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- What is the Fisher Race nomenclature for Rh antigens?
- D, C/c, E/c
- What is the corresp. Weiner symbol for each fisher race?
-
D = Rho
C = rh'
c = rh''
E = hr'
e = hr'' - What is the most common Rh antigen for whites?
- e
- What are the top 4 Rh antigens for whites in order?
- e > D > c > C
- What is the most common Rh antigen for blacks?
- e
- What are the top 4 Rh antigens for blacks in order?
- e > c > D > C > E
- What antigens are present for the genotype Ro?
- Dce
- What antigens are present for the genotype R1?
- DCe
- What antigens are present for the genotype R2?
- DcE
- What antigens are present for the genotype Rz?
- DCE
- What antigens are present for the genotype r?
- dce
- What antigens are present for the genotype r'?
- dCe
- What antigens are present for the genotype r''?
- dcE
- What antigens are present for the genotype ry?
- dCE
- What is the most common genotype in whites?
- R1 - DCe
- What is the most common genotype in blacks?
- R0 - Dce
- What is the least common genotype of all?
- Rz
- What is the 2nd most common genotype for both black/whites?
- r - cde
- what are the naturally occurring antibodies?
- ABO MN Lewis Lua P1
- what are the clinically significant antibodies?
- ABO, Rh, Kell, Kidd, Duffy, SsU
- What are the warm antibodies?
- Rh Kell Duffy Kidd
- What are the Cold antibodies?
- M N P1
- What antibodies usually only react in the AHG's phase?
- Kell Duffy and Kidd
- What antibody can react in any phase?
- Lewis
- What antibodies are not detected by enzyme treatment of cells?
- M N Duffy
- Detection of what antibodies are enhanced by enzymes?
- Rh, Kidd, Lewis, P1
- What antibody is enhanced by acidification?
- M
- What antibodies show dosage?
-
Rh (except D)
MNS
Duffy
Kidd - Which antibodies bind complement?
- I, Kidd, Lewis
- What antibodies cause in vitro hemolysis?
- ABO, Lewis, Kidd, Vell, some P1
- What What antibody is labile in vivo and in vitro, and commonly causes an anamnestic response?
- Kidd
- What antibody is associated with PNH?
- Anti-P
- What antibody is associated with cold agglutinins disease and mycoplasma pneumoniae?
- Anti-I
- What antibody is associated with infectious mono?
- Anti-i
- What is required for a 95% confidence in antibody id?
- 3 pos and 3 neg reactions
- What will agglutinate cord cells? What will not?
-
Will: Anti-i
Will not: Anti-I, Anti-H, Anti-IH - For compatibility testing, what is the patient specimen requirement?
- -Must have been collected within 3 days of transfusion if the patient has been pregnant/transfused in past 3 months.
- What must be done for a complete Compatibility Testing?
-
1. Repeat ABO on donor (Rh if labeled as Rh neg)
2. ABO/Rh type recipient.
3. Crossmatch.
Retain patient specimen, unit segment for 1 week. - When doing a crossmatch you find one Ab screen is pos, and one donor is positive in AHG. What should you suspect?
- An alloantibody; identify it and crossmatch compatible units.
- When doing a crosmatch you find that all Ab screen cells, all donors, and the autocontrol are neg except one donor in the AHG. What should you suspect?
- A positive DAT in the donor. Return it to the bloodcenter.
- When doing a crossmatch you find aht all Ab screen cells, donors, and the autocontrol are positive - only in AHG. What should you suspect?
- A Warm autoantibody; it's best to not transfuse but if you must find a least incompatible unit.
- When doing a crossmatch you find that all Ab screen cells, donors, and the autocontrol are positive - in 37 And AHG. What should you suspect?
- Rouleaux; do a saline replacement technique.
- What is standard protocol for newborn testing?
-
1. ABO/Rh Fwd type the infant cord capillary or venous blood.
2. Ab screen baby or mom.
3. If Ab screen pos, crossmatch compatible units. - How soon do red cells at room temp "go bad"? why?
- 30 min - reach 10'C that fast!
- What are the conditions for reissuing blood?
-
1. Maintain at 1-10'C
2. Closure unbroken
3. At least 1 segment left
4. Inspect
5. Record reissuing - How can you differentiate intra and extravascular hemolysis?
-
-Both have decreased haptoglobin
-Intra shows hburia/hbemia, DIC
-Extra shows jaundice, increased bilirubin, takes 2 days longer. - What usually causes intravascular HTR?
- -ABO incompatibility
- What usually causes extravascular HTR?
- KIDD
- Which is fatal, intra or extra?
- intra
- What causes febrile reactions?
- Anti-leukocyte antibodies.
- What is the clinical sign of a febrile transf rxn?
- Increased temp within 24 hrs.
- What is the sign of an allergic reaction?
- Hives (urticaria)
- What causes an allergic response?
