E2 Flashcards
Which of the following antigens is part of an antithetical pair?
- P1
- D
- M
- Leb
- M
Some blood group antibodies may react stronger with the red cells of individuals who have inherited 2 identical alleles for the antigen. This phenomenon is Known as:
- post zone affect
- Dosage affect
- Prozone affect
- Equivalence affect
Dosage affect
Kell is an antigen attached to the cell by a cysteine bond which makes it
- Susceptible to DTT treatment
- Susceptible to papain treatment
- Susceptible to ficin treatment
-Resistant to all chemical and enzymatic treatment
Susceptible to DTT treatment
Match the following neutralizing substances with their antibody:
Hydatid Cyst fluid
antibody P
Match the following neutralizing substances with their antibody:
Breast milk
antibody I
Match the following neutralizing substances with their antibody:
Normal Human Plasma
Chido/ Rodgers
Match the following neutralizing substances with their antibody:
Saliva
Lewis
Given the serological reactions on the following antigram, how does enzyme treatment affect the antibody in the patient plasma tested?
(Look at picture for reference)
- Enhances
- Destroys
- Not affected
- No answer test provided
Enhances
Which phenotype is heterozygous?
- M+N-S- s-
- K-K+
- Fya(a-b+)
- Js (a+b+)
Js (a+b+)
Though Diego antigens are not listed on the antigram, they are considered clinically significant for HDN and HTR. Why are you unlikely to encounter them?
- Antigens are High incidence/low incidence
- There is not test for them
- They are chemical and enzyme resistant
-They are imaginary
Antigens are High incidence/ low incidence
Choose all that apply: Which of the following antigens is NOT significantly different (<20% different) in frequency between Caucasian and Black populations?
- Fyb
- Jsa
- N
- e
N and e
S, C, c, P1, Jsa, Fya/Fyb, Jkb
Match the antithetical antigens:
Lub
Jka
Jsa
S
Lub - Lua
Jka - Jkb
Jsa - Jsb
S- s
If your patient has a history of anti- Lua and a current negative antibody screen, how many units would you need to cross match to find a compatible unit?
- 1
- 10
- 15
- 20
1
units = 100 x units / % compat
% Compatible = 100 - Antigen Frequency
The physician has requested 3 units of RBCs for patient DB who has two antibodies anti-K and anti-Jka. The frequency of K in the donor population is 9%. The frequency of Jka in the donor population is 77%. How many units will need to be antigen typed for K and Jka to fill the request?
- 2
- 5
- 10
- 15
15
If your facility has a rule of ordering rather than testing antigen negative blood for antibody combinations compatible with less than 20% of the population, what is the maximum number of units you would statistically be expected to phenotype in your facility for a single unit for a single patient?
- 2
- 5
- 10
- 15
5
Given the rule mentioned above (testing for antigens that have compatibility with greater than 20% of the population only) which antisera would routinely be maintained in house?
- anti-k
- anti-Jkb
- anti-s
- anti-e
anti-Jkb
The first antigen group assigned to a specific chromosome was the Duffy group. Which other antigen group shares this chromosome
- Rh
- P
- Glob
- Kell
Rh
The genes of antigen systems typically either transcribe a product that is intrinsic to the red cell membrane or a transferase that builds a carbohydrate chain on the cellular surface. Which of the following antigen systems are created by transferase?
- Lutheran
- Duffy
- MNSs
- P/Glob
P/Glob
Which antibody activity is enhanced by enzymatic treatment of panel cells?
- Jka
- Jsa
- Fya
- Lua
Jka
Enhanced by Enzymes: Damn Kidds like playground
Rh, Kidd, Lewis, P/Glob
How would you use serology to differentiate between anti-e and anti-s?
- e reacts with more cells on the antigram than s
- e is warm acting while s is cold acting
- e fixes compliment while s does not
- e is enhanced by enzymes where is s is destroyed by enzymes
e is enhanced by enzymes where s is destroyed by enzymes
Enzymes: Damn Kids like playgrounds
Name the false statement regarding antibodies in the Kidd system
- They fix compliment
- They are IgG
- They do NOT cause HDN or transfusion reaction
- They are notorious for disappearing
They do NOT cause HDN or transfusion reaction
Antibodies of which blood group are typically NOT known to interfere in reverse typing?
- P
- MNS
- I
- Kell
Kell
Which of the following is generally detected at the anti globulin phase of testing?
- anti-Fya
- anti-P1
- anti-M
- ant- I
anti-Fya
Antibodies of which blood group are typically known to cause hemolytic transfusion reaction but NOT severe HDN?
- Kell
- Rh
- ABO
- Lewis
ABO
Kell - Severe HDN
Rh - causes severe HDN
Lewis - cnt cross placenta
Which antigen is STRONGLY expressed at birth?
- K
- Lub
- A
- I
K
Which characteristics are true of ALL THREE of the following antibodies: anti-K, anti-cya, and anti-Jka
- Detected at IAT but not known to cause HDN or transfusion reaction
- May demonstrate dosage and cause HDN
- Not detected with enzyme treated cells, may cause delayed transfusion reactions
- Detectible at RT and causes hemolytic transfusion reaction
May demonstrate dosage and cause HDN
Kell- severe HDN
Kidd - severe HDN
Which of the following antibodies are known to fix compliment?
- anti-Jka
- anti-Kpa
- anti-Leb
- anti-P1
anti-Jka
Duffy & P som
Felix Jr (Kidd) & Lady Calhoun (Lea) are main antibodies.
