*Final Comp Exam More

Which antibody is most associated with delayed hemolytic transfusion reactions?

Anti-Jka

Which antibody is associated with Mycoplasma pneumonia?

Anti-I

What kind of hemolysis do IgG antibodies cause?

Extravascular hemolysis

Enzyme panels will not react with which family of antibodies?

Duffy (Fy)

What can cause a mom to have a low titer of Anti-D?

Rhogam at 28 weeks

If a baby is receiving blood from its mother, what must be done to the blood first?

Irradiation

What type of error does a room temp crossmatch detect?

ABO error

What is the main reason premature infants need transfusions?

Blood loss from lab tests

What is the best type of cell to use as a positive control for phenotyping?

Heterozygous (+/-) positive

What two things can cause a positive autocontrol at room temp?

Rouleax and cold auto

What procedure can make rouleax go away?

Saline replacement

What procedures can make a cold auto go away?

Warming

What type of AHG will cold auto-antibodies react with?

Polyspecific and C3 monospecific AHG

What is the main use for cryo?

Fibrinogen replacement

FFP is made from plasma which is separated from donor blood and frozen to -35°C to preserve it.

Cryo is made from FFP which is frozen and repeatedly thawed in a laboratory to produce a source of concentrated clotting factors including Factor VIII, von Willebrand factor and fibrinogen.

What has more fibrinogen FFP or Cryo?

Cryo

FFP contains coagulation factors at the same concentration present in plasma. Cryoprecipitate is a highly concentrated source of fibrinogen.

What type of plasma can an AB= patient recieve?

AB plasma

What are the blood requirements an intrauterine transfusion?

CMV negative, radiated, and collected with CPDA

When is FFP transfusion usually indicated?

PT and PTT prolonged

What temps do Lewis ABs react?

Room temp and sometimes 37

What kind of hemolysis do Lewis ABs cause?

In vitro

How long is the sexual partner of an IV drug user deferred from donating blood?

1 year

What can cause a positive Rh control when doing a weak D test?

Positive DAT

What does the PT test monitor?

Coumadin / Warfarin

What’s one parameter not affected by cold agglutinins on the cell counter?

Hemoglobin

What deficiency causes thrombosis?

Protein C

What factor deficiency causes thrombosis instead of bleeding?

Factor XII ( 12 )

When doing a mix of elevated PTT patient plasma with a normal PTT patient plasma and the PTT corrects itself, what does that indicate?

Factor deficiency

When doing a mix of elevated PTT patient plasma with a normal PTT patient plasma and it doesn't correct, what does that indicate?

Lupus anticoagulant

What morphology is seen when making a slide from old blood?

Crenated RBCs and vacuoles in WBCs

What two RBC morphologies cause a lowered sed rate?

Sickle cells and spherocytes

A patient with polycythemia will need to have their anticoagulant adjusted for?

-Polycythemia vera (pol-e-sy-THEE-me-uh VEER-uh) is a type of blood cancer.

-It causes your bone marrow to make too many red blood cells.

-These excess cells thicken your blood, slowing its flow, which may cause serious problems, such as blood clots.

PT and PTT

What are Dohle bodies composed of?

RNA

When are Dohle bodies seen?

Infection, burns, cancer, May-Hegglin anomaly

May-Hegglin Anomaly is a rare, inherited, blood platelet disorder characterized by abnormally large and misshapen platelets (giant platelets) and defects of the white blood cells known as leukocytes.

What is seen in a slide for a patient with megaloblastic anemia?

Hypersegmented neutrophils, pancytopenia, and macrocytes

Why are fetal fibronectin tests performed?

To assess the risk of the mother going into preterm labor

What conditions are associated with an elevated plasma viscosity?

Multiple myeloma, lymphoma, inflammation, infection

What chemistry analytes are most affected by hemolysis?

Potassium, AST, Amylase, Calcium, Total Protein, LDH, Phosphorus, Magnesium, and Bilirubin

What chemistry analytes are most affected by IV contamination?

Sodium, Chloride, Potassium, Glucose, Creatinine

What is Hemoglobin A1C used for?

To monitor average blood sugar levels over the past 3 months

What is the calculation for Anion Gap?

Na⁺ - (Cl⁻+HCO₃⁻)

What is the significance of the anion gap?

