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House Hemat > Blood Group Shit > Flashcards

Blood Group Shit Flashcards

1
Q

ERYTHROCYTE ANTIGENES AND ANTIBODIES

A blood groups system is a group of ______ encoded by _____ at a _______ gene locus or at gene loci _______ that _______ does not occur

A

antigens; alleles

single; so closely linked

cross over

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2
Q

ERYTHROCYTE ANTIGENES AND ANTIBODIES

An antigen collection is a group of antigens that are _________________________________________ but ______________________

A

phenotypically, biochemically or genetically related

their genes are not known to be allelic.

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3
Q

International Society of Blood Transfusion has recently recognized ____ blood group systems.

Apart from _______ and ________, many other types of antigens have been noticed on the red cell membranes.

______ antigen collection have been defined generally.

A

34; ABO and Rhesus system

7

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4
Q

Immunology of the blood group system.

An antigen is a substance that can _______, when introduced into an immuno competent host and can ___________

A

evoke an immune response

react with the antibody.

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5
Q

Most blood group antigens are ________ and their specificity is mostly determined either by the ________ (e.g. ABO) or ____________(e.g. MN, Kell, Duffy, Kidd, Diego)

A

glycoproteins

oligosaccharide

amino acid sequence

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6
Q

Specificity of an antigen is determined by _________ and _______________ with its _______

A

its structure

stereochemical fit with its antibody

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7
Q

An antigen can have several ________ or ____________ with each epitope capable of eliciting an antibody response.

A

epitopes or antigenic determinant

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8
Q

The ability of an antigen to _____________ is called immunogenicity

A

stimulate an immune response

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9
Q

Antigen’s ability to _____________ is called its antigenicity

A

react with the antibody

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10
Q

So, ____,____,______ and the _______ and _______ of the epitope on the red cell membrane affect these immunogenicity and antigenicity

A

size, shape, rigidity

number and location

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11
Q

Antigen expression

_______-labelled _____ and _____ conjugated _____ is used to estimate number of antigenic site.

A

125I; antibody

ferritin; anti-IgG

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12
Q

Antigen development

Most erythrocyte antigen are detected early in fetal development

T/F

A

T

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13
Q

erythrocyte Antigen development

ABH = ____-____ in fetal development

A

5- 6wks

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14
Q

Antigen development

all erythrocyte antigen however are fully developed at birth

A

F

Not all erythrocyte antigen however are fully developed at birth

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15
Q

Adult expression of ABH, I and lewis antigen may take _______

A

2yrs

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16
Q

Adult expression of ______,_____ and ______ antigen may take 2yrs

A

ABH, I and lewis

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17
Q

Lutheran and P1 adult development may take > ________

A

7yrs

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18
Q

_______ and ______ adult antigen development may take >7yrs

A

Lutheran and P1

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19
Q

Genetic variation

Homozygous individual may have (more or less?) number of antigen site than heterozygous for a particular allele and May possess (stronger or weaker?) reaction with the antibody (i.e dosage) allelic antigen like Cc, Ee, Kk, Mn, Ss, Jka and JK5 usually show dosage
Dosage is less with D and lutheran

A

More

Stronger

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20
Q

Haplotype ________ and _______ can affect phenotype expression (e.g inheriting ___ with ____ can suppress expression of D)

A

pairing and gene interaction

C; D

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21
Q

Immunogenicity

After ______ and _____ , ____ is the next immunogenic followed by ____ and ____

A

A and B

D

K and C.

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22
Q

BIOCHEMISTRY OF ANTIGEN
An antibody will recognise

1)4-5 ___________ resided on _______

or

2)1 -7 _____ resided on _______

A

Amino acids sequence; linear polypeptide

sugar; linear polysaccharides

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23
Q

BIOCHEMISTRY OF ANTIGEN

Polysaccharides are made by ______ addition of __________ by _________

A

sequential

specific sugars by specific transferase enzymes

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24
Q

sugars involved in red cell antigens are:

  1. _________
    2.___________
  2. ___________
    4.__________
    5.N-acetylneuraminic acid (sialic acid) and
  3. D-manose
A

D- galactose

N-acetyl D-Galactosamine

N-acetyl-D-glucosamine

L-fucose,

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25
Q

CARBOHYDRATE ANTIGENS

_________________ blood group antigens are examples of Carbohydrate antigens.

A

P, ABO and Lewis

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26
Q

CARBOHYDRATE ANTIGENS

Their specificity depends on ______ or ___________ sugar, the type of polysaccaride to which the sugar is attached and on the type of linkage

