ABID3311Online02
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ABID3311Online02

Course Number: CLS 3311, Fall 2008

College/University: Weber

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CLS 3311 Advanced Clinical Immunohematology Identification Of Unexpected Antibodies Anti body I denti fi cati on When an unexpected antibody has been detected using an IAT or a previous record indicates its presence then... We need to perform an Antibody Identification to discover the unexpected antibody's specificity. We react a PANEL of reagent red blood cells (usually 11) with known phenotypes with the...

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3311 CLS Advanced Clinical Immunohematology Identification Of Unexpected Antibodies Anti body I denti fi cati on When an unexpected antibody has been detected using an IAT or a previous record indicates its presence then... We need to perform an Antibody Identification to discover the unexpected antibody's specificity. We react a PANEL of reagent red blood cells (usually 11) with known phenotypes with the patients serum or plasma, including an Auto Control Tube to rule in or out any auto antibodies. The next slide is an example of a panel reporting sheet for a Gamma Biologics panel. Anti body I denti fi cati on The next hope is that the antibody will actually react with the Panel cells. There are ways to enhance antibody reactivity that we discussed in the Ag/Ab reactions lecture. Remember? How about increasing the serum to cell ratio? Using enhancement media? Enzyme treatment of red blood cells? Etc. The following slides are a set of questions and approaches to basic antibody identification. These need to be mastered before we move on to enzyme treatment, absorptions, elutions, etc. General Questions that need to be answered prior to Ab I d 1. What is the ABO group of the patient? What is the patient's Rh type? What is the gender of the patient? Is there a previous record on this patient? 1. 1. 1. 5. Need to communicate with 1. What is the other members of the diagnosis or healthcare team - certain suspected diagnosis hemolytic anemia's can of your patient? result from an autoimmune process or medication. 1. What is the patient's 6. Has the patient been transfused with packed rbc's transfusion record? within the last three months? If so, accurate antigen typing of their red cells for an antigen to a corresponding antibody will not be possible. Why? I f you ar e r ecor di ng weak r eacti ons wi th many or al l cel l s i n the panel but N OT the auto-contr ol , you may be seei ng: A. A patient who has hypergammaglobulinemia or has recently received a volume expander. Rouleaux formation! Panel 1 B. High titer low avidity (HTLA) antibody. Panel 2 C. A patient who has an antibody to a high frequency b antigen. i.e. anti-Js , anti-k, etc. Panel 3 Panel 1 represents what may be seen in situation A above. Notice that the AHG phase is completely negative. Why? Panel #1 Rh D C E 1 2 3 4 5 6 7 8 9 0 + + + 0 0 0 0 0 + + + 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 0 0 0 0 c + 0 0 e + + + f + 0 0 MNSs P Lewis Lutheran Kell K 0 0 + 0 0 0 + 0 0 0 0 k + + + + + + 0 + W + + Kpa Jsa 0 0 0 0 0 0 0 0 + 0 0 0 0 0 0 0 0 0 + 0 0 0 Duffy Fya Fyb + + 0 0 + + 0 0 + + + + 0 + 0 + 0 + 0 0 + + Kidd Xga RT 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ 37 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ AHG 0 0 0 0 0 0 0 0 0 0 0 0 CC 