UAMS MLT-MLS Comprehensive Exam

Which antibody is most associated with delayed hemolytic transfusion reactions?

Anti-Jka

What is most associated with Anti-I?

Mycoplasma pneumonia

IgG antibodies cause ______ hemolysis from sequestration by spleen.

Extravascular

T/F: Enzyme panels will react with Duffy Antibodies (Fya or Fyb).

False

T/F: RhIG at 28 weeks can cause a mom to have a low titer anti-D.

True

What type of blood should be given if from mom to child?

Irradiated

Room temp crossmatch detects _____ errors.

ABO

Why do premature infants typically need transfusions?

Blood loss from lab tests

When phenotyping, use a positive control that is _______ positive.

Heterozygously

Why is cryoprecipitate normally used?

To replace fibrinogen

What can make an auto control positive? (Distinguish by warming, looking under scope or saline replacement)

Rouleaux and Cold auto

Cold auto will react with _____ AHG and ___ Monospecific AHG.

Polyspecific; C3

What kind of plasma can an AB= patient be transfused with?

AB (+ or =)

_____ transfusion must be fresh, CMV =, radiated and collected with CPDA

Intrauterine

How should intrauterine transfusions be handled?

Radiated and collected with CPDA

When is FFP used?

When PT and PTT are prolonged

Fresh frozen plasma (FFP) is used for patients with a coagulopathy who are bleeding or at risk of bleeding, and where a specific therapy or factor concentrate is not appropriate or unavailable.

At what temperature do Lewis antibodies react?

RT and sometimes 37

What type of hemolysis do Lewis antibodies cause?

In Vitro

How long are sexual partners of IV drug users differed from donating?

1 year

+DAT can make the Rh control ___ when doing weak D test

Positive

Storage: Whole Blood

1-6 C; 35 days

Storage: RBCs (Red cells, Packed RBCs, RBCs)

1-6 C (CPDA- 35 days; ADSOL- 42 days)

Storage: Leukocyte- Reduced RBCs

1-6 C (CPDA- 35 days; ADSOL- 42 days)

Storage: Washed Red Cells

1-6 C; 24 hours

Storage: Irradiated Blood to prevent GVHD

1-6 C; 28 days

Storage: Frozen/ Deglycerolized RBCs

-70 C for 10 years; 1-6 C for 24 hours after prepared

Storage: Random Platelets

20-24 C; 5 days with agitation and temp check every 4 hours (4 hours after pooling)

Storage: Platelets, Apheresis (single-donor)

20-24 C with agitation; 5 days

Storage: Granulocytes, Apheresis

20-24 C; 24 hours

Storage: FFP, frozen

-18 C; 1 year

Storage: FFP, thawed

1-6 C; 24 hours

Storage: Frozen Cryoprecipitated AHF

-18 C; 1 year

Storage: Thawed Cryoprecipitated AHF

RT if used for Factor VIII; 1-6 if used for fibrinogen

Storage: Pooled Cryoprecipitated AHF

20-24 C; 4 hours

What are whole blood transfusions used for?

Cells and volume

What are packed RBC transfusions used for?

Anemia

What are Washed RBC transfusions used for?

Allergy to plasma proteins in IgA deficiencies

What are Leuko-depleted RBC transfusions used for?

Febrile from HLA or CMV risk

What are Frozen, deglycerolized RBC transfusions used for?

Rare or autologous

What must be done to issue red cell products?

ABO, Rh and screening compatible

How are PLTs and WBCs stored?

RT (20-25 C)

What are Leuko-reduced PLT or WBC transfusions used for?

Prevent febrile from HLA and prevent CMV

What are granulocyte transfusions used for?

Severe neutropenia

What are FFP transfusions used for?

Coag disorders (type compatible)

What are cryo transfusions used for?

Factor VIII and IX concentrate- Virus inactivated and lyophilized

What does PT monitor?

Coumadin

What will a cold agglutinin not affect on the cell counter?

Hemoglobin

What does Protein C deficiency cause?

Thrombosis (Thrombosis occurs when blood clots block your blood vessels.)

What does Factor XII deficiency cause?

Thrombosis instead of bleeding

How does old blood affect the RBCs and WBCs?

Crenate RBCs and cause vacuoles in WBCs.

What happens when you mix patient plasma (with a high PTT) with normal plasma?

Corrects Factor Deficiency (Not correct lupus anticoagulant)

Sickle cells and spherocytes will ____ a sed rate.

Lower

Patient with polycythemia needs to have anticoagulant adjusted for ___ or ____

PT or PTT

90% of the hemoglobin is Hgb C and the rest A2 and F on electrophoresis.

