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171 Cards in this Set
- Front
- Back
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Landsteiner
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1901 ABO Blood Groups discovered
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Bernstein
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1924 inheritance of ABO blood groups
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The forward grouping of a patient showed no agglutination of patient cells with antiA, antiB, or anti A-B reagent antisera. The reverse grouping showed agglutination with A1 and B cells. What is this persons ABO group?
a) A b) B c) AB d) O |
d) O
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The Rh antibody agglutinates what percentage of red cells.
a) 15% b) 85% c) 50% d) 35% |
b)85%
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Where are ABH substances detected in secretors?
a) tears b) saliva c) milk d) all of the above |
d) all of the above
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Why is determination of Rh status crucial for obstertric patients?
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All Rh negative mothers are possible candidates for Rh immune globulin
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What ABO group contains the least amt. of H substance?
a) A1 b) A2 c) A1B d) A2B |
c) A1B
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How are the Rh antigens inherited?
a) X linked recessive b) codominant alleles c) X linked dominant d) none of the above |
b) codominant alleles
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What is the source of anti A1 lectin?
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Dolichos biflourus
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Most Rh antibodies are of what immunoglobulin class?
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IgG
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Two drops of serum are added to one drop of A1 cells, and two drops are added to one drop of B cells; the two tubes are centrifuged. The tubes show reactivity when read macroscopically. This is an example of:
a) forward grouping b) reverse grouping c) antibody screening d) crossmatch |
b) reverse grouping
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What clinical manifestation may be associated with the Rhnull syndrome
a) reticulocytosis b) stomatocytosis c) low hemoglobin d) all of the above |
d) all of the above
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An elderly patient is documented as being type O. The forward grouping is negative with anti A and anti B. The reverse grouping show not reactivity with A1 and B cells. What can be done to correct the discrepancy?
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incubate patient serum and reagent cells for 15 minutes at room temp.
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Which of the following Rh antigens is the most immunogenic?
a) D b)C c)e d)E |
a) D
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What immunodominant sugar is responsible for H specificity?
a) D-galactose b) L-fucose c) N-acetyl-D-galactosamine d) D-glucose |
b) L-fucose
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The ABO group antibodies are primarily:
a) alloantibodies b) autoantibodies c) naturally occuring d) drug induced |
c) naturally occuring
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What doe the hh genotype refer to?
a) Lewis b) Sid c) Bombay d) Kell |
c) Bombay
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What is the only possible phenotype of an offspring produced from two group O parents.
a) A b) B c) AB d) O |
d)O
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Which blood group contains the highest concentration of H antigen?
a) A2 b) B c) AB d) O |
d) O
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Rh immune globulin is effective in preventing which type of hemolytic disease of the newborn (HDN)?
a) anti C b) anti E c) anti D d) anti C |
c) anti D
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What is the frequency of E antigen in the general population?
a) 85% b) 15% c) 98% d) 30% |
d) 30%
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A patient was previously typed as blood group O. Forward grouping was negative with Anti A and Anti B. Reverse grouping show reactivity with A1 cells and B cells. The tech. reported patients type as A. What technical error occured?
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Clerical error
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What immunodominant sugar is responsible for B specificity?
a) D galactose b) L fuctose c) N acetyl D galactosamine d) D glucose |
D galactose
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An Ab male mates with another AB female. What could be the genotype of the offspring?
a) AB b) AA c) BB d) All of the above |
d) all of the above
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What percentage of the type A population are A1?
a) 80 b) 50 c) 20 d) 10 |
a) 80%
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Which substance must be formed before A or B specificity is determined?
a) I b) O c) Bombay d) H |
d) H
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Reverse grouping was performed on an AB person. The tech. observed a very weak agglutination macroscopically. The cells appeared as "stacked coins" under a microscope. Which reagent should be added to the tube and recentrifuged in an attempt to resolve the discrepancy?
a) serum b) saline c) water d) LISS |
b) saline
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The Rh gene is located on which chromosome?
a) 1 b) 7 c) 9 d) 11 |
a) 1
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What did Landsteiner discover?
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ABO blood groups
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What did Bernstein discover?
