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Immunohematology Lab > EXPERIMENT 8, 9, 10, 11 > Flashcards

EXPERIMENT 8, 9, 10, 11 Flashcards

1
Q

Type O individuals are the universal red blood cell donors due to the absence of [?] on their red blood cells.

A

A and B antigens

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2
Q

o U. Donor:
o U. Recipient:

A

o U. Donor: O
o U. Recipient: AB

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3
Q

If their blood is given to any [?], no major transfusion reaction is expected to happen.

A

non-O and non-Bombay recipients

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4
Q

However, the serum/plasma of type O Individuals contains naturally occurring [?] that can react to patient’s red cells having the corresponding antigens

A

anti-A and anti-B

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5
Q

If non-O recipients transfused with type O whole blood, incompatibilities can be detected in the [?] if the titer of the antibodles is high enough to cause a reaction.

A

minor crossmatch

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6
Q

is given to recipient

A

Packed rbc

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7
Q

In this case, only [?] should be given to the recipient to avoid reactions brought about by the antibodies coming from the donor.

A

packed red cells

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8
Q

Type O donor is considered only as a universal donor if the antibody titer is [?]

A

< 1:50

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9
Q

EXP 8

Sample:
Reagent:

A

Procedure: Sample: 1:50 dilution of Group “O” serum/plasma (0.1 mL serum/plasma + 4.9 mL NSS) Reagent: 2-5% Known RCS

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10
Q

Introduction to Rh Blood Group System

A

 Rh Genetics
 Rh Biochemical Structure
 Gene frequency of Rh antigen
 Rh Terminologies
 Rh antibodies

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11
Q

The genes are autosomal codominant located on the short arm of

A

chromosome 1

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12
Q

The Rh antigens are inherited as

A

codominant alleles.

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13
Q

(No carbohydrate attached to the protein)

A

Non-glycosylated CHON

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14
Q

are transmembrane polypeptides and are integral part of RBC membrane

A

Rh antigens

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15
Q

D

A

85

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16
Q

d

A

15

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17
Q

C

A

70

rh’

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18
Q

E

A

30

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19
Q

c

A

80

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20
Q

e

A

98

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21
Q

Rh inheritance is controlled by 3 closely linked loci on each chromosome of a homologous pair

A

A. Fisher-Race (DCE Terminology)

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22
Q

Each locus has its own set of alleles which are: Dd, Cc, and Ee

A

A. Fisher-Race (DCE Terminology)

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23
Q

Theory of Multiple Allelomorphic genes

A

B. Wiener (Rh-Hr Terminology)

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24
Q

There is one Rh locus at which occurs one Rh gene, but this gene has multiple alleles producing one agglutinogen composed of three factors

A

B. Wiener (Rh-Hr Terminology)

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25
Q

Rh0hr’hr’’

A

Rh0

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26
Q

Rh0rh’hr’’

A

Rh1

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27
Q

Rh0hr’rh’’

A

Rh2

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28
Q

Rh0rh’rh’’

A

Rhz

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29
Q

hr’hr’’

A

rh

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30
Q

rh’hr’’

A

rh’

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31
Q

hr’rh’’

A

rh”

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32
Q

rh’rh’’

A

rhy

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33
Q

Dce

A

Rh0

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34
Q

DCe

A

Rh1

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35
Q

DcE

A

Rh2

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36
Q

DCE

A

Rhz

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37
Q

ce

A

rh

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38
Q

Ce

A

rh’

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39
Q

cE

A

rh”

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40
Q

CE

A

rhy

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41
Q

R = [?] ; r = [?]

A

D

d

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42
Q

1 or „ =

A

C + e

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43
Q

2 or “ =

A

c + E

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44
Q

0 or (no prime) =

A

c+ e

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45
Q

Z or y =

A

C + E

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46
Q

Rho =

A

D

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47
Q

rh’=

A

C

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48
Q

rh‟=

A

E

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49
Q

hr’rh‟=

A

dcE

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50
Q

Rho hr’hr‟=

A

Dce

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51
Q

hr’ =

A

c

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52
Q

hr‟=

A

e

53
Q

This system has no genetic basis

A

C. Rosenfield (Alpha/Numeric Terminology)

54
Q

It simply demonstrates the presence or absence of the antigen on the red blood cells

A

C. Rosenfield (Alpha/Numeric Terminology)

55
Q

A minus sign preceding a number designates “Absence of an antigen”

A

C. Rosenfield (Alpha/Numeric Terminology)

56
Q

If the antigen has not been typed for, its number will NOT appear in the sequence

