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BB Lab > RH TYPING AND TESTING FOR WEAK D > Flashcards

RH TYPING AND TESTING FOR WEAK D Flashcards

1
Q

Second most important blood group when it comes to
immunogenicity and blood transfusion practice

A

Rh BLOOD GROUP SYSTEM

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2
Q

Rh BLOOD GROUP SYSTEM
Is the Second most important blood group when it comes to _____

A

immunogenicity and blood transfusion practice

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3
Q

Rh BLOOD GROUP SYSTEM
comprises of how many antigens?

A

more than 60 antigens

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4
Q

What are the 5 most common rh antigens?

A

D, c, E, C, e

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5
Q

means the RBCs have D antigens

A

“Rh-positive”

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6
Q

means the RBCs don’t have D antigen

A

“Rh negative

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7
Q

absent rh antigens

A

Rh null phenotype-

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8
Q

All around the world, the prevalence of Rh- positive type
is high. Around how many percent would have the D antigens on their
RBCs

A

> 90%

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9
Q

How many percent
African American (O+)

A

47%

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10
Q

How many percent
AFRICAN AMERICAN A-

A

24%

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11
Q

How many percent
AFRICAN AMERICAN B-

A

18%

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12
Q

How many percent
LATIN AMERICAN O+

A

53%

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13
Q

How many percent
LATIN AMERICAN A+

A

29%

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14
Q

How many percent
LATIB AMERICAN B+

A

9%

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15
Q

How many percent
Caucasian O+

A

37%

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16
Q

How many percent
Caucasian A+

A

33%

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17
Q

How many percent
Caucasian B+

A

9%

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18
Q

How many percent
ASIAN O+

A

39%

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19
Q

How many percent
ASIAN A+

A

27%

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20
Q

How many percent
ASIAN B+

A

25%

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21
Q

is the most common among the
different blood types

A

O positive blood type

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22
Q

is considered as universal blood
donor

A

O negative blood type

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23
Q

Important in emergency cases and in pregnancy

A

O negative blood type

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24
Q

Rh D positive
blood which will not cause Rh hemolytic transfusions
reactions if they’re going to be transfused with Rh
positive blood and also it will not cause any problems
when it comes to transfusion of either A, B, O blood
units.
TRUE OR FALSE?

A

True

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25
Q

Transfusion of blood from other blood types will not cause discrepancy of transfusions or in the attending physician..TRUE OR FALSE

A

FALSE BECAUSE Transfusion of blood from other blood types would
under be the discrepancy of transfusions or
attending physician

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26
Q

How many of Filipinos are Rh- positive

A

99.97%

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27
Q

What blood group is important in transfusion practices

A

RH BLOOD GROUP

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28
Q

They are easy to come by

A

Rh-positive individuals

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29
Q

Rh-negative individuals MUST receive Rh-positive blood..TRUE OR FALSE

A

False because Rh-negative individuals MUST receive Rh-negative blood

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30
Q

They are hard to come by, especially in
populations where 90% are Rh-positive

A

Rh-negative units

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31
Q

Introduction of Rh-positive units to Rh-negative patients
can cause the production of what antibody?

A

alloanti-D

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32
Q

It is known to cause severe HDN and AHTRS

A

Alloanti-D

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33
Q

Accurate phenotyping of D and other Rh antigens is very
necessary TRUE OR FALSE

A

True

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34
Q

WHAT ARE THE REAGENTS USED IN RH TYPING?

A

Saline-based
High protein
Chemically modified
Monoclonal anti-D

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35
Q

• Pure IgM reagent

A

Saline-based

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36
Q

First available anti-D

A

Saline-based

37
Q

Advantage of saline-based

A

• Low-protein
- Not elicit, agglutination reaction
are maybe even rouleaux
formation which are
advantageous specially the
blood you are going to test has
hyperalbuminemia
- Will also caused viscous blood
samples
- Can be used for testing cells
coated with IgG antibodies

38
Q

Disadvantages of saline based

A

• Limited availability
• Expensive to produce
• Lengthy incubation time
• Cannot be used for Weak D
typing

39
Q

• Primarily IgG anti-D

A

HIGH-PROTEIN

40
Q

• Human plasma with high
anti-D

A

HIGH-PROTEIN

41
Q

• Mixed with potentiators
(dextran, bovine albumin)

A

HIGH-PROTEIN

42
Q

Advantages of HIGH-PROTEIN

A

• Reduced incubation time
• Weak D typing and slide
typing may be performed
• Polyspecific

43
Q

DISADVANTAGES OF HIGH PROTEIN

A

• High rate of false-positives
• Must be performed together
with a control reagent (22%
bovine serum albumin/normal
saline solution

44
Q

Composed of modified,
flexible IgG antibodies

A

CHEMICALLY
MODIFIED

45
Q

Replaced saline anti- D
reagents

A

CHEMICALLY
MODIFIED

46
Q

Advantages of CHEMICALLY
MODIFIED

A

• Slide and tube typing may be
performed
• Doesn’t require control tests,
for most of the time
• Fewer false-positives; low
protein