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ V VS CW M N S s P1 Lea Leb Lua Lub 0 0 0 0 0 + 0 0 0 0 0 0 0 0 / / + 0 0 / 0 / 0 + 0 0 0 0 0 0 0 0 0 + + + 0 0 + 0 + + + 0 + + 0 0 + + 0 + + 0 + 0 + 0 + + + + + + + 0 0 0 0 0 0 + 0 + + + 0 + + 0 + 0 0 0 0 0 0 0 0 0 + + + + + + + + + + + + Jka + + 0 + + + + + + 0 0 Jkb Xga IS + + + 0 + 0 + 0 0 + + + + + + + 0 0 + + + + 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ + O 0 + + + + + + 0 + + + + + + + + + + + + + / + 0 0 + W 0 + + 0 + + + + + 0 + 0 + + 0 + 0 + 0 + + 0 0 0 0 10 0 11 + Auto Control With Rouleaux the reaction strength may vary more than indicated and the auto control is positive. Confirmation of rouleaux involves performing a saline replacement test. Panel #2 Rh D C E 1 2 3 4 5 6 7 8 9 0 + + + 0 0 0 0 0 + + + 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 0 0 0 0 c + 0 0 e + + + f + 0 0 MNSs P Lewis Lutheran Kell Duffy Kidd Xga AHG CC +/m+ 1+W 1+W 1+W 1+W 1+W m+ m+ m+ m+ 0 2+ V VS Cw M N S s P1 Lea Leb Lua Lub K 0 0 0 0 0 + 0 0 0 0 0 0 0 0 / / + 0 0 / 0 / 0 + 0 0 0 0 0 0 0 0 0 + + + 0 0 0 + 0 + + + + 0 + + + 0 0 + + + 0 + + + 0 + 0 + + + + 0 0 0 0 0 0 + 0 + + + 0 + + 0 + 0 0 0 0 0 0 0 0 0 + + + + + + + + + + + + 0 0 + 0 0 0 + 0 k Kpa Jsa Fya Fyb Jka Jkb Xga IS RT 37 + + + + + + 0 + 0 0 0 0 0 0 0 0 + 0 0 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 + + 0 0 + + + + 0 + 0 + 0 + 0 0 + + + + 0 + + + + + + 0 0 + + + 0 + 0 + 0 0 + + + + + + + 0 0 + + + + 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 + O 0 + + + + + + 0 + + + + + + + + + + + + + / + 0 0 + W 0 + + 0 + + + + + + 0 0 + 0 + + + 0 + 0 + 0 0 0 0 0 W 0 0 + + 10 0 11 + This represents the reactivity of a H i gh Ti ter L ow Avi di ty (HTLA) antibody. Weak (Microscopic to 1+) reactions with all cells. Weak reactions that persist through many dilutions (titer: at least to 1:64). Auto Control Panel #3 Rh D C E 1 2 3 4 5 6 7 8 9 0 + + + 0 0 0 0 0 + + + 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 0 0 0 0 c + 0 0 e + + + f + 0 0 MNSs Lewis Lutheran Kell Duffy Kidd AHG CC 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ 1+ 0 2+ V VS Cw M N S s P1 Lea Leb Lua Lub K 0 0 0 0 0 + 0 0 0 0 0 0 0 0 / / + 0 0 / 0 / 0 + 0 0 0 0 0 0 0 0 0 + + + 0 0 0 + 0 + + + + 0 + + + 0 0 + + + 0 + + + 0 + 0 + + + + 0 0 0 0 0 0 + 0 + + + 0 + + 0 + 0 0 0 0 0 0 0 0 0 + + + + + + + + + + + + 0 0 + 0 0 0 + 0 k Kpa Jsa Fya Fyb Jka Jkb Xga IS RT 37 + + + + + + 0 + 0 0 0 0 0 0 0 0 + 0 0 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 + + 0 0 + + + + 0 + 0 + 0 + 0 0 + + + + 0 + + + + + + 0 0 + + + 0 + 0 + 0 0 + + + + + + + 0 0 + + + + 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 + O 0 + + + + + + 0 + + + + + + + + + + + + + / + 0 0 + W 0 + + 0 + + + + + + 0 0 + 0 + + + 0 + 0 + 0 0 0 0 0 W 0 0 + + 10 0 11 + Auto Control This represents an antibody to a high incidence antigen (99% of the population). Rh D C E 1 2 3 4 5 6 7 8 9 0 + + + 0 0 0 0 0 + + + 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 0 0 0 0 c + 0 0 e + + + f + 0 0 MNSs V VS CW M N S 0 0 0 0 0 + 0 0 0 0 0 0 0 0 / / + 0 0 / 0 / 0 + 0 0 0 0 0 0 0 0 0 + + + 0 + 0 + + 0 + 0 0 + 0 + 0 + 0 + 0 0 + + 0 + + + 0 + 0 + 0 + Lewis Lutheran Kell k + + + + + + 0 + Duffy Kidd AHG CC 0 2+ 2+ 2+ 2+w 2+ 2+ 2+ 1+s 2+ 0 0 2+ 2+ 2+ s P1 Lea Leb Lua Lub K 0 + + + + + 0 + + + + + + + 0 0 0 0 0 0 + 0 + + + 0 + + 0 + 0 0 0 0 0 0 0 0 0 + + + + + + + + + + + + 0 0 + 0 0 0 + 0 Kpa Jsa Fya Fyb Jka Jkb Xga IS RT 37 0 0 0 0 0 0 0 0 + 0 0 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 + + 0 0 + + + + 0 + 0 + 0 + 0 0 + + + + 0 + + + + + + 0 0 + + + 0 + 0 + 0 0 + + + + + + + 0 0 + + + + 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 + O 0 + + + + + + 0 + + + + + + + + + + + + + / + W 0 + + + 0 + 0 + + 0 0 0 0 0 W 0 0 + + 10 0 11 + Are the Positive reactions of equal Strength with each cell? This would suggest that there is only one antibody specificity causing the reactions. Auto Control Rh D C E 1 2 3 4 5 6 7 8 9 0 + + + 0 0 0 0 0 + + + 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 0 0 0 0 c + 0 0 e + + + f + 0 0 MNSs P Lewis Lutheran Kell Duffy Kidd AHG CC 2+ 2+ 2+ 0 1+s 2+ 2+ 2+ 2+ 2+ 2+ 0 2+ 2+ V VS CW M N S s P1 Lea Leb Lua Lub K 0 0 0 0 0 + 0 0 0 0 0 0 0 0 / / + 0 0 / 0 / 0 + 0 0 0 0 0 0 0 0 0 + + + 0 0 0 + 0 + + + + 0 + + + 0 0 + + + 0 + + + 0 + 0 + + + + 0 0 0 0 0 0 + 0 + + + 0 + + 0 + 0 0 0 0 0 0 0 0 0 + + + + + + + + + + + + 0 0 + 0 0 0 + 0 k Kpa Jsa Fya Fyb Jka Jkb Xga IS RT 37 + + + + + + 0 + 0 0 0 0 0 0 0 0 + 0 0 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 + + 0 0 + + + + 0 + 0 + 0 + 0 0 + + + + 0 + + + + + + 0 0 + + + 0 + 0 + 0 0 + + + + + + + 0 0 + + + + 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2+ 2+ 2+ 0 1+ 2+ 2+ 2+ 2+ 2+ 2+ 0 + O 0 + + + + + + 0 + + + + + + + + + + + + + / + 0 0 + W 0 + + 0 + + + + + + 0 0 + 0 + + + 0 + 0 + 0 0 0 0 0 W 0 0 + + 10 0 11 + Does patient serum react with the same o Auto Control panel cells at 37 C and AHG? This, too would suggest that only ONE unexpected antibody is causing the observed reactions. Var i ati on i n Aggl uti nati on Str ength on Ab Panel s M ul ti pl e Anti bodi es pr esent Can cause variation in agglutination strength in a single phase. i.e. 1+ to 3+ reactions at 37oC phase Can cause variation in agglutination strength between phases: i.e. 1+ at 37oC and 3+ at AHG Dosage Can cause variation in agglutination strength in a single phase. i.e. 1+ to 3+ reactions at 37oC phase Rh D C E 1 2 3 4 5 6 7 8 9 0 + + + 0 0 0 0 0 + + + 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 0 0 0 0 c + 0 0 e + + + f + 0 0 MNSs P Lewis Lutheran Kell Duffy Kidd AHG CC W+ 2+ 0 2+ 1+ 2+ 0 W+ 2+ W+ W+ 0 2+ 2+ 2+ V VS CW M N S s P1 Lea Leb Lua Lub K 0 0 0 0 0 + 0 0 0 0 0 0 0 0 / / + 0 0 / 0 / 0 + 0 0 0 0 0 0 0 0 0 + + + 0 0 0 + 0 + + + + 0 + + + 0 0 + + + 0 + + + 0 + 0 + + + + 0 0 0 0 0 0 + 0 + + + 0 + + 0 + 0 0 0 0 0 0 0 0 0 + + + + + + + + + + + + 0 0 + 0 0 0 + 0 k Kpa Jsa Fya Fyb Jka Jkb Xga IS RT 37 + + + + + + 0 + 0 0 0 0 0 0 0 0 + 0 0 0 0 0 0 0 0 0 + 0 0 0 + + 0 + + + 0 + + + + + 0 + 0 + 0 + + 0 + + + + 0 + + + + + + 0 0 + + + 0 + 0 + 0 0 + + + + + + + 0 0 + + + + 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 + O 0 + + + + + + 0 + + + + + + + + + + + + + / + 0 0 + W 0 + + 0 + + + + + + 0 0 + 0 + + + 0 + 0 + 0 0 0 0 0 W 0 0 + + 10 0 11 + Auto Control Look at the reaction strengths and how they correlate to the zygosity of the Anti-Fya antibody. How strong is the agglutination with the Homozygous cells compared to the Heterozygous cells? DOSAGE can account for this. Rh D C E 1 2 3 4 5 6 7 8 9 0 + + + 0 0 0 0 0 + + + 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 0 0 0 0 c + 0 0 e + + + f + 0 0 MNSs P Lewis Lutheran Kell Duffy Kidd CC V VS CW M N S s P1 Lea Leb Lua Lub K 0 0 0 0 0 + 0 0 0 0 0 0 0 0 / / + 0 0 / 0 / 0 + 0 0 0 0 0 0 0 0 0 + + + 0 0 0 + 0 + + + + 0 + + + 0 0 + + + 0 + + + 0 + 0 + + + + 0 0 0 0 0 0 + 0 + + + 0 + + 0 + 0 0 0 0 0 0 0 0 0 + + + + + + + + + + + + 0 0 + 0 0 0 + 0 k Kpa Jsa Fya Fyb Jka Jkb Xga IS RT 37 AHG + + + + + + 0 + 0 0 0 0 0 0 0 0 + 0 0 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 + + 0 0 + + + + 0 + 0 + 0 + 0 0 + + + + 0 + + + + + + 0 0 + + + 0 + 0 + 0 0 + + + + + + + 0 0 + + + + 0 0 0 0 1+ 1+ 1+ 1+ 3+ 0 0 0 2+ 0 0 0 1+ 0 0 1+ 2+ 0 0 0 0 0 0 0 0 0 + O 0 + + + + + + 0 + + + + + + + + + + + + + / 2+ 2+ 2+ + 0 0 + W 0 + + 0 + + + + + + 0 0 + 0 + + + 0 + 0 + 0 0 0 0 0 1+ 2+ 0 0 0 0 0 0 0 0 0 0 0 0 0 1+ 0 2+ 2+ 2+ 0 W 0 0 + + 10 0 11 + Auto Control 2+ This panel appears to be demonstrating the presence of Multiple Antibody specificities. There is variation in reaction strength within each phase and between phases. RUL I NG OUT!! Look at each Panel Cell that has a NEGATI VE reaction with the serum being tested. 1. Rule out by drawing 1 line through Antigen the specificity at the top of the sheet. 2. Repeat the process for each negative cell in the panel. 3. At the end of the process count the number of mark through lines in each specificity. 1. Each specificity that has 2 or more strikes are considered RULED OUT! They are statistically eliminated as the antibody causing those reactions. Ci r cl e al l speci fi ci ty's whi ch have NOT been RUL ED OUT! Gener al Rul e For some antibody specificity's which are known to show dosage you cannot Rul e Out the antibody as being absent unless 2 H omozygous Cel l s fail to react with the patient serum. Antibody specificity's that are a included under this rule are: Duffy (Fy , b a b Fy ), Ki dd (Jk , Jk ), M , N, S, and s. Rh D C E 1 2 3 4 5 6 7 8 9 0 + + + 0 0 0 0 0 + + + 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 0 0 0 0 c + 0 0 e + + + f + 0 0 MNSs P Lewis Lutheran Kell Duffy Kidd AHG CC 0 0 0 0 1+ 1+ 1+ 1+ 1+ 1+ 1+ 0 2+ 2+ 2+ 2+ 2+ V VS CW M N S s P1 Lea Leb Lua Lub K 0 0 0 0 0 + 0 0 0 0 0 0 0 0 / / + 0 0 / 0 / 0 + 0 0 0 0 0 0 0 0 0 + + + 0 0 0 + 0 + + + + 0 + + + 0 0 + + + 0 + + + 0 + 0 + + + + 0 0 0 0 0 0 + 0 + + + 0 + + 0 + 0 0 0 0 0 0 0 0 0 + + + + + + + + + + + + 0 0 + 0 0 0 + 0 k Kpa Jsa Fya Fyb Jka Jkb Xga IS RT 37 + + + + + + 0 + 0 0 0 0 0 0 0 0 + 0 0 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 + + 0 0 + + + + 0 + 0 + 0 + 0 0 + + + + 0 + + + + + + 0 0 + + + 0 + 0 + 0 0 + + + + + + + 0 0 + + + + 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 + O 0 + + + + + + 0 + + + + + + + + + + + + + / + 0 0 + W 0 + + 0 + + + + + + 0 0 + 0 + + + 0 + 0 + 0 0 0 0 0 W 0 0 + + 10 0 11 + Ruling out using Homozygous cells: Panel cells 1-4 have no reactivity at any phase. These can be used to rule out. Each highlighted box represents a homozygous cell enabling us to rule out one of the blood groups that meet that requirement: Kidd, Duffy and MNSs. Auto Control RUL I NG OUT!! The next slide is a panel that has animated the ruling out process. As you click the mouse button lines will indicate a strike against a blood group specificity. Two strike through's statistically eliminate that antibody specificity from causing the observed panel reactions. Each Circled Specificity indicates an antibody that could possibly be causing the reactions observed on the panel. Rh D C E 1 2 3 4 5 6 7 8 9 0 + + + 0 0 0 0 0 + + + 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 0 0 0 0 c + 0 0 e + + + f + 0 0 MNSs Lewis Lutheran Kell Duffy Kidd AHG CC 1+ 1+ 1+ 0 0 0 0 0 0 0 1+ 0 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ V VS Cw