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Blood Transfusion Reaction Resolution

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What is the purpose of the antibody screen crossmatch test?

To identify antibodies directed against antigens on screening cells

What is the purpose of the Red Cell Affinity Column Technology (ReACT) test?

To detect both antigen and antibody using an immunoreactive gel

What is the purpose of the Solid-Phase Adherence Assay (SPAA) test?

To detect both antigen and antibody using an immunoreactive gel

What is the purpose of the Electronic (Computerized) Crossmatch test?

To determine the compatibility of the donor and recipient blood

What type of test is used to detect antibodies directed against antigens on donor cells?

Antibody screen crossmatch test

What is the primary purpose of crossmatching in blood transfusion?

To prevent transfusion reactions and increase in vivo survival of red cells

Why are some antibodies of the IgM type detected at lower temperatures?

Because they are more reactive at lower temperatures

What is the purpose of performing an antibody screen in patient serum?

To detect the presence of any unexpected antibodies in patient serum

Why is the minor crossmatch unnecessary in modern blood banking?

Because donated units are already tested for antibodies through antibody paneling

What is the desired outcome of a crossmatch in blood transfusion?

A non-reactive crossmatch

What percentage of antibody titers become undetectable after 10 years?

Nearly 50%

What is the most critical pretransfusion serologic test?

ABO/Rh typing

Why is it necessary to perform ABO/Rh typing before proceeding to antibody detection or crossmatching?

Because it is the most critical pretransfusion serologic test

What happens to many antibody titers over time?

They decrease to undetectable levels

What is an example of a notorious antibody that can cause a delayed type of hemolytic transfusion reaction?

KIDD BGS

What is the primary purpose of centrifugation in the card containing the microtubes?

To separate the cells from the serum

Which type of antibody is usually detected in the IS phase?

IgM Naturally occurring Antibody

What is the primary function of the gel matrix in Gel Technology?

To separate particles based on size

What type of antibodies are detected in the IAT phase?

IgG Alloantibodies

What is the characteristic of naturally occurring antibodies?

They are usually IgM in nature

What is the primary focus of the AABB standards for crossmatching?

Detecting ABO incompatibility and clinically significant antibodies

What is the purpose of collecting donor samples at the same time as the full donor unit?

To store a backup sample in case the original unit is contaminated

What is the next step if antibodies are NOT detected in the antibody screen?

Perform an immediate spin crossmatch

What is the desired outcome of a complete crossmatch?

A non-reactive result indicating compatibility

What is the significance of the segments in blood banking?

They are a sample of the donor's blood for testing

What is the purpose of attaching segments to the unit of whole blood during specimen collection?

To prevent contamination of the blood in the bag

What is NOT a function of the crossmatch test?

Guarantee normal survival of RBCs

When is a complete crossmatch performed?

When an antibody or previous alloantibody is detected

What is the limitation of current crossmatching procedures?

They cannot guarantee normal survival of RBCs

What is the primary goal of performing crossmatching in blood transfusion?

To verify donor cell ABO compatibility

What is the minimum acceptable hematocrit level for therapeutic phlebotomy?

40%

What is the purpose of a therapeutic apheresis?

To remove a portion of blood from a patient for medical reasons

What is the most common testing method for infectious disease screening?

Microplate

What is the main purpose of the antibody screen in donor's plasma?

To detect antibodies produced after transfusion or pregnancy

What happens to donor samples after transfusion?

They are stored at 1-6 degrees Celsius for at least 7 days

What is the purpose of quarantine and recipient tracing?

To quarantine prior collections from the donor

What is the primary purpose of ABO and D typing?

To determine the blood type of the donor

What is the main purpose of the Western Blot test?

To confirm the presence of a pathogen

What is the main purpose of Hemagglutination testing?

To detect the presence of syphilis

What is the minimum weight requirement for a therapeutic phlebotomy donor?

59 kg

If an antibody is present, units negative for the antigen must be given.

True

Clinically significant antibodies are reactive at room temperature.

False

The minor crossmatch is required by AABB.

False

The purpose of crossmatching is to detect ABO errors.

True

A non-reactive crossmatch indicates the donor units are not compatible for transfusion.

False

The crossmatch test can guarantee normal survival of RBCs.

False

The electronic crossmatch test can detect all antibodies against donor cells.

False

The purpose of attaching segments to the unit of whole blood is to prevent contamination of the blood in the bag.

True

A complete crossmatch is performed when no antibody is detected in the antibody screen.

False

The crossmatch test can detect ABO/Rh errors.

False

The AABB standard for crossmatching requires the detection of only ABO incompatibility.

False

Samples for donor testing can be collected at any time after the full donor unit.

False

If antibodies are detected in the antibody screen, only the immediate spin (IS) phase is performed.

False

The segments are a sample of the actual unit of whole blood and are used for testing.

False

The desired outcome of a crossmatch is an agglutination reaction.

False

In a crossmatch, if the antibody screen is positive and the antibody is directed against an antigen on the donor cell, the next step is to select antigen negative blood.

True

The Solid-Phase Adherence Assay (SPAA) can only detect antigens.

False

In a crossmatch, if the antibody screen is positive and the antibody is directed against an antigen on the screening cell, the next step is to perform a complete crossmatch.

True

The Red Cell Affinity Column Technology (ReACT) is different from Gel Technology.

False

If the antibody screen is negative, no further testing is required.

