Test questions Flashcards
Perioral Paresthesia
Numbness or tingling in the mouth, presented in donors- reducing the flow rate is the solution
Nucleic acid testing window period for HIV is how many days
9 days
What is the biochemical structure of the H antigen on cells
ceramide- glucose- galactose- GLCNAC-GAL-FUC
Amino acid sequence for M antigen
ser-ser-thr-thr-gly
Linkage disequilibrium
When haplotypes do not occur at expected frequencies, some haploypes are inherited together more frequently then they should be. If you look at HLAA1=15% in population and B8 10%, you would expect the combination of these two together to be 1.5%, however the actual frequency is 7.8%
Recombination
genes are closely linked. SAME AS CROSSOVER, rarely occurs, gives birth to new haplotypes. 0.8% between HLA-A and B. 0.5% between HLA-B and HLA-DR
Non disjunction
the failure of one or more pairs of homologous chromosomes or sister chromatids to separate normally during nuclear division, usually resulting in an abnormal distribution of chromosomes in the daughter nuclei.
Why is the diego blood group of anthropological interest
Dia is more frequent in those of mongolian ancestry
What is the most common CH/RG phenotype
CH/RG 1,2,3,11,12
Which antigen is located on the CR1 protein
McCc
CR1 receptors on macrophages recognize what?
C3b
IgG subclasses most efficient in activating complement are
IgG1 and IgG3
The Fc receptor on phagocytes that has the highest affintiy for binding IgG is:
FcR1
Hospital blood banks that collect blood but do not ship across state lines must be:
Registered with the FDA, not need to be licensed
Which of the following is not allowed by law on employment application forms
Date of birth
90% of the ATP needed by Red blood cells is generated in
Embden- Meyerhoff pathway
Prothrombin complex is indicated for treatment of:
Severe Christmas Disease
Neonatal alloimmune thrombocytopenia is most frequently caused by what antibody?
Anti-HPA-1a
Hook effect
This is similar to post zone or prozone, when the correct number of antibodies and antigens are present it forms a curve steadily increasing until a point where there is too much antibody or antigen is present, creates a āhookā in the graph
Immunogenicity
Property of a substance to induce a detectable immune response
Antigenicity
structure of an immunogen that ellicits immune response āantigenic determinantsā
X-linked agammaglobinemia
immune deficiency, does not generate mature B cells, manifests in complete or near complete lack of antibodies
Immunodiffusion
antigen and antibody react in gel to create precipitin band or ring
Immunoelectrophoresis
antigens separated through electrophoresis and then reacted against an antibody
Capillary tube precipitation
in a tube
Ouchterlony double diffusion
on gel precipitating antigens and antibodies to form identity, non identity or partial identity
Avidity
measure of the overal strength of binding of an antigen with many antigenic determinants
Antibody affinity
K= (AbAg) / (Ab) (Ag)
Seroconversion
the ability to detect and antibody that has developed due to immunization or infection
Radioimmunoassay
RIA an immunoassay that uses radiolabeled molecules, in a stepwise formation of immune complexes
Which chemical enhances vascular spasms?
Serotonin
Embolus
A thrombis that is carried in the bloodstream
The structural basis of blood group A and B antigen specificity
A single terminal sugar residue
In the immune response to hapten-protein conjugate in order to get anti-hapten antibodies it is essential that:
The protein be recognized by helper T cells
Hyperhemolysis what it is and treatment
Patient overhemolyzing, not only the transfused cells but also patients own cells, treatment corticosteroids and IVIG
Consequences of CMV in immunocompromised
Could have no consequences and show seroconversion, however could also have multi-organ involvement, viremia and death
Intravenous Immunoglobulin
is a highly concentrated injection of antibodies pooled from many healthy donors that temporarily changes the way the immune system operates. It works by binding to the antibodies that cause myasthenia gravis and removing them from circulation
One unit of donor RBCs will raise the hgb/hct how much?
1 g/dL OR 3%
One unit of random donor platelets will raise the plt count how much?
5000-10000 in normal patient
random donor units contain how many platelets
5.5 x 10^10
BSA calculation
ht (cm) x wt(kg)/3600
RBCs in bag decrease at what percentage?
1% per day
Once irradiated how long are RBCs good for?
