PART 1 BB Flashcards
is the study of blood group antigens and antibodies, HLA antigens and antibodies, pretransfusion testing, identification of unexpected
alloantibodies, immune hemolysis, Autoantibodies,
Drugs, blood collection, blood components, cryopreservation of blood, transfusion-transmitted
viruses, tissue banking and organ transplantation, blood transfusion practice, safety, quality assessment, records,
blood inventory management, and blood usage review
Immunohematology
1492 - died due to transfusion from 3 human donors. All 4 died
Pope Innocent VII
1869 - recommended sodium phosphate (nontoxic anticoagulant)
Braxton Hicks
● Mnemonics: Bra Na Po
1892 - first successful human
transfusion
James Blandel
● Mnemonics: James Bond
1901 - discovered the ABO blood
groups
Karl Landsteiner
vein-to-vein transfusion of
blood
Edward Lindeman
● Mnemonics: EVV
1915 - determined the minimum AMOUNT OF CITRATE needed for anticoagulation
Lewisohn
1914 - sodium citrate
Hustin
● Mnemonics: Side (Cit = Citrate) Hustle (Hustin)
1916 - introduced a CITRATE-DEXTROSE solution for the preservation of blood
Rous and Turner
pioneered BB technique
Doctor Drew
1943 - of England introduced the
formula for the preservative acid-citrate-dextrose (ACD).
Loutit and Mollusun
Females (__) and Males (__), giving a total of ___ chromosomes in diploid cells
Females (XX) and Males (XY), giving a total of 46 chromosomes in diploid cells
Humans have ____ pairs of autosomes and ___ set of sex chromosomes
Humans have 22 pairs of autosomes and 1 set of sex chromosomes
Structures that carry genetic information encoded on double-stranded DNA
CHROMOSOMES
● Resting stage and chromatin is
uncondensed/ A cell that is not
actively dividing
- Thickening of the chromatin
Interphase
● No division and resting phase
G0 (Gap)
● DNA replication → cell division
S (synthesis)
● RNA and protein production
G1
● RNA and protein production
continuation
G2
● Cell division
M (mitosis)
A process of cell division that results in the same number of chromosomes in the new and old cells
MITOSIS
● 1st stage
● Chromatin is visible
Prophase
● Chromosome move to the equator attached to microtubules (met in the middle)
● Metaphase = Middle
● Sister chromatids separated
● Anaphase = Away (Sister Ana)
● Chromosome at the pole of cell
divides – total cell division
Telophase
● Represent a SINGLE set of
chromosome
N
● Diploid – human body cells (46
chromosomes)
2n
● Haploid – gametes (23
chromosomes)
1n
● _______ – human body cells (46
chromosomes)
Diploid
● ________ – gametes (23
chromosomes)
Haploid
A photomicrograph of a single cell in the metaphase stage of mitosis that is arranged to show the chromosomes in descending order of size.
Karyotype
Process of cell division that occurs in gametes resulting
in one-half the chromosomes in each new cell
MEIOSIS
Example: Sperm/Egg Cells
MEIOSIS
● Results in 4 unique, rather than 2 identical daughter cells
MEIOSIS
Meiosis in cell division is limited to the ova and sperm producing four gametes containing what
complement of DNA?
A. 1N
B. 2N
C. 3N
D. 4N
A. 1N 1n = haploid = 23 chromosomes
involves 2 nuclear divisions in succession resulting in 4 gametocytes each containing half the number of chromosomes found in somatic cells or 1N
MEIOSIS
(5) PATTERNS OF INHERITANCE
- CODOMINANT
- RECESSIVE
- DOMINANT
- AUTOSOMAL
- SEX-LINKED
● Equal expression of both alleles in the phenotype
CODOMINANT
● Blood group systems are usually expressed as this
inheritance pattern.
CODOMINANT
● Same allele must be inherited from both parents to be expressed, it must be homozygous.
RECESSIVE
● A recessive trait is carried by either or both parents but is NOT generally seen at the phenotypic level UNLESS BOTH parents carry the trait.
RECESSIVE
● Only ONE allele must be inherited in order for the phenotype to manifest.
DOMINANT
● Gene product / physical manifestation will always occur.
