dose (300 micrograms) at 28 weeks gestation 2) after birth: - nonimmunized (did not make true anti-D) women will receive one full dose of RhIG within 72 hours of delivery of a Rh-positive baby - more than one dose may be necessary if the mother has fetomaternal hemorrhage of more than 30 mL (one dose of RhIG only covers 30 mL of a bleed)
List causes of HDFN.
1) fetal red cells, carrying antigens inherited from the father, stimulate the mother to produce IgG antibodies 2) maternal IgG antibodies destroy fetal red cells
Upon centrifugation of an antibody screen procedure done by the gel system, the red blood cell agglutinates are dispersed throughout the gel column with a few agglutinates at the bottom of the microtubes. This reaction should be graded as a:
2+
The Kleihauer Betke test was performed using a 1-hour post-delivery maternal blood sample. Results: 20 fetal cells/2000 cells counted It is the policy to add 1 vial of Rh immune globulin to the calculated dose when the estimated volume of the hemorrhage exceeds 20 mL of whole blood. Calculate the number of vials of Rh immune globulin that would be indicated under these circumstances.
20 fetal cells/2000 = 0.01 0.01 x 5000 = 50 mL of fetal whole blood 50/30 = 1.7 1.7 is rounded up to 2 vials. 2 vials + one = 3 vials to be given.
Prior to giving Rh-immune globulin (RhIG), when should a second antibody screen be tested on an Rh(D)-negative woman whose initial antibody screen was negative?
28 weeks gestation
What is Rh Immune globulin (RhIG) and how does it work to prevent HDFN?
RhIG prevents alloimmunization in D-negative mothers - only prevents formation of anti-D antibody
What fetal maternal hemorrhage test is qualitative? Why is this test performed?
Rosette test - used for detection of fetomaternal hemorrhage. - less than 1 rosette per 3 low-power fields: one dose of RhIG - more than 1 rosette per 3 low-power fields: bleed must be quantitated
Random access is an important feature in selecting an automated instrument for testing in the transfusion service. What is random access?
The ability to accommodate STAT testing
What are the indicator cells used in SPRCA assays? a. IgM-coated red cells useful in determining the presence of ABO antibodies b. cells used to agglutinate IgG antibodies to form a pellet in the well after centrifugation c. IgG-coated red cells that cross-link with IgG antibodies attached to the well d. check cells that are added to negative reactions to validate the washing step
c. IgG-coated red cells that cross-link with IgG antibodies attached to the well
A Kleihauer-Betke stain performed on a postpartum blood sample demonstrated 10 fetal cells in a field of 2000. What is the estimated blood volume of the fetomaternal hemorrhage expressed as whole blood? a. 25 mL b. 30 mL c. 45 mL d. 100 mL
a. 25 mL
Which of the following women should receive postpartum RhIG? Mother's ABO/D phenotype/Mother's antibody screen/Newborn's ABO/D phenotype a. A, D-negative/Negative/O, D-positive b. O, D-negative/Negative/A, D-negative c. A, D-positive/Negative/B, D-negative d. B, D-negative/Immune anti-D/B, D-positive
a. A, D-negative/Negative/O, D-positive
How would you interpret the appearance of spherocytes in a baby's blood smear after delivery? a. ABO HDFN b. HDFN caused by anti-D c. HDFN caused by other IgG antibodies d. normal physiologic anemia detected in newborns
a. ABO HDFN
The transfusion service receives one group B, D-positive RBC unit. What repeat testing is required on this donor unit? a. ABO typing only b. ABO and D typing c. ABO, D, and weak D typing d. ABO and D typing; antibody screen
a. ABO typing only
A weakly reactive anti-D was present in a postpartum sample from a D-negative woman who gave birth to a D-positive baby. What is the most probable cause? a. immune anti-D produced from exposure during the first pregnancy b. immune anti-D produced from exposure during the current pregnancy c. antenatal RhIG given d. error in antibody identification or D typing
c. antenatal RhIG given
What is the principle of the Liley method for predicting the severity of HDFN? a. resistance of fetal hemoglobin to acid elution b. ratio of lecithin to sphingomyelin c. change of optical density of amniotic fluid measured at 450 nm d. direct bilirubin evaluation of a cord blood sample
c. change of optical density of amniotic fluid measured at 450 nm
Which of the following statements is true regarding interpretation of SPRCA results? a. Grading reactions are based on a 1-to-4 grading scale, where 4+ is a strong positive. b. A tight button of cells on the bottom of the well would be interpreted as a positive reaction. c. Hemagglutination assay results are interpreted the same as SPRCA results. d. An evenly distributed layer of cells on the well surface is a negative reaction.
