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What vitals are required to be monitored when given a transfusion? Select all that apply.
Temperature
Blood Pressure
Pulse
Oxygen Saturation
Temperature
Blood Pressure
Pulse
Acute transfusion reactions include all of the following except?
TACO
TA-GVHD
Mild or severe allergic
AHTR
TA-GVHD
The definition of an acute transfusion reaction is _______________________.
A complication occurring within 24 hours of a transfusion
A complication occurring within 48 hours of transfuison
A complication occurring after 2 weeks
A complication occurring after 24 hours of a transfusion
A complication occurring within 24 hours of a transfusion
Review the results in table 1. Transfusion of which product is most likely the cause of these results?
Pre:
DAT: IgG negative; C3 negative; ctrl neg
Temperature: 37.0C
Blood Pressure: 130/85
Pulse: 77 bpm
Symptoms: stable
Post:
DAT: IgG positive; C3 positive; ctrl neg
Eluate: anti-A, -A,B
Temperature: 38.5C
Blood Pressure: 120/75
Pulse: 85 bpm
Symptoms: chills, rigors, fever
O positive platelets
A positive FFP
A positive platelets
O positive PRBCs
O positive platelets
While receiving a type compatible platelet, the patient started having urticarial rash around the transfusion site. The nurse stopped the transfusion, medicated the patient with antihistamine, and then continued transfusing the remaining product. The transfusion reaction was reported after completion of the product.
If an urticarial rash is the only symptom, treating the symptom and continuing to transfuse is acceptable
The nurse is going against FDA protocol by continuing transfusion
If another symptom was present, this still would have been the correct route of action
If an urticarial rash is the only symptom, treating the symptom and continuing to transfuse is acceptable
If urticaria was the only symptom, what is the required transfusion reaction workup?
ABORh, DAT, and ABID
ABORh and DAT on post transfusion sample
ABORh and DAT on pre and post sample
Clerical check only
Clerical check only
What product is the most likely cause of Transfusion Associated Sepsis?
Platelets
Cryo
FFP
PRBCs
Platelets
What is the minimum required dose of irradiation to prevent TA-GVHD?
15 grays to the center and rest of the product
50 grays to all of the product
15 grays to the center and 25 grays to the rest of the product
25 grays to the center and 15 grays to the rest of the product
25 grays to the center and 15 grays to the rest of the product
All of the following are complications associated with a massive transfusion except?
Increase in temperature
Hyperkalemia
Hypothermia
Chelation of calcium due to citrate
Increase in temperature
Leukocyte reduction can help in reducing which type of transfusion reaction?
TACO
FNHTR
AHTR
DHTR
FNHTR
Paroxymal Cold Hemoglobinuria (PCH) is associated with antibody specificity toward _____________.
Kidd blood group system antigens
I antigen
P antigen
MNS blood group system antigens
P antigen
Cold agglutinin syndrome (CAS or CAD) is associated with antibody specificity toward what antigen and what age group is it found in?
I antigen and >50 years old
M antigen and >50 years old
P antigen and <50 years old
I antigen and <50 years old
I antigen and >50 years old
Review the following lab results. What type of antibody does this patient have?
ABORh APositive
ABSC Positive both cells
ABID Pan-reactive including auto ctrl
DAT IgG positive; C3 positive; ctrl negative
Eluate Pan-reactive
Adsorption No underlying common allo-antibodies
multiple antibodies
antibody against a high frequency antigen
CAA
WAA
WAA
Anti-A/4+
Anti-B/0
Anti-D/4+
A1 cells/0
B cells/4+
SCI/2+
SCII/2+
Antibody ID/panel:
Panreactive
Auto control positive
Eluate positive
Warm treated pt cells panel: some reacted while others didn't at AHG.
is the patient making a clinically significant underlying alloantibody? Patient wasn't transfused and we had enough sample...
Yes
No
Yes
Which of the following is an immediate immune transfusion reaction?
Circulatroy Overload
Bacterial Contamination
Hemolytic Transfusion reaction
Damage to the red cells in the bag
Hemolytic Transfusion reaction
Which of the following is an immediate non-immune transfusion reaction?
