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Mercy CLS 4: Blood Bank > 7. ABID & problem resolution > Flashcards

7. ABID & problem resolution Flashcards

(64 cards)

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1
Q

Antigens represented on screening cells

A

D, C, E, e, c
M, N, S, s
P1
Lu a/b
K, k
Fy a/b
Jk a/b

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2
Q

advantages of ABS (3)

A

advance warning of XM problems
time to find compatible blood before critical point
clarify problems in ABO/Rh testing

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3
Q

limitations of ABS (3)

A

only 2-3 cells
some antigens not homozygous
some antigens not represented at all

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4
Q

ABS+ may indicate… (3)

A

alloAb
autoAb
anomaly

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5
Q

used to rule out autoAb

A

autocontrol
DAT

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6
Q

Autocontrol + at IS (2)

A

cold autoAb
rouleaux

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7
Q

Autocontrol + at AHG (2)

A

warm autoAb
trxn

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8
Q

examples of anomalies (5)

A

rouleaux
fibrin
wharton’s jelly
imperfections in surface of tube
Ab to test component (PEG, gel, dye)

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9
Q

when is DAT performed? (4)

A

after trxn
after HDFN
after ABS+
Dr orders

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10
Q

what happens after ABS+? (2)

A

ABID panel
DAT

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11
Q

very first procedures after getting ABS+ (2)

A

call floor to let them know there will be a delay
obtain pt hx (transfusion, dx, medications, pregnancy hx, age)

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12
Q

ABID STEPS (7)

A
  1. rule-outs
  2. decide possibles
  3. decide probables
  4. use Fisher’s exact test to confirm probables
  5. eliminate other possibles
  6. perform Ag typing on pt cells
  7. XM units negative for clinically significant Ab
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13
Q

factors used to determine probables (4)

A
  • pattern of reactivity
  • phase/temp
  • dosage
  • enzyme treatment
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14
Q

IS/cold Abs (4)

A

Lewis
MN
P1
Lua

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15
Q

AHG/warm Abs (6)

A

Rh
Kell
Fy
Jk
SsU
Lub

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16
Q

Marked dosage (4)

A

MNS
Jk
Fy
some Rh

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17
Q

No dosage (5)

A

D
Kell
Lutheran
P1
Lewis

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18
Q

Destroyed by enzymes (2)

A

MN
Duffy

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19
Q

Enhanced by enzymes (4)

A

Rh
Jk
P1
Lewis

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20
Q

Enzymes have no effect (2)

A

Kell
SsU

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21
Q

probables must have ——– to ensure results are not due to chance

A

p-value ≤ 0.05

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22
Q

Fisher’s exact test

A

3 positives
3 negatives

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23
Q

how to select cells to eliminate possibles

A

negative for probables
homozygous for possible
OR 3 heterozygous for possible

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24
Q

never ruled out heterozygously

A

Kidd

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25
can resolve ABID problems using ---- or ---- to denature IgM
DTT 2-ME
26
↑ anti-M
acidify plasma
27
neutralization can help in ABID of...
Lewis P1 Sda (urine)
28
used to resolve interfering known antibodies in ABID
auto or allogeneic adsorption techniques
29
Ag typing ensures...
consistency of ABID results
30
+ control in Ag typing should be... why?
heterozygous ensures that the test detects the weakest potential expression of antigen
31
QC is run how often for Ag typing?
every day of testing
32
how to select # of units to screen
units needed / proportion compatible
33
most discrepancies result from -------- why we need...
tech error well-written, meticulously followed testing procedures
34
first attempt at resolving a discrepancy problem
repeat testing with washed cells
35
often a clue to expect rouleaux
multiple myeloma
36
eliminate fibrin (2)
dissolves at 37° dissolved by protamine sulfate
37
Hodgkin lymphoma
decreases antigen expression
38
eliminate high titer A or B substance in serum
wash test saliva
39
increases reactivity of ABO abs
RT incubation
40
2 lectins used to ID subgroups
**A1 lectin** — reacts with A1 cells **H lectin** — helps detect bombay
41
anti-------- may help get a stronger forward rxn with subgroups
anti-A,B
42
causes of unexpected forward type results (5)
- cold autoAb or alloAb - Ab to dyes - Acquired B antigen - rouleaux or wharton's jelly - transfusion/transplantation
43
resolve cold Ab giving discrepant forward results (2)
warm saline wash DTT (denatures IgM)
44
resolve Ab to dyes giving discrepant forward results
wash
45
resolve acquired B antigen giving discrepant forward results (2)
repeat with monoclonal, acidified anti-B autocontrol — anti-B in reverse type does not react
46
explain acquired B
caused by **GI disturbance** (malignancy, obstruction, GN septicemia) N-acetylgalactosamine is cleaved to give **galactosamine** mistaken for D-galactose by some reagents
47
resolve wharton's jelly
wash 4x
48
what do you do after getting an MF rxn?
pt hx check
49
causes of unexpected reverse type results (7)
**Patient** - Age, young or old - Immcomp disease states - Transfusion **Test system** - AutoAb or alloAb - ABO subgroup - Prozone - Rouleaux
50
resolve low Ab titer (age) giving discrepant reverse results (4)
incubate RT 15-30 mins incubate 4° 15-30 mins add O plasma to system as control if forward type is O, add anti-A,B
51
resolve ABO subgroups giving discrepant reverse results
test with 3 A1 and 3 A2 cells
52
3 A1 and 3 A2 all + means...
acquired anti-A via transfusion
53
interferes with testing after transfusion
CD47
54
resolve prozoning giving discrepant reverse results
dilute serum
55
resolve auto/allo Ab giving discrepant reverse results (3)
cold autoadsorption prewarm technique ABID; retest with segments of units = for antigen
56
causes of Rh false negatives (5)
- incorrect reagent/forgot reagent - reading error - **heavy cell suspension** - **undercentrifugation** - **CML (interferes with Rh)**
57
causes of Rh false positives (5)
- **DAT+ (autoAb)** - rouleaux - **polyagglutination** - incorrect reagent - **overcentrifugation**
58
EGA
EDTA glycine acid
59
EGA purpose
**dissociates bound Ab from cells**, leaving cells intact inactivates Kell **used to get accurate weak-D when DAT+**
60
A2 discrepant test results (2)
anti-H 2+ A1 reverse 0-2+
61
A3 discrepant test results (4)
anti-A: 2+mf anti-A,B: 2+mf anti-H: 3+ A1 reverse: 0-2+
62
Ax discrepant test results (5)
anti-A: +/= anti-A,B: 1-2+ anti-H: 4+ A1 reverse: 0-2+ no A substance in saliva
63
B3 discrepant test results (3)
anti-B: 1+mf anti-A,B: 2+ anti-H: 4+
64
Bx discrepant test results (4)
anti-B: +/= anti-A,B: 0-2+ anti-H: 4+ no B substance in saliva

Mercy CLS 4: Blood Bank (13 decks)

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