a. Grading reactions are based on a 1-to-4 grading scale, where 4+ is a strong positive.
A layer of red blood cells agglutinates at the top of the gel media, and a pellet of unagglutinated red blood cells forms at the bottom. These findings are comparable to which of the following reactions in the test tube? a. Mixed-field b. Negative c. Weak positive d. Invalid
a. Mixed-field
Which of the following antibodies carries no risk of HDFN? a. anti-Lea b. anti-C c. anti-K d. anti-S
a. anti-Lea
What is the principle of the Kleihauer-Betke test? a. fetal hemoglobin resists acid elution b. adult hemoglobin resists acid elution c. fetal red cells lose hemoglobin under alkaline conditions d. adult red cells accept dye under alkaline conditions
a. fetal hemoglobin resists acid elution
Select the method that uses the principle of sieving to separate larger agglutinates from smaller agglutinates in antigen-antibody reactions. a. gel b. solid phase c. microplate d. none of the above
a. gel
Which of the following products is crossmatched with the recipient if the unit contains greater than 2 mL of RBCs? a. granulocyte concentrates b. plasma c. platelets d. cryoprecipitate
a. granulocyte concentrates
A mother is group A, D negative with anti D in her serum. Select the appropriate units for an intrauterine transfusion. a. group O, D-negative b. group O, D-positive c. group A, D-negative d. group A, D-positive
a. group O, D-negative
What is the greatest danger to the newborn affected by HDFN postpartum? a. kernicterus b. anemia c. conjugated bilirubin d. immature lung development
a. kernicterus
A rosette test performed on a D-negative mother who delivered a D-positive baby demonstrated two rosettes per three fields observed. What is the correct course of action? Consult Fig 12.7 for test interpretations. a. submit the sample for a Kleihauer-Betke test b. recommend two vials of RhIG c. suggest that RhIG is not necessary because records indicate that the mother received prenatal RhIG d. recommend one vial of RhIG because it is below the cutoff for the fetal screen
a. submit the sample for a Kleihauer-Betke test
What tests are performed with the MTS monoclonal A/B/D grouping gel card? a. typing A, B, and D antigen b. antiglobulin crossmatches c. typing Rh system antigens d. DATs
a. typing A, B, and D antigen
What FMH bleed is detectable by the rosette test? a. 5 mL b. 10 mL c. 20 mL d. 30 mL
b. 10 mL
What is the greatest danger to a fetus affected by HDFN before delivery? a. kernicterus b. anemia c. hyperbilirubinemia d. hypertension
b. anemia
What test detects serologic incompatibility between donor RBCs and recipient serum? a. antibody screen b. crossmatch c. DAT d. autologous control
b. crossmatch
Situation: During the issue of an autologous whole blood unit, you observe a dark red plasma layer. Select the best course of action. a. remove the plasma and issue unit as red blood cells b. do not issue the unit and place in quarantine c. issue unit as unit is acceptable for autologous use only; note plasma color on issue d. Gram stain the unit before issue
b. do not issue the unit as red blood cells
Situation: The recipient's phenotypes are group AB, D-positive and has a positive antibody screen. Antibody identification confirmed the presence of an alloanti-M. The transfusion order requires 1 unit of Red Blood Cells. The crossmatch on the selected donor unit is compatible. Select a possible explanation for these results. a. donor's red cells are DAT positive b. donor is a heterozygote for the M antigen c. patient antibody identification is incorrect d. patient's plasma is reacting with the enhancement media
b. donor is a heterozygote for the M antigen
What RBC units are issued to a woman of childbearing age in emergency release? a. group O, D-positive b. group O, D-negative c. group A, D-positive d. group AB, D-negative
b. group O, D-negative
A D-negative woman with anti-D has a titer performed on her week 24 prenatal sample. After 4 weeks, another sample was tested in parallel with a current sample. The titration results are in the table. 1:1 1:2 1:4 1:8 1:16 1:32 1:64 1:128 1:256 Week 24: 2+ 1+ 1+ 0 0 0 0 0 0 Week 28: 3+ 2+ 2+ 2+ 1+ 1+ 0 0 0 Interpret the titer's results. a. an intrauterine transfusion is necessary b. early induction of labor may be necessary c. consider Doppler ultrasonography d. administer RhIG
