Flashcard decks

exam 3

65 flashcardsby Montana
Study these flashcardsFree · spaced repetition · iPhone, Android, Mac & web

All cards

1
how do autoantibodies develop (select all that apply)
  • exposure to foreign antigens
  • spontaneous development
  • transfusion
  • pregnancy
2
what makes an alloantibody clinically significant
  • those that are capable of decreasing RBC survival
  • all of the above
  • those that are against Kell antigens
  • those that react at immediate spin
3
when do clinically significant antibodies tend to react
  • 37C/AHG
  • DAT
  • room temp/IS
  • all temps/phases
4
which antigens show dosage
  • C/c
  • kidd
  • E/e
  • Lua/Lub
  • MNSs
  • Lea/Leb
  • duffy
5
what are possible causes of a postive autocontrol
  • cold alloantibody
  • transfusion reaction
  • warm alloantibody
  • autoantibody
6
how do you select additional cells for a rule out
  • negative for putative antibody and those you want to rule out
  • negative for putative antibody, positive for those you want to rule out
  • positive for putative antibody and those you want to rule out
  • positive for putative antibody, negative for those you want to rule out
7
what does the rule of three determine
  • antibodies that pass rule of three are present
  • antibodies that pass rule of three are absent
  • is used to determine whether more cells are suitable for further antibody testing
8
what is the purpose of antigen typing
  • done to find more cells for antibody ID
  • done to find donor cells negative for corresponding antigen
  • done to determine ABO/Rh type
  • done as a follow-up for panels to confirm antibody presense/absence
9
what is the function of PEG
  • enhances cold allos
  • enhances cold autos
  • enhances warm autos
  • enhances warm allos
10
which antigens are enhanced by enzymes
  • MNSs
  • kidd
  • kell
  • I/i (big and little i)
  • duffy
  • Rh
  • Lewis
  • P
11
which enzyme destroys kell antigens
  • ZZAP
  • trypsin
  • ficin
  • papain
12
what neutralizes P antigens
  • hyatid cyst fluid
  • P substance in pigeon eggs
  • ficin
  • pooled plasma
13
what is the purpose of an allo-adsorption/diff adsorption
  • remove 1+ allos to ID other antibodies
  • adds autoantibodies for rule outs
  • remove 1+ autos to ID other antibodies
  • destroys antigens that would react with alloantibodies
14
what best describes the FDA
  • voluntary for blood banks, inspection every 2 years
  • mandatory for blood banks, inspection every 4 years
  • mandatory for blood banks, inspection every 2 years
  • voluntary for blood banks, inspection every 4 years
15
what best describes the AABB
  • voluntary for blood banks, inspection every 2 years
  • mandatory for blood banks, inspection every 3 years
  • voluntary for blood banks, inspection every 3 years
  • mandatory for blood banks, inspection every 2 years
16
what best describes CAP
  • mandatory for blood banks, inspection every year
  • mandatory for blood banks, inspection every 2 years
  • voluntary for blood banks, inspection every year
  • voluntary for blood banks, inspection every 2 years
17
what best describes FACT
  • mandatory for blood banks, inspection every 2 years
  • voluntary for blood banks, inspection every 3 years
  • mandatory for blood banks, inspection every 3 years
  • voluntary for blood banks, inspection every 2 years
18
which agency uses the CFR
  • AABB
  • ISO
  • FACT
  • FDA
19
what is the purpose of the AABB
  • meets additional cGMP/cGTP compliance requirements for FDA
  • safety and efficacy of bloodlood components and reagents
  • uses a checklist of transfusion medicine standards
  • risk mitigation and patient assurance
20
what is the purpose of CAP
  • meets additional cGMP/cGTP compliance requirements for FDA
  • uses a checklist of transfusion medicine standards
  • risk mitigation and patient assurance
  • safety and efficacy of bloodlood components and reagents
21
what is the purpose of FACT
  • uses a checklist of transfusion medicine standards
  • safety and efficacy of bloodlood components and reagents
  • meets additional cGMP/cGTP compliance requirements for FDA
  • risk mitigation and patient assurance
22
