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106 Cards in this Set

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What is the Fisher Race nomenclature for Rh antigens?
D, C/c, E/c
What is the corresp. Weiner symbol for each fisher race?
D = Rho
C = rh'
c = rh''
E = hr'
e = hr''
What is the most common Rh antigen for whites?
e
What are the top 4 Rh antigens for whites in order?
e > D > c > C
What is the most common Rh antigen for blacks?
e
What are the top 4 Rh antigens for blacks in order?
e > c > D > C > E
What antigens are present for the genotype Ro?
Dce
What antigens are present for the genotype R1?
DCe
What antigens are present for the genotype R2?
DcE
What antigens are present for the genotype Rz?
DCE
What antigens are present for the genotype r?
dce
What antigens are present for the genotype r'?
dCe
What antigens are present for the genotype r''?
dcE
What antigens are present for the genotype ry?
dCE
What is the most common genotype in whites?
R1 - DCe
What is the most common genotype in blacks?
R0 - Dce
What is the least common genotype of all?
Rz
What is the 2nd most common genotype for both black/whites?
r - cde
what are the naturally occurring antibodies?
ABO MN Lewis Lua P1
what are the clinically significant antibodies?
ABO, Rh, Kell, Kidd, Duffy, SsU
What are the warm antibodies?
Rh Kell Duffy Kidd
What are the Cold antibodies?
M N P1
What antibodies usually only react in the AHG's phase?
Kell Duffy and Kidd
What antibody can react in any phase?
Lewis
What antibodies are not detected by enzyme treatment of cells?
M N Duffy
Detection of what antibodies are enhanced by enzymes?
Rh, Kidd, Lewis, P1
What antibody is enhanced by acidification?
M
What antibodies show dosage?
Rh (except D)
MNS
Duffy
Kidd
Which antibodies bind complement?
I, Kidd, Lewis
What antibodies cause in vitro hemolysis?
ABO, Lewis, Kidd, Vell, some P1
What What antibody is labile in vivo and in vitro, and commonly causes an anamnestic response?
Kidd
What antibody is associated with PNH?
Anti-P
What antibody is associated with cold agglutinins disease and mycoplasma pneumoniae?
Anti-I
What antibody is associated with infectious mono?
Anti-i
What is required for a 95% confidence in antibody id?
3 pos and 3 neg reactions
What will agglutinate cord cells? What will not?
Will: Anti-i

Will not: Anti-I, Anti-H, Anti-IH
For compatibility testing, what is the patient specimen requirement?
-Must have been collected within 3 days of transfusion if the patient has been pregnant/transfused in past 3 months.
What must be done for a complete Compatibility Testing?
1. Repeat ABO on donor (Rh if labeled as Rh neg)
2. ABO/Rh type recipient.
3. Crossmatch.
Retain patient specimen, unit segment for 1 week.
When doing a crossmatch you find one Ab screen is pos, and one donor is positive in AHG. What should you suspect?
An alloantibody; identify it and crossmatch compatible units.
When doing a crosmatch you find that all Ab screen cells, all donors, and the autocontrol are neg except one donor in the AHG. What should you suspect?
A positive DAT in the donor. Return it to the bloodcenter.
When doing a crossmatch you find aht all Ab screen cells, donors, and the autocontrol are positive - only in AHG. What should you suspect?
A Warm autoantibody; it's best to not transfuse but if you must find a least incompatible unit.
When doing a crossmatch you find that all Ab screen cells, donors, and the autocontrol are positive - in 37 And AHG. What should you suspect?
Rouleaux; do a saline replacement technique.
What is standard protocol for newborn testing?
1. ABO/Rh Fwd type the infant cord capillary or venous blood.
2. Ab screen baby or mom.
3. If Ab screen pos, crossmatch compatible units.
How soon do red cells at room temp "go bad"? why?
30 min - reach 10'C that fast!
What are the conditions for reissuing blood?
1. Maintain at 1-10'C
2. Closure unbroken
3. At least 1 segment left
4. Inspect
5. Record reissuing
How can you differentiate intra and extravascular hemolysis?
-Both have decreased haptoglobin
-Intra shows hburia/hbemia, DIC
-Extra shows jaundice, increased bilirubin, takes 2 days longer.
What usually causes intravascular HTR?
-ABO incompatibility
What usually causes extravascular HTR?
KIDD
Which is fatal, intra or extra?
intra
What causes febrile reactions?
Anti-leukocyte antibodies.
What is the clinical sign of a febrile transf rxn?
Increased temp within 24 hrs.
What is the sign of an allergic reaction?
Hives (urticaria)
What causes an allergic response?
Plasma proteins that are foreign to the system.
What is a clinical sign of anaphylatic transf rxn?
bronchospasms
What causes an anaphylactic response to transfusion?
Anti-IgA in an IgA deficient recipient.
Who do you commonly see circulatory overload in?
Children, cardiac/pulmonary patients, elderly
What causes circulatory overload?
Transfusion of too high volume
What are the signs of circ overload?
coughing/cyanosis/problems breathing.
What causes septicemia from a transf reaction?
septic blood
What are some signs of contaminated blood transfusion?
Renal failure, DIC, fever, cramps, diarrhea, everything.
What ABO type mothers are most at risk for causing HDN?
O
What type of elution is used for investigating ABO HDN?
Heat or freeze-thaw
What type of elution is used for investigating Rh HDN?
Acid
When is RhIg given to mothers?
-28 wks gestation