28 days or expiration dates
calculating platelets in WB unit
volume of WB (mL) x donor platelet count (typically done per uL, donāt forget conversions!
calculating platelet yield
number of platelets in PRP (platelet rich plasma from wb)/ #plts in WB = percentage recovery or yield
how will one unit of FFP affect clotting factors in patient
raise all clotting factors by about 10%
Most common transfusion related death
TRALI
How was weak D initially discovered
IAT test
What happens in a trauma situation where an O negative patient receives 2Opos blood and once realized 6oneg units?
unlikely to cause delayed hemolytic transfusion reaction, due to the fact that six o negative units were given after the inital opos, most likely wonāt be any o pos rbcs left once an antibody is formed
LW antigens pregnancy
weakened during pregnancy
McLeod syndrome symptoms
involuntary movements and seizures
The most common infectious adverse affect of transfusion is what?
hepatitis
the amino acid sequence responsible for the M antigen is?
ser-ser-thr-thr-gly
What is responsible for keeping the bag at pH of 6.2
bicarbonate and gas permeable storage bag. Bicarbonate helps prevent unit from becoming acidic due to lactic acid production. Gas permeable storage bag helps to allow CO2 to be released
Antigen located on CR1
Knops antigens
Knops antibodies are neutralized by what
sCR1 (soluble CR1) not neutralized by plasma, not enough free floating CR1 in plasma, recombinant soluble sCR1 can be made and neutralize the antibodies
Vel antigen prevalence in race
high frequency antigen. Vel negative seen in europeans with higher prevalence in Scandinavians (1 in 1700)
Vel antibodies
AHTR and HDFN, very dangerous, very difficult to match blood for
KCAM
antigen of the Knops system
Knops a negative individuals
more common in caucasians, Knops a is a very high frequency antigen
Knops antigens
It consists of eight antigens: Kna, Knb, McCa, SI1, Yka, McCb, SI2, and SI3. most are common with >90% prevalence. low prevalence= knops b and McCb (0% whites 42% blacks)
HTLA like antigens
Knops, Chido/Rogers, Dombrock, Cost, JMH
JMH gene
semaphorin 7A, not associated with hemolytic transfusion reactions
COST blood collection
Csa- 98% Csb-34%, this used to be associated with Knops blood group. Serologically related to Yka on knops blood group system. not on CR1
Er blood collection
Era= high incidence >99% Erb= <1%
Vel collection
Vel and ABTI, both high incidence
Anwj
receptor for haemophilus influenzae, high incidence, implicated in severe AHTR
Lan antigen
anti-Lan- severe AHTR, high incidence antigen
Ata collection
only found in african americans, high incidence
Jra blood group
mostly found in japan, high incidence not associated with hemolytic transfusion reactions
Sda
present on other cells besides red blood cells, not typically associated with HDFN, AHTR, high incidence
Helgeson phenotype
knops null phenotype by serological methods- CR1 is present on red cells.
Knops and Plasmodium falciparum
some knops phenotypes may offer a degree of resistance to severe malaria, CR1 appears to be involve in rosetting associated with Plasmodium falciparum.
RIA
radioimmunoassay an immunoassay that uses radio labeled molecules in a stepwise formation of immune complexes
CR1 receptors on macrophages recognize
C3b
The Fc receptor on phagocytes that has the highest affinity for binding IgG is
FcR1
Hosptial blood banks that collect blood but do not ship across state lines need to be_____ with the FDA:
registered (not licensed or accredited)
The most common Chido/Rogers phenotype
CH/RG: 1,2,3,11,12
Which antigen is located on the CR1 protein
Knops antigens: Kna, Knb, McCa, Sl1, Yka
The Cell that reguates whether or not the immune response will occur is:
T cells
Which of the following is not allowed by law on employment application forms? Previous employer, Educational background, address, or date of birth
Date of Birth
The best education objective for a course to teach simple repair of instruments is:
To repair 9/10 machine malfunctions
An employee who has been employed 4 years failed a proficiency survery, previously the employee has been achieving 100% on all proficiency surverys, you should:
Determine the cause of the error, retrain or counsel depending on the cause and document
when determining number of units to screen for patient must include into calculation:
Blood Group percentage, Rh percentage and any negative antigen types
peripheral smear from obstetrical patient of african ethnicity shoes marked target cells and large oblong crystalloid structures within red cells. Patient told in the past that her āiron was too lowā to donate blood. Patient most likely has:
Hb C disease
Hemoglobin C disease
Hemoglobin C disease is a condition affecting a protein in the blood (hemoglobin) which transports oxygen throughout the body. Symptoms of this condition can include fatigue, weakness, and anemia . The spleen can also become enlarged as a result of this disease. Change from Lysine to glutamic acid at position 6 of B-hemoglobin chain. Shows up with centrally targetted RBCs
Smudge cells are indicative of
CLL
90% of the ATP needed by RBCs is generated in:
Embden Meyerhoff Pathway
Prothrombin comlex is indicated for the treatment of which of the following: Mild von willebrands Disease, severe hemohilia A without Factor VIII inhibitors, severe hemophilia A with factor VIII inhibitors, severe christmas disease
Severe christmas disease (Factor IX)
Poor clot formation is indicative of what factor deficiency
XIII- Fibrinogen makes the clot, so as long as a clot is formed it shouldnāt be a deficiency of Fibrinogen, XIII performs the crosslinking
Neonatal alloimmune thrombocytopenia is caused primarily by which antibody:
HPA-1a
The amount of antigen being measured that is exceeding the amount of antibody in ELISA can cause a technical problem called:
hook effect
In ELISA for hepatitis B surface antigen, the second antibody linked to a reporter enzyme is called
the conjugate antibody (it is conjugated to the enzyme)
The substance used at the very end of ELISA in order to make a colorimetric or Fluorescent change for detection is called
the substrate
the antigen or antibody in the bottom of the well of ELISA is called
the capture antigen or antibody
Ael serological
no reaction with Anti-A or anti-A,B, weak back type with A cells and only H in saliva
Ax serological
Only H in saliva reacts weakly *****
To differentiate anti-Fy3 and anti-Fy5 you need to test what type of cell?
