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Unit 2 Flashcards

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1
Q

What is antithetical

A

antigens that are products of pairs of genes like Fya and Fyb

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2
Q

^a and ^b indicate _____ expect for in the ____ system

A

antithetical, lewis system

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3
Q

What is a type and screen

A

type- test for ABO and Rh phenotypes

screen- test to find if there are any notable antibodies present in plasma

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4
Q

What is front type vs reverse type

A

front- finding what blood type you are

reverse-finding what blood type you are not

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5
Q

What is in the Front type test mixture

A

reagents anti A, B and D + your antibodies

if there is a reaction ex with anti A, you are type A blood

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6
Q

What is in the mixture for reverse type testing

A

reagents A and B antibodies + your plasma
if there is a reaction, this is what antibodies you’re body has, revealing what blood type you are not
if reagent B reacts, you must be blood type A

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7
Q

What is a crossmatch

A

test to see if blood it compatible with patient, mixing donor blood with patient plasma, we want this to be negative, so that the blood can be considered compatible

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8
Q

What is the difference between IS and Ext crossmatching

A

IS- directly add donor to patient cells after spinning
Ext- extended, add patient+donor plasma, incubate for 15 min, add AHG, centrifuge and read rxn, lastly use check cell if -

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9
Q

What type of antibodies are in AHG?

A

antihuman IgM antibodies

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10
Q

What is Anti-Sera

A

monoclonal or polyclonal manufactured antibodies

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11
Q

What are reagent cells

A

manufactured human cells with known antigens

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12
Q

Describe what a + rxn, - rxn and cell button look like

A

+ agglutination or hemolysis
- no agglutination or hemolysis
cell button- clump of red cells after centrifugation

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13
Q 
What is 
FFP
pRBCs
PLTs
CRYO
LK
IRR
A

FFP- fresh frozen plasma- has clotting factors
pRBCs - packed RBCs
PLTs- platelets suspended in a little plasma
CRYO- concentration of coag F VIII, fibrinogen, F XIII and VW factor
LK- leukoreduced
IRR- irradiated

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14
Q

Why would we need to LK blood?

A

leukoreduce- to prevent donor from mounting immune response against recipient. Can’t introduce donor WBCs into patient, or the donor WBCs will attack everything as foreign

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15
Q

Describe what a negative test in a tube looks like

A

Initially there is a pellet, but when spun slightly it dissipates back into a homogenous solution

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16
Q

Describe what a positive result looks like in a test tube

A

Starts with a pellet that does not fully dissipate, instead has clumps and never fully becomes a homogenous solution again

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17
Q

What are the 4 basic types of reagents

A

commercial RBCs with known antigens
Antisera with monoclonal or polyclonal antibodies
antiglobulin- with anti human Anti-IgG or anti-complement
antibody enhancers

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18
Q

What are polyclonal antibodies

A

antibodies that can recognize multiple epitopes

AHG- could be anti IgG and IgM

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19
Q

What are polyspecific reagents

A

AHG that has anti IgG and complement C3b

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20
Q

Anti-A, Anti-B and Anti-IgG are examples of what type of antibodies

A

AHG monoclonal antibodies

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21
Q

Monoclonal antibodies are secreted by:

A

a single clone of antibody producing B cells

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22
Q

Polyclonal antibodies are secreted by:

