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IMMUNOHEMATOLOGY > LEC5- BLOO DGROUP SYSTEM > Flashcards

LEC5- BLOO DGROUP SYSTEM Flashcards

1
Q

Antigens usually found on the cell surface (RBC surface

A

BLOOD GROUP SYSTEM

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2
Q

Defines uniqueness of each cell

A

BLOOD GROUP SYSTEM

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3
Q

Genes of each blood system are coded on different
___

A

chromosome

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4
Q

CHROMOSOME 1LOCUS

A

Rh, Duffy, Scianna, Cromer, Knops

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5
Q

Chromosome 4 locus

A

MNS

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6
Q

Chromosome 7 locus

A

kell

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7
Q

Chromosome 9 locus

A

ABO

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8
Q

Chromosome 18 locus

A

kidd

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9
Q

Chromosome 19 locus

A

H, Lewis, Lutheran

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10
Q

Chromosome 22 locus

A

P1

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11
Q

A scientific society founded in 1935

A

International Society for Blood Transfusion (ISBT)

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12
Q

Aims to promote study of blood transfusion
and spread knowhow of the manner in which blood
transfusion medicine can best serve patients’ interest

A

International Society for Blood Transfusion (ISBT)

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13
Q

numerical codes for blood
groups composed of 6 numbers

A

ISBT SYSTEM NUMBER

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14
Q

FIRST 3 DIGITS in ISBT

A

blood group system

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15
Q

last 3 DIGITS in ISBT

A

antigenic specificity

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16
Q

We have about how many different blood group systems

A

36

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17
Q

he Drew blood from himself and five associates,
separated the cells and serum, and then mixed
each cell sample with each serum.

A

Karl Landsteiner

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18
Q

year when Karl Landsteiner dre blood from himself and other associates

A

1901

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19
Q

Discovery of 4th Blood Type (AB group by

A

Von Decastello and Adriano Sturli

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20
Q

Discovery of 4th Blood Type (AB group by von and adriano

A

1902

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21
Q

Discovery of Subgroups of Blood Group A
▪ A1 and A2

A

Emil Frieherr Von Dungern and Ludwik Hirszfel

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22
Q

year when Emil Frieherr Von Dungern and Ludwik Hirszfel
o Discovery of Subgroups of Blood Group A
▪ A1 and A2

A

1911

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23
Q

he Classified Blood into A, B and O groups

A

Karl Landsteiner

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24
Q

Individuals normally produce antibodies directed against
the A and/or B antigen(s) absent from their RBCs.

A

Naturally occurring ABO antibodies

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25
Q

nature of ABO antibodies

A

Predominantly IgM in nature

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26
Q

Best reacts with room temperature or colder

A

IgM

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27
Q

test we perform in visualizing ABO antibodies

A

ABO antibody testing - reverse typing

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28
Q

why we can’t test baby’s blood type in reverse ?

A

The production of ABO antibodies is initiated at birth, but titers are generally too low for detection

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29
Q

Antibody production
▪ ____y/o – PEAKS

A

5 – 10

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30
Q

Antibody production

▪ _____ – Declines

A

Later in Life

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31
Q

Elderly people and Infants

usually have lower levels of _____

A

anti-A and anti-B

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32
Q

blood A, B, AB was been characterized as what IG

nature of A, B, AB

A

IgM

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33
Q

blood O was been characterized as what IG

A

IgG

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34
Q

ABO blood unit/type that was been classified as a silent gene/amorph gene

A

blood O

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35
Q

temperature where IgG best reacts

A

37*C

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36
Q

in forward typing, what is the patient sample used

A

red cells

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37
Q

in reverse typing, what is the patient sample used

A

serum

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38
Q

the known A cells and known B cells used in reverse typing came is done or provided by making __

A

red cell suspensions from blood type A and B suspension

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39
Q

Reverse results with Forward typing

A

Reverse Grouping/ Backward/ Indirect Typing

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40
Q

INHERITANCE PATTERN OF THE ABO BLOOD GROUPS

was been described by ___

A

Felix berstein

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41
Q

INHERITANCE PATTERN OF THE ABO BLOOD GROUPS

  • ______described by Bernstein
A

1924

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42
Q

Inheritance pattern follows ___

A

mendelian genetics

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43
Q

Demonstrated that an individual inherits one
ABO gene from each parent and that these
two genes determine which ABO antigens
are present on the RBC membrane.

