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Transfusion > Week 3 > Flashcards

Week 3 Flashcards

Other Blood Group Systems

1
Q

Which alleles in blood group systems are co-dominant?

A

A and B
C and c
E and e
M and N
S and s
K and k
Fya and Fyb
Jka and Jkb

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2
Q

Which alleles in blood group systems are dominant?

A

H
D
Le
A and B
Se
Fya and Fyb over Fy

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3
Q

Which alleles in blood group systems are recessive?

A

h
d
le
O
se
Fy

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4
Q

What is the dosage effect in blood banking?

A

The dosage effect refers to how the quantity of the target antigen present on red blood cells can significantly affect the strength of an antibody reaction.

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5
Q

How does the dosage effect influence antibody reactions?

A

The strength of the antibody reaction increases or decreases based on the quantity of the antigen present on the red blood cell surface. More antigen sites result in a stronger reaction.

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6
Q

Why is the dosage effect important in blood testing?

A

It helps in interpreting blood tests, as stronger or weaker reactions may indicate homozygous or heterozygous antigen expression, respectively.

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7
Q

How does Anti-Jka react with Jk(a+b-) red blood cells?

A

Anti-Jka reacts significantly stronger with Jk(a+b-) red blood cells due to the double dose of the Jka antigen.

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8
Q

What is the reaction strength of Anti-Jka with Jk(a+b+) heterozygous red blood cells?

A

Anti-Jka reacts weaker with Jk(a+b+) heterozygous red blood cells because they carry a single dose of the Jka antigen.

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9
Q

What is meant by a “double dose” in the context of Anti-Jka?

A

A “double dose” refers to homozygous expression of the Jka antigen, where both alleles carry Jka, as seen in Jk(a+b-) red blood cells, leading to a stronger antibody reaction.

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10
Q

What is meant by a “single dose” in the context of Anti-Jka?

A

A “single dose” refers to heterozygous expression of the Jka antigen, where one allele carries Jka and the other carries Jkb, as seen in Jk(a+b+) red blood cells, resulting in a weaker antibody reaction.

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11
Q

Which Rh antibodies exhibit dosage?

A

-C
-E
-c
-e

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12
Q

Which Duffy antibodies exhibit dosage?

A

-Fya
-Fyb

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13
Q

Which Kidd antibodies exhibit dosage?

A

-Jka
-Jkb

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14
Q

Which MNSs antibodies exhibit dosage?

A

-M
-N
-S
-s

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15
Q

What can enzymes do to antigen reactivity with antibodies?

A

Enzymes can enhance, suppress, or inhibit entirely the antigen reactivity with the antibody.

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16
Q

Name four examples of proteolytic enzymes used in antigen-antibody reactions.

A

Ficin, Trypsin, Papain, and Bromelin.

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17
Q

What effect do enzymes have on red cell membranes in antigen-antibody reactions?

A

They remove the net negative charge on red cell membranes and denature the antigenic determinants.

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18
Q

How do enzymes enhance the agglutination of some antigens?

A

By reducing the Zeta potential.

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19
Q

Which antigens are destroyed by enzymes?

A

Duffy
MNSs

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20
Q

Which antigens are enhanced by enzymes?

A

Rh
Kidd
Lewis

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21
Q

What does the H gene code for?

A

The H gene codes for L-Fucosyltransferase (FUT 1 enzyme), which adds L-Fucose to the precursor substance to produce the H antigen.

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22
Q

What are the two significant alleles of the H gene?

A

H and h.

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23
Q

What is the silent allele of the H gene, and what is its function?

A

The silent allele is ‘h,’ which does NOT code for an enzyme.

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24
Q

How common is the hh genotype?

A

The genotype hh is rare.

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25
Q

What genotype is associated with the Bombay phenotype?

A

The rare hh genotype.

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26
Q

What happens to the precursor substance in individuals with the Bombay phenotype?

A

No fucose is added to the precursor substance.

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27
Q

Why can neither A nor B sugars be added in the Bombay phenotype?

A

Because the H antigen is not produced due to the absence of fucose.

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28
Q

How do individuals with the Bombay phenotype type in ABO blood grouping?

A

They type as Group O.

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29
Q

What antibodies are present in the serum of individuals with the Bombay phenotype?

A

Anti-A, Anti-B, Anti-A,B, and Anti-H.

