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MLT-MLS Spring 2023 > Immunologic Principles Related to Blood Bank > Flashcards

Immunologic Principles Related to Blood Bank Flashcards

1
Q

What is the ultimate role of immunohematology?

A

Successfully provide safe and effective blood components for treatment

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2
Q

Intravascular hemolysis occurs when?

A

Cell membrane is destroyed by complement (not by antibody)

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3
Q

Which causes immediate problems?
-Intravascular hemolysis
-Extravascular hemolysis

A

Intravascular hemolysis

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4
Q

In immunohematology, what is the most common and most severe cause of intravascular hemolysis?

A

Wrong ABO type of blood given to a patient

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5
Q

Extravascular hemolysis

A

Antibody is attached to red cell membrane

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6
Q

What removes antibody coated red cells from circulation during extravascular hemolysis?

A

The spleen

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7
Q

Examples of extravascular hemolysis (2)

A

-Delayed transfusion reactions
-Hemolytic Disease of the Newborn

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8
Q

Which immune response does blood bank focus on:
-Humoral
-Cellular

A

Humoral

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9
Q

Definition: Substance capable of inducing a specific immune response

A

Antigen

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10
Q

Another name for antigen

A

Immunogen

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11
Q

Portion of the antigen where the antibody combines

A

Epitope

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12
Q

Another name for epitope

A

Antigenic determinant

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13
Q

How can antigens be acquired? (3)

A

-Injection
-Inhalation
-Ingestion

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14
Q

Definition:
Overall strength of reaction between several epitopes and antibodies

A

Avidity

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15
Q

Avidity is dependent on what 3 factors?

A

-Affinity of the antibody
-Valency
-Noncovalent attractive forces

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16
Q

Protein synthesized by plasma cells

A

Antibody

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17
Q

Another name for antibody

A

Immunoglobulin

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18
Q

Antibody to a foreign substance

A

Alloantibody

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19
Q

Antibody to self

A

Autoantibody

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20
Q

What are classes of antibodies based on?

A

Heavy chain composition

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21
Q

What are the heavy chains of concern in blood bank?

A

IgM (Mu) and IgG (Gamma)

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22
Q

What are the light chains found in immunoglobulins?

A

Kappa and Lambda

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23
Q

Immunoglobulin structure:
This portion binds to the antigenic determinant (epitope)

A

Fragment antigen binding portion (Fab)

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24
Q

Immunoglobulin structure:
This includes the binding site for complement and macrophage Fc receptors

A

Fragment crystallizable portion (Fc)

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25
Q

Immunoglobulin structure:
Disulfide bonding which holds the light chain and heavy chain together

A

Hinge region

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26
Q

Immunoglobulin structure:
Allows flexibility for immunoglobulin to attach to antigen

A

Hinge region

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27
Q

What 2 enzymes can split the antibody molecule at the hinge region?

A

Papain and Pepsin

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28
Q

Number of binding sites for IgG

A

2

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29
Q

Number of binding sites for IgM

A

10

30
Q

IgM has how many monomers?

A

5

31
Q

IgG has how many monomers?

A

1

32
Q

IgG or IgM:
Crosses the placenta

A

IgG

33
Q

IgG or IgM:
Reacts at room temperature

A

IgM

34
Q

IgG or IgM:
Reacts at 37C

A

IgG

35
Q

IgG or IgM:
First antibody seen in primary immune response

A

IgM

36
Q

IgG or IgM:
Is part of the anamnestic immune response

A

IgG

37
Q

IgG or IgM:
Naturally occurring

A

IgM

38
Q

IgG or IgM:
Must be previously exposed in order to create

A

IgG

39
Q

IgG or IgM:
Requires enhancer to visualize lattice formation

A

IgG

40
Q

Where antibodies are located

A

Plasma or serum

41
Q

Where antigens are located

A

On the red blood cell membrane

42
Q

Strength of the binding between a single antibody and an epitope of an antigen

A

Affinity

43
Q

First stage of antigen-antibody reactions

A

Sensitization stage aka Recognition stage

44
Q

Second stage of antigen-antibody reactions

A

Agglutination stage

45
Q

Antigen-antibody stage in which the antibody is attached to antigen on the red cell membrane but a visible reaction is NOT observed

A

Sensitization Stage

46
Q

Antigen-antibody reactions:
Random pairing determined largely by chance

A

Sensitization stage

47
Q

What is the serum-to-cell ratio? (#s)

A

2 drops of plasma/serum to 1 drop of red cells

48
Q

TRUE or FALSE: Increasing the serum/plasma amount increases the concentration of antibodies available to bind to red cell antigens but does NOT increase reaction probability

A

TRUE

49
Q

What environmental factors influence the sensitization stage of antigen-antibody reactions? (4)

A

-Incubation time (15-60 minutes)
-Temperature (IgG 37C/IgM RT or lower)
-pH (optimal ~7.0)
-Ionic strength (physiologic saline)

50
Q

___________ forms when red cells are in close proximity to promote lattice formation between the antibody and antigenic sites on adjacent red cells

A

Agglutination

51
Q

What factors influence agglutination? (3)

A

-Distance between red blood cells (zeta potential)
-Optimal concentrations of antigen and antibody (zone of equivalence)
-Effect of centrifugation

52
Q

Definition:
The force or repulsion between red cells in a physiologic saline solution

A

Zeta potential

53
Q

Red cells possess a net _______ charge on the cell surface in a saline suspension. ________ from the saline environment are attracted to these charges.

A

-negative
-cations (+ charge)

54
Q

What is IgM able to facilitate agglutination better than IgG?

A

It is larger in size with more binding sites

55
Q

Excess antibody

A

Prozone

56
Q

Excess antigen

A

Postzone

57
Q

Maximum agglutination is observed when amount of antibodies = amount of antigens

A

Zone of equivalence

58
Q

Prozone and postzone can both cause what type of test results?

A

False negatives

59
Q

What helps facilitate the formation of a lattice network by forcing red cells closer together?

A

Centrifugation

60
Q

Why is hemolysis considered a positive reaction in blood bank?

A

Hemolysis can mean that complement was activated by the antibody (probable IgM)

61
Q

Primary response vs Secondary/anamnestic response:
Takes 5-7 days

A

Primary

62
Q

Primary response vs Secondary/anamnestic response:
Takes 24-48 hours

A

Secondary

63
Q

Primary response vs Secondary/anamnestic response:
Total titer is higher

A

Secondary

64
Q

Primary response vs Secondary/anamnestic response:
Titer lasts longer

A

Secondary

65
Q

Primary response vs Secondary/anamnestic response:
More IgM

A

Primary

66
Q

Primary response vs Secondary/anamnestic response:
Mostly IgG

A

Secondary

67
Q

Primary response vs Secondary/anamnestic response:
Memory B cells

A

Secondary

68
Q

Primary response vs Secondary/anamnestic response:
Needs more antigen to stimulate

A

Primary

69
Q

Primary response vs Secondary/anamnestic response:
Delayed hemolytic transfusion reaction

A

Secondary

70
Q

White cells that synthesize antibodies

A

Plasma cells

71
Q

Zeta potential can be easily overcome by this immunoglobulin to produce agglutination

A

IgM

MLT-MLS Spring 2023 (25 decks)

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