A

terminal or immunodominant

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27
Q

CARBOHYDRATE ANTIGENS

_______________ is the immuno- dominant sugar for A and P antigen

__________– for B, P1 and Pk

_______ for substace H, Lewis

A

N-acetyl-D-Galactosamine

D-galactose

fucose

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28
Q

CARBOHYDRATE ANTIGENS

N-acetyl-D-Galactosamine is the immuno- dominant sugar for _____ and ____ antigen

D-galactose – for _____,_____, and _____

fucose for ______,_______

A

A and P

B, P1 and Pk

substace H, Lewis

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29
Q

In the ABO system, the ___ antigen encodes the gene that encodes, for the transferase enzyme.

The ABO locus is located on chromosome ____ at

The H-antigen gene is located on chromosome _____ and expressed as a ______ containing glycan

A

I

9

19

fucose

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30
Q

PROTEIN ANTIGEN

-______,_____,______, and ______ are all glycoylated protein

__________ antigen are non- glycocylated protein

A

MNS, Kell, Duffy and Lutheran

RH and kidd

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31
Q

PROTEIN ANTIGEN

  • MN: Resides on ________ (with 131 ass and 15-G-linked oligosaccharide chains)
A

glycophorin A

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32
Q

The RH protein is especially hydro______ and transverse the red cell membrane the RH.

The gene coding for the RH antigen are located on _______ loci on long arm of chromosome ___(_____-_____)

A

phobic

two gene

1

p36-p34

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33
Q

DISTRIBUTION OF RED CELL ANTIGEN IN HEALTH AND DISEASE
RH, Kell, Duffy and Kidd antigens are found only on red cell so also is MNS and Lutheran except. Lub (on renal endothelial cell and liver hepatocytes)
MN activity is seen on renal capillary endothelium

A
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34
Q

DISTRIBUTION OF RED CELL ANTIGEN IN HEALTH AND DISEASE

____,_____,_______ and _______ antigens are found only on red cell

so also is ______ and _______ except. _____ (on __________ and _________)

A

RH, Kell, Duffy and Kidd

MNS and Lutheran

Lub

renal endothelial cell and liver hepatocytes

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35
Q

MN activity is seen on renal capillary endothelium

T/F

A

T

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36
Q

Physiologic disorders of red cell antigen and some observed associated medical conditions

ABH are found on endothelial cells and epithelial cells except for these of the _________.

ABH, Lewis I and P blood group antigen seen in _______,_______, And _______

A

CNS

plasma, platelets, lymphocyte

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37
Q

Physiologic disorders of red cell antigen and some observed associated medical conditions

Blood group A = carcinoma of ____,_____,______,_______ and also with thrombosis.

blood group o: ______,_______,______,______.

non secretion of ABH is associated with __________

A

salivary gland , stomach, colon and ovary

duodenal ulcers , gastric ulcers , rheumatoid arthitis, vWD

Candida Albicans

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38
Q

Erythrocyte that lack Duffy (Fya and Fyb ) antigen are ________________ (_________)

A

not infected by malaria parasite (P vivax)

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39
Q

Rhnull syndrome (an autosomal recessive condition characterized by ______________________ is associated with ____________________

A

complete lack of all Rh antigens

hereditary stomatocytosis

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40
Q

Mcleod phenotype: resulting from decreased expression of the 23 _____ blood group antigens with absence of the ________ antigen on red cell

i.e the ____ synthesized by _____ on the ___ chromosome is lost due to a mutation…

A

kell

xK

xK protein ; Xk gene; X

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41
Q

this xk protein interact with the _______ to help _______ the RBC membrane. And also protect _________ functions.

A

cytoskeleton

stabilized

neurological

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42
Q

McLeod phenotype

This patient are:

Mostly (male or female?)
Have defect in _____ transport

___________cytosis

After ____yrs they develop a progressive form of _________
are associated with deletion on the X-chromosome at position XP21.

