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61 Cards in this Set
- Front
- Back
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what are alloantibodies
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antibodies that develop to human antigens of a different subset from their own
I.E. transfusions |
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which blood group antigens are not co-dominant?
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O
d (rh -) |
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what type of hypersensitivity rxn is hemolysis
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type II hypersensitivity
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what antibody type are cold acting Ab
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IgM
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what do cold acting Ab's do
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agglutinate
fix compliment |
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what type of Ab are warm acting Ab's
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IgG
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what do warm acting Ab's do
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fix compliment and result in cell lysis
facilitate the removal of cells by the spleen |
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what are the most immunogenic Ag
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A, B, D, and K
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what type of Ab's do type O individuals produce
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anti-A and anti-B
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what serum Ab's do type AB individuals have
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none
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what is "forward type" blood typing
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patients cells are put in a bath of Ab's to see if agglutination occurs
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what is "back typing" blood typing
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patients Ab's are put in with a known cell type to see if agglutination occurs
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who is the "universal" blood donor
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O rh negative
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what are atypical Ab's
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alloantibodies to blood group antigens other than A or B
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what % of people are d
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15% of people are rh -
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what are the 3 loci of alleles that determine Rh type
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D
C and c E and e |
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what is a Kell antigen? (K)
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an atypical blood antigen that occurs in 10% of the population
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what does the re-exposure to a highly immunogenic blood antigen lead to
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hemolytic transfusion rxn
or hemolytic disease of the newborn (HDN) |
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what is a Duffy (Fy) antigen
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an atypical blood antigen commonly absent on the RBC's of African Americans (it is the receptor for plasmodium vivax
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what is a Kidd (Jka) antigen?
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an atypical blood antigen that can cause serious, life threatening hemolytic transfusion rxn
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what atypical Ag/Ab uncommonly cause clinical disease
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lewis
MN P Leutheran (S and U are also other atypicals, but can cause clinical disease) |
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what atypical Ag's used to be used for paternity testing
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MN
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What is warm autoimmune hemolytic anemia (WAIHA)
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80% of autoimmune hemolysis
Ab's optimally reactive at 37 C positive DAT |
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what is DAT
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direct antihuman globulin test
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what are the causes of WAIHA
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drugs
autoimmunie disease (SLE) lymphoproliferative disease (CLL, Lymphoma) |
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what are cold agglutinin autoantibodies
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antibodies (IgM) to I or i antigens
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what are the causes of cold agglutinins
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viral infections (EBV, CMV, Influenza)
lymphoproliferative disease, Waldenstrom macroglobulinemia mycoplasma pneumonia infection |
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what is another name for a Direct Antihuman globulin Test (DAT)
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a direct Coombs test
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what is a direct coombs test
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antihuman globulin is added directly to a sample of a pts RBCs
if the cells agglutinate = + (the Ab's coated the pts cells IN VIVO) |
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what is an indirect coombs test
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Pts SERUM is added to cells with known antigens
cells are washed and then antihuman globulin is added if the cells agglutinate= + (cells sensitized IN VITRO) |
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what infectious agents are blood samples tested for
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Syphilis
Hep C Ab Hep B Ag and Ab HIV-1 & 2 Ab HIV nucleic acid HTLV west nile chagas |
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what are blood donations stored in
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CPDA at 4 deg C
Citrate, Phosphate, Dextrose, Adenine |
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what is the shelf life for RBC's stored in CPDA
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42 days
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how do you crossmatch blood
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donor cells are mixed with recipients serum
if agglutination or hemolysis develops = bad match |
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what are the indications for the use of packed RBC's
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acute blood loss
chronic anemia c Hb of 7 or less chronic anemia c Hb > 7 if necessary (for each unit: Hb inc 1.5, Hct inc 3-4%) |
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storage time for and indications for use of frozen RBC's
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10yrs in glycerol
rare blood types unusual Ab's in recipient autologus blood |
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indications for the transfusion of platelets
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count < 50,000 c bleeding
count < 30,000 platelet dysfxn in a bleeding pt (dose: 6-10 units. inc of 7,500/unit) |
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what are the contraindications for the use of platelet transfusions
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autoimmune thrombocytopenia
TTP |
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indications for the use of Fresh Frozen Plasma (FFP)
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prolonged PT and/or PTT time
AND bleeding or going into surgery |
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how long can you store FFP
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1 year
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what are the contents of and indications for cryoprecipitate
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Factor VIII, Fibrinogen, VW
bleeding due to deficiencies in the above |
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what are the indications for the use of washed RBCs
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indicated when plasma proteins must be removed
- repeat transfusion allergies - IgA deficiencies |
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what are the indications for using CMV negative blood
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- neonates
- immunosuppressed - pts anticipating organ transplant |
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what are immune serum globulins used for
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supportive treatment for:
immunodeficiencies agamaglobulinemias immune thrombocytopenia rubella, measles, Hep A |
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what is Transfusion Related Acute Lung Injury (TRALI)
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a life threatingi transfusion reaction most associated with Fresh Frozen plasma.
causes sudden pulmonary edema with progression to ARDS |
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what causes TRALI
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donor plasma contains Ab to the recipients WBC's. the subsequent release of free radicals causes vascular damage.
most cases are caused by multiparous donors |
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what is a febrile non-hemolytic transfusion reaction
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headache, fever, chills, flushing, tachy
caused by accumulation of pyrogenic cytokines in stored blood |
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what is a hemolytic transfusion rxn
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Ab's against the donors RBC's
may be fatal |
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symptoms of a hemolytic transfusion rxn
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burning at the site of infusion
pain in low back hypotension hemoglobinuria symptoms of DIC Oligouria |
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treatment of hemolytic transfusion rxn
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Stop xfusion
give mannitol to spare the kidneys treat the DIC |
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what is Transfusion related immunomodulation
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temporary suppression of the immune system following blood transfusions
seen with kidney transplants or miscarriages can cause cancer recurrence, infections, poss organ fail |
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what is Apheresis
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the removal of blood from pt or donor, centrifugation to remove a particular aspect of the blood, then reintroduction to the pt circulation again
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what is hydrops fetalis
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accumulation of fluid during intrauterine growth
-general edema - ascites - effusions |
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what are the causes of hydrops fetalis
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congenital heart defects
diaphragmatic hernias homozygous a thalassemia parvovirus B19, CMV, toxoplasmosis, syphilis hemolytic disease of the newborn |
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what is immune hydrops
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fetal RBCs are a different type from the mother
mom develops Ab's to them and attacks the fetal cells |
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Rh hemolytic disease of the newborn
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fetus is D, mother is d
mom develops Ab' during first pregnancy and then attacks the infants of subsequent pregnancies |
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non-typical causes of Rh hemolysis of the newborn
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amniocentesis
Abortions placental problems during pregnancy |
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how do you prevent Rh hemolytic disease of the newborn
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Rhogam (D immune globulin)
given: - at 28 weeks - within 72 hrs of delivery - with any amniocentesis or abortion |
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if you find anti-D Ab's in the mother, what should you do next?
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amniocentesis to check for bilirubin levels.
if high, begin transfusions |
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why is an ABO incompatibility not typically a problem for infants
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mothers Ig is IgM and does not cross the placenta
-A,B antigens are poorly expressed by the fetus |
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what are the main consequences of hemolytic disease of the newborn
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erythroid hyperplasia of bone marrow
extramedullary hematopoesis Erythroblastosis fetalis (inc Reticulocytes) Hydrops fetalis jaundice and Kernicterus (lethal or brain damage if not controlled early) |
