BB Exam 4 Practicum Flashcards by Joshua Nguyen

What is complete antibody? What type of antibody is usually responsible for it?

Can bind to corresponding antigen and directly agglutinate RBCs suspended in saline. IgM’s are usually suspected.

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Describe incomplete antibody. What type of antibody is usually responsible for it?

Nonagglutinating because their monomer structure is too small to directly agglutinate. They need sensitized RBCs to agglutinate. IgG is usually suspected.

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What is associated with anti- big i?

Cold agglutinin syndrome or cold hemagglutinin disease (CHD)
The bacteria associated with this antibody is M. pneumoniae
Patients can present with peripheral vascular occlusion (acrocyanosis) or hemolytic anemia

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What is associated with anti - little i?

Infectious mononucleosis
Epstein barr virus
CMV
Lymphoproliferative disorders

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Big i and little i antigens are involved in what kind of condition or diseases?

Cold agglutinins
Acquired hemolytic anemia
chronc dyserythropoietic anemia type II
Hereditary erythroblastic multinuclearity (HEMPAS)
Congenital cataracts (commonly in asians)

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What is associated with anti - P?

PCH
Syphilis (Treponema pallidum)
Parasitic infection (Anti- P1) - Echinococcus granulosus
Facioliasis aka bovine liver fluke disease - Anti-P1
Habitual early abortion

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Duffy null or Fy(a=b=) is associated with

Resistance to P. knowlesi and P. vivax (malaria)

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Anti- Kell is associated with

McLeod Syndrome (anti-K, anti-k) - CGD
vulnerable to bacterial infection
Fetal anemia

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Kell antibodies are associated with…

Immediate / delayed HTR
HDFN
Streptococcus faecium (not sure why)

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What are circumstances a person might exhibit unexpected antibodies?

Transfusion
Transplantation
Pregnancy

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What is an antibody screen?

Its a method to detect clinically significant antibodies ( and insignificant) in both blood donor and recipient as part of pretransfusion compatibility testing

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Describe the RBC reagent used in antibody screen.

Mandated by the FDA, type O RBCs express

Type O RBCs that have the most common and significant antigens. Group O is used to avoid agglutination from Anti-A and Anti-B antibodies. This will allow other antibodies to bind. Each different O type RBCs used usually have R1R1, R2R2, or/and rr.

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What is a cell panel?

A method used for antibody ID. Its a collection of 11 to 20 group O RBCs with various antigen expressed. Diverse antigen expressions are used to help rule out antibodies. They include homozygous expression of Rh, Duffy, Kidd, and MNSs antigens.

Profile sheet can indicate presence of rare cells (low prevalence antigens).

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How would an antibody screen react in the presence of multiple antibodies?

The multiple antibodies would present as multiple strengths of agglutination in the same phase or different phases.

Certain antibodies can be enhanced or destroyed by enzymes

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What kind of antibodies would react in RT phase?

Usually IgM

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What kind of antibodies would react in 4C phase?

IgM or Cryoagglutinins

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What antibodies would react at 37C or AHG phase?

IgG would react

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What enzymes are found in papaya?

Papain

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What enzymes are found in pineapple?

Bromelin

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What enzymes are found in figs?

Ficin

What enzymes are found in a pig’s stomach?

Trypsin

What is zeta potential?

How does albumin enhance agglutinaiton?

Increases dielectric constant leading to a reduced zeta potential

What blood groups show dosage?

Kidd, Duffy, Rh, and MNSs

What blood groups are complement dependent?

Kidd, Lewis, and Big i

What blood groups are enhanced by enzymes?

Rh, Kidd, Lewis, Big i, and P1

What blood groups are destroyed by enzymes?

Duffy and MNSs

What blood groups are hemolytic?

Lewis Anti-Vel ( low frequency) P1 Kidd ABO

What blood groups react best in RT with saline?

Lewis Big I and little i P1 M ABH N Anti-Lua

What blood groups react

What does chloroquine do in antibody studies?

Strips IgG from DAT+ RBCs and removes Bg (HLA antigens) antigens from RBCs

DTT, dithiothreitol in antibody studies?

denatures RBC antigens of mutliple groups including Kell, Lutheran, Dombrock, Yt, and LW. It can also remove IgM antibody activity from serum.

ZZAP in antibody studies

Combination of DTT and proteolytic enzymes. Removes IgM antigens on RBCs

What kind of antibodies react best at 4C?

Anti - I Anti - i Anti - M Anti - N Anti - P1

What kind of antibodies react best during LISS / Albumin, or AHG phase?

Rh group antibodies Anti - S Anti - s

What kind of antibodies best react during AHG phase only?

Rh Kell Ss Duffy Kidd Anti-Lub

What antibodies are crossmatch compatible?

Anti-Lea Anti-Leb Anti-P1 Anti-M Anti - N

What blood groups are destroyed by sulfhydryl compounds?

Lutheran Kell Dombrock Cartwright LW

What antibody can be undetectable, clinically significant, and may required multiple techniques to identify conclusively?

Kidd, Jka & Jkb

What antibodies can be neutralized?

Lewis, Big I, P, and Sda

What antibody prefers an acidic environment?

Anti-M

Why do weak reactions sometimes occur between RBCs and their corresponding antibodies?

Occurs b/c of dosage effect4. Its a phenomenon whereby an antibody reacts more strongly with an RBC carrying a double dose (homozygous) than with a RBC carrying a single dose (heterozygous) of an antigen.

When are elutions of value?

When an antibody or complement is bound to the surface of the RBC. Eluate may be tested against an RBC panel to identify antibody. It is usually done after a positive DAT.

What is a total elution?

A method of elution that releases antibodies and RBC antigen. The RBC is destroyed in the process. Useful in antibody identification

What is a partial elution?

Antibody is released from the RBC without destroying it. The pH method uses glycine acid solution (pH 3) to release antibody into acidic supernatant. After harvesting supernatant the supernatant low pH is neutralized with buffer.

What is adsorption?

Used to remove antibody from serum by adding target antigen and allowing the antibody to bind to the antigen during incubation. It is useful in removing autoantibody that may be masking an alloantibody. There can only be a maximum number of 4 adsorptions.

When are adsorptions of value?

Used to... Detect autoimmune disorders Separate multiple antibodies Remove autoantibody Confirm antigen existence on RBC Confirm antibody specificity Detect weakly expressed antigens Detect weakly reactive antibodies

What is auto-adsorption and when is it used?

Auto-adsorption removes autoantibodies from plasma, leaving behind alloantibodies. The procedure uses patient's cells + patient's serum. The technique is used in patients that have no been transfused and to eliminate suspicion of an autoimmune disorder.