crossmatch, computer crossmatch, issue/administration, antibody identification, molecular testing, adsorption/elution/cell separation, indications for components, emergency release, massive transfusion, transfusion reactions, and reaction investigation.

What type of crossmatch uses donor red cells and patient serum?

Major crossmatch

What mnemonic is given for the major crossmatch?

DRoPS

What does DRoPS stand for in the major crossmatch?

Donor red cells

An IS crossmatch is acceptable only if the recipient has demonstrated no what type of antibodies?

Significant antibodies

If the recipient has clinically significant antibodies or a history of them, what crossmatch phases are required?

37°C IAT

After transfusion, the recipient sample and donor segment must be stored at refrigerated temperature for at least how many days?

7 days

Computer crossmatch can only be used if the recipient has no clinically significant antibodies and no what?

Previous history

If the computer system is used to detect ABO incompatibility, it must be what on site?

Validated

In computer crossmatch, the system must contain the donation identification number and what product information?

Component name

In computer crossmatch, the system must include the ABO and Rh of what item?

Component

In computer crossmatch, the system must also contain the confirmed blood component ABO group and how many recipient identifiers?

Two identifiers

In computer crossmatch, the system must contain the recipient ABO and Rh type plus what antibody testing information?

Screen results

The computer crossmatch system must also contain the interpretation of what?

Compatibility

Before blood components are released by computer crossmatch, what must exist for data entry?

Entry verification

The computer system must alert the user to discrepancies between donor label ABO/Rh and what testing result?

Confirmatory typing

The computer system must also alert the user to ABO incompatibility between the recipient and what?

Donor unit

Every issued blood container must have an attached label or tie tag indicating the intended recipient’s how many identifiers?

Two identifiers

The issue tag must include the donation identification number or what other pool-related number?

Pool number

The issue tag must include the interpretation of what testing, if performed?

Compatibility tests

At time of issue, the records check includes intended recipient identifiers plus what blood group data?

ABO Rh

At time of issue, the records check includes donor identification number and donor ABO and, if required, what other type?

Rh type

At time of issue, the records check includes interpretation of crossmatch tests and what special needs?

Special requirements

At time of issue, the records check includes the expiration date and, if applicable, what other expiration detail?

Expiration time

At time of issue, the records check must include the date and time of what event?

Issue

What visual step must occur before the product is released?

Final inspection

Basic antibody identification begins after what screening result?

Positive screen

Antibody identification studies use the patient’s serum and what kind of reagent red cells?

Group O cells

How many reagent red cell vials are usually used in an antibody identification panel?

10–14 vials

Antibody identification panel cells should express antigen combinations that maximize identification of what?

Specificities

Panel cells used for antibody identification must be what zygosity to help rule out antibodies?

Homozygous

Antibody identification studies usually include what self-control?

Autocontrol

Antibody identification procedures typically include IS, 37°C, and what final phase?

IAT

What additional agents may help with antibody identification studies?

Enhancement media

During antibody identification, what should be graded at each phase?

Reactivity

Proteolytic enzymes may destroy some antigens so their corresponding antibodies will no longer do what?

React

Enzymes may also do what to the reactivity of certain antibodies?

Enhance

Phenotyping the patient’s own red cells helps define what the patient can produce?

Antibodies

Phenotyping the patient’s own red cells also helps eliminate antibodies the patient what?

Cannot produce

If a patient has a known antibody, what kind of panel may be used to look for others?

Selected panel

What strategy is specifically named as an aid in antibody identification?

Cross-out strategy

Once an antibody specificity is determined, what classic confirmation rule is used?

Rule of three

The rule of three requires how many antigen-positive cells to react with the patient’s serum?

Three positive

The rule of three also requires how many antigen-negative cells to be nonreactive?

Three negative

In the sample panel where cells 1, 2, 4, and 6 react only at IAT, what antibody was identified?

Anti-C

In the selected-cell example, anti-C was present but what additional antibodies could not initially be ruled out?

c E K Lea

In the c-negative selected panel, what two antibodies were demonstrated?

Anti-c anti-E

In the enzyme-treated panel example, which two antibodies were not initially crossed out?

K Fya

After repeat testing in that enzyme example, which antibody was identified because it was destroyed by enzyme treatment?

Anti-Fya

In the dosage-effect example, which cells expressed double dose of M according to your reviewer?

2 3 8 10

After adding a 15-minute room-temperature incubation in the dosage example, which antibody was identified?

Anti-M

In the final cross-out example, what antibody combination was identified?