Acute hemolytic transfusion reaction
Febrile, non-hemolytic transfusion reaction
Urticarial / Anaphylactic transfusion reaction
Circulatory Overload
Circulatory Overload
Which of the following is a delayed immune transfusion reaction?
Graft vs host disease (GVHD)
Iron overload / hemosiderousis
infections: parasites, viruses, prions
TRALI
Graft vs host disease (GVHD)
A patient with two or more documented febrile nonhemolytic transfusion reactions (FNHTRs) should receive __________ blood components.
Leukocytes reduced
hemoglobin S- negative
Cytomegalovirus-negative
Irradiated
Leukocytes reduced
Which of the following questions should be asked when investigating a transfusion reaction?
What time of day was the donor unit collected?
How many milliliters of red blood cells were transfused?
What was the donor unit hematocrit?
What methodology was used for serologic testing?
How many milliliters of red blood cells were transfused?
What measure can be taken to prevent transfusion-associated hypothermia?
Premedication with calcium gluconate
Close monitoring of patient vital signs
Transfusion of product using a blood warmer
Prudent use of platelet concentrates
Transfusion of product using a blood warmer
Persons with a documented history of anaphylactic reactions should be transfused with _________ blood products.
washed
leukodepleted
irradiated
IgE-deficient
washed
Negative direct antiglobulin test (DAT) is found in all of the following transfusion reactions except:
Febrile nonhemolytic transfusion reaction
Acute immune hemolytic transfusion reaction
Transfusion-associated sepsis
Acute nonimmune hemolytic transfusion reaction
Acute immune hemolytic transfusion reaction
An acute hemolytic transfusion reaction occurs greater than 24 hours after the start of transfusion.
True
False
False
Which of the following is the most common transfusion reaction reported to blood banks?
Extravascular hemolytic reaction
Febrile reaction
Intravascular hemolytic reaction
Anaphylactic reaction
Febrile reaction
A delayed hemolytic transfusion reaction is most often the result of:
a unit of packed cells infected with hepatitis B virus.
an anamnestic response in a patient who has been previously sensitized by transfusion or pregnancy.
bacterial-contaminated red blood cells.
hemosiderosis in a massively transfused patient.
an anamnestic response in a patient who has been previously sensitized by transfusion or pregnancy.
What is the most frequent cause of circulatory overload?
Transfusion of a partially deglycerolized unit
Transfusion of a unit at too fast a rate
Transfusion of a unit at too slow a rate
Transfusion of a type incompatible platelet
Transfusion of a unit at too fast a rate
All of the following are clinical manifestations of cold hemagglutinin disease (CHD) except:
Acrocyanosis of the hands and feet
hepatosplenomegaly.
Agglutination of red cells in capillaries.
Raynaud's phenomena
hepatosplenomegaly
Refer to the following lab data on a patient without previous transfusions:
Hgb is7.4
Retics 22%
DAT; 3+ with Poly, 3+ with anti-IgG, Neg with anti-complement; neg ctrl
Eluate is postive with panagglutinin
Screen is 3+ on cell l and ll at AHG
What clinical condition do you think is most consistent with these results?
Cold hemagglutinin
ABO-medicated hemolytic transfusion reaction
Autoimmune hemolytic anemia
Penicillin-induced hemolytic anemia
Autoimmune hemolytic anemia
Autoantibodies are generally directed against which antigens?
ABO
Low-frequency
High-frequency
Duffy
High-frequency
A drug is suspected to be the cause of a patient's positive DAT. The patient's serum and eluate react with all cells tested in the absence of the drug.
Which drug is most likely the cause of this phenomenon?
Aldomet/methyldopa
Quinidine
Penicillin
Cephalosporin
Aldomet/methyldopa
What is the drug most commonly associated with the immune complex mechanism of drug-induced positive DAT?
Penicillin
Neosporin
Aldomet/Methyldopa
Quinidine
Quinidine
A patient is in critical need of a transfusion but initial pretransfusion testing seems to indicate a warm autoantibody reacting with all cells tested. What is your primary concern at this point?
To titer the autoantibody, in order to determine if it is clinically significant
To neutralize the autoantibody
To identify the autoantibody
To determine whether there are underlying significant alloantibodies present
To determine whether there are underlying significant alloantibodies present
What percentage of AIHA cases are caused by warm reactive autoantibodies?