-within 72 hrs of birth if baby is Rh pos
What is standard protocol for when an Rh pos baby is born to a neg mom?
-Draw mom's blood w/in 1 hr.
-Do rosette test to screen for fetal bleed
If the rosette test is positive postpartum, what should you do?
Klei=hauer Betke acid elution to quantiate the fetal bleed.
What is the principle of the Kleihauer-Betke test?
Fetal cells resist acid elution and stain pink.
Momma cells appear as ghosts.
You count the baby cells to see how bad the bleeding was.
How much Rhogam should be dosed after a fetal maternal bleed?
1 dose per 15 ml Baby CELLS or 30 ml fetal whole blood.
how long is the deferral for taking aspirin?
3 days if only giving plt
how long is the deferral for measles, mumps, polio, or yellow fever vaccines?
2 wks
how long is the deferral for rubella vaccine?
4 wks.
how long is the deferral for pregnancy?
6 wks.
how long is the deferral for having travelled to an endemic area for malaria?
1 yr
how long is the deferral for having lived in a malaria area?
3 yrs
What is the anticoagulant volume for blood collection?
63 ml
What is the blood volume collected for transfusions?
450 +/- 45 mL
How low of a volume can be collected for a unit before adjusting the anticoag?
Down to 300
How fast should blood be collected?
4-10 min
Name 3 anticoag/preservatives
-ACD acid citrate dextrose
-CPD citrate phosphate dextrose
-CPDA1 - w/ adenine
Which preservatives have 21-day shelf lives?
ACD and CPD
whats the shelf life of CPDA1?
35 days
what are 3 additives?
adsol
nutricel AS-2
nutricel AS-3
what are the best addtives? why?
adsol and nutrisel as-3; increase shelf life to 42 days
How much should one unit of blood increase a person's hct?
3%
how long are frozen rbcs good for?
10 yrs from drawing; 24hrs after thawing
how soon should RBCs be prepared for freezing?
within 6 days
what temp should frozen RBCs be stored at?
20% glycerol -120
40% glycerol -65
What are washed RBCs given for? (condition)
PNH patients or IgA deficient but prefer frozen for the latter
what is the max amt of WBCs that can remain in leuko reduced units?
no mroe than 5 x 10'6
what is used to rejuvenate rbcs?
PIPA
what is the new shelf life of RBCs if rejuvenated?
24 hrs, or else freeze them.
when are RBCs rejuvenated?
up to 3 days after outdate; restores their 2,3-DPG and ATP
whats the exception for rejuvenating?
can't do it to cells in additive solution (adsol/nutricel)
what are RBCs irradiated for?
Transfusing immunocompromised or intrauterine patients, to prevent GVHD
What is the indication for FFP?
Coag factor deficiency - EXCEPT factors 1, 8 and 13
What is the indication for Cryo?
-Hemophilia A
-Von willebrand's
-Hypofibrinogenemia
-Factor XIII defic.
What temp should FFP be stored at? What is its shelf life?
Store at <18, for 12 months
What are the storage conditions of cryo?
Same as FFP
What are the conditions to be met by cryo?
Should contain at least 80 IU Factor VIII and 150 mg fibrinogen.
How soon should cryo be transfused after thawing?
6 hrs, or 4 if pooled.
How much plasma is in a pile of platelets?
Enough to keep the pH at 6
What is the storage temp for platelets and granulocytes?
24'C - room temp!!!
what is the shelf life of plts and grans?
plt: 6 days if agitating

Grans: 24 hrs
do WBCs need to be crossmatched?
you betcha - they contain RBCs too
What should a plt transfusion do for the patient?
Raise the plt count by 5-10,000/uL in a 75 kg patient
How long can units be usable if they've been stored at room temp?
4 hrs