exam 2 - other blood group systems Flashcards

1
Q

(T/F) antigens are part of a gene sequence that codes only for the structure of the antigen

A

false

some genes code for enzymes that form the ag

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2
Q

(T/F) transfusion recipients can get a matched ABO and Rh but are not likely to receive identical cells in other blood group system

A

true

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3
Q

_____ identifies a blood group /antigen in a blood group

A

alloantibody

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4
Q

which of the ff blood group system contains the least amount of polymorphism? (clarify this)

a. Lw
b. MNS
c. Rh
d. Kell

A

A

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5
Q

(T/F) DNA analysis can detect polymorphisms/ variants that can be classified into a blood group

A

false

MUST be defined by an alloantibody

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6
Q

(T/F) type 1 single pass antigens have an intracellular C-terminal structure

A

true

Type 2 single pass have intracellular N-terminal

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7
Q

which of the ff is not a carbohydrate-type blood group?

a. ABO
b. Lewis
c. P
d. duffy

A

D

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8
Q

which of the ff is false about Secretors?

a. FUT2 secretor gene produces fucosyltransferase like the H gene
b. Secretors have ABH substance in body secretions and in plasma
c. Se fucosyltransferase acts on Type 2 chains
d. onlly 20% of the population are non-secretors

A

C

acts on type 1 chains (soluble precursor)

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9
Q

which of the ff is the gene that codes for fucosyltransferase involved in the Lewis system?

a. FUT4
b. FUT3
c. FUT2
d. FUT1

A

B

FUT3 = Le
FUT2 = Se
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10
Q

(T/F) Lewis antigen is formed in plasma and subsequently adsorbed onto RBCs

A

true

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11
Q

which of the ff is false about the Lewis system?

a. Le gene is linked to Se and H genes
b. Le gene codes for enzymes that form both Le(a) and Le(b) antigens
c. only the Le(b) antigen is adsorbed in RBCs
d. Le(b) is formed thru interactions of FUT3 and FUT2 genes

A

B

Le gene alone = Le(a)
Le gene + Se gene = Le(b)

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12
Q

(T/F) type 2 chains are found in cell surface membranes

A

true

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13
Q

which of the ff is a non secretor?

a. Le (a+b-)
b. Le (a-b-)
c. Le (a+b+)
d. Le (a-b+)

A

A

B can also be a non secretor (LeSe but Le gene may be mutated)

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14
Q

(T/F) an Le(a-b+) phenotype means that only Le(b) is present in both RBCs and in plasma

A

false

Le(a) can also present but is not as easily absorbed into RBCs so only Le(b) is detected

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15
Q

(T/F) the Le gene codes for an enzyme that forms the Le(b) antigen

A

true

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16
Q

(T/F) the Le(a+b-) phenotype is most common among whites, blacks and japanese

A

false

Le(a-b+) is most common,
Le(a+b-) is a non secretor (found in minority)

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17
Q

Lewis antibodies are:

a. IgG
b. IgM

A

B

cold reactive

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18
Q

which of the ff is not true about Lewis ab?

a. are only found in Le(a-b-) phenotype
b. anti-Le(a) may react and bind compl at 37C
c. are never IgG
d. Anti-Le(a) is stronger and more common that anti-Le(b)

A

C

some can be IgG

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19
Q

which of the ff is true about P blood group?

a. D-galactose is the immunodominant sugar
b. does not add L-fucose
c. P antigens are formed on type 1 chains
d. P1 antigen are found on other blood cells

A

C

formed in type 2 chains

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20
Q

which phenotype will most likely react with anti-P?

a. P1 only
b. P2 only
c. P1 and P2
d. p (null)

A

C

coz P1 has P1 and P precursor

P2 = P1 neg but still has P precursor

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21
Q

(T/F) the P2 phenotype reacts with Anti-P1 and not with Anti-P

A

false

coz P2 = P1 neg + P precursor
P2 reacts with anti-P only

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22
Q

which of the ff is not true?

a. Anti- PP1Pk is reactive over broad thermal range
b. P1k and P2k phenotypes are rare
c. anti-P1 is a rare, severe reacting ab
d. Anti-P1 is rarely IgG

A

C

it is a common benign ab

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23
Q

(T/F) ab directed againts P and Pk ag are associated w/ higher abortion rate in women with p or P1k or P2k phenotype

A

true

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24
Q

which of the ff is false?

a. both I and i ag are low incidence ag
b. the i ag is present mostly at birth or cord blood
c. i antigen is a branched precursor for ABH antigens
d. I and i are not antithetical