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30
Q

How does a patient with the Oh (Bombay) phenotype react with cells when they have Anti-H?

A

They will react with all cells except those from another Bombay individual.

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31
Q

How do reaction strengths vary when detecting the Oh phenotype?

A

Reaction strength varies according to the amount of H antigens on cells (SCI/SCII/Panel).

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32
Q

What is the result of antibody panels for a patient with the Oh phenotype?

A

They show positive reactions on all antibody panels.

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33
Q

What antigens can be found in soluble form in secretors?

A

A, B, and H antigens.

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34
Q

What happens when the Se gene is inherited?

A

An enzyme adds fucose to a Type 1 precursor substance.

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35
Q

What does it mean if you inherit the Se gene?

A

You are a secretor.

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36
Q

Which gene is dominant in determining secretor status, Se or se?

A

Se is dominant over se (silent allele/amorph).

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37
Q

What enzyme does the Se gene produce?

A

The FUT-2 enzyme.

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38
Q

What percentage of individuals are secretors?

A

80% of individuals.

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39
Q

What condition must be met for the A & B transferases to add their sugars to the tissue-type chain?

A

The Se gene must be present, in which case a soluble H antigen will be produced and allow for the addition of sugars from the A & B transferases.

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40
Q

Where are Lewis antigens produced?

A

Lewis antigens are produced and secreted by tissues on Type 1 precursor chains, not directly on the RBC membrane.

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41
Q

How do Lewis antigens appear on red blood cells (RBCs)?

A

Lewis antigens are absorbed onto the RBC membrane from tissues.

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42
Q

Where is the Le gene located?

A

The Le gene is located on Chromosome 19.

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43
Q

What is the silent allele in the Lewis system?

A

The le gene is the silent allele (amorph), which does not produce an enzyme.

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44
Q

What Lewis antigens can be present on RBCs?

A

Lea or Leb antigens.

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45
Q

What antigen expression is found in both RBCs and saliva when a person inherits the AB, HH, and SeSe genes?

A

RBC: A, B, H
Saliva: A, B, H

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46
Q

What antigen expression is found in the saliva of a person with the AB, HH, and sese genes?

A

None (no antigens in saliva).

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47
Q

What antigen expression is found in both RBCs and saliva when a person inherits the OO, HH, and SeSe genes?

A

RBC: H
Saliva: H

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48
Q

What antigen expression is found in the saliva of a person with the OO, HH, and sese genes?

A

None (no antigens in saliva).

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49
Q

How do the Le, H, and Se genes affect precursor chains in relation to ABO type?

A

Varying amounts of precursor chains are converted depending on the ABO type.

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50
Q

What substances can be found in secretions when the Le, H, and Se genes are present?

A

H, A, B, Lea, and Leb substances can be found in secretions.

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51
Q

What happens to most of the Lea in the presence of the Se gene?

A

Most of the Lea is converted to Leb by the Se gene.

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52
Q

Which substance is absorbed in significant amounts by red cells in the presence of the Se gene?

A

Red cells absorb only Leb in significant amounts.

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53
Q

How much Lea is typically found on red cells in the presence of the Se gene?

A

Red cells absorb only Leb in significant amounts.

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54
Q

How much Lea is typically found on red cells in the presence of the Se gene?

A

Trace or no Lea is found on red cells.

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55
Q

What antigen is produced when the Le, H, and sese genes are present?

A

Only Lea is produced.

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56
Q

What happens to the addition of sugars in individuals with the Le, H, and sese genes?

A

There is no further addition of sugars.

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57
Q

What antigen is absorbed by the red cell membrane when the sese gene is present?

A

The red cell membrane absorbs only Lea.

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58
Q

What soluble antigens are present in the plasma of individuals with the sese gene?

A

Plasma contains only Lea soluble antigens.

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59
Q

What soluble antigens are absent in individuals with the sese gene?

A

There are no H, A, or B antigens in soluble form.

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60
Q

How many Lewis genes are there?

A

There is only the LE gene.

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61
Q

Are there specific genes for Lea or Leb antigens?

A

No, there are no specific Lea or Leb genes.

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62
Q

Are Lea and Leb alleles of the same gene?

A

No, Lea and Leb are not alleles.

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63
Q

How many antigens absorb onto the RBC membrane in the Lewis system?

A

Only one antigen absorbs onto the RBC membrane.

