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Blood Bank > Unit 1 > Flashcards

Unit 1 Flashcards

1
Q

What is an antigen, where can it be found

A

A substance recognized by the body as being foreign which can cause an immune response

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2
Q

What is an immunogen

A

Any substance that is capable of stimulating an immune response

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3
Q

Define an immune response

A

The reaction of the body to substances that are foreign or interpreted as being foreign

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4
Q

What is a Hapten

A

a small molecule which, when combined with a larger carrier such as a protein, can elicit an immune response, cannot activate immune system by itself

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5
Q

What is immunogenicity

A

The ability of an Ag to stimulate an ab response

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6
Q

What RBC antigens are more or less immunogenic, put the in order from most to least

A

ABO>D>K

ABO creates worse reaction if non match

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7
Q

What factors influence immunogenicity

A

foreignness, size, chemical composition/ complexity, solubility/ physical characteristics/ charge, degradability, accessibility

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8
Q

What is alloimmunization

A

when there is an immune response to foreign antigens because of exposure to cells or tissue from a genetically different member of the same species
ie blood transfusion

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9
Q

How can antibodies be categorized

A

naturally occurring: no stimulation needed, produced due to response to substances in the environment (pollen, bacteria membranes)
immune based: non naturally occurring, could occur due to blood transfusion or baby to mother transfer

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10
Q

What charge do RBCs have overall, how does this affect the way that they interact with each other

A

RBCs have a net - charge, they naturally repel from each other

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11
Q

explain what Zeta potential is

A

A potential is created because of of an ionic cloud of cations that are in the blood that attract the zone of negative charge on a RBA, it keeps RBCs 25nm apart at all times. Na is usually the cation present in blood

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12
Q

What is an autoantibody

A

Antibody directed against an individual’s own antigenic determinants
i.e. Warm Auto Hemolytic Anemia, causes autoimmune disease

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13
Q

What is a heteroantibody? What other name does this term have?

A

Xenoantibody- ab produced in a species against an Ag present in another species

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14
Q

Describe in vivo vs in vitro

A

in vivo: within the body

in vitro: artificial environment outside of body

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15
Q

What are the primary and secondary organs of the immune system

A

primary-BM, thymus, liver (in fetus only)

secondary-Lymph nodes and spleen,

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16
Q 
What organs: 
produce B cells
produce T cells
stores iron and has erythropoiesis during fetal stages of life
processes and aids in Antigen detection
A

BM-B cells
Thymus-T cells
Liver-
Lymph nodes and spleen

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17
Q

Where do all immune cells originate from

A

pluripotent hematopoietic progenitors, turn into Myeloid or lymphoid precursor cells

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18
Q

What are the myeloid lineage cells, what is their general role and what type of immunity do they aid in

A 
phagocytes: monocytes, neutro, eos, baso
RBCs
Platelets 
Can destroy engulfed pathogen or process it and present them to lymphs (APC)
innate and acquired immunity
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19
Q

What are the lymphoid lineage cells

A

T, B and NK cells

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20
Q

What are cytokines and what is their role

A

polypeptide substances that are immune response regulators, can activate and deactivate cells, regulate immune specificity, intensity and duration

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21
Q

What is the role of B cells

A
  • can recognize one or a set of antigens on foreign cell, no help needed
  • APC to CD4 T helper
  • Can be activated into plasma cells and secrete abs
  • Can become memory cells that remain in the system
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22
Q

What do antibodies do after they have been produced by a plasma cell?

A

They can circulate freely in the plasma, body secretions and lymphatic sys.
Can bind to antigen on foreign cell to block it from attaching to something else
Are lysed when Complementary system is activated by Ag-Ab complex

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23
Q

What do T cells do? Name the function of each type of T cell

A

CD4-T helper, can recognize ag after APC presents one, help B cells evolve into plasma cells which causes them to produce antibodies
CD8-Cytotoxic T- Destroy target cells often associated with cancer or viruses
CD8+ T suppressor- shuts down immune response once pathogen is destroyed by releasing lymphokines

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24
Q

What “tools” do T cells use to create an immune response/ recognize an antigen

A 
CD4- need HLA class II- best for finding bacteria
CD8- need HLA class I- best for finding viruses
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25
Q

What types of specific markers do each type of T cells have?

