Question

History:

V is a 52-year old woman who just underwent surgery that resulted in the need to transfuse two units of red blood cells. V has three children and has reported to have been transfused twice in the past.

6.         Which of the following antibodies remain after completion of the antibody identification (completion of panel antigram)? (2 pts)

            A.        Anti-Js^a

            B.        Anti-Lu^b

            C.        Anti-e

            D.        Anti-Jk^b

7.         Given the patient history and all serology results, what is the best hypothesis of the antibody/ies identity(ies)?

            A.        Antibody to a low-incidence antigen

            B.        An HTLA alloantibody

            C.        An autoantibody

            D.        Antibody to a high-incidence antigen

8.         Which of the following tests would best help you in the resolution of this case?

            A.        An elution

            B.        A selected cell panel

            C.        An absorption

            D.        An extended crossmatch

9.         Which of the following antibodies below is the most probable culprit in this case?

            A.        Anti-k

            B.        Anti-e

            C.        Anti-Lu^b

            D.        Anti-M

10.       A physician would like to transfuse two units of red blood cells to this patient. Which of the following units should be selected for this patient?

            A.        A negative, k antigen negative units

            B.        O negative red blood cells

            C.        O positive, M antigen negative red blood cells

            D.        B positive, k antigen negative red blood cells

Forward Tv Anti-B Reverse IV Anti-A Anti-ABA1 cells B cells 0 4 4 Rh Typing Anti-D D control 4 Antibody Screen AC IS 37° C AHG Check cells NT NT, Nottested Screen Cell Antigran NSS Lutheran uffy Panel Antigram Lutheran NSS atient АНС

Answer 1

Answer 6 - (C)

Antibodies with anti-E specificity are detected in 14–20% of pregnant women and it is one of the most common non-D Rhesus (Rh) antibody in the pathogenesis of neonatal hemolytic disease . However, anti-E is rarely associated with severe hemolytic anemia in the fetus

Answer 7 - (A)

Antibody to low incidence antigen

Low-incidence antigens are antigens that occur in less than 1% of the population.Low-incidence antigens are not usually found on screen cell and antibody panels. ... Suspect this antibody if an AHG crossmatch is incompatible and other causes have been ruled out, such as a positive donor DAT or ABO incompatibility.

Answer 8 - (D)

Immediate Spin Crossmatch. ... This crossmatch really is designed for one thing only: Detecting ABO incompatibility between donor red blood cells and recipient serum/plasma. The electronic (“computer”) crossmatch is an acceptable alternative to this procedure.

Answer 9 - (B)

Anti-E can occur as a natural immunoglobulin M antibody without immune stimulation or an immunoglobulin G antibody in those with a history of a transfusion or prior pregnancy. Most often anti-E alloimmunization is associated with mild to moderate hemolytic disease of the fetus or newborn.