Hgb C disease

Associated with hyper-segmented neutrophils, pancytopenia and macrocytes.

Megaloblastic anemia

What are Howell-jolly bodies made up of?

DNA fragments

When are Howell-Jolly Bodies seen?

Non-function spleen & accelerated or abnormal erythropoiesis

What is basophilic stippling made up of?

Denatured RNA

When is basophilic stippling seen?

Lead poisoning & thalassemia

What are pappenheimer bodies (Siderocytes) made up of?

mitochondria and ribosomes that contain iron

When are pappenheimer bodies (Siderocytes) seen?

Sideroblastic anemia, thalassemia, splenectomy

When are Heinz bodies seen?

G6PD deficiency, unstable hemoglobin causing iron to be unprotected, oxidizing drugs, alpha thalassemia

What are Heinz bodies made up of?

Denatured hemoglobin

When are Cabot rings seen?

Severe anemias, pernicious anemia, dyserythropoiesis

What are Cabot rings made up of?

arginine-rich histone and non-hemoglobin iron (remnants of spindle fibers)

When are hemoglobin c crystals seen?

Hemoglobin C disease

What are hemoglobin C crystals made up of?

Abnormal hemoglobin crystallizes

When are Dohle Bodies seen?

May Hegglin Anomaly

DIC lab tests

^PT, PTT, TT, FSP; low Fibrinogen & PLT count; + D-dimer; schistocytes

What are Dohle Bodies made of?

Strands of endoplasmic reticulum RNA

Lab tests for Multiple Myeloma

Protein electrophoresis (M-spike), N/N anemia, pancytopenia (low PLT, RBC & WBC); rouleaux; BM biopsy >30% plasma cells

How do you distinguish Hemophilia A from VWD?

Normal BT

How does lipemia affect the results of the automated CBC?

Falsely elevated Hgb. Correct by replacing lipemic plasma with saline.

Osmotic fragility results with hereditary spherocytosis

Increased; cells are Hyperchromic and easily lyse

Lysed RBC- hypotonic; diluted; can cause false neg

Ghost cell

WBC in a hypotonic urine

Glitter cell

Hypertonic; can cause false negative

Crenated RBC

Composed of Tamm-Horsfall protein; made in the distal convoluted tubules (nephrons)

Casts

Cystine crystals; smell like sulfur

Cystinuria

Tyrosin crystals; liver disease

Tyrosyluria

Mouse odor

PKU

Diabetes mellitus

Micro-albumin

Gout; Horizontal = blue

MSU

Gout is a common crystal-induced arthritis, in which monosodium urate (MSU) crystals precipitate within joints and soft tissues and elicit an inflammatory response.

Pseudogout; Horiz = yellow

CPPD

Pseudogout (SOO-doe-gout) is a form of arthritis characterized by sudden, painful swelling in one or more of the joints. Episodes can last for days or weeks.

Syrup odor, leucine crystals

MSUD

+ Clinitest

Clinitest (reagent tablet) is a semi-quantitative test used for the determination of total reducing substances in urine, which include glucose, galactose, lactose, and pentose.

Galactosemia

Galactosemia is a rare, hereditary disorder of carbohydrate metabolism that affects the body's ability to convert galactose to glucose.

Effects of prolonged storage of urine

Alkaline

A solution of a soluble base has a pH greater than 7.0.

+ WBC, Bacteria

Cystitis

Cystitis is inflammation of the bladder, usually caused by a bladder infection. It's a common type of urinary tract infection (UTI),

+ WBC, bacteria, WBC cast

Pyelonephritis

A kidney infection is also called pyelonephritis. A kidney infection needs prompt medical treatment.

RBC, RBC casts

AGN

Acute glomerulonephritis (AGN) comprises a specific set of kidney diseases in which an immunologic mechanism triggers inflammation and proliferation of glomerular tissue that can result in damage to the basement membrane, mesangium, or capillary endothelium.

Fatty casts, OFB, cholesterol

Nephrotic syndromeephrotic syndrome

A kidney disorder that causes the body to excrete too much protein in the urine.

RTE/ RTE casts, Waxy/ broad

Renal failure

Urine color: amber/ brown-orange

Bilirubin; yellow foam

Urine color: orange

Pyridium

Pyridium is a prescription and over the counter medicine used to prevent treat the symptoms of the lower urinary tract. Pyridium

Urine color: red, cloudy

Intact RBCs (hematuria)

Urine color: red, clear

Hemoglobin; myoglobin

Urine color: red-purple/ burgundy

Porphyrins

Urine color: black

Melanin or homogentistic acid

Urine color: cloud

WBCs, crystals

Urine color: milky

Fats, nephrotic Syndrome