Fya+Fyb+ Rh null
Patient received red blood cells, her blood pressure dropped and she experienced difficulty breathing, she was treated for shock. What type of red cells should she receive to prevent this type of reaction?
Washed Red Blood Cells
hrB
RH31
HR0
RH17
Hr or Hrs
RH18
HrB
HR34
hrs
RH19
A(B) phenotype
same idea as B(A) in reverse
B(A) phenotype
autosomal dominant, weak A expression on group B cells, B=4+ A=<2+, strong anti-A reactive with both A1 and A2 cells
cis AB
can use a and b specific nucleotide sugars in an equal way, unlike B(A) or (A(B) CisAB allele in trans to O allele, cause weaker expression of A and B
Acquired B and acidified human serum anti-B
does not react with acidified serum
A1 ISBT number
is the fourth antigen in the ABO group 001.004
What is the effect of having an elevated expression of CD47 on the cell surface?
Prevents phagocytosis, binds to signal regulatory protein alpha on the surface of macrophages, to diminish the CD47 expression would be to increase phagocytosis. Increased expression of CD47 has been found on human tumor cells
M antigen amino acids
From base to the end: Gly-Thr-Thr-Ser-Ser
N antigen amino acids
From base to end: Glu-Thr-Thr-Ser-Leu (same as end of Glycophorin B)
Percentage of f positive
65% white 92% black
autoanti-IH/HI associated with?
Less H on surface of red cells. i.e. patients that are A1, if someone has autoanti-HI could see hemolysis especially with O RBCs where H is more prevalent
Lewis in plasma
glycolipid
Lewis in pregnancy
increased plasma volume in pregnancy, elutes Lewis off of the red cell
FUT2*01w.02
weak secretor, 17% Japanese Lea+ Leb+, H binds as successfully as Lewis does making about 50% A and 50% B
Percentage of Whites and blacks with Lea- Leb-
5% whites 25% blacks
Lewis in blacks
(25/50/25) 25 Lea+, 50 Leb+, 25 Lea-/Leb-
Lewis in whites
20/75/5 Lea+/Leb+/both negative
Anti-Leb
very infrequent in lea+/Leb- individuals more commonly positive in patients that are negative for both (anti-Lea, anti-Leb, anti-Le3 (a,b)
Why is it not necessary for antigen negative units with Lewis
- antigen will elute off of the cell and patients antigen will adsorb onto surface after some time in new environment 2. Also recipients antibodies will often bind to antigen found in plasma and neutralize it.
i is a sign of what
stressed erythropoiesis, can occur in people with chronic hemolytic disorders
Disorders i
- i adult- autocsommal recessive caused by mutations in GCNT2- in asians is associated with congenital cataracts 2. congenital dyserythropoietic anemia Type 2 )=(HEMPAS)
I enhancement
enzyme treatinet, albumin.
Which Rh phenotype has the least amount of CD47 on the surface
Rh null, CD47 is associated with the Rh complex. Dā cells have the highest expression of CD47, whereas Rhnull cells express barely any CD47.
Renal transplant patients B/O can receive:
A2 kidney if their anti-A titer is low
Hereditary hemochromatosis is an autosomal recessive disorder caused by inappropriate absorption of iron and abnormal iron cycling. This results in an accumulation of iron within tissue, including the liver, pancreas, skin, and endocrine organs. The excessive iron stores can result in organ dysfunction. Which is the most common genetic abnormality seen in the HFE gene product resulting in hereditary hemochromatosis?
C282Y. change from a tyrosine to a cytosine. carrier rate in Caucasians is 1 in 10
What needle gauge is used for transfusion
18-20 gauge
how long is the deferral for someone received gamma globulin
120 days if exposure to hepatitis A, if prophylactically can donate right away.