c. consider Doppler ultrasonography
A patient who phenotypes as group AB, D-negative requires 1 unit of plasma. Which of the following units of plasma would be best for transfusion? a. group A, D-negative b. group B, D-positive c. group AB, D-positive d. group O, D-negative
c. group AB, D-positive
Situation: Current pretransfusion testing on John Smith reveals a negative antibody screen. There is no history of alloantibody production. He is group A, D-positive. The transfusion order is three units of red blood cells. Which of the following procedures can be used to identify compatible units? a. computer crossmatch and antiglobulin crossmatch b. antiglobulin crossmatch and immediate-spin crossmatch c. immediate-spin crossmatch and computer crossmatch d. only immediate-spin crossmatch
c. immediate-spin crossmatch and computer crossmatch
What is the mechanism for HDFN occurrence? a. maternal antigens react with fetal antibodies b. fetal antibodies react with maternal antibodies c. maternal antibodies react with fetal antigens d. fetal antigens react with maternal antigens
c. maternal antibodies react with fetal antigens
In the gel test, what is a button of cells at the bottom of the well called? a. 4+ positive reaction b. 1+ positive reaction c. negative reaction d. invalid reaction
c. negative reaction
What is the purpose for the irradiation of blood selected for an exchange transfusion? a. prevent formation of HLA antibodies b. prevent sepsis from bacterial contamination c. prevent graft versus host disease d. prevent transmission of viruses
c. prevent graft versus host disease
Situation: A record review of Jane Hope revealed a history of anti-Jka. Her phenotype is group AB, D-positive. Current pretransfusion testing demonstrates a negative antibody screen. Select your further testing strategy before the transfusion of two RBC units. a. confirm patient's phenotype by testing patient's red cells for Jka antigen b. confirm anti-Jka in patient's plasma using an enzyme panel c. provide Jk(a−) RBC units crossmatch compatible in antiglobulin crossmatch d. crossmatch group AB, D-positive units and release compatible units for transfusion
c. provide Jk(a-) RBC units crossmatch compatible in antiglobulin crossmatch
What item listed is not a goal for performing a whole blood exchange transfusion? a. decrease the level of maternal antibody b. reduce the level of indirect bilirubin c. provide platelets to prevent disseminated intravascular coagulation d. provide compatible RBCs to correct anemia
c. provide platelets to prevent disseminated intravascular coagulation
An antiglobulin crossmatch result is a 2+ agglutination reaction after the addition of the antihuman globulin reagent. What is the most likely explanation for this result? a. recipient's RBCs are demonstrating polyagglutination b. recipient's RBCs have a low-frequency antigen c. recipient possesses an IgG alloantibody d. recipient possesses a cold autoantibody
c. recipient possesses an IgG alloantibody
A recipient's antibody screen is negative; however, the recipient is incompatible with the selected donor unit. Select a possible explanation for these results. a. recipient RBCs possess a high-frequency antigen b. recipient has a warm autoantibody c. recipient possesses an antibody to a low-frequency antigen d. recipient RBCs possess a cold autoantibody
c. recipient possesses an antibody to a low-frequency antigen
Which of the following is not a characteristic of ABO HDFN? a. may occur in first pregnancy b. usually treated with phototherapy c. strongly positive DAT d. most frequent in babies born to group O mothers
c. strongly positive DAT
Mixed-field reactions were observed in the ID-MTS gel test for ABO and D phenotype when the test was automated. What is the most probable cause of this observation? a. improper pipetting technique b. the use of contaminated reagents c. transfusion of group O cells to an A or B patient d. centrifugation error
c. transfusion of group O cells to an A or B patient
Cannulation of the umbilical vein under ultrasound guidance is known as:
cordocentesis.
