Blood Bank (part 2)

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Landsteiner

This scientist concluded that serum antibodies are directed against the antigens that are missing from red cells

1902

In what year was the AB blood group discovered

Forward Grouping

This tests red cells for the presence or absence of A or B antigens by adding anti-A and anti-B (separate tubes) and checking for agglutination after centrifugation

Reverse Grouping

This tests plasma or serum for the presence or absence of anti-A or anti-B by adding reagent A₁ and B (separate tubes) and checking for agglutination after centrifugation

A blood group

In a forward grouping test, a result of A1+, B- would be interpreted as what

O blood group

In a forward grouping test, a result of A₁-, B- would be interpreted as what

B blood group

In a reverse grouping test, a result of A₁+, B- would be interpreted as what (opposite)

Retain a large amount of H antigen

Because there are no A or B gene specified transferases in group O persons to convert H chains to A or B, group O cells do what

A and B specific sugars

As the A and B transferases convert the H antigen to A and/or B antigens, the H determinant is masked by what

O, A2, A2B, B, A1, A1B

The correct order of the amount of H antigen on various ABO phenotypes, ranging from greatest to least is what

A antigen

During the sequence of antigen formation, when an A gene is present, what antigen is formed

None, there will be no change in the H antigen structure

During the sequence of antigen formation, when an O gene is present, what antigen is formed

Bombay phenotype

When two h genes (hh genotype) are inherited, what is the phenotype result

The type of linkage between the terminal carbohydrates

There are two types of H gene precursor chains, which are type 1 and type 2, which are differentiated by what

Proteins

The type 1 and type 2 precursor chain (of H gene) found in body fluids are primarily attached to what

Lipids

The type 2 precursor chain (of H gene) found on the red cells are primarily attached to what

1,000,000

How many A antigen sites are located on A₁ phenotype red cells

250,000

How many A antigen sites are located on A₂ phenotype red cells

750,000

How many B antigen sites are located on B phenotype red cells

1,700,000

How many H antigen sites are located on O phenotype red cells

A1, A2, B, O

What are the most prevalent antigens located on the surface of red cells (4)

Anti-A1 used to differentiate between A₁ (or A₁B) and A₂ antigens

The lectin extract from the seeds of Dolichos biflorus are the source of what

Presence of A₁ (or A₁B) antigen

A strong agglutination of patient cells with the addition of lectin anti-A1 indicates what

Anti-H

The lectin extract from the seeds of Ulex europaeus are the source of what

Fucose

The lectin from Ulex europaeus binds with what sugar

sugar-N-acetylgalactosamine (A sugar)

The lectin from Dolichos biflorus binds with what sugar

IgM

ABO antibodies are typically what class

IgM

ABO antibodies are divided into natural and immune forms. What class is the naturally occurring form

IgG

ABO antibodies are divided into natural and immune forms. What class is the immune occurring form

IgM and IgG

What class(es) of antibody has the ability to bind complement and cause in vivo hemolysis

Plasma, saliva and colostrum

Where are ABO antibodies found within the body (IgM, IgG, and IgA)

IgG

The antibody anti-A,B phenotype is found in group O persons. What immunoglobulin class is it

IgG (Anti A,B)

Which antibody (and phenotype) most often crosses the placenta and causes Hemolytic Disease of the Newborn, where child is group A or B

Allo Anti-H

What antibody is produced by persons of the Bombay phenotype, has a wide thermal range of 4-37 C, and is always clinically significant

Classic Bombay phenotype

This describes the phenotype that is homozygous for sese alleles at the Se locus and do not produce enzyme to produce H, A, or B antigens in the secretions

Type O (Oh identifies this group)

What group do Bombay phenotypes type as

D or Rh positive

A person that inherits both RHD and RHCE genes from each parent would be what Rh type

D or Rh negative

A person that inherits only a single RHCE gene from each parent would be what Rh type

Haplotype

This is the inherited allele from one parent

Genotype

This is the inherited haplotypes (alleles from both parents)

Anti-D

Weak D patients do not usually make _____ antibodies

Positive DAT
Rouleaux
Reagent contamination
Antibody to low incidence antigen
Human error

What are the reasons for a false positive Rh test

Hemolytic anemia with stomatocytes

People that suffer from Rh null syndrome (Rh null and Rh mod) experience a form of what

Rh null

These individuals fail to demonstrate the presence of any Rh antigens, as a result of the absence or mutation to the RHAG gene

Rh mod

These individuals express markedly reduced amounts of Rh antigens as a result of modifications to the RHAG gene

Silent, No

Regarding the Hh blood group, the h gene is a ____ allele and produces ____ antigen

Single

Of the different structures of the A, B, H antigens, linear structures have a _____ epitope

Multiple antigenic

Of the different structures of the A, B, H antigens, branched structures have _________ epitopes

5 weeks after conception

How quickly are ABH antigens formed on red cells

Do not

Red cells of newborns _____ have branched ABH structures

2-4 years of age

Full development of the ABH antigens occurs at what age

Diluted

Lectins must be ______ and used properly or else false results will occur

Naturally occurring

ABO antibodies are ______ ______ antibodies that are stimulated in the gut and environment