A

A

are high incidence
so Ab against them are rare

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25
Q

which of the ff is not true for Anti-I?

a. a common benign ab
b. is a cold agglutinin
c. is an auto ab
d. shows strong agglutination in cord RBCs but weaker rxn with adult RBC

A

D

the other way around

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26
Q

which of the ff is not true about the MNS system?

a. ag are carried on glycophorins GPA and GPB
b. ag are encoded by M or N and S or s genes
c. genes are inherited as a haplotype
d. ab rxn is enhanced with enzyme treated cells

A

D

ag are cleaved by enzymes

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27
Q

(T/F) the sialioglyprotein GPA is a pathogen receptor in E. coli and influenza infections and can give resistance to parasitic infections

A

true

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28
Q

(T/F) the enzyme cleavage site for the MNS antigens occur just above where the antigen detection site is located

A

false

cleavage site is below where they sit in the glycophorin, so they are removed w/ enzyme treatment

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29
Q

which MN phenotype is commonly seen in both whites and blacks?

a. M+N-
b. M+N+
c. M-N+
d. M-N-

A

B

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30
Q

which Ss phenotype is commonly seen in whites?

a. S+s–U+
b. S+s+U+
c. S–s+U+
d. S–s–U–

A

b and c

S+s+U+ = 44%
S-s+U+ = 45%
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31
Q

which MNS ag are found on GPB?

a. M only
b. both M and N
c. S and s
d. M, N and Ss

A

C

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32
Q

which of the ff can cleave MNS ag from its glycophorin?

a. ficin and papain
b. trypsin and pronase
c. DTT and AET
d. chloroquine

A

A

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33
Q

(T/F) linkage disequilibrium is seen between S and s, and M and N antigens

A

true

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34
Q

which is the correct order of relative frequencies of MNS haplotypes that are seen in caucasians?

a. NS>MS>Ms>Ns
b. Ms>Ns>MS>NS
c. Ns>Ms>MS>NS
d. NS>MS>Ms>NS

A

C

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35
Q

which of the ff is false about Anti-M?

a. are a mixture of IgM and IgG
b. reacts at 37C
c. reaction is stronger with M+N-
d. reacts best at pH 6.5

A

B

reacts at

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36
Q

which of the ff is false about Anti-S and s?

a. are mostly IgM
b. unlikely reacts with enzyme treated RBcs
c. may cause HDNF
d. reacts at 37C

A

A

are mostly IgG

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37
Q

which of the ff is false about Anti-U?

a. are found in ppl of African ancestry
b. are usually IgM
c. production is stimulated by transfusion or pregnancy
d. may cause HDFN

A

B

are usually IgG

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38
Q

which of the ff phenotypes are more associated with people of African descent?

a. M+N-
b. S+s+U+
c. M-N+
d. S-s-U-

A

D

must know this!!!

M+N+, S-s-U-

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39
Q

which of the ff phenotypes is frequently seen in blacks?

a. S+s–U+
b. S+s+U+
c. S–s+U+
d. S–s–U–

A

C

40
Q

which of the ff is false about the MkMk null phenotype?

a. does not produce M ag but can produce N,S and U
b. results from an almost complete deletion of GYPA and GYPB gene
c. phenotype shows decreased RBC sialic acid content
d. RBCs type as M-N-S-s-U-

A

A

MkMk cannot produce any of the MNS antigens

41
Q

which of the ff Kell blood group antigens are of low incidence?

a. k
b. Kpa/ Kpb
c. Kpa and Jsa
d. Kpb and Jsb

A

C

a superscripts denotes very LFA

42
Q

which of the ff Kell antigens have a higher frequency in the white and black population?

a. K+k–
b. K+k+
c. K–k+
d. K-k-

A

C

whites = 91%
blacks = 98%
neg w/ low incidence antigens are more common!