What test uses the Capture-R Select microwell strips? a. DAT b. antiglobulin testing of selected panel cells c. weak D test d. all of the above
d. all of the above
Where can false-negative reactions occur in both the gel and solid-phase testing? a. failing to centrifuge b. not mixing reagent red cells sufficiently c. incubation time was too short d. all of the above
d. all of the above
Which of the following tests is not necessary when testing a cord blood sample? a. ABO b. D c. DAT d. antibody screen
d. antibody screen
Which of the following requirements is important when selecting blood for exchange transfusion to avoid elevated levels of potassium? a. irradiated blood b. CMV-negative blood c. leukocyte-reduced blood d. blood less than 7 days old
d. blood less than 7 days old
Which method is used in the automated Immucor and Bio-Rad systems for ABO and D phenotype? a. SPRCA b. enzyme-linked immunosorbent assay (ELISA) c. reverse-passive hemagglutination (RPHA) d. hemagglutination in a microwell
d. hemagglutination in a microwell
What is the name of an often-fatal condition characterized by general edema that results from anemia? a. kernicterus b. disseminated intravascular coagulation c. erythroblastosis fetalis d. hydrops fetalis
d. hydrops fetalis
A donor's RBC phenotype gave the following results when checked in the transfusion service. The donor unit label states group A, D-negative. What is the next step? Red Blood Cells Tested With: Anti-A Anti-B Anti-D 4+ 0 3+ a. transfuse as a group A, D-negative b. transfuse as a group A, D-positive c. discard the unit d. notify the collection facility
d. notify the collection facility
What information does the AABB Standards require on a labeled blood sample for the blood bank? a. name b. name, unique identification number, date of collection c. name, unique identification number, date of collection, physician name d. two independent identifiers
d. two independent identifiers
Define the elution procedure and how the test is used clinically.
dissociates antigen-antibody complexes on red cells; freed IgG antibody is tested for specificity
What is emergency release and what is the procedure?
emergency release of blood products: 1) release must be signed by physician 2) tag on donor unit indicating emergency release: compatibility and/or infectious disease 3) patient name and identifiers 4) donor unit number(s), ABO and D typing, expiration date 5) retain segments from units for crossmatching 6) name of person issuing units
A large fetomaternal bleed in a D-negative woman who delivered a D-positive infant should be suspected if the:
fetomaternal hemorrhage screen result is positive
Blood transfusions to the fetus and premature infants should be ________ to prevent graft-versus-host disease.
gamma irradiated
What is the most appropriate type of blood to select for transfusion to a patient with a history of a clinically significant antibody?
group O, D-negative
What type(s) of RBC(s) is (are) acceptable to transfuse to an O-negative patient?
group O, D-negative
Having checked the patient's prior history after having received the specimen and request, you:
have to compare the results of your ABO, Rh, and IAT with the previous results.
When can a crossmatch test be abbreviated to the immediate-spin only test?
no antibodies in the current antibody screen (negative screen) or any history of antibodies in the patient's past record.
In testing amniotic fluid, the Liley method of predicting the severity of hemolytic disease of the fetus and newborn is based on:
optical density of bilirubin at 450 nm
A smooth layer of cells in the bottom of the well is interpreted as a/an ____________ reaction when the solid-phase red cell adherence method is completed for the antiglobulin test:
positive
All of the following are common characteristics of ABO hemolytic disease of the fetus and newborn except:
the mother is group A.
