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29 Cards in this Set
- Front
- Back
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You have a pt who has coughed up blood, fatigue, 5 pnds weight loss. After work up you get diagnosis of Goodpasture's Disease. WHat lab finding would be most important to support this diagnosis?
a. auto-antibody against ds DNA b. elevated erythrocyte sedimentation rate c.IgG binding to lung tissue from biopsy d. auto-antibody against pulmonary surfactant e. elevated thyroid stimulating hormone |
c.IgG binding to lung tissue from biopsy
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Young boy with severe gram-positive bacterial pneumonia. 2nd such infeciton this year. has 2 older sisters, but other family member who died early. Kid has low IgG, M, and A. Very low circulation B cells, but normal levels of T cells. most likely diagnosis?
a. X linked aggamaglobulinemia b. Di George syndrome C. Common variable hypogammaglobulinemia d. severe combined immunodeficiency (SCID) e. transient hypogammaglobulinemia of infnacy |
a. X linked aggamaglobulinemia
this is the same thing as X-linked hypogammaglobulinemia....yeah I looked it up to make sure |
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What antigen is on the erythrocyte of someone with O blood type
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H Rbc Antigen
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What antigen is on the erythrocyte of someone with B blood type
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B
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What antigen is on the erythrocyte of someone with A blood type
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A
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What antigen is on the erythrocyte of someone with AB blood type
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AB
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What antibody/ies do/does a person with O blood type have?
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Anti-A and Anti-B
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What antibody/ies do/does a person with A blood type have?
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anti-B
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What antibody/ies do/does a person with B blood type have?
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anti-A
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when is the chorionic villi formed? what is it?
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by 9 weeks chorionic villi, by 12 easiest to see.
Chorionic villi are villi that sprout from the chorion in order to give a maximum area of contact with the maternal blood.Thus, the villi are part of the border between maternal and fetal blood during pregnancy. |
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What are some of the clinical signs of transfusion reactions?
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Fever, chills, burning at the injection site
Reaction may progress to dyspnea and hypotension Joint and back pain Shock, generalized bleeding and renal failure |
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do you have acute or delayed reactions with transfusion reactions?
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both
delayed can occur 3-10 days later as a memory type rxn |
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besides ABO what is the other blood group?
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Rhesus blood group system
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What rhesus antigen causes the most problems?
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D
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if someone is Rh+ or negative, what antigen are we talking about
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D
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What % of population are Rh+?
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85%
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If you have a mother, who is RhD negative, and she has a baby who is RhD+, what will happen after the baby is born (assume first pregnancy)
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the blood will mix at some point (child and mothers)
this will make the mother have anti-bodies to Rh for future children |
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say you have a mother who was Rh- her first birth, had an Rh+ baby, and now is having a 2nd Rh+ baby? How do you prevent this?
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The built antibodies will attack the 2nd child
give Anti-RhD antibodies to mother near the end of FIRST pregnancy, they bind to children's RBCs and stop the sensitization process in the mother |
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how do you ensure a successful transfusion? 3 ways
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1. Type and Screen (see ABO and RhD)
2. Cross match (look for antibodies in recipient) 3. Coombs (anit-globulin) test: used to detect antibody or complement adsorbed onto rbc and uses antibody against human serum Ig as test reagent. |
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Anti-globulin (Coombs) test
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is used to detect antibody or complement adsorbed onto rbc and uses antibody against human serum Ig as test reagent.
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the cross-match
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compatibility between donor and recipient is determined directly. Washed donor cells are combined with recipient serum and observed for hemolysis or agglutination.
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Type and Screen
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ABO and Rh(D) types determined by mixing recipient or donor rbc with anti-A, anti-B, or anti-D. The recipient’s serum is screened for alloantibodies using suspensions of erythrocytes with known erythrocyte antigens on the surface.
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What is hemolytic disease of the newborn (HDN)
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In HDN, an Rh- mother carries an Rh+ fetus. Fetal rbc’s get into the mother’s circulation and elicit an immune response, and anti-RhD antibodies. If a subsequent pregnancy is with an Rh+ child, mother’s IgG anti-RhD antibody can cross the placenta and destroy fetal erythrocytes. Results can include hemolytic anemia, hydrops, jaundice, and hyperbilirubinemia
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what prevents HDN?
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HDN is prevented by giving the mother concentrated anti-D antibody within 72 hours of that first delivery. This antibody will bind and eliminate the fetal Rh+ rbc’s before they can elicit a maternal immune response.
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direct antiglobulin test (DAT)
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detects antibody or complement coating the surface of erythrocytes
type of Coombs (anti-globulin) test take pts blood and want to know if it already has anti-body on it used in autoimmune tests |
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indirect antiglobulin test (IDAT)
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detects antibody in the serum that CAN bind
type of Coombs (anti-globulin) test |
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what is one thing that can go wrong with blood transfusion besides immune response?
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Infectious diseases transmitted by blood or blood product transfusion
HIV Hepatitis B Hepatitis C HTLV I and II Cytomegalovirus (CMV) Malaria Babesia |
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what is the difference btw a direct and indirect Coombs test
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DAT: is used to detect if antibodies or complement system factors have bound to RBC surface antigens in vivo
IAT: s used to detect in-vitro antibody-antigen reactions. It is used to detect very low concentrations of antibodies present in a patient's plasma/serum prior to a blood transfusion (so antibodies that are capable of attaching [indirect] versus ones that have already attached [direct]) |
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what is a key clinical feature of a transfusion reaction?
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positive DAT
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