5-PRETRANSFUSION Flashcards
(117 cards)
1
Q
Which process prevents immune mediated hematologic transfusion reactions
A
Pretransfusion testing
2
Q
Which step begins pretransfusion testing
A
Clinician’s order for right blood product and dose
3
Q
Which step involves confirming patient identity
A
Positive patient identification
4
Q
Which step involves obtaining blood samples for compatibility testing
A
Collection of blood samples
5
Q
Which step involves checking patient’s transfusion history
A
Review of patient history
6
Q
Which blood groupings are performed in pretransfusion testing
A
ABO blood grouping + Rh blood grouping
7
Q
Which test screens for red blood cell antibodies in patient serum or plasma
A
Red blood cell antibody screening
8
Q
Which procedure matches donor blood with patient blood
A
Crossmatching procedure
9
Q
Which information is labeled on the blood unit
A
Product details + Patient identification information
10
Q
Which report is generated and given with the blood product
A
Compatibility report
11
Q
What are the three main components of pretransfusion testing
A
Pre-analytical procedures + Serologic testing + Post-analytical procedures
12
Q
What is the most common clerical error in pretransfusion testing
A
Misidentification
13
Q
When do errors in patient identification usually occur
A
Blood sample drawn + Sample handling in laboratory + During transfusion
14
Q
What must be legible on the blood request form
A
Printing
15
Q
What type of printouts are preferred for blood request forms
A
Computerized printouts
16
Q
What information must accompany recipient samples according to AABB standards
A
Sufficient information for positive and unique identification
17
Q
What must be compared with the requisition form for patient identification
A
Patient wristband identification
18
Q
Which temporary identifiers can be used for patient identification
A
Temporary tie tags + Wrist band + Ankle band
19
Q
What should be asked to the patient for positive identification
A
Full name spelled out
20
Q
Which specimen types are acceptable for pretransfusion testing
A
Anticoagulated specimens + Clotted specimens
21
Q
Which specimen type is preferred for ease of handling
A
Anticoagulated specimens
22
Q
Why are red blood cells from anticoagulated samples ideal
A
Prepare uniform cell suspension
23
Q
What additional step may clotted red blood cells require
A
Additional washing
24
Q
What can serum contain that complicates agglutination interpretation
A
Small fibrin clots
25
What effect does anticoagulation have on complement binding antibodies
Inactivation due to calcium chelation
26
Why is intravenous line contamination unacceptable
May cause sample contamination
27
From where should specimens be collected relative to IV catheter
Arm opposite the IV catheter
28
What must be done if specimen is collected from IV line
Stop infusion + Flush line + Discard three times dead space volume
29
What effect can hemolyzed specimens have on test results
Mask antigen-antibody mediated hemolysis + Difficult evaluation
30
How often must specimens be collected if patient transfused or pregnant within past 3 months
Every 3 days
31
When does specimen expire for pretransfusion testing
Midnight on day 3 after collection
32
What is the purpose of the 3-day testing window
Minimize risk of adverse reaction from emerging alloantibody
33
At what temperature are pretransfusion specimens and donor unit segments stored
2 to 8 degrees Celsius
34
How long must patient sample and donor unit segment be retained post-transfusion
At least 7 days
35
Why is retention of samples post-transfusion important
Investigate adverse transfusion events + Delayed hemolytic transfusion reaction
36
What should be reviewed in patient history before pretransfusion testing
Prior unexpected antibodies + Previous transfusion reaction
37
Which blood group is most important in transfusion and transplantation due to immunogenicity
ABO blood group
38
Which methods can be used to perform ABO grouping
Tubes + Column-agglutination technology + Microtiter plates in solid-phase red cell adherence tests
39
What must be resolved before transfusion in ABO grouping
ABO discrepancies
40
Which blood group should be selected if ABO discrepancy cannot be resolved before transfusion
Group O red blood cells
41
