Blood Bank review activity for Clinical entrance Exam

What blood probucts can be stored at 1-6C?

Irradiated RBCs, RBCc collected in CPD, RBCs collected in CPDA-1, and RBCs collected in CPD w/ additive.

What blood bank products are stored at 20-24C?

Platelets and Pooled cryo thawed (temp)

What blood bank products are stored at -18C?

Fresh Frozen Plasma (Temp)

What blood bank product is stored at -65C?

Frozen glycerolized RBCs preserved for long-term storage

What blood bank product lasts for 4 hours?

Pooled cryo thawed (storage)

What blood bank product lasts for 5 days?

Platelets (storage)

What blood bank product lasts for 21 days?

RBCs collected in CPD (storage)

What blood bank product lasts for 28 days?

Irradiated RBCs (storage)

What blood bank product lasts for 35 days?

RBCs collected in CPDA-1

What blood bank product lasts for 42 days?

RBCs collected in CPD w/ additives

What blood bank product lasts for 1 year?

Fresh Frozen Plasma (Storage)

What blood bank product lasts for 10 years?

Frozen glycerolized RBCs (storage)

Patient has IgA deficiency what blood product would you give?

Washed red blood cells

If a patient needs a replacement of coag factors what would you give?

Fresh Frozen Plasma

A patient that is severely immunocompromised needs increased oxygen carry capacity what would you give?

Irradiated red blood cells

Postoperative bleeding patient what would you give?

Platelets

Patient with severe neutropenia what would you give?

Granulocyte concentrate

Patient has a history of non-hemolytic febrile transfusion reaction what would you give?

Leukocyte-reduced red blood cells

Patient has a fibrinogen deficiency what would you give?

Cryoprecipitate

What would you use to re-type O+ donor units?

Anti-AB

What would you use to re-type AB- donor units?

Anti-A, Anti-B, and Anti-D

What would you use to re-type B+ donor units?

Anti-A and Anti-B (B+ donors)

What would you use to re-type A+ donor units?

Anti-A and Anti-B (A+ Donors)

What testing is done as part of the initial transfusion reaction work up?

DAT, visual check for hemolysis, and clerical check.

What are the follow up transfusion reaction work-up?

IgA levels, Hgb, Hct, bilirubin, haptoglobin, crossmatch, ABO/Rh type, and antibody screen

If the Rh control is POS in the Initial Spin phase what is could be causing that?

Reaction to the Additives

Rh control POS in the second phase (AHG) due to what?

Cells are already coated in antibody (POS DAT)

NO POS reaction in the third phase (CHECK CELLS) due to what?

Reagent not working, No reagent added, or inadequate cell washing.

When is DAT testing most commonly preformed?

If auto control is POS during testing, Transfusion reaction, or NewBorns (cord blood).

Weak D testing is most commonly preformed when?

Newborns, Pregnant women Rh neg, and Donor cells that are types as Rn neg

What testing is preformed on Cord Blood (newborn)?

Direct Antiglobulin Test (DAT), Rh testing, Weak D, and Forward typing.

What Prenatal testing do we do?

Rh testing, Weak D testing, Forward type, reverse type, antibody screen, and antibody panel.

Pre-transfusion testing do we do?

Forward and reverse typing, Rh testing, crossmatch, antibody screen, antibody panel, and antigen typing.

H antigen

L-Fucose

B antigen

D-Galactose

A antigen

N-acetgalactosamine

ABO HDFN

Impacts first child, less severe, more common in type O moms with A or B babies.

Rh HDFN

More severe, Does not impact first child, Rhogam can prevent

Delayed Hemolytic transfusion reaction

>24 hours, IgG, extravascular hemolysis, and Rh antibodies.

Acute hemolytic transfusion reaction

<24 hours, IgM, intravascular hemolysis, and due to ABO incompatibility.

When do we use check cells?

Prove a negative is a negative and confirm the accuracy of testing results.

What are check cells?

Antigen coated red blood cells that react with AHG.

What is the precent of Saline suspension normally mad efor RBCs? Why?

5% suspension and to mimic body conditions to prevent hemolysis during testing.

Antigen on type O

NONE

Antigen on type A

A-antigen

Antigen on Type B

B-antigen

Antigen on type AB

A-antigen and B-antigen

Antibodies on type O

A-antibodies and B-antibodies

Antibodies on type A

B-antibodies

Antibodies on type B

A-antibodies

Antibodies on type AB

NO antibodies

What is compatible for type O for RBCs?

Type O can receive blood from type O only.

What type of plasma can type O receive?

O, A, B, and AB plasma

What type of RBCs can type A receive?

Type A can receive A and O type RBCs.

What type of plasma can Type A receive?

A and AB plasma

What type of RBCs can type B receive?

Type B can receive B and O type RBCs.

What type Plasma can Type B receive?