A

C. Rosenfield (Alpha/Numeric Terminology)

57
Q

Rh1 = D; Rh2 = C; Rh3 = E, Rh4 = c; Rh5 = e

A

C. Rosenfield (Alpha/Numeric Terminology)

58
Q

DCe/dce

A

R1r

59
Q

Rh:1, 2, –3, 4, 5

A

R1r

60
Q

DCe/DCe

A

R1R1

61
Q

Rh:1, 2, –3, –4, 5

A

R1R1

62
Q

dce/dce

A

rr

63
Q

Rh: –1, –2, –3, 4, 5

A

rr

64
Q

DCe/DcE

A

R1R2

65
Q

Rh:1, 2, 3, 4, 5

A

R1R2

66
Q

Universal language (both eye and machine readable)

A

D. ISBT: Numeric Terminology

67
Q

Adopted a 6-digit number for each authenticated blood group specificity

A

D. ISBT: Numeric Terminology

68
Q

First three number = represents “system”

A

D. ISBT: Numeric Terminology

69
Q

Second three number = represents “antigen specificity”

A

D. ISBT: Numeric Terminology

70
Q

IgG in nature; react at 37’C or in AHG

A

Rh antibodies

71
Q

Exposure to less than 1mL of Rh (+) red cells can stimulate antibody production in an Rh-negative person

A

Rh antibodies

72
Q

DO NOT BIND COMPLEMENT

A

Rh antibodies

73
Q

Mechanism of red cell destruction:

A

EXTRAVASCULAR HEMOLYSIS

74
Q

refer to the presence or absence of the red cell antigen D.

A

“Rh positive” and “Rh negative”

75
Q

After the A and B antigens, [?] is the most important red cell antigen in transfusion practice for it has greater immunogenicity than other red cell antigens

A

D

76
Q

In contrast to A and B, however, persons whose red cells lack the D antigen do not regularly have [?]

A

anti-D

77
Q

Formation of anti-D results from exposure, through [?], to red cells possessing the D antigen.

A

transfusion or pregnancy

78
Q

In clinical practice, five blood typing reagents are readily available:

A

anti-D, -C, -E, -c, and-e.

79
Q

Routine pretransfusion studies include only tests for

A

D

80
Q

Other reagents are used principally in the resolution of

A

antibody problems or in family studies

81
Q

Rh Typing: Procedure
 Slide method
 Tube method
 Sample: [?]
 Reagents: [?]
 Rh viewbox (surface temperature: [?]) for [?] minutes
 Read for [?]

A

Capillary blood slide method); 2-5% RCS (tube method)

Anti-D antiserum (also anti-C, anti-c, anti-E, and antie antisera)

45-50°C; 5

agglutination

82
Q

Agglutination in the anti-D tube, combined with a smooth suspension in the control tube, indicates that the red cells under investigation are

A

D (+) → Rh positive

83
Q

A smooth suspension of red cells in both the anti-D and the control tubes is a

A

negative test result

84
Q

Donor blood must be further tested for the presence of weak D antigen → perform antihuman globulin test (indirect) to differentiate

A

weak D expression from Rh negative phenotype

85
Q

have historically been defined as having a reduced amount of D antigen

A

Weak D red cells

86
Q

In Rh phenotyping, the absence of agglutination reaction in slide and tube methods is not immediately reported as

A

Rh negative

87
Q

Some red blood cells express the [?] so weakly that most anti-D reagents do not directly agglutinate them

A

D antigen

88
Q

Thus, test for weak expression of the D antigen must be performed before reporting

A

Rh negative results

89
Q

 Caused by one or more parts of D antigen is missing

A
  1. Partial D (D Mosaic)
90
Q

 Qualitative problem

A
  1. Partial D (D Mosaic)
91
Q

 Caused by Position effect

A
  1. C trans
92
Q

 D is trans to C

A
  1. C trans
93
Q

 Caused by few numbers of D antigen

A
  1. Genetic weak D
94
Q

 Quantitative problem

A
  1. Genetic weak D
95
Q

Testing for Weak D

 Sample:
 Reagents:

A

2-5% RCS

Anti-D antiserum, Antihuman globulin reagent

96
Q

Principle: Some weak D antigens are recognized only by

A

IAT procedure

97
Q

Note: If a test was performed for the Rh typing, the same tube may be used for the

A

weak D testing

98
Q

Testing for Weak D Procedure
1. Unknown tube with [?]
2. Washing phase (?)
3. Add [?] of AHG reagent
4. Centrifuge for [?]
5. Dislodge the cell button → Examine for [?]

A

NO Agglutination

3 times

2 drops

15 seconds @3,400 RPM

agglutination

99
Q

Absence of agglutination confirms the blood group to be

A

Rh negative

100
Q

Presence of agglutination means presence of

A

weakly reacting D

101
Q

For each negative ltube add [?] of check cells

A

1 drop

102
Q

is expected after the addition of check cells.