70%
25%
12%
18%
70%
Some drugs can cause changes to the RBC membrane, resulting in non-specific protein adsorption. Which of the following are most likely associated with this mechanism of a drug-induced positve DAT?
Aldomet/Methdopa
Quinidine
Penicillin
Cephalosporin
Cephalosporin
Which of the following findings apply to PCH? (Choose all the apply)
Often appears to be anti-P
Antibody is IgG
mild or benign in course, rarely see anemia as a consequence
Acts as a biphasic hemolysin
mild or benign in course, rarely see anemia as a consequence
Warm autoantibodies may seem to be directed against common blood group antigens, in this case they may be referred to as "mimicking" specificities. Often, these appear to be directed against antigens in which system:
MN
ABO
Rh
Duffy
Rh
The specificity most frequently encountered in cases involving cold autoantibodies may be directed against which of the antigen systems below?
Kell
I/i
Lewis
ABO
I/i
EGA reagent works by disassociating antibodies from the cells allowing them to be antigen typed at the AHG phase.
True
False
True
Patient has a hx of anti-E and anti-Fyb and has received 2 RBCs/week for the past 4 months. RBCs were sent over that were antigen matched and XM compatible through AHG. Patient received one of the two units and had a reaction including the following symptoms: tachycardia, fever greater than 2 degrees F from pre-transfusion temperature, and rigors. A post transfusion specimen was immediately collected and the remainder of the RBC was sent to the blood bank. Transfusion reaction clerical check was resulted as no clerical errors identified. Serologic transfusion reaction testing results were as follows:
DAT IgG (pre neg, post pos)
DAT C3 (pre neg, post pos)
What is the most likely cause of the reaction, what testing should be performed next, and can the doctor give the remaining RBC unit?
Patient reacted severely to the preservative in the RBC, no further testing required, and yes, give the other unit
Patient developed another antibody, perform an eluate, and no, the other unit cannot be given
Patient had a febrile, non hemolytic transfusion reaction. Give leukoreduced RBCs.
Patient developed another antibody, perform an eluate, and no, the other unit cannot be given
The enzyme L-fucosyl transferase adds fucose to Precursor Substance 2 on the RBC membrane. With no further modification of the H chain, these cells would phenotype as:
B
Rh positive
O
A
O
Choose the SINGLE best answer from the choices given.
If the ABO testing on a cord blood sample is uncertain (mixed field, etc.), the infant's type may be most rapidly and efficiently investigated by:
A Kleihauer-Betke stain
ABO grouping on mother and father, using their results to predict the likely type(s)
Repeating testing on a heel-stick specimen from the infant
ABO reverse grouping on a cord-blood specimen
Repeating testing on a heel-stick specimen from the infant
Which apheresis platelet should be irradiated? What is the minimum required grays to be considered and irradiated product?
directed unit from an unrelated friend; 25 grays to the entire product
autologous unit; 15 grays to the middle of the product and 25 grays to the rest of the product
HLA matched unit; 25 grays to the middle and 15 grays to the rest of the product
allogeneic unit; 25 grays to the center of the product and 15 grays to the middle of the product
HLA matched unit; 25 grays to the middle and 15 grays to the rest of the product
Post Transfusion Purpura is usually caused by _______?
anti-A
white cell antibodies
anti-P1
anti-HPA-1a
anti-HPA-1a
Which of the following transfusion reactions is characterized by high fever, shock, and hypotension that could lead to renal failure and DIC?
transfusion associated circulatory overload
transfusion associated acute lung injury
transfusion associated sepsis
febrile non-hemolytic
transfusion associated sepsis
A patient is readmitted to the ED 3 weeks post transfusion of 2 RBCs with a hemoglobin level of 7 g/dL. What do you expect to see in the DAT?
positive due to complement only
negative
mixed field positive
mixed field negative
mixed field positive
The most important step in safe transfusion of blood is to _______?
accurately identify the donor unit and recipient
select only qualified donors
get an accurate medication list
perform pre-transfusion testing accurately
accurately identify the donor unit and recipient
In a quality assurance program, Cryoprecipitated AHF must contain a minimum of how many international units? How many IU in a pooled Cryo?
