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SBB ACTUAL FINAL EXAM UPDATED
QUESTIONS & ANSWERS UPDATED A+
GRADED
Band 3 CORRECT ANSWER>>>> macrocomplex of proteins including:
- Rh
- RhAG
- LW (ICAM-4)
- GPA
- GPB
- CD ATP source for RBCs CORRECT ANSWER>>>> 90% from Glycolysis (Embden-Meyerhoff pathway) 10% from pentose phosphate pathway Methemoglobin Reductase Pathway CORRECT ANSWER>>>> necessary to maintain heme iron in ferrous (Fe2+) state Deficiency causes accumulation of methemoglobin, nonfunctional from of Hgb
Leubering Rapaport Shunt CORRECT ANSWER>>>> permits accumulation of 2,3-DPG "Tense form" of Hgb CORRECT ANSWER>>>> DEOXYGENATED widening of beta-chain lower affinity for O2 expels 2,3-DPG "Relaxed form" of Hgb CORRECT ANSWER>>>> OXYGENATED beta-chain pulled together higher affinity for O2 expels 2,3-DPG "Shift Right" CORRECT ANSWER>>>> higher P50 value decreased pH (increased H+ ion), acidosis increased 2,3-DPG higher temperature high pCO Seen in compensated anemia "Shift Left" CORRECT ANSWER>>>> lower P50 value increased pH (decresed H+ ion), alkalosis decreasede 2,3-DPG lower temeratures low pCO Seen in storage of RBC Type 2 precursor CORRECT ANSWER>>>> Gal-GlcNAc B1- 4 Type 1 precursor CORRECT ANSWER>>>> Gal-GlcNAc
Ael subgroup CORRECT ANSWER>>>> Negative anti-A Secretes H only Highest expression of H Lowest expression of H CORRECT ANSWER>>>> O>A2>B>A2B>A1>A1B> H deficient Lewis transferase & Sugar CORRECT ANSWER>>>> FUT- 3 Fuctose alpha1- 4 Type 1 H antigen transferase & sugar CORRECT ANSWER>>>> FUT- 2 Fuctose alpha1- 2 anti-Le bh vs anti-Le bl CORRECT ANSWER>>>> Anti-Le bh= reacts best with Leb & H are on rbc reacts best with group O and A2 does not react with A1 & B Anti-Le bl= reacts independently of amount of H on rbc best antisera to use when typing RBC autoanti-H, - HI is most common in... CORRECT ANSWER>>>> A1 patients, have the least amount of H
Elevated i antigen associated with... CORRECT ANSWER>>>> cord cells reticulocytes in megaloblastic anemia leukemia stressed erythropoiesis I gene CORRECT ANSWER>>>> IGnT adds GlcNAc to Gal starts branching/ multivalent anti-i associated with what disease CORRECT ANSWER>>>> infectious mono autoanti-i, - I commonly seen in patients with.... CORRECT ANSWER>>>> Mycoplasma pneumoniae infections Lymphoproliferative disorder (Waldenstrom macroglobinemia) P1K & P2K lack what gene/ antigen CORRECT ANSWER>>>> B3GalNAct missing P antigen (also Gb5 & LKE) p lack what gene/ antigen CORRECT ANSWER>>>> A4GALT missing P1/PX2 & Pk (also P, Gb5 &LKE) P1 substance derived from... CORRECT ANSWER>>>> Hydaited cyst Bird eggs liver fluke
Ch/Rg (E/DTT) CORRECT ANSWER>>>> Enzyme= destroys Gerbich (E/DTT) CORRECT ANSWER>>>> Enzyme decrease Ge2 &Ge Crom (E/DTT) CORRECT ANSWER>>>> DTT= Sesitive Knops (E/DTT) CORRECT ANSWER>>>> DTT= Sensitive Resistent to papain, sensitive to ficin Indian (E/DTT) CORRECT ANSWER>>>> Enzyme= sensitive DTT= sensitive JMH (E/DTT) CORRECT ANSWER>>>> Enzyme= sensitive DTT= sensitive Enzyme destroys CORRECT ANSWER>>>> MN Fya/Fyb Ge2, Ge Indian JMH Ch/Rg Yt- variable Ss-variable
Enzymes enhance CORRECT ANSWER>>>> Rh I P Kidd Lewis Dombrock (sesitive to trypsin) DTT Destroys CORRECT ANSWER>>>> Kell LW Cromer Knops Indian JHM Scianna Weakens= Yt, Lutheran, MER2, Dombrock *Destroys disulfide bonds Chloroquine Diphosphate Weakens CORRECT ANSWER>>>> Rh Dombrock Knops JMH
RHD pseudogene CORRECT ANSWER>>>> Rh Negative Gene present but inactive due to stop codon Partial D; DIII CORRECT ANSWER>>>> DAK (Rh54) Partial D; DIVa CORRECT ANSWER>>>> Goa (Rh30) Partial D; DIVb CORRECT ANSWER>>>> Evans (Rh37), also associated with D** (dot dot) Partial D; DV CORRECT ANSWER>>>> Dw (Rh23) Partial D; DVI CORRECT ANSWER>>>> BARC (Rh52) Partial D; DVII CORRECT ANSWER>>>> Tar (Rh40) anti-hrs reacts best with.... CORRECT ANSWER>>>> f+ cells anti-hrb reacts best with... CORRECT ANSWER>>>> Ce+ cells Strongest to weakesot expression of D CORRECT ANSWER>>>> D>R2R2>R1R2>R1R1>Ro
