Blood Bank

How many additional cells must be tested to meet the "3+3 rule" for Anti E?

0

It is the policy of this laboratory to identify two antigen negative units for patients with antibodies even if the original order was for a type and screen only. There are 30 group O positive unites in the labs inventory. The antigen frequencies are E antigen = 30% and K antigen = 9%. APPROX how many of these units would be expected to be negative for the antigens to the antibodies that have been identified?

19-20

What do "check cells" contain?

Rh(D)+ red blood cells coated with anti-D

If the Fisher Race notation is D then the Wiener notation is

Rh0

Initial exposure of an individual to a specific antigen resulting in an immune response

Sensitization

When checking out a unit of blood to the floor:

all of the above

A silent gene; a gene for which there is no known gene product

amorph

A delayed hemolytic transfusion reaction is most often the result of:

an anamnestic response in a patient who has been previously sensitized by transfusion or pregnancy

Polyspecific AHG contains

anti-IgG and anti-C3d

A patient with a warm reacting autoantibody needs 2 units of compatible, packed cells. Medical history reveals a blood transfusion 2 months ago. A homologous absorption is performed using the following red blood cell phenotype: R2R2, ss, Fy (A-b+), Jk(a+b-, kk. What alloantibody would remain in the serum after absorption?

anti-S

An acquired form of anemia in which an individual's antibodies destroy his own red blood cells

autoimmune hemoltyic anemia

Method used to remove IgG antibodies that are coating a patient's red blood cells

elution

If the Fisher Race notation is e (little e) then the Wiener notation is

hr"

If the Fisher Race notation is c (little c) then the Wiener notation is

hr'

What would be the result of group B blood given to a group O patient?

immediate hemolytic transfusion reaction

All of the following statements regarding the AHG test are true except:

incubation time with LISS should be a minimum of 30 minutes

Red blood cells of known antigen make-up which are used in testing for the presence of antibodies

reagent red cells

If the Fisher Race notation is E then the Wiener notation is

rh"

Immune hemolytic anemia is defined as:

shortened RBC survival mediated through humoral antibody production

Which of the following statements is correct?

statements a, b, and c are correct

Given the results of the antibody detection and antibody identification testing, what is/are the most likely antibodies present in AZ's serujm?

Anti E and Anti K

What is the immunologic principle of RhIG administration?

Anti-D attaches to Rh-positive cells of the infant in maternal circulation and are subsequently removed by cells of the reticuloendothelial system, preventing sensitization

Which of the following is a characteristic of autoantibodies?

Antibody reacts with high-incidence antigens

What might be found in the serum of a person who is exhibiting signs of TRALI?

Antileukocyte antibody

AZ, a 37 year old males, is scheduled for a same day surgical procedure for a hernia repair. He has no history of significant medical problems, with the exception of injuries received during his service in the military. He was given 6 units of red blood cells following a land mine explosion 4 years ago. At that time the transfusions were uneventful. Given the results of the antibody detection test, what hypothesis can be developed?

Both choices A and B are potential solutions

Rosenfield notation Rh 2 is equal to what Fisher Race notation

C (big C)

Anti-Jka was identified in a previously transfued patient. Five cells that were homozygous for Jka yielded 2+ reactions in the AHG phase. The same cells were treated with ficin and yielded 3+ reactions in AHG. Therefore, Jka is_________ by enzyme treatment.

Enhanced

The response to a transfusion of incompatible blood characterized by destruction of transfused red blood cells primarily in the spleen

Extravascular transfusion reaction

Which of the following 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

A Duffy phenotype prevalent in blacks but virtually nonexistent in whites

Fy (a-b-)

If you suspect anti-C is present in a patients serum, and anti-Fya still has to be ruled out using other reagent cells, what would the phenotype of the rule out cell have to be?

Fy(a+), C-, Fy(b-)

A type and screen is done on a 49-year-old woman who is scheduled for a hysterectomy in 1 week. Hid blood type is A-positive, and her antibody screen was positive. What must be done before her surgery date?

Identify antibody and phenotype units

"Complete" agglutinins that agglutinate red blood cells in saline are which immunoglobulin class?

IgM

The indirect antiglobulin test detects which antigen-antibody reactions

In vitro

Why is incubation omitted in the direct antihuman globulin test?

In vivo antigen antibody complex is already formed

A patient came in for a routine type and screen prior to surgery. The antibody screen was negative at 37C and at the AHG phase. Check cells did not produce agglutination often. What is a possible explanation for this result?