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64
Q

What is the red cell phenotype for the genotype Le sese H?

A

Le(a+b-)

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65
Q

What antigens are found in secretions for the genotype Le Se H?

A

Lea, Leb, and H antigens.

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66
Q

What is the red cell phenotype for the genotype lele Se H?

A

Le(a-b-)

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67
Q

What antigens are found in secretions for the genotype lele sese hh?

A

None.

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68
Q

What is the frequency of the Le(a-b+) phenotype in white and black populations?

A

72% in whites and 55% in blacks.

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69
Q

What is the red cell phenotype for the genotype Le Se H?

A

Le(a-b+)

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70
Q

What is the usual Lewis antigen phenotype for newborns?

A

Newborns are usually Le(a-b-) and may be typed as Le(a+b+) until the transition to Le(a-b+) is complete.

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71
Q

Until what age is Lewis phenotyping considered unreliable?

A

Phenotyping is unreliable until 6 years of age.

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72
Q

How can Lewis antigen expression on RBC membranes change over time?

A

Antigens can be reabsorbed back into plasma, decreasing their expression on the RBC membrane.

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73
Q

How can pregnancy affect a woman’s Lewis antigen phenotype?

A

Pregnant women can experience a change in phenotype and be typed as Le(a-b-).

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74
Q

Which individuals can make Anti-Lea and Anti-Leb antibodies?

A

Le(a-b-) individuals.

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75
Q

Is Anti-Leb common in Le(a+b-) individuals?

A

No, Anti-Leb is rare in Le(a+b-) individuals.

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76
Q

Would an Le(a-b+) individual produce Anti-Lea?

A

No, Le(a-b+) individuals would not produce Anti-Lea.

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77
Q

What is the clinical significance of Lewis antibodies?

A

Lewis antibodies have no link to HDFN, do not cross the placenta, but can activate complement.

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78
Q

What class are most Lewis antibodies?

A

Most Lewis antibodies are IgM.

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79
Q

At what temperatures do Lewis antibodies optimally react?

A

They react at IS, 37°C, and occasionally with AHG.

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80
Q

How do enzymes affect Lewis antibodies?

A

Enzymes enhance the reactivity of Lewis antibodies.

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81
Q

What is a key characteristic of agglutination with Lewis antibodies?

A

Agglutination is easily dispersed, and neutralizing techniques are available.

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82
Q

How are antigens in the OBG systems grouped?

A

They are grouped according to similar antigens inherited by alleles at a single gene locus or linked loci.

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83
Q

What are the structural characteristics of antigens in the OBG systems?

A

Antigens can be carbohydrate or protein in structure.

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84
Q

Do the OBG systems display characteristics similar to ABO and Rh antigens and antibodies?

A

Yes

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85
Q

When do OBG system antigens typically develop?

A

OBG system antigens develop at birth.

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86
Q

What are some key characteristics of OBG system antibodies?

A

Antibodies are classified by their immunoglobulin class, tested through serology, and assessed for clinical significance, such as whether they cross the placenta or bind complement.

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87
Q

How do OBG system antigens react to enzymes?

A

Their reactions to enzymes vary based on the antigen structure.

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88
Q

What are the two major antigens in the Kell system?

A

K and k.

89
Q

What are the two major antigens in the Duffy system?

A

Fya and Fyb.

90
Q

What are the two major antigens in the Kidd system?

A

Jka and Jkb.

91
Q

What are the major antigens in the MNSs system?

A

M, N, S, and s.

92
Q

What are the two major antigens in the P system?

A

P1 and PK.

93
Q

What are the major antigens in the Ii system?

A

I and i.

94
Q

What are the two major antigens in the Lewis system?

A

Lea and Leb.

95
Q

What are some carbohydrate-based antigens in the major OBG systems?

A

ABO, Hh, Lewis, and P are carbohydrate-based antigens.

96
Q

Which protein in the Duffy system is a multi-pass protein, and how many passes does it have?

A

The Duffy protein is a multi-pass protein with 7 passes.

97
Q

How are antigens classified in the OBG systems based on structure?

A

Antigens can be classified as multi-pass proteins (e.g., Rh), single-pass proteins with carbohydrates (e.g., MNSs), or carbohydrate branches (e.g., ABO).

98
Q

What are multi-pass proteins in the major OBG systems?