43
Q

which of the ff Kell antigens have a LOWER frequency in the black population?

a. K+k–
b. K+k+
c. K–k+
d. K-k-

A

A

this is rare to have a low incidence antigen

44
Q

which of the ff Kell antigens have a HIGHER frequency in the black and white population?

a. Kp(a+b-)
b. Kp(a-b+)
c. Kp(a+b+)

A

B

45
Q

which of the ff Kell antigens have a HIGHER frequency in the black and white population?

a. Js(a+b-)
b. Js(a-b+)
c. Js(a+b+)

A

B

46
Q

which of the ff is false about the kell system ab?

a. anti-K is an IgG
b. ab has low titer and avidity
c. Anti-K best reacts w/ AHG
d. can cause HDFN

A

B

has high titer and avidity
coz ab is common

47
Q

which of the ff is false about the kell and Kx antigens?

a. Kx is required for kell ag expression
b. kell ag are single pass
c. Kx ag is single pass
d. Kell-Kx ag are held together by disulfide bonds

A

C

Kx is a multipass

48
Q

_____ the phenotype that results from the lack of Kx and Km and weak expression of Kell ag

A

McLeod phenotype and syndrome

49
Q

which of the ff is false about McLeod phenotype and syndrome?

a. passed thru autosomal inheritance
b. highly associated with chronic granulomatous disease
c. symptoms include neuromuscular and neurological defects
d. shows acanthocytosis with compensated hemolytic anemia

A

A

an X-linked inheritance

50
Q

(T/F) Kell null phenotype has Kell and Kx neg ag vs Mcleod phenotype which has Kell weak but Kx neg ag

A

False

2nd part true

Knull = K neg, Kx pos
McL = K weak, Kx neg
51
Q

____ the phenotype that results from a weak expression of Kell system ags

A

Kmod

is this same with Km?

52
Q

*(T/F) antibodies against K+, Jsa+ and Kpa+ are rare. Same is true for HFA.

A

true

LFA = because so few people are exposed to these antigens.
HFA = coz only a few lack the ag
53
Q

which is false about the ag of the Duffy system?

a. are multipass
b. ag glycoprotein are involved in viral inf
c. Fya and Fyb only vary by one nucleotide/aa
d. ag are expressed in multiple tissues

A

B

involved in parasitic malaria inf, they use the ag as receptor

54
Q

(T/F) Duffy antigen glycoprotein inhibit a variety of proinflammatiry chemokines

A

false

they bind them thru FY receptor!

55
Q

(T/F) Fy(a-b-) phenotype are resistant to Plasmodium vivax infection

A

true

56
Q

(T/F) Duffy null is rare and causes a disrupt in erythroid expression in most ppl of African descent

A

true

57
Q

which of the ff phenotypes are most frequent in whites?

a. Fy(a+b-)
b. Fy(a+b+)
c. Fy(a-b+)
d. Fy(a-b-)

A

B

43%

58
Q

which of the ff phenotypes are most frequent in blacks?

a. Fy(a+b-)
b. Fy(a+b+)
c. Fy(a-b+)
d. Fy(a-b-)

A

D

67%

59
Q

which of the ff phenotypes are most frequent in asians and aussies?

a. Fy(a+b-)
b. Fy(a+b+)
c. Fy(a-b+)
d. Fy(a-b-)

A

A

82-91%, 93%

60
Q

(T/F) Fy(a-b-) phenotypes make anti-Fya, Fyb and Fy3

A

true

Fy3 ag is req for Fya and Fyb formation and is lacking in the null phenotype (clarify)

61
Q

____ the duffy chemokine receptor/ “promiscuous scavenger”

A

FY

62
Q

(T/F) the duffy ab are considered clinically significant

A

T

coz they react by IAT

63
Q

which of the ff is false about duffy ab?

a. reacts by IAT
b. anti-Fyb is more common and stronger
c. are mostly non reactive with enzyme treated cells
d. anti Fy3, Fy4 and Fy5 are reactive with enzyme treated cells

A

B

anti-Fya is stronger and more common than anti-Fyb

64
Q

which of the ff does NOT apply with the kidd blood group system?

a. Encoded by the HUT 11 gene
b. gene is in Chr 18
c. antigens are involved in urea transport
d. antigens are single pass glycoproteins

A

D

mutlipass 10 membrane domains

65
Q

(T/F) Jka/Jkb antigens differ by several amino acid on the 4th extracellular loop of glycoprotein

A

false

differ by ONE
Jka = Asp
Jkb = Asn

66
Q

which of the ff Kidd phenotypes is most common with BLACKS?

a. Jk(a+b-)
b. Jk(a+b+)
c. Jk(a-b+)
d. Jk(a-b-)

A

A

67
Q

which of the ff Kidd phenotypes is most common with WHITES?

a. Jk(a+b-)
b. Jk(a+b+)
c. Jk(a-b+)
d. Jk(a-b-)

A

B

68
Q

which of the ff Kidd phenotypes is very rare?

a. Jk(a+b-)
b. Jk(a+b+)
c. Jk(a-b+)
d. Jk(a-b-)

A

D

69
Q

which of the ff does not apply to Kidd blood group antibodies?

a. are a mixture of IgG and IgM
b. not clinically significant
c. can bind complement
d. ab titers may be difficult to detect

A

B

ALWAYS clin. sig.

