ISBB Mother Notes Flashcards
Immunodominant sugar of H gene
L-fucose
Immunodominant sugar of A gene
N-acetyl-D galactosamine (GalNac)
Immunodominant sugar of B gene
D-galactose
How many percent of Blacks have A blood group?
26%
How many percent of Asians have A blood group?
28%
How many percent of White population have B blood group?
11%
ABO antigens are formed as early as ______ day of fetal life.
37th
Full expression of ABO antigens is found in what age?
2-4 yrs of age
What is the precursor and linkage of ABO antigens in secretions?
-Type I precursor
-Beta-1-3 linkage
What is DUBSTAMP (ABO antigens in secretors)
Digestive juices
Urine
Bile
Saliva
Tears
Amniotic fluid
Milk
Pathological fluids (pericardial, pleural, peritoneal, ovarian cyst fluid)
Excessive ABH substances in secretions can be observed in? (Clue: PIC)
-Pseudomucinous ovarian cyst
-Intestinal obstruction
-Carcinoma of stomach and pancreas
Absorption vs Elution
Absorption - removal of unbound antibodies from the serum
Elution - removal of bound antibodies in the surface of RBCs
Subgroups of A antigen
A1, A2, A3, Ax, Aend, Am, Ael, Ay
Conditions that cause weaker reactions
-Leukemia
-Chromosomal translocations
-Hemolytic diseases
-Hodgkin’s dse
-Hypogammaglobulinemia (CLL)/ Immunodeficiency
Conditions that cause Pseudoantigens in Acquired A phenomenon:
-Proteus mirabilis infxn
-Tn activation
Conditions that cause pseudoantigens in Acquired B phenomenon:
-E. coli 086
-Proteus vulgaris infxn
-Intestinal obstruction
-Carcinoma of colon and rectum
-Clostridium tetani
ISBT # of ABO blood group
001
ISBT # of Rh blood group
004
RHAG gene is located in chromosome _____.
Chromosome 6
RHD and RHCE genes are located in chromosome ______.
Chromosome 1
What are the four most common genotypes of Rh system?
R1, R2, r, Ro
The most common Rh genotype is blacks
Ror
Most common Rh genotype in Asians/whites
R1r
What does ISBT mean
International Society of Blood Transfusion
What is the most immunogenic antigen after A and B antigen?
D antigen
A test that detects weak D antigen
IAT
Conditions associated with Rh null phenotype
-Hemolytic anemia
-reticulocytosis
-stomatocytosis
-decreased Hb, Hct, Haptoglobin
-Increased Bilirubin and HbF
Rh null regulator type has mutation in what gene
RHAG gene
Rh null Amorphic type has a mutation in what gene?
RHCE gene
True or False
Rh antibodies are naturally occurring.
False
Most clinically significant Rh immunoglobulin
IgG 1 and IgG 3
Best Immunoglobulin at crossing placenta
IgG 1
Cannot cross placenta
IgG 2
ISBT # of LW blood group
016
LW blood group gene location
Chromosome 19
Used to differentiate A antigen from LW
Dithiothreitol (DTT)
Lewis ISBT #
007
Le Gene is located in what chromosome?
Chromosome 19 p13.3
LE antigens can be found in:
-lymphocytes,platelets
-pancreas, stomach, intestine
-skeletal muscle
-renal cortex, adrenal glands
Le antigens in secretions are ______and Le cell-bound antigens absorbed onto RBCs from plasma are _______.
-glycoproteins
-glycolipids
Le (a+b+) are common in ________.
Asians
lele is common in ________.
Africans
Phenotype changes (in Lewis) can be caused by:
-pregnancy
-cancer
-viral and parasitic infxn
-alcoholic cirrhosis
ISBT # of MNS
002
MNS is found in chromsome_____.
chromosome 4
MNS antibody seen in multiparous woman
Anti-M
Anti-N antibody is seen in ______ patients.
renal dialysis patients
Disease associated in GPA receptor of MNS blood group
E. coli infection
Disease associated in GPA and GPB receptor of MNS
P. falciparum infections
The P1 antigen is poorly expressed at birth and fully expressed at age _______.
7 yo
Common P1PK phenotypes:
-P1 and P2
P1Pk antibody that is IgG autoantibody
Autoanti-P
Antibody neutralized by hydatid cyst from E. granulosus
Anti-P1
antibody first described from Mrs. Jay suffering from adenocarcinoma
Anti-P1Pk
receptor for Parvovirus B19
P
receptor for Shiga toxins
Pk
Receptor for P-fimbriated uropathogenic E. coli
Psys. (P, P1, Pk)
found in spontaneous abortions in early pregnancy
Anti-Tja
ISBT # of I system
027
The most common disease transmitted by blood transfusion
Hepatitis C aka “Post-transfusion Hepatitis
If blood products are tested positive for HIV, in which reference lab must it be sent?
RITM
If a patient sample in the lab has tested positive for HIV, in which reference lab is it sent?
SACCL/San Lazaro
Used as a screening test for HIV in blood donors/blood bags
ELISA
Used as a confirmatory test for blood donors/bags
Western Blot
Confirmatory tests for Anti-HTLV test in blood products
Western blot, RIPA, NAT
What is SAGM
SAGM are additive solutions namely:
-Saline
-Adenine
-Glucose
-Mannitol
Increased in blood storage lesion
-Hemoglobin
-Ammonium
-Lactic acid
-Potassium
Decreased in blood storage lesion
-2,3-DPG
-pH
-Glucose
-ATP
-Sodium
Light spin speed and duration
3,200 rpm/2000 g for 3 mins
Heavy spin speed and duration
3,500 rpm / 5,000 g for 5-8 minutes
Source of radiation for Irradiated RBCs
Cobalt 60
Cesium 137
Blood component used for maintaining blood volume and colloidal oncotic pressure
5% albumin
Blood component for patients with congenital hypogammaglobulinemia
Immune Serum Globulin (ISG)
Blood component for hypovolemic shocks and severe burns
Single Donor Plasma
Cryoprecipitate contents
- 150 to 250 mg of Fibrinogen
- 80 to 120 U of Factor VIII
- 40 to 70 U of vWF
- 20 to 30 U of Factor XIII
How to prepare cryoprecipitate
By thawing at 4degC, Hard spin, then leave only 10-15 mL plasma
pore size of first generation blood filters
170-260 um
pore size of second generation transfusion/blood fliters
20-40 um
Pore size of third gen filters
7-10 um
STOP TRANSFUSION but keep IV lines open with _______.
physiologic saline
Enumerate the transfusion reaction
- Check for clerical errors
- Do a visual check
- DAT
- Repeat ABO/Rh typing
- Repeat AB screen and panel
- Repeat Crossmatch
- Bilirubin test
- Check urine for free Hgb and urobilinogen
- Hemosiderin appears weeks after transfusion
- Check Hgb and Hct
common antibodies implicated in DHTR
anti-Jka
anti-E
anti-D
anti-C
anti-K
anti-Fya
anti-M
S/s in Immediate HTR
fever with back pain
S/s in Delayed HTR
Jaundice and decreasing Hct levels
Effects in the blood of Immediate HTR
Increased plasma free Hb
Increased Bilirubin
Decreased haptoglobin
+/- DAT
Effects in blood of Delayed HTR
Decreased Hb and Hct
(+) DAT
(+) Post-transfusion Ab screen
S/S of TACO
Coughing
Cyanosis
Difficulty breathing