Define the titration procedure and how the test is used clinically.
titration helps determine whether certain procedures should be performed - noninvasive way to monitor the pregnancy
Define the adsorption procedure and how the test is used clinically.
uses red cells (known antigens) to remove red cell antibodies from a solution (plasma or antisera); group A red cells can remove anti-A from solution
Define massive transfusion.
A total volume exchange of blood withing 24 hours.
What is an abbreviated crossmatch?
A type and screen plus an immediate spin crossmatch.
A patient is typed as AB positive. Two units of blood have been ordered by the physician. Currently, the inventory shows no AB units, 10 A-positive units, 1 A-negative unit, 5 B-positive units, and 20 O-positive units. Which should be set up for the major crossmatch?
A-positive units
In the event of a clinically significant antibody found in the mother's serum, what must be performed to determine its concentration?
Antibody titer
What is the most appropriate type of crossmatch test to be performed in a patient with evidence of significant antibody in: 1) the current sample 2) historical record
Antiglobulin Crossmatch
What is the physiological mechanism of Rh-immune globulin?
Attachment of fetal Rh-positive red blood cells in maternal circulation, inhibiting production of anti-D
Define maximum surgical blood order schedule.
Average number of blood units used for surgical procedures is determined in a facility. - this number is used as the standard blood order for surgical procedures - may also be used as a guide for the number of autologous units that can be donated
The computer crossmatch requires two ABO and D phenotypes on the recipient.
False
True or False A crossmatch demonstrating a 2+ agglutination is compatible.
False
True or False A crossmatch detects most errors in the identification of antigens on patient's red cells.
False
True or False A crossmatch prevents the immunization of the recipient to blood group antigens.
False
True or False An immediate-spin crossmatch of a D-positive recipient with a D-negative donor unit is usually incompatible.
False
True or False Group O plasma is the universal donor of plasma products.
False
True or False The computer crossmatch does not require ABO and D phenotype on the current recipient's sample.
False
True or False The computer crossmatch does not require validation for implementation.
False
True or False The only component requiring a crossmatch is a unit of RBC.
False
True or False When selecting an automation partner, a laboratory does not need to determine its requirements in terms of customer support, training, and service.
False
What best describes the principle of the Kleihauer-Betke test?
Fetal hemoglobin is resistant to acid (alkali) and appears pink, whereas maternal red blood cells appear as ghost cells
Select the method that uses the principle of sieving to separate larger agglutinates from smaller agglutinates in Ag-Ab reactions.
Gel technology
Which donor red blood cells would be chosen to use in an intrauterine transfusion?
Group O, Rh(D) negative that lack the offending antigen
Rh immune globulin contains:
IgG anti-D.
A group O patient was crossmatched with group B red blood cells. What phase of the crossmatch will first detect this incompatibility?
Immediate spin
What is the most appropriate type of crossmatch test to be performed in a patient with no evidence of clinically significant antibodies in: 1) the current sample 2) historical record
Immediate-spin Crossmatch
A nurse just called to request additional RBC units for a patient for whom you performed compatibility testing 4 days ago. She would like you to use the original specimen, as you keep it for 7 days anyway. Your most appropriate course of action would be to:
Indicate that a new specimen is necessary because the patient has been recently transfused.
A group A, D-negative mother demonstrating anti-D antibodies delivered a group O, D-negative baby with a positive DAT (2+), elevated bilirubin (18 mg/dL), and low hemoglobin (8 g/dL). Which is the most probable explanation for these test results? a. ABO hemolytic disease of the newborn b. hemolytic disease of the newborn with a false-negative D typing due to blocking antibodies c. large fetomaternal hemorrhage causing discrepancy in the blood type d. prenatal RhIG administration
b. hemolytic disease of the newborn with a false-negative D typing due to blocking antibodies
Select the situation where the administration of Rh immune globulin would be contraindicated.
Mother r"r; 4+ anti-D detected Newborn R2r: DAT positive
A fetal screen test is performed. No rosettes are seen on the microscopic examination. This test is interpreted as:
Negative
Can an Rh-negative patient be transfused with Rh-positive RBCs? Why or why not?
