1S [LEC]: Intro + History Flashcards
1
Q
In 1492, blood was taken from three young men and given to the stricken ___ in the hope of curing him
A
Pope Innocent VII
2
Q
In 1869, ___ recommended sodium phosphate as a safe anticoagulant
A
Braxton Hicks
3
Q
In 1901, ___ discovered the ABO blood groups
A
Karl Landsteiner
4
Q
___ carried out vein-to-vein transfusion of blood by using multiple syringes and a special cannula for puncturing the vein through the skin
A
Edward E. Lindemann
5
Q
___ designed his syringe-valve apparatus that transfusions from donor to patient by an unassisted physician became practical
A
Unger
6
Q
In 1914, ___ reported the use of sodium citrate as an anticoagulant solution for transfusions
A
Hustin
7
Q
In 1915, ___ determined the minimum amount of citrate needed for anticoagulation and demonstrated its nontoxicity in small amounts
A
Lewisohn
8
Q
Mechanism of action of citrate as an anticoagulant
A
Chelates calcium
9
Q
In 1916, ___ and __ introduced a citrate-dextrose solution for the preservation of blood
A
Rous and Turner
10
Q
The function of glucose in RBC metabolism was not understood until the ___
A
1930s
11
Q
In February 1941, ___ was appointed director of the first American Red Cross blood bank at Presbyterian Hospital
A
Dr. Charles Drew
12
Q
In 1943, ___ and ___ of England introduced the formula for the preservative acid-citrate-dextrose (ACD)
A
Loutit and Mollison
13
Q
In July 1947, what journal on blood preservation was published?
A
Journal of Clinical Investigation
14
Q
In 1957, ___ introduced an improved peservative solution called citrate-phosphate dextrose (CPD)
A
Gibson
15
Q
A citizen seeking spiritual rebirth descended into a pit, or fossa sanguinis
A
Taurobolium
16
Q
The ___ bathed in blood to resuscitate the sick and rejuvenate the old
A
Egyptians
17
Q
In 1666, ___ was the first to successfully transfuse blood from one animal to another (dogs)
A
Richard Lower
18
Q
In 1667, ___ performed animal (sheep) to man transfusion
A
Richard Lower
19
Q
The first man to received blood from an animal (sheep)
A
Arthur Coga
20
Q
In 1667, ___ is documented as the first one to perform animal to man transfusion
A
Jean-Baptiste Denis
21
Q
In 1667, ___ successfully transfused sheep blood into a 15 y/o with long-standing fever
A
Jean-Baptiste Denis
22
Q
Substance that reacts to antibody
A
Antigen
23
Q
The product of antigenic stimulation
A
Antibody
24
Q
T/F: All blood groups are immunogen
A
True
25
Most immunogenic blood antigen
A, B
26
Second most immunogenic blood antigen
RhD
27
Third most immunogenic blood antigen
K (Kell)
28
Foreign molecules that bind specifically to an antibody or a T-cell receptor
Antigen
29
Antigen in its role of eliciting an immune response
Immunogen
30
Glycoprotein that recognizes a particular epitope on an antigen and facilitates clearance of that antigen
Antibody
31
The component of an immunoglobulin that connects the monomers
J chain
32
The name of the immunoglobulin depends on the ___
Heavy-chain composition
33
The agglutinating antibody
IgM
34
How many molecules of IgM are needed to activate complement?
1
35
Temperature of binding of IgM
20-24C or colder
36
The immunoglobulin capable of passing through the placenta
IgG
37
Temperature of binding of IgG
37C (body temp)
38
How many molecules of IgG is needed to activate complement?
2
39
The coating antibody
IgG
40
Light-chain composition of the antibodies
Kappa and Lambda
41
The smallest antibody
IgG
42
The ratio of kappa to lambda
2:1
43
Identify the antibody:
Capable of destroying transfused antigen-positive RBCs
IgG
44
Identify the antibody:
Predominant Ab produced in the secondary response
IgG
45
Subclass of IgG that is best in passing through placenta
IgG1
46
Subclass of IgG that is the worst in passing through placenta
IgG2
47
Subclass of IgG that is best in complement activation
IgG3
48
Subclass of IgG that is the worst in complement activation
IgG4
49
Identify the antibody:
Rh, Duffy, Kidd, Kell
IgG
50
Identify the antibody:
Most commonly encountered naturally occurring Ab (ABO system)
IgM
51
Identify the antibody:
Produced in response to commonly occurring antigens such as intestinal flora and pollen grains
IgM
52
Identify the antibody:
ABO, Lewis, Ii, P, MN
IgM
53
Identify the antibody:
Can interfere with detecting IgG by masking their reactivity
IgM
54
Can exist in monomeric or pentameric form with J chain
IgM
55
The IgM form present in the surface of B cells
monomeric
56
The IgM form present in serum
pentameric
57
Identify the antibody:
Exist as monomer, dimer, or trimer joined by J chain
IgA
58
Identify the antibody:
For mucosal immunity and secretions
IgA
59
Identify the antibody:
30% of anti-A and anti-B
IgA
60
Identify the antibody:
May cause severe anaphylaxis
IgA
61
Identify the antibody:
Can increase the effect of IgG-induced RBC hemolysis
IgA
62
Identify the antibody:
May cause urticaria if transfused in patients with severe allergic reactions
IgE
63
