Term
| What is the MOST Important test to diagnose AIHA, especially when the patient will sometimes have no symptoms or clinical features? |
|
Definition
|
|
Term
| What can AutoABYs to RBC AGNs be responsible for? |
|
Definition
Decreased RBC survival
Interference with BB Testing |
|
|
Term
|
Definition
| Failure of suppressor T lymphs and non-self-discrimination |
|
|
Term
True or False:
Healthy ppl sometimes have a + DAT |
|
Definition
|
|
Term
| 1 in 1000 donors may have a positive DAT, what is this MOST likely due to? |
|
Definition
|
|
Term
True or False:
There are instances of IHA where the DAT is = |
|
Definition
|
|
Term
True or False:
There are instances of + DAT with NO shortened life span of cells |
|
Definition
|
|
Term
| What % of AIHA are WAIHA? |
|
Definition
|
|
Term
| What % of AIHA are Cold aggultinin Syndrome? |
|
Definition
|
|
Term
| What % of AIHA are Drug reactions? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Is PCH more common in adults or children? |
|
Definition
|
|
Term
| What are the Clinical Presentations of AIHA? |
|
Definition
Anemia
Mild Jaundice
Splenomegaly |
|
|
Term
| In Chronic Cold AIHA what Clinical Presentation can be present? |
|
Definition
|
|
Term
| Other than +DAT, what other tests are characteristic of AIHA? |
|
Definition
Increased Retic
Polychromasia
Increased Unconjugated Bilirubin
Decreased Haptoglobin |
|
|
Term
| If ______ hemolysis occurs, tests associated with hemolysis will be abnormal including Decreased Haptoglobin, Free Hemoglobin, Hemoglobinuria |
|
Definition
|
|
Term
| For AIHA, what type or types of AHG should be used? |
|
Definition
| Polyspecific & Monospecific AHG |
|
|
Term
| What is the treatment associated with AIHA? |
|
Definition
| Prednisone, other immunosuppressive drugs, or sometimes splenectomy for WAIHA |
|
|
Term
| Cold Autoantibodies can be idiopathic, but often come after what illness/diseases? |
|
Definition
Mycoplasma
Infectious Mono |
|
|
Term
| What is the thermal range for CAS (Cold agglutinin syndrome)? |
|
Definition
|
|
Term
True or False:
In the case of CAS, the extremities can get cold enough to bind C' and cause cell lysis |
|
Definition
|
|
Term
What is the following characteristic of:
Thermal range lower than CAS & usually lower titer |
|
Definition
| Harmless Cold autoantibodies which do NOT cause destruction of RBCs |
|
|
Term
| Generally Pathologic Colds cause _______ hemolysis |
|
Definition
|
|
Term
| Cold Autoantibodies are usually positive for what? |
|
Definition
|
|
Term
True or False:
The likelihood of getting a cold autoantibody increases as you age |
|
Definition
|
|
Term
| Is a Cold Autoantibody / Cold AIHA IgG or IgM? |
|
Definition
|
|
Term
Are the following consistent with cold or warm AGNs/ABYs:
P, M, N, Le^a, Le^b |
|
Definition
|
|
Term
Are the following consistent with cold or warm AGNs/ABYs:
P, M, N, Le^a, Le^b |
|
Definition
|
|
Term
True or False:
CAS / Cold AIHA - RBCs may spontaneously aggregate causing problems in ABO and Rh typing |
|
Definition
|
|
Term
| At what temperature can you keep and test blood samples if a Cold autoantibody is suspected? |
|
Definition
|
|
Term
| What can you add to a cold autoantibody suspected sample to abolish colds and allow accurate forward typing? |
|
Definition
|
|
Term
What are the following considered as:
Dithiothreitol
2-Mercaptoethanol |
|
Definition
|
|
Term
| The serum of cold autoantibody patients often contains what that can interfere with IAT and reverse typing, and can mast significant ABYs? |
|
Definition
|
|
Term
| What AHG is BEST to use to prevent insignificant colds from interfering with IAT? |
|
Definition
|
|
Term
| What is the BEST method to use if the patient has no previous transfusions for Absorption studies? |
|
Definition
|
|
Term
| Other than Auto, what other Absorption studies can you use? |
|
Definition
|
|
Term
True or False:
Generally you do NOT perform eluate with suspected cold autoantibody because C3d is on the cells, so there will not be an antibody to be identified |
|
Definition
|
|
Term
True or False:
C3d is NOT an ABY |
|
Definition
|
|
Term
True or False:
C3 on the cells will NOT react with ANY panel cells |
|
Definition
|
|
Term
| CAS/ Cold Autoantibody - What kind of tube must you use for DAT so that harmless cold antibodies do NOT bind in vitro? |
|
Definition
|
|
Term
Identify the following:
Specific type of cold autoantibody associated with transient infection and often called Donath-Landsteiner Hemolytic Anemia |
|
Definition
| Paroxysmal Cold Hemoglobinuria (PCH) |
|
|
Term
True or False:
PCH is an ABY that is IgG having biphasic hemolysis with anti-P specificity |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What specificity does PCH have? |
|
Definition
|
|
Term
Name the following test:
ABY binds to RBCs at low temperatures and then causes hemolysis via activation of C' as the blood is warmed to 37 degrees Celsius |
|
Definition
|
|
Term
True or False:
PNH is NOT an Auto ABY |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Are Warm Autoantibodies IgG or IgM? |
|
Definition