70 IU and 350 IU FVIII
80 IU FVIII and 150 mg fibrinogen
80 IU FVIII and 760 mg fibrinogen
80 IU and 400 IU FVIII
80 IU and 400 IU FVIII
Based on the following results, is mom still a candidate for RhIg? Consider her future pregnancies.
Baby:
ABORh: ABNeg
ABSC: Pos
DAT: Neg
Mom:
ABORh: ANeg
ABSC: Pos
ABID: anti-D passively acquired
Yes, anti-D is passive
No, mom has anti-D
No, baby has positive ABSC
Yes, mom has anti-C
Yes, anti-D is passive
Patient received 2 units of PRBCs 2 weeks ago and is back in the ED with a H/H of 6.5 g/dL and 19% hct. Her ABSC is now positive and the repeat ABSC of her old sample is still negative. An ABID was performed and anti-c (little) was identified. What type of transfusion reaction is this and what panel cell would you need to run in order to get a homozygous big E rule out?
AHTR and RzRz
DHTR and RzRz
DHTR and R2R2
DHTR and RzR1
DHTR and RzRz
What is the most likely cause of this ABO discrepancy?
anti-A / 3+mf
anti-B / 0
anti-D / 3+mf
A cell / 0
B cell / 3+
Type OPos patient transfused with ONeg PRBCs
Type ANeg patient transfused with APos PRBCs
Type APos patient transfused with OPos PRBCs
Type APos patient transfused with ONeg PRBCs
Type APos patient transfused with ONeg PRBCs
RhIg evaluation arrives with a sample on mom and baby. Review the following results and make a recommendation as to how many doses of RhIg the mom needs.
Baby
Type: APos
DAT: Pos
Mom
Type: ONeg
ABSC: Neg
FS: Pos
HgF Quantitation = 3%
6 doses of 300ug RhIg
4 doses of 300ug RhIg
6 doses of 50ug RhIg
5 doses of 300ug RhIg
6 doses of 300ug RhIg
Review the following lab results. What mechanism(s) of DIIHA (drug induced immune hemolytic anemia) could be represented? Select all that apply.
TestResult
ABORh BPos
ABSC negative
DAT Positive IgG, C3 positive, ctrl neg
EluateNegative
Drug adsorption (rarely)
Membrane modification mechanism
Immune complex mechanism
Induced Autoimmune
Drug adsorption (rarely)
Membrane modification mechanism
Immune complex mechanism
Referring to table 2 in a previous question, what drug(s) could be responsible for the reactivity? Select all that apply.
Methydopa/Aldemet
Cephalosporin
Penicillin
Quinidine
Cephalosporin
Penicillin
Quinidine
What is the test for a patient who has paroxymal cold hemoglobinuria (PCH) called?
Lui Freeze Thaw
Donath Lansteiner
Thermal Amplitude study
Short cold panel
Donath Lansteiner
In regards to the Donath Landsteiner test being represented in table 3:
What reagent cells are used and at what % cell suspension?
Type O, P1 antigen negative (presumably P positive), 70% cell suspension
Type O, P1 antigen positive (presumably P positive), 2-3% cell suspension
Type O, P1 antigen positive (P positive), packed cells no suspension
Type O, P1 antigen positive (presumably P positive), 50% cell suspension
Type O, P1 antigen positive (presumably P positive), 50% cell suspension
In a WAA workup, if the patient has been transfused in the past 3 months which adsorption method should be used? How many passes would be recommended if the DAT strength was 2+?
Autologous adsorption with one pass
Allogeneic adsorption with at least 3 passes
Allogeneic adsorption with at least two pass
Autologous adsorption with at least 3 passes
Allogeneic adsorption with at least 3 passes
Which is more common?
