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Immunohematology and Blood Transfusion Medicine > Blood Banking > Flashcards

Blood Banking Flashcards

1
Q

Identified as antigens capable of initiating an immune response, which can affect RBC compatibility

A

Surface markers

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2
Q

T/F: surface markers are identified as antigens capable of initiating an immune response, which can affect RBC compatibility

A

True

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3
Q

Antigens are either __ or __

A

Sugars

Proteins

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4
Q

T/F: antigens are either sugars or proteins

A

True

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5
Q

Blood group describe by Karl Landsteiner in 1900

A

ABO blood group

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6
Q

Who discovered ABO blood group

A

Karl Landsteiner

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7
Q

Year ABO blood group was discovered

A

1900

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8
Q

Most important blood group system

A

ABO blood group

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9
Q

Principle of ABO blood group

A

Individuals possess antibodies against antigens they lack

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10
Q

T/F: in ABO blood group, individuals possess antibodies against antigens they lack

A

True

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11
Q

Char of antibodies in ABO blood group (4)

A

Production initiated at birth, but titer low until 3-6 mos of age
If A or B Ag is absent, person will make antibodies against missing antigens
Naturally-occurring
Complementary relationship enables ABO testing of Px sera and RBCs

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12
Q

ABO antigens exhibit this kind of inheritance

A

Autosomal codominance

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13
Q

T/F: ABO Ags exhibit autosomal codominant inheritance

A

True

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14
Q

Location of ABO

A

Chromosome 9

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15
Q

ABO: One locus in chromosome 9 is occupied by one of 3 alleles: (3)

A

A, B, O

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16
Q

T/F: ABO: One locus in chromosome 9 is occupied by one of 3 alleles: A, B, O

A

True

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17
Q

T/F: ABO: Each person has a pair of chromosomes that carry one allele

A

True

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18
Q

Group O is a

A

Silent allele

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19
Q

Silent allele

A

Group O

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20
Q

Allele wherein gene product not detectable

A

Silent allele or amorph

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21
Q

Secretor genes: location

A

Chromosome 19

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22
Q 
Secretor genes (2)
 -describe each
A

Hh- H antigen on RBC

Se- H antigen in secretions

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23
Q

T/F: Hh and Se are on chromosome 19 and are closely linked

A

True

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24
Q

T/F: H and Se genes: each locus has 2 recognized alleles, 1 allele is an amorph

A

True

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25
Q

Produces a glycosyltransferwse that acts on type 2 chains- H Ag on RBCs

A

H gene

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26
Q

H gene produces a glycosyltransferwse that acts on type __ chains- H Ag on RBCs

A

2

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27
Q

Produces a glycosyltransferwse that acts on type 2 chains- H Ag on __

A

RBCS

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28
Q

T/F: H gene produces a glycosyltransferwse that acts on type 2 chains- H Ag on RBCs

A

True

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29
Q

Non-secretors (3)

A

h gene

se gene

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30
Q

Produces a glycosyltransferwse that acts on type 1 chains- H Ag in secretions

A

Se gene

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31
Q

Se gene produces a glycosyltransferase that acts on type __ chains- H Ag in __

A

1, secretions

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32
Q

Bombay phenotype

A

Genotype hh

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33
Q

Genotype hh

A

Bombay phenotype

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34
Q

Very rare, doesn’t make transferase to form H Ag

A

Genotype hh or Bombay phenotype

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35
Q

T/F: hh is very rare, doesn’t make transferase to form H Ag

A

True

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36
Q

Char of Bombay phenotype (3)

A

Bombay RBCs fail to react with anti-A, anti-B, or anti-H lectin
Only blood from other Bombay phenotype scan be transfused
Bombay serum contains anti-A, anti-B, anti-A,B, and anti-H (potent, reacts strongly at 37。C

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37
Q

Genotype hh Se

A

Para-Bombay phenotype

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38
Q

Normal amount of H ag is detectable in saliva because these are secretors but may produce a weak anti-H

A

Para-Bombay phenotype

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39
Q

T/F: para-Bombay phenotype: Normal amount of H ag is detectable in saliva because these are secretors but may produce a weak anti-H

A

True

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40
Q

A subgroups:
__% A1
__% A2 or weaker

A

80%

20%

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41
Q

Inheritance of A2 gene:

A

Small amount of H Ag conversion

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42
Q

T/F: Inheritance of A2 gene: Small amount of H Ag conversion

A

True

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43
Q

T/F: A subgroups have same immunodominant sugars

A

True

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44
Q

Differentiation of A1 and A2 subgroups based on:

A

Reactivity with anti-A1 (lectin [Dolichos biflorus] or human-based)
-A1 cells react with anti-A1 while A2 cells don’t

