PO Box 2074 Kelvin Grove Qld 4059 Australia T +61 7 3129 8450 F +61 7 3838 9413 E-mail: [email protected] www.rcpaqap.com.au/transfusion ABN 32 003 520 072 Transfusion TEST and TEACH PROGRAM 2012-1 QUESTIONS The following questions were taken from various sources and designed to not only test and teach but also encourage laboratory staff to further their knowledge in the field of immunohaematology. It is recommended that all staff actively working in the blood bank laboratory perform this exercise, initially without the benefit of the answers. Use the table to record your answers and score. Most answers are referenced so participants may read further if interested. The completed document should be filed as evidence of on-going education. THIS IS AN EDUCATIONAL EXERCISE - PLEASE DO NOT RETURN RESULTS Answers Guide - Select one (1) answer option only, i.e. only one of the options given is correct. 1. With respect to anti-IH select the most appropriate response. a. This is a benign usually cold reacting antibody found in group A1, B and A1B individuals that has never been associated with a haemolytic transfusion reaction b. This is an antibody found in individuals with the Bombay and para-Bombay phenotype that is responsible with severe haemolytic transfusion reactions c. This is a benign usually cold reacting antibody found in group A1, B and A1B individuals that has been reported to cause a severe haemolytic transfusion reaction d. This is a benign usually cold reacting antibody found in group O individuals that has been reported to cause a severe haemolytic transfusion reaction 2. In the investigation of Delayed Haemolytic Transfusion Reaction, crossmatching the post-transfusion patient’s plasma against the original donor units may be helpful in establishing the diagnosis. a. False b. True 3. Insert the appropriate A subgroup against the following reactions. A1 A2 A3 Ax Ael 1 2 3 4 5 Anti-A ++++ 0 ++(+) mf ++++ 0/+ Anti-A,B ++++ 0 ++(+) mf ++++ ++(+) Anti-A1 ++++ 0 0 0 0 Anti-H 0 ++++ ++++ ++++ ++++ Substance in Saliva A,H H A,H A,H H Anti-A1in serum No Sometimes Sometimes Sometimes Often Subgroup Reproduced from Storry, J.R. et al, 2009, ‘The ABO blood group system revisited: a review and update’, Immunohaematology, vol 25, pp 48-59 4. Patients with common type 1,2 or 3 weak D phenotype usually do not make anti-D and can safely receive D+ blood. a. True b. False © - RCPA QAP P/L ABN: 32 003 520 072 PO Box 2074 Kelvin Grove Qld 4059 Australia Ph: (+61 7 3129 8450) Fax: (+61 7 3838 9413) Chair: Dr B Williams Program Manager: N Herrmann Page 1 ABN 32 003 520 072 Transfusion 5. Patients with DVI positive RBCs do not produce anti-D following transfusion of D positive blood. a. True b. False 6. In pregnancy, women with DVI positive RBCs must be given RhD-Ig prophylaxis to avoid Haemolytic Disease of the Foetus and Newborn. a. True b. False 7. In an A Positive (R2r) patient, identify the most likely clinically significant antibody(s) present from the reactions in the table: Antigen R1R1 R1wR1 R2R2 R2R2 R0r r1r r’’r rr rr rr rr Auto 8. D C E c e Cw K k Kpa Fya Fyb Jka Jkb M N S s P1 Lea Leb Lua Cob + + + + + 0 0 0 0 0 0 + + 0 0 0 + 0 0 0 0 0 0 0 + + 0 0 + 0 0 0 0 0 0 + + + + + + + + + + + 0 0 + + + + + + + 0 + 0 0 0 0 0 0 0 0 0 0 0 0 + 0 0 0 + 0 0 0 + + + + + + + + + + + 0 0 0 0 0 0 0 0 + 0 0 0 + + 0 + + + + + + 0 + 0 0 + + + + 0 + 0 + + + 0 + + + + + + + 0 0 + + 0 0 + 0 + + 0 + + + + + + 0 + + + 0 + 0 + + 0 0 + + 0 + + + + 0 0 + + 0 + + 0 0 0 + + + + + + 0 + + + + 0 + + + + + + + + 0 + 0 + 0 + 0 + 0 0 0 + + + 0 + 0 + 0 + + 0 0 0 0 0 0 0 0 0 0 + 0 0 0 0 0 0 + + 0 0 0 0 0 0 Reaction 0 2+ 2+ 2+ 1+ 2+ 1+ 3+ 1+ 2+ 0 0 The following diagram represents Immunoglobulin G (IgG). b a c Match a, b, and c to the appropriate domain name: 1. Variable light chain region (VL) ....................... 2. Constant light chain region (CL) ...................... 3. Variable heavy chain region (VH) .................... © - RCPA QAP P/L ABN: 32 003 520 072 PO Box 2074 Kelvin Grove Qld 4059 Australia Ph: (+61 7 3129 8450) Fax: (+61 7 3838 9413) Chair: Dr B Williams Program Manager: N Herrmann Page 2 ABN 32 003 520 072 Transfusion 9. In a patient with a history of transfusion in the past 3 months, a sample collected for crossmatch will be valid for? a. 7 days b. 72 hours c. 1 month 10. At 28 weeks pregnancy, all Rh negative women must have RhD-Ig. Select the most appropriate response: a. A blood sample is taken prior to the injection of RhD-Ig and tested for red cell antibodies b. A blood sample is taken after the injection and tested for red cell antibodies and to confirm the presence of anti-D c. No further testing is required ANSWER TABLE AND ASSESSMENT Question Your Answer Correct Answer Your Score Allocated Score 1 1 2 1 3.1 1 3.2 1 3.3 1 3.4 1 3.5 1 4 1 5 1 6 1 7 1 8.1 1 8.2 1 8.3 1 9 1 10 1 Total Score 10 © - RCPA QAP P/L ABN: 32 003 520 072 PO Box 2074 Kelvin Grove Qld 4059 Australia Ph: (+61 7 3129 8450) Fax: (+61 7 3838 9413) Chair: Dr B Williams Program Manager: N Herrmann Page 3
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