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Blood Bank: Spring 2024 > Serology > Flashcards

Serology Flashcards

1
Q

Objective

Give agglutination reaction grade

A

0
negative, no agglutination
Cells remove from cell button as smoke or cloud

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2
Q

Objective

Give agglutination reaction grade

A

3+
Many large agglutinates in clear background. As cell button is shaken, agglutinates remove easily in large chunks

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3
Q

Objective

Give agglutination reaction grade

A

1+
Very small agglutinates. Come off as cookie bites from button

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4
Q

Objective

Give agglutination reaction grade

A

4+
Solid agglutination
Cells stick together into one solid chunk floating in liquid background

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5
Q

Objective

Give agglutination reaction grade

A

2+
Many small agglutinates in clear background.
Agglutinates appear to crumble off into solution

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6
Q

Objective

How do you interpret results of serologic reactivity in determining the presence or absence of Ag on patient RBCs or Ab in patient’s plasma?

A
  • Positive or Negative
  • Incompatible or Compatible
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7
Q

Word of the day

Monoclonal

A

Antibodies usually mouse-sourced that come from single clone of hybridoma cells

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8
Q

How do you get monoclonal antibodies?

A
  1. Immunize mouse with human specific Ag
  2. Remove spleen cells and combine B cells with human myeloma cells
  3. Hybridoma cells screened for antibody
  4. One clone selected and propagated in tissue culture
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9
Q

Advantages of mAbs?

Single ant

A

Single Ab secreted is available forever, highly specific, and pure

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10
Q

Disadvantages of mAbs?

A
  • Only detects single epitope so can miss variables in population
  • Initially takes longer to produce
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11
Q

Incidence

A

% frequency of Ag present in population in population frequency chart

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12
Q

High incidence

A

More than 90%

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13
Q

Low incidence

A

Less than 10%

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14
Q

Ag phenotypic testing

A

Serology where you use anti-sera to ID RBC Ag

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15
Q

T/F
A person makes an Ab for an Ag they do have on RBCs

A

False
People make Ab for Ag they don’t have on RBCs. Antithetical Ag does not matter

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16
Q

What population frequency of Ag indicates compatible blood?

A

100%

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17
Q

Antibody ID method

A

Use known cells to ID unknown Ab

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18
Q

What is the #1 cause of a transfusion reaction?

A

Data entry error

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19
Q

Document control regulations

A
  • All test results must be recorded as they are tested, don’t wait to record even if you don’t think what you see is right
  • All data entry needs 2nd tech to review
  • Consult procedures before discarding. Strict guidelines for how long docs are kept
  • All original docs must be legible and in permanent pen. Single line cross-out errors followed by date and initials accepted
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20
Q

Sample labels

A
  • 2 pt identifiers
  • date/time of collection
  • collector name
  • secondary ID method if necessary (armband or 2nd specimen)
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21
Q

When do you reject a hemolyzed sample?

A

Moderate hemolysis
hemolysis >= 200 mg/dl

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22
Q

How do you maintain sample integrity?

A
  • EDTA preferred, centrifuged to separate from plasma
  • No gel separator or hemolysis
  • Appropriate labeling
  • Enough volume to perform testing
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23
Q

Causes of hemolysis?

A
  • Already occurring in pt or due to blood draw
  • Hemolysis can indicate positive reaction in blood bank testing (but it’s bad)
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24
Q

Patient history to look for (compare records to current results and investigate/resolve discrepancies before issuing unit for transfusion)

A
  • ABO/Rh type
  • Difficult blood typing
  • Clinically significant Ab
  • Adverse events to transfusion
  • Special transfusion requirements
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25
Q

Explain the 3-day rule

A
  • Pre-transfusion testing must be done within 72 hrs after collection
  • Day 0 is draw day
26
Q

How long are samples retained post-transfusion and why that length of time?

A

7 days
bc pt may show transfusion reaction after 7 days

27
Q

Why might you draw blood before transfusion?