M N S s P1 Lea Leb Lua Lub K 0 0 0 0 0 + 0 0 0 0 0 0 0 0 / / + 0 0 / 0 / 0 + 0 0 0 0 0 0 0 0 0 + + + 0 0 0 + 0 + + + + 0 + + + 0 0 + + + 0 + + + 0 + 0 + + + + 0 0 0 0 0 0 + 0 + + + 0 + + 0 + 0 0 0 0 0 0 0 0 0 + + + + + + + + + + + + 0 0 + 0 0 0 + 0 k Kpa Jsa Fya Fyb Jka Jkb Xga IS RT 37 + + + + + + 0 + 0 0 0 0 0 0 0 0 + 0 0 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 + + 0 0 + + + + 0 + 0 + 0 + 0 0 + + + + 0 + + + + + + 0 0 + + + 0 + 0 + 0 0 + + + + + + + 0 0 + + + + 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 + O 0 + + + + + + 0 + + + + + + + + + + + + + / + 0 0 + W 0 + + 0 + + + + + + 0 0 + 0 + + + 0 + 0 + 0 0 0 0 0 W 0 0 + + 10 0 11 + Auto Control Rule out by drawing 1 line through the Ag specificity at the top of the sheet for each negative cell with a + in the box. For example Cell #4 is the first negative cell. Moving from left to right beginning with the D antigen is a + on cell #4, this is where we begin by drawing a single line through the D. It now has one strike. RUL I NG OUT!! The next slide is the same panel without the rule out strikes or circles. Go through the rule out process by yourself and compare results with the ruled out panel. Remember, begin with a negative cell, homozygous cells are required for Kidd, Duffy and MNSs to rule out. Circle all specificities that cannot be ruled out. Rh D C E 1 2 3 4 5 6 7 8 9 0 + + + 0 0 0 0 0 + + + 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 0 0 0 0 c + 0 0 e + + + f + 0 0 MNSs Lewis Lutheran Kell Duffy Kidd AHG CC 1+ 1+ 1+ 0 0 0 0 0 0 0 1+ 0 2+ 2+ 2+ 2+ 2+ 2+ 2+ 2+ V VS Cw M N S s P1 Lea Leb Lua Lub K 0 0 0 0 0 + 0 0 0 0 0 0 0 0 / / + 0 0 / 0 / 0 + 0 0 0 0 0 0 0 0 0 + + + 0 0 0 + 0 + + + + 0 + + + 0 0 + + + 0 + + + 0 + 0 + + + + 0 0 0 0 0 0 + 0 + + + 0 + + 0 + 0 0 0 0 0 0 0 0 0 + + + + + + + + + + + + 0 0 + 0 0 0 + 0 k Kpa Jsa Fya Fyb Jka Jkb Xga IS RT 37 + + + + + + 0 + 0 0 0 0 0 0 0 0 + 0 0 0 0 0 0 0 0 0 + 0 0 0 + + 0 0 + + 0 0 + + + + 0 + 0 + 0 + 0 0 + + + + 0 + + + + + + 0 0 + + + 0 + 0 + 0 0 + + + + + + + 0 0 + + + + 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 + O 0 + + + + + + 0 + + + + + + + + + + + + + / + 0 0 + W 0 + + 0 + + + + + + 0 0 + 0 + + + 0 + 0 + 0 0 0 0 0 W 0 0 + + 10 0 11 + Auto Control Panel Wr i te-Up #1. List all of the circled specificities: D, C, V, VS, Cw, S, L ea, L ua, K, Kpa, J sa, Fyb, J kb These represent all of POSSI BI L I TI ES of antibodies that could be causing the reactions on this panel. These are the ones that have not been ruled out. #2. List those antibody specificity's that cannot be ruled out but which were so RARE that either no cell on the panel was positive for them or only one cell was positive and does not appear to be the cause of the reactions: V, VS, Cw, Panel Wr i te-Up #3. List the antibodies that are not the probable cause because their typical PH ASE OF REACTI VI TY does not match the observed phase of reactivity: L ea, L ua On this panel all the reactions occurred at AHG phase (using Monospecific -IgG AHG). What is the optimal phase of reactivity for Lea and Lua? Both are cold reacting antibodies. They should demonstrate reactivity at IS or Room Temp. Panel Wr i te-Up #4. List the M OST L I KEL Y ANTI BODY based on pattern of reactivity. Anti -C Look at the pattern of the agglutination reactions and compare them to each remaining antibody specificity. Begin at the left with Anti-D. Is there a reaction between the serum and the antigen specificity EACH TIME the antigen is present on the panel cells? Is there NO reaction between the serum and the panel cells each time the antigen is NOT present on the panel cells? Does this antibody normally react at this Phase? Is th...

