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Blood Bank > Blood Bank Unit 2 Exam > Flashcards

Blood Bank Unit 2 Exam Flashcards

(67 cards)

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1
Q

What is the antiglobulin test (Coombs Test) used for?

A

to detect RBCs sensitized with IgG antibodies and/or complement components

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2
Q

In vitro Coombs Test

A

Indirect (IAT)

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3
Q

In vivo Coombs test

A

Direct (DAT)

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4
Q

How are monoclonal reagents made?

A

spleen lymphocytes from immunized mice are fused with myeloma cells

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5
Q

Monoclonal reagents - specificity (eg. how many antibodies are made)

A

multiple of ONE type of antibody is made that reacts with one specific epitope

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6
Q

How are polyclonal reagents made?

A

by injecting animals with human globulin components and collecting the antihuman antibodies

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7
Q

Polyclonal reagents - specificity (eg. how many antibodies)

A

reacts with multiple epitopes, less specific with a giant mix of antibodies

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8
Q

What can a positive DAT tell us (diagnosis)?

A
  • Hemolytic Disease of the Newborn (in pregnant women)
  • Autoimmune hemolytic anemia (autoimmune diseases)
  • Transfusion reaction
  • Drug/anti-drug complexes
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9
Q

What is the purpose of the DAT?

A

To demonstrate in vivo sensitization of red cells with IgG and/or Complement

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10
Q

What is the purpose of the IAT?

A

To demonstrate in vitro sensitization of red cells with antibody and/or complement

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11
Q

What is the IAT used for?

A

Antibody screening
Antibody identification
Crossmatches
Antigen Typing

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12
Q

Describe the test procedure for the DAT (tube used, suspension, how many washes, etc)

A
  • Collect in EDTA blood bank tube
  • 3-5% RBC suspension with 0.9% saline
  • one drop of suspension washed 3 times
  • 2 drops AHG
  • centrifuge and read (clumping = positive)
  • add indicator cells to negative reactions
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13
Q

When should you add indicator cells? What should the result be? What if the results are not what they should be?

A

Indicator cells should be added to negative reactions only.
Indicator cells should then be positive.
If they are negative, you must repeat everything.

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14
Q

Describe the procedure for the IAT

A
  • 2 drops serum/plasma + 1 drop red cell reagent
  • read at initial spin
  • 2 drops enhancement media (LISS/PEG)
  • incubate 37C for 15 min
  • centrifuge and read
  • wash 3 times
  • add 2 drops AHG reagent
  • centrifuge and read
  • add check cells to negative tubes
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15
Q

Polyspecific Reagent

A
  • green reagent used primarily for DAT that contains both IgG and C3 (cannot differentiate between which one it is binding, agglutination could be either)
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16
Q

Anti IgG reagent

A

monospecific reagent that can detect IgG binding RBC

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17
Q

Anti-Complement reagent

A

monospecific reagent that can only detect Anti C3 complement binding RBC

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18
Q

False Negative sources of error in AHG testing (low sensitivity)

A
  • inadequate washing
  • under centrifugation
  • loss of reagent activity
  • inappropriate RBC concentration
  • failure to add regents
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19
Q

False Positive sources of error in AHG testing (decreased specificity)

A
  • over centrifugation
  • dirty glassware (contamination from bacteria or other patient)
  • agglutination prior to washing in IAT
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20
Q

What are check cells?

A

O positive cells coated with anti-D that serve as cross-linking supplement when AHG added, making sensitization visible

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21
Q

Antithetical

A

antigens that are products of allelic genes (Duffy, Kidd, Rh)