47
Q

Disadvantages of CHEMICALLY
MODIFIED

A

Requires control if “AB Rhpositive
blood is being teste

48
Q

• Derived from single clones
of antibody- producing
cells

A

MONOCLONAL ANTI-D

49
Q

• Blend of IgM and IgG

A

MONOCLONAL ANTI-D

50
Q

Advantages of MONOCLONAL ANTI-D

A

• Increased specificity
• May be used for most
methods
• Can also be used for weak D
• Not of human source; less risk
for transmitting infections

51
Q

Disadvantage of MONOCLONAL ANTI-D

A

Narrow specificity

52
Q

In most of our testing procedures we are using what reagent

A

monoclonal blend of IgM and IgG

53
Q

Reagents for C/c and E/e antigen testing are
manufactured nowadays, helping in ____

A

antibody screen and
ID.

54
Q

Reagents are NOT USED IN ROUTINE TESTING due to
expensiveness but can be helpful in tertiary
laboratories

A

Reagents for C/c and E/e antigen testing

55
Q

strict adherence to the
manufacturer’s directions must be followed.

A

Rh antisera

56
Q

PRINCIPLE OF RH TYPING

A

• DIRECT HEMAGGLUTINATION
Presence of agglutination = Rh antigen testing for is present =
POSITIVE RESULT. If D is tested, RH- POSITIVE

57
Q

do not use latex, instead, use red
blood cells which contain antigens found in RBC
membrane

A

Indicator particles

58
Q

Antigen found in Indicator particle + particular
antiserum=

A

agglutination

59
Q

If the test result is Rh negative, immediately
declare/report negative. TRUE OR FALSE??

A

False!!If the test result is Rh negative, do not immediately
declare negative.

60
Q

What to do if the result is negative?

A

Perform tube testing or weak D
testing because it provides a proper antigenantibody
ratio.

61
Q

If negative results, Redo testing then check for technical errors encountered
before proceeding with weak D testing.
TRUE OR FALSE?

A

TRUE

62
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Cell suspension too heavy
A

False positive
Correction: adjust suspension, retype

63
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTIVE ACTION

  • immunoglobulin-coated cells (in vivo)
A

False negative
- use saline active typing reagent

64
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Cold agglutinins
A

False positive
- Wash with warm saline, retype

65
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Saline-suspended cells (slide)
A

False negative
- Use unwashed cells

66
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Test incubated too long or drying (slide)
A

False positive
- Follow manufacturers instructions precisely

67
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

-Failure to follow manufacturer’s directions precisely

A

False negative
- Review directions; repeat test

68
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Rouleaux
A

False positive
- Use saline-washed cells, retype

69
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Omission of reagent manufacturers directions
A

False negative
- Always add reagent first and check before adding cells

70
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Fibrin interference
A

False positive
- Use saline-washed cells, retype

71
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Resuspension too vigorous
A

False negative
- Resuspend all tube test gently

72
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Contaminating low-incidence antibody in reagent
A

False positive
- Try another manufacturers reagent or use known serum antibody

73
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Incorrect reagent selected
A

False negative
- Read vial label carefully, repeat

74
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Polyagglutination
A

False positive
- See chapter on polyagglutination

75
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Variant antigen
A

False negative
- Refer sample for further investigation

76
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Bacterial contamination of reagent vial
A

False positive
- Open new vial of reagent, retype

77
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Reagent detoriation
A

False negative
- Open new vial

78
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Incorrect reagent selected
A

False positive
- Repeat test; read vial label carefully

79
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Incorrect reagent selected
A

False negative
- Repeated test, read vial label carefully

80
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Centrifugation too long
A

False positive
Repeat the test using shorter centrifugation time

81
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • Centrifugation too short
A

False negative
- Repeat the test using longer centrifugation time

82
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • RPM too high
A

Repeat test using lower RPM

83
Q

FALSE POSITIVE OR NEGATIVE?
Give me the CORRECTION ACTION

  • RPM too low
A

Repeat test using higher RPM

84
Q

Investigate primarily negative results and if you ruled out
false positive and false negative causes, you should

A

check the background of the person

85
Q

is performed by detecting reagent
antibody-sensitized patient or donor RBCs through
Indirect Coombs’ Test (IAT)

A

Weak D testing

86
Q

What test use to detect weak D

A

Indirect Coombs’ Test (IAT)

87
Q

If the test and record show a negative result, do weak
D phenotyping to declare if person is a really weak d
carrier or a true Rh-, we use what test?

A

Indirect Coombs’ Test (IAT)

88
Q
  • Check for RBC sensitize by reagent antibody
  • Helps detect in vitro sensitization of RBC
A

Indirect antiglobulin test

89
Q

The presence of antigens in red blood cells will not cause
agglutination due to the few D antigens present. Upon
adding a reagent antibody (anti- D antiserum having IgG),
there is a binding of antibody to sensitized RBC forming
bridge between two RBCs causing now agglutination (+
result) after centrifugation

A

Indirect antiglobulin test

BB Lab (2 decks)

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