Podcast
Questions and Answers
What is the primary reason for testing an auto control and O cell control concurrently with reverse typing?
What is the primary reason for testing an auto control and O cell control concurrently with reverse typing?
- To confirm the accuracy of ABO typing.
- To detect cold agglutinins that enhance reactivity. (correct)
- To identify minor ABO incompatibility.
- To prevent hemolysis during infusion.
What characteristic feature may appear in a mixed-field agglutination?
What characteristic feature may appear in a mixed-field agglutination?
- A uniform color change in the test medium.
- A consistent clumping of all RBCs.
- A clear zone of unagglutinated cells.
- A halo effect of unagglutinated RBCs. (correct)
What complication is associated with major ABO incompatibility?
What complication is associated with major ABO incompatibility?
- Allergic reactions during transfusion.
- Increased leukocyte count.
- Hemolysis of RBCs at the time of infusion. (correct)
- Resistance to blood type changes.
Which type of incompatibility is described when the donor’s plasma is incompatible with the recipient’s RBCs?
Which type of incompatibility is described when the donor’s plasma is incompatible with the recipient’s RBCs?
What unique challenge do transfusion services face post-ABO incompatible HPC transplantation?
What unique challenge do transfusion services face post-ABO incompatible HPC transplantation?
What remains in the tissues of a patient following an ABO-incompatible HPC transplant?
What remains in the tissues of a patient following an ABO-incompatible HPC transplant?
What does chimerism refer to in a medical context?
What does chimerism refer to in a medical context?
What can cause mixed-field reactions in blood typing?
What can cause mixed-field reactions in blood typing?
What factor primarily causes an extra-positive reaction in ABO discrepancies?
What factor primarily causes an extra-positive reaction in ABO discrepancies?
Which of the following is NOT a technical error that can lead to ABO discrepancies?
Which of the following is NOT a technical error that can lead to ABO discrepancies?
What is the first step that should be taken to resolve most technical errors in ABO discrepancy testing?
What is the first step that should be taken to resolve most technical errors in ABO discrepancy testing?
Which statement correctly describes forward grouping?
Which statement correctly describes forward grouping?
Which technical error could most likely lead to false-negative results during ABO grouping?
Which technical error could most likely lead to false-negative results during ABO grouping?
What key factor must be checked when resolving an ABO discrepancy if a clerical error is suspected?
What key factor must be checked when resolving an ABO discrepancy if a clerical error is suspected?
In forward grouping, which antisera is used to detect the presence of B antigens?
In forward grouping, which antisera is used to detect the presence of B antigens?
Which of the following actions is recommended to avoid reagent contamination during testing?
Which of the following actions is recommended to avoid reagent contamination during testing?
What is the primary reason that true chimerism is rarely found in individuals?
What is the primary reason that true chimerism is rarely found in individuals?
Which of the following correctly identifies a scenario for artificial chimerism?
Which of the following correctly identifies a scenario for artificial chimerism?
What causes Group II Discrepancies in blood grouping?
What causes Group II Discrepancies in blood grouping?
How can weakly reactive antigens be detected more effectively during testing?
How can weakly reactive antigens be detected more effectively during testing?
What phenomenon can result in weak reactions with anti-B antisera?
What phenomenon can result in weak reactions with anti-B antisera?
Which factor does NOT contribute to the emergence of mixed cell populations in artificial chimeras?
Which factor does NOT contribute to the emergence of mixed cell populations in artificial chimeras?
What occurs as a result of vascular anastomosis during twin pregnancies?
What occurs as a result of vascular anastomosis during twin pregnancies?
Which situation would most likely lead to a Group II Discrepancy in blood typing?
Which situation would most likely lead to a Group II Discrepancy in blood typing?
What is a typical characteristic of the forward grouping reaction with B antigen?
What is a typical characteristic of the forward grouping reaction with B antigen?
What causes the ABO discrepancy in the reverse grouping of cis-AB individuals?
What causes the ABO discrepancy in the reverse grouping of cis-AB individuals?
Which phenomenon can result from unequal crossing over between A and B genes in cis-AB individuals?
Which phenomenon can result from unequal crossing over between A and B genes in cis-AB individuals?
Which of the following examples represents a technical error leading to an ABO discrepancy?
Which of the following examples represents a technical error leading to an ABO discrepancy?
What is likely indicated by an ABO type showing 4+ with Anti-A, 4+ with Anti-B, and 2+ with A1 cells?
What is likely indicated by an ABO type showing 4+ with Anti-A, 4+ with Anti-B, and 2+ with A1 cells?
In individuals with the Acquired B phenomenon, which reaction is typically observed?
In individuals with the Acquired B phenomenon, which reaction is typically observed?
What enzyme deficiency is commonly noted in cis-AB individuals compared to ordinary group AB sera?
What enzyme deficiency is commonly noted in cis-AB individuals compared to ordinary group AB sera?
What disorder may manifest through an extra positive reaction in reverse grouping with negative autocontrol?
What disorder may manifest through an extra positive reaction in reverse grouping with negative autocontrol?
What modification leads to the formation of the pseudo-B antigen in the acquired B phenomenon?
What modification leads to the formation of the pseudo-B antigen in the acquired B phenomenon?