DOMINANT
● Genes expressed with EQUAL FREQUENCY in males and females on non-sex chromosomes.
AUTOSOMAL
When 2 heterozygous individuals mate, they can produce a child who inherits a recessive gene from each parent, and therefore the child becomes HOMOZYGOUS for that trait and will therefore manifest the phenotype.
AUTOSOMAL RECESSIVE
Example: Parents are Rh type Dd in Blood Banking; child becomes_____
dd – Rh negative
● DD, Dd, Dd – there is a 75% chance for the child to become Rh positive (3/4). The D gene is dominant, therefore only 1 gene is needed for it to manifest.
● dd – 25% chance for the child to be Rh negative, observed in the example. (1/4)
AUTOSOMAL RECESSIVE
● All members of a family who carry the allele show the physical characteristic.
AUTOSOMAL DOMINANT
● Generally, each individual with the trait has at least one parent with the trait, and the gene is expressed if only one copy of the gene is present
AUTOSOMAL DOMINANT
● Unlike X-linked traits, ________ traits usually do not
show a difference in the distribution between males and
females. This is a helpful clue in the evaluation of genetics
AUTOSOMAL
(2) TYPES OF AUTOSOMAL
- AUTOSOMAL RECESSIVE
- AUTOSOMAL DOMINANT
(2) TYPES OF SEX-LINKED
- X-LINKED DOMINANT
- X-LINKED RECESSIVE
● Carried on the X chromosome; therefore there is NO FATHER-TO-SON TRANSMISSION.
X-LINKED DOMINANT
● Will only be expressed if passed from FATHER TO DAUGHTER or from MOTHER TO SON.
X-LINKED DOMINANT
EXAMPLE
*XX
*X^TY
● Affected Daughters – 100%
● Unaffected Sons – 100%
● XT X - T signifies the trait. A single trait will make them a
carrier and the disease will be expressed. It can be seen that both daughters can obtain the trait.
● Observed in the punnett square is that both XYs or the sons will have 0 copies of the trait.
X-LINKED DOMINANT
● Women can be either homozygous or heterozygous for
an ________ trait
X-LINKED TRAIT
- Therefore when mothers have an X-linked trait, their daughters will inherit the trait in a manner identical to autosomal inheritance.
- The sons have a 50% chance of inheriting the trait. Because the trait is dominant, the sons who inherit it will express it.
- But if the mother is the carrier, it means the daughter will also inherit the trait. However they do not express it. This is because only rare homozygous females X’X’ will express it. In which case both parents have the trait.
T signifies the trait. A single trait will make them a carrier and the disease will be expressed. It can be seen that both daughters can obtain the trait.
X^T X
It is carried on the X chromosome.
X-LINKED RECESSIVE
- Males: inherit it from carrier mothers
- traits are exhibited most commonly in males (e.g. hemophilia A).
X-LINKED RECESSIVE
- Females: can exhibit the trait but must inherit it from both carrier mother and affected father.
X-LINKED RECESSIVE
● In this case, the father always expresses the trait but NEVER passes it on to his SONS.
X-LINKED RECESSIVE
- The FATHER always passes the traits to all his DAUGHTERS, who are then CARRIERS of the trait.
X-LINKED RECESSIVE
- The FEMALE carriers will pass the trait on to HALF of their SONS, who also will be carriers.
X-LINKED RECESSIVE
- classic example of this inheritance is Hemophilia A, which affected many of the royal houses of Europe
X-LINKED RECESSIVE
classic example of X-LINKED RECESSIVE
Hemophilia A
● Homozygous males with only one trait will EXPRESS the trait.
X’Y
● TRAIT homozygous females will express the trait
X’X’
● The more COMMON trait for females (carrier)
X’X
X-LINKED RECESSIVE EXAMPLE
*X^T X
*XY
● Carrier State Daughters – 100%
● Affected Sons – 50%
● Unaffected Sons – 50%
BOARD EXAM QUESTION
● In this type of inheritance, the father carries the traits on his X-chromosome. He has no sons with the trait because he passed his Y chromosome to them; however, all his daughters will express (disease) the trait.