A

CD3 clusters of differentiation when non differentiated
CD4 T helper
CD8 Cytotoxic T cell
CD8+ Suppressor cell

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26
Q

What cells are APCs?

A

macrophages, B lymphocytes, dendritic cells (langerhans), Glial cells, Kupffer cells, osteoclast, thymus

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27
Q

What cells are part of innate immunity? and adaptive?

A

innate- neutrophils, macrophages and other APCs

adaptive- B, T and NK cells

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28
Q

What special methods can NK cells use to kill pathogens

A

They can lyse antibody coated cells, do not need MHC molecules to recognize pathogens, lyse virally infected cells and tumor cells directly with its HLA class I

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29
Q

Are haptens immunogenic?

A

no, they cannot illicit an immune response on their own.

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30
Q

How do cells bind to antigens?

A

B or T cells bind to the epitope of the antigen on a foreign cell

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31
Q

What is the difference between an immunogen and an antigen?

A

immunogens always elicit immune responses, antigens do not necessarily

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32
Q

What are opsonins and what do they do

A

molecules that are free roaming that aid Macros and neutrophils in phagocytosis, “prepare for eating”, they do this through opsonization, they can bind to phagocytes or bind to pathogens to coat them and create binding sites for immune cells to grab onto, forks

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33
Q

What are the 2 main types of opsonins?

A
  • complement protein C3b (from complement system)

- antibodies

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34
Q

What antigens are produced during a primary immune response (initial exposure to an antigen)

A

IgM in large quantities first, then igG in small quantities

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35
Q

What processes are involved in the primary immune response?

A

phagocytosis and alternative pathway that triggers the complementary system

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36
Q

During the log phase of the primary immune response, what changes do the antibodies go through?

A

IgM converts to IgG through heavy chain switching in low amounts, IgM breaks apart to become single IgG antibodies

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37
Q

What proportion of IgM vs IgG during the primary response

A

50/50

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38
Q

How does the immune system react differently to a second exposure (secondary immune response)

A

T and B cells are faster to react to threat due to memory cell activation
log phase is much shorter, IgG produced almost immediately, this effect is called Anamnestic

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39
Q

How does the secondary immune response relate to a blood transfusion?

A

A patient who was given slightly wrong transfusion might have a smaller reaction the first time, not notable, would take a while for body to create adaptive immunity/ memory cells
Once introduced to the same blood a second time if the positive reaction is not detected, the second time will be much more severe and likely fatal

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40
Q

What is the proportion of IgG to IgM in a secondary immune response

A

much more IgG to IgM,

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41
Q

Primary immune response is characterized by a lot of what type of antibody?

A

IgM

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42
Q

What antigens are most abundant? put them in order from least to greatest

A

GAMDE

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43
Q

What size are antigens usually and what are they made of?

A

over 10,000 daltons
proteins, glycolipids, glycoproteins and lipoproteins
anything smaller is usually a hapten

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44
Q

What RBC antigens make the best immunogens

A

proteins: Rh, M and N

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45
Q

What factors influence antigen immunogenicity

A

size, foreignness, composition, dosage, route of exposure

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46
Q

Are larger or smaller antigens more immunogenic?

A

larger

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47
Q

What structure on an antigen gives it specificity

A

the epitope on the cell surface, antigenic determinant

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48
Q

What RBC antigen is most immunogenic

A

the D antigen

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49
Q

Where are antigens in the body

A

ABO antigens in RBCs, and all blood cells kidneys and heart

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50
Q

What antigens do WBCs have and other nucleated blood cells

A

HLA human leukocyte antigen

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51
Q

What types of antigens are a concern in BB?