A

INHERITANCE PATTERN OF THE ABO BLOOD GROUPS

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44
Q

INHERITANCE PATTERN OF THE ABO BLOOD GROUPS

how many gene from the parents

A

▪ 1 ABO gene from the mother
▪ 1 ABO gene from the father

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45
Q

antigens in ABO bloo dgroup system

Appear in the ___ week of fetal life

A

6th

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46
Q

antigens in ABO bloo dgroup system

present on the red cell membrane and in other tissues such as

A

salivary glands, pancreas, kidneys and
other body fluids except the cerebrospinal fluid)

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47
Q

is a precursor on which the A and B
antigens are made

A

H antigen

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48
Q

in order for our A and B to be expressed, must have a what gene

A

H gene

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49
Q

Is H antigen part of ABO blood group system?

A

no

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50
Q

it produces a specific enzyme that
will promote what is the antigen to be
expressed on the surface area of the red blood cells

A

ABH antigen

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51
Q

what are the enzymes that ABH antigen will produce to help the rbc express its antigen

A

Glycosyltransferases

o L-fucosyltransferase
o N-acetylgalactosaminyltransferase
o D-galactosyltransferas

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52
Q

These enzymes will add sugars to a basic precursor
molecule (paragloboside)

A

Glycosyltransferases:

o L-fucosyltransferase
o N-acetylgalactosaminyltransferase
o D-galactosyltransferase

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53
Q

Responsible for giving specificity to the cell

A

Immunodominant sugar

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54
Q

what are the Immunodominant sugar

A

▪ L-fuctose
▪ N-Acetylgalactosamine
▪ D-galactose

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55
Q

▪ L-fructose

this immunodominant sugar is responsible for ___

A

H antigen

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56
Q

▪N-Acetylgalactosamine

this immunodominant sugar is responsible for ___

A

A antigen

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57
Q

D-galactose

this immunodominant sugar is responsible for ___

A

B antigen

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58
Q

This is where the sensitization of secreted substances occurs

A

Type 1 Precursor Chain

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59
Q

Type 1 Precursor Chain beta linkage

A

1-3

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60
Q

beta linkage of type 1 precursor chain is located in

A

it is located within the terminal of the
D-galactose
and N-aceylglucosamine.

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61
Q

the precursor chain that is Based on the inheritance of the secretor gene

A

Type 1 Precursor Chain

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62
Q

the secretor gene in type 1 precursor chain is coded on

A

chromosome 19

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63
Q

Type 1 Precursor Chain has an expression of H gene which will express what antigen?

A

H antigen

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64
Q

There’s another gene in TYPE 1 precursor which is SE gene, SE gene can be classified as _____

A

secretor gene
non secretor gene

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65
Q

if secretor SE gene, the genotype we have is

A

Sese or SeSe

66
Q

if non secretor SE gene, the genotype we have is

A

sese - lahat small

67
Q

The ABH antigen is formed with the same basic precursor material.
The basic material of the ABH antigen is known as the _________

A

paragloboside

68
Q

can we use saliva in determination of blood type? which precursur is it associated

A

yes, in type 1 precursor chain

69
Q

can a non secretor type 1 chain expressed ABH antigen in saliva?

A

no, there’s no glycoisyltransferase and immunodominant sugar that will induce the ABH antigen to expressed it

70
Q

Type 2 Precursor Chain

beta linkage

71
Q

a type of precursor chain

This would be associated with the expression of ABH antigen
within the red cell membrane

A

type 2 Precursor Chain -

72
Q

beta linkage of type 2 precursor chain is located in __

A

it is also located at the terminal of the D-galactose
and N-acetylglucosamine.