|
|
Term
| Will Warm Autoantibodies react at 37 degrees Celsius? |
|
Definition
|
|
Term
| Though Warm Autoantibodies can be idiopathic, they can also be secondary to what? |
|
Definition
|
|
Term
| Warm Autoantibodies - DAT will be + with what type of AHG? |
|
Definition
|
|
Term
True or False:
WAIHA - DAT is + with polyspecific AHG but caoting can be IgG OR C3d |
|
Definition
|
|
Term
True or False:
WAIHA - Can cause + Rh control if using High Protein Anti-D Reagent |
|
Definition
|
|
Term
| What type of Anti-D reagent should you use with WAIHA? |
|
Definition
|
|
Term
| Usually using low protein Anti-D reagent will give accurate results, but you may need to add what to dissociate AGN/ABY Complex from RBCs? |
|
Definition
|
|
Term
True or False:
WAIHA - If IAT is +, MUST determine if just autoantibody or if also underlying alloantibody |
|
Definition
|
|
Term
| Where will Autoantibodies be found? |
|
Definition
|
|
Term
True or False:
If serum demonstrates consistent and strong reactivity with ALL reagent RBCs at AHG, must then determine if it is alloABY, AutoABY, or Both |
|
Definition
|
|
Term
| WAIHA - when determining allo or auto, you first remove ABY from cells with what? |
|
Definition
|
|
Term
| Sometimes WAIHA has specificity to Rh system including ___________, and sometimes reacts with ALL panel cells |
|
Definition
|
|
Term
True or False:
Transfusion often make the hemolysis WORSE with WAIHA, so avoid if at all possible |
|
Definition
|
|
Term
True or False:
When patient has been recently transfused autoadsorptions are dangerous as donor cells in circulation could adsorb out alloantibodies as well as autoantibodies |
|
Definition
|
|
Term
| For warm autoABYs, it is often necessary to remove some of autoantibodies with _____ before the autoantibody can take up more ABY from the serum |
|
Definition
|
|
Term
Given the Test, Compare CAA & WAA:
DAT - Poly |
|
Definition
Cold Hemagglutinin : +
Warm AIHA : + |
|
|
Term
Given the Test, Compare CAA & WAA:
DAT - IgG |
|
Definition
Cold Hemagglutinin : =
Warm AIHA : + |
|
|
Term
Given the Test, Compare CAA & WAA:
DAT - C3d |
|
Definition
Cold Hemagglutinin : +
Warm AIHA : Usually =, but can be + |
|
|
Term
Given the Test, Compare CAA & WAA:
Eluate and Normal Panel |
|
Definition
Cold Hemagglutinin : =
Warm AIHA : + (Rh or nonspecific) |
|
|
Term
Given the Test, Compare CAA & WAA:
Autoadsorption |
|
Definition
Cold Hemagglutinin : 4 degrees
Warm AIHA : 37 degrees Celsius |
|
|
Term
| How do you detect Drug Mediated Destruction of RBCs? |
|
Definition
+ Auto control @ AHG
+ Diagnostic DAT |
|
|
Term
| What may Drug Induced ABYs result in? |
|
Definition
Decreased Cell Survival
Complicate Pretransfusion Testing |
|
|
Term
True or False:
Discontinuing the drug NEVER resolves the serologic problems |
|
Definition
|
|
Term
True or False:
Discontinuing the drug Usually resolves the serologic problem |
|
Definition
|
|
Term
| What are the 4 mechanisms of Drug Mediated Destruction of RBCs? |
|
Definition
Drug absorption
Immune complex "Innocent bystander"
Membrane modification
Drug induced AIHA - autoantibody formation |
|
|
Term
| What will Drug absorption often have that is positive? |
|
Definition
|
|
Term
| What will Drug absorption rarely have? |
|
Definition
|
|
Term
| Drug absorption - What does DAT indicate? |
|
Definition
| IgG on cells Sometimes C3 & IgG |
|
|
Term
| Drug absorption - Elution is ______ with normal cells |
|
Definition
|
|
Term
| Penicillin-sensitized RBCs must be prepared ______ and then tested with the eluate in order to demonstrate reactivity |
|
Definition
|
|
Term
| With Immune complex "Innocent bystander" what initiates C' activation? |
|
Definition
| Drug + ABY form circulating immune complexes which attach loosely to cell membranes |
|
|
Term
True or False:
Immune complex "Innocent bystander" - RBCs which are NOT hemolyzed, have a + DAT with C3d |
|
Definition
|
|
Term
| What is an example of Immune complex "Innocent bystander"? |
|
Definition
|
|
Term
| Immune complex "Innocent bystander" - How are eluates? |
|
Definition
|
|
Term
| Membrane Modification - Wwhat can modify the RBC membrane, allowing cells to adsorb protein such as IgG giving a positive DAT |
|
Definition
|
|
Term
True or False:
Drug induced AIHA - + DAT & Immune hemolysis are indistinguishable from WAIHA except that drug reactions rarely cause anemia where WAIHA does cause |
|
Definition
|
|
Term
| What do drug reactions rarely cause that WAIHA does cause? |
|
Definition
|
|
Term
| What percent of people taking Aldomet or Procainamide will get Positive DAT & 1% Hemolysis |
|
Definition
|
|
Term
| What do drugs interfere with that leads to an elaboration of autoantibodies by B cells? |
|
Definition
| Suppressor T cell function |
|
|
Term
| Drugs interfere with Suppressor T cell function leading to an elaboration of autoantibodies by what type of cells? |
|
Definition
|
|
Term
| With Drug induced AIHA - the DAT usually reacts only with what? |
|
Definition
|
|
Term
| With Drug Induced AIHA Eluate is what with normal cells? |
|
Definition
|
|
