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Immunology > Blood Group Immunology > Flashcards

Blood Group Immunology Flashcards

1
Q

What are the 2 antiglobulin tests?

A

IAT/DAT

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2
Q

Who receives whole blood?

A

Pts who need Volume and cells

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3
Q

How do packed cells help pts who need red cells?

A

1 unit increases HCT by 3% and Hgb 1 g/dl

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4
Q

What is an antibody?

A

: serum protein that is induced by, and reacts specifically with a foreign substance (Ab)

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5
Q

What is an antigen?

A

foreign substance that induces an immune response by causing production of antibodies and or sensitized lymphocytes that react specifically with that substance(Ag

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6
Q

How is a persons blood grp antigen inherited?

A

Individuals inherit a gene which codes for specific sugar(s) to be added to the red cell.
The type of sugar added determines the blood group.

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7
Q

What blood type do you give in an emergency?

A

Type O negative

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8
Q

What does a blood grp refer to?

A

antigenic properties of blood constituents

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9
Q

What are the antigenic properties of blood constituents?

A

Red blood cell antigens
White blood cell antigens
Platelet antigens
Plasma protein antigens

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10
Q

What is the most rare blood type?

A

AB

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11
Q

What is the clinical significance of blood antibodies?

A

ABO antibodies are immune and will result in destroying incompatible cells . Never transfer an antigen to someone with corresponding antibody

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12
Q

What immunoglobulin is responsible for hemolytic transfusion rxn?

A

IgM

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13
Q

Describe transfusion rxn?

A

Most severe with ABO mismatches.Rapid intravascular hemolysis.Free Hgb is releasd to the plasma. Severity also related to the amount of RBCs given

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14
Q

What are symptoms of a major HTR?

A

Fever, Chills, Backache, Headaches,Apprehension

Dyspnea, Hypotension, Vascular collapse

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15
Q

What are possible complications of HTR?

A

DIC, acute renal failure

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16
Q

How do you treat HTR?

A

if suspected stop transfusion, draw sample of blood and look for Hemoglobenimia(pink plasma)
Vigorously hydrate the patient
Forced diuresis with Manitol may help prevent renal damage

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17
Q

What are symptoms of anaphylactic transfusion rxn?

A

Urticaria and bronchospasm

Due to plasma proteins most of the time

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18
Q

What is the pathogenesis of anaphylactic transfusion rxn?

A

IgA deficient patients, may have anti-IgA and develop reactions to the IgA dissolved in the plasma (transfusion)

19
Q

What happens if blood is contaminated and how do you treat it?

A

Occurs with gram negative bacteria. Rare. Septicemia and shock from endotoxins. If suspected, culture the blood unit and treat patient with antibiotics

20
Q

Describe Grp O blood

A

No A or B antigens present, think of as “0” antigens present.These individuals form potent anti-A and anti-B antibodies. UNIVERSAL DONOR

21
Q

Describe Grp A blood

A

No B antigens present.

These individuals form potent anti-B antibodies

22
Q

Describe Grp B blood

A

No A antigens present.

These individuals form potent anti-A antibodies

23
Q

Describe Grp AB blood

A

Both A and B antigens present.
These individuals possess no ABO antibodies.
Their blood does not react against any other ABO type.UNIVERSAL RECIPIENT

24
Q

What Ag do we test for with Rh blood grp?

A

D Ag, most antigenic

25
Q

Describe Rh antibodies

A

Produced by a D negative person who has been sensitized or immunized (“exposed”) to the D Ag
Can occur during pregnancy or after blood transfusion. Anti-D is an IgG

26
Q

What happens if a Rh negative women is pregnant and baby is Rh positive?

A

the antibody can cross the placenta and destroy Rh (D) positive fetal cells resulting in death.

27
Q

What is genotype of Rh negative?

A

dd

28
Q

What is hemolytic disease of the newborn?

A

Abs from the mother enter the fetal circulation and destroys fetal red blood cells. During pregnancy or at birth (feto-maternal hemorrhage), mother becomes exposed to fetal RBCs and develops Anti-D

29
Q

What causes hemolytic disease of newborn?

A

Caused primarily by maternal Anti-D recognizing D Ag in fetal RBCs.

30
Q

What is the pathogenesis of hemolytic disease of newborn?

A

During pregnancy or at birth (feto-maternal hemorrhage), mother becomes exposed to fetal RBCs and develops Anti-D. Anti-D is a monomer can cross the placenta. affects subsequent pregnancies

31
Q

What are mild symptoms of hemolytic newborn disease?

A

mild anemia, jaundice, or breathing problems detected at birth

32
Q

What are severe symptoms of hemolytic newborn disease?

A

heart failure, brain damage, stillbirth or miscarriage

33
Q

How do you prevent hemolytic newborn disease?

A

with Rh immune globulin (RhIG) given to the Rh negative mothers. screen fathers

34
Q

What is rhogam and what does it do?

A

Anti-D antibody (RhoGAM) provides a “passive immunization” to the fetus by suppressing mother’s immune system from attacking it

35
Q

When is Rhogam not needed?

A

If the father is absolutely known to be Rh(-);

36
Q

When is Rhogam given?

A

to D negative mothers at 28 Wks and 72hrs after delivery of a D-positive baby. Also given after miscarriage, abortion or amniocentesis. Repeated every pregnancy

37
Q

Why do anti-A and anti-B antibodies not cross the placenta?

A

because these immunoglobulins are IgM

38
Q

What is the antihuman globulin test (coomb’s test)?

A

Uses a commercial antibody against human globulin (AHG) to detect globulin coated RBCs
Also used for Hemolytic conditions

39
Q

How does testing for blood grp antigens work?

A

Patients RBCs are combined with known antiserum (antibodies) commercially available, observing for agglutination. If the Ag present on the cells correspond to the antibody in the reagent, Ab will bind to the Ag and cause clumping of the cells (agglutination)

40
Q

What is in whole blood?

A

450ml blood and 63 ml anticoagulant, Hct 40%

41
Q

What is whole blood not a good source of?

A

platelets, factor V or VIII

42
Q

What is in packed cells?

A

RBCs

43
Q

When is FFP given?

A

for multiple factors deficiency

44
Q

What is in cryo?

A

factor VIII, XIII, fibrinogen, vWF, fibronectin

Immunology (8 decks)

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