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45
Q

T/F: Genes at 3 separate loci control the presence and location of the A, B, and H antigens: ABO, Hh, and Se

A

True

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46
Q

H gene
Gene product/enz:
Antigen:
Immunodominant sugar:

A

H gene
Gene product: L-fucosylytransferase
Antigen: H antigen
Immunodominant sugar: L-fucose

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47
Q

A gene
Gene product/enz:
Antigen:
Immunodominant sugar:

A

A gene
Gene product: N-acetylgalactosaminyltransferase
Antigen: A antigen
Immunodominant sugar: N-acetylgalactosamine

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48
Q

B gene
Gene product/enz:
Antigen:
Immunodominant sugar:

A

B gene
Gene product: D-galatosyltransferase
Antigen: B antigen
Immunodominant sugar: D-galactose

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49
Q

Generally, A and B genes encode these that produce A and B antigens

A

Glycosyltransferases

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50
Q

T/F: genes do not directly encode for the antigen but encode for the ENZYME that transfers the immuno dominant sugar that confers the specificity

A

True

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51
Q

T/F: O gene does not encode a functional enzyme because it is an amorph gene

52
Q

T/F: A and B genes are dominant genes while O gene is an amorph gene

53
Q

T/F: weak a subgroups show weaker reactivity than A2

54
Q

Weak A subgroups (2)

55
Q

Weak A subgroup with mixed-field pattern of agglutination with anti-A

56
Q

Weak A subgroups make up __% of the population

57
Q

T/F: weak A subgroups make up 1% of the population

58
Q

Weak A subgroup with stronger reaction with anti-A, B than anti-A

59
Q

Weaker A subgroups are detected by

A

Elution and adsorption of anti-A

60
Q

Very rare, little consistency in description, recognized by variations in strength of reaction with anti-B and anti-A,B

A

B subgroups

61
Q

People typed as A and B generally produce this class of antibodies and small quantities of this class of antibodies

A 
IgM class ABO antibodies 
*and small quantities of IgG
62
Q

People typed as O produce this class of antibodies

A

IgG class antibodies- anti-A,B

63
Q

Readily crosses the placenta

64
Q

Aka RBC typing

A

Forward typing

65
Q

Aka forward typing

A

RBC typing

66
Q

Reagents for forward typing (2)

A

Anti-A and anti-B

67
Q

Anti-A and anti-B used for forward typing are generally __ this designed to give at least __ or stronger reactions

A

Monoclonal antibodies

3+

68
Q

aka serum typing

A

Reverse typing

69
Q

Aka reverse typing

A

Serum typing

70
Q

ABO testing which uses anti-A and anti-B

A

Forward typing

71
Q

ABO testing which uses A1 cells and B cells

A

Reverse typing

72
Q

Reagents used for reverse typing

A

A1 cells and B cells

73
Q

Reagent cells for ABO typing are Rh _

A

Rh negative

74
Q

T/F: reagent cells for ABO typing are Rh neg

75
Q

RBCs contain __ or __ on their __ or as __

A

RBCs contain surface markers or antigens on their surface or as part of their membranes

76
Q

Expected reaction in reverse typing

-anything weaker may indicate __

A

2+

Serum problem

77
Q

T/F: expected result in reverse typing is 2+ and anything weaker may indicate serum problem

78
Q

Forward and reverse typing are both required in patients and donors to serve as __ for each other

79
Q

T/F: Forward and reverse typing are both required in patients and donors to serve as check for each other

80
Q

Non-routine reagents (3)

-and use/s or description of each

A 
Anti-A,B
 -used to aid in classification of subgroups
 -confirm group O units (retype)
A2 cells 
 -discrepancy resolution
Lectins
 a. Anti-A1: Dolichos biflorus
 b. Anti-A2: Ulex europaeus
81
Q

Uses of anti-A,B (2)

A
  • used to aid in classification of subgroups

- confirm group O units (retype)

82
Q

Process of confirming group O units

83
Q

Use of A2 cells

A

For discrepancy resolution

84
Q

Lectins (2)

-also describe

A

Anti-A1 from Dolichos biflorus

Anti-H from Ulex europaeus

85
Q

Source of anti-A1 and anti-H

A

Anti-A1 from Dolichos biflorus

Anti-H from Ulex europaeus

86
Q

Dolichos biflorus as source of this lectin

87
Q

Ulex europaeus as source of this lectin

88
Q

Causes of ABO discrepancies: 4 groups

A

Weak or missing antigen reactivity
Extra antigen reactivity
Weak or missing antibody reactivity
Extra antibody reactivity