A
  • If pt was transfused in the preceding 3 months with allogenic cells (from different person)
  • If pt was pregnant in preceding 3 months
  • If history is uncertain/unavailable
28
Q

T/F
There shall be 2 determinations of the recipient’s ABO/Rh type

A

True
Compare pt serological results to another copy of that pt

29
Q

T/F
Manager must monitor QC at least annually

A

False
Monthly

30
Q

Temps critical for equipment need to be monitored how often?

A

At least daily

31
Q

How often must storage device alarms be tested?

A

At least quarterly before store products go out of acceptable limits

32
Q

Centrifuge calibration is performed how often?

A

At least bi-annually

33
Q

Rpms and tachometers are tested how often?

A

Quarterly

34
Q

Daily QC

A
  • Run before pt testing
  • Tests reagents before use
  • Manual reagents run on daily basis in typical method: IS or AHG (blood type, antibody screen)
35
Q

Non-routine QC

A
  • Run with pt testing
  • Tests the test system
  • May have to consult package insult for instructions
  • Reagents used for specific test (phenotyping anti-sera, neutralization test, fetal screen)
36
Q

anti-A color?

A

Blue

37
Q

anti-B color?

A

Yellow

38
Q

anti-D color?

A

Clear

39
Q

anti-G color?

A

May or may not be green

40
Q

Blood mixture % for tube and gel testing

A
  • Tube: 3% cells to saline
  • Gel: 0.8% cells to saline
41
Q

Screen and panel cells come from what kind of human donor?

A

Type O

42
Q

Reverse cells come from what kind of human donor?

A

Multiple human donors

43
Q

Ab and RBC storage

A

2-10°C
Look for growth, abnormal color, hemolysis in cells

44
Q

Describe first reagents

A
  • Entirely from human donors
  • Drawbacks: donor safety,, difficult to create in bulk, non-specific
  • Donors were hyper-immunized to get better results
45
Q

Polyclonal Ab

A

Made from multiple plasma cell sources to detect multiple sites on same Ag

46
Q

Poly-specific Ab

A

Ab mix that detects multiple Ag or detects same Ag in different ways (IgG and IgM) to give one result

47
Q

How are polyclonal Ab made?

A
  1. Immunize rabbit against desired Ag
  2. Purify rabbit serum for desired Ab
48
Q

Advantage of polyclonal Ab

A

More likely to react with Ag bc it detects more Ag sites

49
Q

Disadvantages of polyclonal Ab

A
  • Non-specific reactivity possible
  • Non-standardized
  • Hard to determine potency of single product
  • Smaller production volume
50
Q

Prozone phenomonen

A

Ab excess

51
Q

Postzone phenomenon

A

Ag (RBC) excess

52
Q

Affinity

A

Fit of single Ab on Ag
Overcomes steric hindrance and zeta potential

53
Q

Avidity

A

Multimeric bonds (ionic, H-bond, hydrophobic bonds, van der Waals)

54
Q

Immediate spin test

A
  • IgM Ab form lattices without addition of extra reagents
  • Direct test
  • Centrifugation brings reactants close together
  • Room temp
  • Plasma 2
55
Q

Agglutination testes that require 37°C incubation

A

Complement and IgG
Coombs test

56
Q

When and why are enhancements added to Coombs test?

A
  • LISS, albumin, PEG may be added after immediate spin and before 37°C inc to reduce zeta potential (negative charge), thus bringing RBCs closer together
  • Enzymes reduce steric hindrance of interfering Ag
57
Q

Low ionic strength solution (LISS)

A

Reduces zeta potential by reducing ions around red cells, thus allowing RBCS to come closer and form lattice

58
Q

Albumin as enhancement agent

A

Protein decreases distance between sensitized cells

59
Q

Polyethylene glycol (PEG)

A

Water-soluble linear polymer sucks water away from RBCs to bring Ab closer to Ag

60
Q

Polybrene (hexadimethrine bromide)

A

Quarternary ammonium polymer that non-specifically binds RBCS to bring them closer for Ag-Ab binding

Blood Bank: Spring 2024 (7 decks)

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