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Serologic Testing Flashcards

1
Q

Pre-transfusion testing - Autologous Donation

A

ABO
Rh

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2
Q

Pre-transfusion testing of Allogenic Transfusion

A

ABO, Rh
Antibody Screen
Crossmatching

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3
Q

Serum within 3 days

A

Specimen for pre-transfusion testing procedures

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4
Q

7 days

A

Retain patient specimen and segment after transfusion

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5
Q

Universal Donor RBCs

A

Type O

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6
Q

Universal Recipient RBCs

A

Type AB

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7
Q

Universal Plasma Donor

A

Type AB

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8
Q

Universal Plasma Recipinet

A

Type O

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9
Q

Current mandated test for Pretransfusion sample - ABO
* Forward
* Reverse

A

Current mandated test for Pretransfusion sample - ABO
* Forward - Anti-A, Anti-B
* Reverse - A1 and B cell

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10
Q

DAT/Direct Coomb’s Test

Direct Antiglobulin Test

A

Detect clinical conditions due to IN VIVO sensitization of RBCs

HTR, HDFN, AIHA, DIHA

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11
Q

DAT Specimen

A

EDTA

avoid in viotro activation of C’

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12
Q

IAT/Indirect Coomb’s Test

A

Detect IN VITRO sensitization of RBCs used in various serologic tests

Antibody screening, Antibody identification, Weak D testing, Crossmatch

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13
Q

IAT Specimen

A

Serum

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14
Q

Composition of Polyspecific AHG

Green in color

A

Anti-IgG
Anti-C3d
Ant-kappa and lambda chains (IgG, IgM)
Anti-C3b, Anti-C4b, Anti-C4d

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15
Q

Composition Monospecific AHG

Colorless

A

Either Anti-IgG or Anti-C3d

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16
Q

AHG Sources of Error - False Positive

A

AHG Sources of Error - False Positive

* Improper Specimen - Refrigerated/Clotted/Used Serum (DAT)
* Cold autoantibody
* Bacterial contamination
* Overcentrifugation

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17
Q

AHG Sources of Error - False Negative

common are technical probelms

A

AHG Sources of Error - False Negative

  • Inadequate washing
  • Fail to add AHG
  • Neutralization of AHG
  • Prozone/Prozone phenomenon
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18
Q

Check cells/Coomb’s cells

A

detect if added and with reactive AHG and adequate washing

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19
Q

Check Cell Interpretation
* (+) Agglutination
* (-) No agglutination

A

Check Cell Interpretation
* (+) Agglutination - FREE AHG (AHG is added & reactive)
* (-) No agglutination - nonreactive AHG, NSS, fail to add AHG