Elevated D CORRECT ANSWER>>>> Demonstrates no Cc/Ee forms anti-Rh17 (Hro, Solomon) absent antigens, Rh17, Rh18 (Hr), Rh34 (HrB) Rh null; amorph CORRECT ANSWER>>>> RHCE deletion can make anti-Rh29 associated with Stomatocytosis/Spherocytosis Absent Ag: Rh, Lw, Fy Reduced: RhAG, GPB, CD 47 Rh null; regulator CORRECT ANSWER>>>> RHAG gene altered (nucleotide changes in RHAG) can make anti-Rh29 associated with Stomatocytosis/Spherocytosis Absent Ag: Rh, Lw, RhAG, Fy Reduced Ag: CD47, GPB Rh null: Regulator vs Amorph CORRECT ANSWER>>>> Amorph: RHD deletion, reduced RhAG Regulator: RHAG altered, absent RhAG Rh mod CORRECT ANSWER>>>> decreased expression of Rh antigen no associated antibodies M antigen amino acid sequence CORRECT ANSWER>>>> Ser-Ser-Thr-Thr-Gly
Ko CORRECT ANSWER>>>> Kell null lack all Kell antigens make anti-Ku & - Km What antibodies to McLeod patients make CORRECT ANSWER>>>> anti-KL= anti-Km + anti- Kx anti-Fy3 vs anti-Fy5 CORRECT ANSWER>>>> anti-Fy3 will react with Rh null rbc anti-Fy5 wont react with Rh null rbc T Polyagglutinaiton CORRECT ANSWER>>>> acquired by infection/bacteria bacteria produce neuraminidase cleaves Nacetylneuraminic acid from rbc membrane negative autocontrol Th Polyagglutination CORRECT ANSWER>>>> acquired in septic patients neuraminidase weaker than Tn & T Tk Polyagglutination CORRECT ANSWER>>>> acquired in septic patients
bacteria produces endo/exo-B-galactosidase cleaves galactose residue from paragloboside once infection is cleared, polyagg disappears Tn Polyagglutination CORRECT ANSWER>>>> Mutation in hematopoietic tissue= inherited clone lacks B- 3 - D-galactosyltrasferase permanent autocontrol= mixed field anti-Tn is naturally occuring Cad/Sda CORRECT ANSWER>>>> Cad+ cells agglutinated by anti-Sda= looks like autoantibody Normal levels of Sialic acid Sda found in urine- urine neutralizes anti-Sda HEMPAS CORRECT ANSWER>>>> Congenital Dyserythropoietic Anemia Type II RBC have second membrane (internal) RBC have increased i, decreased H lysis by anti-I and anti-i
Polybrene with Polyagglutination CORRECT ANSWER>>>> Polybrene is a positively charged polymer Neutralizes negative charge on normal cells Positive= Normal cells Negative= Polyagglutination Vitamin K dependent Coag factors CORRECT ANSWER>>>> II (thrombin) VII IX X Protein C Protein S Frozen Red cells CORRECT ANSWER>>>> must be frozen within 6 days of collection If the unit has additive; freeze before expiration Rejuvenated RBC CORRECT ANSWER>>>> Restore 2,3-DPG and ATP above normal levels contains inosine, phosphate & adenine wash and transfuse within 24 hours or freeze (cannot use AS-3/AS-5)
Deglycerolized RBC CORRECT ANSWER>>>> Deglyc with solution of decreasing osmolarity to avoid hemolysis Mean RBC recover >80% hemolysis <3% Refraction value < Osmolality <400 mOsm/kg H2O RBC Leukocyte reduced CORRECT ANSWER>>>> must reatain 85% of original rbc <5x10^6 leukocytes/unit Low Volume RBC CORRECT ANSWER>>>> 450 ml bag= 300-404 ml 500 ml bag= 333-449 ml Apheresis RBC CORRECT ANSWER>>>> mean Hgb >60g per unit (180 ml) 95% of tested, Hgb >50 (150 ml) Aperesis RBC Leukocyte Reduced CORRECT ANSWER>>>> Mean Hgb >51 g per unit (153 ml) 95% of tested:
42.5 g per unit (128 ml)
- < 5x10^6 leukocytes FFP CORRECT ANSWER>>>> frozen within 8 hours of collection expires 24 hours after thaw (can be transformed to thawed plasma)
contains: fibrinogen, vWF, FVIII, FXIII & fibronectin min. requirements: 150 mg Fibrinogen, 80 IU FVIII Plasma cryo reduced CORRECT ANSWER>>>> Plasma with cryo removed, frozen within 24 of thawing reduced: FVIII, vWF, fibrinogen, FXIII normal FV & ~200 mg fibrinogen primary use: plasma exchange in pt. with TTP Recovered Plasma CORRECT ANSWER>>>> aka plasma for manufacture donation originally intended for transfusion used for fractionation into derivatives (ie albumin) Infrequent plasma donation CORRECT ANSWER>>>> Source plasma= plasma for further manufacturing derivatives Donation interval= 2 days aka serial plasmapheresis
Source Plasma CORRECT ANSWER>>>> plasma collected by plasmapheresis and intended as source material for further manufacturing derivatives (ie albumin, clotting factors, ect) Platelet unit CORRECT ANSWER>>>> resuspended in 40-70ml of plasma 90% of tested:
5.5 x 10^10 platelets/unit
6.2 ph at end of storage Platelet leukocyte reduced CORRECT ANSWER>>>> same prep at unfiltered PLT ( ml of plasma) 75% tested: >5.5 x 10^10 PLT/unit
90% tested: >6.2 ph at end of storage 95% tested: <8.3x 10^5 leukocytes Plasma dose CORRECT ANSWER>>>> 10 - 20 ml/kg Apheresis PLT CORRECT ANSWER>>>> Therapeutic dose collected from single donor 200 - 300 ml/unit