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inheritance of ABO blood groups
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The immunodominant suger responsible for blood group H specificity is:
a) L fuctose b)N acetyl D galactosamine c) d galactose d) uridine disphosphate N acetyl D galactoseH gene immunodominant sugar is |
L Fucose
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The immunodominant suger responsible for blood group A specificity is:
a) L fuctose b)N acetyl D galactosamine c) d galactose d) uridine disphosphate N acetyl D galactose |
N acetyl D galactosamine
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The immunodominant suger responsible for blood group B specificity is:
a) L fuctose b)N acetyl D galactosamine c) d galactose d) uridine disphosphate N acetyl D galactoseB gene immunodominant sugar is |
D galactose
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The immunodominant suger responsible for blood group O specificity is:
a) L fuctose b)N acetyl D galactosamine c) d galactose d) no H genes - silent amorph |
no H genes are converted - silent amorph
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The order of inheritance of Hh and ABO genes is
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O> A2> B> A2B> A1> A1B
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Bombay phenotype
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Oh
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What does naturally occuring?
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born with antigens from parents
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What is HDN and what doe it do?
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Hemolytic Disease of the Newborn - destruction of RBCs of the fetus and newborn
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What antibodie is involved in HDN?
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IgG because it cannot cross placenta
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In HDN the fetus is _______ and the mother is ________ for the same antigen
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postive, negative
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Where does HDN develop?
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In utero
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fWhat is fetomaterial hemorrahage?
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seepage of fetal RBC's
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ABO HDN occurs in what pregnancy
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1st time pregnancy
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In ABO HDN the mother is type O and the child is ______ antigen
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A or B
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In the case of ABO HDN what does the infant present with?
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Jaundice
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Testing is done for ABO HDN after birth on?
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The cord blood
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How many time do you wash to remove Whartons Jelly?
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3X
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What are the treatments used for ABO HDN?
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Phototheraphy and Exchange transfusion
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Phototherapy is
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exposure to artificial or sunlight to reduce jaundice
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Exchange transfusion involves
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removing new born RBCs and replaced them with donor cells
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What type of blood do you give fetus?
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CMV negative
Leukoreduced Irradiated Fresh whole blood Group O, D negative (material blood if possible) |
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In Rh HDN the mother is ________ and child is ________,
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D negative, D positive
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What is the most severe from of HDN?
Rh HDN ABO HDN |
Rh HDN
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Fetal Maternal Hemorrhage is caused by
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Placental membrane hemorrage
Trauma to abdomal Aminocentesis Abortion |
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IgG has a half life of
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25 days
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RBC destruction and anemia cause bone marrow to release erythroblasts hence the name
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erythroblastosis fetalis
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Heptosplenomegaly
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enlarged liver and spleen
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Hypoproteinemia leads to cardiac failure edema called
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Hydrops fetalis
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Unconjugaged (indirect) bilirubin can reach toxic levels of
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(18 - 20 mg/dl)
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Kernicterus
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high levels of unconjugated bilirubin can lead to brain damage
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IgG reacts at what temperature?
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room temperature
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The newborn baby has no antibodies for how many weeks?
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6 weeks
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what is given to the mother to prevent immunization to the D antigen
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Rhlg or RhoGAM
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What is the qualitative measure of fetomaterial hemorrhage?
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Rosette Test
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What ithe quantitative measure of fetomaterial hemorrhage?
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Kleihauer Betke acid elution
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Which antigen is highly immunogenic?
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D antigen
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Genetics
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study of inheritance
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Gregor Mendel
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transmission of characteristics from parent to offspring
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How many chromosomes do humans have?
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23 pairs or 46 single
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Sex cell contains how many chromosomes?
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23 single
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What does DNA stand for?
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Deoxyribionucleic Acid
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Who was credited with structure of DNA
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Watson and Crick
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What are the 4 bases of DNA?
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Adenine, Guanine, cytosine, thymine
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What does adenine pair with?
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Thymine
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What does cytosine pair with?
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Cytosine
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Mitosis
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2 identical daughter cells
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Meiosis
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creates 4 unique rather than 2 identical
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How long is a DNA strand?
