Blood: Blood Groups L4 Flashcards

1
Q

define blood group

A

classification of blood based on presence of inherited antigenic substances on surface of red blood cells

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2
Q

define antigen

A

a material not found in the host and is considered as foreign provoking an immune response

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3
Q

describe the antigens on the surface of red blood cells

A

mixture of proteins, glycoproteins and glycolipids
they are found on all red blood cells and a range of other cells in the body

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4
Q

can the antigens on red blood cells that have been inherited change

A

yes
- those inherited tend to be life long but ca be changed by infection, malignancy, autoimmune disease or after a bone marrow transplant

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5
Q

what are the two main blood groups systems

A
  1. ABO
  2. Rhesus
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6
Q

who discovered ABO blood group system

A

Karl Landsteiner

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7
Q

what are the blood types in ABO blood group system

A

A , B, O, AB
- A and B are codominant
- A and B are dominate to O

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8
Q

what are the 5 sugars involved in the ABO system

A

Fucose*
galactose*
N-acetylgalactosamine*
N-acetylglucosamine
Sialic Acid

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9
Q

what type of enzymes are used and what are the 3 main ones used in ABO system

A

glycosyl transferases
1. Fucosyl transferase (FUT1)
2. N-acetylgalatosamine transferase (A transferase)
3. Galactose transferase (B transferase)

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10
Q

what are the two genes involved in ABO system

A
  1. ABO
  2. H
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11
Q

what is the ABO blood group determined by

A

terminal sugar structure of substances found on surface of red blood cells

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12
Q

what do the ABO and H genes encode and what is the products function

A

they encode specific glycosyltransferases
- transfer monosaccharides to polysaccharide chains

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13
Q

what are the possible alleles of ABO and H genes

A

ABO: A, B or O
- O encodes a non-functional protein so no enzymatic activity
H: H or h

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14
Q

what does the H allele encode and what is its function

A

encodes for fucosyl transferase (FUT1)
- Adds fructose to terminal galactose molecule of precursor substance forming H antigen

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15
Q

where is H gene located
what is the function of H and h and which is dominant

A

chromosome 19
H: dominant, encodes for FUT1
h: recessive, encodes non-functional protein
-HH make H antigen
- Hh make H antigen
- hh do not make H antigen

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16
Q

what name is given to the hh genotype and describe it

A

Bombay phenotype
No symptoms or related disease but hh people can receive transfusions only from others with the same blood group.

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17
Q

where is ABO gene found
what causes O allele
how do A and B alleles differ
which residues determine A and B to encode different glycosyltransferase

A

found in seven exon gene on chromosome 9
O allele caused by deletion in 6 of the exons causing a frameshift therefore protein is inactive
A and B differ by 7 nucleotide substitution
- 4 of these substitutions cause different amino acids to form
residues 266 and 268

18
Q

A allele encodes A- transferase (N-acetyl galactosamine transferase) while B allele encodes B transferase (galactose transferase)
what do A and B transferase do

A

A transferase turns H antigen to A antigen
- adds N-acetyl galactosamine to terminal galactose
B transferase turns H antigen to B antigen
- adds galactose to terminal galactose of H antigen
both use UDP to do this

19
Q

describe blood group O

A

people who have neither A or B transferases and make only H substance

20
Q

hh May posses functional A or B transferases but can not make ABO antigens
- why is this

A

they don’t have functional FUT1 they can not make substance H
(can not turn precursor substance to A or B antigen)

21
Q

describe AB blood group

A

person has both A and B transerases
- some of the H antigens will have galactose added and some will have N-acetylgalactosamine added
- forms blood cells with both A and B sugar chains on their surface.

22
Q

what are the 6 genotypes of ABO blood group system

A
  1. AA- only makes A antigens
  2. BB - only makes B antigens
  3. AO- only make A antigens
  4. BO- only make B antigens
  5. AB- make both A and B antigens
  6. OO- makes only H antigen
23
Q

What is the function of A and B antigen

A

unknown
- those with O do not have A or B antigen but are still healthy

24
Q

give examples of diseases linked with ABO blood group

A
  1. gastric cancer for blood group A
  2. gastric and duodenal ulcers in group O individuals
  3. ABO phenotype correlates with level of factor VIII and von Willebrand factor (vWF). Blood group O individuals have about 25% less factor VIII and vWF in their plasma.
25
Q

which is the most common blood group across ethnicities and which is the rarest

A

most common: O
rarest: AB

26
Q

A,B,O are glycoproteins so are antigenic
- what can this provoke

A

an immune response

27
Q

what kind of antibodies will blood group O develop

A

A and B (alpha and beta)

28
Q

what antibodies will blood group A make

A

B (beta)

29
Q

what antibodies will blood group B make

A

A (alpha)

30
Q

what antibodies will blood group AB make

A

none
Note that blood group antigens are also known as agglutinogens and the antibodies raised against them are known as agglutinins

31
Q

what will happen if blood group A mixes with B

A

B antibodies from A’s plasma will agglutinate red blood cells

32
Q

what does agglutination lead to

A

lysis of red blood cells in the blood vessels, complement system is activated. Leads to kidney failure, uncontrolled clotting and circulatory shock; can be fatal.

33
Q

why is donated blood less clinically significant

A

Donated blood also contains antibodies that can agglutinate recipient RBCs - Clinically of less significance as are quickly diluted in the recipient’s blood.

34
Q

what molecule are rhesus antigens and how many can be present on RBL

A

proteins
- not glycoproteins
49

35
Q

which is the most common type of rhesus antigen

A

D
Individuals who are homozygous dominant (DD) or heterozygous (Dd) are Rh+.
Individuals who are homozygous recessive (dd) are Rh-ve
- positive is most common of all ethnicities

36
Q

what are anti-Rh antibodies

A

antibodies that destroy rhesus positive blood they find
- RBC bound by IgG, engulfed by macrophages, transported to liver and spleen for removal.
- Less serious than intravascular haemolysis

37
Q

who can O- blood be given to
and who can they receive blood off

A

everyone
- has no antigens on surface
only receive off O-
- has all antibodies

38
Q

who can AB+ be given to and who can they take blood off

A

they can receive from anyone
- have all antigens so have no antibodies
can only donate to AB+

39
Q

read the rest using pp table

A
40
Q

what is Haemolytic disease of the newborn

A

a father is Rh+ mother is Rh-
during first pregnancy, mother will make Rh antibodies as baby is Rh+
during second pregnancy and baby is Rh+, anti-Rh antibodies made by mother will cause agglutination of babies RBC causing anaemia and jaundice, can kill the foetus

41
Q

how can haemolytic disease of a newborn be prevented

A

Rh-ve mothers given anti-D immunoglobulin which removes any foetal Rh+ve blood from her circulation before she can make anti-D antibodies

42
Q

Mothers may make antibodies to a baby’s ABO antigens
why is this not an issue like anti-Rh antibodies

A

These antibodies are of the IgM class and do not cross the placenta thus the foetus can not be harmed.