3-6 months

ABO antibodies are not detectable in the newborn until what age

5-10 years

Highest levels of ABO antibodies are found in children of what ages

4-2048

ABO antibody titers in adults may range from what

65

People over what age may have reduced ABO antibody levels

antibody, antigen

People are expected to produce an _____ against the missing ______ on their red cells

IgM, occasionally IgG

What immunoglobulin class is anti-A₁ (subgroup of A)

If it reacts at 37 degrees C

Anti-A₁ is considered clinically insignificant when

A1, A1B, and occasionally B

Auto anti H may be present in the serum of what type persons

insignificant

Auto anti-H usually reacts at 37 C, and is considered clinically ___ .

Always significant

Allo anti-H is found in Bombay phenotypes and is considered clinically ________

Nucleotide substitutions or deletion at the genetic level

Of the alleles at the ABO locus, there are many other alleles that produce subgroups of A and B. These are a result of what

Diminished levels of A and B antigens on cells

A and B subgroup changes produce aberrant transferases that result in what

A1 phenotype

What is the only type of cell will react positively with Dolichos biflourus (anti-A₁)

80%

What percent of the population that is group A, is A1 phenotype

20%

What percentage of the population that is group A, is A2 phenotype

A1 transferase

What converts both simple unbranched chains (H1) and highly branched chains (H₃ & H₄) into A antigen

Less than 1%

Subgroups of A, other than A₁ or A₂ which react weaker than other A phenotypes, comprise what percentage

Degree of reactivity
Presence of anti-A₁
Presence of A and H substances in saliva of secretors

Subgroups of A are characterized and categorized by what

Increase

Typically as the number of A antigen sites decrease, the number of H antigen sites will ______

A₃ phenotype

This phenotype subgroup of A has 80,000 sites per red cell, gives a characteristic mixed field reaction with anti-A and occurs in about 1/1000 group A persons

Degree of reactivity with anti-B and anti-A,B
Presence of B & H substances in saliva of secretors

Subgroups of B are rare, and gives a weak or variable reaction with anti-B. They are characterized and categorized by what

anti-A and anti-A,B would cause transfusion reaction

In a case of a donor with subgroup A being mislabeled as O, then transfused into an O recipient, what would happen

1 in 7,600

Bombay phenotype (Oh) frequency is higher in India and occurs with an overall frequency of what

Bombay phenotype

People with this phenotype lack H, A, and B antigens and make potent anti-A, anti-B, and anti-A,B

Anti-H

In Bombay phenotypes, the antibody screening of patient serum will react strongly to all group O cells and can demonstrate in vivo hemolysis. This is due to what

Negative

The antibody screen for a Bombay phenotype will yield a _____ auto control

Ulex europaeus

Bombay phenotype can be confirmed by demonstrating the absence of the H antigen by using what

Para-bombay phenotype

Phenotypes Ah, Bh, ABh, have a nonfunctional H gene but a normal Se gene, producing glycosyl transferase which produces H substance in the plasma
are referred to as what

Secretor

The Se gene is what type of gene

weaker

The anti-H produced by para-bombay phenotypes is ____ than classic Bombay

adsorption and elution procedures

Para-Bombay patients may give a weak reaction to anti-A and anti-B reagents, but A and B antigens may be detected after what

Non-reactive

Para-Bombay patients will react ____ with anti-H

Rh (severe)
IgG (mod)
ABO (mild)

As degrees of incompatibility go, what is the most severe to least severe? (3)

Pk

What phenotype makes anti-P

X linked recessive

Hemophilia A disease is what type of inheritance pattern?

Js^a antigen (makes anti-Js^a)

Js(a-b+) means the patient lacks what?

indirect

Weak D antigen testing is an example of what type of antiglobulin test?

Degree of reactivity with anti-A, -A₁, -A₁B

Subgroups of A are characterized and categorized by what?

Autosomal co-dominant

What is the mode of inheritance for Kell antigens K and k?

anti-i

Which I antibody reacts the strongest with cord blood?

phenotype the patient red cells for the corresponding antigen

What is the final step in the antibody identification process?

PEG

The addition of what reagent to the antibody id test may inhibit or prevent the detection of IgM antibodies?

2nd

Centrifugation affects what stage of hemagglutination?

Mixed field

An A₃ subgroup will demonstrate what type of reactivity with typing reagents?

low incidence

Kp^a is a low or high incidence antigen?

P₂ individuals

Anti-P₁ is usually produced by what?

Partial D

This phenotype has most but not all of the D proteins present.

glycophorin A

M and N are allelic genes that code for the specific amino acid sequence what?

1st stage

Ionic strength affects what stage of hemagglutination?

D antigen

D deletion phenotypes will express elevated levels of what?

glycophorin B

The U-phenotype results in the absence of what protein?

C3

The activation of the classic complement pathway results in what complement protein being deposited on the red cell membrane?

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