what best describes the ISO
  • mandatory for blood banks, inspections every 3 years
  • mandatory for blood banks, inspections every 2 years
  • voluntary for blood banks, inspections every 2 years
  • voluntary for blood banks, inspections every 3 years
23
what is the purpose of the ISO
  • risk mitigation and patient assurance
  • has specific transfusion medicine standards
  • focused on the quality management system
  • meets additional cGMP/cGTP compliance requirements for FDA
24
what is the purpose of quality assurance
  • validate protocols
  • ensure quality of products and services
  • investigates product recalls, errors, and complaints
  • coordinates internal quality auditing programs
25
what are the 5 Ps of good manufacturing practices
  • practices
  • payments
  • processes
  • premises
  • persistance
  • primary materials
  • procedures
  • protocols
  • people
26
how long must records be kept for products with an expiration date
  • 5 yrs
  • 8 yrs
  • 10 yrs
  • indefinitely
27
how long must records be kept for products without an expiration date
  • 10 yrs
  • indefinitely
  • 5 yrs
  • 8 yrs
28
define change control
  • tracks the changes of a specific product over its lifespan
  • methods of updating old equiptment
  • develops or changes existing processes or procedures
  • method of tracking how lab personnel changes over time
29
how often are competency assessments done
  • every other year for all procedures performed
  • annually for al procedures performed
  • done only upon hiring and when an employee makes a mistake resulting in patient harm
  • twice during the first year, then annually for all procedures performed
30
what is the function of a root cause analysis
  • investiagates errors involving a donor or patient
  • seeks to find reasons why an employee was fired and how to prevent those from happening again
  • seeks to find the reason why a particular piece of equiptment failed
  • ensures personnel competency on a regular basis
31
define validation
  • establishes a valid reason to begin change control
  • ensures that an employee is able to perform the duties asked of them
  • establishes that a process can consistently produce a result that complies with predetermined standards
  • ensures the functionality of new equiptment prior to implementation
32
define calibration
  • ensures blood products are not compromised by equiptment
  • resets an instrument to its original settings
  • standardizes an instrument
  • standardizes a reagent
33
define quality control
  • determines accuracy and precision of testing components
  • ensures that all blood products were processed and labeled accordingly
  • ensure quality of products and services
  • ensures that all reagents are within their expiration date
34
which agency prepares proficiency testing surveys
  • FACT
  • CAP
  • ISO
  • FDA
35
what is the purpose of proficiency testing
  • validates the skill levels of new employees
  • ensures test methods and equiptment are working properly
  • ensures that all products and reagents are within their expiration date
  • ensures employees are able to perform the duties asked of them
36
which label standard uses the four quadrant system
  • ISBT 238
  • ISBN 13
  • ISBT 128
  • ISO 128
37
how often must biological safety cabinets and clean rooms be certified
  • every 3 yrs
  • every 2 yrs
  • twice annually
  • annually
38
what occurs during the 37C incubation period when antigens are combined with their corresponding antibodies
  • validation
  • agglutination
  • sensitization
  • cold alloantibody binding
39
which antibodies likely react at 37C
  • Kell
  • Lutheran
  • Rh
  • Lewis
40
what are the clinically significant AHG-reacting antibodies
  • P
  • S/s
  • Kidd
  • Rh
  • Kell
  • Duffy
  • M/N
  • lewis
41
how should you proceed when the antibody screen and history are negative
  • complete XM through AHG
  • IS XM/computer XM
42
whats the best way to enhance a cold allo
  • spin for an additional 10 sec
  • incubate at 37C
  • incubate at room temp
  • incubate below room temp
43
which antibodies are clinically insignificant/nuisance antibodies
  • cold auto