True

Match the following terms with their corresponding descriptions:

Antibody screen = Detects the presence of any unexpected antibodies in patient serum Crossmatching = Prevents transfusion reactions and increases in vivo survival of red cells Minor Crossmatching = Not required by AABB since 1976 Clinically significant antibodies = Reactive at 37°C

Match the following processes with their corresponding purposes:

ABO/Rh typing = Prevents ABO errors Antibody identification = Detects the presence of any unexpected antibodies in patient serum Crossmatching = Increases in vivo survival of red cells Antibody paneling = Detects antibodies in donated units

Match the following tests with their corresponding characteristics:

IgM type antibodies = May be detected at lower temperatures Antibody screen = Detects the presence of any unexpected antibodies in patient serum Crossmatching = Prevents transfusion reactions Electronic Crossmatch = Cannot detect all antibodies against donor cells

Match the following terms with their corresponding descriptions:

Universal Recipient = Has antibodies against all ABO blood groups Universal Donor = Has O type blood with no A or B antibodies Autologous Crossmatching = Used for self-donation Pedipacks = Special packs for infant transfusion

Match the following steps with their corresponding purposes:

Collecting donor samples = To test for antibodies in donated units Quarantine and recipient tracing = To prevent transfusion-transmitted infections Therapeutic phlebotomy = To reduce iron overload Hemagglutination testing = To detect antibodies against donor cells

Match the following blood components with their storage requirements:

Packed cells = Refrigerated at 2-6°C for up to 35 days Platelets = Stored at room temperature for up to 5 days Fresh Frozen Plasma = Frozen at -18°C or colder for up to 1 year Cryoprecipitate = Frozen at -18°C or colder for up to 1 year

Match the following crossmatching methods with their temperatures:

Immediate Spin (IS) = Room temperature 37°C Incubation = 37°C Antiglobulin (AHG) = Room temperature Thermophase = 60°C

Match the following sample types with their collection requirements:

Donor samples = Collected at the same time as the full donor unit Pilot samples = Used for testing and labeling Segments = Attached to the unit of whole blood during specimen collection Cards = Used for tracking and identification

Match the following crossmatching outcomes with their interpretations:

Non-reactive result = Units are compatible for transfusion Reactive result = Units are incompatible for transfusion Incomplete crossmatch = Performed when no antibodies are detected in the antibody screen Complete crossmatch = Performed when antibodies are detected in the antibody screen

Match the following steps with their order in the crossmatching process:

ABO/Rh typing = First step Antibody screen = Second step Immediate Spin (IS) = Third step if no antibodies are detected Complete crossmatch = Final step if antibodies are detected

Match the following statements about crossmatching with their corresponding descriptions:

CROSSMATCH WILL = Verify donor cell ABO compatibility and detect most antibodies against donor cells CROSSMATCH WILL NOT = Guarantee normal survival of RBCs or prevent patient from developing an antibody Purpose of attaching segments = To prevent contamination of the blood in the bag Limitation of current crossmatching procedures = Cannot guarantee the fate of a unit of blood to be transfused

Match the following procedures with their corresponding conditions:

Perform ONLY immediate spin phase = If no antibody is detected Perform COMPLETE CROSSMATCH = If antibody or previous alloantibody is detected No need to open the actual bags = To prevent contamination of the blood in the bag Units of Whole Blood with segments attached = For donor cells collection

Match the following statements about blood transfusion with their corresponding descriptions:

Importance of crossmatching = To prevent hemolytic reaction from the patient Purpose of collecting donor samples = At the same time as the full donor unit Significance of segments = For donor cells collection Limitation of current crossmatching procedures = Not 100% effective yet

Match the following statements about crossmatching with their corresponding descriptions:

Primary goal of crossmatching = To detect incompatible units Purpose of crossmatching = To prevent hemolytic reaction from the patient Importance of ABO typing = Before proceeding to antibody detection or crossmatching Limitation of current crossmatching procedures = Cannot guarantee the fate of a unit of blood to be transfused

Match the following statements about blood transfusion with their corresponding descriptions:

Purpose of crossmatching = To detect incompatible units Importance of attaching segments = To prevent contamination of the blood in the bag Limitation of current crossmatching procedures = Not 100% effective yet Primary goal of crossmatching = To prevent hemolytic reaction from the patient

Match the following compatibility tests with their descriptions:

Manual (IS and IAT) = Uses antigen-antibody reaction and adherence to a solid phase support system Gel Technology = Similar to ReACT; uses an immunoreactive gel and a mixture of protein G and A Electronic (Computerized) Crossmatch = Uses a computerized system to detect antibodies against donor cells Solid-Phase Adherence Assay (SPAA) = Can detect BOTH ANTIGEN and ANTIBODY

Match the following antibody-screening results with their resolutions:

Pos Neg = Antibody directed against antigen on screening cell; ID antibody and select antigen negative blood Neg Pos = Antibody directed against antigen on donor cell; ID antibody and select antigen negative blood or perform DAT on donor unit Pos Pos = Antibodies directed against both screening and donor cells; ID antibody and select antigen negative blood for both cells Neg Neg = No antibodies detected; proceed with crossmatch

Match the following types of antibodies with their characteristics:

IgM = Usually detected at lower temperatures IgG = May be attached to donor cells Clinically significant = Reactive at room temperature Naturally occurring = Usually detected in the IS phase

Match the following blood transfusion procedures with their purposes:

Centrifugation = Primary purpose of centrifugation in the card containing the microtubes Therapeutic phlebotomy = Minimum acceptable hematocrit level for therapeutic phlebotomy Quarantine and recipient tracing = Purpose of quarantine and recipient tracing ABO and D typing = Primary purpose of ABO and D typing

Match the following blood banking procedures with their limitations:

Crossmatching = Can detect ABO/Rh errors but does not guarantee normal survival of RBCs Electronic crossmatch = Cannot detect all antibodies against donor cells Antibody screening = Limited to detecting antibodies directed against antigens on screening cells Solid-Phase Adherence Assay = Cannot detect antibodies without antigens

This quiz covers the process of resolving crossmatching issues in blood transfusion, including identifying and managing antibodies, and selecting compatible blood units.

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