A. Autosomal dominant
B. Autosomal recessive
C. X-linked dominant
D. X-linked recessive
C. X-linked dominant
(2) MENDELIAN INHERITANCE PRINCIPLES
- Law of Independent Segregation
- Law of Independent Assortment
Two members of a single gene pair PASSED from one generation to the next in separate gametes
Law of Independent Segregation
Traits inherited from different chromosomes EXPRESSED SEPARATELY and discretely
Law of Independent Assortment
states that factors for different
characteristics are inherited INDEPENDENT of each other other
Gregor Mendel
● Each square represents a
possible genotype for an offspring.
Punnett square
● An offspring would have a 25%
chance of inheriting any one of
the four possible variants.
Punnett square
● It is useful for understanding the inheritance of blood groups and ramifications of heterozygosity, or homozygosity
Punnett square
● Individual inherits IDENTICAL ALLELES (gene variation) at the
same gene locus from both
parents
Homozygous
● Individuals inherit DIFFERENT ALLELES (gene variation) at the
same gene locus from each
parent.
Heterozygous
● Agglutination reactions are
generally STRONGER FOR HOMOZYGOUS CELLS and slightly
weaker for heterozygous cells.
Dosage effect
_______ will react stronger with homozygous
Dosage effect
With dosage effect: (6)
Those Kidd Loot My Duffy Grrr
○ Those = Dosage
○ Kidd = Kidd Antigen
○ Loot = Lutheran
○ My = Mn
○ Duffy = Duffy (Fy)
○ Grrrr = Rh except B
● Anti-Duffy A will react stronger with:
A. Duffy A+ and Duffy B+
B. Duffy A- and B-
C. Duffy A- and B+
D. Duffy A+ and B-
D. Duffy A+ and B-
Rationale: Again, the dosage effect is stronger in homozygous. Letter D is homozygous as only the Duffy A is positive. Letter C is also homozygous, but A is negative, which will not react because the reagent is Anti-Duffy
is divided into major and minor group
Blood group system
(2) major group:
- ABO
- Rh
The first three numbers in ____ represent the system and the remaining three the antigenic specificity
ISBT (International Society of Blood Transfusion)
Discovered by: Karl Landsteiner via blood typing
ISBT 001: ABO BLOOD GROUP SYSTEM
ISBT 001 discovered by
Karl Landsteiner via blood typing
If an individual has the antigen, that individual will not have the antibody. This is a universal
law and has few exceptions
Landsteiner’s Rule
For example: if an individual is Type A he/she will not create Anti-B; he/she will create the opposite (Anti-B)
Landsteiner’s Rule
● Found on RBCs, endothelial cells, epithelial cells, lymphocytes, platelets, tissue cells, bone marrow, organs, and secretion.
- Even though it is called the ABO blood group, it is found not only in the blood but also throughout the body.
ABO ANTIGENS
ABO is the most _____________
ABO is the most immunogenic
- It binds to antibody
ABO
Immune system response to immunogen leading to (4)
cardinal signs of inflammation
● Calor = heat
● Dolor = pain
● Tumor = swelling
● Rubor = redness
Most IMPORTANT blood group
ABO
These antigens can be secreted by tissue cells if the appropriate genes are present
Glycolipid or glycoprotein
■ These are combinations of lipid and carbohydrates
Developed in utero at _____ weeks of gestation
○ Developed in utero at 5-6 weeks of gestation
■ After a month, there is already ABO
■ But, there are ABOs that are present but not fully expressed.
■ Full expression of ABO antigens
occurs between 2 and 4 years of
age
■ Full expression of ABO antigens
occurs between___ and ___ years of age
■ Full expression of ABO antigens
occurs between 2 and 4 years of
age
● Only “MAJOR” blood group with naturally occuring antibody without prior exposure
- This claim is partly wrong because in minor blood group there are naturally occuring antibody
- Naturally occurring antibody means if a person is Type A he/she will create Anti-B without prior exposure
ABO
H and Se genes: CHROMOSOME
chromosome 19
ABO genes: CHROMOSOME
chromosome 9
Glycosyl Transferase - A
N-acetylgalactosaminyltransferase
Greatest amount of H to least:
■ O → A2 → B → A2B → A1 → A1B
■ Bombay is not included as it is absent!!!