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approximately 2 meters long
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What doe the DNA strand form?
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a double spiral
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What doe RNA stand for?
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Ribonucleic Acid
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What are the 3 types of RNA?
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Ribosomal RNA rRNA
Messenger RNA mRNA Transfer RNA tRNA |
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In RNA what does Adenine pair with instead of Thymine
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Uracil
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What is Rh Null?
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A condition that occurs when red cells have no Rh antigen sites
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What is D-Deletion?
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No reaction occurs when RBC's are tested with anti E, anti e, anti C or anti c
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C in trans posiiton to D
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Dce/dCe
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C in cis position to D
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DCe/dce
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What position is the weak D?
a)trans b) cis |
a)trans
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What are the Rh Antigens?
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D, C, E, c and e
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If you are Rh + you
a) do not have the D antigen b) have the D antigen |
b) have the D antigen
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Fisher Race
D d C c E e What is the Wiener Rh Hr terminology? |
Weiner Rh
D - Rh 0 d - r C - rh' c - hr' E - rh" e - hr" |
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Fisher Race
D d C c E e What is the Rosenfeld terminology? |
Fisher Race
D - Rh1 d - C - Rh2 c - Rh4 E - Rh 3 e - Rh 5 |
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What is the Cw Ag?
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A variant Ag
Allele of C/c |
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What % of the population has the Cw Ag?
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2-4% in the white population
rare in blacks |
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what animal was used in Landsteiner and Wiener Rh theory?
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Rhesus monkey
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Rh O or D antigen
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are very immunogenic
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Group 1 ABO discrepancies in weak or missing AB
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New born or elderly
Leukemia or lymphoma Immunosuppressive drug therapy Bone Marrow transplant |
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Resolution Group I
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Enhance weak reaction with 15-30 min incubation at room temp.
If this dosent work try at 4C |
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What is Chimerism?
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rare 2 cell population in 1 person
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What is ABO discrepancies?
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forward and reverse grouping do not match as expected
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What could cause ABO discrepancies?
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technical errors
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What are some technical errors that can cause ABO discrepances?
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Incorrect ID of patient sample
and test tubes Cells suspension too light or heavy Clerical error Missed hemolysis results Failure to add reagents/follow instructions Contaminated reagents |
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What is Whartons Jelly?
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A gelatinous intercellular substance consisting of primitive connective tissue of the umbilicol cord.
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What are the fluids which A, B, and H substances can be detected in secretors
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Saliva, Tears, Urine, Digestive Juices, Bile, Milk, Amniotic fluid, and pathogenic fluids: pleural, periotoneal, pericardial, ovarian cyst.
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ABO frequencies are:
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Group O, 45%
Group A, 40% Group B, 11% Group AB, 4% |
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ABO blood group has naturally occuring antibodies that are primarily _______.
a) IgG b)IgM c)IgA d)IgD |
b) IgM
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ABO genes like those of most other blood groups are inherited in a ___________ manner
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codominant
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The immunodominant suger responsible for blood group A specificity is:
a) L fuctose b)N acetyl D galactosamine c) d galactose d) uridine disphosphate N acetyl D galactose |
b) N acetyl D galactosamine
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What ABH substance would be found in the saliva of a group B secretor?
a)H b)H and A c) H and B d) H, A, and B c) H and B |
c) H and B
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What ABH substance would be found in group A secretor?
a)H b)H and A c) H and B d) H, A, and B |
b) A and H
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What ABH substance would be found in group O secretor?
a)H b)H and A c) H and B d) H, A, and B |
a) H
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What ABH substance would be found in group AB secretor?
a)H b)H and A c) H and B d) H, A, and B |
d) H, A, and B
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A1 make up _____of all Group A individuals
a) 20% b) 30% c) 80% d) 25% |
c) 80%
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What ABH substance would be found in the saliva of a group B secretor?
a)H b)H and A c) H and B d) H, A, and B c) H and B |
c) H and B
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What ABH substance would be found in group A secretor?
a)H b)H and A c) H and B d) H, A, and B |
b) A and H
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What ABH substance would be found in group O secretor?