What effect does lowering the pH of reagents containing monoclonal anti-B clone (ES4) have on the agglutination reaction?
What effect does lowering the pH of reagents containing monoclonal anti-B clone (ES4) have on the agglutination reaction?
Why does testing the patient's serum or plasma against autologous RBCs yield a negative reaction in the acquired B phenomenon?
Why does testing the patient's serum or plasma against autologous RBCs yield a negative reaction in the acquired B phenomenon?
Which of the following factors does NOT affect the agglutination of acquired B antigen when reacting with anti-B?
Which of the following factors does NOT affect the agglutination of acquired B antigen when reacting with anti-B?
What is the consequence of excessive amounts of blood group–specific soluble substances in a patient's plasma?
What is the consequence of excessive amounts of blood group–specific soluble substances in a patient's plasma?
What is the expected outcome when treating RBCs with acetic anhydride in the context of acquired B phenomenon?
What is the expected outcome when treating RBCs with acetic anhydride in the context of acquired B phenomenon?
What is the significance of secretor studies in the context of the acquired B phenomenon?
What is the significance of secretor studies in the context of the acquired B phenomenon?
Which of the following best describes low-prevalence antibody reactions in relation to anti-A or anti-B reagents?
Which of the following best describes low-prevalence antibody reactions in relation to anti-A or anti-B reagents?
Flashcards
ABO Blood Group Discrepancies
ABO Blood Group Discrepancies
Unexpected results in forward or reverse blood grouping, often caused by issues with patient serum, RBCs, or both.
Forward Grouping
Forward Grouping
Detects RBC antigens using commercial antisera on patient RBCs.
Reverse Grouping
Reverse Grouping
Identifies ABO antibodies in patient serum using known reagent RBCs.
Clerical Errors
Clerical Errors
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Sample Errors
Sample Errors
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Reagent Issues
Reagent Issues
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Instrument Problems
Instrument Problems
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Procedure Errors
Procedure Errors
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Major Incompatibility
Major Incompatibility
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Minor Incompatibility
Minor Incompatibility
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Chimerism
Chimerism
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Group II Discrepancies
Group II Discrepancies
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Acquired B phenomenon
Acquired B phenomenon
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Resolving Group II Discrepancies
Resolving Group II Discrepancies
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Rare Group II Discrepancies
Rare Group II Discrepancies
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Cis-AB
Cis-AB
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Saline Suspensions
Saline Suspensions
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Patient History Review
Patient History Review
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Study Notes
ABO Blood Group Discrepancies
- ABO discrepancies arise when unexpected results occur in forward or reverse blood grouping.
- Potential causes include issues with the patient's serum, RBCs, or both.
- Discrepancies manifest as extra-positive, weak, or missing reactions.
Grouping Definitions
- Forward grouping detects RBC antigens using commercial antisera (anti-A, anti-B) on patient RBCs.
- Reverse grouping identifies ABO antibodies in patient serum using known reagent RBCs (A1 and B cells).
Technical Errors Leading to Discrepancies
- Clerical Errors: Inaccurate identification of blood specimens can lead to discrepancies.
- Sample Errors: Mix-ups or missed observations such as hemolysis may occur.
- Reagent Issues: Expired or contaminated reagents can impact results.
- Instrument Problems: Use of uncalibrated centrifuges may yield inaccuracies.
- Procedure Errors: Inadequate sample preparation, such as incorrect cell suspension density or failure to follow instructions, can lead to errors.
Resolving Technical Errors
- Retesting with saline suspensions can eliminate some issues caused by sample problems.
- Review patient history for age, diagnosis, and transfusion records is essential.
- Concurrent testing with auto controls and O cell controls is recommended to detect common cold agglutinins.
Major and Minor ABO Incompatibilities
- Major Incompatibility: Occurs when donor RBCs are incompatible with recipient plasma (e.g., group B donor and group O recipient).
- Minor Incompatibility: Occurs when donor plasma reacts against recipient RBCs (e.g., group O donor with anti-B plasma and group B recipient).
- Bidirectional Incompatibility: Presence of both major and minor incompatibility types.
Chimerism
- Chimerism refers to the presence of two distinct cell populations in one individual, often identified in twins.
- True chimerism arises from in utero blood exchange, allowing both populations to coexist without antibody formation.
Group II Discrepancies
- May result from weakly reacting or missing antigens, often occurring with blood group subgroups or in conditions like leukemia.
- Acquired B phenomenon alters A antigen structure, resulting in weak reactions with anti-B antisera, often due to digestive tract diseases.
Resolution Strategies for Group II Discrepancies
- Enhancing agglutination of weakly reactive antigens through incubation at room temperature or cold temperatures.
- Testing against controls and considering enzyme pretreatment of RBCs.
- The acquired B phenomenon can be resolved with specific monoclonal antibodies (ES4) or by lowering reagent pH.
Rare Group II Discrepancies
- May be caused by excess soluble blood group substances in plasma or antibodies to low-prevalence antigens.
- Some individuals, such as those with cis-AB, showcase unique antigen patterns that complicate standard grouping.
Key Notes
- Continuous monitoring and adherence to strict protocols prevent inconsistencies in blood typing.
- Blood components must be compatible with both donor and recipient blood types during transfusions to prevent serious complications.
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