A

Male ; H2O

Acantho

40; muscular dystrophy

43
Q

Gerbich Negative phenotype

•(_____ type)
•lacks _____ or ———
•Tend to have _____cytosis
•Have weakened expression of ____ blood antigen.
All these are associated with ________

A

leach

glycophorin C or D

elipto; Kell

haemolytic Dx

44
Q

Bombay Phenotype: presents a serious problem in blood transfusion practice. They ____________ and thus develop __________

A

lack substance H

anti-H antibodies

45
Q

RED CELL ANTIBODIES

Classification
Based on target site:

_____-antibodies

______-antibodies

A

Auto

Allo

46
Q

RED CELL ANTIBODIES
Classification

In terms of mode of sensitization

___________ – usually ________ from substance similar to red cell antigen

________ antibodies

A

Naturally occurring

hetero agglutinin

Immune

47
Q

RED CELL ANTIBODIES
Classification

In term of optimal temperature
Cold – ___-____oc
Warm – ______oc

A

2-4

37

48
Q

RED CELL ANTIBODIES
Classification

TYPES
Ig____ is the immune type red cell antibody, receptors or macrophage in the liver

A

G

49
Q

spleen removes Ig__ coated red cell from circulation.

A

G

50
Q

IgG anti RBC antibody are capable of complement fixation

T/F

A

T

51
Q

Arrange the IgG anti RBC antibody in order of decreasing capability to fix complement

A

IgG 3>IgG1>IgG2>IgG4

52
Q

Binding to complement by IgG antibody is determined by

________
____________________

A

Surface density

Location of the recognized antigen

53
Q

Binding to complement by IgG antibody is determined by:

Surface density
Location of the recognized antigen

Why?

A

This is because C1q requires that at least two IgG molecule bind to a red cell within a span of 20-30nm to initiate the complement cascade

54
Q

IgG-anti-D often bind complement

T/F

A

F

IgG-anti-D rarely bind complement

55
Q

IgG-anti-D rarely bind complement because _________________; and the epitope is _______________

A

most D sites are spaced too far apart

so small that only one anti –D molecule per epitope can bind

56
Q
  • Most IgG anti ABH antibody agglutinate saline suspended red cell

T/F

A

F

Most IgG anti ABH antibody do not agglutinate saline suspended red cell rather they sensitize red cell at 37oc and can be detected with the help of AHG.

57
Q

IgG antibody crosses placenta.
IgM antibody crosses placenta.

T/F

A

T

F

IgG antibody crosses placenta.
IgM is a pentamer, does not cross the placenta.

58
Q

Ig__ and Ig___ can agglutinate red cells and activate complement effectively

A

G

M

59
Q

Note both haemolytic and agglutinating abilities of antibodies can be destroyed by ___________ or _________

A

dithiothreitol or 2-mercaptoethanol

60
Q

Low affinity IgM may agglutinate red cells only at temp _________%

Meaning they bind to red cells at _____ temperature and dissociate at ____oc)

A

below 37

low

37

61
Q

Ig____ is the primary antibody in secretion

A

A

62
Q

IgA Exist predominately as _____ with a secretory component there in

A

dimers

63
Q

IgA

Does not cross placenta

Does not fix complement

T/F

A

T

T

64
Q

aggregated IgA can activate ______ pathway of complement

Multmeric IGA antibodies in serum are as __________ in serology tent and are associated with ___,_____,______ activity

A

alternate

haemaglutinins

A, B or Lutheran

65
Q

IgG levels in fetal circulation rise between _________ -_______ as the selective transport system matures in the placenta

actual fetal antibody production begins ______________ (all detected antibodies in fetus are ______)

low levels of Ig___ followed by Ig___ and Ig__ develop several weeks after birth (Anti A and Anti B takes _________)

A

22-23weeks

shortly after birth

maternal

M; G; A

2-6month

66
Q

Naturally occurring allo-antibodies are mostly associated with ______ antigen (____,_____,_____)

They occur in person ___________________________

A

carbohydrate

ABO, Lewis and P

lacking the corresponding antigen

67
Q

Immune antibodies are found mostly in ______________________ individual

A

multiply transfused

68
Q

CLINICAL SIGNIFICANCE OF RED CELL ANTIBODY
1. Haemolytic transfusion reaction:

Intravascular

Immediate transfusion reaction:_______

Delayed:______ (Jka, JKb)

A

ABO

KIDD

69
Q

CLINICAL SIGNIFICANCE OF RED CELL ANTIBODY
1. Haemolytic transfusion reaction: Extravascular:

IgG1 and IgG3 reacting at ——- temperature(IgG antibodies of _______,_____,_____,_____,______ antigen) and these make up the bulk of clinically significant antibodies

A

body

Rh, Kidd, Kell, Duffy or Ss

70
Q

Haemolytic Disease of the newborn a.k.a ___________

Ig___ and Ig____ which crosses placenta are mostly implicated

A

erythroblastosis fetalis

G1; G3

71
Q

HDN

Aetio-pathogenesis
1.______ related
2._____ related
3. other red cell antigen/antibody