What antigen presence or absence is detected in Rh typing
D antigen
42
Which antibody promotes direct agglutination of red blood cells at room temperature
IgM
43
Which antibody is used in indirect antiglobulin test for weak D antigen detection
IgG
44
What must be tested in parallel with anti-D reagent in indirect antiglobulin test
Rh control
45
Which recipients should receive Rh-negative red blood cells
Rh-negative recipients
46
Why should Rh-negative recipients receive Rh-negative red blood cells
To prevent production of anti-D alloantibodies
47
What must be detected and clinically assessed in antibody screening
Antibodies to blood group antigens
48
Which antibodies are associated with red blood cell destruction and hemolytic transfusion reactions
Clinically significant antibodies
49
Which antibodies are not clinically significant
IgM antibodies
50
Which antibodies shorten survival of transfused red cells and cause hemolytic disease of the newborn
Clinically significant antibodies
51
Which antigens must be expressed on red blood cells used in antibody detection tests
D + C + E + c + e + K + k + Fya + Fyb + Jka + Jkb + Lea + Leb + P1 + M + N + S + s
52
Which low-incidence antigens are not required in antibody detection tests
V + Cw + Kpa + Jsa
53
What are the types of unexpected antibodies
Immune alloantibodies + Naturally occurring antibodies + Passively acquired antibodies
54
What causes unexpected antibodies
Red cell stimulation from transfusion or hemolytic disease of the newborn
55
Which antibodies are clinically significant
IgG antibodies
56
What characteristics do screening cells have
Group O cells + Known antigenic content + Positive for common blood group antigens + Homozygous for genes showing dosage
57
What are the forms of screening cells
Single vial pooled cells + Two vials with different donors + Three vials with different donors
58
Which screening cells offer increased sensitivity
Single-donor vials
59
How many vials are required for detection of antibodies in pretransfusion testing
Two or three vials
60
What does a negative antibody screen indicate
No reactions with any test cells
61
What must be done if antibody screen is positive
Identify responsible antibody
62
Which tests are required on donor blood components before distribution
ABO grouping + Rh typing + Weak D test + Antibody screen
63
Which infectious disease tests are required on donor units
HBV DNA + HBsAg + HBc antibodies + HCV antibodies + HCV RNA + HIV1/2 antibodies + HIV-1 RNA + HTLV I/II antibodies + WNV RNA + Serologic test for syphilis + Antibodies to Trypanosoma cruzi + Zika virus
64
What must be compatible between donor red blood cells and recipient plasma
ABO antigens + Naturally occurring anti-A and/or anti-B
65
When must donor and recipient be ABO identical
When whole blood is the only option
66
Can Rh-negative red blood cells be given to Rh-positive recipients
Yes
67
What must donor units be if patient has clinically significant antibodies
Negative for corresponding antigen(s)
68
Is compatibility testing required for platelets thawed plasma and cryoprecipitate
No
69
What is sufficient for platelet transfusion compatibility
Current or historical ABO grouping
70
Why is Rh typing ignored for platelets thawed plasma and cryoprecipitate
Very few red blood cells present
71
What platelet units should be selected to ensure adequate survival
ABO identical
72
What plasma units should be compatible with
Recipient's ABO red blood cell antigens
73
What are the two main functions of crossmatching
Final check of ABO compatibility + Detect antibodies not found in antibody screening
74
What does a serologic crossmatch test
Mixing recipient plasma with donor cells to detect ABO or antibody incompatibilities
75
What does a nonreactive serologic crossmatch indicate
Donor unit is compatible and safe
76
What is immediate spin crossmatch used for
Detect ABO incompatibility when no clinically significant antibodies are present
77
How is immediate spin crossmatch performed
Mix recipient plasma with donor cells
78
What indicates ABO compatibility in immediate spin crossmatch
Absence of agglutination and hemolysis
79
What are possible reasons for crossmatch incompatibility
Incorrect ABO grouping + Cold-reactive allo- or autoantibody + Abnormalities in recipient plasma
80
When is antiglobulin crossmatch required
