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MLS > Blood Bank Exam 1 > Flashcards

Blood Bank Exam 1 Flashcards

1
Q

RBC Membrane is freely permeable to

A
  • Water
  • Anions
  • O2 and CO2
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2
Q

RBC Membrane is NOT freely permeable to

A
  • Na+
  • K+
  • Ca2+
    Active transport is required, using energy (ATP)
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3
Q

RBCs get their energy from

A
  • 90% from Anaerobic Glycolysis
  • 10% from Monophosphate Shunt
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4
Q

Minimum Requirement for pRBC unit viability

A

75% survival of transfused RBCs after 24 hours

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5
Q

RBC storage temp

A

1-6°C

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6
Q

One Unit pRBC contains

A

405-495 mL of blood
63 mL anticoagulant/preservative

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7
Q

WB (Whole Blood) Storage temp

A

1-6°C

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8
Q

Plasma (FFP) Storage temp

A

-18°C or below

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9
Q

Platelets Storage temp

A

20-24°C

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10
Q

Two Stages of Agglutination

A

1: Sensitization
2: Lattice formation

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11
Q

AHG

A

Anti-human globulin, added to assist with lattice formation

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12
Q

PEG

A

Polybrene & Polyethylene Glycol

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13
Q

Zeta Potential

A

Net negative charge on surface of RBCs. Pushes each other away, resisting lattice formation

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14
Q

ABO Forward Reactions

A

Using reagent antisera to test for patient antigens

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15
Q

ABO Reverse Reactions

A

Using reagent cells to test for patient antibodies in serum

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16
Q

ABO Gene Locus

A

Chromosome 9

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17
Q

Hh Gene Locus

A

Chromosome 19

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18
Q

Sese Gene Locus

A

Chromosome 19

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19
Q

Where are blood type antigens found?

A

On RBCs, epithelial cells and in soluble form in the plasma

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20
Q

“H” gene codes for

A

fucosyltransferase, adds fucose to CHO (“carbohydrate”) chain, forming the H antigen

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21
Q

h/h Genotype

A

Bombay blood. No fucose added, no H antigen, no A/B phenotype possible. “Oh” phenotype.

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21
Q

Two types of CHO precursors

A

Type 1 - Body Fluids, 1-4 linkage
Type 2 - RBCs, 1-3 linkage

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22
Q

“A” gene codes for

A

N-acetylgalactosaminyl transferase, adds N-acetylgalactosamine to fucose chain, forming the A antigen

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23
Q

“B” gene codes for

A

Galactosyl transferase, adds galactose to the end of the fucose chain, forming the B antigen

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24
Q

“O” gene codes for

A

No enzyme (amorph). Fucose remains terminal on the CHO chain, displaying the H antigen

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25
Q

Test for Bombay blood

A

Anti-H lectin

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26
Q

“Se” gene codes for

A

Secretion of H, A, and B antigen (in saliva, tears, bile, milk, etc.)

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27
Q

ABO Antibody class from immune exposure

A

IgG

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28
Q

ABO Antibody class that is naturally occurring

A

IgM

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29
Q

Antibody productions starts at what age?

A

3-6 months of life, ignore reverse reactions on cord blood

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30
Q

Discrepancy

A

When the forward reaction doesn’t match the reverse reaction

31
Q

In type A and B patients, antibodies to the opposite tend to be

A

IgM

32
Q

In type O patients, antibodies to A and B tend to be

A

IgG

33
Q

Type A vs Type A2

A
  • Type A has A1 and “A” (A2) antigens
  • Type A2 has A2 antigens only
34
Q

Mixed Field Reaction

A

Obvious agglutination with a cloudy (unagglutinated) background

35
Q

Group I Discrepancies

A

Weakly reacting or missing antibody reactions
- Age
- Immunodeficiency

36
Q

Group II Discrepancies

A

Weakly reacting or missing antigens; extra antigens
- disease-related
- acquired B antigens
- Rare antibodies

37
Q

Group III Discrepancies

A

Protein/plasma abnormalities
- increased globulins
- increased fibrinogen
- plasma expanders
- Wharton’s Jelly

38
Q

Group IV Discrepancies

A

Miscellaneous
- Polyagglutination
- Cold reactive antibodies
- Warm autoantibodies
- Unexpected antibodies
- Unexpected Ag-Ab complexes
- cis AB phenotype

39
Q

DAT Testing Detects

A

IN VIVO coating of RBCs with Antibody or C’

40
Q

IAT Testing Detects

A

IN VITRO reactions of serum and reagent RBCs (hunting for antibodies)

41
Q

IgG 1 is best at

A

crossing the placenta

42
Q

IgG 4 is least likely to

A

activate complement

43
Q

Which AHG reagent isn’t used in routine testing

A

Anti-C3d,C3b

44
Q

Common complement binding antibodies

A
  • Anti-A
  • Anti-B
  • Anti-Jka
  • Anti-Lea
45
Q

Check Cells are added to

A

negative AHG tubes to confirm it as a true negative (both DAT and IAT)

46
Q

Rh control is used when

A

albumin (high protein) reagent is used

47
Q

Rh control is positive when

A

DAT is positive

48
Q

If Check Cells are negative

A

likely error in wash steps

49
Q

3 Phases of IAT testing

A
  • RT - detect “cold antibodies” (IgM)
  • 37C - detect “warm antibodies” (IgG)
  • AHG - detects sensitized cells
50
Q

Why are albumin reagents falling out of fashion?

A

Prone to spontaneous agglutination

51
Q

If you have the D antigen, you are Rh

A

positive

52
Q

HDN

A

Hemolytic Disease of the Newborn

53
Q

Where is the D antigen found

A

on RBCs only (integral membrane component)

54
Q

5 most common Rh antigens

A

D, C, c, E, e

55
Q

Tippet/Rosenfield

A

Rh naming system, is primarily used for research

56
Q

Fisher Race

A

Rh naming system, most used, 3 closely linked loci inherited as a unit

57
Q

Genotype that strengthens expression of D antigen

A

R2 (cDE)

58
Q

Cis effect

A

E antigen weakens when on the same haplotype as D

59
Q

Trans effect

A

E and C antigens weaken when on opposite haplotypes from D

60
Q

Weak D notation

A

Du

61
Q

Who is tested for weak D

A
  • Blood donors
  • Mom/Baby testing
62
Q

Anti-G

A

Anti-C,D; expressed by D neg individuals

63
Q

LW Antigen

A

Separate from D antigen, but weaker in D neg individuals

64
Q

Rh Null

A

No Rh Antigens (d/d, deletion of C/c and E/e). Very rare

65
Q

Antibodies to Rh antigens result from

A

exposure

66
Q

Rh Antigen Immunogenicity

A

e < C < E < c < D

67
Q

Enhancement Media for Rh antibody testing

A

PEG or LISS

68
Q

Concomitant Antibodies

A

Antibodies which often occur together (E and c due to common R1 genotype)

69
Q

Protein % in albumin reagent

A

20-24%

70
Q

Rhi antigen

A

C,e compound antigen found on DCe haplotype cells (R1 gene)

71
Q

f antigen

A

c,e antigen that occurs when c and e are in the same haplotype (Dce)

72
Q

Frequency of D vs d phenotype

A

85% D, 15% d

73
Q

Frequency of C, c, e

A

70%

74
Q

Frequency of E

A

30%

75
Q

Most common Rh haplotypes

A

DCe (white, native, asian), dce (white, black), Dce (black)

76
Q

Most common Rh genotypes for Caucasians

A

DCe/dce - 33%
DCe/DCe - 18%
dce/dce - 15%

MLS (18 decks)

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