My review ASCP

Question Answer
HDN (erythroblastosis fetalis ) Mother Rh-ve and fetus is Rh+ve,
Destruction of RBCs, anemia, hyperbiliruniemia in new born
Most frequent implicated in HDN ABO and Rh antibodies. MNS Kell Kidd and Duffy can cause also HDN.
Severe HDN Anti D, anti CD and anti CE
Moderate HDN Anti c, anti E and anti k
ABO HDN Weak positive DAT, anemia absent or very mild, increased spherocytes after 24 or 48 hour after delivery and reticulocytes, mild jaundice and often in A1 or B infants to mother group O
Rh HDN Anemia is present , positive DAT, increased reticulocytes and Jaundice appear in 24 hours and bilirubin levels are greatly increased
DTT Eliminate agglutinating IgM so IgG can be titered.
Qualitative test, rosetting test Distinguishing Rh pos fetal RBCs and Rh neg maternal RBCs in fetomaternal bleeds
Quantitative tests, Kleihauer-Betke stain Distinguish Hgb F fetal RBCs from Hgb A in adult cells. Alcohol smear, acid to eliminate Hgb A, HgbF cells will be stained and Hgb A appear as ghost cells
Exchange transfusion Decrease bilirubin , correct anemia, remove infant sensitized RBCs and decrease concentration of incompatible AB
For Rh Ig DAT on cord blood must be negative
RhIG Number of fetal cells/1000 adult cells * 5000 or mL fetal whole blood/30 = numbers of vitals to give (dose 300ug) one vital is of RhIG is given if no fetal cells are detected.
PCH cold agglutinin diaease Auto-Anti P (Donath Landsteiner antibody)
DAT +ve because of C3d on RBCs
Aseptic technique Providing iodine scrub
2 units of RBCs Deferral is 16 weeks and must now decrease the donor hematocrit below 30% or Hgb lower than 10 g/dL
Therapeutic aphersis Removal of blood components or removal of blood substances such as protein or immune complexes
Acute normovolemic hemodilution One or more units removed from donor and replaced with crystalloid or colloid just prior to surgery. During anesthesia, stored at RT for 8 hr or 1-6°C up to 24 hours. Autologous use only.
NAT (nucliec acid amplification testing) On HIV-1 and HCV (RNA?)
Dose of RhIG Fetal cells/mother RBCs(1000s)*5000 then (that number) is divided by 30 to get the number of vitals
Bands appear at positive HIV At least: P24/gp41 and/or GP120/160
pH affect on anti-M Enhance reactivity of anti-M
AET treated cells Denatures Kell (K,k) antigen and prevents Kell antibodies during testing of antibodies
Autocontrol with ZZAP reagent treated cells Removes IgG antibodies from red cells. Will not remove IgM antibodies.

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