  • cold allo
  • warm allo
  • warm auto
44
which antibodies tend to be cold allos
  • anti N
  • anti E
  • anti M
  • anti e
  • anti P1
  • anti s
  • anti S
45
why would a cold allo/auto cause a discrepancy (choose all that apply)
  • respective antigens exist on back type (A1/B) cells
  • reactions are done at room temp which is best suited for IgM
  • they are neutralized/destroyed when incubated as 37C
  • they tend to cause pan-agglutination
46
autoantibodies can cause the following
  • negative AC and DAT
  • positive AC and DAT
  • negative AC positive DAT
  • positive AC negative DAT
47
which antibody type is associated with previous Mycoplasma pneumoniae or infectious mononucleosis history
  • cold allo
  • cold auto
  • warm allo
  • warm auto
48
which antibodies are cold allos
  • anti-IH
  • anti-N
  • anti-I
  • anti-M
  • anti-H
  • anti-P
49
when do cold autos tend to react
  • 37C/AHG, positive AC and DAT (to polyspecific AHG, IgG, and C3)
  • IS, postive AC and DAT (to C3)
  • IS, postive AC and DAT (to polyspecific AHG)
  • 37C/AHG, negative AC and positive DAT (to C3)
50
which cold auto do most healthy individuals have
  • anti-N
  • anti-i
  • anti-I
  • anti-M
51
which disease fits the following:
- idiopathic cause
- secondary to M. pneumoniae/infectious mononucleosis)
- peaks incidence >50 yrs old
  • paroxysmal cold hemaglobinuria
  • cold hemaglutinin disease
  • warm autoimmune hemolytic anemia
  • Raynaud's syndrome
52
describe the pathophysiology of cold hemaglutinin disease
  • cold weather triggers acute and rapid intravascular hemolysis
  • cold agglutinin activates in skin capillaries, causing localized blood stasis, and IgM bonding activates C'
  • spleen is unable to filter out C'-bound cells, resulting in poor circulation and a cold feeling to the skin
53
what happens to C'-bound cells when blood returns to warm areas of the body in cold hemaglutinin disease
  • IgM attaches, causing extravascular hemolysis
  • IgM detaches, spleen/liver phagocytes remove C'-bound cells
  • IgM detaches, warmth activates C' and triggers agglutination
  • IgM remains attached, causing intravascular hemolysis
54
what DAT results are associated with cold agglutinin syndrome
  • negative DAT with poly AHG, anti C3d, and anti IgG
  • positive DAT with poly AHG and anti C3d, negative with anti IgG
  • positive DAT with poly AHG, anti C3d, and anti IgG
  • negative DAT with poly AHG and anti C3d, positive with anti IgG
55
how can you resolve hematology testing issues caused by cold hemaglutinin disease
  • remove clots and rerun sample
  • add AHG
  • incubate at 20-24C for 15 min
  • warm at 37C for 15 min
56
which antibody is associated with paroxysmal nocturnal hemoglobinuria
  • allo anti E
  • auto anti M
  • allo anti P
  • auto anti P
57
what kind of hemolysis is associated with paroxysmal nocturnal hemoglobinuria
  • extravascular
  • intravascular
58
which antibody is a biphasic IgG
  • anti N
  • auto anti P
  • anti M
  • auto anti D
59
what does a positive donath-landsteiner test indicate
  • negative for PCH
  • positive for PCH
  • negative for cold hemaglutinin disease
  • positive for cold hemaglutinin disease
60
what kind of sample does the donath-landsteiner test use
  • plasma
  • serum
61
what DAT results are seen in PCH
  • neg polyspecific AHG, neg IgG, pos C3d
  • pos polyspecific, IgG, C3d
  • pos polyspecific AHG, neg IgG, pos C3d
62
which of the following are valid methods for avoiding cold autoantibody reactions (select all that apply)
  • using monspecific IgG AHG
  • use PEG in place of LISS
  • use bovine serum in place of LISS
  • use adsorption techniques
  • skip IS and 37C phases
  • incubate at room temp for 15 min
  • incubate at 20-24C for 15 min
  • do IS and 37C phases only
  • prewarm all tubes to 37C
63
what is the purpose of adsorption processes
  • reduce reactivity of certain antigens
  • provide excess antibodies
  • remove interfering antibodies from plasma
  • provide excess antigens
64
how can you autoadsorb plasma
  • incubate at 37C
  • add LISS after incubation
  • perform elution
  • incubate at cold temps
65
slide 155
Study all 65 cards for free