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B&L Unit 3 > Immunohematology ABO/Rh (complete) > Flashcards

Immunohematology ABO/Rh (complete) Flashcards

1
Q

How common are the blood types?

A

In US white pop’n:
O>A>B>AB

In US black pop’n:
same but more B and less A

Very different throughout the world

O common for South Am, rare in China

B common in Vietnam

OVERALL: AB is the RAREST blood type

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2
Q

What are the red cell Ags in the blood types?

A

O => H Ag

A => A Ag

B => B Ag

AB => split 50/50 A&B

Bombay => h Ag

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3
Q

Which ABO antibodies are in the plasma of each blood type?

A

O => anti-A & anti-B

A => anti-B

B => anti-A

AB => none

Bombay => anti-A, anti-B, & anti-O

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4
Q

Persons w/ O blood can receive which type of blood?

A

O

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5
Q

Persons w/ A blood can receive which type of blood?

A

A & O

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6
Q

Persons w/ B blood can receive which type of blood?

A

B & O

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7
Q

Persons w/ AB blood can receive which type of blood?

A

all types

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8
Q

Persons w/ O blood can donate which type of blood?

A

all types

except Bombay

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9
Q

Persons w/ A blood can donate which type of blood?

A

A & AB

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10
Q

Persons w/ B blood can donate which type of blood?

A

B & AB

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11
Q

Persons w/ AB blood can donate which type of blood?

A

AB

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12
Q

What are the possible genotypes of O blood?

A

OO

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13
Q

What are the possible genotypes of A blood?

A

AA or AO

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14
Q

What are the possible genotypes of B blood?

A

BB or BO

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15
Q

What are the possible genotypes of AB blood?

A

AB

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16
Q

What is the antibody class of most ABO isohemagglutinins?

A

IgM!!!

This is especially important when you think about pregnancy!

Mom doesn’t launch immune response to fetus b/c IgM can’t cross the placenta

17
Q

Explain the ABO Ag situation in a person with Bombay blood type

A
  • Final sugar not placed in “core” Ag b/c they lack the transferase gene that does this
  • Therefore no additional sugars (e.g. A or B) can be put on penultimate sugar

Those w/ Bombay blood can still have functioning glycosyltransferases that put A or B on penulti sugar, but they can’t do so w/o final sugar on the end of “core” Ag

18
Q

What are the consequences of a transfusion of non-Bombay blood into a patient with Bombay blood?

A

Death

Bombay blood has anti-O, anti-A, and anti-B

A non-Bombay transfusion would launch an immuno response on the pt’s own blood

19
Q

Define the crossmatch

A

A lab test! Done after matching ABO and Rh

  • Prospective recipient’s plasma is mixed w/ prospective donor’s RBCs
  • If red this indicates hemolysis

NOT compatible if it turns red or there is clumping

20
Q

Explain why the crossmatch is important

A
  • Otherwise complement-mediated hemolysis would occur

- This can lead to acute renal failure

21
Q

Explain how red cells are destroyed following a mismatched transfusion and why this may be devastating to the pt

A
  • Via complement-mediated hemolysis

- Free Hb is then deposited in the kidneys => acute renal failure

22
Q

What are the techniques of a direct antiglobulin test?

A
  • Take recipient RBCs
  • Wash them
  • Add anti-IgG Ab
  • If agglutination, positive test
23
Q

What are the techniques of a indirect antiglobulin test?

A
  • Take donor RBCs
  • Add recipient plasma
  • Wash unbound proteins
  • Add anti-IgG Ab
  • Agglutinates if positive

Antiglobulin crosslinks the bound Abs

24
Q

The direct antiglobulin test is designed to answer which questions?

A

Is there Ab already on these cells?

25
Q

The indirect antiglobulin test is designed to answer which questions?

A

Is there unexpected Ab to red cell Ags in the plasma of this potential recipient?

26
Q

What is a heterophile Ab?

A
  • Cross-reactive Abs
27
Q

What is a common disease in which one type of heterophile Ab is increased enough to be useful diagnostically?

A

Infectious mononucleosis!

  • Abs produced in mono also cross-react w/ horse RBCs
  • A quick and cheap test!
28
Q

In the Hemolytic Disease of the Newborn explain the consequences of severe hemolysis in the newborn

A
  • Causes high levels of bilirubin (presents as jaundice)

- Bili can cross the BBB and damage the basal ganglia => cerebral palsy or fetal death

29
Q

In the Hemolytic Disease of the Newborn explain the way in which the mother becomes sensitized

A
  • Happens in last trimester, especially at time of delivery
  • Rh(D)- mom is exposed to Rh(D)+ baby’s blood
  • Mom produces IgM to Rh(D) => becomes IgG and produces memory T cells to Rh(D)+
  • Those Abs cannot be used b/c there’s no more baby
30
Q

In the Hemolytic Disease of the Newborn explain the class of antibody to Rh(D) the mother makes

A

IgG

CAN cross the placenta in future pregnancies

31
Q

In the Hemolytic Disease of the Newborn explain the consequences of sensitization to subsequent fetuses

A
  • Mom’s IgG from previous exposure can now cross the placenta and can attack fetus’s RBCs
  • leads to jaundice and potentially other problems
32
Q

In the Hemolytic Disease of the Newborn explain the role of Rh-immune globulin (RhoGAM)

A
  • Mom receives IgG Ab to Rh(D)+ at the time of delivery
  • These Abs combine w/fetal RBCs, opsonize them and are destroyed before they immunize her
  • Whole point is to prevent sensitization (immunization) of mom to Rh(D)+
  • Mom must do this at each pregnancy

Prevent hemolytic disease of the newborn

33
Q

Explain the situation in which ABO hemolytic disease of the newborn can occur.

A
  • This happens if a mom w/ O blood makes IgG isohemagglutinins
  • leads to disease if fetus has A, B, or AB blood
  • no RhoGAM-like Ab for this

Remember:

  • IgG crosses placenta
  • O blood makes anti-A and anti-B

B&L Unit 3 (12 decks)

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