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IH PF > OTHER BLOOD GROUPS P2 > Flashcards

OTHER BLOOD GROUPS P2 Flashcards

1
Q

found in glycophorin A (GPA) (major RBC sialic acid- rich glycoprotein)

A

M & N Antigens

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2
Q

(M & N Antigens)

antithetical and differ in their amino acid residues at positions 1 and 5

___: serine at position 1
___: glycine at position 5

A

M ; N

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3
Q

(M & N Antigens)

antigens are well developed at birth

A

yes

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4
Q

(M & N Antigens)

easily destroyed by _____, ____, ___ and by the less common enzymes ______ and _____

A

ficin, papain, and bromelin ; trypsin and pronase

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5
Q

also destroyed by ZZAP (combination of DTT and papain or ficin) BUT not affected by DTT alone,
2-aminoethyliso-thiouronium bromide (AET), α-chymotrypsin, chloroquine, or glycineacid EDTA
treatment.

A

(M & N Antigens)

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6
Q

M and N antibodies are _________

A

heterogeneous

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7
Q

found in glycophorin B (GPB)

differentiated by the amino acid at position 29

A

S & s Antigens

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8
Q

________ defines S, whereas ______ defines s

A

Methionine ; threonine

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9
Q

S and s also are well developed at birth.

A

yes

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10
Q

(S & s Antigens)

easily degraded by _____

A

enzymes

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11
Q

(S & s Antigens)

destroyed by ____, ______. ______, ______, and _______ ( amount of degradation may depend on the strength of the enzyme solution, the length of treatment, and the enzyme-to-cell ratio)

A

Ficin, papain, bromelin, pronase, and α-chymotrypsin

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12
Q

(S & s Antigens)

_________ by Trypsin , DTT, AET, chloroquine, or glycine-acid EDTA treatment

A

NOT destroyed

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13
Q

____: associates with protein band 3, which affects the expression of the antigen Wr(b) of the Diego blood
group system (located on protein band 3)

A

GPA

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14
Q

_____: associated with the Rh protein and Rh-associated glycoprotein complex as evidenced by the greatly
reduced S and s expression on Rhnull RBCs.

A

GPB

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15
Q

-naturally occurring saline agglutinins that react below 37°C
- 50% to 80% are IgG or have an IgG component

A

Anti- M

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16
Q

Anti- M do not bind _________ & do not react with ___________

A

complement ; enzyme-treated RBC

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17
Q

more common in children (especially patients with bacterial infections)

A

Anti- M

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18
Q

(Anti- M) Exhibits dosage: anti-M may react better with ______ RBCs (genotype MM) than with ______ RBCs
(genotype MN).

A

M+N– ; M+N+

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19
Q

(Anti- M)

Antibody reactivity can be enhanced by increasing the ________ or ________, or both, by decreasing incubation temperature or by adding a potentiating medium.

A

serum-to-cell ratio or incubation time

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20
Q

(Anti- M)

pH-dependent, reacting best at pH _____

A

6.5.

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21
Q

Anti-M does not react at ____ it is not clinically significant for transfusion

A

37°C,

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22
Q
  • Anti-M rarely causes ____, decreased red blood cell survival, or ____
A

HTRs ; HDFN

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23
Q

(Anti- M)

Some: react only with _____ exposed to glucose solutions

A

RBCs

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24
Q

made by individuals whose RBCs type M+N– and S+ or s+

A

Anti- N

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25
Q

(Anti- N)

  • cold-reactive IgM or IgG saline agglutinin
A

YES

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26
Q

not clinically significant unless it reacts at 37°C. (does not bind complement or react with enzyme-
treated RBCs.)

A

Anti- N

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27
Q

(Anti-N)

reacting better with _______ RBCs than with _______ RBCs

A

M–N+ (NN) ; M+N+ (MN)

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28
Q

Anti-N is seen in rare cases of ______

A

mild HDFN

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29
Q

less common than anti-M.

A

Anti- N

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30
Q

Also seen in renal patients who were dialyzed on equipment sterilized with formaldehyde.

A

Anti-N

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31
Q

(Anti-N)

Dialysis-associated anti-N reacts with any _______ RBCs treated with ________ (called anti-Nf )

anti-Nf does not react at ____, it is clinically insignificant for transfusion

A

N+ or N– ; formaldehyde ; 37°C

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32
Q

IgG, reactive at 37°C and the antiglobulin phase of testing

A

Anti- S & Anti- s

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33
Q

(Anti- S & Anti- s)

optimal reactivity between _____ and ______ by saline indirect antiglobulin test.