Patients that serologically type as Jk(a-b-) make cells that:
- are resistant to P.Vivax
- are stomatocytes
- are acanthocytes
- are resistant to lysis in 2M urea
are resistant to lysis in 2M urea
Nulls of which blood group provide protection from plasmodium vivax?
- P
- MNS
- Duffy
- Kidd
Duffy
If you had an antibody demonstrating unexplained mixed field reactivity, which antibody do you suspect?
- anti-s
- anti-Fyb
- anti-N
- anti-Lua
anti-Lua
A patient has a this phenotype: Fy (a+b-) M+N+S+s- K+k+ R1R2, which antibody is NOT ruled out as a potential alloantibody?
-anti-U
-anti-K
-anti-c
-anti-s
anti-s
An AB positive patient with a negative antibody screen that was transfused five days ago is collected today for a new type and screen because the hemoglobin did not increases as much as the physicians wanted after transfusion. The new type and screen specimen appears tone hemolyzed, recollection of the sample is not any better. You perform a DAT and find that the patient has compliment medicated hemolysis and the antibody screen is now positive in the AHG phase. Which antibody do you suspect you will identify ?
- anti-Lub
- anti- Jkb
- anti-K
- anti-P1
anti-Jkb
Five days ago they had a transfusion. After that there is hemolysis/kid
What type of antibody is most closely associated with the pattern on the below antigram?
Look at the picture for reference
- High incident antibody
- Low incident antibody
- Cold agglutinin
- Warm auto antibody
High incident antibody
The Rh system demonstrates population disequilibrium with the inheritance of certain gens together more often than mendelian genetics would calculate. Which other antigen group demonstrates this phenomenon?
- MNS
- Kidd
- Duffy
- P
MNS
MN and Ss are similar in all of the following ways EXCEPT
- their genes are on the same chromosome
- they are both glycophorin chains
- they are susceptible to enzyme treatment
- their antibodies prefer colder temperatures
their antibodies prefer colder temperatures
Being on chromosome 19, the Lutheran genes have been shown to be autosomal linked to all of the following EXCEPT?
- P
- Se
- H
- Le
P
Which of the following antigens appears on the antigram but does not need to be ruled out unless suspected because it is low incidence?
- K
- Kpa
- Ina
- Xga
Kpa
Which pair antithetical antigens is considered to be a low incidence/high incidence pair?
-Jka/jkb
- Lea/Leb
- K/k
- M/N
K/k
–
- Low incident would mean frequency in the population of <10%
- High incident would mean frequency in the population of >90%
- Jka frequency is 77% and Jkb is 74% neither qualify as high or low frequency
True or False: A rule out is counted when an antigen is not present on a cell reactive when tested with patient plasma.
False
A rule out is a lack of reactivity with a cell indicates that the antibody cannot detect its antigen there
In which of the following procedures would a positive agglutination reaction complete your workup?
- Rule in
- Rule out
- Phenotype testing of a donor cell
- Phenotyping testing of a patient cell
- Rule in
Anti-Ch is considered to be high titer low avidity (HTLA) antibody. This antibody serologically tests as:
- Reactive strongly after multiple dilutions
- Reactive weakly after multiple dilutions
- Reactive strongly but disappears after a few dilutions
- Reactive weakly and then disappears after a few dilutions
Reactive weakly after multiple dilutions
Utilizing the provided antigram for Mary Poppins, which clinically significant antibodies do not have at least one rule out?
- anti-P1
- anti-E
- anti-M
- anti-K
anti-M
anti-K
Utilizing the antigram for Mary Poppins: assuming only one antibody is present in the patient serum, what activity is the antibody demonstrating?
- Enzyme resistance
- Dosage
- Low incidence
- Compliment activation
Dosage
–
The weaker reactions are occurring on cells that are heterozygous for the antigen.
Utilize the panel for Mary Poppins to answer the following question: What does the auto control result mean?
- The patient results are invalid
- The patient has likely been transfused within the previous month
- The antibody identified is an autoantibody
- There is more than one antibody acting
The patient has likely been transfused within the previous month
–
Mixed field reaction indicates the presence of two cell lines which would be perfectly reasonable for a patient who has been transfused. The patient cells are in the sample as well as the transfused cells.
Check all that apply: Utilize the antigram panel for Mary Poppins to answer the following question: What additional steps need o be taken in order to complete the workup?
- Rule out anti-K
- Rule out anti-M
- Phenotype the patient for the suspected antigen(s)
- Investigate the positive autocontrol
- Rule out anti-K
- Investigate the positive autocontrol
Utilizing the antigram for Mary Poppins: Which antibody is most likely acting in the patient’s serum?
- anti-M
- anti-K
- anti-S
- anti-Leb
anti-M
Utilizing the antigram for Mary Poppins: The physician wants 1 unit on hold for Mary Poppins. Statistically, how many units would you expect to phenotype to find compatible blood?
- 1
- 3
- 7
- 15
3
–
M frequency is 78% ~80%. 100%-80% = 20% compatible. Double check the math.
7
Which two cells on the antigram would you choose for a positive and negative control for M phenotyping ?
- 12 & 13
- 13 & 17
- 13 & 15
- 12 & 15
she also accepts 13& 15.
A cell that is postive for M antigen heterozygously should be used for the positive control. A cell that is negative for the M antigen should be used as the negative control