A

RBC WBC and platelet antigens, for successful blood transfusion

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52
Q

What is the least common immunoglobulin

A

IgE, it is only around during allergies and anaphylaxis

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53
Q

What part of the immunoglobulin determines the antibody class

A

the heavy chains if alpha beta gamma delta or epsilon

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54
Q

What is the only immunoglobulin that can cross the placental barrier

A

IgG

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55
Q

What are the different types of IgG immunoglobulins

A

IgG1 -IgG4

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56
Q

What part of an antibody binds to an antigen

A

The variable region, Fab

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57
Q

Describe the “Chains” in immunoglobulin

A

2 light chains, 2 heavy chains, connected by a disulfide linkage, heavy chains on inside, light chains on outside

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58
Q

What is the function of IgA

A

secretory protein found in saliva, breast milk, mucous

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59
Q

What is the function of IgD

A

interacts with mast cells, causes allergies

60
Q

What is the function of IgE

A

also allergy and type 1 hypersensitivity, works with mast cell, also present in parasitic infection, coats helminths and helps other cells attach to it to kill it. Can bring in neutrophils or eosinophils

61
Q

What is the function of IgG

A

first type you have as a child, can cross placenta, work with B cells to help with specific antigens, tends to help with opsonization

62
Q

What is the function of IgM

A

most common on surface of B cells, pentamer that can bind to more things at one, aids in complement much faster than other immunoglobulins

63
Q

What are the different functions of all immunoglobulins

A

neutralization-binds to binding sites on pathogens
opsonization-binds to pathogen to aid in phagocytosis
signaling- as a receptor on B cell surface
complement-bind to pathogen, complement proteins bind to Fc region and starts up complement cascade ending in cell lysis of pathogen
Cytotoxic cell aiding- bind to NK cell and pathogen, help complete cell lysis

64
Q

Which immunoglobulin has the highest valence?

A

IgM

65
Q

What is the structure of each immunoglobulin

A 
IgG-monomer
IgA-dimer
IgM-Pentamer
IgD-monomer
IgE-monomer
66
Q

What is affinity? Avidity?

A

Affinity- the strength an ab can bind

avidity- the total strength of binding molecules

67
Q

Which antibody has the highest affinity? Which has the highest avidity

A

highest affinity IgG

highest avidity IgM

68
Q

Which IgG antibodies are good for activating complement? Put them in order from best to worst

A

IgG3
IgG1
IgG2
IgG4

69
Q

KIDD is an example of what immunoglobulin

A

IgG

70
Q

Which antibody is most clinically significant

A

IgG- can decrease RBC survival time the most, most important in BB to avoid transfusion reactions, because it has the highest affinity

71
Q

Which IgG antibodies are mostly Rh system antigens

A

IgG1 and IgG3

72
Q

Which part of the blood has viable amounts of compliment, which could cause hemolysis if antigen antibody positive reactions occur

A

the serum, which is why in BB we use the serum to see a reaction visually

73
Q

What factors affect the speed of agglutination

A

the amount of antibodies and the amount of antigen sites,
post zone-if too many antigens, agglutination slows down
prozone-If too many antibodies the same occurs

74
Q

What might cause a false negative in BB to occur

A

if the proportions of antibody or antigen are wrong, the blood will not visibly agglutinate and the BB might think they are a good match, a false negative

75
Q

What are the two stages of agglutination

A

1- sensitization, antibody attaches to antigen on RBC

2- lattice formation-RBCs aggregate due to attached antibodies, visible rxn

76
Q

What factors affect sensitization

A

temp, pH, time, ionic strength (zeta potential), ratio of an to ab

77
Q

What antibody reacts most to incompatible RBCs at body temp

A

37C- IgG

78
Q

What antibody reacts most to incompatible RBCs at cold temperatures

A

22C or colder- IgM

79
Q

What antibody reacts the most to a low pH

A

IgM

80
Q

What does LISS do?