No, they cannot. If the Rh-negative patient is exposed to the D-antigen via transfusion with Rh-positive blood - the Rh-negative patient will form anti-D.
After centrifugation using anti-IgG gel cards, a layer of agglutinated cells was observed at the top of two of the three screening cell microtubes. What is the next step? a. repeat the test b. proceed to an antibody identification panel c. perform a DAT to determine whether the patient has an autoantibody d. verify the negative reaction with check cells
b. proceed to an antibody identification panel
Results of a Kleihauer-Betke test determine there was a fetomaternal hemorrhage of 35 mL of whole blood during delivery. What is the correct dosage of RhIG? a. one vial b. two vials c. three vials d. four vials
b. two vials
Select the statement that is true regarding the rosette test. a. performed on a cord blood sample b. used to screen for FMH c. a quantitative test used to calculate the volume of FMH d. an acid elution used to estimate the volume of FMH
b. used to screen for FMH
What are the benefits and challenges to implementing Blood Bank automation?
benefits: 1) reduction in operating costs 2) redesign of work processes and support systems 3) increased productivity 4) enhanced total quality challenges: 1) concerns among staff - job replacement and involvement in decision making 2) cost justification issues - capital investment plan should be developed 3) automation implementation issues - time investment and training and validation may require extra stuff
Select the volume of whole blood covered in an FMH with a 300-μg dose of RhIG. a. 10 mL b. 15 mL c. 30 mL d. 50 mL
c. 30 mL
What is the time frame for RhIG administration after delivery? a. 6 hours b. 48 hours c. 72 hours d. 96 hours
c. 72 hours
Select the antibodies detected in the immediate-spin crossmatch. a. Rh antibodies b. high-titer, low-avidity antibodies c. ABO antibodies d. Kell antibodies
c. ABO antibodies
Which of the following tests is not included in routine compatibility testing? a. ABO b. Rh c. DAT d. Antibody Screen
c. DAT
Define patient blood management.
PBM: a patient-centered, multidisciplinary, evidence-based approach to using blood products 1) identify and manage anemia and bleeding risks before treatment 2) use intraoperative blood recovery 3) review how blood products are used and provide feedback to physicians 4) employ strategies during ICU and postoperative care that decrease need for transfusions 5) provide education on PBM to health care providers
What does a negative reaction in the MTS Gel Test look like in the gel card?
Pellet of cells at bottom of column.
Which of the following treatments uses ultraviolet light to treat hyperbilirubinemia after the infant is delivered?
Phototherapy
An exchange transfusion will accomplish all of the following EXCEPT:
Reduce the hemoglobin level in the newborn's circulation
If an emergency exists and there is not enough time to perform a crossmatch for red cells, what is the correct procedure?
Release group O, D-negative RBC units.
Compare and contrast the types of automation available for Blood Bank testing.
1) hemagglutination assays - performed on microplates using the same principles as in tube agglutination 2) SPRCA assays - used for both indirect antiglobulin tests (IATs) and direct antiglobulin tests (DATs) 3) Solidscreen II - detects RBC antibodies in serum or plasma 4) Erytype S - hemagglutination assay; ABO, D, and other RBC antigen testing 5) automated solid-phase systems: a) TANGO Infinity (Bio-Rad) - Combines Erytype S and Solidscreen II b) Capture system (Immucor) - microtiter plates accommodate SPRCA or hemagglutination testing 6) ID-MTS Gel Test (Ortho Clinical Diagnostics) - automated instrument is ORTHO ProVue; microprocessor controlled unit; stand-alone or interfaced unit; uses gel cards and digital image processing
What information is required on a pretransfusion Blood Bank specimen?
1) patient's full name and two independent identifiers 2) name of blood product 3) unique donor unit number or pool number 4) unit's expiration date and ABO and D typing 5) interpretation of crossmatching 6) technologist's identification
What are the requirements for issuing a unit of blood for transfusion?