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20
Q

Final Check for Compatibility

A

Crossmatching

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21
Q

Major Crossmatch

A

Test if patients antibodies from antigens of doors red cells

PSDR

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22
Q

Minor Crossmatch

A

dtects if donor serum has antibody for patients red cells

DSPR

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23
Q

Replaced Minor crossmatch

A

Antibody screening

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24
Q

Can transfuse even in ABO-incompatible patients

A

Plateltets

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25
Only needs Crossmatching
RBCs
26
Phases of Antibody detection * IS (RT) * Thermophase (37C) * AHG Phase
Phases of Antibody detection * IS - IgM, ABO antibodies, Clerical errors * Thermophase (37C) - Agglutinating IgG * AHG Phase - non-agglutinating antiobodies, alloantibodies
27
Interpretation of Compatibility Tests Antibody screen: (+) Compatibility: (-)
Possible Compatible | phenotype donor to confirm compatibility
28
Interpretation of Compatibility Tests Antibody screen: (+) Compatibility: (-)
Possible Compatible | phenotype donor to confirm compatibility
29
Interpretation of Compatibility Tests Antibody screen: (-) Compatibility: (+)
Not Compatible | Ab reacts to low incidience antigen (+) DAT Technical Error
30
Interpretation of Compatibility Tests Antibody screen: (-) Compatibility: (-)
Compatible | No antibody detected
31
Interpretation of Compatibility Tests Antibody screen: (-) Autocontrol: (-) Compatibility: (+)
* ABO Grouping Error * DONOR unit = DAT (+) * Donor with alloantibodies to low incidence antigen
32
Interpretation of Compatibility Tests Antibody screen: (+) Autocontrol: (-) Compatibility: (+)
Patient has alloantibodies to donors antigen
33
Interpretation of Compatibility Tests Antibody screen: (+) Autocontrol: (+) Compatibility: (+)
Px. Autoantibody Px. Alloantibody Rouleaux formation
34
# Enhancement medium Albumin
**Allows sensitized cell to aggregate or come closer together**
35
# Enhancement medium LISS | Low and Messeter
**Increase antibody uptake** and shorten incubation time | lowers zeta potential
36
# Enhancement medium PEG
Increase antibody uptake by **removing water **in sorrounding RBCs
37
# Enhancement Medium Proteolytic enzyme | papain, ficin, trypsin
cleave RBC membrane to destrog antigen or expose antigens
38
Destroyed by Enzymes | Duffy is watching Yt seX with MNS and Chido/Rogers
Fy Yt Xg MNS Chiso/Rogers
39
Enhanced by Enzymes | Enhanced LIPS kasi Rich Kidd
Le I P Rh Kidd
40
Removes antibody in sensitized RBCs
Elution | after a positive DAT
41
Revoves antibody in serum
Adsorption | after a positive IAT
42
Heat Elution method
detect ABO antibodies of ABO HDN
43
Chloroform elution method
For positive DAT assciated with warm reactive (IgG) auto- or unexpected antibody
44
Digitonin
remove Ab by destroying RBCs
45
Composition - ZZAP
Cysteine activated papain + DTT | used to adsorb and enzyme treatment at the same time
46
AET and DTT | *AET - 2-aminoethilsothioronium bromide ; DTT - Dithiothreitol
Create a RBCs negative for all antigens of the Kell blood group (except Kx)
47
Best Eluant
**Chloroquine diphosphate** *dissociate IG from red cell positive DAT so that they may be typed with blood grouping reagents that reuire for IAT*
48
Prewarminng technique
keep all test components at 37C prior to testing
49
Neutralization
inhibit reactivity of antibody, allowing separation
50
Neutralize - AntiSda
Urine
51
Neutralize - Autoanti-P
Hydatid cyst fluid
52
Neutralize - Human milk
Anti-I
53
# Agglutination Reading 4+ | Tube method
One solid agglutinate, Clear background
54
# Agglutionation Grading 3+
Large agglutinate, Clear background
55
# Agglutination Grading 2+ | Tube method
**Medium** agglutinates, **Clear background**
56
# Agglutination Grading 1+ | Tube method
**Small** agglutinates, **Turbid background**
57
# Agglutination Grading w+ | Tube Method
**Tiny** agglutinates, **Turbid background**
58
Composition - Gel Technology | Dr. Yves Lapierre
Dextran acrylamide Gel + LISS
59
Specimen - Gel Technology * Donor's RBCs * Patient's Serum
Specimen - Gel Technology * Donor's RBCs - 50 ul * Patient's Serum - 25 ul
60
# Gel Technology Grading 4+
**Solid band** of agglutinate at the top
61
# Gel Technology Grading 3+
Majority of agglutinated cells at **upper half** of the gel
62
# Gel Technology Grading 2+
Agglutinates disperesed **throughout the gel**
63
# Gel Technology Grading 1+
Agglutinates in the **lower half **of the gel
64
# Gel Technology Grading **Negative**
**Pellet in the bottom**
65
# Gel Technology Grading mf
Agglitinates in the **top** and pellet in the **bottom**
66
Gel Technology * Centrifugation * Incubation
Gel Technology * Centrifugation: 10 minutes * Incubation: 37C for 15 minutes
67
Advantage - Gel Technology
* **Standardization (major)** * Stability (2-3 days) * Less sample * Increase sensitivity and specificity
68
Disadvantage - Gel Technology
Disadvantage - Gel Technology * Need special equipment * Not used for Lipemic, Icteric and Hemolysed samples
69
**Microplate** with RBC membranes bound to surface of wells
Solid Phase Red Cell Adherence
70
SPRCA * Centrifugation: * Incubation:
SPRCA * Centrifugation: 2 mins * Incubation: 15 mins
71
SPRCA * Positive Reaction * Negative Reaction
SPRCA * Positive Reaction: Adherence - Monolayer of RBCs (Ragged edges) * Negative Reactin: No adherence - button of RBCs in bottom of the well

IHBB (11 decks)

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