A

lowers ionic strength in RBCs causes them to be too close to each other, makes them agglutinate easier with IgG

81
Q

What does Bovine albumin do

A

increases electric current to lower zeta potential, affects distance between RBCs

82
Q

What does PeG do? Polyethylene glycol

A

removes H20 (dehydration) to enhance antibody-antigen reactions

83
Q

What do proteolytic enzymes do

A

used to decrease RBC negative charge, lowers zeta potential, denatures antigens

84
Q

What factors affect the lattice formation of RBCs?

A

the size of the ab, amount of abs, amount of antigens, location of antigens and zeta potential

85
Q

How are agglutination reactions graded

A

from 0 to 4+
0- negative no clumps
4- solid clump, clear supernatant

86
Q

What does a positive reaction in gel look like for agglutination testing

A

a band at the top, means the antigen and antibody have formed a complex too big to move through gel, the further up the band, the more severe the reaction, if sitting at the bottom, no reaction occurred, negative result

87
Q

What organ produces the complement proteins in the complement system

A

the liver

88
Q

What are the function of the complement system

A

opsonization aid in phagocytosis
lysis of abnormal cells, including viruses
inflammatory response- C3a works to call other cells to action
cripple pathogens by covering them

89
Q

What are the 3 ways to activate the complement system

A

classical, alternative and lectin pathway
classical is the main focus in BB
antigen-antibody binding

90
Q

How many IgM molecules are needed to activate complement? how many IgG?

A

1 IgM

2 IgG

91
Q

What are the proteins in the complement system and what order do they activate in where are the complexes

A

C1-C9
C1-C4-C2-C3-C5-C6-C7-C8-C9

C3b-opsonization
C5-C9 mac complex
C3 convertase: C4b, C2 and C3

92
Q

What do the a and b on complement proteins mean

A

a-fragment that triggers inflammation

b-active fragment of complement

93
Q

What are homozygous and heterozygous

A

homo- same allele on a pair of chromosomes

heter- 2 different alleles on pair of chromosomes

94
Q

What is dosage

A

antibodies reacting more strongly with homozygous RBCs than heterozygous RBCs, more binding sites for abs to attach to

95
Q

Which RBC would have the strongest dosage to a Jka antigen
Jk(a+b-)
Jk(a+b+)

A

Jk(AA)- stronger reaction, double dose of A antigen

Jk(AB)

96
Q

What blood types are most affected by dosage

A

Rh, Duffy, Kidd and M

Kidds and Duffy the monkey (Rh) eat lots of M&Ns

97
Q

What is an amorph

A

A silent gene, no detectable antigen

98
Q

What is polymorphic

A

2+ alleles at a given locus

99
Q

Would a population be better off being more polymorphic or amorphic? What blood type system are most _?

A

polymorphic RH and MNS

100
Q

What factors in terms of location affect the reaction to antigen D ?

A

Trans location dramatically reduces the expression of D, if Ce is trans to D

101
Q

Number the gene interaction effect of the following 0 to 4
dCe/DcE
dcE/Dce
DCE/Dce

A

dCe/DcE 0+ weak D
dcE/Dce 2+ or 3+
DCE/Dce 4+

102
Q

What needs to occur for Sex linked dominant inheritance to show for a trait?
Sex linked recessive?

A

one copy needed can be X or Y linked

2 copies of X-affects only women

103
Q

What blood groups are dominant? Recessive?

A

A and B are dominant

O recessive

104
Q

What does the + and - mean on a blood group antigen symbol

A

+ antigen present

- antigen not present

105
Q

How is the Kidd system notated

A

Jk

106
Q

How is the lewis system notated

A

Le

107
Q

How is the Duffy system notated?

A

Fy

108
Q

Which portion of the immunoglobulin molecules binds to complement?

A

heavy chain constant region

109
Q

Which of the following is not involved in the acquired (adaptive) immune response?

a. Phagocytosis
b. Production of antibody or complement
c. Induction of immunologic memory
d. Accelerated immune response upon subsequent exposure to antigen

A

phagocytosis

110
Q
  1. Which cells are directly involved in the production of antibodies?
A

B lymphocytes

111
Q

Which cell is involved in antigen presentation and recognition following phagocytosis?