CAA
Single alloantibody
WAA
Multiple alloantibodies
Single alloantibody
When you see the term "acquired B" antigen, what part of the body do you immediately think of:
Brain
Bowel
Bladder
Big Toe
Bowel
How many of the following errors can contribute to an ABO discrepancy? Choose all that apply.
failure to follow the manufacturer's instructions on
how to use the reagent
failure to add AHG reagent
clerical error in recording your results
cell suspension is too heavy or too light
failure to follow the manufacturer's instructions on
how to use the reagent
clerical error in recording your results
cell suspension is too heavy or too light
In cases of HDN, the mother produces antibody against an antigen that is expressed on her baby's RBC. The antigen is:
must be inherited from both parents (dosage effect)
inherited from mother, not found on the father's cells
inherited from the father, not found on mother's cells
a paternal antigen also found on the mother's cells
inherited from the father, not found on mother's cells
ABO HDFN:
always occurs in the firstborn child
usually requires an exchange transfusion
frequently results in stillbirth
is most often seen in group A or B newborns of group O mothers
is most often seen in group A or B newborns of group O mothers
Antibodies formed against the antigens M, N, S and s are typically all cold reactive and not generally clinically significant.
True
False
False
Laboratory studies of a mother and newborn baby sample yield the following results:
Mother: O, Rh neg, AB screen positive, Anti-E in serum
Baby: B, Rh pos, DAT= 2+, Anti-E in eluate made from cord cells
If you have to do an exchange transfusion, the best choice of blood would be _________?
O, Rh neg, E pos
B, Rh pos, E pos
O, Rh pos, E neg
B, Rh neg, E pos
O, Rh pos, E neg
you don't want to transfuse with blood that mom has antibody for
Blood used for intrauterine transfusion should have all of the following attribute(s). Select all that apply.
compatible with any maternal antibodies present
greater than 7 days old
ABO Rh compatible with mom and baby, usually O negative
HgbS positive
Irradiated
compatible with any maternal antibodies present
greater than 7 days old
ABO Rh compatible with mom and baby, usually O negative
Irradiated
Anti-U is clinically significant in pregnancies and transfusions.
True
False
True
Rh Immune Globulin (RhIg) is given to:
Rh negative mothers, not yet immunized to D antigen
Rh positive mothers, HDN not present
infants who are Rh negative
mothers who have already formed anti-D during their pregnancies
Rh negative mothers, not yet immunized to D antigen
When assessing whether an Rh-negative mother is a candidate for Rh Immune Globulin, if you do not know baby's Rh type (as in cases of miscarriage, etc.) it is:
best to draw sample from the father and do family studies to predict the most likely Rh type, then treat mom accordingly
safer to assume the baby is Rh negative; don't give the mother RhIg
Safer to assume the baby is Rh positive; give the mother RhIg
Safer to assume the baby is Rh positive; give the mother RhIg
You are performing a post delivery Rh Immune Globulin workup. The mother is Rh negative. Her baby is Rh positive and has a negative DAT. What additional test is indicated, before you issue the RhIg?
an antibody screen must be performed on the mother
an antibody screen on the baby's sample
a fetal screen (rosette) test for fetal maternal hemorrhage
weak D test on the baby
a fetal screen (rosette) test for fetal maternal hemorrhage
A patient is type OPos and has an anti-E and anti-Fya. Select the best RBC for this patient. Keeping in mind both frequency of phenotypes and inventory availability.
Type O, R1r, Fy(a-b+)
Type O, R2r, Fy(a-b+)
Type O, R2R2, Fy(a-b+)
Type A, R1R1, Fy(a+b-)
Type O, R1r, Fy(a-b+)
What patient population is likely to have an antibody
against a Lewis antigen?
Cardiac patients
Pregnant patients
Dialysis patients
Pediatric patients
Pregnant patients
Which statement best describes the fetal screen (rosette) test? It is:
confirmatory test, which proves that no fetal bleed has occurred and therefore no RhIg is indicated
a quantitative test, it tells you the exact amount of fetal bleed
a qualitative test, indicating that a fetal bleed occurred.
This test requires follow up to determine exact amount of fetal bleed.
a qualitative test, indicating that a fetal bleed occurred.
This test requires follow up to determine exact amount of fetal bleed.
The same donor from question #1 (17 year old male) comes back to donate after 6 weeks. Can he donate?
No
A 17 year old male presents at his high school's blood drive with the following vitals. Can he donate whole blood?