When clinically significant antibody is detected
81
What does antiglobulin crossmatch consist of
Immediate spin crossmatch + Incubation at 37 degrees Celsius + Antiglobulin test
82
What indicates incompatibility in antiglobulin crossmatch
Reactivity or hemolysis at any phase
83
What additional tests are included in antiglobulin crossmatch
Anti-globulin testing phase + Autocontrol
84
What are possible reasons for antiglobulin crossmatch incompatibility
New alloantibody in recipient plasma + Alloantibody to low-incidence antigen on donor cells + Warm-reactive autoantibody in recipient plasma + Donor unit positive direct antiglobulin test
85
What blood type is used in emergent transfusions when recipient blood type is unknown
Group O red blood cells
86
When can ABO group-specific red blood cells be issued in emergent transfusions
Once recipient blood type is obtained
87
How is massive transfusion defined
8 to 10 red blood cell units in less than 24 hours or 4 to 5 units within 1 hour
88
What transfusion ratio is recommended for massive transfusion
Red blood cells + Thawed plasma + Platelets in 1:1:1 ratio
89
What is the goal of massive transfusion treatment
Restore blood volume + Maintain hemostasis + Oxygen-carrying capacity + Oncotic pressure + Biochemical parameters
90
When may pretransfusion testing be abbreviated in neonatal transfusions
Infants less than 4 months old
91
Which plasma may be used for antibody screening in neonatal transfusions
Infant's plasma + Mother's plasma
92
What must donor units be if clinically significant antibody is identified in neonatal transfusions
Antigen-negative or antiglobulin crossmatch compatible
93
When can group O red blood cell transfusions be given to infants
If antibody screen is negative
94
What are intrauterine transfusions indicated for
Severe fetal anemia
95
How are intrauterine transfusions performed
Needle insertion into umbilical vein guided by high-resolution sonography
96
What tests may be performed on fetal samples in intrauterine transfusions
Blood typing + Direct antiglobulin test + Antigen typing + Bilirubin levels
97
What blood type and characteristics should donor units have for intrauterine transfusions
Group O Rh-negative + Fresh less than 7 days old + Leukocyte-reduced + Irradiated + Negative for hemoglobin associated with sickling
98
What must donor units be if maternal antibody is present in intrauterine transfusions
Antigen-negative + Crossmatch compatible at antiglobulin phase
99
Which test is useful for identifying patients with auto-antibodies
Autocontrol
100
Which situation may make finding a compatible blood unit difficult
Presence of auto-antibodies
101
What is the direct Coombs test used for
Detection of in vivo coating of red blood cells with globulins
102
Which specimen is used in the direct Coombs test
Washed red blood cells from patient or donor
103
Which reagent is used in the direct Coombs test
Antiglobulin reagent
104
Which condition is diagnosed using the direct Coombs test
Hemolytic disease of the newborn
105
Which condition is diagnosed using the direct Coombs test
Autoimmune hemolytic anemia
106
Which investigation is performed using the direct Coombs test
Red blood cell sensitization caused by drugs
107
Which investigation is performed using the direct Coombs test
Transfusion reactions
108
What is included in post-analytical procedures for pretransfusion testing
Labeling of unit with product and patient identification information + Generation of compatibility report
109
What information is included on the unit label
Product details + Patient identification information
110
Which report is given to accompany the blood product
Compatibility report
111
When must donor units be labeled
At the time of issue
112
Which requirements must be met before blood components are issued
All special transfusion requirements
113
What must be visually inspected before issuing blood components
Presence of hemolysis or clots
114
When can blood components not be issued
Until all discrepancies are resolved
115
Who confirms recipient identification and donor unit information at the bedside
Transfusionist
116
How are blood components administered
According to facility policy
117
What is done if an adverse event related to transfusion occurs
Investigated according to policy