It can show if you have an imbalance of electrolytes or too much/not enough acid in the blood.

What can cause a low calcium level?

Malnutrition, hypoalbuminemia, leukemia, osteoporosis medications, Vitamin D deficiency, underactive parathyroid gland

What is anti-i related to?

Epstein-Barr Virus

Whole Blood Storage and Stability

1-6 C for 35 days

Washed RBCs stability

24 hours

CPDA RBCs storage and stability

1-6 C for 35 days

Adsol RBCs storage and stability

1-6 C for 42 days

Frozen RBCs (glycerol) storage and stability

-65°C for 10 years

Rejuvenated RBC stability

3 days past expiration date

Apheresed Random Platelets storage and stabilty

Room Temp for 5 days

Irradiated RBCs stability

28 days or expiration date

Granulocytes storage and stability

24 hours at room temp

FFP storage and stability

-18 for 1 year

FFP thawed storage

24 hours

Cryo stability and storage

-18 C for 1 year

AHF (factor VIII), Factor IX, and Albumin storage

1-6 C

What antibodies are destroyed by enzymes?

M, N, S, and Duffy

ZAPP destroys what antibodies?

M, N, S, Duffy, and Kell

Which antibodies are enhanced by enzymes?

Rh, Kidd, Lewis, I, and P

When do Rh- women recieve RhiG?

28 weeks gestation and 72 hours after birth

Blood from mom to baby must be...

Irradiated

RhiG at 28 weeks can cause

Mom to have low Anti-D titer and baby to have positive DAT

Room temp XM detects what kind of errors?

ABO

AHG crossmatch detects...

Auto/alloantibody incompatibilities

Cold autoantibodies will react with what types of AHG?

Poly specific and C3 monospecific

Cryoprecipitate contains

fibrinogen, factor VIII (8) and von Willebrand's factor

intrauterine transfusion must have what kind of blood?

fresh, CMV-, radiated, CDPA

When is FFP indicated?

When PT and PTT are prolonged

Which antibodies react at 37 or AHG?

D, C, E, c, e

Which antibodies only react at AHG?

K, k, Fya, Fyb, Jka, Jkb, S, s

Which antibodies only react at RT?

M, N, P1, I, i

What antibodies react at both RT and 37?

Lea, Leb, P

Anti-A: +, A1 cells: +, A2 cells: -, A1 lectin: -

A2 with anti-A1

What age is the minimum for blood donation?

17

16 with parental consent

What's the temperature requirement for blood donation?

Less than or equal to 99.5 F

What's the hematocrit requirement for blood donation?

Greater than or equal to 38%

What's the pulse requirement for blood donation?

50-100 beats per minute

What's the minimum weight for blood donation?

110 pounds

What's the minimum hemoglobin requirement for blood donation?

12.5 g/dL

How long is someone deferred if they are visibly under the influence when they try to donate blood?

Permanently

How long is someone deferred if they have received blood products?

1 year

How long is someone deferred if they have a chronic illness?

Permanent

How long is someone deferred if they use accutane?

30 days

How long is someone deferred from donating platelets if they took aspirin?

3 days

How long after a pregnancy is a woman deferred from donating blood?

6 weeks

How long is someone deferred from donating blood if they've been exposed to AIDS or Hepatitis?

1 year

How long is a person deferred from donating blood if they have Babesia, Typanosoma, or Chagas' disease?

Permanently

How long is someone with hepatitis, HIV, or IV drug use deferred from donating blood?

Permanently

How long is someone who's been exposed to an area with malaria deferred from donating?

1 year

How long is someone with Malaria deferred from donating blood?

3 years

How long is someone with syphillis/gonorrhea deferred from donating blood?

1 year

How long is someone who's taken Growth Hormone deferred from donating blood?

Permanently

How long is someone with Hep B Globulin deferred from donating?

1 year

Which tests are increased in DIC?

PT, PTT, TT, FSP, Dimer

Which tests are decreased in DIC?

Fibrinogen, platelet count

What type of RBC morphology is present in DIC?

Schistocytes aka helmet cell

What drug does the PT test monitor?

Coumadin/Warfarin

What coagulation system is monitored by PT?

Extrinsic

What drug is monitored by the PTT test?

Heparin

What coagulation system is measured by PTT?

Intrinsic