A

Rh (12 pass), RhAg (12 pass), and Kidd are examples of multi-pass proteins.

99
Q

What are single-pass proteins with carbohydrate components in the major OBG systems?

A

MNSs are examples of single-pass proteins with carbohydrate components.

100
Q

What are the co-dominant alleles in the MNSs system?

A

M and N antigens, as well as S and s antigens, are co-dominant alleles.

101
Q

How are antigens in the MNSs system inherited?

A

Antigens are inherited by a complex pattern involving crossing over, gene recombination, and substitutions, similar to the Rh system.

102
Q

At what stage of life are MNSs antigens well-developed?

A

MNSs antigens are well-developed at birth.

103
Q

What is the phenotype frequency of M, N, S, and s antigens in the white population?

A

M: 78%
N: 72%
S: 55%
s: 89%

104
Q

What is the phenotype frequency of M, N, S, and s antigens in the African American population?

A

M: 74%
N: 75%
S: 31%
s: 93%

105
Q

Where are MNSs antigens integrated?

A

MNSs antigens are integrated into the cell membrane and are single-pass glycoproteins.

106
Q

What genes encode for the MNSs system?

A

The GYPA and GYPB genes encode for the MNS system on chromosome 4, inherited as a haplotype.

107
Q

What does Glycophorin A (GPA) code for in the MNSs system?

A

GPA codes for M and N antigens, with structures that differ based on the amino acid sequence.

108
Q

What does Glycophorin B (GPB) code for in the MNSs system?

A

GPB codes for S and s antigens, with structures that differ based on the amino acid sequence.

109
Q

When is the U antigen always present in the MNSs system?

A

The U antigen is always present when S or s is inherited.

110
Q

When is Anti-M clinically significant?

A

Anti-M can be clinically significant if it reacts at AHG and after prewarming. It is cold-reacting.

111
Q

What class of antibody is Anti-M, and what effect do enzymes have on it?

A

Anti-M is typically IgM (some IgG forms exist) and is destroyed by enzymes.

112
Q

Is Anti-N clinically significant, and what type of reaction does it exhibit?

A

Anti-N is clinically insignificant and is cold-reacting.

113
Q

What class of antibody is Anti-N, and what effect do enzymes have on it?

A

Anti-N is IgM and is destroyed by enzymes.

114
Q

What is the clinical significance of Anti-S and Anti-s?

A

Anti-S and Anti-s are red cell immune, cause transfusion reactions, and can cause Hemolytic Disease of the Fetus and Newborn (HDFN).

115
Q

What class of antibodies are Anti-S and Anti-s, and how do enzymes affect them?

A

They are IgG and are destroyed by enzymes.

116
Q

What is the clinical significance of Anti-U?

A

Anti-U is red cell immune, causes transfusion reactions, and can cause HDFN.

117
Q

What class of antibody is Anti-U, and how do enzymes affect it?

A

Anti-U is IgG and resistant to enzyme treatment.

118
Q

What are the main antigens in the Kell system?

A

K and k, Kpa and Kpb, Jsa and Jsb.

119
Q

Which Kell antigens are low-frequency?

A

K, Kpa, and Jsa.

120
Q

Which Kell antigens are high-frequency?

A

k, Kpb, and Jsb.

121
Q

Where is Kell glycoprotein expressed, and what is its structure?

A

Kell glycoprotein has extensive folding in the cell membrane and is expressed in tissues.

122
Q

How do sulfhydryl reagents like 2-ME, DTT, and AET affect Kell antigens?

A

These reagents disrupt disulfide bonds and destroy Kell antigens.

123
Q

How immunogenic are Kell antigens compared to other blood group antigens?

A

Kell antigens are highly immunogenic and rank second to the D antigen in immunogenicity.

124
Q

What antibody can be produced by individuals with the Kell null phenotype?

A

Anti-Ku.

125
Q

What is the most significant antibody within the Kell system?

A

Anti-K is the most significant antibody within the Kell system.

126
Q

How immunogenic is Anti-K compared to other blood group antibodies?

A

Anti-K is the most immunogenic after the D antigen.

127
Q

What class of immunoglobulin is typically seen with Anti-K?

A

Anti-K is usually IgG, though some IgM forms are seen.

128
Q

At what temperature does Anti-K react optimally?

A

Anti-K reacts optimally at the IAT phase.

129
Q

Do Kell antibodies bind complement?

