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15 Oct 2018

6- With respect to a group A Rh (D) Positive patient who has been transfused with group O Rh (D) Negative red cells during the medical evacuation. What blood would you select for subsequent STAT transfusion?

* Group O Rh (D) Positive red cells.

* Group A Rh (D) Positive red cells.

* Group A Rh (D) Negative red cells

* Group O Rh (D) Positive red cells.

7- result of a direct anti-globulin test after a delayed transfusion reaction may be:

* Mixed-field.

* All of the alternatives.

* Positive with anti-C3d AHG but not anti-IgG AHG

* Positive.

* Negative.

8- in an emergency when there is insufficient time for normal pretransfusion testing which of the following should be issued without waiting for the results of a crossmatch?

* O Rh (D) Positive whole blood.

* O Rh (D) Positive packed cells.

* O Rh (D) Negative packed cells or modified whole blood.

* O Rh (D) Negative whole blood.

9- A patient presents for a 4 unit crossmatch. The patients blood group is AB Rh (D) Positive. You have the following units of blood available. 10 units of group O Rh (D) Positive, 6 units of group O Rh (D) Negative, 8 units of A Rh (D) Postive units. What units would you select for the crossmatch?

* 4 units of group O Neg.

* Ring the NHSBT and urgently request four units of AB Pos

* 2 units of O Pos and 2 units of O Neg.

* 4 units of A Pos.

10- You carry out an ABO and Rh grouping on a six cord bloods. Three of the cord bloods group as AB Rh (D) Positive. What steps would you take before reporting these results?

* Work out the statistical probability of such an occurrence, and if p<0.05 accept the results

* Do another ABO Rh check. If the same, report.

* Wash the cord blood cells in saline, and then repeat the groups.

* Check the maternal and paternal blood groups.

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Lelia LubowitzLv2

18 Oct 2018

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The A antigen (the protein that makes A blood A blood) is embedded in the red blood cell (RBC) membrane. Blood group A individuals will automatically carry antibodies (proteins that are in the blood plasma-liquid part of blood) that will attack blood group B cells. Blood group B individuals will carry antibodies that will attack blood group A cells. Blood group O individuals, lacking either of the A or B antigens will carry BOTH types of antibodies and will attack either A or B cells. When there is a transfusion with incompatible blood groups, cells can clump creating blockages in arteries throughout the body. Other pathways can lead to the lysing of RBCâs which will release their contents into the bloodstream elevating these component in the blood which can have sever effects on the heart (potassium primarily-in case you are interested).

Remember, the Rh is a typical one gene, two allele scenario. Rh+ blood can accept Rh+ or Rh- blood. A person with Rh- blood can only receive Rh- blood. Unlike ABO where an individual manufactures the antibody to an antigen they lack without prior exposure, the Rh factor requires previous exposure to illicit an immune response. If a Rh- person is exposed to Rh+ blood, the individual will create the antibody against the Rh antigen. Now, if Rh+ blood is introduced into this individual again, the recipientâs blood contains anti-Rh antibodies and will attack the Rh+ cells-Bad news for the recipient. This is the same thing that happens with an Rh- mom who gets pregnant with an Rh+ baby. By the time the first Rh+ baby is born and blood mixing may have occurred during late pregnancy (small breaks in the placenta can cause some of babyâs blood to mix with that of mom), first baby escapes unharmed. Subsequent babies arenât so lucky.

If there are small tears in the placenta (which are normal), momâs anti Rh antibodies can go in and attack the Rh+ babyâs blood. This can kill the baby. Now, Rh- moms are given a substance that will coat the babyâs RBCâ; kind of like putting them into stealth mode so they canât be seen by momâs immune system. Later-poof, out pops unaffected baby.

1. What blood type(s) can be given to an A positive individual?

2. If you have B negative blood, what blood types can you receive?

3. What blood types can an O negative receive? O positive?

4. If a man is blood group B and his wife is blood group A what blood type(s) are you 100% sure they could produce in their children?

5. If you have a blood group O father and a blood group B mother, can they produce an O child? Explain your answer.

6. You have a male friend who is blood group AB. He is successful in business but knows very little about biology. His wife just had an O child. Knowing that you have been studying the genetics of blood groups, he asks you for an education on blood groups. What do you think about this situation?

