Test 2: ABO Blood Group System Flashcards
Who do you report to if you break compliance with the FDA?
CBER
What are the three main regulatory agencies of Blood Bank?
-FDA
-CDC
-AABB
What agency is under the CDC that is who is reported to voluntarily?
These reports do not change regulations (unlike many other countries)
NHSN
-Regulatory agency that only does blood bank
-Voluntary accreditation
AABB
-standards for BBTS
-CAP, COLA, CLIA, etc
AABB
_______ is over AABB but AABB tells them what to do/change.
FDA
What does T/S and T/C mean?
-type and screen order
-type and cross order
How do you identify a patient?
must have TWO independent patient identifiers
What could be used for patient identification?
-Name
-DOB
-MRN
What should NEVER be used as a patient identifier?
-accession number
-visit/financial number
When should a patient’s sample be labeled?
AT THE BEDSIDE (aka immediately after collection)
Should a patient’s sample be labeled before or after collection?
after
What else should be included on the patients sample label?
Date/Time of collection &
collecting personnel ID
What is different and what is the same for Pink top and purple top tubes?
Pink- used for blood bank (plasma)
purple- for hematology (plasma)
they are both EDTA
What is another collection tube that is acceptable for blood bank besides pink top?
red- no anticoagulant or preservative, used for serum
(compliment gets activated —> clots)
- EDTA binds ____ and ____ that inhibits complement activity —> no clotting
Calcium, magnesium
Why are pink top tubes preferred for DAT and elutions?
Due to lack of fibrin which causes false positives
What should you do if there is a delay in testing?
(Check this one). ????
-refrigerate
-greater than 48 hours -remove serum from cells, freeze
When do specimens intended for compatibility testing expire?
on the 3rd day at midnight
What is the storage protocol for specimens?
Refrigerated until 7 days post transfusion
(keep 10 days total just in case need transfusion or need to test again in the case of patient death (even without transfusion))
What testing is done prior to any blood transfusion? (unless emergent)
- Type (two tests)
- Blood type: A, B, AB or O
- Rh: Positive or Negative
- Screen
- Antibody detection:
unexpected antibodies
- Antibody detection:
What is Landsteiner’s rule (law)?
healthy individuals possess ABO antibodies directed toward the A or B antigen that is absent from their RBCs
ABO antigens are detected in the embryo as early as ___ to __ weeks’ gestation.
Full expression occurs at about ______ years of age.
5, 6
2 to 4
ABO antigens can be intrinsic to the RBC membrane or _________ (body fluids)
soluble
Newborns’ RBCs have fewer numbers and ________ developed antigens
partially
this blood typing test looks for the presence or absence of A and B ANTIGENS
Forward typing
this blood typing tests patients serum/plasma for presence or absence of anti-A and anti-B (ANTIBODIES)
reverse typing aka back typing
-It is a confirmatory test for the forward blood typing
When would a blood typing test must be done by hand?
for hyperlipemic samples if it is greater than 2+ lipemic
Blood bank rarely rejects samples due to quality unless contaminated with __________.
IV fluid
What is a positive reaction grade for forward typing?
*** 3-4+ = antigen present
What is a positive reaction grade for reverse typing?
*** 2-4+ = antibody is present
What is added to the test tube for forward typing?
-1 drop of antisera (anti-A or anti-B)
-1 drop of cells suspension
What is added to the test tube for reverse typing?
-2 drops of serum/plasma
-1 drop reagent A1 cell or B cell
What is the % of each blood type for the white population?
O: 45%
A: 40
B: 11
AB: 4
What is the % of each blood type for the black population?
O: 49%
A: 27
B: 20
AB: 4
What is the % of each blood type for the Asian population?
O: 40%
A: 28
B: 27
AB: 5
Chromosome ___ – A, B or O (amorph)
9
the genetics of blood type exhibits ________ expression.
O is the _______
codominant
-O being the autosomal recessive trait
What does “double dose” refer to?
when the blood genotype is homozygous so there will be more expression of that type
variation of antigen expression due to the number of alleles present
dosage
Genes at ____ separate loci influence the occurrence and location of ABO antigens: ABO, H, Se
3
the gene that encodes the ABO antigen carbohydrates is on what chromosome?
chromosome 9
The presence or absence of the ABH antigens on the RBC membrane is controlled by the _____ gene
* FUT1 on chromosome 19
H
The presence or absence of the ABH antigens in
secretions is influenced by the ____ gene
* FUT2 on chromosome 19
Se
amorph blood type ,meaning no functional gene product is produced from this sequence of DNA
O
FUT2 on chromosome 19 —–> ____ gene
Se
FUT1 on chromosome 19 ——> _____ gene
H
The ____________ chain is a basic precursor structure for several RBC antigens, including A, B, and H
oligosaccharide
-Attached to a protein or lipid carrier molecule
What is the difference between type 1 and 2 oligosaccharide chains?
Type1: body fluids and secretions (beta1 —> 3 linkage)
Type 2: red blood cells and body fluids and secretions (beta1 —> 4 linkage)
The ____ antigen is the
foundation for the A and/or
B antigens
H
*H antigen:
gene product?
immunodominant sugar?
L-Fucosyltransferase
L-Fucose
*A antigen:
gene product?
immunodominant sugar?
N-Acetylgalactosaminyltransferase
N-Acetylgalactosamine
*B antigen:
gene product?
immunodominant sugar?
D-Galactosyltransferase
D-Galactose
The H gene codes for a
_____________ enzyme
that transfers the
immunodominant sugar, Lfucose, to the terminal sugar of the oligosaccharide chain (Type 2)
glucosyltransferase
*** Order of blood types with the most H antigens to the fewest H antigens
O, A2, B, A2B, A1, A1B
If you do not have H then ___ and ____ cannot be present.
A, B
What is used to distinguish A1 from A2 red cells?
Dolichos biflorus (anti-A1)
What does Dolichos biflorus agglutination with?
what does it not agglutinate with?
A1
A2
Which A type is branched?
A1
____% A1 and A1B
____% are A2 and A2B
80
20
What is called when the RBCs lack the H antigen (hh)?
Bombay
-rare but more common in India
The h gene is an ______ and results in little or no production of Lfucosyltransferase
amorph
What blood type contains antibodies to H, A, and B?
Bombay
Why can type O RBCs not be given to Bombay type?
the H antigen is present
only autologous units or rare donor files can be used
***What A type is associated with mixed field?
A3
-also B3, but most hospitals do not test for this because it is not prevalent
Which A type has the most antigen sites?
A1 (810-1170)
What lectin is associated with anti-B?
Bandeiraea simplicifolia
What lectin is associated with anti-H?
Ulex europaeus
What % of the population are secretors (SeSe or Sese)?
80%
What can be done to establish ABO group when serologic testing was difficult?
ABH secretions
___ gene needed for ABH soluble antigens to be present in
secretions
Se
What type of transfusion is required in whole blood transfusions?
-ABO identical unit
-low titer group O whole blood
what is the universal donor for RBC transfusions?
plasma transfusions?
O
AB
What is the universal recipient for RBC transfusions?
Plasma transfusions?
-AB
-O (type A in emergent situations)
If a recipient is Group
A, what can the donor be for…
whole blood, red blood cells, and plasma?
Whole blood: A
Red blood cells: A, O
Plasma: A, AB
If a recipient is Group
O, what can the donor be for…
whole blood, red blood cells, and plasma?
Whole blood: O
Red blood cells: O
Plasma: O, A, B, AB
