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Short Answer Qs Flashcards

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1
Q

What are Red Blood Cells (RBCs) used to treat?

A

Anemia and blood loss

RBCs are crucial in restoring oxygen-carrying capacity in patients with anemia or significant blood loss.

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2
Q

What is the storage temperature and shelf life of Red Blood Cells?

A

1–6°C, shelf life up to 42 days with additive solution

Proper storage conditions are vital to maintain the viability of RBCs.

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3
Q

What are Fresh Frozen Plasma (FFP) used for?

A

Coagulopathies and liver disease

FFP is essential for patients needing clotting factors.

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4
Q

What is the storage temperature for Fresh Frozen Plasma?

A

–30°C

FFP must be frozen quickly after collection to preserve its clotting factors.

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5
Q

What are the three common blood products mentioned?

A

Red Blood Cells, Fresh Frozen Plasma, Platelets

Platelets are specifically used for thrombocytopenia or bleeding.

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6
Q

What does Solvent/Detergent (S/D) Treatment do?

A

Destroys lipid-enveloped viruses (e.g., HIV, HBV, HCV)

This method is crucial for ensuring the safety of plasma products.

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7
Q

What is the purpose of Heat Treatment in viral inactivation?

A

Inactivate non-enveloped viruses

Pasteurization at 60°C for 10 hours is a common method.

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8
Q

What does Nanofiltration do?

A

Physically removes viruses based on size exclusion

This technique helps to enhance the safety of blood products.

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9
Q

What causes FNHTR (Febrile Non-Haemolytic Transfusion Reaction)?

A

Cytokines or recipient antibodies reacting with donor leukocytes

This reaction typically occurs shortly after transfusion.

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10
Q

What are the symptoms of FNHTR?

A

Fever, chills, rigors within 1–2 hours of transfusion

Monitoring for these symptoms is important during transfusions.

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11
Q

How can FNHTR be prevented?

A

By using leukocyte-depleted blood products

This reduces the risk of reactions related to transfusion.

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12
Q

What is Intravascular Hemolysis?

A

RBCs destroyed within blood vessels

This can occur due to ABO incompatibility or complement-mediated lysis.

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13
Q

What are the features of Intravascular Hemolysis?

A

Hemoglobinemia, hemoglobinuria, ↑ LDH

These indicators help in diagnosing hemolytic conditions.

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14
Q

What is Extravascular Hemolysis?

A

RBCs destroyed by macrophages in liver/spleen

This is often associated with autoimmune conditions.

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15
Q

What are the features of Extravascular Hemolysis?

A

Spherocytes, jaundice, ↑ indirect bilirubin

These features can indicate underlying hemolytic anemia.

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16
Q

What is the use of HLA in laboratories?

A

Tissue typing for organ and stem cell transplantation

HLA matching is crucial for transplant success.

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17
Q

What is one application of HLA testing in patients?

A

Platelet transfusion matching in refractory patients

This helps to ensure compatibility in patients who have had previous transfusion reactions.

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18
Q

What is an example of disease association testing using HLA?

A

HLA-B27 in ankylosing spondylitis

HLA typing can help in the diagnosis of certain autoimmune diseases.

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19
Q

What is the principle of Column Agglutination Technology (CAT)?

A

Uses microtubes filled with gel or glass beads to detect agglutination

CAT is a method utilized in blood typing and compatibility testing.

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20
Q

In which procedures is Column Agglutination Technology (CAT) used?

A
  • ABO typing
  • Antibody screening
  • Crossmatching

These applications are crucial in transfusion medicine.

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21
Q

What are the advantages of Column Agglutination Technology (CAT)?

A
  • Standardized
  • Sensitive
  • Requires minimal interpretation

These advantages contribute to its effectiveness in laboratory settings.

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22
Q

List the advantages of automation in blood testing.

A
  • Increased throughput and efficiency
  • Reduced human error and variability
  • Faster turnaround time

Automation enhances laboratory operations significantly.

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23
Q

What are the disadvantages of automation in blood testing?

A
  • High cost
  • Requires training and maintenance
  • May not handle unusual or complex cases well

These factors can limit the feasibility of automation in certain settings.