A

10°C and 22°C

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34
Q

may or may not react with enzyme-treated RBCs, depending on the extent of treatment and the
efficiency of the enzyme

A

Anti- S & Anti- s

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35
Q

seen less often than anti-M

A

Anti- S & Anti- s

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36
Q

(Anti- S & Anti- s)

clinically significant:

may bind _______
seen in severe HTRs with ______
also caused _____

A

complement ; hemoglobinuria ; HDFN

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37
Q

RBCs of three rare phenotypes lack GPA or GPB or both GPA and GPB; consequently, they lack all _______

A

MNS antigens

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38
Q

3 MNS PHENOTYPES

A
  1. U- Phenotype
  2. En(a-) Phenotype
  3. M(k) Phenotype
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39
Q
  • located on GPB very close to the RBC membrane between amino acids 33 and 39
  • have type S–s–U–
  • can make anti-U in response to transfusion or pregnancy
A

U- Phenotype

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40
Q

found on RBCs of all individuals except about 1% of African Americans (and 1% to35% of
Africans) who lack GPB because of a partial or complete deletion of GYPB

A

U antigen

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41
Q

IgG ; reported to cause severe and fatal HTRs and HDFN.

A

Anti-U

42
Q

altered GPB that does not express S or s.

A

U variant (Uvar):

43
Q

RBCs, although weakly, by adsorption and elution

A

Anti-U react with apparent U–

44
Q

1969, they described an antibody to the same high prevalence antigen, called Ena (for envelope)

A

Darnborough and coworkers and Furuhjelm and colleagues

45
Q

1969: Darnborough and coworkers and Furuhjelm and colleagues described an antibody to the same high prevalence antigen, called Ena (for envelope)

A

En(a–) Phenotype

46
Q

En(a–) individuals appeared to be

A

M–N–

47
Q

produce anti-Ena

A

En(a–) Phenotype

48
Q

En(a–) Phenotype results from homozygosity for a rare gene deletion at the _______

Cause: no ____ is produced, but ____ is not affected

A

GYPA locus ; GPA ; GPB

49
Q

En(a–) Phenotype caused severe _____ and ______

A

HTRs and HDFN.

50
Q

1964; they Named a rare silent gene M(k)

A

Metaxas and Metaxas-Buhler

51
Q

single, near-complete deletion of both GYPA and GYPB

A

M(k) Phenotype

52
Q

null phenotype in the MNS system

A

MkMk genotype

53
Q

MkMk genotype is associated with decreased ________ content
but increased ________ of RBC membrane band 3.

A

RBC sialic acid ; glycosylation

54
Q
  • Autoantibodies to U and Ena: ________
  • associated with warm-type __________
A

more common ; autoimmune hemolytic anemia

55
Q

(Disease Associations in MNS)

  • ______ may serve as the receptor by which certain pyelonephritogenic strains of E. coli gain entry to
    the urinary tract
  • ___________ appears to use alternative receptors, including GPA and GPB for cell invasion
A

GPA(M) ; Plasmodium falciparum

56
Q

ano na next group teh

A

The Kell (006) and Kx (019) Systems

57
Q
  • consists of 36 high-prevalence and low-prevalence antigens
  • first blood group system discovered after the introduction of antiglobulin testing
A

Kell (006) & Kx (019) System

58
Q

1946 ;

Anti-K was identified in the serum of ________

________ was described

A

Mrs. Kelleher ; anti-k

59
Q

high-prevalence antithetical partner to K, was described

_____: was describe in 1957

A

Anti-K ; Kpa

60
Q

Kpa was describe

discovery of the null phenotype designated Ko

A

1957

61
Q

Kpb was describe

A

1958

62
Q

Other antigens: ____ (described in 1958) and ____ (described in 1963)

A

Jsa ; Jsb

63
Q

Kell blood group antigens are found only on _____

A

RBCs

64
Q

K antigen can be detected on fetal RBCs as early as ______ ; well developed at birth

k antigen has been detected at _______

A

10 weeks ; 7 weeks

65
Q

(Kell (006) & Kx (019) System)

  • not denatured by the routine blood bank enzymes (______ & ______)
  • destroyed by _______ & ________ (used in combination)
A

ficin & papain ; trypsin & chymotrypsin

66
Q

(Kell (006) & Kx (019) System)

  • Thiol-reducing agents, such as ___________, __________, ______, and ______ (which contains DTT in addition to enzyme), destroy Kell antigens but not Kx.
  • _________ (an IgG-removal agent) also destroys Kell antigens.
A

100 to 200 mM DTT ; 2-mercaptoethanol (2-ME) ; AET ; ZZAP ; Glycine-acid EDTA

67
Q
  • K is rated ______ only to D in immunogenicity
A

second ; (ABO> D> K)

68
Q

Anti-K appear to be induced by ________ and ________

A

pregnancy and transfusion

69
Q

Alleles ____ and _____ are low-prevalence mutations of their high-prevalence partner Kpb

A

Kpa and Kpc

70
Q

Kpa antigen found in about ___ of whites.

A

2%

71
Q

associated with suppression of other Kell antigens on the same molecule, including k and Jsb.

A

Kpa gene

72
Q

result from a reduced amount of the Kell glycoprotein inserted in the RBC membrane.

A

Kpa gene

73
Q

rarer Kpa, Kpb, and Kpc antigen

A

Kpc antigen

74
Q

_______, antithetical to the high-prevalence antigen Jsb

A

Jsa antigen

75
Q

The prevalence of Jsa in ______ is almost 10 times greater than the prevalence of the K antigen in blacks.

A

blacks

76
Q

Jsa and Jsb were linked to the _________ when it was discovered that Ko RBCs were Js(a–b–).