70
Q

(T/F) Kidd antibodies react with enzyme treated cells

A

true

71
Q

(T/F) Kidd IgM are responsible for delayed hemolytic transfusion reactions

A

true

clarify this

72
Q

which of the ff does not apply to the Lutheran blood group system
a. are not clinically significant
b. Lu glycoproteins belong to immunoglobulin
superfamily of adhesion molecules
c. antigens are mostly low incidence
d. Lu antibodies are low incidence

A

C

ag are high incidence
so not much ab are formed

73
Q

which of the ff about the Lu system is false?

a. Anti-Lua may be naturally occurring
b. Lub antigen are fully formed at birth
c. anti-Lu3 can be produced by Lu(a-b-)
d. Anti-Lub produced by transfusion

A

B

NOT formed at birth

74
Q

which of the ff blood group systems can be used to track transmission of genetic traits?

a. Diego
b. Kell
c. Lutheran
d. Xg

A

D

coz its X-linked!

75
Q

(T/F) Diego antigens are multipass

A

true

76
Q

which of the ff blood group systems is strictly an RBC antigen?

a. Diego
b. P
c. Lutheran
d. MNS

A

D

77
Q

which of the ff blood group systems have auto benign antibodies?

a. Lewis
b. Duffy
c. Ii
d. MNS

A

C

78
Q

(T/F) Diego antigens are mostly high incidence

A

false

low incidence except Dib

79
Q

___ Diego antigens that are more frequent in Southeast Asia (8%) & among Sth American indigenous populations
(4%)

A

Dia

80
Q

which of the ff about the Xg blood group is false?

a. Xg(a+) is frequently seen in males
b. gene is in X chr
c. Ab reacts by IAT
d. Ab non reactive with enzyme treated cells

A

A

Xg (a+) in 88.7% of females
Xg (a-) in 34.4% of males

81
Q

(T/F) Xg (a-) is more frequent in the male population

A

False

in males
Xg (a+) = 65.6%
Xg (a-) = 34.4%

82
Q

which of the ff is false about Xg antigen frequency?

a. Xg(a-) is more freq in males than females
b. Xg(a+) is freq seen in both males and females
c. Xg(a+) is more freq seen in females than males
d. Xg(a+) is more freq seen within the male population

A

all is true!

see page 88 of lec 4 for clarity

83
Q

(T/F) Anti-Xga is reactive w/ enzyme treated cells

A

false

NON reactive

84
Q

(T/F) Anti-Xga is uncommonly seen and binds weakly with its epitope

A

true

85
Q

which of the ff blood group systems have antigens involved in anion transport?

a. Diego
b. Kell
c. Lutheran
d. Xg

A

A

86
Q

which of the ff anitbodies are involved in shigella infections?

a. anti-Le(a)
b. anti-P1
c. anti- M
d. Anti-Jkb

A

B`

87
Q

which of the ff blood group systems whose antigens are not manufactured in the RBCs?

a. MNS
b. Duffy
c. Lewis
c. P

A

C

made in secretions and adsorbed into RBCs

88
Q

which of the ff antibodies is a biphasic hemolysin found in paroxysmal cold hemoglobinuria?

a. anti-D
b. anti-P
c. anti-N
d. anti-Jkb

A

B

89
Q

_______ is also known as Donath-Landsteiner

test to detect anti-P

A

biphasic hemolysin test

90
Q

which of the ff phenotypes indicates that GPB might be missing/not present?

b. S+s+U+
c. S–s+U+
d. S–s–U–

A

D

coz the S and U antigens are formed in glycophorin B

91
Q

(T/F) an individual with phenotype S-s-U- doesn’t have GPB and the residual N antigen

A

true

92
Q

(T/F) an individual who makes anti-S and anti-s still has the U antigen and will not make Anti-U

A

false

they don’t have U (true negative) and will not make the antibody

93
Q

(T/F) people who have low incidence antigens are 1 in 500

A

true

94
Q

(T/F) antibodies to high incidence antigen are commonly encountered (high frequency)

A

false

the opportunity to be immunized is low coz majority have the antigen = will not make ab

95
Q

which of the ff anitbodies are involved in suppression in erythropoeisis?

a. anti-Le(a)
b. anti-P1
c. anti- M
d. Anti-K

A

D

causes HDFN and anemia