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24
Q

What is intravascular hemolysis?

A

Destruction of red blood cells within the bloodstream

This condition can lead to hemoglobinemia and hemoglobinuria.

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25
What are common causes of intravascular hemolysis?
* ABO mismatch * Malaria * Mechanical heart valves ## Footnote These conditions can trigger hemolysis in patients.
26
What does FNHTR stand for?
Non-hemolytic febrile transfusion reaction ## Footnote FNHTR is associated with cytokines or antibodies against leukocytes.
27
How can FNHTR be prevented?
By using leukocyte-reduced blood components ## Footnote This strategy helps minimize the risk of FNHTR.
28
What is the purpose of antibody screening?
Detects unexpected alloantibodies ## Footnote This is a critical step in ensuring transfusion safety.
29
What is the purpose of crossmatching?
Ensures donor RBCs are compatible with recipient serum ## Footnote Crossmatching is essential to prevent transfusion reactions.
30
What defines 'Weak' RhD?
Quantitative reduction in D antigen expression ## Footnote This condition can complicate RhD typing.
31
What is 'Partial' RhD?
Qualitative defect—missing parts of D antigen ## Footnote This poses a risk of anti-D formation if exposed.
32
What is the purpose of irradiating blood products?
Prevent transfusion-associated graft-versus-host disease (TA-GvHD) ## Footnote This is particularly important for immunocompromised patients.
33
What method is used for irradiating blood products?
Gamma or X-ray irradiation damages donor T lymphocytes ## Footnote This method effectively reduces the risk of TA-GvHD.
34
For whom are irradiated blood products typically used?
* Immunocompromised patients * Intrauterine transfusions ## Footnote These patients are at higher risk for TA-GvHD.
35
What is the principle of Solvent Detergent (S/D) Treatment of Human Plasma?
Inactivates lipid-enveloped viruses using solvent and detergent ## Footnote Examples of solvent include tri-n-butyl phosphate and detergent includes Triton X-100
36
What types of viruses does Solvent Detergent (S/D) Treatment target?
Lipid-enveloped viruses ## Footnote Examples include HIV, HBV, HCV
37
Which viruses are not inactivated by Solvent Detergent (S/D) Treatment?
Non-enveloped viruses ## Footnote Examples include HAV and parvovirus B19
38
What is the primary use of Solvent Detergent (S/D) Treatment?
Producing pathogen-reduced pooled plasma products
39
What does Column Agglutination Technology (CAT) utilize?
Columns of gel or beads in microtubes
40
What is the method of Column Agglutination Technology (CAT)?
Centrifugation separates agglutinated from non-agglutinated cells
41
List the applications of Column Agglutination Technology (CAT).
* ABO/Rh typing * Antibody screening * Crossmatching * DAT/IAT
42
What are the advantages of Column Agglutination Technology (CAT)?
* Objective * Sensitive * Standardized
43
What does the Direct Antiglobulin Test (D.A.T.) detect?
In-vivo coating of RBCs with IgG and/or C3
44
What conditions is the Direct Antiglobulin Test (D.A.T.) used to diagnose?
* Autoimmune haemolytic anaemia (AIHA) * HDFN * Transfusion reactions
45
What are the mandatory viruses screened for in blood donations?
* HIV-1/2 * HBV * HCV * HTLV-I/II * West Nile virus (in endemic areas) * Hepatitis E virus (in some regions) * Syphilis (not a virus but required)
46
What are common enzymes used in transfusion serology?
Ficin, papain, trypsin ## Footnote These enzymes modify RBC surface antigens to enhance or destroy antigen-antibody reactivity.
47
What is the function of enzymes in transfusion serology?
Modify RBC surface antigens → enhance or destroy antigen-antibody reactivity ## Footnote This is crucial for identifying or enhancing reactivity of antibodies.
48
What does L.I.S.S. stand for?
Low Ionic Strength Solution ## Footnote L.I.S.S. is used to improve antibody uptake and agglutination.
49
What is the principle of L.I.S.S.?
Reduces zeta potential between RBCs, increasing antibody uptake and enhancing agglutination ## Footnote This principle is applied in indirect antiglobulin testing.
