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SBB PRACTICE SCRIPT UPDATED 2026
TESTED SOLUTIONS
⫸ KEL3 Issues Answer: KPa in cis position may have suppressive effect on other Kell system antigens ⫸ Adsorption applications in RBC testing Answer: Remove autoantibody Separate multiple antibodies Confirm antigen or antibody specificity ⫸ Antilymphocyte Globulin (ALG) Answer: Made from horse serum Interferes with DAT and IAT Relation to Lu(a-b-) ⫸ PCR and TMA Answer: PCR used for DNA amp TMA used for RNA amp ⫸ Autologous donor qualifications Answer: DR's order Hgb >11, HCT 33% Collected >72 hrs before surgery or Tx
Deferred if risk of bacteremia ⫸ Plateletpheresis count info Answer: >150,000 min pre procedure plt count not required for infrequent donors post-procedure plt count may be used to qualify donor for next procedure ⫸ Two units RBC apheresis post donation H/H Answer: Donor HCT not <30% or Hgb <10 g/dL after volume replacement following donation ⫸ Anticoagulants and purpose of Answer: Dextrose: Supports ATP generation Adenine: Provides substrate for ATP synthesis Sodium biphosphate: Controls pH or is buffer Citrate: prevents clotting and coagulation ⫸ Changes in bag upon storage Answer: decreases in: pH 2,3-DPG ATP
Cryo ⫸ Components for replacing deficient coag factors Answer: FFP Cryo ⫸ Components for fighting infections Answer: WBCs ⫸ Use for cryo-poor plasma Answer: treat TTP patients ⫸ PLTs purpose and contraindication Answer: Improve hemostasis do not give for TTP or ITP unless absolutely necessary ⫸ Fathers genotype is BO, mom's is OO. Prob to have 3 OO kids? Answer: 0.5x0.5x0.5 =. ⫸ Calcium's involvement in coag cascade Answer: involved at: 12a and 11 reaction to 11a 11a and 9 reaction to 9a 9a's and 8a's reaction on 10 to 10a 10a's and 5a's reaction on prothrombin to thrombin ⫸ Coag factor enzymes Answer: Factor 2a Factor 7a
Factor 9a Factor 10a Protein C TPA Plasmin ⫸ Coag Factor Cofactors Answer: Tissue Factor Factor 5 Factor 8 Protein S ⫸ Coag Factor Miscellaneous Answer: Fibrinogen Factor 13 Alpha-2 antiplasmin PAI- 1 Antithrombin ⫸ Vit K dependent factors Answer: 2 7 9 10 Protein C Protein S
⫸ Factor XI Answer: Deficiencies cause bleeding, especially after surgery ⫸ Fibrinolysis key proteins Answer: Plasminogen Plasmin Tissue Plasminogen Activator (tPA) ⫸ Fibrinolysis inhibitors Answer: Plasminogen Activator Inhibitor (PAI-1) Alpha-2 antiplasmin ⫸ Fibrinolytic pathway Answer: Plasminogen acted on by tPA they then act on Plasmin Antiplasmin can inhibit plasmin PAI-1 can inhibit tPA ⫸ Natural anticoagulants and what they act on Answer: Tissue Factor Protein Inhibitor: TF and VIIa Antithrombin: IX and VIII X and V II Protein C and Protein S:
IX and VIII X and V ⫸ Platelet lifespan and circulating properties Answer: Lifespan is 7- 10 days PLTS circulate freely or are sequestered in spleen 1/3rd of PLTs located in spleen ⫸ PLT adhesion uses Answer: GP Ib - glycoprotein receptor) to bind vWF to bind it to collagen ⫸ Platelet Structure/Storage Answer: GP Ib attaches to vWF to allow adhesion Once platelets bind to each other via GP IIb/IIIA then dense and alpha granules released ⫸ Activated platelets release Answer: ADP Factor V ⫸ PLT aggregation occurs via Answer: GP IIb/IIIa and fibrinogen ⫸ PT Answer: Prothrombin Time Plasma + calcium + Tissue thromboplastin
Plasma Exchange ⫸ Glanzmann thrombasthenia basic issue and diagnosis Answer: Gp IIb/IIIa abnormal Aggregation test abnormal with epi, collagen, ADP but normal with ristocetin ⫸ Bernard-Soulier Syndrom basic issue and diagnosis Answer: GP Ib abnormal Aggregation test normal with epi, collagen, ADP but abnormal with ristocetin ⫸ Treatment for Anti-HPA-1a or Anti-HLA plt issue Answer: Treat PLTs with chloroquine diphosphate denatures HLA (Bg) antigens ⫸ Aspirin effect process Answer: Inhibits PLT function by acetylation of PLT cyclo-oxygenase Leads to decreased Thromboxane-A2 formation PLTs can adhere to collagen and release granules, but cannot aggregate Can be used in pool but not sole source of unit ⫸ vWD treatment Answer: Type 1 treated with DDAVP All others treated with F8 that contains vWF Humate-P