7. A woman is AB and her husband is A. They have a B child. What are all the blood groups possible in their children if he is heterozygous?

8. A woman is Rh- and her husband is Rh+. Their first baby is Rh-. What is the genotype, with respect to Rh, of the parents? What is the probability their next child will be Rh+? Does the woman have to worry about any issues with future children? Explain!

Define antibody screen and antibody identification.

2. Differentiate between the importance and use of the antibody screen versus antibody identification regarding each of the following:
a. Potential blood recipient
b. Donor unit
c. Prenatal/Postpartum patients
d. Recently transfused patients with positive DAT (Direct Antiglobulin Test)
e. Neonate with positive DAT

3. State the three phases of testing used in the antibody screen or antibody identification and which type of antibody can be detected in each phase.

4. State the significance of a negative antibody screen.

5. State the significance of a positive antibody screen.

6. Explain the importance of obtaining a patient transfusion and medication history when investigating a positive antibody screen.

7. Given the type of antibody identified, determine the necessary procedure for compatibility testing to provide blood for transfusion for the patient.

8. Explain the purpose of the autocontrol and its relationship to the DAT.

9. Define dosage as it relates to antibody-antigen interactions.

10. Given specific red cell antigen expression, determine if the antigen expression is homozygous or heterozygous.

11. Explain the significance of using screening and panel cells with homozygous antigen expression when performing an antibody screen or identification.

12. Explain the â3 cell rule-inâ rule with regard to antibody identification for single or multiple antibodies present.

13. Explain the ârule-outsâ rule with regard to antibody identification.

14. Given antibody agglutination results for an antibody identification panel, perform the â3 cell rule-inâ and all ârule-outsâ to identify the antibody(ies) present.

15. State which blood group antigens are destroyed by enzyme treatment and which antibodies have enhanced expression when tested against enzyme treated reagent red blood cells.

16. Define mixed field agglutination.

17. Describe specific occasions when mixed field agglutination may be present and identified.

18. Given a patient history, current ABO/Rh type, antibody screening and (if applicable) antibody identification results, interpret the testing results.

19. Given a patient history, current ABO/Rh type, antibody screening and (if applicable) antibody identification results, select the appropriate ABO/Rh type of red cell products for transfusion.

20. Given a patient history, current ABO/Rh type, antibody screening and (if applicable) antibody identification results, select the appropriate ABO type of frozen component products for transfusion.

21. Given a patient history, current ABO/Rh type, antibody screening and current or historical antibody identification results, determine the appropriate red blood cell antigen negative blood that would be required for transfusion.

22. For patients in Objective #21, given the antigen frequency of those red blood cell antigens, calculate the number of red blood cell donor units that would need to be screened for transfusion to fulfill the order requested by the physician.

23. Given a patientâs ABO/Rh type and/or other red blood cell antigen phenotyping results, determine the most probable genotype of the patient.

24. Given a patientâs ABO/Rh type and/or other red blood cell antigen phenotyping results, determine the most probable genotype or phenotype of the patientâs parents.

25. Given a patientâs ABO/Rh type and/or other red blood cell antigen phenotyping results, determine the antibody(ies) present in the patientâs serum or plasma.

26. Given donor physical, screening and/or history results, determine if the donor would be accepted, temporarily deferred, or permanently deferred from donating blood products

Which best describes the term "immunological disorder"?

a. An exaggerated or inadequate immune response.

b. A disorder that destroys the immune system.

c. Any genetic disease.

d. A complete lack of immune function.

e. Immune problems that cause disease but cannot be detected.

2. How would an immune deficient person react to the introduction of an antigen to their bodies, assuming the cause of the deficiency was genetic?

a. Inadequate immune response due to primary immunodeficiency.

b. Inadequate immune response due to secondary immunodeficiency.

c. Excessive immune response due to primary immunodeficiency.

d. Excessive immune response due to secondary immunodeficiency.

3. An ordinarily innocuous substance that can trigger a harmful immunological response in a sensitized person.