50
In which tests is L.I.S.S. used?
Indirect antiglobulin testing, antibody screening and identification ## Footnote It facilitates better results in these tests.
51
What does A.H.G. stand for?
Anti-Human Globulin ## Footnote A.H.G. is crucial in IAT and DAT.
52
What does A.H.G. bind to?
Human IgG and/or complement on sensitized RBCs ## Footnote This binding causes agglutination in tests.
53
What are the two types of A.H.G.?
Polyspecific (IgG + C3), monospecific (IgG or C3 only) ## Footnote Each type serves different diagnostic purposes.
54
What is F.N.H.T.R.?
Febrile Non-Haemolytic Transfusion Reaction ## Footnote This reaction is caused by cytokines or recipient antibodies reacting with donor leukocytes.
55
What are symptoms of F.N.H.T.R.?
Fever, chills (without haemolysis) ## Footnote Symptoms indicate a febrile reaction but not hemolysis.
56
How can F.N.H.T.R. be prevented?
Use of leukocyte-reduced blood products ## Footnote This is an effective preventive measure against the reaction.
57
What is the purpose of leucodepletion of blood components?
Removes white blood cells to prevent FNHTR, HLA alloimmunisation, CMV transmission ## Footnote This is essential for patient safety during transfusions.
58
What is the method for leucodepletion?
Pre-storage filtration (<1 × 10⁶ WBCs/unit) ## Footnote Ensures minimal white blood cells in the blood products.
59
What are Coombs Control Cells?
Reagent cells coated with IgG used to validate negative AHG test results ## Footnote They ensure that the AHG reagent was added and functional.
60
What is the importance of Coombs Control Cells?
Validates negative AHG test results ## Footnote Ensures accuracy in testing for sensitized RBCs.
61
What are common enzymes used in transfusion serology?
Ficin, papain, trypsin ## Footnote These enzymes modify RBC surface antigens to enhance or destroy antigen-antibody reactivity.
62
What is the function of enzymes in transfusion serology?
Modify RBC surface antigens → enhance or destroy antigen-antibody reactivity ## Footnote This is crucial for identifying or enhancing reactivity of antibodies.
63
What does L.I.S.S. stand for?
Low Ionic Strength Solution ## Footnote L.I.S.S. is used to improve antibody uptake and agglutination.
64
What is the principle of L.I.S.S.?
Reduces zeta potential between RBCs, increasing antibody uptake and enhancing agglutination ## Footnote This principle is applied in indirect antiglobulin testing.
65
In which tests is L.I.S.S. used?
Indirect antiglobulin testing, antibody screening and identification ## Footnote It facilitates better results in these tests.
66
What does A.H.G. stand for?
Anti-Human Globulin ## Footnote A.H.G. is crucial in IAT and DAT.
67
What does A.H.G. bind to?
Human IgG and/or complement on sensitized RBCs ## Footnote This binding causes agglutination in tests.
68
What are the two types of A.H.G.?
Polyspecific (IgG + C3), monospecific (IgG or C3 only) ## Footnote Each type serves different diagnostic purposes.
69
What is F.N.H.T.R.?
Febrile Non-Haemolytic Transfusion Reaction ## Footnote This reaction is caused by cytokines or recipient antibodies reacting with donor leukocytes.
70
What are symptoms of F.N.H.T.R.?
Fever, chills (without haemolysis) ## Footnote Symptoms indicate a febrile reaction but not hemolysis.
71
How can F.N.H.T.R. be prevented?
Use of leukocyte-reduced blood products ## Footnote This is an effective preventive measure against the reaction.
72
What is the purpose of leucodepletion of blood components?
Removes white blood cells to prevent FNHTR, HLA alloimmunisation, CMV transmission ## Footnote This is essential for patient safety during transfusions.
73
What is the method for leucodepletion?
Pre-storage filtration (<1 × 10⁶ WBCs/unit) ## Footnote Ensures minimal white blood cells in the blood products.
74
What are Coombs Control Cells?
Reagent cells coated with IgG used to validate negative AHG test results ## Footnote They ensure that the AHG reagent was added and functional.
75