73
Q

a type of precursor chain in order to provide expression of ABH to red cell membrane

A

type 2 precursor chain

74
Q

how ABH have an expression in RBC membrane?

A

type 2 needs an H antigen, then H antigen will push tru to expressed ABH substances to RBC membrane

but still glycosyltransferases and immunodominant sugar is still needed

75
Q

H gene’s glycosuyltransferase and immunodominant suagr

A

L-fucosyltransferase l-fucose

76
Q

A gene’s glycosyltransferase and immunodominant sugar

A

N-acetylgalactosaminyltransferase

N-acetylgalactosamine

77
Q

b -gene’s glycosyltransferase and immunodominant sugar

A

D-galactosyltransferase

78
Q

The anti H lectin na ginagamit sa laboratory
would be the

A

Ulex europaeus

79
Q

H anti-sera is also known as the __which is associated from plants.
It is mainly extracted from plants

A

anti-H lectin

80
Q

Using this anti-H lectin or the Ulex europaeus mas nagr-react
ang blood group ____

highest ammount or reactivity

A

blood group O

81
Q

Using this anti-H lectin or the Ulex europaeus least ammount or reactivity

82
Q

blood group A secretor, antigen in Saliva is

83
Q

blood group B secretor, antigen in Saliva is

84
Q

blood group AB secretor, antigen in Saliva is

85
Q

blood group O secretor, antigen in Saliva is

86
Q

ABH are can be expressed not only in saliva, where can we get it more?

A

tears, urine, digestive enzyme, milk, amniotic fluid, pathologic fluid except CSF

87
Q

Agglutination Inhibition – involvement of ___. which are
incomplete antigens.

88
Q

Kaya hemagglutination inhibition ang principle kasi ang indicator cells na ginagamit for the determination of secretor status would be _____

A

red blood cells.

89
Q

In 1930, ______ postulated a four-allele system of inheritance
based on the discovery of Emil Frieherr von Dungern and Ludwig

A

O. Thompson

90
Q

O. Thompson’s four allele

A

A1, A2, B and O.

91
Q

how to distinguised A1 and A2

A

use anti a1 lectin

92
Q

anti-A1 lectin that we have is the ____

A

Dolichos biflorus

93
Q

Based sa anti-A1 lectin reagent natin, si Dolichos
biflorus, only the which subgroup of A will yield a positive result

94
Q

____ reagent in blood bank is the polyclonal human anti-AB reagent

95
Q

quantitative changes in subgroup a1 and A2

A

decrease number of antigen sites
decrease amount of transferase enzyme
decrease amount of branching

96
Q

qualitative changes in subgroup a1 and A2

A

differences in the precursor oligosaccharide chains
subtle differences in transferase enzyme
formation of anti a1, in a percentage of some subgroups

97
Q

which one got unexpected antibodies that is anti A1

98
Q

which one has decrease antigen site

99
Q

Characteristics of Weak ABO Subgroups

A

Decreased number of A antigen sites per RBC (resulting in weak or no
agglutination with anti-A)

Varying degrees of agglutination by human anti-A, B.

Increased variability in the detectability of H antigen, resulting in strong
reactions with Anti-H

Presence or absence of anti-A1 in the serum.

99
Q

if a secretor, a blood group A scretor’s antigen

99
Q

which one is the most common weak ABO subgroups

A

weak A subgroups

m, y, x, el, end, 3

99
Q

A1’s antigen site

99
Q

very rare subgroups of ABO

A

B subgroups

m, ,x, el, , ,3

100
Q

The Bombay phenotype was first reported by Dr. in 1952

A

Y.M. Bhende

100
Q

The term “Bombay” has been used to refer to the phenotype that lacks
normal expression of the ABH antigens because of the lack inheritance of
the ____ genotype

100
Q

Designated as Oh. as its nomenclature

A

BOMBAY GROUP

101
Q

The hh genotype does not elicit the production of which glycosyltransferase

A

a-2-L fucosyltransferase.

