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CCHS SBB > Platelet and Granulocyte Antigens and Antibodies > Flashcards

Platelet and Granulocyte Antigens and Antibodies Flashcards

1
Q

how does expression of ABO antigens on platelets occur?

A

adsorption from plasma and material that is intrinsic to surface membrane of the platelet

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2
Q

where are HLA antigens found?

A

nucleated cells

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3
Q

platelets are part of what HLA class?

A

class I

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4
Q

what HLA antigens are associated with platelets

A

HLA-A and HLA-B

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5
Q

what is responsible for primary HLA alloimmunization in patients who have been transfused platelets?

A

residual white cells

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6
Q

how long after platelet transfusion is platelet response measured?

A

10-60 minutes

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7
Q

what defines a platelet refractory state?

A

post-transfusion CCI of <5000-7500 following 2 consecutive platelet transfusions

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8
Q

most common immune cause of platelet refractoriness

A

HLA sensitization

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9
Q

nonimmune-related reasons for recipient platelet refractoriness

A

massive bleeding, fever, sepsis, splenomegaly, DIC, allogeneic transplant, drugs, TTP

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10
Q

how is HLA sensitization diagnosed

A

microlymphocytotoxicity testing

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11
Q

corrected count increment calculation

A

(BSA x plt ct increment) / number of platelets transfused

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12
Q

post-transfusion platelet recovery calculation

A

(total blood volume x plt ct increment) / number of plts transfused

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13
Q

total blood volume estimate in adult patients

A

75 ml/kg

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14
Q

expected platelet count increase from platelet concentrate

A

5,000-10,000

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15
Q

expected platelet count increase from apheresis platelet

A

30,000-60,000

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16
Q

transfusion requirement for HLA-matched platelets

A

irradiation to prevent GVHD

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17
Q

transfusion options for platelet refractoriness

A

crossmatched platelets
HLA-matched platelets
antibody specificity prediction

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18
Q

most widely used method for platelet crossmatching

A

solid-phase red cell adherence

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19
Q

5 platelet specific antigens characterized as alloimmunogenic and polymorphic

A

GPIa, -Ib, -IIb, -IIIa, CD109

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20
Q

alternative approach to HLA-matched and crossmatched platelets determining recipient’s HLA antibody specificity and then selecting platelet donors who lack antigens to antibodies produced by the recipient

A

antibody specificity prediction

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21
Q

prevention of HLA alloimmunization from platelet transfusion

A

leukocyte reduction

UVB irradiation

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22
Q

HPA-1a antigen frequency

A

98% of white population

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23
Q

most commonly encountered platelet-specific antibody identified in white population

A

anti-HPA-1a

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24
Q

HPA-1b platelet antigen frequency

A

27% of white population

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25
location of HPA-1a and HPA-1b
GP111a platelet membrane glycoprotein
26
disease state in which patients lack GP111a glycoprotein and don't express HPA-1 antigens
Glanzmann thrombasthenia type 1
27
major complication of neonatal alloimmune thrombocytopenia
major bleeding that can lead to intracranial hemorrhage
28
confirmation test to diagnose neonatal alloimmune thrombocytopenia
platelet-specific antibody within maternal serum and corresponding incompatibility for the antigen in parental platelet types
29
treatment of neonatal alloimmune thrombocytopenia
IVIG with or without compatible platelet transfusions
30
most common platelet antigen incompatibility in neonatal autoimmune thrombocytopenia
HPA-1a
31
identified when patient experiences sudden, dramatic, self-limiting form of thrombocytopenia ~5-10 days after blood transfusion coinciding with potent platelet-specific alloantibody
posttransfusion purpura
32
treatment of posttransfusion purpura
IVIG
33
diagnosis of posttransfusion purpura
genotyping and platelet antibody assays
34
platelet antibody detection method type: assays mixing patient serum with normal platelets using platelet function-dependent endpoints
phase I
35
platelet antibody detection method types: measures surface or total platelet-associated immunoglobulin
phase II
36
platelet antibody detection method types: solid-phase assays, binding of antibodies to isolated platelet surface glycoproteins
phase III
37
platelet antibody detection assay in which intact platelets are immobilized in round-bottom wells of microtiter tray, incubated with patient's serum, washed, antibody specific coated red cells added, incubate, centrifuge, visually examine
mixed passive hemagglutination assay
38
drawback of mixed passive hemagglutination assay platelet antibody detection
fails to distinguish non-platelet-specific from platelet-specific antibodies
39
mixed passive hemagglutination assay is phase _ type of platelet antibody testing
I
40
flow cytometry is phase __ type of platelet antibody detection
II
41
platelet antibody detection assay often used for platelet crossmatching using immunofluorescence
flow cytometry
42
monoclonal antibody-specific immobilization of platelet antigen assay is phase ___ type of platelet antibody detection
III
43
platelet antibody detection method that requires use of murine monoclonal antibodies that can recognize target antigens
monoclonal antibody-specific immobilization of platelet antigen
44
chronic immune thrombocytopenia usually seen in what patient population?
adults
45
first line therapy for chronic ITP
steroids or IVIG
46
autoantibodies directed against platelet antigens could result in what pathological conditions?
immune thrombocytopenia or immune thrombocytopenic purpura
47
acute IPT usually seen in what patient population
kids
48
first line therapy for acute ITP
IVIG or anti-D immunoglobulin infusions given to D-positive patients
49
platelet autoantibody classes
IgG, IgM, IgA
50
complication of drug therapy in treatment for platelet autoantibodies
thrombocytopenia caused by drug-induced platelet antibodies
51
common drugs associated with drug-induced thrombocytopenia
quinine/quinidine, sulfa, heparin, colloidal-gold
52
testing for drug-dependent platelet antibodies
flow cytometry, SPRCA assay
53
drug-induced immune response to platelets triggered by widespread use of heparin
heparin-induced thrombocytopenia
54
clinical syndromes that implicate antibodies against neutrophil antigens
neonatal alloimmune neutropenia TRALI immune neutropenia after HPC transplant refractoriness to granulocyte transfusion chronic benign autoimmune neutropenia or infancy
55
implemented by maternal antibodies against antigens on fetal granulocytes
neonatal alloimmune neutropenia
56
antigens associated with neonatal alloimmune neutropenia
HNA-1a, HNA-1b, HNA-2a
57
treatment of neonatal alloimmune neutropenia
antibiotics, plasma exchange, IVIG, granulocyte colony-stimulating growth factor
58
characteristic symptoms of TRALI
hypo or hypertension, respiratory distress, noncardiogenic pulmonary edema
59
TRALI commonly seen within 2 hours of what blood component
plasma-containing components
60
TRALI brought on by antibodies towards what?
granulocyte-specific antigens or antibodies to HLA antigens
61
autoantibody implicated in autoimmune neutropenia
HNA-1a or HNA-1b
62
testing for granulocyte antibodies
combination of agglutination and immunofluoresence

CCHS SBB (40 decks)

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