What is the importance of Coombs Control Cells?
Validates negative AHG test results ## Footnote Ensures accuracy in testing for sensitized RBCs.
76
What are the two main column agglutination technologies?
Gel Cards and Glass Bead Columns ## Footnote Gel Cards (e.g., Bio-Rad, Grifols) use gel to trap agglutinated cells, while Glass Bead Columns (e.g., Ortho MTS) use a different matrix but rely on the same principle.
77
What is the purpose of both Gel Cards and Glass Bead Columns?
To visualize agglutination through antigen-antibody reactions followed by centrifugation ## Footnote This process is essential for blood typing and compatibility testing.
78
What does the Direct Antiglobulin Test (DAT) detect?
In vivo coating of RBCs by IgG and/or complement ## Footnote A positive result indicates conditions like autoimmune hemolysis, HDFN, or drug-induced hemolysis.
79
In which conditions is the Direct Antiglobulin Test positive?
* Autoimmune hemolysis * HDFN * Drug-induced hemolysis ## Footnote These conditions involve the immune system attacking red blood cells.
80
What is the purpose of the ABO RhD Forward Group?
To detect A/B antigens on patient RBCs using anti-A/B/D reagents ## Footnote This test is crucial for blood transfusion compatibility.
81
What anomalies may occur in the ABO RhD Forward Group?
* Weak subgroups (e.g., A3, B3) * Mixed-field reactions (recent transfusion) * Polyagglutination * Technical errors ## Footnote These anomalies can lead to incorrect blood typing results.
82
What is the purpose of irradiating blood products?
To prevent Transfusion-Associated GvHD by inactivating donor T lymphocytes ## Footnote This is particularly important for immunocompromised patients.
83
Indications for irradiating blood products include:
* Immunocompromised patients * Intrauterine transfusion * Stem cell recipients ## Footnote These populations are at higher risk for complications from transfusions.
84
What techniques are used for virus inactivation in frozen plasma products?
* Solvent-detergent treatment * Heat treatment * Pathogen reduction technologies (e.g., amotosalen + UV light) ## Footnote These methods help ensure the safety of blood products by inactivating viruses.
85
What are the main antigens in the Duffy Blood Group System?
Fya and Fyb ## Footnote These antigens are located on the Duffy antigen receptor for chemokines (DARC).
86
What is the inheritance pattern of the Duffy Blood Group System?
Codominant alleles ## Footnote Common phenotypes include Fy(a+b−), Fy(a−b+), and Fy(a+b+).
87
What clinical significance do Fya and Fyb antigens have?
They can cause haemolytic disease of the fetus and newborn (HDFN) and delayed hemolytic transfusion reactions (HTR) ## Footnote HDFN is particularly significant when maternal antibodies target fetal red cells.
88
Which phenotype confers resistance to Plasmodium vivax?
Fy(a−b−) ## Footnote This phenotype is common in people of African descent.
89
What type of antibodies are Anti-Fya and Anti-Fyb?
IgG ## Footnote They react at 37°C in the indirect antiglobulin test (IAT) phase.
90
How are antibodies in the Duffy Blood Group System detected?
Routine antibody screening using IAT ## Footnote Antigen typing can confirm donor or patient phenotype.
91
What is the pathophysiology of Haemolytic Disease of the Newborn (HDFN)?
Maternal IgG antibodies cross the placenta and destroy fetal red cells expressing paternally-inherited antigens ## Footnote Most commonly, this involves RhD antigens.
92
What are the common causes of HDFN?
* RhD incompatibility * Kell * Duffy * Kidd * ABO (less severe) ## Footnote RhD incompatibility is the most common cause.
93
What are the consequences of HDFN?
* Fetal anemia * Jaundice * Hydrops fetalis * Stillbirth ## Footnote These complications arise from the destruction of fetal red blood cells.
94
What preventive measure is taken for RhD-negative mothers?
Anti-D prophylaxis at 28 weeks and post-delivery if the baby is RhD-positive ## Footnote This helps prevent sensitization to RhD antigens.
95
What routine screening is performed during antenatal care?