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CLS 3311 Advanced Immunohematology Objectives for Other Blood Groups II: I, Le, P, etc. The student will have the opportunity to: 1. Apply properties of blood group (I, Le, P) ANTIGENS to interpret antibody screening, clinical significance of antibod
Weber - CLS - 3311
CLS 3311 Advanced ImmunohematologyObjectives for Identification of Unexpected Antibodies. The student will have the opportunity to: 1. Compare and contrast auto- vs. alloantibody 2. Describe the appropriate sample to be used for cells and serum/plas
Weber - CLS - 3311
TRANSFUSION REACTION CASE STUDIES Your assignment is to prepare a transfusion reaction case study and present your case to the rest of the class using NEAT, CLEAR overheads. Sample panel sheets of various companies and lots are available for your use
Weber - CLS - 1113
CLS 1113 Introduction to Clinical Laboratory Practices Urinalysis Case Studies CASE #1A urine specimen is obtained from a 14-year-old boy with a history of a sore throat. Three weeks ago he was cultured and treated for a streptococcal throat infecti
Weber - CLS - 3311
CLS 3311 Advanced Clinical ImmunohematologyDonor Physical and InterviewDonor Processing Donor Physical Basic physical and testing processes including Hematocrit, Blood pressure, Pulse, Temperature, and Weight.rvie Donor Inte w Series of ques
Weber - CLS - 3311
CLS 3311 Advanced Clinical ImmunohematologyAntihuman Globulin Follow-Up Lecture1FalsePositive I AT or DAT :1. Tube or saline s 1. May cause non specific aggregation contam inate with e ss d xce silicone 1. May cause non specific aggregation 1. D
Weber - CLS - 1113
CLS 1113 Introduction to Clinical Laboratory PracticesHepatitis and HIVHEPATITIS Definition Hepatitis A, B, C, D, E, G HAV, HBV, HCV, HDV, HEV, HGV EBV and CMV Infectious Agents that pose a serious threat:HAV Enteric transmission Contami
Weber - CLS - 1113
CLS 1113 Introduction to Clinical Laboratory PracticesUnit 5 Immunology Procedures Chapter 8Antigen & Antibody ReactionsAffinity vs. Avidity Affinity Measure of the binding strength between an antigenic determinant (epitope) and an antibody com
Weber - CLS - 3311
CLS 3311 Advanced Immunohematology Objectives for Other Blood Groups 1: Kell, Kidd, Duffy MNSs The student will have the opportunity to: 1. Apply properties of blood group (Kell, Kidd, Duffy, Lu, and MNSs) ANTIGENS to interpret antibody screening, cl
Weber - CLS - 1113
Clinical Laboratory Sciences 1113 Introduction to Clinical Laboratory Practices UNIT 3: BLOOD COLLECTION (Phlebotomy) Learning Objectives for Unit 3: At the completion of this unit of instruction, the Clinical Laboratory Technician student will be ab
Weber - ED - 3780
1ED 3780 Part G: The Lecture-DemonstrationContent: Page 2-4 5 6 7 7-8 Introduction to Lecture-Demonstration Liven Up Your Lecture Benefits and Limitations of Lecturing Preparing the Lecture Tips on Delivering and Pacing the LectureUpdated 08/06
Weber - TBE - 2200
Guide to Operating Systems Third EditionConfiguring Input and Output DevicesGuide to Operating SystemsThird EditionObjectivesAfter reading this chapter and completing the exercises you will be able to: Understand how operating systems interfa