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22
Q

Type

A

the test for ABO and Rh (specifically D) phenotype

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23
Q

Screen

A

The test to determine if there are any antibodies present in the patients plasma

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24
Q

Front Type

A

“what you are” - unknown patient cells tested with known anti-serum

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25
Back/Reverse Type
"what you are not" - known cells tested with unknown antibodies
26
Crossmatch
test to see if blood is compatible with pt - mixing of donor blood with pt plasma
27
IS/Immediate Spin Crossmatch
add donor RBC and pt plasma together and immediately spin them and read reaction
28
Extended Crossmatch/AHG crossmatch
add pt plasma and donor RBC and incubate 37C for 15 min add AHG, centrifuge, read check cells for neg reactions
29
Anti-sera
manufactured monoclonal/polyclonal antibody
30
Reagent cells
manufactured human RBC that have known antigens
31
Panels
Set of reagent cells that allow you to identify antibodies
32
Positive Reaction in blood bank
any agglutination or hemolysis that occurs (depends on the test)
33
Negative reactions in blood bank
No agglutination or hemolysis occurs (depends on the test)
34
Cell button
the clump/pellet of red cells after centrifugation
35
Hemolysis
destruction of RBC
36
FFP
fresh frozen plasma - contains all clotting factors
37
pRBCs
packed red blood cells (red blood cell portion of whole blood)
38
PLTs
platelets suspended in a little plasma
39
CRYO
a concentrated source of coagulation factor VIII that also contains fibrinogen, factor XIII and VWF.
40
LK
leukoreduced - filtered to remove the major of WBC
41
IRR
irradiated - gamma radiation of a cellular blood product for protection against graft vs host disease
42
4 types of BB reagents
commercial RBCs Antisera Antiglobulin reagents Potentiators
43
Polyclonal vs. Polyspecific Reagents
Polyclonal - AHG with IgG and IgM | Polyspecific - AHG with IgG and C3b
44
What is the most specific type of commercial antibodies??
Monoclonal antibodies
45
Advantages/Disadvantage of monoclonal antibodies
Advantage - highly specific | Disadvantage - very expensive
46
Positive Agglutination reactions for each blood type in FORWARD TYPE reaction
A - positive reaction with anti-A B - positive reaction with anti-B AB - positive reaction with both anti-A and anti-B O - no agglutination will occur
47
what color is anti-A reagent
blue
48
what color is anti-B reagent
yellow
49
what color is anti-D reagent
clear
50
what color is anti-A,B reagent
clear
51
Forward Typing reactions for D antigen
D-positive - positive reaction with anti-D | D-negative - no positive reaction
52
What is a low-protein anti-D reagent?
6% bovine albumin that have replaced high protein reagents
53
What should controls show during ABO testing?
The control should show no agglutination
54
When is a separate control used?
When RBCs agglutinate with all ABO anti-sera (eg. AB+) | A separate control is not needed if there is any negative result in the forward type
55
What procedures use commercial RBCs?
- ABO serum testing (reverse type) - screening tests - antibody identification
56
What are the reagent RBCs?
A1 and B cells
57
Positive agglutination reactions for each blood type during REVERSE TYPING
A - positive reaction with reagent B cells B - positive reaction with reagent A1 cells AB - no positive reactions O - positive reaction with both reagent A1 and B cells
58
T/F: A1 and B cells are positive for Rh antigens.
False; they are negative for Rh antigens
59
Screening cells
Used in antibody screen. Available in sets of 2-3 vials; pt serum added to screening cells to see if antibody/antigen complexes form
60
Panel Cells
Similar to screening cells but are 10+ vials
61
LISS
increases rate of antibody uptake
62
Potentiators/Enhancement medias
LISS, PEG, proteolytic enzymes, BSA
63
what does PEG do
Concentrates the antibody in the test environment in LISS
64
what do proteolytic enzymes do
removes negative charges from the red cell membrane to reduce zeta potential; denatures some red cell antigens
65
what does BSA do
Reduces the repulsion between cells but does not shorten incubation time
66
solid phase positive vs negative reaction
positive reaction - no cell button (cells adhere to the sides of the well) negative reaction - cell button (cells settle to the bottom of the well)
67
Column Agglutination Technology (0-4+)
``` 0 - cells on bottom of tube 1+ - cells mostly on bottom of tube but towards the middle too 2+ cells evenly distributed throughout 3+ cells mostly towards the top 4+ all cells at the top ```

Blood Bank (7 decks)

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