Routine antenatal screening for atypical antibodies ## Footnote This helps identify potential risks for HDFN.
96
What test is used to assess fetal-maternal hemorrhage?
Kleihauer test ## Footnote This test helps determine the extent of fetal blood cells in maternal circulation.
97
What does L.I.S.S. stand for?
Low Ionic Strength Saline ## Footnote L.I.S.S. enhances antibody uptake by reducing ionic strength in the test environment.
98
What is the principle of L.I.S.S.?
Enhances antibody uptake by reducing ionic strength, promoting closer interaction between RBC antigens and antibodies.
99
What is the use of L.I.S.S.?
Speeds up and improves sensitivity of indirect antiglobulin tests (IAT).
100
In what clinical situations is L.I.S.S. used?
Antibody screening, crossmatching, and identification.
101
What does the Direct Antiglobulin Test (DAT) detect?
In vivo coating of RBCs with antibodies or complement.
102
What is the procedure for the Direct Antiglobulin Test (DAT)?
Patient RBCs are washed and incubated with anti-human globulin (AHG); agglutination indicates a positive test.
103
What are the uses of the Direct Antiglobulin Test (DAT)?
* Haemolytic disease of the newborn (HDFN) * Autoimmune haemolytic anaemia (AIHA) * Haemolytic transfusion reactions
104
What enzymes are used in transfusion serology?
* Ficin * Papain * Bromelin
105
What is the action of enzymes in transfusion serology?
Modify RBC membrane proteins by cleaving sialic acid, reducing zeta potential and enhancing agglutination.
106
What are the uses of enzymes in transfusion serology?
* Enhance detection of certain antibodies (e.g., Rh, Kidd) * Destroy certain antigens (e.g., M, N, Duffy) for antibody identification.
107
What is the principle of the Forward Group (ABO RhD Typing)?
Detects antigens on patient RBCs using commercial anti-A, anti-B, and anti-D antisera.
108
What confirms antigen presence in the Forward Group (ABO RhD Typing)?
Agglutination with antisera.
109
What does agglutination with anti-A indicate?
A antigen present.
110
What does agglutination with anti-D indicate?
RhD positive.
111
What is Zeta Potential?
Electrostatic repulsion between negatively charged RBCs.
112
Why is Zeta Potential relevant?
Prevents spontaneous agglutination.
113
What happens when Zeta Potential is reduced?
Allows antibodies to bridge cells, facilitating agglutination in tests like IAT.
114
Where are the RHD and RHCE genes located?
Chromosome 1.
115
What does the RHD gene encode?
D antigen.
116
What does the RHCE gene encode?
C, c, E, e antigens via alternative splicing.
117
What is the clinical importance of the RhD antigen?
Highly immunogenic; essential in transfusion and pregnancy compatibility.
118
What is the definition of Haemovigilance?
Surveillance system for monitoring adverse events related to blood transfusion. ## Footnote Aims to enhance safety and detect errors in blood transfusion.
119
What are the goals of Haemovigilance?
* Improve transfusion safety * Detect trends and causes of errors * Implement preventive measures ## Footnote These goals are intended to enhance the overall safety of blood transfusions.
120
Name two examples of Haemovigilance systems.
* SHOT (UK) * National Haemovigilance Office (Ireland) ## Footnote These organizations are responsible for monitoring and improving blood transfusion safety in their respective regions.
121
What is the principle behind Column Agglutination Technology (CAT)?
Gel or microbead columns trap agglutinated RBCs while non-agglutinated cells pass through. ## Footnote This method helps in various blood typing and compatibility tests.
122
List three uses of Column Agglutination Technology (CAT).
* ABO/RhD typing * Antibody screening/identification * Crossmatching * DAT ## Footnote CAT is widely used in blood banks for accurate testing.
123
What is one advantage of using Column Agglutination Technology (CAT)?
Standardized, stable endpoints, reduces subjective interpretation. ## Footnote This helps in achieving consistent and reliable test results.
124
What is Intravascular Haemolysis?
