Blood Group Immunology Flashcards
Serum is made up of?
liquid (proteins, carbs, lipids, salts, electrolytes, abys, etc)
NO clotting factors
*plasma= liquid minus blood cells.
Plasma made up of?
90% H20 & serum
*serum=liquid minus clotting factors
Indirect anti-globulin test & Direct anti-globulin tests are used for what?
important in differentiating the types of blood groups so that you dont transfuse pt w/ incompatible blood.
Immunohematology is what?
the study of human blood groups, evaluation of blood groups, blood banking, testing for blood group Ags, antiglobulin test
Applications of Immunohematology?
Transfusion medicine, pregnancy, HDN, organ transplant, paternity testing
What blood products would you require if you needed to increase volume and cells?
Whole blood
What blood products would you require if you need to increase cell mass?
Packed cells
What blood products would you require if you need to increase clotting?
platelets, plasma (factor V and VIII)
Blood group Antigens are made up of what?
Sugars, they are inherited.
In emergency transfuse which blood group?
O negative (universal donor)
What is the most and least common blood group?
Most= O Least = AB
Most common blood group systems after ABO, Rh
Kell, Duffy, Kidd, HLA (important for transplants)
REVIEW THIS IN ONENOTE
SLIDE 17; ABO system genetics chart
What would happened to an individual trasnfused with an incompatible blood group?
transfusion rxn: may be acute or delayed (delayed is worse) agglutination leading to hemolysis.
What aby is responsible for hemolytic transfusion rxn?
IgM
Signs/Symptoms of Transfusion Rxn
- fever
- chills
- backache (d/t kidneys)
- HA
- apprehension
- dyspnea
- hypotension
- vascular collapse
- anaphylactic rxn (if IgA deficient and blood contains IgA)
- Contaminated blood»>septicemia
- in very severe cases:
- -Diffuse intravascular coagulation (DIC) (excessive clotting followed by excessive bleeding)
- -Acute Renal Failure (from tubular necrosis and clotting in renal system)
Treatment of Hemolytic transfusion rxns
- stop transfusion
- watch for hemoglobinemia (pink urine)
- vigorously hydrate patient
- Manitol (for forced diuresis)
- if septicemia treat w/ abx
Which blood group do abys occur naturally in ?
ABO
*Rh abys do not occur naturally
Rh antibodies are produced under what circumstance?
when an Rh(D) negative person has been sensitized or exposed to the D Ag.
*can occur during pregnancy or after blood
transfusion
- D antigen is very immunogenic; individuals exposed to it will very likely make and aby to it.
Anti-D is which type of Immunoglobulin?
IgG
Most important patient population to consider for Rh Ag?
females of child-bearing age
Can Rh(D) Ag cross the placenta?
YES!
Hemolytic Disease of Newborn: What is this and under what circumstances does it occur?
this happens when Rh D antibody (developed from first pregnancy) crosses the placenta and destroys Rh (D)+ fetal cells resulting in death.
Circumstances: Usually affects subsequent pregnancies, 1st pregnancy is not affected.
- Mother is Rh- and baby is Rh+
- Father typing for Rh group
- if both mother and father are Rh+, mom + and dad -, screening test doesnt need to be done
Prevention of Hemolytic Disease of Newbown
Rhogam (Rh immune globulin RhIG)
Fetal outcomes of HDN
Mild cases: mild anemia, jaundice, breathing problems
Severe: heart failure, brain damage, stillbirth, miscarriage
Genetics of Rh Blood Groups
Rh+=DD, or Dd (D =dominant), you do have D Ag.
Rh- = dd (d=recessive), you do not have D Ag.
Administration of Anti-D aby provides what type of immunization?
passive!
Anti-D aby is what type of Immunoglobulin?
IgG
Treatment for Rh(-) Mothers
- ) screen for Rh Aby at 1st prenatal visit:
- if Rh+: monitor fetus
- if Rh-: retest mother at 28weeks. - ) 28week test
- if +: monitor fetus
- if -: give RhoGAM - ) At delivery; test infants blood type:
- if +: give 2nd dose to mother
- if -: no further doses are needed
*Repeated with each pregnancy
indications for RhoGAM if Rh- mother
- Post partum- 72hrs after delivery
- Antepartum- 28weeks
- Antepartum- amniocentesis, chorionic villus sampling, percutaneous umbilical blood sampling
- Antetpartum- abdominal trauma, ectopic pregnancy, abortion oor threatened abortion at any stage in gestation with continuation of pregnancy
- Transfusion of Rh- incompatible blood
*if father is abosloutely know to be Rh- RhoGAM is not needed.
Anti-A and Anti- B are which type of immunoglobulins?
IgM, cannot cross the placenta
How to test blood group ag
pts RBC combined with known antiserum (Abys) and observer for agglutination, if Ag present on cell correspond t the ABy in reagent. Aby will bind to the Ag and cause clumping of cells.
What are the types of tissue transplants?
Autografts: from same individual
Allograft: from same species
*ABO and Rh must be matched along w/ histocompatibility testing
Coombs test
antihuman globulin test, uses a commercial aby against human globulin to detect globulin coated RBCs.
