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blood bank sem 2 > transfusion transmitted diseases > Flashcards

transfusion transmitted diseases Flashcards

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1
Q

what reservoir for bacterial category

A

human reservoir
vector reservoir

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2
Q

parasitic consist of

A

babesia
t.cruzi
plasmodium

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3
Q

what is prion

A

causes transmissible spongiform encephalopathies
(mad cow)

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4
Q

5 ways to prevent disease transmission

A

1) educate the donor pool
2) screen the donors
3) test the units
4) quarantine blood
5) make products with good manufacturing practices

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5
Q

initial unit testing is done by either

A

nucleic acid testing (NAT) or enzyme linked immunoassay (EIA)

confirm with immunoblots

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6
Q

initial test is screen and if unit reactive in pool

A

confirmatory test run in duplicate

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7
Q

if either/ both of duplicates in pair are reactive

A

unit is discarded and donor informed/deferred based on specific infection

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8
Q

screen is _____ and confirmation is _____

A

sensitive; specific

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9
Q

what is window period

A

time between infection and time an infection becomes serologically detectable

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10
Q

what has shortened the window period

A

molecular techniques

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11
Q

hepatitis B required testing

A

HBsAG
anti-HbC (IgM and IgG)
HBV DNA

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12
Q

hepatitis C required testing

A

anti-HCV (IgG)
HCV RNA

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13
Q

HIV required testing

A

IgM and IgG against HIV- 1/2
HIV RNA

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14
Q

HTLV required testing

A

IgG against HTLV 1 and 2

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15
Q

Syphilis required testing

A

IgM and IgG against T.pallidum

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16
Q

West nile required testing

A

WNV DNA

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17
Q

T. cruzi required testing

A

IgG to T.cruzi

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18
Q

Zika virus required testing

A

ZIKV RNA

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19
Q

viral disease we worry most about

A

hep B
enveloped DNA virus with freely floating soluble surface antigen which helps in detection

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20
Q

hep B incubation period

A

8-12 weeks
65% cases are asymptomatic
-more dangerous younger the pt

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21
Q

nucleic acid testing for hep B

A

first test to show detectable virus
2-12 weeks post infection

screen: PCR in mini pools of 16 donors
confirm: repeat in duplicate

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22
Q

surface antigen test Hep B

A

detectable 4-8 weeks post infection
-won’t find in 4-6 months

screen: EIA/ChLIA
confirm: neutralization assay

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23
Q

explain neutralization assay

A

donor plasma mixed with anti-HBs
-plate with HBsAg

of reactivity reduced by 50% or more than must have been HBsAg in donor plasma that neutralized antibody

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24
Q

Anti-HBc testing

A

antibody develops in response to infection with HBV (not vaccine)

-used to cover window period

screen: EIA/ChLIA
confirmation: NAT for HBV DNA by PCR

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25
if positive for HBcAg
permanently deferred products destroyed lookback performed
26
Hep C anti-HCV
screen: EIA/ChLIA confirmation: recombinant immunoblot (RIBA) modified western membrane is inoculated with rHCV proteins, patient plasma added, antibodies to specific proteins detected
27
which strain is more severe of HIV
1 -sexually transmitted -parenteral (needles and transfusion) -congenital -symptoms nondescript AIDs presents CD4 drops
28
screen anti-HIV-1 is detected via
EIA or ChLIA (window period 20 days) -NAT now used !!! (10 days) but high false-positive rate
29
confirm for anti-HIV-1-2
western blot detection of p24, gp41, and gp 120/160 call indeterminate if only some are found
30
positive EIA, positive NAT deferral
permanent
31
positive EIA, negative NAT (and vice versa)
temporary 8 weeks donor must have complete negative to re-enter
32
positive EIA Negative NAT Positive wb deferral
permanent
33
HTLV stands for
human t-lymphocyte virus cancer causing virus -adult t-cell leukemia (5% people get this)
34
how is HTLV passed
IV drug abuse, rarely sex or childbirth
35
testing for HTLV
EIA/ChLIA 2 positives- permanent defer no confirmatory test
36
CMV
DNA herpes virus -big deal for infants and immunodeficient pts -causes nervous system issues
37
patients that are seronegative give
CMV-negative units can't eliminate risk completely- short window period before developing antibodies
38
west nile virus
RNA virus -mosquito vector 80% asymptomatic infectious period short window period 2 days
39
WNV deferral
120 days from time of diagnosis OR 120 days from time of positive test
40
syphilis testing
screen: T. pallidum hemagglutination (TP-HA) treponemal antigen conjugated to chicken RBCs confirm: (TP-PA) conjugated to gel particles
41
RPR/VDRL screen followed with
treponemal test like FTA
42
if confirm test is positive for syp. patient is deferred from donation for
1 year from time of treatment completion -if screen is positive, but confirm - up to blood center
43
T.cruzi causes
chagas disease -transmitted by reduviid bug
44
how is t.cruzi diagnosed
blood smear chronic-- serologically (anemia, weakness, fever, edema)
45
testing for T.cruzi
screen for t.cruzi antibodies -- abbott prism chagas (false +) only first donation is tested, if negative not tested again
46
if t. cruzi first test is +
indefinite deferral
47
what is malaria spread by
Anopheles mosquito also by transfusion symptoms: hemolytic anemia, weakness, pallor, splenomegaly, fever, chills
48
why is malaria hard to diagnose via transfusion
normally get when travel -so not expected if haven't traveled recently
49
how is malaria ID
blood smears -if negative you could have missed so do not rule out NO serological test; screened exclusively questionnaire
50
malaria treated with
quinines or tetracycline -some are resistant due to RBC/Hgb variation
51
babesia carried by
deer tick -similar to malaria but has risk of DIC and renal failure
52
babesia diagnosed by
blood smear or serology -can survive refrigeration
53
how are donors screen for babesia
questionnaire -no serological test
54
prion diseases
years to manifest and no test for donor units diagnosed: autopsy, but can be detected in CSF in certain tests
55
what does prion cause
transmissible spongiform
56
sporadic presentation of Creutzfedt- jakob disease occurs in older patients and is
80-90% of cases -discovered post-mortem
57
hereditary CJD accounts for
5-10% of cases
58
treatment caused (iatrogenic) CJD accounts for
5% -contaminated medical equipment, medicine, blood products
59
variant CJD linked to
tainted beef (mad cow)
60
prion diseases screened with
questionnaire -living in Europe or medicine from human/animal source
61
when PT develops a TTD they are notified and product
is tracked and donor will be informed -anyone who has also got a unit from that donor will get notified to receive certain testing -all other products destroyed (person deferred permanent )
62
autologous units can be given to the donor if
donor does have a transmissible infection -not given to anyone else -testing on unit must be repeated every 30 days if not issued immediately

blood bank sem 2 (6 decks)

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