1) physician's order 2) intended recipient's two independent identifiers, ABO group, and D type 3) requisition form: patient name and blood product 4) compare requisition form with donor unit tag 5) compare donor unit tag with blood product label 6) check blood product's expiration date 7) visual check of unit: discoloration? clot? abnormal appearance? 8) documentation of person issuing and person receiving donor unit 9) special transfusion requirements 10) date and time of issue, unit destination
LIS interfaces are an important component in automation because of its potential in:
1. providing a mechanism for the electronic crossmatch 2. recognizing errors in sample ID 3. flagging discrepancies with previous test results
A 300-µg dose of Rh immune globulin contains sufficient anti-D to protect against how much whole blood?
30 mL
If not stored in a monitored refrigerator, how long can RBC units remain outside the transfusion service to allow reissue?
30 minutes
A minimum of at least one ______ dose of Rh-immune globulin (RhIG) must be administered to all Rh(D)-negative women who deliver an Rh(D)-positive infant, provided the woman has not already made anti-D.
300 µg
Following delivery, when should Rh immune globulin be administered?
72 hours
In which type of HDFN is the firstborn affected?
ABO
The most common cause of hemolytic disease of the newborn is incompatibility between the mother and the infant in which blood group system?
ABO
What tests are included in a routine cord blood evaluation in Blood Bank?
ABO Typing D Typing Weak D Testing (if needed) DAT Elution (if needed)
What tests are included in a routine pretransfusion testing in Blood Bank?
ABO and D typing: discrepancies should be resolved before transfusion Antibody detection: unpooled reagent RBCs should be used Crossmatching: demonstrates ABO incompatibility and clinically significant antibodies to RBC antigens
Which tests are performed to identify the cause of suspected hemolytic disease of the fetus and newborn?
All of the above: DAT ABO Rh
What is the most appropriate type of crossmatch test to be performed in a patient with no evidence of clinically significant antibodies in: 1) the current sample 2) historical record has two ABO determinations and validated computer system
Computer Crossmatch
The most important serologic test for the diagnosis of HDFN is the ________ with anti-IgG reagents.
DAT
What fetal maternal hemorrhage test is quantitative? Why is this test performed?
Kleihauer-Betke test (KB test) - calculates the additional doses of RhIG
Why is strict specimen collection criteria important for pretransfusion specimens?
Life-threatening or uncomfortable transfusion reactions can occur if a patient receives incompatible blood.
Which elution method is ideal in the investigation of ABO hemolytic disease of the fetus and newborn?
Lui freeze-thaw
To what does the abbreviation "MSBOS" refer?
Maximum blood order schedule.
Why is it acceptable to transfuse an AB person with A packed red blood cells but unacceptable to transfuse type A whole blood?
The anti-B in donor whole blood would sensitize recipient cells.
Which of the following is true regarding the rosette test?
The test is valid only if the mother is D-negative and the infant is D-positive.
True or False A good practice for recipient's sample is to label with full name, a second unique identifier, date collected, and some means of identifying the phlebotomist.
True
True or False A type and screen protocol provides a mechanism to increase the number of uncrossmatched donor units in inventory.
True
True or False Automation should make it easier to do things the right way and more difficult to do the wrong things.
True
True or False Automation vendors submit their instrument to an US Food and Drug Administration review and approval process.
True
True or False Bar code technology is used in automated instruments to ensure positive sample identity.
True
True or False If a patient has been pregnant within the last 3 months before transfusion, the pretransfusion sample must be no more than 3 days old at time of intended transfusion.
True
True or False In a solid-phase red cell adherence antibody screening assay, a negative result appears as a red cell button.
True
True or False LIS interfaces link the automated test system with a LIS for reporting results.
True
True or False Rapid turnaround times for selected samples and the ability to accommodate large-volume batch testing contribute to overall operational efficiency.
True
True or False Solidscreen II technology uses Protein A to capture anti-IgG AHG.
True
True or False Using the same patient's sample, the antibody screen can be positive with the gel method and negative with the solid-phase method.
True
True or False Vendor assessment, base technology, and instrument assessment are important considerations in the selection of an automated system.
True
True or False: Vendors of automation for the transfusion service require prior approval from the Food and Drug Administration (FDA).
True