A

Kell antibodies do not bind complement.

130
Q

What clinical conditions are Kell antibodies associated with?

A

Kell antibodies are associated with transfusion reactions and Hemolytic Disease of the Fetus and Newborn (HDFN).

131
Q

How does enzyme treatment affect Kell antibodies?

A

Enzymes have no effect on Kell antibodies.

132
Q

What percentage of the population is Kell negative?

A

More than 90% of the population is Kell negative.

133
Q

Why is Anti-k rare?

A

Anti-k is rare because k is a high-frequency antigen.

134
Q

What happens when the XK gene is not inherited?

A

The Kx antigen is not expressed on red cells.

135
Q

How does the absence of the Kx antigen affect the Kell blood group system?

A

It reduces the expression of the Kell blood group system antigens.

136
Q

What red cell abnormalities are associated with the McLeod phenotype?

A

Acanthocytes, which have spur-like projections, are present in individuals with the McLeod phenotype.

137
Q

What is the McLeod phenotype?

A

It is a condition associated with the absence of the Kx antigen and reduced expression of Kell antigens, leading to red cell abnormalities.

138
Q

Are Duffy antigens present at birth?

A

Yes, Duffy antigens are present at birth and detectable on fetal red cells.

139
Q

How many times does the Duffy glycoprotein span the membrane’s lipid bilayer?

A

It spans the membrane’s lipid bilayer 7 times.

140
Q

What are the co-dominant alleles in the Duffy system, and what do they code for?

A

FYA and FYB are co-dominant alleles that code for Fya and Fyb.

141
Q

What does the FY allele encode for in the Duffy system?

A

The FY allele encodes no identifiable Duffy antigen.

142
Q

How do enzymes like papain and ficin affect Duffy antigens and antibodies?

A

Duffy antigens and antibody reactions are susceptible to proteolytic degradation by enzymes, destroying them.

143
Q

What is the function of the Duffy glycoprotein related to chemokines?

A

It acts as a receptor for proinflammatory chemokines, aiding in the activation of white cells.

144
Q

What role do the Fya and Fyb antigens play in malaria?

A

Fya and Fyb antigens serve as receptors for the malarial parasites Plasmodium vivax and Plasmodium knowlesi.

145
Q

What is the phenotype that provides resistance to malaria in the Duffy system?

A

The Fy(a-b-) phenotype provides resistance to malaria.

146
Q

What is the significance of the Fy homozygous phenotype in African Americans?

A

The Fy(a-b-) phenotype has a high frequency in African Americans and provides resistance to malaria.

147
Q

How does the FY allele provide a selective advantage in certain geographic areas?

A

The FY allele provides a genetic selective advantage in areas where Plasmodium vivax is endemic, helping individuals resist malaria infection.

148
Q

Why is there a challenge in transfusing patients with sickle cell anemia and the FyFy genotype?

A

Because sickle cell anemia and the FyFy genotype can occur concurrently, making it difficult to find compatible blood.

149
Q

What does CBS perform to help with transfusion challenges in FyFy patients?

A

CBS performs genetic testing to determine the likelihood of a FyFy patient producing Anti-Fyb.

150
Q

What impact does the GATA1 mutation have on the Duffy system?

A

The GATA1 mutation impacts the expression of the Fyb antigen.

151
Q

Do patients with the FyFy genotype produce Anti-Fyb?

A

No, patients with the FyFy genotype do not produce Anti-Fyb.

152
Q

What type of blood can be given to Fy(a-b-) patients, making transfusions easier?

A

These patients can be given Fy(a-b+) blood, making it easier to find compatible blood.

153
Q

What is the clinical significance of Duffy antibodies?

A

Duffy antibodies are red cell immune, do not bind complement, and are clinically significant but an uncommon cause of HDFN. They can cause immediate and delayed transfusion reactions.

154
Q

What class of immunoglobulin are Duffy antibodies?

A

Duffy antibodies are typically IgG.

155
Q

How do enzymes affect Duffy antibodies?

A

Duffy antibodies are non-reactive after enzyme treatment because the enzymes degrade the antigens.

156
Q

What is unique about Anti-Fya compared to other Duffy antibodies?

A

Anti-Fya is more immunogenic compared to other Duffy antibodies.

157
Q

What antibodies can be produced by Fy(a-b-) individuals?

