ABO/Rh/Genetics Flashcards
What naturally occurring antibody always appears in the serum of an Rh positive individual?
None
very rarely anti-E or anti-Cw
Purpose of washing red blood cells
Eliminates serum proteins
What happens when a patient receives multiple units of compatible blood type different from their own?
Patient may show mixed cell populations
May temporarily type as Rh negative
What other reaction is interpreted as a positive reaction if using serum (not plasma)?
Hemolysis
Where are the red cell antigens found?
Surface of the red cell
Homozygous
Identical alleles are inherited at a given locus
Ex. cc
Genotype
The actual genes on the chromosome
Ex. AO
Phenotype
The expression of the genotype
Ex. A
Prozone
Excess antibody which discourages or stops the bridging between antibody-antigen complex to form agglutination
Dominant
A trait or characteristic that will be expressed even though it is on only one of a chromosome pair
Ex. A
Recessive
A gene that will not be expressed if its dominant allele is present, it will be expressed in homozygous state only
Ex. O
Cis
Alleles on the same chromosome
Ex. DCe/dce
Trans
Alleles on different chromosomes
Dce/DCe
Heterozygous
Two different alleles - one on each individual chromosomes
Ex. Fya and Fyb
Paragloboside
Precursor for H antigen
Paragloboside + fucose
H antigen (precursor for A and B)
4+ agglutination reaction
One large agglutinant
3+ agglutination reaction
Several large agglutinants
2+ agglutination reaction
small agglutination with clear backround
1+ agglutination reaction
fine agglutination with red background
Causative agent of intravascular transfusion reaction
IgM antibody that has a broad thermal range of activity
Consequence of intravascular transfusion reaction
Complement proceeding to lysis of donor RBCs (intravascular hemolysis)
Causative agent of extravascular transfusion reaction
IgG antibody
Consequence of extravascular transfusion reaction
Antigen (RBC) and antibody complex removed slowly in spleen
What is the first thing you do if you find an ABO/Rh typing discrepancy?
Repeat testing
Order of decreased in H substances
O > A2 > B > A2B > A1 >A1B > >Oh
Which blood type would be most likely to make anti-H?
A1B because it has the least H on surface. Seen as foreign
Antigen: patient RBCs
Antibody: purchased reagent
Front testing
Antigen: purchased RBCs
Antibody: patient serum
Reverse testing
Antigen: patient RBCs
Antibody: purchased reagent + potentiator
D tube testing
Antigen: patient RBCs
Antibody: none + same potentiator as D tube
Rh control tube
What antibody class is naturally occuring ABO antibodies?
IgM
What temp does IgM antibodies react at?
Broad thermal range. Reacts at 4 degrees, room temp (24 degrees), and body temp (37 degrees)
What blood group has H antigen missing?
Bombay
H specificity sugar
Fucose
A specificity sugar
N-acetylgalactosamine
B specificity sugar
D-galactose
When can ABO antibodies first be detected?
3-6 months
Lectins
Plant proteins that act like particular antibodies
Lectin for anti-A1
Dolichos biflorus
Lectin for anti-H
Ulex europaeus
What determines the specificity of A and B antigens?
Terminal sugars attached by the inheritance of transferases
What genes are involved to determine if a person has H antigen?
Hh
What genes are involved to determine if a person is a secretor or not?
Sese and Hh
What is the difference in the precursor molecule between an A, B, H, antigen and A, B, H substance?
Substances are glycoprotein
Antigens are glycolipids
Purpose of using lectin for anti-A1 and anti-H
Typing A1 and A2 individual donors
How to determine if a patient is A1 or A2
Use anti-A1 lectin (Dolichos biflorus)
Substances found in saliva of type A secretors
A, H
Substances found in saliva of type B secretors
B, H
Substances found in saliva of type AB secretors
A, B, H
Substances found in saliva of type O secretors
H
What ABH substances would be found in the saliva of nonsecretors?
None
Why isn’t the crossmatch tube showing agglutination if an Rh pos donor is crossmatched with an Rh neg recipient?
No antibody (anti-d) in recipient’s blood to react with donor D antigen.
Rh antigen that is always significant for transfusion purposes
D
3 reasons for Rh typing to appear as weak D pos
Genetic
Trans
Mosaic
Rh null
Patient does not have D, Cc, Ee antigens
Rh deletion
Patient is missing Cc or Ee
Rh mosaic
One or more the antigenic determines of the D antigen are missing.
LW antigens
LWa, LWb, LW (silent)
LW antibodies
Anti-LW may react with D pos cells & very weakly with d neg cells.
Anti-LW reacts with cord cells whether the baby was Rh pos or neg
Cw
Antigen present in 2% whites
Anti-Cw may be NRBC stimulated
G
Antigen is an epitope present on most C & D pos RBCs.
Anti-G reacts like anti-C plus anti-D, truly only an antibody to a specific epitope that is present on both AGs.
f
Antigen is on RBC surface if c, e is in the cis position on the chromosome
rhi
Ce are in the cis position on the RBC.
V
ce.
Found in 30% of African Americans
VS
e
Another compound antigen seen in African Americans
Rh control reagent
Suspension or potentiator used in anti-D reagent. Used to confirm that the agglutination with anti-D was because of an antigen-antibody combination
How many antigens are in the Rh system?
About 50
Which Rh antigens are the most likely to make non-red blood cell stimulated antibodies?
E, Cw
Control for weak D testing
Indirect AHG
When is it essential to do weak D testing?
For donors who initially typed as Rh negative
Purpose of albumin
Enhances Rh reactions
Purpose of LISS
Not as strong as albumin, but stays less sticky
Two reasons why a patient may type as Rh positive and also have anti-D
Anti-LW
D mosaic
Rh gene combinations in Native Americans
DCe
Rh gene combinations in black populations
Dce
Rh gene combinations in Caucasian populations
DCe
Order of immunogenic strength of Rh antigens
D > c > E > C > e
Which Rh antigens show dosage?
All but D
how do the Rh antigens (DCcEe) react with enzymes?
All enhanced
If a donor was DCe/dce and the recipient was dce/Dce, what are the possible antibodies that may be produced?
Anti-C
If a patient has both anti-D and anti-C, what antibody combination is this called?
anti-G