⫸ PT Normal and APTT Normal Answer: F13 deficiency ⫸ PT Abnormal and PTT Normal Answer: Factor 7 deficiency ⫸ PT Normal and PTT abnormal Answer: Factor 8, 9, 11, 12 deficiency or Factor 8 inhibitor ⫸ PT Abnormal and PTT abnormal Answer: Factor 1, 2, 5, 10 deficiency (common pathway) ⫸ Hemphilia levels and treatment Answer: <1% is severe for F8 levels 1 - 5% is moderate condition >5% is mild condition Treat with F8 concentrates Recombinant is safest Virus inactivated, plasma derived ⫸ Inhibitors to F8 Answer: Bethesda units <5 BUs then give increased dose of F >5 BUs then give F7a Activated Prothrombin Complex Concentrates (FEIBA) or
Hypothermia Hyperkalemia ⫸ Non-immune hemolysis indication Answer: see hemoglobinemia but negative DAT ⫸ Most common causes of Delayed HTRs Answer: Kidd Kell Duffy E c D ⫸ Bilirubin in infant/fetus Answer: Infant liver is immature at birth cannot conjugate amount of bilirubin that results from destruction of Ab- coated RBCs Unconjugated bili is toxic to CNS causes kernicterus ⫸ HDFN big problems for newborns Answer: Excess unconjugated bilirubin kernicterus ⫸ HDFN big problems for fetus Answer: Severe anemia
Cardiac failure and generalized edema Hydrops fetalis ⫸ HDFN prenantal testing options Answer: Amniocentesis (Liley graph) PUBS (Cordocentesis) Intrauterine transfusion (exchange) ⫸ Fy(a+b-), Kpa+ Answer: White FyaFya homozygous genotype ⫸ Fy(a+b-), Jsa+ Answer: Black FyaFy heterozygous genotype ⫸ WB Donor PLT Count of 220K, donates 500 mL WB. PLT Conc is 8.5x10^10. What is PLT Yield Answer: 220000x1000x500 = 1.1x10^ 0.85x10^11/1.1x10^11 or 0.85/1.1 = 77% yield ⫸ Structure of i antigen Answer: GlcNAC + Gal + GlcNAC + Gal Type II unbranched chain
- poorly developed on cord cells
- gradually acquired during first 18 months of age I^F
- fetal origin of I antigen, fundamental to all human red cells I^T
- unusual antigen expression
- Lots on cords >>>Adult cells>>>i adult cells ⫸ H deficient phenotypes Answer: All have increased expression of Ii antigens Oh partially deficient non-secretor has hh, sese genes, ABO genes Trace H on RBCs Nothing in saliva ⫸ Anti-B lectin Answer: Bandeiraea simplicifolia ⫸ A subgroups with A and H in secretions Answer: A Aint A Am ⫸ A subgroups with H only in secretions Answer: Ax
Ael Aend Abantu Afinn ⫸ B Subgroups with B and H in secretions Answer: Bx Bm B3 has only H in secretions (differs from A3) ⫸ A subgroups weakly pos with Anti-A and why Answer: A Mixed Field Aend <10% mf Ax weak with anti-a,b ⫸ A subgroups negative with Anti-A Answer: Am Secretes A and H Aend Secretes weak A and H Ael Secretes H only All the above adsorb and elute anti-A
Gal GlcNAc Gal Gal ⫸ Pk structure Answer: Cer Glu Gal Gal ⫸ P structure Answer: Cer Glu Gal Gal GalNAc ⫸ Pk individual antibodies Answer: naturally occuring Anti-P in serum reacting equally with P1K and P2K people ⫸ RhD neg in african americans Answer: Inactivating mutations of RHD and see RHDpsi Hybrid RHD-CE-D in africans, portions of RHCE into RHD
⫸ Rh Glycoprotein RhAG note Answer: Absent in Rhnull, U- red cells ⫸ Partial D's most common in European ancestry Answer: DNB DVI DVII With DVI anti-D reagents are designed to be neg at IS and pos at IAT for it ⫸ Partial D's most common for African American Answer: DIIIa DIVa Type as RhD pos at IS ⫸ DIIIa's low prevalence antigen Answer: DAK ⫸ DIVa's low prev antigen Answer: Go^a ⫸ DVa's low prev antigen Answer: D^w ⫸ DVI's low prev antigen Answer: BARC ⫸ DVII's low prev antigen Answer: Tar