Glycosyl Transferase - H
L-fucosyltransferase
Glycosyl Transferase - B
D-galactosyltransferase
Glycosyl Transferase - AB
Both A & B
*N-acetylgalactosaminyl
transferase
*D-galactosyltransferase
Immunodominant Sugar - H
L-fucose
Immunodominant Sugar - A
N-acetyl-D-galactosamine
Immunodominant Sugar - B
D-galactose
Immunodominant Sugar - AB
Both A and B
*N-acetylgalactosaminyl
transferase
*D-galactosyltransferase
● RBC has type __ chain regardless of blood group
- Type __ chain are usually carbohydrates
- In type __ chain it is like the “ground floor of a building”
type 2
REVIEW!
Example: A gene
Enzyme: N-acetylgalactosaminyltransferase
transfers N-acetyl-D-galactosamine (NADG
REVIEW!
Example: H gene
- In chromosome 19 there is the code to produce the L-fucosyltransferase
- DNA produces an mRNA (Messenger RNA) through transcription
○ mRNA will leave the nucleus and go to the ribosomes (mRNA is the code to produce a protein)
○ The ones that will get the amino acid are the tRNA (Transport RNA)
■ Amino acids will line and create
proteins, including enzymes.
○ Take note that what the H gene produces is not the H antigen but an enzyme
■ The function of enzymes is to
transfer (transferase).
■ It transfers sugar (L-fucose),
which is at the top of the type 2
chain.
_______________is necessary (H antigen) because D-galactose and N-acetyl in the type 2 chain cannot stick because L-fucose should be in the middle
L-fucose
_________ refer to the antigen present in the secretions, not in the RBCs.
Soluble antigens
If an individual has no H antigen, the phenotype is _________
Bombay
REVIEW THE FORMATION OF A, B, & H SOLUBLE ANTIGENS
- ABH-soluble antigens can also be found in all body secretions
- All bodily fluids also transmit the individual’s blood type. - Their presence is dependent on the ABO gene inherited and on the inheritance of another set of
genes called Sese (secretor genes) that regulate their formation
- It is important to note that secretion requires the presence of a specific gene, namely the Se gene. - The inheritance of an Se genes codes for the production of a transferase (α-2-L-fucosyltransferase)
that modifies the type 2 precursor substance in secretions to form H substance - This H substance can then be modified to express A and B substance
- The Se genes does not affect the formation of A, B, or H antigens on the RBC
- Whenever a gene is represented by a small letter, it is classified as absent.
- A, B, H means that regardless of Se gene it will express in RBCs; whether it is capital (SE) or small
(se) - People who inherit the sese genotype are termed nonsecretors
- It is possible that a person’s blood type is A and his/her saliva does not have blood type A
- Secretion has nothing to do with the individual’s blood type. - A, B, and H antigens, appropriate to the individual’s
ABO group, are found in saliva, urine, tears, bile, amniotic fluid, breast milk, exudate, and digestive fluids of secretors (Se)
ABH-soluble antigens can also be found in all ________ secretions
- All _________ ______ also transmit the individual’s blood type.
ABH-soluble antigens can also be found in all body secretions
- All bodily fluids also transmit the individual’s blood type.
Their presence is dependent on the ABO genes inherited and on the inheritance of another set of
genes called _____
Sese (secretor genes) that regulate their formation
People who inherit the sese genotype are termed _______
nonsecretors
Where type 2 chain can be found?
: RBCs
Where type 1 chain can be found?
:Secretions
mRNA produce
Protein
tRNA produce
Amino Acid
Take note that what the H gene produces is ___ the H antigen but an _____
Take note that what the H gene produces is NOT the H antigen but an ENZME
What is the function of the enzyme?
To transfer (transferase)
Enzyme transfers sugar (H)?
L-fucose (Type 2 chain)
If an individual has NO H antigen, the phenotype is ________
Bombay
________ _______ refer to the antigen present in the secretions, NOT in the RBCs
Soluble Antigens
Secretion requires the presence of a specific gene, namely the _______
Se gene
H substance can then be modified to express
A and B substance
Whenever a gene is represented by a small letter, it is classified as
ABSENT
People who inherit the “sese” genotype are termed
Nonsecretors
- It is possible that a person’s blood type is A and his/her saliva does not have blood type A
- Secretion has nothing to do with the individual’s blood type.