A

Fy(a-b-) individuals can produce Anti-Fya, Anti-Fy3, and Anti-Fy5.

158
Q

How immunogenic are Kidd antigens compared to other blood group antigens?

A

Kidd antigens do not rank high in terms of red cell immunogenicity.

159
Q

When are Kidd antigens detectable on fetal red blood cells?

A

Kidd antigens are detectable on fetal RBCs as early as 7-11 weeks of gestation and are fully developed at birth.

160
Q

What is the significance of Jk(a-b-) red cells in the Kidd system?

A

Jk(a-b-) red cells are more resistant to lysis in the presence of 2 M urea.

161
Q

What is the function of the JK glycoprotein?

A

The JK glycoprotein facilitates rapid urea transport across the red cell membrane.

162
Q

What are the co-dominant alleles in the Kidd system?

A

JKA and JKB are co-dominant alleles.

163
Q

Are Jka and Jkb antigens common in the population?

A

Yes, both Jka and Jkb are high-frequency antigens.

164
Q

What is the JK allele in the Kidd system?

A

The JK allele is a silent allele.

165
Q

How does complement activation occur in the Kidd system?

A

Due to the proximity of the antigens, when antibodies attach, complement can be activated.

166
Q

What is the result of complement activation in the Kidd system?

A

Complement activation can cause intravascular transfusion reactions.

167
Q

What are the clinical signs associated with Kidd antibodies?

A

Kidd antibodies are red cell immune, associated with delayed transfusion reactions, extravascular hemolysis, and can cause HDFN. They also bind complement.

168
Q

What class of immunoglobulin are Kidd antibodies?

A

Kidd antibodies are typically IgG.

169
Q

At what temperature do Kidd antibodies react optimally?

A

Kidd antibodies react optimally at the IAT phase.

170
Q

At what temperature do Duffy antibodies react optimally?

A

Duffy antibodies react optimally at the IAT phase.

171
Q

How do enzymes affect Kidd antibodies?

A

Enzymes enhance the reactivity of Kidd antibodies.

172
Q

Why can Kidd antibodies be difficult to detect in vitro?

A

Kidd antibodies often show weak reactivity in vitro, making them hard to detect and identify.

173
Q

How do Kidd antibody titers behave after immune stimulation?

A

After immune stimulation, Kidd antibody titers can rise and quickly decrease.

174
Q

In what situations do Kidd antibodies often appear?

A

Kidd antibodies often appear in combination with other antibodies.

175
Q

On which cells is the I antigen found?

A

The I antigen is found on almost all adult cells.

176
Q

What type of chains is the I antigen associated with?

A

The I antigen is associated with branched chains.

177
Q

Where is the i antigen predominantly found?

A

The i antigen is found in infants (cord blood).

178
Q

What type of chains is the i antigen associated with?

A

The i antigen is associated with linear chains.

179
Q

Over what period does the i antigen convert into the I antigen?

A

The i antigen converts into the I antigen over a 2-year period.

180
Q

Where are both I and i antigens found besides red cells?

A

Both antigens are present on the red cell membrane and found in body secretions.

181
Q

What is the clinical significance of Anti-I and Anti-i antibodies?

A

Anti-I is clinically insignificant, but strong Anti-I is associated with Mycoplasma pneumoniae infections and cold hemagglutinin disease, while strong Anti-i is associated with infectious mononucleosis and lymphoproliferative disease.

182
Q

What class of immunoglobulin are Anti-I and Anti-i antibodies?

A

They are typically IgM.

183
Q

At what temperature do Anti-I and Anti-i antibodies react optimally?

A

They react optimally at cold temperatures.

184
Q

How common is Anti-I among individuals?

A

Most individuals possess Anti-I, which is detectable at room temperature.

185
Q

What is a notable feature of Anti-I regarding complement binding?

A

Anti-I binds complement, and Anti-C3d can be used to detect the reaction.

186
Q

What technique is used to prevent reactions with Anti-I and Anti-i?

A

Prewarming technique can be used to prevent reactions.

187
Q

What is the compound antibody involving both I and i antigens?

A

Compound Antibody Anti-HI.

188
Q

In which individuals is Anti-P1 fairly common, and is it clinically significant?

A

Anti-P1 is fairly common in P2 individuals but is not clinically significant.

189
Q

What type of antibody is Anti-P1, and at what temperature does it react?