A

several different clones of antibody producing B cells

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23
Q

What reagents are used for ABO typing

A

anti-A and anti-B antisera reagents monoclonal

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24
Q

What colors does the ABO typing reagent have

A

anti A- Blue
Anti B- Yellow
anti AB- clear

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25
What is in the polyclonal Anti D blend
human IgM anti-D | polyclonal IgG anti-D
26
Explain the D antigen typing procedure
anti-D mixed with patient and donor RBCs if agglutination occurs, the D antigen is present if it does not, there is no D antigen a negative control is done to make sure it is not a false positive result
27
If a monoclonal control for anti-D testing control is _____ the test is invalid
positive, | it should give a negative result
28
What is in low protein anti D reagents
monoclonal ANTI D antibodies (IgM) or polyclonal 6% bovine albumin replaced high proteins reagents
29
What blood type result requires a control run
AB+
30
What is low protein reagent used for
control, should show no agglutination, | protein is in mixture to detect the positive reaction from protein abnormalities rather than RBC antigens
31
If RBCs agglutinates with all ABO antisera, then a separate control must be done with what reagent and what test result for a forward blood type, assuming the patient is truly AB+
negative-low protein reagent | If positive- something else is causing the + rxn
32
``` Practice writing out the results to the following table anti A Anti B Anti D Rh control A+ A- B+ O- AB+ AB- ```
answer Ch4 slide 26
33
What testing is done with A1 and B cells
reverse typing- find what you are not
34
Practice filing out the following table for reverse typing ``` reagent A1 B O+ A- AB+ B+ A+ AB- O- O+ ```
answers Ch4 slide 30-31
35
What if forward typing results don't match the reverse typing?
the issue is probably the reverse
36
Are A1 and B cell reagents also positive for Rh antigens?
no, they are negative for Rh to keep specificity
37
What concentration are screening cells usually in
2-5% concentration
38
What are screening cells for
antibody screening, for detection of unexpected abs, patient serum is added to see if agglutination occurs, result should be negative, comes with an antigram that shows the antigen profile sets of 2-3 vials
39
What are panel cells
reagent cells in 10+ vials, used to ID abs in an antibody panel.
40
What do antiglobulin test reagents contain
anti IgG | and/ or anti-C3b complement
41
What is a direct antiglobulin test?
DAT- detects IgG or complement bound to RBCs in vivo | this is post transfusion to see if a bad transfusion occurred
42
What test is this? RBCs washed, patient sample+ anti-IgG= agglutination
DAT
43
What does a positive DAT mean?
that there is sensitization occurring in a live person
44
What reasons are there for a DAT to be positive
transfusion rxn hemolytic disease of the fetus and newborn autoimmune hemolytic anemia drug related rxn
45
If a DAT test is positive due to the donor cells being coated with IgG
the patient had a incompatible transfusion
46
If a DAT is positive because fetal RBCs are coated with IgG the explanation is
maternal antibodies have cross the placenta
47
What is an Indirect antiglobulin test
IAT- detects IgG or complement bound to RBCs in vitro
48
What type of test is this IgG patient sample antibodies incubated at 37C with RBC reagents RBC washed then combined with AHG
IAT
49
What is IAT testing used for
to find the presence of and identify antibodies antibody screening crossmatch antigen typing
50
What are the sources of false positives in IAT testing
red cells agglutinated before washing, dirty glassware over centrifugation
51
If during an IAT test you do not wash the cells correctly before adding AHG reagent
you could have a false negative because unbound human serum globulins have neutralized the AHG reagent
52
During an IAT test if you forget to add the reagent,
you would get a false negative
53
When do you need to use check cells or indicator cells
if AHG results are negative | control added to a negative test should cause agglutination
54
What are check cells made of
O+ RBCs coated with IgG antibodies
55
What might cause a false negative in check cell control testing
no AHG reagent added reagent not reactive did not wash RBCs correctly
56
What does LISS do
it is an antibody potentiator, increases rate of antibody uptake, enhances agglutination
57
What does PEG do
polyethlene glycol | concentrates the antibody in the test environment in LISS
58
What do proteolytic enzymes do
speed up agglutination by removing negative charges from RBC membrane, reducing zeta potential
59
What does bovine serum albumun do?
reduces repulsion between cells, does not shorten incubation time
60
What concentration does bovine serum albumin remain in
22-30%
61
What are lectins
seed extracts that are specific towards RBC antigens
62
What is CAT
column agglutination technology, a test where a dextran acrylamide gel has predispensed antigens.
63
What temperature should CAT testing be stored at
stored in fridge, has to be room remp before testing
64
What concentration do CAT tests have?
0.8-1% cell suspension- diluted
65
What blood type is on slide 50 ch 4
O-
66
What CAT test result is the following description | red cell agglutinates are dispensed throughout the length of the gel
2+
67
What CAT test results are described | majority of the red cell agglutinates are trapped in the upper half of the gel
3+
68
What are the disadvantages to CAT
need special equipment, cant use hemolyzed or lipemic samples. higher risk of rouleaux
69
what is rouleaux?
stacked coin appearance on RBCs could be due to a disease present
70
What are the advantages of CAT
no wash step more specific and sensitive standardization
71
What is solid phase Red cell adherence
a test that indicates if a reaction occurs, it there is a cell button- negative if no button- +
72
Explain the procedure for solid phase red cell adherence
``` well has antigen on sides already embedded add patient plasma and LISS incubate at 37 wash well with saline add antiG coated RBCs centrifuge ```
73
If a solid phase test shows cells adhered to the sides and bottom of well and there is no button this is a
positive
74
If a solid phase test shows blood settling to the bottom of well and create a cell button, this is a
negative result
75
Practice labelling slide 55 Ch4
center image
76
What are the advantages of solid phase testing
well defined endpoints, longer shelf life
77
What are the disadvantages of solid phase testing
too much could be added making it unreadable | need special equipment
78
How are monoclonal reagents made
spleen lymphocytes from immunized mice that are fused with myeloma cells
79
A reagent that makes a lot of one type of antibody that reacts with one specific epitope is a
monoclonal reagent
80
How are polyclonal reagents made
injecting animals with human globulin components then collecting the resulting antihuman antibodies
81
A reagent that is directed against multiple epitopes is
polyclonal
82
List the test procedure for DAT
EDTA tube collected 3-5% RBC suspension mixed with 0.9% saline 1 drop of suspension washed 3 times with saline add 2 drops of AHG readent centrifuge and read if negative rxn, add indicator cells
83
What temperature and what specific antibody is immediate spin IAT testing looking for? and extended ?
cold-IgM | warm-IgG
84
What is the procedure for IAT testing
``` looks for IgM 2 drops of serum or plasma added to 1 RBC reagent drop read at initial spin ------------------- Looks for IgG 2 drops of LISS incubate at 37C for 15 minutes centrifuge and read wash 3 times with buffered saline add 2 drops of AHG reagent centrifuge and read if negative, add check cells- ```
85
What is the purpose of washing the RBCs?
washing removes any unbound abs and the AHG reagent will make agglutination visible
86
What are the possible reasons a DAT could show a false negative
inadequate washing undercentrifugation loss of reagent reactivity
87
In a coombs control, what should the reaction result be if it is a valid test when the check cells are added
there should be a reaction check cells are O+ with Anti-D all blood types will react with this if no reaction, something else is causing agglutination
88
Which IAT test does not require check cells
gel testing

Blood Bank (8 decks)

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