Blood Pressure: 110/70
Pulse: 67 BPM
Temperature: 37C
Hgb: 14.5 g/dL
Yes
Joey made a series of poor decisions which led to his incarceration with tentative sentence of 6 months. He was released last week for good behavior after serving 4 months. As part of his transformation in becoming a law abiding citizen he wanted to donate. His vitals are listed below, can he donate?
BP: 120/85
Pulse: 78 BPM
Temperature: 98.9F
Hgb: 15.5 g/dL
No
What is the only process that can prevent transfusion associated graft verses host disease?
Irradiation
What is the maximum transfusion time for any blood product?
8 hours
6 hours
4 hours
2 hours
4 hours
Jamie was born in the 1960's and lived through the era of the first discovery of HIV/AIDS and lost many friends. She is skeptical of the safety of blood transfusions and wants to donate for herself in preparation for her hip surgery the following week. Select the best answer for the autologous donation.
Must donate at least 72 hours prior to surgery
Must have a Hgb >11.0 g/dL
Temperature must not be
>99.5F
All options are correct
all options are correct
To manufacture whole blood derived platelets, whole blood must be cooled towards 20-24C and then centrifuged in what order?
soft spin, soft spin
hard spin, hard spin
soft spin, hard spin
hard spin, soft spin
soft spin, hard spin
To be considered leukocytes reduced, a product must have less than what number of leukocytes?
<3.0x10^11
< 5.0 x10^6
>5.0 x 10^6
>5.5x10^5
< 5.0 x10^6
How many IU's of FVIII must be present in a pool of 5 single cryo?
a minimum of 400 IU FVIII
True or False: Type O whole blood can be used interchangeably with type O packed RBCs.
False
Apheresis platelets must contain a minimum of 3.0x10^11 platelets per bag.
True
False
True
Adding additive solution to a unit of packed RBCs will lengthen the expiration date of the unit to ___________?
35 days
6 hours
42 days
365 days
42 days
Match the following products to their appropriate SHIPPING temperatures.
1-10C
20-24 C
<-18 C
PRBCs
Platelets
FFP
thawed plasma
PRBCs 1-10C
Platelets 20-24C
FFP <-18C
thawed plasma 1-10C
While performing a routine postpartum Rh Immune Globulin workup, you find a very weak anti-D in the mother's serum. This is most likely the result of ______?
the mother has a positive DAT
massive fetal-maternal hemorrhage at the time of delivery
antenatal administration of Rh Immune Globulin at 28 weeks gestation, providing passive immunization in the mother
contamination of the mother's sample with Wharton's Jelly
antenatal administration of Rh Immune Globulin at 28 weeks gestation, providing passive immunization in the mother
Reviewing antibodies: After you've done a panel, performed your ruling out process, and identified what antibody most likely present in a patient sample, what test should you generally do on the patient's RBC?
Enzyme treatment
Neutralization
Adsorption
Antigen/Phenotype
Antigen/Phenotype
The following results are seen in a sample from a 20-year old, healthy blood donor: Anti-A=0, Anti-B=0, Anti-D=4+, A1 cell=0, B cell=3+
Of the options given below, what is the most likely cause of the discrepancy?
very weak subgroup of A
Bombay phenotype
loss of A antigen due to a disease process
aquired B phenotype
very weak subgroup of A
Consider these ABO typing results:
Anti-A=4+, Anti-B=0, Anti-D=3+, A1 cells=1+, B cells=4+
You decide to look at the "extra" reaction in the A1 cell. You do some additional testing, a short cold panel:
A1 cell: IS=1+, Rm T=2+, 4C=4+
A2 cell: IS=1+, Rm T=2+, 4C=4+
B cell: IS=4+, Rm T=4+, 4C=4+
Screen cell I: IS=1+, Rm T=2+, 4C=4+
Screen cell II: IS=1+, Rm T=2+, 4C=4+
Auto control: IS=1+, Rm T=2+, 4C=4+
Cord cell: IS=0, Rm T=0, 4C=0
What is the most likely source of this
The patient is exhibiting acquired A antigen
The patient is A2B with anti-A1
The patient has a cold alloantibody like anti-M
The patient has a cold autoantibody
The patient has a cold autoantibody
You identify an anti-M in the serum during a workup on a patient which has caused an ABO discrepancy. This identifies the antibody / problem but it does not give you a front type and back type that are complementary. So: How will you perform the reverse type, to confirm/resolve this ABO?
use A1 and/or B cells which are negative for the M antigen
type the patient for M
you don't need the reverse type for ABO confirmation
adsorb and elute anti-M from his RBC
use A1 and/or B cells which are negative for the M antigen
You ran an antibody ID panel and identified anti-Fya; everything else was ruled out. RBCs have been requested. Your next steps include ____? Select all that apply.
