Blood Bank and Haematology Collide Quiz

Answer: Anti-B antibodies

Anti-B antibodies will be present in the person. This is usually after six months of age. They are referred to as "naturally occurring" as if they arise spontaneously but are thought to be a cross-reactivity of the antibodies for capsular antigens of bacteria in the gut with the ABO blood group antigens.

The ABO antibodies are always against the antigen the red cells do not express. That means that group A people have anti B, group B have anti-A, group O have anti-A and anti-B and group AB have no antibodies. For the purists, group O individuals have a combined anti-A/B as well as anti-A and anti-B. Group AB individuals may well have antibodies to sub-groups of A antigens. Let me get to that in another quiz.

Answer: Iron deficiency anaemia

Iron deficiency anaemia is usually treated by iron supplements or a dietary change unless the anaemia is life threatening or the patient is aged. Homozygous beta-thalassemia and sickle cell disease are treated routinely with transfusion to prevent further complications as well as management of the continuing disease.

Answer: Autologous

Autologous donations are those for the recipient from their own blood. Autologous donations are usually taken twice in the month preceding the operation, giving the patient at least a fortnight to recover their blood volume prior to the procedure.

Answer: Homologous

Homologous transfusion or transplant is from a donor of the same species but not the same individual.

Answer: Normal serum albumin

Normal serum albumin (called NSA) is pooled from the serum of multiple blood donations.

Answer: Human T-cell lymphotropic virus type (HTLV)

Human T-cell lymphotropic virus type I was the first human retrovirus isolated. It was the first to be found to cause a malignant disease.

Answer: Irradiation

Lymphocytes retain proliferative ability in the peripheral circulation, whereas all other white cells are terminally differentiated. Proliferative capability means that irradiation can target actively mitotic cells.
Filters are used to remove white cells, but their efficacy in the removal of lymphocytes is limited due to the small size of these white cells. Cooling the blood prior to transfusion would do no good at all, and would injure the patient (at the very least it would hurt).

Answer: Transfusion Related Acute Lung Injury

Transfusion Related Acute Lung Injuries result from transfusion of blood products leading to chills, fever and hypotension. It is thought to be transmitted through the transfusion of HLA or neutrophil directed antibodies from the donor, combined with the accumulation of recipient's white cells in the lungs due to trauma.
Often the patient is ventilated and unconscious and therefore is unable to complain of discomfort and the respiratory insufficiency may be attributed to another cause.

Answer: The person is ABO Group B and Rh (D) positive.

In blood grouping, the ABO group is given first (A, B, AB or O) and the positive or negative refers to the presence or absence of the D antigen, respectively. The D antigen is part of the Rh system.
Statistically, B positive is a very prevalent blood group in the Chinese population.

Answer: Disseminated intravascular coagulation

Disseminated intravascular coagulation is a particularly nasty occurrence where the blood clots inside the circulation. The causes of DIC include acute haemolytic transfusion reactions, severe Gram-negative sepsis and obstetric accidents.