As a result, L-fucose is not added to the type 2 chain, and H substance
is not expressed on the RBC.

102
Q

____ lectin can be used to differentiate and
to confirm if your patient has Bombay phenotype

A

Anti-h

however, only group O will turn positive to anti-h lectin

103
Q

The reaction of the Bombay phenotype is mainly associated with the
reaction pattern of blood group ____

A

blood group O

104
Q

describe the reverse and forward typing og bombay

A

same with blood group O

105
Q

____ occur when unexpected reactions occur in the forward and reverse grouping

A

ABO discrepancies

106
Q

ABO discrepancies can usually be resolved by repeating on the same
sample by using a _______ of RBCs if the initial test was
performed using RBCs suspended in serum or plasma.

A

saline suspension

107
Q

It is important to make sure that any and all technical factors that may
have given rise to the ABO discrepancy was reviewed and corrected.

oki?

108
Q

It is also essential to acquire information regarding the patient’s age,
diagnosis, transfusion history, medications, and history of pregnancy.

true or false

A

true the fire

109
Q

If the discrepancy persists and appears to be due to an error in
specimen collection or identification, a new sample should be drawn
from the patient and the RBC and serum grouping repeated

110
Q

When a discrepancy is encountered, results must be ____, but
interpretation of the ABO type must be delayed until the discrepancy
is resolved.

111
Q

If blood is from a potential transfusion recipient, it may be necessary
to administer Group O, Rh-compatible RBCs before the discrepancy
is resolved. - -

A

Rh negative for blood type O.
Rh positive for blood type AB.

112
Q

clerical or technical issues?

mislabeled

113
Q

clerical or technical issues?

improper recoding

114
Q

clerical or technical issues?

deleted prcoedural step

115
Q

clerical or technical issues?

not followiing manufacturer’s intruction

116
Q

clerical or technical issues?

missed or underinterpreted weak reactions

117
Q

clerical or technical issues?

incorrect interpretation of serologic reactions

118
Q

clerical or technical issues?

missing oor incorrect reageent

119
Q

clerical or technical issues?clerical or technical issues?

equipment malfunction

120
Q

clerical or technical issues?

contaminated antisersa or cells

121
Q

incorrect cell suspension

122
Q

in emergency situation and we need the blood, we can administer

A
    • Group O, Rh negative for blood type O.
      Group O, Rh positive for blood type AB
123
Q

Weakly reacting or missing antibodies

A

GROUP I DISCREPANCIES

124
Q

group discrepancies where there’s unexpected reaction in REVERSE TYPING

125
Q

group 1 discrepanscies

A
  1. Newborns
  2. Elderly patients
  3. Patients w/ Leukemia (hypogammaglobulinemia)
  4. Patients w/ Lymphoma (hypogammaglonulinemia)
  5. Patients with immunosuppressive drugs
  6. Patients with congenital hypogammaglobulinemia
  7. Patients w/ immunodeficiency diseases
  8. Patients with bone marrow transplantations
126
Q

Umiinom ng medication in which is used to treat autoimmune
disorders such as SLE, rheumatoid arthritis, autoimmune
thyroiditis, and even sa synthetic corticosteroids. Yung mga
umiinom ng prednisone, budesonide, cortisone, and
hydrocortisone

A

GROUP I DISCREPANCIES

127
Q

Resolution of Common Group 1 Discrepancies

A

Enhance the weak or missing reaction in the serum by incubating the
patient serum with reagent A1 and B cells at RT for approximately 15 to 30 minutes

if no reaction, incubate in 4* same time, centri and observe the reaction

128
Q

sample tested using control coming from the same blood

A

autocontrol

129
Q

common naturally occuring antibodies for group 1

A

anti- I - commonly encountered cold agglutinin in adult rbc’s

130
Q

Weakly reacting or missing reacting ABO antigens

A

GROUP II DISCREPANCIES

131
Q

group discrepancies where there’s unexpected reaction in FORWARD TYPING

A

Group 2 discrepancies

132
Q

Group ____ is the least frequently encountered ABO discrepancies.