Do an enzyme panel to prove that it is really -Fya
Phenotype the patient for Fya: He should be Fya-
Phenotype units and perform AHG crossmatches on the Fya- units
Do a prewarm technique to abolish the reactions you saw
Phenotype the patient for Fya: He should be Fya-
Phenotype units and perform AHG crossmatches on the Fya- units
Rh Immune Globulin has been requested for an Rh negative mother who has the following test results:
anti D=0, Weak D test= w+ m.f., Weak D ctrl/CC =0/2+, DAT/CC = 0/2+
What is the most likely explanation of her positive weak D test?
mom is weak D positive
the anti-D reagent is contaminated with an atypical antibody
the mother's RBCs are coated with IgG
there has been a fetal maternal hemorrhage of fetal D+ cells, which have been detected in mom's circulation in your weak D test
there has been a fetal maternal hemorrhage of fetal D+ cells, which have been detected in mom's circulation in your weak D test
What is the most appropriate interpretation/ evaluation for the results given below?
Mom: anti-D= neg, weak D test=neg, DAT=neg, Fetal Screen=neg
Baby: anti-D=neg, weak D test=neg, DAT=neg
mother is not a candidate for Rh Immune Globulin (RhIg)
mother needs 2 doses of 300ug RhIg
mother needs 1, 300ug dose of RhIg
a Kleihauer-Betke stain is needed to determine the amount of RhIg needed
mother is not a candidate for Rh Immune Globulin (RhIg)
What is the first (BEST) step you should perform, if an ABO discrepancy is obtained?
Repeat the testing from the beginning
Short cold panel
Interpret the ABO based on the most probable type
Prewarm incubation
Repeat the testing from the beginning
An eluate is performed after a positive DAT IgG to identify possible specificities of the antibody(ies) coating the patient's PRBCs. What circumstances would lead you to performing a DAT? Select all that apply.
Cord study in an RhIg evaluation
pretransfusion testing on a neonate
1 of 6 AHG XMs are incompatible
the auto control in an ABID panel is reactive
Cord study in an RhIg evaluation
1 of 6 AHG XMs are incompatible
the auto control in an ABID panel is reactive
Kleihauer-Betke stain results on a postpartum mother indicate that there has been a fetal maternal bleed; 1% of the cells counted are fetal cells. Assuming the woman has a blood volume of 5000mL, please calculate the proper RhIg dosage.
1 mini dose
3 full doses
2 full doses
1 full dose
3 full doses
A type and screen is performed on a 49-year-old woman who is scheduled for a hysterectomy in 1 week. Her blood type is A-positive, and her antibody screen was positive. There are 3 PRBCs preoperatively ordered. What must be done before her surgery date?
Identify antibody and phenotype units
Phenotype the patient
Identify antibody and phenotype platelets
Identify antibody
Identify antibody and phenotype units
A strongly positive Fetal bleed screen could be due to the baby's blood being tested by mistake.
True
False
True
How can the ABO and Rh of the fetus be determined in utero?
percutaneous umbilical cord sampling
All of the options are correct
amniocentesis
chorionic villus sampling
All of the options are correct
A patient has an antibody that is reactive against every cell where Jka or Jkb or both Jka and Jkb antigens are present and is non-reactive when there are no Kidd antigens present. This patient most likely has what antibody and where cold appropriate units be located?
anti-Jk3 and Pacific Islanders
anti-Fy3 and Africans
anti-Lu3 and Caucasians
anti-Ku and Italians
anti-Jk3 and Pacific Islanders
Rh-immune globulin should be given within how many hours after delivery?
24
72
48
36
72