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79 Cards in this Set
- Front
- Back
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Medical terminology & units of measure to report test results *review* |
*review* |
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Laboratory safety practices & appropriate responses to any unsafe situation in accordance with established policies to minimize harm and danger to self and others *review* |
*review* |
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Blood banking and transfusion medicine practices (protocols), basic lab skills, and values that can be applied *case studies* |
*case studies* |
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Patient ID |
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Donor phlebotomy |
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Sample collection |
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Preanalytic/analytic/postanalytic errors |
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Whole blood - Indications & anticipated therapeutic effects of transfusion |
Indications: -actively bleeding pts & those who have lost greater than 25% blood |
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RBCs - Indications & anticipated therapeutic effects of transfusion |
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PLTs - Indications & anticipated therapeutic effects of transfusion |
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Plasma - Indications & anticipated therapeutic effects of transfusion |
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Cyroprecipitate - Indications & anticipated therapeutic effects of transfusion |
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Defend the rational for pre-donation screening |
enhance safety for the blood recipient and the blood donor |
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PRBC prep |
-leuko-reduction -washed -pooled |
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FFP prep |
plasma that is removed from a donor, separated, and placed in freezer w/in 8 h of collection (or 6 h, ifACD is the anticoagulant/preservative) |
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PLT prep |
-leuko-reduction -washed -pooled |
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Cryoprecipitate prep |
-thawed FFP @ refrigerated T --if pooled using closed system, once thawed, use w/in 6 h --if pooled using open system, once thawed, use w/in 4 h |
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Use of leuko-reduction (LR) of both RBCs & PLTs |
-neonates -transplant recipients -pts w/ history of FNHTRs |
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Use of irradiation |
To prevent Transfusion Associated Graft vs Host Disease (TV-GVHD) (gamma irradiation prevents T cell proliferation) -fetal & neonatal recipients -immunocomp pts -recipients of blood components from blood relative -marrow, stem cell transplant recipient -recipients receiving HLA-matched donor components |
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Use of cryoprecipitate |
*cold insoluble ppt containing FI, FVIII, FXIII, vWF & fibronectin -bleeding associated w/ FI deficiency (<100 mg/dL) &/or FXIII deficiency, & volume issues prevent use of FFP -2nd line therapy for severe vWD & hemophilia A |
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Use of RBC & platelet washing |
RBCs: -IgA deficient pts -neonates -fetus (intrauterine transfusion) PLTs: -IgA deficient pts -pts w/ severe life threatening plasma allergies uncontrollable w/ meds |
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Use of red cell rejuvenation |
*soln containing phosphate, pyruvate, inosine & adenine -to restore 2,3-DPG and ATP levels in RBCs collected in CPD or CPDA-1 during storage or w/in 3 days after expiration, extends freezing exp date (longer than a yr), extends transfusion date |
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Blood typing |
-classification of blood based on presence or absence of Ags on surface of RBCs |
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Detection and ID of antibodies |
-Screen: detects Ab to Ag resulting from exposure to red cells through transfusion & pregnancy -ID: determines Ab specificity for Ab or Abs detected in Ab screen |
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Compatibility testing |
-detect unexpected Abs in the pt/ prevent transfusion rxn (2nd check of Ab screen) -establish ABO comp between pt & blood products/ maximize in vivo RBC survival (2nd check of ABO errors) |
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Quality control in BB |
-to determine whether analytical phase of testing is working properly |
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Rationalize additional testing of samples in cases of incomplete antibody workups |
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Anti-A,B (non-routine) use |
used for O donor units |
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Antiglobulin (AHG) mechanism & use |
cross-links IgG sensitized RBCs |
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Bovine serum albumin (BSA) mechanism & use |
reduces zeta potential & membrane hydration |
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Low ionic strength saline (LISS) mechanism & use |
lowers ionic strength, incr rate of Ab uptake |
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Polyethylene glycol (PEG) mechanism & use |
lowers ionic strength, enhance Ab uptake, concentrates Ab |
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Proteolytic enzymes: papain, ficin & bromealin mechanism & use |
reduces RBC zeta potential by removing neg charges; destroys some RBC Ag |
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Dolichos biflorusmechanism |
binds A1 Ag |