A

A positive resultv

103
Q

This implies that the test has been properly performed.

A

A positive result is expected after the addition of check cells.

104
Q

with these cells indicate an improperly performed test and the test should be repeated

A

Negative results

105
Q

If the reaction is positive for the test of Du, the person must be given proper designation because the person might have weakened D reaction due to missing part in the D antigen (?)

A

D mosaic

106
Q

Thus, if given accidentally to an [?] with complete D antigen, the person might develop an antibody against that missing part which should be avoided

A

ABO compatible Rh-positive blood

107
Q

Remember: [?] are classified as Rh positive when they donate blood and Rh negative when they receive blood.

A

Du positive individuals

108
Q

Described in 1945 by Coombs, Mourant, and Race

A

ANTIGLOBULIN TEST (COOMB’S TEST)

109
Q

Detects bound red cell antibodies that do not produce direct agglutination

A

ANTIGLOBULIN TEST (COOMB’S TEST)

110
Q

Based on the principle that anti-human globulin obtained from immunized non-human species bind to human globulins such as IgG or complement in free state or attached RBCs

A

ANTIGLOBULIN TEST (COOMB’S TEST)

111
Q

Primarily detects /qG and/or Complement-sensitized RBCs

A

ANTIGLOBULIN TEST (COOMB’S TEST)

112
Q

Primary Reagent

A

Antihuman Globulin Reagent

113
Q

The antiglobulin test uses a [?], made in another species and directed against human globulins, that attaches and agglutinates sensitized red cells.

A

secondary antibody

114
Q

Preparation: the antibody is produced by injecting animals with human globulins to stimulate antibody production against the

A

foreign human protein (AHG serum)

115
Q

Anti-lgG and Anti-Cad

A

Polyspecific AHG

116
Q

Either anti-igG or anti-C3d only

A

Monospecific AHG

117
Q

Pool of heterogenous anti-IgG from many rabbits

A

Polyclonal AHG

118
Q

Pool of anti-igG from a single clone of plasma cells

A

Monoclonal AHG

119
Q

Prepared by Hybridoma Technology using mice

A

Monoclonal AHG

120
Q

Detects in vivo sensitization of RBCs with IgG and/or complement components

A

DAT

121
Q

DIRECT ANTIGLOBULIN TEST (DAT)
Specimen:
Sample:
Reagents:

A

Specimen: EDTA
Sample: 2-5% Red cell suspension
Reagents: AHG reagent, Coomb’s control cells (diluted anti-D + 5% “O+” RCS)

122
Q

DIRECT ANTIGLOBULIN TEST (DAT)

Procedure
1. 2-5% RCS (Sample) = [?]
2. Add AHG reagent = [?]
 [?] should be added to confirm the validity of NEGATIVE RESULTS
3. Centrifuge for [?]
4. [?]

A

2 DROPS

2 DROPS

Coombs control cells

15 seconds @3,400 RPM

AGGLUTINATION

123
Q

Blood sample from a patient with Immune mediated haemolytic anaemia: antibodies are shown attached to antigens on the [?] → The patient’s washed RBCs are incubated with [?] → [?]: anthuman antibodies form links between RBCs by binding to the human antibodies on the RBCs.

A

RBC surface

antihuman antibodies (Coombs reagent)

RBCs agglutinate

124
Q

DAT Application

A
  1. Hemolytic Disease of the Newborn
  2. Hemolytic Transfusion Reaction
  3. Autoimmune Hemolytic Anemia
  4. Drug-induced Hemolytic Anemia
125
Q

Detects in vitro sensitization of RBCs with IgG and/or complement components

A

IAT

126
Q

IAT

Sample:
Reagents:

A

Sample: 2-5% Red cell suspension, Serum
Reagents: AHG reagent

127
Q

IAT Application

A
  1. Antibody Detection (Compatibility tests and Antibody screening)
  2. Antibody Identification (Antibody Panel Tests)
  3. Antibody Titration
  4. Red cell phenotyping
  5. Weak D testing
128
Q

IAT Procedure
1. Serum (?) + RCS (2 drops)
2. Centrifuge: [?]
3. Place in water bath (?)
4. Centrifuge: [?]
5. [?]
6. [?]
7. AHG (?)
8. Centrifuge: [?]
9. [?]
 [?] should be added to confirm the validity of NEGATIVE RESULTS

A

2 dropS ; 2 drops

15 seconds @ 3,400 RPM

37°C for 15 minutes

15 seconds @3,400 RPM

OBSERVE

WASHING PHASE

2 drops

15 seconds @3,400 RPM

OBSERVE

Coombs contral cells

Immunohematology Lab (3 decks)

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