Identify the antibody:
Releases histamines
IgE
64
Form of IgE most commonly seen in secretions
dimer
65
Identify the antibody:
Least significant in blood banking
IgD
66
Identify the antibody:
Found in the surface of B cells
IgD
67
Identify the antibody:
Not able to cross placenta and activate complement
IgD
68
Antibodies derived from more than one antibody-producing parent cell
Polyclonal
69
Produced in response to a single antigen with more than one epitope
Polyclonal
70
Heterogenous antibody against the same antigen
Polyclonal
71
Antibodies derived from a single ancestral antibody-producing parent cell
Monoclonal
72
Preferred in testing; highly specific, well-characterized, and uniformly reactive
Monoclonal
73
The antigen-binding site
Epitope
74
The antibody-binding site
Paratope
75
Type of alloantibody:
Found in individuals without previous exposure to RBC antigens from transfusions, injection, or pregnancy
Naturally occurring
76
Type of alloantibody:
ABH, Hh, Ii, Lewis, MN, P
Naturally occurring
77
Type of alloantibody:
Mostly IgM cold agglutinins
Naturally occurring
78
Type of alloantibody:
Needed for serum typing
Naturally occurring
79
Type of alloantibody:
Found in individuals with previous exposure to transfusion, injection, and pregnancy
Immune
80
Type of alloantibody:
Mostly IgG
Immune
81
Type of alloantibody:
Rh, Duffy, Kidd, Kell, Ss
Immune
82
Type of serological test done in naturally occurring alloantibody
Indirect/ Reverse/ Backward
83
Type of serological test done in immune alloantibody
Direct/ Forward
84
Type of alloantibody:
Reacts in saline at ambient room temp or at 4C
Naturally occurring (IgM antibody)
85
Type of alloantibody:
May cause hemolysis at 37C
Naturally occurring (IgG antibody)
86
Type of alloantibody:
Reacts best at 37C
Immune
87
Type of alloantibody:
Requires AHG (Coomb's) sera for detection
Immune
88
Type of antibody:
Produced after exposure to non-self antigens
Alloantibodies
89
Type of antibody:
Produced in response to self-antigens
Autoantibodies
90
Type of antibody:
Transfused px with undetectable alloAb may elicit a stronger immune response against previous Ags and cause severe transfusion rxns
Autoantibodies
91
Type of antibody:
Positive autocontrol or direct antiglobulin test (DAT)
Autoantibodies
92
Type of antibody:
Targets antigen absent to px's red cell
Alloantibodies
93
Type of antibody:
Targets antigen present to px's red cell
Autoantibodies
94
This test differentiates alloantibody from autoantibody
Autocontrol
95
Components of autocontrol testing
px's red cell + px's serum
96
Positive result for autocontrol test
Agglutination
97
The antigen-antibody or immune complex is also called as ___
epitope-paratope complex
98
Complex of one or more antibody molecules bound to an antigen
Immune complex
99
The extend of the reciprocal relationship (fit) between the antigen and its binding site on the antibody
Lock and key mechanism
100
Factors influencing antigen-antibody reactions
1. intermolecular binding forces
2. antibody properties
3. host factors
4. tolerance
101
Intermolecular binding force:
Attraction between two molecules on the basis of opposite charge
Electrostatic forces (ionic binding)
102
Intermolecular binding force:
A positively charged region of a molecule is attracted to the negatively charged region of another molecule
Electrostatic forces (ionic binding)
103
Intermolecular binding force:
Attraction of two negatively charged groups (X-) for a H+ atom
Hydrogen binding
104
Intermolecular binding force:
Weak bonds formed as a result of the exclusion of water from the antigen-antibody complex
Hydrophobic bonding
105
Intermolecular binding force:
Attraction between the electron cloud (-) of one atom and the protons (+) within the nucleus of another atom
van der Waals forces
106
Antibody property:
Strength of the binding between a single antibody and an epitope of an antigen
Affinity
107
Antibody property:
Overall strength of reaction between several epitopes and antibodies; depends on the affinity of antibody, valency, and noncovalent attractive forces
Avidity
108
Antibody property:
Number of epitopes per molecule of antigen
Valency
109
High avidity = ___ dissociation
Low
110
One of the most important characteristics of an antibody that is related to its relative avidity for antigen
Specificity
111
A characteristic of an antibody that produces a reaction to similar antigen
Cross reactivity
112
Defined as the lack of an immune response or an active immunosuppressive response
Tolerance
113
Exposure to an antigen during fetal life
Chimera
114
Presence of different populations of cells in a single individual
Chimera
115
Prevents D-negative mothers from developing anti-D antibodies after delivering Rh-positive infants
Tolerance
116
The most common complement pathway where there is an antigen-antibody reaction
Classical pathway
117
A complement pathway where the membrane property of a microorganism is involved
Alternative pathway
118