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Ulex europaeus |
binds H Ag |
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Vicia graminea |
binds N Ag |
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Iberis amara |
binds M Ag |
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Massive transfusion - need for and/or type of compatibility testing req & recommend steps |
-T&S -XM (O, Rh neg when XM not done) |
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Autologous blood transfusion - need for and/or type of compatibility testing req & recommend steps |
-ABO & Rh only -Infectious disease testing ONLY IF transfused outside collection facility (may transfuse viral positive blood w/ permissions) |
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Red cell transfusion of infant less than 4 mo - need for and/or type of compatibility testing req & recommend steps |
-ABO (no reverse type-no production of Ab) & Rh only -Ab screen: if pos=give Ag neg blood or IAT XM-compatible blood; if neg=NO XM as long as O RBCs are transfused -If a non-group O neonate is to receive non-group O RBCs NOT comp w/ maternal ABO group, neonate's serum/plasma is tested for anti-A or anti-B |
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Non-red cell products - need for and/or type of compatibility testing req & recommend steps |
-Plasma: not usually XM (unless sig RBCs in plasma/PLTs) -PLTs: not usually XM |
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ABO compatibilities for WB, RBCs & Plasma/PLT transfusions |
-PRBCs: same ABO/Rh type otherwise compatible -Rh-neg to Rh-neg (exceptions, not clin sig: anti-A1, anti-P1, anti-Lu^a, anti-M or anti-N) |
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Priority of blood products in a massive transfusion & in cases of limited blood and blood product supplies |
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Analyze topic-related case studies and propose valid solutions (Look @ examples) |
(Look @ examples) |
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Dosage blood group systems |
-Duffy -Kidd -Rh -MNS |
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Incr w/ enzymes |
"Lewis P is a Rhotten Kidd" -Le, P, Rh, Kidd |
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Decr w/ enzymes |
-Duffy -MNSs (S & s variable) |
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Unaffected or variable w/ enzymes |
-Kell -Lutheran |
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Cold-reacting (IgM) Abs |
"LIPMaN" -Le, I/i, P1, M, N |
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Warm-reacting (IgG) Abs |
-S, s, U, K, k, Jk^a, Jk^b, Fy^a, Fy^b, P, PP1Pk, Lu^b, D, C, c, E, e (ABO, Rh, Kell, Kidd, Duffy, S, s, U, Lu^b) |
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Low prevalence Ags |
Exceptions to homozygous rule K, Kp^a, Js^a, Lu^a, also F, V, Cw, Wr^a, Co^b, Xg^a unlikely Ab |
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ABO discrepancy - sample problem: Red cell testing (forward grouping) |
-extra Ags (polyagglut, rouleaux, Whorton's jelly) -missing weak Ags -M-F rxns |
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ABO discrepancy - sample problem: plasma/serum testing |
-extra Abs -missing/weak Abs -M-F rxns |
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ABO discrepancy - extra Ags: acquired B phenomenon |
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ABO discrepancy - extra Ags: science of acquired B Phenomenon |
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ABO discrepancy - extra Ags: resolving acquired B Phenomenon |
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ABO discrepancy - extra Ags: B(A) phenomenon |
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ABO discrepancy - extra Ags: science of B(A) Phenomenon |
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ABO discrepancy - extra Ags: resolving B(A) Phenomenon |
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ABO discrepancy - extra Ags: other reasons |
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ABO discrepancy - missing/weak Ag |
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ABO discrepancy - extra Ags: science of subgroups of A or B |
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ABO discrepancy - resolving missing/weak Ag subgroups |
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ABO discrepancy - MF rxns |
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ABO discrepancy - science of MF rxns |
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ABO discrepancy - resolving MF rxns |
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ABO discrepancy - extra Abs |
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ABO discrepancy - Anti-A1in A2 or A2BPerson |
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ABO discrepancy - science of Anti-A1 |
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ABO discrepancy - resolving Anti-A1 |
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ABO discrepancy - cold Abs |
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ABO discrepancy - science of cold Abs |
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ABO discrepancy - resolving cold allo/auto-Abs |
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ABO discrepancy - rouleaux |
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ABO discrepancy - science of rouleaux |
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ABO discrepancy - resolving rouleaux |
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ABO discrepancy - missing or weak Abs |
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ABO discrepancy - science of missing or weak Abs |
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ABO discrepancy - resolving missing or weak Abs |
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