A

Kell system

77
Q

most common antibody seen in the blood bank

A

Anti-K

78
Q

Anti-K is:

  • usually ___ and reactive in the ______ phase
  • usually made in response to antigen exposure through ________ and ________
A

IgG ; antiglobulin ; pregnancy and transfusion

79
Q

________________ examples of anti-K are rare and have been associated with bacterial infections.

A

Naturally occurring IgM

80
Q

studied an IgM anti-K in an untransfused 20-day-old infant with an E. coli infection whose mother did not
make anti-K.

A

Marsh and colleagues

81
Q

(IgM anti-K)

  • react poorly in methods incorporating low-ionic media, such as ______, and in some automated systems.
  • most reliable method of detection is the ____________
  • Increase reactivity by _________, _____
  • seen in severe _______.
  • associated with severe ______.
  • Fetal anemia in anti-K HDFN is associated with suppression of __________ due to destruction of erythroid precursor cells.
A
  • LISS
  • indirect antiglobulin test.
  • potentiating medium, PEG
  • HTRs
  • HDFN
  • erythropoiesis
82
Q

(Antibodies to Kpa, Jsa, and Other Low-Prevalence Kell Antigens)

  • _____ because so few people are exposed to these antigens.
  • routine antibody detection RBCs do not carry ____________, the antibodies are most often detected through unexpected incompatible crossmatches or cases of HDFN.
A

rare ; low-prevalence antigens

83
Q

(Antibodies to Kpa, Jsa, and Other Low-Prevalence Kell Antigens)

  • The serologic characteristics and clinical significance of these antibodies parallel anti-K.
  • The original anti-Kpa was naturally occurring, but most antibodies result from _______ or _______
A

transfusion or pregnancy.transfusion or pregnancy.

84
Q

(Antibodies to k, Kpb, Jsb, and Other High-Prevalence Kell Antigens)

  • rare because so few people ____ these antigens.
  • They also _____ anti-K in serologic characteristics and clinical significance.
A

lack ; parallel

85
Q

(Antibodies to k, Kpb, Jsb, and Other High-Prevalence Kell Antigens)

  • ___________ are easy to detect but difficult to work with because most blood banks do not have the antigen-negative panel cells needed to exclude other alloantibodies
  • Testing an unidentified high-prevalence antibody against _______ or _______-treated RBCs is a helpful
    technique
A

High-prevalence antibodies ; DTT- or AET

86
Q

(Antibodies to k, Kpb, Jsb, and Other High-Prevalence Kell Antigens)

  • Caution is needed before assigning Kell system specificity until antigen-negative RBCs are tested because DTT also denatures JMH and high-prevalence antigens in the LW, Lutheran, Dombrock,
    Cromer, and Knops systems.
  • Finding compatible units for transfusion can be difficult; siblings and rare-donor inventories are the
    most likely sources.
A

yes

87
Q

located on chromosome 7 at position 7q33

A

KEL gene

88
Q

(KEL gene)

  • Several different mutations have been found that result in the rare null phenotype ____

-People who tested _____ for two low-prevalence Kell antigens had always been found to carry the
encoding alleles on opposite chromosomes.

A

Ko ; positive

89
Q

In 2009, report, two unrelated individuals with very weak K antigens were found to be heterozygous for _______ and ________

A

KKpa and kKpb

90
Q
  • encodes the Kx antigen
  • independent of KEL
  • located on the short arm of the X chromosome at position Xp21.
A

gene XK

91
Q

present on all RBCs except those of the rare McLeod phenotype

A

Kx

92
Q

have increased Kx antigen.

A

Ko and Kmod phenotype:

93
Q

When Kell antigens are denatured with AET or DTT, the expression of Kx _______

A

increases

94
Q

(Ko Phenotype & Anti-Ku)

_____ RBCs lack expression of all Kell antigens.

  • no membrane abnormality and survive normally in circulation.
  • phenotype is rare
A

ko

95
Q

(Ko Phenotype & Anti-Ku)

_______: single specificity and cannot be separated into components.
- caused both HDFN and HTRs.

A

Anti-Ku

96
Q
  • described a young male medical student who initially appeared to be Kell null but who demonstrated weak
    expression of k, Kpb, and Jsb detectable by adsorption-elution methods

Named after the student

A

1961: Allen and coworkers

97
Q
  • very rare. All are male, inheritance is X-linked
  • RBCs lack Kx and another high prevalence antigen, Km, and have marked depressionof all other Kell antigens.
A

McLeod Phenotype & Syndrome

98
Q

(McLeod Phenotype & Syndrome)

  • __________ (having irregular shapes and protrusions) with decreased _______ and reduced in vivo
    ______
A

acanthocytic ; deformability ; survival

99
Q

(McLeod Phenotype & Syndrome)

have a variety of muscle and nerve disorders that, together with the serologic and hematologic picture, are
collectively known as the __________

A

McLeod syndrome

100
Q

(McLeod Phenotype & Syndrome)

develop a slow, progressive form of muscular _______ between ages 40 and 50 years and _________
(leading to cardiomyopathy)

A

dystrophy ; cardiomegaly

101
Q
A

IH PF (6 decks)

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