- Plasma proteins that are foreign to the system.
- What is a clinical sign of anaphylatic transf rxn?
- bronchospasms
- What causes an anaphylactic response to transfusion?
- Anti-IgA in an IgA deficient recipient.
- Who do you commonly see circulatory overload in?
- Children, cardiac/pulmonary patients, elderly
- What causes circulatory overload?
- Transfusion of too high volume
- What are the signs of circ overload?
- coughing/cyanosis/problems breathing.
- What causes septicemia from a transf reaction?
- septic blood
- What are some signs of contaminated blood transfusion?
- Renal failure, DIC, fever, cramps, diarrhea, everything.
- What ABO type mothers are most at risk for causing HDN?
- O
- What type of elution is used for investigating ABO HDN?
- Heat or freeze-thaw
- What type of elution is used for investigating Rh HDN?
- Acid
- When is RhIg given to mothers?
-
-28 wks gestation
-within 72 hrs of birth if baby is Rh pos - What is standard protocol for when an Rh pos baby is born to a neg mom?
-
-Draw mom's blood w/in 1 hr.
-Do rosette test to screen for fetal bleed - If the rosette test is positive postpartum, what should you do?
- Klei=hauer Betke acid elution to quantiate the fetal bleed.
- What is the principle of the Kleihauer-Betke test?
-
Fetal cells resist acid elution and stain pink.
Momma cells appear as ghosts.
You count the baby cells to see how bad the bleeding was. - How much Rhogam should be dosed after a fetal maternal bleed?
- 1 dose per 15 ml Baby CELLS or 30 ml fetal whole blood.
- how long is the deferral for taking aspirin?
- 3 days if only giving plt
- how long is the deferral for measles, mumps, polio, or yellow fever vaccines?
- 2 wks
- how long is the deferral for rubella vaccine?
- 4 wks.
- how long is the deferral for pregnancy?
- 6 wks.
- how long is the deferral for having travelled to an endemic area for malaria?
- 1 yr
- how long is the deferral for having lived in a malaria area?
- 3 yrs
- What is the anticoagulant volume for blood collection?
- 63 ml
- What is the blood volume collected for transfusions?
- 450 +/- 45 mL
- How low of a volume can be collected for a unit before adjusting the anticoag?
- Down to 300
- How fast should blood be collected?
- 4-10 min
- Name 3 anticoag/preservatives
-
-ACD acid citrate dextrose
-CPD citrate phosphate dextrose
-CPDA1 - w/ adenine - Which preservatives have 21-day shelf lives?
- ACD and CPD
- whats the shelf life of CPDA1?
- 35 days
- what are 3 additives?
-
adsol
nutricel AS-2
nutricel AS-3 - what are the best addtives? why?
- adsol and nutrisel as-3; increase shelf life to 42 days
- How much should one unit of blood increase a person's hct?
- 3%
- how long are frozen rbcs good for?
- 10 yrs from drawing; 24hrs after thawing
- how soon should RBCs be prepared for freezing?
- within 6 days
- what temp should frozen RBCs be stored at?
-
20% glycerol -120
40% glycerol -65 - What are washed RBCs given for? (condition)
- PNH patients or IgA deficient but prefer frozen for the latter
- what is the max amt of WBCs that can remain in leuko reduced units?
- no mroe than 5 x 10'6
- what is used to rejuvenate rbcs?
- PIPA
- what is the new shelf life of RBCs if rejuvenated?
- 24 hrs, or else freeze them.
- when are RBCs rejuvenated?
- up to 3 days after outdate; restores their 2,3-DPG and ATP
- whats the exception for rejuvenating?
- can't do it to cells in additive solution (adsol/nutricel)
- what are RBCs irradiated for?
- Transfusing immunocompromised or intrauterine patients, to prevent GVHD
- What is the indication for FFP?
- Coag factor deficiency - EXCEPT factors 1, 8 and 13
- What is the indication for Cryo?
-
-Hemophilia A
-Von willebrand's
-Hypofibrinogenemia
-Factor XIII defic. - What temp should FFP be stored at? What is its shelf life?
- Store at <18, for 12 months
- What are the storage conditions of cryo?
- Same as FFP
- What are the conditions to be met by cryo?
- Should contain at least 80 IU Factor VIII and 150 mg fibrinogen.
- How soon should cryo be transfused after thawing?
- 6 hrs, or 4 if pooled.
- How much plasma is in a pile of platelets?
- Enough to keep the pH at 6
- What is the storage temp for platelets and granulocytes?
- 24'C - room temp!!!
- what is the shelf life of plts and grans?
-
plt: 6 days if agitating
Grans: 24 hrs - do WBCs need to be crossmatched?
- you betcha - they contain RBCs too
- What should a plt transfusion do for the patient?
- Raise the plt count by 5-10,000/uL in a 75 kg patient
- How long can units be usable if they've been stored at room temp?
- 4 hrs