Test 4 Flashcards
List five antibodies that are IgM antibodies.
Anti- Lea, anti-Leb, anti-I, anti-P1, anti-M, anti-N, anti-Lua
Anti-Lewis
List five antibodies that are IgG antibodies.
Anti-K, Anti- Fya, Anti-Fyb, Anti- Jka, Anti-Jkb, anti-S
Anti-kell, anti- Duffy, anti-Kidd
Which class of antibody reacts at room temperature but not at 37 degrees Celsius?
IgM
List four antibodies whose reactivity would show increased agglutination if the screening cells were pre-treated with enzymes (do not include Rh system antibodies).
Kell, Kidd
Anti-Jka, anti-Jkb, anti-C, anti-K
List four antigens that are removed from the red blood cell membrane by enzyme treatment.
M, N, Fya, Fyb
List three antigens that are not expressed on cord blood cells.
Lea, Leb, I
Which antigen is most immunogenic next to the D antigen?
K
What is another name for the anti-PP1Pk antibody produced by people with the p genotype?
Anti-Tja
Which of these antibodies might be present in a patient who has never been transfused nor pregnant?
a. Anti-Lea
b. Anti-Fya
c. Anti-Jka
d. Anti-N
e. Anti-P1
f. Anti-K
g. Anti-Jsa
h. Anti-S
a. Anti-Lea
d. Anti-N
e. Anti-P1
List two antigens that are made from another antigen.
I, Leb
Which antibodies are very dangerous because their titers fall rapidly to undetectable levels?
Kidd antibodies
Which antibody causes paroxysmal cold hemoglobinuria? Is it IgM or IgG?
Auto anti-P, IgG
If a patient builds an anti-U antibody, which three antigens are not present on their red blood cells?
U, S, s
Which antigen is associated with Chronic Granulomatous Disease?
Kx
State whether finding compatible blood with the following antibodies would be “easy” or “difficult”
a. Anti-Jsa b. Anti-Kpb c. Anti-K d. Anti-k e. Anti-Fya f. Anti-S g. Anti-s
a. Anti-Jsa easy- antigen low incidence
b. Anti-Kpb difficult- antigen high incidence
c. Anti-K easy- antigen low incidence
d. Anti-k difficult- antigen high incidence
e. Anti-Fya easy- antigen low incidence
f. Anti-S easy- antigen low incidence
g. Anti-s easy 10%- antigen low incidence 10%
Describe “dosage” effect.
Reaction is going to be stronger with homozygous than heterozygous
Which group of antibodies typically give a “mixed field” agglutination pattern in serological testing?
Lua and Lub
What procedure would help distinguish an anti-K and anti-Fya antibody on an Identification Cell Panel?
Addition of enzymes
Which antibody agglutinates all adult red blood cells but will not agglutinate Group O cord blood cells?
Anti-I
If a patient has the genotype M+N+S-s-, what other antigen is also missing?
U antigen
Which of the following antigens is a low incidence antigen?
a. k (cellano)
b. Kpa (Penny)
c. Kpb (Rautenberg)
d. Jsb (Matthews)
B. Kpa (Penny)
List three common characteristics of IgG blood group antibodies.
React at 37 degrees Celsius
Don’t usually activate complement
Cause HDN
Which antigen is missing from the patient’s red blood cells if they have McLeod syndrome?
Kx
Which of the following antibodies might cause Hemolytic Disease of the Fetus and Newborn?
a. Anti-Lea
b. Anti-K
c. Anti-N
d. Anti-Fya
e. Anti-P1
f. Anti-s
b. Anti-K
d. Anti-Fya
f. Anti-s
What procedure could you use to identify an anti-I antibody?
Group O cord blood cells
Which antibody causes Cold Agglutinin Disease?
I
Which antibody is sometimes formed after infection with Mycoplasma pneumoniae?
Anti-I
Which antibody is called a “biphasic” antibody? What is another name for this antibody?
Auto anti-P
Donath-Landsteiner
Why do we “grade” agglutination reactions?
May show there is two antibodies other 1
What procedure can we perform to eliminate interference in the antibody screen or identification panel caused by a cold reacting autoantibody?
Pre-warming
Which antibodies causes HDN and HDFN?
IgG
Which antibody reacts at 37 degrees (body temp)?
IgG
Which antibodies are cold reacting (room temp and below)?
IgM
Which antibodies are called clinically insignificant?
IgM
How many sets of alleles does the Kell system have and what are they?
3
K and k
Kpa and Kpb
Jsa and Jsb
What is the only antibody that is commonly encountered in the Kell system?
Anti- K
Which antigens are low frequency in the Kell system?
Jsa and Kpa
Which antigens are high frequency in the Kell system?
Jsb and Kpb
K antigen is absent in what percentage of people?
91%
Do most patients have the ability to build the antibody for K or do they have the antigen?
Build the antibody
9% have the antigen
What is the most immunogenic antibody next to the D antigen?
Anti- K
Is anti- K IgM or IgG?
IgG
Does anti-K activate complement?
No
Is Kx present is most patients?
Yes
How is Kx antigen inherited? (X or Y)
X-linked
What can the absences of Kx antigen cause?
McLeod syndrome
Chronic Granulomatous disease
What alleles are in the Duffy system?
Fya and Fyb
Are the Duffy system antibodies common or rare?
Relatively common
What percentage of people can make the Fya antibody?
34%
What percentage of people can make the Fyb antibody?
17%
Does Fya and Fyb activate complement? And are they IgM or IgG?
No and IgG
Can Duffy antigens be removed by enzymes?
Yes
What are the Kidd alleles?