Anti-C anti-S

To confirm anti-C plus anti-S in that example, what kind of cell was suggested for testing?

C-negative S-dose

Molecular testing can determine red cell phenotypes in recently transfused patients because serology may be affected by what issue?

Mixed cells

Molecular testing is particularly useful for phenotype determination when the autocontrol is what?

Positive

Molecular testing is useful in patients with a positive DAT for evaluating weak D or what other D variant?

Partial D

Molecular testing can be used for antigen typing to evaluate risk for what fetal condition?

HDFN

In prenatal testing, molecular methods help differentiate weak D from partial D for administration of what prophylaxis?

RhIG

Molecular testing can be used to screen donors for extended antigen profiles and for donors lacking certain what antigens?

High-incidence

Molecular testing also helps identify the genetic basis for what kind of typing results?

Unusual serology

What technique removes antibody from serum by giving it its corresponding antigen under optimal conditions?

Adsorption

Adsorption can be used to remove what kind of antibody after modification of autologous red cells?

Autoantibody

Adsorption can also remove alloantibody or autoantibody after modification of what kind of red cells?

Allogeneic cells

After adsorption, the adsorbed serum is tested to evaluate for antibodies not what by the process?

Removed

Adsorption may also be used to verify the presence of what on red cells?

Red cell antigen

Adsorption is specifically useful for verifying weak expression of which two ABO antigens?

A B

What technique frees antibody from sensitized red cells by disrupting antigen-antibody bonds?

Elution

Elution recovers the antibody into what kind of liquid for further testing?

Diluent

Physical methods of elution include heat and what other method?

Freeze-thaw

Chemical methods of elution include organic solvents or what other method?

Acid

Elution is useful in evaluating HDFN, delayed transfusion reactions, autoimmune hemolytic anemia, and what other immune hemolysis?

Drug-induced

What technique separates different red cell populations in recently transfused individuals?

Cell separation

Cell separation recovers younger autologous red cells based on differences in what property?

Density

Cell separation is useful if red cell phenotyping is needed in a recipient of what recent event?

Transfusion

What blood component category is used to treat symptomatic anemia?

Red cells

Red cell components are used to increase oxygen-carrying capacity and what else?

Red cell mass

Platelet components are used to treat bleeding associated with what low-count condition?

Thrombocytopenia

Platelet components are also used prophylactically for what general reason?

Low platelets

Platelet components are indicated in congenital and acquired disorders with abnormal what?

Platelet function

In massive transfusion protocols, platelets help address what dilutional problem?

Thrombocytopenia

Granulocytes are used in profound neutropenia with bacterial or fungal infection unresponsive to what?

Antimicrobials

Granulocyte transfusion is considered for profound neutropenia below what count?

500/µL

Plasma components are used in bleeding patients or invasive procedures with coagulation deficiencies due to DIC, liver disease, and what transfusion situation?

Massive transfusion

Plasma components can be used for reversal of what anticoagulant effect?

Warfarin

Plasma is also indicated for congenital factor deficiencies when no factor what is available?

Concentrate

Plasma is the primary replacement fluid for what therapeutic procedure?

Plasma exchange

Cryoprecipitated AHF is used to treat congenital or acquired deficiency of what?

Fibrinogen

In urgent release, the record must contain a signed statement from the physician indicating what?

Clinical urgency

In emergency release, blood bank personnel must issue properly labeled blood that is ABO what?

Compatible

If the recipient’s ABO is unknown during emergency release, what red cell product is usually issued?

Group O RBCs

What whole blood option is also listed for emergency release when ABO is unknown?

Low-titer O

In emergency release, Rh-positive units are usually issued to whom in general?

Most recipients

Which recipient group should preferentially receive Rh-negative units during emergency release?

Childbearing females

If a D-negative recipient receives D-positive red cells in emergency release, what may be considered to prevent anti-D formation?

RhIG

What must the label on an emergency-release unit state about compatibility testing?

Incomplete testing

After emergency release, all testing must be completed and the physician notified immediately if what is detected?

Incompatibility

Massive transfusion is defined as administration of about how many RBC units in less than 24 hours?

8–10 units

Massive transfusion can also be defined as acute administration of how many RBC units within 1 hour?

4–5 units

The massive transfusion protocol ratio of FFP:platelets:RBCs is listed as 1:1:1 or what alternative ratio?

1:1:2

In massive transfusion, the typical initial components are group O red cells and what plasma group?

AB FFP

If the recipient is Rh-negative during massive transfusion, what sequence of Rh use is described?

Neg-pos-neg