Inadequate washing

Which of the following mother/infant blood types would be considered at risk for ABO hemolytic disease of the fetus and newborn?

Mother is group O; baby is group B

An ABO type on a patient gives the following reactions: Patient cells with: Anti A: 4+ Anti B: neg Patient serum with: A1 cells: 2+ B cells: 4+ O cells: 2+ AUto Control: Neg These results are most likely due to:

Non-ABO alloantibody

Given the combined results of the antibody detection and antibody identification tests, which of the following antibodies has NOT been ruled out?

None of the above

AZ, a 37 year old males, is scheduled for a same day surgical procedure for a hernia repair. He has no history of significant medical problems, with the exception of injuries received during his service in the military. He was given 6 units of red blood cells following a land mine explosion 4 years ago. At that time the transfusions were uneventful. What is AZ's ABO & Rh type?

O pos

Rosenfield notation Rh 4 is equal to what Fisher Race notation

c (little c)

The immediate spin crossmatch test includes the following:

Patients plasma and donor's red cells

AZ, a 37 year old males, is scheduled for a same day surgical procedure for a hernia repair. He has no history of significant medical problems, with the exception of injuries received during his service in the military. He was given 6 units of red blood cells following a land mine explosion 4 years ago. At that time the transfusions were uneventful. Given the initial serological findings, what should the medical laboratory scientist do next?

Perform an antibody identification panel

How might a technologist detect a patient with drug-induced hemolytic anemia?

Positive DAT

The rejection of platelets in multiply transfused patients is called:

Refractioriness

What is the action of PEG?

Removes water molecules, thereby concentrating antibody

The tech observed a 2+ agglutination upon performing the direct coombs test with broad spectrum coombs serum. What is the next step?

Repeat the test with Anti IgG AHG & Anti C3d AHG (two separate tests)

An antibody screen is performed, and all three tubes are negative after adding AHG. Check cells are added, and the tubes are centrifuged. No agglutination occurs after the addition of check cells. What is the next course of action?

Repeating the antibody screen

What is the purpose of washing cells in the AHG test?

To remove all unbound protein

A 300-ug dose of Rh-immune globulin contains sufficient anti-D to protect against how much whole blood?

30 mL

At what temperature is the incubation phase of AHG test?

37C

How many units would have to be antigen-types for E and K in order to find 2 units negative for both antigens?

4

In order to be considered fresh frozen plasma, the plasma needs to be prepared within_________ of collection?

8 hours

In the ABO system which of the following statements are correct: 1) codominance system: heterozygote AB will express both alleles 2) H gene specified transferase adds sugar fucose to the precursor chain to make H chain 3) A gene: N-acetyle galactosamine is added to galactose 4) B gene: Galactose is added to galactose 5) if niether A or B is present (the "O" condition) then antigen is H 6) Least essential system for transfusion practice 7) Anti A & Anti B are IgM antibodies 8) Group O have a naturally occurring IgG antibody called Anti A, B

All of them except 6

What tests are involved when a physician orders a 4-unit crossmatch on a patient?

ABO, Rh, antibody screen, IS crossmatch

Which blood product is used in the treatment of DIC?

All of the above

Why are check cells added to all negative reactions in the AHG test?

To ensure AHG was not neutralizing by free globulin molecules

AZ, a 37 year old males, is scheduled for a same day surgical procedure for a hernia repair. He has no history of significant medical problems, with the exception of injuries received during his service in the military. He was given 6 units of red blood cells following a land mine explosion 4 years ago. At that time the transfusions were uneventful. Based on the antibody identification test results and the laboratory rule out criteria listed above, which of the following cells would rule out anti-c?

Cell 9

A group of enzymatic proteins found in normal serum, some of which become associated with the cell membrane following interaction of antibody with its corresponding red cell antigen.

Complement

Rosenfield notation Rh 1 is equal to what Fisher Race notation

D

What is the cause of HDFN?

Destruction of the fetus's RBCs by antibody produced by the mother

Rosenfield notation Rh 3 is equal to what Fisher Race notation

E (big E)

What quantitative test is performed when the rosette test for fetal maternal hemorrhage is positive?

Kleihauer-Betke

Which of the following characterizes an alloimmune response in immune hemolytic anemia?

The patient produces anti-K to transfused red blood cells

Note there are no cells on this panel that have a double dose of the K antigen. Which of the following statements is true regarding the K+k- phenotype?

The phenotype is rare due to the high prevalence of the k antigen in the population