89
Q

Weak or missing antigen reactivity (6)

-describe each

A 
Mixed cell populations and chimeras
 -review transfusion and transplant history
Excessive blood group substance
 -can neutralize reagents
Newborns
 -lower number of A a/o B antigen sites
Subgroups of A and B
 -A3, Ax, Ael
 -B subgroups rare
Leukemia
 -weak expression of A a/o B antigen
Cis-AB phenotype 
 -rare chromosome
90
Q

MOST common cause of chimerism

A

Transfusions

91
Q

T-F: transfusions are the most common cause of chimerism

92
Q

Extra antigen reactivity (4)

A

DAT +
Acquired B
Contaminated cord blood samples
Unwashed cell suspensions

93
Q

Patient types as AB, but serum contains anti-B

A

Acquired B

94
Q

Transient condition associated with disorders of the gastrointestinal tract

A

Acquired B

95
Q

Acquired B is a transient condition associated with disorders of the ___

A

Gastrointestinal tract

96
Q

T/F: acquired B is a transient condition associated with disorders of the gastrointestinal tract

97
Q

T/F: certain clones used to make monoclonal anti-B cause strong reactions with acquired B cells

98
Q

T/F: Acquired B: strength of reactivity is weakened with reduced reagent pH

99
Q

Strength of reactivity is weakened with reduced reagent pH

A

Acquired B

100
Q

Strength of reactivity is weakened with __ reagent pH

101
Q

Associated with colonic bacterial infections

A

Acquired B

102
Q

Test RBCs with human anti-B acidified to pH __

103
Q

T/F: strongly reactive DAT cells can spontaneously agglutinate with cell grouping reagents

104
Q

Most often seen with Rh typing reagents

A

Direct antiglobulin test +

105
Q

T/F: DAT + can occur with ABO reagents if coating antibody is cold-reactive

106
Q

Can occur with ABO reagents if coating antibody is cold-reactive

107
Q

DAT + can occur with ABO reagents if coating antibody is __

A

Cold-reactive

108
Q

Resolution for DAT + (3)

A

Wash cells with 37•C
Incubate Px cell suspension at 37•C and wash with warm saline
Elute antibodies from RBCs with chloroquine diphosphate or dithiothreitol (DTT)

109
Q

Used to elute antibodies from RBCs to resolve DAT + (2)

A

chloroquine diphosphate or dithiothreitol (DTT)

110
Q

Main cause of contaminated cord blood samples

A

Wharton’s jelly

111
Q

How to resolve contaminated cord blood samples (2)

A

Wash w/ saline 3 or 4x, retest

Request heel-stick sample

112
Q

Sample requested to resolve contaminated cord blood samples

A

Heel-stick sample

113
Q

Washing can dissipate problems caused by (2)

A

Px antibodies to reagent components

Rouleaux formation

114
Q

Resolves Px antibodies to reagent components and rouleaux formation

115
Q

Weak or missing antibody reactivity (4)

-describe also

A 
Chimeras
 -persistent chimeras develop a tolerance to both cell populations
Missing antibodies 
 -immunocompromised Px
Low antibody levels
 -newborns and older Px
Subgroups
 -cells from A subgroup Px's often typed as group O
116
Q

T/F: persistent chimeras develop a tolerance to both cell populations

117
Q

Low antibody levels usually seen in (2)

A

Newborns

Older pop

118
Q

Missing antibodies are usually in

A

Immunocompromised Px’s

119
Q

Cels from A subgroup Px’s often typed as group __

120
Q

T/F: titer of anti-A is usually higher than that of anti-B in most group O

121
Q

T/F: subgroups may be due to anti-A1 or other allo antibodies and not by anti-A

122
Q

Testing panel of (3) can help determine of subgroup discrepancy exists

A

A1, A2, and O cells

123
Q

Rouleaux formation: resolution:

A

Saline replacement technique

124
Q

How to resolve cold-reactive antibodies (allo antibody or autoantibody) (2)

A

Use of mini-cold panel

Testing with A2, O, and autologous cells, in addition to tests with A- and B cells

125
Q

How to resolve passively acquired antibodies (1)

A

Check Px transfusion history

126
Q

Extra antibody reactivity (3)

A

Cold-reactive antibodies (autoantibody or alloantibody)
Passively acquired antibodies
Rouleaux

127
Q

Suggested resolution process for ABO serologic problems (5)

A

Repeat testing on same sample
Wash Px cells
Obtain Px info
-diagnosis
-historical blood group
-history: transfusions, transplants, medications
Review results with group O RBCs and autocontrol
Obtain new sample if contamination suspected

Immunohematology and Blood Transfusion Medicine (2 decks)

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