Jka and Jkb
Are Kidd system antibodies IgM or IgG? Can they activate complement?
IgG and yes
Kidd antibodies cause what kind of destruction?
Intravascular and extravascular
Which antibody titer can rapidly fall to undetectable levels?
Kidd antibodies
Jka and Jkb
What antibody is the major cause of delayed transfusion reaction?
Kidd antibodies
Jkb and Jka
Which antibodies are usually produced in association with other antibodies?
Kidd antibodies
Which antigen is a newborn negative for at birth but can become positive?
Lewis
Which antigens are absorbed onto the red blood cell after birth?
Lewis antigens
Are Lewis antigens IgM or IgG
IgM
Are Lewis antigens clinically insignificant?
Yes
Which antigen can interfere with room temperature ABO reverse grouping, etc.?
Lewis antigen
Do Lewis antigens still circulate in body fluids even if you are a nosecretor?
Yes
How do you get the I antigen?
From little i
Newborns only get i antigen which converts to I in the first couple years of life
What does everyone build to I?
Auto anti-I but it is only reactive at cold temperatures
What happen if thermal amplitude rises with auto anti- I?
The anti-I attaches to the patients rbcs and causes cold agglutinin disease
What detects the I antibody?
Group O cord blood
What antibody can people with P antigen make? Is the antibody IgG or IgM
P1 and IgM
Is clinically insignificant
Some people can make auto anti-P antibody, what can it cause?
Paroxysmal cold hemoglobinuria
Is auto anti-P IgG or IgM? Does it activate complement?
IgG and yes
What is the auto anti-P also called?
Donath- Landsteiner antibody
Bi-phasic
What is the anti- PP1PK?
Antibody made by very rare p people who lack the P system antigens
Is ANTI- PP1PK IgG or IgM?
IgG
Who is p people compatible with?q
Only other p people
What is the old name for anti-PP1PK?
Anti-Tja
What are anti- M and anti- N IgM or IgG
IgM
Anti-S and anti-s are IgG or IgM?
IgG
Are M and N removed by enzymes?
Yes
U antigen is present in people who have what?
An S or s antigens
Is anti- Lua IgG or IgM?
IgM and usually clinically insignificant
Anti-Lub is IgG or IgM?
IgG
Is Lutheran antibodies rare or common?
Rare
Which antibodies have mixed field agglutination?
Lutheran
- Which blood group system possesses the Jsb and Kpa antigens?
a. Duffy. c. Kell
b. Lutheran. d. Kidd
C
- An antibody commonly associated with delayed transfusion reactions is:
a. anti-Lua. c. anti-Jkb
b. anti-S. d. anti-M
C
- Which phenotype is associated with a resistance to malarial invasion?
a. Fy(a−b−). c. Le(a−b−)
b. Jk(a−b−). d. Lu(a−b−)
A
- Enzyme-treated reagent red cells used in antibody identification enhances all of the following antibodies except:
a. anti-M. c. anti-Jkb
b. anti-Lea. d. anti-C
A
- Which of these antibodies are typically IgM?
a. anti-K. e. anti-Leb
b. anti-S. f. anti-Jkb
c. anti-U. g. anti-P1
d. anti-N
D
E
G
- Which of the following reagents destroys the Kell system antigens?
a. ficin. c. PEG
b. albumin. d. DTT
D
- Glycophorin A and glycophorin B possess antigen sites for which blood group system?
a. Duffy. c. Lewis
b. Kidd. d. MNS
D
- Select the antibody that is characteristically clinically insignificant:
a. anti-Kpb. c. anti-Leb
b. anti-S. d. anti-Fya
C
- The McLeod phenotype is associated with:
a. Rhnull phenotype. c. U-negative phenotype
b. K0 phenotype. d. absence of Kx antigens
D
- Typing as Lu(a−b−) would be considered:
a. rare in whites but not blacks. c. rare in all populations
b. rare in blacks but not whites. d. common in all populations
C
- Cold autoantibodies are usually of which specificity?
a. I. c. P1
b. M. d. S
A
- Individuals with the p phenotype can make:
a. anti-P2. c. anti-P
b. anti-p. d. anti-Tja
D
- Alleles within the Lewis system include:
a. Le, le. c. Le, Se, H
b. Lea, Leb. d. Le, Le
A
- Which of the following antibodies requires the antiglobulin test for in vitro detection?
a. anti-M. c. anti-U
b. anti-P1. d. anti-I
C
- What procedure would help to distinguish between an anti-Fya and anti-Jka in an antibody mixture?
a. lowering the pH of the patient’s serum
b. using a thiol reagent
c. running an antibody identification panel
d. running a ficin-treated panel
D
- Anti-K1:
a. agglutinates IATs
b. is usually of the IgM antibody class
c. does not agglutinate with K+k+ panel cells
d. loses reactivity in enzyme phases
A
- Which of the following antigens is poorly expressed on cord blood cells?
a. K1. c. Leb
b. M. d. D
C
- Reagent antibody screening cells may not detect antibodies directed against low-incidence antigens. Which antibody is most likely to go undetected?
a. Vel. c. Kpa
b. S. d. K
C
- Select the disease commonly associated with the McLeod phenotype:
a. infectious mononucleosis. c. Hodgkin’s disease
b. chronic granulomatous disease. d. PCH
B
- Which set of antibodies could you possibly find in a patient with no history of transfusion or pregnancy?
a. anti-I, anti-S, and anti-P. c. anti-A, anti-I, and anti-D
b. anti-M, anti-c, and anti-B. d. anti-B, anti-I, and anti-Lea
D