a)H b)H and A c) H and B d) H, A, and B |
a) H
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What ABH substance would be found in group AB secretor?
a)H b)H and A c) H and B d) H, A, and B |
d) H, A, and B
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A1 make up _____of all Group A individuals
a) 20% b) 30% c) 80% d) 25% |
c) 80%
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The major immunoglubulin class of anti B in a group A individual are:
a) IgM b) IgG c) IgM and IgG d) IgM and IgA |
a) IgM
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What percentage of the world population are HH or Hh?
a)89% b)50% c)99.9% d)78% |
c)99.9%
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Which of the following best describes mitosis:
a) genetic material is quadruplicated b) Genetic material is duplicated c) Genetic material is triplicated d) Genetic material is halved |
b) Genetic material is duplicated
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When a recessive train is expessed it means that:
a) One gene carrying the trait was present b) Two genes carrying the trait was present c) No gene carrying the trait was present d) The trait is present but difficult observe |
b) two genes carrying the trait is present
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In a pedigree, the "index case" is another name for:
a) stillbirth b) Consanguineous mating c) Propositus d. Monozygotic twins |
c) Propositus
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What four nitrogenous bases makes up DNA
a) Adenine, Leucine, guanine, thymine b) Alanine, cytosine, guanine, purine c) Isoleucine, lysine, uracil, leucine d) Adenene, cytosine, guanine, thymine |
d) adenine, cytosine, guanine, thymine
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Protein and Peptides are composed of:
a) golgi bodies grouped together b) paired nitrogenous bases c) nucleur basic particles d) linear arrangement of amino acids |
d) linear arrangements of amino acids
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Which phenotype would not result in the mating of a Jk (a+b+) female and a Jk (a+b+)male.
a) Jk (a+b-) b) Jk (a+b+) c) Jk (a-b+) d) Jk (a-b-) |
d) Jk (a-b-)
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Exon refers to:
a. the part of a gene that contains non sense mutations b. The coding region of a gene c. the noncoding region of a gene d. the enzymes used to cut DNA into fragments |
b. the coding part of a gene
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PCR technology can be used to:
a) amplify small amts of DNA b) Isolate intact nucleur RNA c) Digest genome DNA into small fragments d) Repair broken pieces of DNA |
a. amplify small amts of DNA
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Transcription can be defined as:
a) introduction of DNA into cultured cells b) reading of mRNA by the ribosome c) Synthesis of RNA using DNA as a template d) removal of exteral sequences to form a mature RNA |
c) synthesis of RNA using DNA as a template
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When a man posesses a phenotypic trait that he passes to his daughters and none of his sons, the trait is said to be:
a) X linked dominant b) X linked recessive c) autosomal dominanat c) autosomal rececessive |
a)X linked recessive
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DNA is replicated:
a) semiconservatively from DNA b) in a random manner from RNA c) by coping protein sequences from RNA d) by first copying RNA from protein |
a) semiconservatively from DNA
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RNA is processed:
a) after RNA is copied from the DNA template b) After protein folding and unfolding on the ribosome d) before DNA is copied from DNA template |
a) after RNA is copied from DNA template
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Meiosis is necessary to:
a) keep the N number of the cell changing within populations b)Prepare RNA for transciption c) Generate new DNA sequences in daughter cells |
c) generate new DNA sequences in daughter cells
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The Rh system was first recognized in a case report about what disorder?
a) hemolytic transfusion reaction b) Hemolytic disease of the newborn C) Circulatory overload d) autoimmune hemolytic anemia |
a) hemalytic transfusion reaction
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What antigen is found in 85% of the white population and is always significant for transfusion purposes?
a. d b. d c. D d. E e. e |
c) D
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How are weaker than expected reactions with anti D typical reagents categorized?
a. Rhmod b. Partial D c. DAT positive d. Dw |
d) Partial D
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Cells carrying a week D antigen require the use of what test to demonstrate its presence?
a) indirect antiglobulin test b) direct antiglobulin test c) microplate test d) warm auto absorbtion test |
a) indirect antiglobulin test
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How are Rh antigens inherited?