A

Anti-P1 is an IgM antibody that is cold-reacting and enhanced by enzymes.

190
Q

How can Anti-P1 antibodies be neutralized in testing?

A

Commercially purchased P1 substance is used to neutralize the Anti-P1 antibody.

191
Q

What type of antibody is Auto Anti-P, and what condition does it cause?

A

Auto Anti-P is an IgG antibody that causes clinically significant Paroxysmal Cold Hemoglobinuria (PCH).

192
Q

What is another name for Auto Anti-P, and how does it function?

A

Auto Anti-P is also known as the Donath-Landsteiner antibody (a biphasic hemolysin). It binds at low temperatures, complement is attached, and hemolysis occurs when body temperature is restored.

193
Q

What is the possible genotype for K-k+?

A

kk

194
Q

What is the possible genotype for K+k-?

A

KK

195
Q

What is the possible genotype for K+k+?

A

Kk

196
Q

What is the possible genotype for Fy(a-b+)?

A

FybFyb

197
Q

What is the possible genotype for Fy(a+b-)?

A

FyaFya

198
Q

What is the possible genotype for Fy(a+b+)?

A

FyaFyb

199
Q

What is the possible genotype for Jk(a-b+)?

A

JkbJkb

200
Q

What is the possible genotype for Jk(a+b-)?

A

JkaJka

201
Q

What is the possible genotype for Jk(a+b+)?

A

JkaJkb

202
Q

What is the possible genotype for M+N+S+s+?

A

MS/Ns or Ms/NS

203
Q

What is the possible genotype for M-N+S-s+?

A

Ns/Ns

204
Q

What is the possible genotype for M+N-S+s-?

A

MS/MS

205
Q

What is the possible genotype for M-N+S+s+?

A

NS/Ns

206
Q

What is the possible genotype for Fy(a-b-)?

A

FYFY

207
Q

An antibody commonly associated with delayed
transfusion reactions is:
a) Anti-Lua
b) Anti-S
c) Anti-Jkb
d) Anti-M

A

c) Anti-Jkb

208
Q

Which phenotype is associated with a resistance
to Plasmodium vivax?
a) Fy(a-b-)
b) Jk(a-b-)
c) Le(a-b-)
d) Lu(a-b-)

A

a) Fy(a-b-)

209
Q

Enzyme-treated reagent red cells used in
antibody identification enhance all of the following
antibodies except:
a) Anti-M
b) Anti-Jkb
c) Anti-Lea
d) Anti-i

A

a) Anti-M

210
Q

Glycophorin A and glycophorin B possess antigen
sites for which blood groups?
a) Duffy
b) Kidd
c) Lewis
d) MNSs

A

d) MNSs

211
Q

Alleles within the Lewis system include:
a) LE, le
b) Lea, Leb
c) Le, Se and H
d) Le, Le

A

c) Le, Se and H

212
Q

What procedure would help distinguish between an Anti-Fya and Anti-Jka?
a) Lowering of the pH of the patient’s plasma
b) Using an Rh control
c) Testing at a cooler temperature
d) Testing ficin-treated panel cells

A

d) Testing ficin-treated panel cells

213
Q

Anti-K
a) Agglutinates in the AHG phase of the antibody screen
b) Is usually IgM antibody
c) Does not agglutinate with K+k+ cells
d) Loses reactivity in the enzyme panel

A

a) Agglutinates in the AHG phase of the antibody screen

214
Q

Which of the antigens is poorly expressed on
cord blood cells?
a) K
b) M
c) Leb
d) D

A

c) Leb

215
Q

What is the most likely Lewis phenotype of a
non-secretor?
a) Le(a-b-)
b) Le(a+b+)
c) Le(a+b-)
d) Le(a-b+)

A

c) Le(a+b-)

216
Q

Which antigen system is not initially present on
red blood cells surface:
a) Duffy
b) Lewis
c) MNSs
d) P

A

b) Lewis

217
Q

A high-incidence antigen is present in:
a) No persons
b) Very low percentages
c) Different amounts of each person’s cells
d) A large percentage of individuals

A

d) A large percentage of individuals

218
Q

An antibody that reacts best at temperatures
less than body temperatures is:
a) Anti-I
b) Anti-K
c) Anti-k
d) Anti-s

A

a) Anti-I

Transfusion (8 decks)

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