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Blood Bank > Unit 2 > Flashcards

Unit 2 Flashcards

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
Q

What is in the polyclonal Anti D blend

A

human IgM anti-D

polyclonal IgG anti-D

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26
Q

Explain the D antigen typing procedure

A

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

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27
Q

If a monoclonal control for anti-D testing control is _____ the test is invalid

A

positive,

it should give a negative result

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28
Q

What is in low protein anti D reagents

A

monoclonal ANTI D antibodies (IgM) or polyclonal
6% bovine albumin
replaced high proteins reagents

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29
Q

What blood type result requires a control run

A

AB+

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30
Q

What is low protein reagent used for

A

control, should show no agglutination,

protein is in mixture to detect the positive reaction from protein abnormalities rather than RBC antigens

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31
Q

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+

A

negative-low protein reagent

If positive- something else is causing the + rxn

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32
Q 
Practice writing out the results to the following table 
            anti A   Anti B   Anti D    Rh control
A+
A-
B+
O-
AB+
AB-
A

answer Ch4 slide 26

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33
Q

What testing is done with A1 and B cells

A

reverse typing- find what you are not

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34
Q

Practice filing out the following table for reverse typing

reagent A1    B 
O+
A-
AB+
B+
A+
AB-
O-
O+
A

answers Ch4 slide 30-31

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35
Q

What if forward typing results don’t match the reverse typing?

A

the issue is probably the reverse

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36
Q

Are A1 and B cell reagents also positive for Rh antigens?

A

no, they are negative for Rh to keep specificity

37
Q

What concentration are screening cells usually in

A

2-5% concentration

38
Q

What are screening cells for

A

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
Q

What are panel cells

A

reagent cells in 10+ vials, used to ID abs in an antibody panel.

40
Q

What do antiglobulin test reagents contain

A

anti IgG

and/ or anti-C3b complement

41
Q

What is a direct antiglobulin test?

A

DAT- detects IgG or complement bound to RBCs in vivo

this is post transfusion to see if a bad transfusion occurred

42
Q

What test is this?

RBCs washed, patient sample+ anti-IgG= agglutination

A

DAT

43
Q

What does a positive DAT mean?

A

that there is sensitization occurring in a live person

44
Q

What reasons are there for a DAT to be positive

A

transfusion rxn
hemolytic disease of the fetus and newborn
autoimmune hemolytic anemia
drug related rxn

45
Q

If a DAT test is positive due to the donor cells being coated with IgG

A

the patient had a incompatible transfusion

46
Q

If a DAT is positive because fetal RBCs are coated with IgG the explanation is

A

maternal antibodies have cross the placenta

47
Q

What is an Indirect antiglobulin test

A

IAT- detects IgG or complement bound to RBCs in vitro

48
Q

What type of test is this
IgG patient sample
antibodies incubated at 37C with RBC reagents
RBC washed then combined with AHG

A

IAT

49
Q

What is IAT testing used for

A

to find the presence of and identify antibodies
antibody screening
crossmatch
antigen typing

50
Q

What are the sources of false positives in IAT testing

A

red cells agglutinated before washing,
dirty glassware
over centrifugation

51
Q

If during an IAT test you do not wash the cells correctly before adding AHG reagent

A

you could have a false negative because unbound human serum globulins have neutralized the AHG reagent

52
Q

During an IAT test if you forget to add the reagent,

A

you would get a false negative

53
Q

When do you need to use check cells or indicator cells

A

if AHG results are negative

control added to a negative test should cause agglutination

54
Q

What are check cells made of

A

O+ RBCs coated with IgG antibodies

55
Q

What might cause a false negative in check cell control testing

A

no AHG reagent added
reagent not reactive
did not wash RBCs correctly

56
Q

What does LISS do

A

it is an antibody potentiator, increases rate of antibody uptake, enhances agglutination

57
Q

What does PEG do

A

polyethlene glycol

concentrates the antibody in the test environment in LISS

58
Q

What do proteolytic enzymes do

A

speed up agglutination by removing negative charges from RBC membrane, reducing zeta potential

59
Q

What does bovine serum albumun do?

A

reduces repulsion between cells, does not shorten incubation time

60
Q

What concentration does bovine serum albumin remain in

A

22-30%

61
Q

What are lectins

A

seed extracts that are specific towards RBC antigens

62
Q

What is CAT

A

column agglutination technology, a test where a dextran acrylamide gel has predispensed antigens.

63
Q

What temperature should CAT testing be stored at

A

stored in fridge, has to be room remp before testing

64
Q

What concentration do CAT tests have?

A

0.8-1% cell suspension- diluted

65
Q

What blood type is on slide 50 ch 4

A

O-

66
Q

What CAT test result is the following description

red cell agglutinates are dispensed throughout the length of the gel

A

2+

67
Q

What CAT test results are described

majority of the red cell agglutinates are trapped in the upper half of the gel

A

3+

68
Q

What are the disadvantages to CAT

A

need special equipment, cant use hemolyzed or lipemic samples. higher risk of rouleaux

69
Q

what is rouleaux?

A

stacked coin appearance on RBCs could be due to a disease present

70
Q

What are the advantages of CAT

A

no wash step
more specific and sensitive
standardization

71
Q

What is solid phase Red cell adherence

A

a test that indicates if a reaction occurs, it there is a cell button- negative
if no button- +

72
Q

Explain the procedure for solid phase red cell adherence

A 
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
Q

If a solid phase test shows cells adhered to the sides and bottom of well and there is no button this is a

A

positive

74
Q

If a solid phase test shows blood settling to the bottom of well and create a cell button, this is a

A

negative result

75
Q

Practice labelling slide 55 Ch4

A

center image

76
Q

What are the advantages of solid phase testing

A

well defined endpoints, longer shelf life

77
Q

What are the disadvantages of solid phase testing

A

too much could be added making it unreadable

need special equipment

78
Q

How are monoclonal reagents made

A

spleen lymphocytes from immunized mice that are fused with myeloma cells

79
Q

A reagent that makes a lot of one type of antibody that reacts with one specific epitope is a

A

monoclonal reagent

80
Q

How are polyclonal reagents made

A

injecting animals with human globulin components then collecting the resulting antihuman antibodies

81
Q

A reagent that is directed against multiple epitopes is

A

polyclonal

82
Q

List the test procedure for DAT

A

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
Q

What temperature and what specific antibody is immediate spin IAT testing looking for? and extended ?

A

cold-IgM

warm-IgG

84
Q

What is the procedure for IAT testing

A 
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
Q

What is the purpose of washing the RBCs?

A

washing removes any unbound abs and the AHG reagent will make agglutination visible

86
Q

What are the possible reasons a DAT could show a false negative

A

inadequate washing
undercentrifugation
loss of reagent reactivity

87
Q

In a coombs control, what should the reaction result be if it is a valid test when the check cells are added

A

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
Q

Which IAT test does not require check cells

A

gel testing

Blood Bank (8 decks)

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