A

Rhesus; ABO

72
Q

Rhesus Related HDN
•
1. sensitization of rhesus ____ mothers by previous blood transfusion using _____ donors, ____ transfusion or other means which leads to ______ of Rh ______ fetus, abruption placenta etc

A

negative; Rh + ; fetal

abortions; positive

73
Q

Rhesus Related HDN

Is the (more or less?) severe phenotype

With reason

A

More

because Rh antigens are more concentrated on red cells and fully developed in-utero

74
Q

Rhesus Related HDN

critical titer is ___:____ which would lead to _________

A

1:32

fetal hydrops

75
Q

ABO related HDN

affects women with blood group ______ with a ________ of _________ and a fetus with blood group _________

A

O+

high titer of immune anti A or B.

A or B.

76
Q

ABO related HDN

it is usually (more or less?) severe

With reason!!

A

Less

ABH antigen is widely distributed on virtually all nucleated cells

ABO is not fully developed till after birth

77
Q

HDN: Other red cell antigen/antibodies

Over ____ other red cell surface antigens have been implicated in HDN (E.g Kell, duffy- -Fya). However only anti-____ and anti- ____ (K1) are associated with severe disease.

Critical value for k1 is ___:____

A

50

Rhc; kell

1:8

78
Q

Clinical features of HDN

_______ skin

_________ amniotic fluid, umbilical cord and eyes

Enlarged______ or _______

Hydrops fetalis( _______,______,______)

____________

A

Pale skin

Yellowish

liver and or spleen.

massive edema, heart failure and organomegally

kernicterus

79
Q

Laboratory features of HDN

___________
_______________

Peripheral blood film:_____________ features

_________

A

Anaemia
Thrombocytopaenia

erythro-leucoblastic

polychromasia

80
Q

diagnosis of HDN

________
________________ sampling
_________

A

Amniocentesis

Percutaneous umbilical cord blood

ultrasonography

81
Q

treatment of HDN

Prophylaxis (maternal after a ______ test)

________ transfusion
Early_______

______therapy

Exchange blood transfusion

Intravenous _________

A

Keilhauer

Intra-uterine

delivery

immunoglobulin

82
Q

______ antigen is a typical example of a haplotype

A

Rhesus

83
Q

Rhesus antigen has 2 different loci that has 2 different set of alleles

One by _____

One by ______

A

D

CE Or Ce Or ce Or cE

84
Q

Absence of ___ = Rhesus negative

A

D

85
Q

Which is more antigenic??

A or B

A

A

86
Q

Which is more immunogenic ??

B or D

A

B

87
Q

___________ is the baseline glycoprotein

A

Substance H

88
Q

Substance H is the raw material from which ______ is formed

A

ABH

89
Q

Substance H is located on chromosome ____

A

9

90
Q

Substance H is located on the same loci on chromosome 9 as the AB antigen

T/F

A

F

Different

91
Q

Substance H circulates in the blood and attaches to the _____ membrane and as well as any ___________ cell

A

Rbc

Nucleated

92
Q

Erythropoietin acts on already committed stem cells

T/F

A

T

93
Q

Red cell antigens are formed with the membrane

T/F

A

F

They are not

94
Q

Dosage phenomenon:

Antigenicity of _____zygous > Antigenicity of _____zygous

A

Homo

Hetero

95
Q

A group of genotype that are closely linked together = ___________

A

Haplotype

96
Q

In the case of ______ on the loci of ____________ genes, where __________ , The H antigen ____________

Hence this people have H blood group

A

mutation; enzyme producing

the enzyme isn’t produced

remains unremodelled

97
Q

_________ and ________ are pure proteins

A

Rhesus

Kidd

98
Q

________ phenotype is usually mistakenly grouped as blood group O

A

Bombay

99
Q

Bombay phenotype

Production of ______,______,_____

A

Anti-A

Anti-B

Anti-H

100
Q

Which is better, agglutinin or hemolysin?

A

Agglutinin

101
Q

agglutinin is to Ig__

As

hemolysin is to Ig__

A

M

G

102
Q

Young RBCs are usually resistant to _____

A

HCL

103
Q

Anti-Rhesus C is just as severe as RH HDN

T/F

A

T

104
Q

Anti-Rhesus preparation = ______

A

Rhogam D

House Hemat (29 decks)

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