A

Macrophage

112
Q
  1. The role of the macrophage during an antibody response is to
A

d. Process antigen and present it.

113
Q

Which immunoglobulin is the primary Ig produced in the primary immune response?

A

IgM

114
Q

Which of the immunoglobulin is primary Ig produced in the secondary immune response?

A

IgG

115
Q

Which of the following immunoglobulins is most efficient at binding complement? (Do not consider subtypes)

A

IgM

116
Q

How is the classical complement cascade activated?

A

c. Antibody and antigen formation

117
Q

Which of the following is known as the “membrane attack complex” in the classical complement pathway?

A

d. C5b, C6, C7, C8, C9

118
Q
  1. Which of the following refers to the effect of an excess amount of antigen present in a test system?
A

Postzone

119
Q

13Which of the following refers to the presence of an excess amount of antibody present in a test system?

A

Prozone

120
Q

Molecules, like C3b complement, that promote the update of bacteria for phagocytosis are:

A

a. Opsonins.

121
Q

Select the term that describes the unique confirmation/shape of the antigen itself that allows for antibody recognition and binding by a specific antibody is?

A

Epitope

122
Q

Which of the following terms refers to the net negative charge surrounding red blood cells?

A

d. Zeta potential

123
Q

When a recessive trait is expressed

A

b. Two genes carrying the trait were present.

124
Q

When a male possesses a phenotypic trait that he passes to all his daughters and none of his sons, the trait is said to be:

A

a. X-linked dominant.

125
Q

When a female possesses a phenotypic trait that she passes to all of her sons and none of her daughters, the trait is said to be

A

b. X-linked recessive.

126
Q

The pattern of inheritance most commonly expressed by blood group genes is

A

c. Autosomal codominant.

127
Q

What is the Landsteiner rule

A

“you only make abs against antigen you lack”

128
Q

Define what a chromosome is

A

a structure within the cell’s nucleus that transmits genetic information

129
Q

Define what an autosome is

A

Any chromosome that is not a sex chromosome

130
Q

Define what a sex chromosome is

A

X and Y, only has 1 locus, only carries sex genes

131
Q

Define what a gene is

A

the portion of a chromosome that determines a trait, a unit of inheritance

132
Q

Define what a locus is

A

the position occupied by a gene on a chromosome

133
Q

Define what an allele is

A

1 of 2+ different genes that occupy a specific locus on a chromosome

134
Q

How many alleles per parent is seen in codominance

A

one per parent

135
Q

Define what a trait is

A

characteristic that is inherited, observed expression of the gene

136
Q

Define what gene interaction is?

A

genes located at distant loci interact to produce a trait

137
Q

Define genotype and phenotype

A

genotype- an individual’s genetic makeup

phenotype-characteristics that are evident from the results of test or direct observation

138
Q

Define cis and trans

A

cis: 2+ genes on the same chromosome of a homologous pair
trans: 2+ genes on opposite chromosomes of a homologous pair

139
Q

True or False: All antigens exhibit dosage

A

False

140
Q 
Which of the following RBC antibodies are naturally occurring? which are immune based?
Anti-A 
Anti-B
Anti-AB
Anti-D
Anti-K
A

Anti A,B and AB- natural

Anti-D and K- immune based

141
Q

Define Complete vs incomplete antibodies

A

complete-agglutinating

incomplete-non agglutinating

142
Q

What is the phase that lag is reffering to

A

inductive phase, initial exposure to antigen

143
Q

What are the main characteristics of the log phase

A

antibody production is occurring, turns stable into plateau

144
Q

Which immune response has more IgM proportionally? Primary or secondary

A

Primary where there are almost equal amounts of IgM vs IgG , in secondary there is way more IgG than IgM,

145
Q

Which RBC antigens are glycolipids

A

ABO, lewis P1

146
Q

Which RBC antigens are glycoproteins

A

HLA

147
Q

Which RBC antigens are lipoproteins

A

HBsAg

Blood Bank (8 decks)

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