Study cards
Blood Banking
24 cards from 4 lessons in Blood Banking, each linking to the passage it came from.
Turn the cards
Click the card to turn it. Then → Got it or ← Not yet. A card marked Not yet comes back before the round ends.
Every card turned
All cards
Erythrocyte Physiology and the Storage Lesion
What happens to supernatant potassium during refrigerated red-cell storage?
It increases as potassium leaves the red cells.
Cold slows the pumps that keep potassium inside red cells. The rise matters most when a large volume is transfused rapidly or to a small recipient such as a neonate.
Why does pH fall in a conventionally stored red-cell component?
Continued glycolysis produces lactate and hydrogen ions that accumulate in the closed container.
Refrigeration slows metabolism, and the falling pH then slows glycolysis further.
How can ATP change during refrigerated red-cell storage?
ATP may rise early and then decline during prolonged storage.
An early ATP value above baseline is an expected storage change and does not point to a faulty unit.
How does loss of 2,3-BPG during storage affect hemoglobin oxygen affinity?
Affinity increases and the oxygen dissociation curve shifts left.
Normally, 2,3-BPG favors oxygen release. Its depletion temporarily reduces oxygen unloading at a given oxygen tension.
Which pathway supplies nearly all ATP in a mature red cell?
Embden-Meyerhof glycolysis.
Mature red cells have no mitochondria. The ATP from glycolysis runs the membrane pumps and keeps the cell deformable.
What does the pentose phosphate pathway provide for red-cell antioxidant defense?
NADPH.
NADPH helps maintain reduced glutathione, protecting hemoglobin and membrane proteins from oxidative injury.
Hemolytic Disease of the Fetus and Newborn
Which antibody class crosses the placenta and can cause hemolytic disease of the fetus and newborn (HDFN)?
IgG.
Maternal IgG can reach fetal circulation and bind a corresponding antigen on fetal red cells. Antibody presence alone does not define disease severity.
Read the passage: Maternal antibody transfer to the fetal circulation
Why can unconjugated bilirubin rise after delivery in a newborn with ongoing hemolysis?
Placental bilirubin clearance stops while the newborn's conjugating capacity is limited.
Before birth, the maternal liver clears bilirubin that crosses the placenta. After delivery, bilirubin can climb while maternal IgG keeps destroying red cells.
Read the passage: Maternal antibody transfer to the fetal circulation
How can anti-K cause fetal anemia in addition to destroying circulating red cells?
It can suppress erythropoiesis by targeting erythroid precursors.
Kell antigens are expressed on precursors. Titer and bilirubin findings can therefore underestimate the severity of anemia.
What does an anti-IgG DAT demonstrate on neonatal red cells?
Detectable IgG coating of the tested red cells.
DAT reactivity does not prove hemolysis or measure its severity. Hemolysis is shown by a falling hemoglobin and a rising bilirubin.
Pretransfusion Testing: ABO, Antibody Investigation, and Compatibility
What cells and reagents are used in ABO forward grouping?
Recipient red cells are tested with anti-A and anti-B.
The reactions detect A and B antigens on the recipient cells. Reverse grouping supplies a separate plasma check.
What is tested in ABO reverse grouping?
Recipient serum or plasma is tested against A₁ and B reagent red cells.
This detects expected ABO antibodies. The forward and reverse results must agree before a routine adult ABO assignment.
What is the expected forward and reverse pattern for an adult with group A blood?
Anti-A positive; anti-B negative; A₁ cells negative; B cells positive.
The recipient cells express A antigen, and the plasma contains expected anti-B. Reaction strength varies with the testing system.
Which ABO group is used for unexpected-antibody screening cells, and why?
Group O cells, to avoid reactions with the recipient's expected anti-A or anti-B.
The reagent cells have known antigen profiles for detecting non-ABO antibodies with the selected method.
What does a nonreactive antibody screen establish?
No antibody was detected against the screening cells under those test conditions.
An antibody can be below the detection limit or target an antigen absent from the cells. Check the patient's antibody history as well.
How does a historical, clinically significant anti-K affect red-cell selection when the current screen is negative?
Select K-negative units and complete the applicable serologic crossmatch.
An antibody can fall below detection while memory B cells remain. Antigen-positive red cells can then bring it back and cause a delayed hemolytic reaction.
What does a reactive antibody panel with a nonreactive autocontrol favor?
An alloantibody.
Compare each panel cell's antigens with its reactions and complete the exclusions before naming the specificity or selecting units.
Which samples are paired in a serologic red-cell crossmatch?
Recipient serum or plasma and cells from the selected donor red-cell unit.
This checks compatibility with that unit. A current or historical clinically significant antibody requires testing through the antiglobulin phase.
What antibody findings permit consideration of an electronic crossmatch?
A nonreactive current screen and no clinically significant antibody history.
The computer system must also hold two matching ABO and D types for the recipient, from a prior record or a second specimen, and check the donor unit data. The antibody findings alone do not allow issue.
Transfusion Indications and Component Therapy
Which side of ABO compatibility matters when selecting plasma?
Donor plasma antibodies must be compatible with the recipient's red-cell antigens.
Anti-A or anti-B in donor plasma can react with recipient cells, so plasma compatibility runs opposite to red cells, and group AB plasma suits a recipient of any ABO group.
Which four hemostatic proteins are concentrated in cryoprecipitate?
Fibrinogen, factor VIII, factor XIII, and von Willebrand factor.
Its fibrinogen content makes it the usual component for fibrinogen replacement. It lacks the vitamin K-dependent factors, so plasma replaces a multiple-factor deficiency.
What does leukoreduction remove from a cellular blood component?
Donor leukocytes.
It reduces the risk of recurrent febrile nonhemolytic reactions, HLA alloimmunization, and cytomegalovirus (CMV) transmission. Preventing transfusion-associated graft-versus-host disease requires irradiation.
How does irradiation prevent transfusion-associated graft-versus-host disease?
It prevents viable donor T lymphocytes from proliferating.
Leukoreduction leaves viable T lymphocytes, so it does not replace irradiation when irradiation is required.
What does washing primarily remove from red cells prepared for a patient with severe allergic reactions?
Residual plasma proteins.
Removing the plasma removes the proteins that can trigger the reaction. A washed component gets its own storage limit and a new expiration.
These cards are also free to download for Anki: see Anki decks.