Destruction of RBCs within blood vessels. ## Footnote This condition can lead to severe complications during transfusion.
125
What are two causes of Intravascular Haemolysis?
* Acute haemolytic transfusion reaction (ABO incompatibility) * Complement-mediated lysis ## Footnote These causes can lead to serious adverse reactions during blood transfusions.
126
List two features of Intravascular Haemolysis.
* Haemoglobinemia * Haemoglobinuria * Fever * Chills * Hypotension * Renal failure ## Footnote These symptoms are critical for recognizing and managing this condition.
127
What type of immunoglobulin is responsible for causing immediate intravascular haemolysis?
IgM ## Footnote IgM antibodies are the first response antibodies in blood transfusion reactions.
128
Which immunoglobulin crosses the placenta and is relevant for HDFN?
IgG ## Footnote IgG antibodies can lead to hemolytic disease of the fetus and newborn (HDFN).
129
What is the function of IgA in transfusion?
Mucosal immunity ## Footnote IgA deficiency may lead to anaphylaxis to blood products.
130
True or False: IgE is commonly relevant in transfusion reactions.
False ## Footnote IgE is primarily associated with allergies and parasitic infections, making it rarely relevant to transfusion.
131
What is the minimal role of IgD in transfusion?
B-cell receptor ## Footnote IgD has a limited function in the context of blood transfusion.
132
What genes are responsible for the Kidd Blood Group System?
SLC14A1 gene ## Footnote Includes Jka and Jkb antigens.
133
What is a clinical significance of the Kidd Blood Group System?
Causes Delayed Haemolytic Transfusion Reactions (DHTRs) ## Footnote Often undetectable pre-transfusion due to low antibody levels.
134
What type of antibodies are usually associated with the Kidd Blood Group?
IgG ## Footnote React best at 37°C and in the indirect antiglobulin test (IAT).
135
What effect do Kidd antibodies show?
Dosage effect ## Footnote Stronger reaction if antigen is homozygous.
136
What is a challenge in detecting Kidd antibodies?
Transient antibody levels ## Footnote May fall below detectable levels, leading to missed incompatibility.
137
What is the function of the auto-control in ABO RhD grouping?
Confirms absence of autoagglutination ## Footnote Ensures valid interpretation.
138
What does the positive control for anti-D confirm?
Confirms reagent activity ## Footnote Using a known RhD-positive red cell sample.
139
What does the negative control for anti-D confirm?
Confirms specificity ## Footnote Should show no agglutination with RhD-negative cells.
140
What is the purpose of known A cells in the reverse group?
Confirms detection of anti-A in patient serum
141
What is the cause of Haemolytic Disease of the Newborn (HDFN)?
Maternal sensitisation to RhD antigen ## Footnote Due to RhD-positive fetal cells entering RhD-negative mother’s circulation.
142
How does Anti-D immunoglobulin prevent HDFN?
Passive IgG anti-D antibodies bind and clear fetal RhD-positive RBCs ## Footnote From maternal circulation before immune sensitisation can occur.
143
What are the routine antenatal prophylaxis timings for Anti-D immunoglobulin?
Administered at 28 and/or 34 weeks gestation
144
What events require additional prophylaxis for HDFN?
Miscarriage, amniocentesis, trauma, bleeding
145
What is the impact of Anti-D immunoglobulin protocols?
Significant reduction in incidence of HDFN ## Footnote And associated neonatal morbidity/mortality.
146
What is the definition of the HLA system?
Human Leukocyte Antigen system ## Footnote Encoded by genes on chromosome 6 (MHC).
147
What are the classes of the HLA system?
Class I (HLA-A, -B, -C), Class II (HLA-DR, -DQ, -DP)
148
What is a clinical significance of HLA matching in transplantation?
Critical to reduce rejection
149
What can HLA antibodies cause in transfusion?
Platelet refractoriness and TRALI
150
Which disease is associated with HLA-B27?
Ankylosing spondylitis
151
What are the detection methods for HLA typing?
PCR-based HLA typing, Flow cytometry, Serological typing

Transfusion Science (17 decks)

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