The antigen-antibody complex is removed from the body's circulation through the ___
Mononuclear phagocyte system
119
In vitro RBC Ag-Ab reactions are detected by visible ___
Agglutination (hemagglutination) or hemolysis
120
Result of complement activation
Lysis (hemolysis)
121
Stage of hemagglutination:
Attachment of Ab to corresponding Ag on RBC membrane
Sensitization
122
Stage of hemagglutination:
Combination of antibody and a multivalent antigen to form crosslinks
Lattice formation
123
Lattice formation is improved by ___
Centrifugation
124
Factors that influence agglutination
Centrifugation
Ag-Ab ratio
pH
Temperature
Ig type
Enhancement media
125
Factors that influence agglutination:
Enhances agglutination reactions
Centrifugation
126
Factors that influence agglutination
Decreases reaction time by increasing the gravitational forces on the reactants to bringing reactants closer together
Centrifugation
127
Ag-Ab ratio:
Excess Ag
Postzone (false neg)
128
Ag-Ab ratio:
Excess Ab
Prozone (false neg)
129
Ideal pH for Ag-Ab reactions
6.5-7.5
130
T/F:
Anti-M and Anti-Pr (Sp1) reacts at a higher pH
False (lower pH)
131
Ig type:
Can readily agglutinate RBCs in saline than IgG
IgM
132
Ig type:
Has more Ag-combining sites
IgM
133
Ig type:
Cold reacting
IgM
134
Ig type:
ABO Abs
IgM
135
Ig type:
Warm reacting
IgG
136
Ig type:
Rh Abs
IgG
137
A biphasic antibody, causing Donath-Landsteiner hemolytic anemia
autoanti-P
138
Difference in negative charge between the inner and outer surfaces of the cloud
Zeta potential
139
Higher zeta potential = ___ Distance
Higher
140
T/F: The higher the zeta potential, the more difficult for RBCs to agglutinate
True
141
Decreases ZP by increasing dielectric constant or adding more cations
Protein media
142
Protein media:
Cheapest but longest incubation time
Bovine serum albumin (BSA)
143
Protein media:
Removes excess water and doesn't need centrifugation
Polyethylene glycol (PEG)
144
If centrifugation is done when using PEG as a protein media, there is a possibility of ___ in the result
false positive
145
Protein media:
Most commonly used with shortest incubation time of 5-15 mins; ave. 10 mins
Low ionic strength solution (LISS)
146
NaCl concentration of LISS
0.2%
147
In using LISS as a protein media, the higher the rate of Ab uptake = ___ incubation time
lower
148
In using LISS as a protein media, when the rate of Ab uptake is increased the incubation time is improved from ___ to ___ mins
30-60 mins to 5-15 mins
149
Incubation time of PEG
10-30 mins
150
Mechanism of action of proteolytic enzymes as enhancement media
Cleaves sialic acid from RBC membrane
151
Identify the proteolytic enzyme used in BB:
Isolated from fig plants
Ficin
152
Identify the proteolytic enzyme used in BB:
From papaya
Papain
153
Identify the proteolytic enzyme used in BB:
From pig stomach
Trypsin
154
Identify the proteolytic enzyme used in BB:
From pineapple
Bromelin
155
Blood antigens enhanced by proteolytic enzymes
Rh, Kidd, P1, Lewis, I Ags
156
Blood antigens depressed by proteolytic enzymes
MNSs, Duffy Ags
157
An enhancement media that determines if RBCs are coated with Ab and/or complement
Anti-human globulin (AHG) reagents
158
An enhancement media that acts as a bridge
Anti-human globulin (AHG) reagents
159
T/F: In using AHG reagents, small IgG can both sensitize and cause agglutination
False (they rarely cause agglutination and cannot overcome zeta potential)
160
Components of LISS
0.2% NaCl
Glycine (to prevent cell lysis)
161
Introduced direct blood transfusion using two silver cannulae
James Aveling
162
Antisera that would react at lower than normal (6.5-7.5) pH level
anti-M and anti-Pr(Sp1)
163
These substances work by increasing the dielectric constant (a measure of electrical conductivity), which then reduces the zeta potential of the RBC
Colloids (working as protein media)
164
Identify the potentiator:
Inc. for 15-60 mins, works by adjusting the zeta potential between RBCs
22% albumin
165
Identify the potentiator:
Inc. for 5-15 mins, provides low ionic strength environment that causes RBCs to take up antibody more rapidly
LISS
166
Identify the potentiator:
Inc. for 10-30 mins, increases test sensitivity and aggregates RBCs
PEG (polyethylene glycol)
167
Identify if the factor would affect sensitization or lattice formation:
Temperature
Sensitization
168
Identify if the factor would affect sensitization or lattice formation:
Incubation time
Sensitization
169
Identify if the factor would affect sensitization or lattice formation:
pH
Sensitization
170
Identify if the factor would affect sensitization or lattice formation:
Ionic strength
Sensitization
171
Identify if the factor would affect sensitization or lattice formation:
Zeta potential
Lattice formation
172
Identify if the factor would affect sensitization or lattice formation:
Zone of equivalence
Lattice formation
173
Identify if the factor would affect sensitization or lattice formation:
Centrifugation
Lattice formation