Weber - TBE - 2300
Guide to Networking Essentials Fifth EditionChapter 12 Network Administration and SupportObjectives Manage networked accounts Monitor network performance Protect your servers from data lossGuide to Networking Essentials, Fifth Edition2Man
Weber - TBE - 3200
SUSE Linux Enterprise Desktop AdministrationChapter 15 Deploy SUSE Linux Enterprise Desktop 10Objectives Objective 1-Installation Options and Deployment Strategies Objective 2-Autoinstallation Basics Objective 3-The Configuration File for Auto
Oakland University - CSE - 30341
Overview of Mass Storage Structure Magnetic disks provide bulk of secondary storage Drives rotate at 70 to 250 times per second Ipod disks: 4200 rpm Laptop disks: 4200, 5400 rpm or 7200 rpm Desktop disks: 7200 rpm Server disks: 10000 rpm or 150
Oakland University - CSE - 30341
Fragmentation External Fragmentation total memory space exists to satisfy a request, but it is not contiguous Internal Fragmentation allocated memory may be slightly larger than requested memory; this size difference is memory internal to a parti
Oakland University - CSE - 30341
Data center server One of the specification is the size that server will take in a rack. 1U is the smallest size and blade servers, which fit one unit are all the rage Dual (Quad Core Xeon, 2x4MB Cache, 2.66 GHz, 1333 MHz FSB), 16 GB memory, 2x73GB
Oakland University - CSE - 40373
CSE 4/60373: Multimedia Systems Outline for today On the 802.11 Turbulence of Nintendo DS and Sony PSP Hand-held Network Games Mark Claypool. In Proceedings of the 4th ACM Network and System Support for Games (NetGames) Hawthorne, NY, USA October 2
Oakland University - CSE - 40373
CSE 4/60373: Multimedia Systems Instructor: Surendar Chandra (surendar@nd.edu) Room: 356C Fitz (631-8975) Office Hours: Wed 2:00-3:00 (other times, by email appt) Email/iChat/AIM is the best way to reach me Course Web: cse.nd.edu/courses/cse40373/w
Weber - AC - 3750
Understanding the Context of Information SystemsThe Big PictureThe Modeling ProcessThe Modeling ProcessReal WorldThe Modeling ProcessModeling Tool Real WorldThe Modeling ProcessModeling Tool Real World ModelThe Modeling ProcessMode
Weber - ENGR - 2250
Pre Engineering ENGR 2250 Syllabus Spring 2009Course Title: Electrical Circuits Description: Ohm's law, Kirchoff's laws and network theorems. Power in DC and AC circuits, LRC circuits and Fourier analysis of functions. Prerequisites: Math SI1220 In
Weber - CEET - 3010
Computer and Electronics Engineering Technology CEET 3010 Syllabus Fall 2008Course Title: Advanced Circuit Analysis I Description: Advanced topics related to electronic circuit analysis, Laplace transforms, differential equations, Fourier series, F
Weber - CEET - 3010
Laboratory 6CEET 3010 Fall 2008Laplace Transforms via MATLABPurpose:Introduce Students to MATLAB and some of its computational capabilities.Equipment and Components: Computer with MATLAB. All computers in the CEET computer lab (B4 408) have M
Weber - CEET - 3010
Laboratory 7CEET 3010 Fall 2008FiltersPurpose:Introduce students to circuit analysis in the S-Domain through the analysis of a filter.Equipment and Components: Computer with MATLAB and PSpice. Prototyping board, Multimeter, Signal Generat
Weber - CEET - 3010
Month / Day / Year StapleCourse NumberName (Last, First)1 2Problem Number (part A)Complete Problem Definition. Including figures, graphs, schematics, etc. May be copied directly from the assignment. Leave some space between definition and s