133
Q

group 2 discrepancies

A
  1. Subgroups of A and B
  2. Leukemias
  3. Hodgkin’s disease
  4. Acquired B phenomenon
  5. Antibodies to low incidence antigens
  6. Excess amounts of blood group specific soluble (BGSS) substances
    present in plasma (carcinoma of stomach and pancreas).
134
Q

Associated in pathologic finding. Related sa diseases of digestive tract and septicemia?

A

Acquired B phenomenon - group 2

135
Q

pathologic finding, wherein the blood type is looking like blood AB

A

Acquired B Phenomenon

136
Q

Disease of gastrointestinal tract.

A

Acquired B Phenomenon

137
Q

associated with the deacetylase enzyme. This
enzyme produces acquired B antigen.

A

Deacetylation

138
Q

The acquired B antigen is
caused by enzyme produced by those gram negative bacteria such
as

A

Escherichia coli O86, Clostridium tertium, and some strains of
Proteus bulgaris OX-19.

139
Q

This _____ mainly arises when the bacterial enzymes
modify the blood group

A

Acquired B Phenomenon

140
Q

solution for acquired B phenomenon

A

1-2 drops of hcl + 1ml of anti-b antisera

Ang solution is kailangan i-acidify the anti-B reagent

Need gumawa
ng drops of the reagent and 1 to 2 drops of 1 N of Hydrochloric acid
and you have to mix it with 1mL ng anti-B antisera. measure pH, once acidify, the true B antigen will react.

141
Q

acquired B phenomena

Test patient serum against autologous RBCs, this will yield a

A

negative
reaction.

142
Q

Protein or plasma abnormalities resulting to rouleaux formation

A

Group III Discrepancies

143
Q

Discrepancies both forward and reverse typing but it has factors
to consider. It is caused by protein or plasma abnormalities and it
can be resulted in pseudoagglutination or rouleaux formation

144
Q

group 3 discrepancies

A
  1. Elevated levels of globulin from certain disease: -
    Multiple myeloma – increased in IgG -
    Waldenstroms macroglobulinemia – increased in IgM
  2. Elevated levels of fibrinogen
  3. Plasma expanders such as dextran or polyvinylpyrrolidone
  4. Whartons Jelly
145
Q

gelatinous substances within the umbilical cord.

A

Whartons Jelly

146
Q

Whartons Jelly group discrepancies

147
Q

Resolution of Common Group 3 Discrepancies

A

Perform saline dilution or saline replacement technique.
Wash cord cells six to eight times with NSS.

148
Q

Miscellaneous -
It is also between the forward and reverse grouping that is due to
the miscellaneous problems.

A

GROUP IV DISCREPANCIES

149
Q

GROUP IV DISCREPANCIES

A
  1. Polyagglutination
  2. Cold reactive antibodies
  3. Unexpected ABO isoagglutinins
  4. Antibodies other than anti-A and anti-B
  5. RBCs with cis “AB phenotype”
150
Q

– these are antibodies produced by an individual
that cause agglutination of RBCs with other individual

A

Isoagglutinins

151
Q

mmutation in glycosyltransferases in AB phenotype

A

cis AB phenotype

152
Q

Resolution of Common Group 4 Discrepancies

A

Potent cold autoantibodies can cause spontaneous agglutination of
the patient’s cells.

RBCs could be incubated at 37°C for a short period, then washed with
NSS and retyped.

If not successful in resolving forward type, treat patient’s RBC with
0.01M dithiothreitol to disperse to IgM related agglutination.

As for the serum, the reagent RBCs and serum can be warmed to
37°C then mixed, retested and read at 37°C.

If the reverse typing is negative – Autoabsorption is done to remove
autoantibody.

153
Q

in group 4

If the reverse typing is negative – ___ is done to remove
autoantibody.

A

Autoabsorption

IMMUNOHEMATOLOGY (14 decks)

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