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Immunology Block 2 > Transfusion Immunology > Flashcards

Transfusion Immunology Flashcards

1
Q

what are the 3 basic concepts involved in blood groups and transfusion reactions?

A

1- self and foreigness
2- T dependency and independency
3- genetic polymorphism and inheritance

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2
Q

blood cell antigens are what kind of antigens?

A

alloantigens

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3
Q

what determines the chemical composition of blood cell antigens?

A

polysaccharide determined by glycosyl transferases

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4
Q

what are the mechanisms of inheritance of blood cell antigens?

A

…

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5
Q

what are the mechanisms of expression of blood cell antigens?

A

dominant or codominant

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6
Q

what gene codes for the backbone in the sugar moiety?

A

H gene

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7
Q

what does the H gene encode?

A

a fucosyltransferase which encodes the O antigen base structure

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8
Q

the H gene is absent in which form of leukocyte deficiency?

A

Bombay blood group phenotype

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9
Q

sugar for A allele

A

N-acetylgalactosamine glycosyl transferase

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10
Q

sugar for B allele

A

galactosyl transferase

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11
Q

the carbohydrate structure is recognized by which cells?

A

B cells (found only in individuals not expressing the phenotype)

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12
Q

Natural antibodies or isohemagglutinin immune responses against the shared bacterial antigens are dependent on which cells?

A

T cells

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13
Q

Is the H allele recessive or dominant?

A

recessive
- it is considered recessive because individuals develop antibodies against the missing blood group antigen around the 3-6th month of life

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14
Q

Anti-A and Anti-B antibodies represent what class?

A

IgM

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15
Q

what are the other blood groups?

A 
secretor
Lewis
MNSs
Kell
Duffy
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16
Q

secretor

A

most of us encode a gene which allows the A,B and H antigens to be secreted

17
Q

Lewis

A

LeA and LeB are not ABO linked by are structurally related; natural antibodies in Le- individuals

18
Q

MNSs

A
  • MN group located on glycophorin A

- Ss group on glycophorin B

19
Q

Kell

A
  • K and k allelic forms; K is the stronger antigen

- protein antigen may provoke strong transfusion reaction and HDN

20
Q

Duffy

A

Duffy antigen receptor for chemokines (DARC)

  • FyA or FyB - an important receptor on RBCs for the malarial parasite Plasmodium vivax; also binds various chemokines
  • Fy- or Duffy null - 60% African or of African descent
21
Q

the Rh system has how many different antigens?

A

44

22
Q

which of the 6 alleles of the Rho system is clinically the most important because of its high immunogeneicity?

A

D

23
Q

when does Rh appear in a human?

A

early fetal development

24
Q

induced antibodies in Rh- person can be found following which events?

A
  • mis-matched transfusion
  • pregnancy
  • abortion
25
Q

transfusion reactions occur due to reactivity btw _____ antibodies and _____ red blood cells

A

recipient

donor

26
Q

what hemolytic symptoms occur after an incompatibility rxn?

A 
diffuse muscular pain
headache
vomiting
rise in temperature
shock 
renal failure
27
Q

what is the primary means by which HDN occurs?

A

Rh- mother has a Rh+ baby

28
Q

what is the second most common HDN blood group?

A

Kell

29
Q

under what condition would HDN happen to the first baby?

A

1- if mother had previously received mismatched transfusion

2- mother had a previous miscarriage or abortion of an Rh+ baby

30
Q

in HDN mother becomes _____ with baby’s cells when they enter ______during first pregnancy; this number is ususally too low to induce problems for that baby

A

sensitized

circulation

31
Q

What are the steps for HDN that begin with a mother is pregnant with her first Rh+ fetus?

A

1- sensitization of mother
2- during delivery, Rh+ from cord blood mix with mom’s blood
3- mother becomes immunized producing anti Rh+ IgG
4- IgG can cross placenta and damage subsequent Rh+ fetus

32
Q

___ incompatibility MAY diminish the possibilities of HDN

A

AB;
Normally occurring anti-A and anti-B blood groups in the mother may clear antigenic Rh+ fetal RBCs and prevent sensitization

33
Q

approximately what percent of cases are due to ABO incompatibility?

A

50-60%;

Cases are usu minor with transient anemia and jaundice with slightly elevated bilirubin

34
Q

Direct Coombs testing purpose

A

detects presence of antibodies on RBCs

35
Q

INdirect Coombs testing

A

detects presence of antibodies against RBC antigens

36
Q

cross matching

A

matches rbc of donor against serum of recipient to avoid reaction against other antigens (indirect coomb’s)

37
Q

practice coombs

A

…

Immunology Block 2 (12 decks)

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