Weber - CEET - 3020
Computer and Electronics Engineering Technology CEET 3010 Syllabus Fall 2008Course Title: Advanced Circuit Analysis I Description: Advanced topics related to electronic circuit analysis, Laplace transforms, differential equations, Fourier series, F
Weber - CEET - 4030
Computer and Electronics Engineering Technology CEET 4030 Syllabus Fall 2007Course Title: Control and Systems Description: Introduction to automatic control theory, analysis, and testing, pole, zero, Bode plots, and frequency response. The design a
Weber - CEET - 4030
Month / Day / Year StapleCourse NumberName (Last, First)1 21.1 aComplete Problem Definition. Including figures, graphs, schematics, etc. May be copied directly from the assignment. Leave some space between definition and solution Show Probl
Weber - CEET - 3010
Laboratory 6CEET 3010 Fall 2007Laplace Transforms via MATLABPurpose:Introduce Students to MATLAB and some of its computational capabilities.Equipment and Components: Computer with MATLAB. All computers in the CEET computer lab (B4 408) have M
Weber - CEET - 3010
Laboratory 4CEET 3010RC and RL circuitsPurpose:Introduce students to the transient behavior of circuits made up of resistors and inductors or capacitors.Equipment and Components: Prototyping board, Multimeter, Power supply, Signal Generato
Weber - CEET - 3010
Laboratory 7CEET 3010 Fall 2007FiltersPurpose:Introduce students to circuit analysis in the S-Domain through the analysis of a filter.Equipment and Components: Computer with MATLAB and PSpice. Prototyping board, Multimeter, Signal Generato
Weber - AC - 3750
The Database Approachx Emphasizesthe integration of data across the organizationComponents of Relational ModelData structure: Represented in the form of tables with rows and columns x Data manipulation: Powerful operations (SQL) used to manipul
Weber - MATH - 3750
BOUNDARY VALUE PROBLEMS MATH 3710, ID #1968001, Fall 2003Text: Boundary Value Problems by David L. Powers, Harcourt Academic Press, 4 th Edition, 1999, ISBN 0-12-563734-9.Prerequisites: Math 2210 and Math 2280.Class Meetings: 8:30-9:45 TTH, LL 22
Weber - AC - 2010
2001 Annual ReportKellogg Company One Kellogg Square Battle Creek, Michigan 49016-3599 Telephone (616) 961-2000 www.kelloggs.comAfter a year ofchange.2 0 01 WA S A Y E A R O F T RWe exchanged near-term sales growth for a smooth integration o
Weber - AC - 3750
Chapter 7System DesignLearning ObjectivesTo learn the activities that take place during the second phase of the SDLC q To discover how to create a preliminary system design q To understand how to develop the detailed specifications for an AIS q T
Weber - AC - 3750
Internal Control StructureLearning ObjectivesqqqqqTo understand the components of an organization's internal control structure To know the objectives and limitations of internal control To learn which characteristics of a control environ
Weber - AC - 3750
Chapter 8System Implementation and OperationLearning ObjectivesTo discover which activities take place during the third and fourth phases of the SDLC. q To know how auditors participate in system implementation q To understand how to do a postimp
Weber - AC - 3750
Chapter 14System ControlsA Quote"The factory of the future will have only two employees, a man and a dog. The man will be there to feed the dog. The dog will be there to keep the man from touching the equipment."Warren BennisLearning Objective