final exam flashcards

Fya and Fyb frequencies

Fya and Fyb frequencies

66% & 83%

Jka and Jkb frequencies

77% & 73%

K and k frequencies

9% & 91%

D antigen frequency

85%

CEce frequencies

70%, 30%, 80%, 98%

Le(a) and Le(b) frequencies

22% & 72%

MN frequencies

78% & 72%

Ss frequencies

55% & 89%

ABO frequencies

O = 45

A = 40

B = 11

AB = 4

Lele sese Hh AO antigens and secretions

Ags: H, A, Le(a)

secretions: Le(a)

Lele Sese Hh AO antigens and secretions

Ags: H, A, Le(b)

secretions: H, A, Le(a), Le(b)

lele Sese, Hh antigens and frequencies

Ags: H

secretions: H

which Abs show dosage?

duffy, kidd, MNSs, CEce

which Abs are destroyed by enzymes?

duffy, MN

which Ags are not well developed at birth?

lewis, P1, I

how does Kell react to enzymes?

no effect

what neutralizes Lewis Abs?

saliva and Lewis substance

what neutralizes P1?

hydatid cyst fluid and saliva

what neutralizes I/i?

plasma, milk, amniotic fluid

what neutralizes Sda?

pooled urine

causes of weak/missing antibody (rvs)

elderly, NB, immunosuppressed (leukemia, hypogammaglobulinemia, BMT, immundef)

cause of weak/missing antigen (fwd)

subgroup of A/B, disease (leukemia), BMT

how to resolve weak/missing antibody/antigen

• incubate RT 30min

• incubate 4C 30 min

• adsorption/elution

cause of extra rxn in rvs

subgroup of A, cold allo, cold auto

how to resolve an extra rxn in the rvs

• run O cells, A2 cells, AC

• AC pos = cold auto = autoadsorption or REST

• O and A2 pos = cold allo = ABID, repeat rvs typing using Ag negative A and B cells

• A2 pos = Anti A1 = type pt cells with anti A1 lectin

what causes rouleaux?

MM, waldenstrom’s, plasma expander dextrose, wharton’s jelly, inc FIB

how to resolve rouleaux interference in ABO typing?

fwd: wash cells

rvs: saline replace

causes of pos IS XM

• wrong ABO typing

• allo ab

• auto ab

causes of pos extended XM

• new allo ab

• alloab to low incidence

• warm reactive auto

• donor pos DAT

acute HTR

• within 15 min

• ABO mismatch

• SS: fever, chills, low BP, hgburia/hematuria, burning at infusion site, back/flank pain, dyspnea

delayed HTR

• 2-8 days

• previous antibody

• SS: dec HH, inc bili, fever, dark urine, pos IAT post transfusion

febrile TR

• 1-2 hrs

• cytokines OR Ab to WBC

• prevent via leukocyte reduced components

• SS: 1-2 C inc, shaking, chills, nausea, vomiting

bacterial TR

• rbc = during transfusion

• plt = 3 hrs

• y. enterocolitica, e. coli, pseudomonas, c. freundii

• prevent by visually checking unit

• SS: sudden fever inc 2C, abd cramps, diarrhea, DIC, shock, renal failure, vascular shock

TRALI

• 1-6hrs

• donor Abs to pt wbcs (HLA)

• SS: fever, hypoxemia, low BP, pulm edema, dyspnea

TACO

• 1-6hrs

• volume overload

• SS: high BP, pulm edema, dyspnea

anaphylactic TR

• immediate

• Anti IgA in IgA def pts

• prevent by checking IgA levels, washing rbcs or giving plt/plasma from IgA def donor

• SS: low BP, resp distress, abd cramps, vomit, diarrhea, rash, no pain/fever

allergic TR

• IgE Abs to soluble Ag in donor plasma

• treat with antihistamine

• SS: hives, itching, diffuse rash

GVHD

• 30 days

• viable transfused lymphs attack pt tissue

• prevent by irradiating unit

• SS: skin rash first, fever, diarrhea, hepatomegaly

ZZAP

• dissociate IgG from red cells and inc red cell absorptivity to autoab

• DTT: cleaves IgM disulfide bonds

• enzymes: remove An from rbc

• make kell null cells

chloroquine diphosphate

separate IgG from red cells for phenotyping

thiol reagents

• cleave IgM to distinguish from IgG

• cleaves disulfide bonds

• DTT, 2-ME, AET

whole blood QC

min hct 33%

leukocyte reduced rbc QC

hgb: 43g

hct 65-75%

less than 0.8% hemolysis

washed rbcs

• 24 hr storage

• hgb 43g

• hct 65-75%

• less than 0.8% hemolysis

frozen rbc QC

volume > 185ml

hgb 36g

hct 65-75%

RDP

5 - 7 days

75% units >5.5 x 10^10

pH > 6

SDP

24-48 hrs

75% > 3.0 x 10^11

pH > 6.0

thawed plasma

5 days

FFP QC

F VIII > 70%

all coag factors

cryo QC

150 mg FIB

80 IU F VIII

expected increases for plts

RDP: 5-10k

SDP: 20-60k

quality system

organizational structure, procedures, processes, and resources needed to implement quality management

quality assurance

planned, systematic activities implemented within the quality system to provide confidence that requirements for quality will be fulfilled

quality control

operational techniques and activities used to fulfill the requirements for quality

policy

a very broad view of what is expected

if a pt needs blood, they will need and TS sample sent to BB

process

the steps that occur to get the type and screen sample from the pt thru testing by the BB (flowcharts)

procedure

provides directions to completing each step in the process. these are called SOPs in the lab. the SOP for ABO typing would describe how to determine the type, part of the larger TS process