B and AB plasma

What type of RBCs can AB receive?

AB can receive A, B, AB, and O type RBCs.

What type of plasma can AB receive?

Only AB

If a 78 year old women is missing antibodies what do we do?

We can do longer incubation or add more serum

47 year old man has severe gram negative septicemia has a bacteria that mimics B antigen (acquired B) what can we do? (You have excess antigen)

Try a different reagent or auto control use patient’s cells against own serum.

A patient has Waldenstrom macroglobulinemia and has cell type as A and Serum type as O due to excess antibodies. What do we do?

Due to high antibodies (false agglutination from IgM and extra proteins) we can do a saline replacement by spin down sample remove serum and add 2 drops of saline.

A patient who has a history of being transfused has excess antibodies against A1 cells. Patient may have A2 antigen and antibodies against A1 cells. What can we do?

Lectin antibodies looks for the presence of A1 antigens so we want no reaction. We can do Patient’s serum against A1 cells with a POS reaction and Patient’s serum against A2 cells with a neg reaction to prove patient is A2.

What are the Rh antigens in the Rh system?

E,D,C,e, and c

What is the difference between Polyspecific Antihuman Globulin reagan and Monospecific AHG?

Polyspecific has both complement and IgG. Monospecific has either complement or IgG

What is AHG typically used for the detection of what?

The Antihuman Globulin (AHG) test is typically used for the detection of antibodies attached to red blood cells.

What are the factors for the DAT test?

In-vivo, RBC, Saline washing step, uses AHG, and uses Coombs check cells. WE DO NOT INCUBATE

What are the factors for IAT(Indirect Antiglobulin Test) testing?

In-vitro, may use plasma or serum, saline washing step, uses AHG, incubation step, and uses Coombs check cells.

What do we use IAT (Indirect Antiglobulin Test) testing for?

Weak D, antibody screen, and AHG crossmatch

When preforming crossmatch procedures, where does the antigen source come from and the antibody source come from?

The antigen source comes from the donor's red blood cells, while the antibody source is typically the patient’s serum or plasma.

What qualifies a patient for IS crossmatch?

No previous transfusion reaction history, negative antibody screen, and current ABO on file (3 days) .

What qualifies a patient for AHG crossmatch?

Previous transfusion reaction history, recently transfused, or a positive antibody screen.

What criteria must be met for a mother to receive Rhogam?

Rh negative and doesn’t have antibodies against the Rh factor.

One dose of 300ug RhoGam covers how much of fetal whole blood?

30 mL of fetal whole blood

Is Fetal Maternal Hemorrhage Screen quantitative or qualitative?

Qualitative

Is the Kleihauer-btke test qualitative or quantitative?

Quantitative

What information must be on the label in order to be used for transfusion testing?

Patient’s name, DOB, MRN (unique ID number) collector’s name, time, and date.

How long does a patient’s sample last for in blood bank?

72 hours from the time of collection for transfusion testing.

What is the equation for how much RhoGam to give?

(Number of Fetal RBC)/(total 2,000 RBCs) X100= percentage of Fetal cells.

Percentage of Fetal cells X50 =Volume of FMH

(volume of FMH)/(30mlRhoGam Dose) = how many vials always round up.

What antibodies have dosage?

Kidd, Duffy, M, N, S and U

What antibodies have NO dosage?

Le, I and P

What Antibodies can vary when it comes to dosage?

Kell and P1

What Antibodies are destroyed by enzymes?

Duffy, M, N, U, and S

What antibodies are enhanced by enzymes?

Kidd, Le, I, P, and P1

What antibody has no change with enzymes?

Kell

What antibodies are clinically significant?

Kell, Kidd, Duffy, P, S, and U

What antibodies are clinical insignificant?

Lewis, I, P1, M, and N (insignificant)

Which antibodies are IgG?

Kell, Duffy, Kidd, P, M, S, and U

What antibodies are IgM?

Lewis, I, P, P1, M, and N (IgM)

What antibodies react at room temp?

Lewis, I, P, P1, M, and N

What antibodies react at 37C?

Kell, Duffy, Kidd, Lewis, P, M, N, S, and U 37C

What antibodies react at AHG phase?

Kell, Kidd, Duffy, Lewis, P, M, N, S, and U AHG

What antibodies react at IS phase?

Lewis, I, P, P1, M, and N (IS)

If the Infant is D POS and Mom is Rh NEG is she a candidate for RhoGam?

Yes she can have RhoGam

If infant is D NEG, but is Weak D POS and Mom is Rh POS can Mom receive RhoGam?

No, RhoGam is not needing due to Mom being Rh POS

If infant is D NEG and Mom is Rh NEG does mom need RhoGam?

No, since infant is D NEG

Infant is Weak D POS and Mom is Rh NEG does mom get Rhogam?

Yes, since infant is Weak D POS and Mom is Rh Neg.