a) autosomal recessive alleles b) sex linked genes c) codominant alleles d) x linked |
c) codominat alleles
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Biochemically speaking, what type of molecules are Rh antigens?
a) glycophorins b) simple sugars c) proteins d) lipids |
C) proteins
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Rh antibodies react best at what temperature (C)
a. 22 b. 18 c. 15 d. 37 |
d. 37
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Rh antibodies are primarily of which immunoglubulins class?
a. IgA b. IgM c. IgG d. IgD e. IgE |
c. IgG
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Rh antibodies have been associated with which one of the following clinical conditions?
a) erythroblastosis fetalis b) thrombocytopenia c) Hemolytic transfusion reactions d) Hemophilia A e) Both A and C |
e) Both A and C
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What do Rh null cells lacks:
a) Lewis Antigens b) Normal oxygen carrying capacity c) Rh antigens d) MNS antigens |
c) Rh antigens
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What antigen system is closely associated phenytypically with Rh?
a) McCoy b) Lutheran c) Duffy d) LW |
d. LW
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Anti LW will not react with which of the following
a) Rh postive RBCs b) Rh negative RBC's c) Rh null RBCs d) Rh 33 RBCs |
c) Rh null RBC's
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The forward grouping of a patient showed no agglutination of patient cells with anit A, anti B, B reagent antisera. The reverse grouping showed agglutination with A1 and B cells. What is this person's ABO group?
a) A b) B c) AB d) O |
D) O
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The forward grouping of a patient showed no agglutination of patient cells with anit A, anti B, B reagent antisera. The reverse grouping showed agglutination with A1 and B cells. What is this person's ABO group?
a) A b) B c) AB d) O |
D) O
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The forward grouping of a patient showed no agglutination of patient cells with anit A, anti B, B reagent antisera. The reverse grouping showed agglutination with A1 and B cells. What is this person's ABO group?
a) A b) B c) AB d) O |
D) O
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The forward grouping of a patient showed no agglutination of patient cells with anit A, anti B, B reagent antisera. The reverse grouping showed agglutination with A1 and B cells. What is this person's ABO group?
a) A b) B c) AB d) O |
D) O
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Why are premature newborns more likely to require exchange transfusions that full term infants?
a) premature newborns are deficient in carrier protein (albumin) for biliruben. b) Premature newborns have excess indirect bilirubin due to placental transfer of maternal bilirubin c) premature newborn livers are too underdeveloped to conjugate bilirubin r |
c) premature newborn livers are too underdeveloped to conjugate bilirubin
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Why are premature newborns more likely to require exchange transfusions that full term infants?
a) premature newborns are deficient in carrier protein (albumin) for biliruben. b) Premature newborns have excess indirect bilirubin due to placental transfer of maternal bilirubin c) premature newborn livers are too underdeveloped to conjugate bilirubin r |
c) premature newborn livers are too underdeveloped to conjugate bilirubin
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Why are premature newborns more likely to require exchange transfusions that full term infants?
a) premature newborns are deficient in carrier protein (albumin) for biliruben. b) Premature newborns have excess indirect bilirubin due to placental transfer of maternal bilirubin c) premature newborn livers are too underdeveloped to conjugate bilirubin r |
c) premature newborn livers are too underdeveloped to conjugate bilirubin
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Why are premature newborns more likely to require exchange transfusions that full term infants?
a) premature newborns are deficient in carrier protein (albumin) for biliruben. b) Premature newborns have excess indirect bilirubin due to placental transfer of maternal bilirubin c) premature newborn livers are too underdeveloped to conjugate bilirubin r |
c) premature newborn livers are too underdeveloped to conjugate bilirubin
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How are units for exchange transfution prepared:
a) group O+ red cells and group O plasma b) group O- red cells and group A plasma c) group O- red blood cells and group AB plasma d) group O+ red cells and group B plasma |
c) group O- red blood cells and group AB plasma
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How are units for exchange transfution prepared:
a) group O+ red cells and group O plasma b) group O- red cells and group A plasma c) group O- red blood cells and group AB plasma d) group O+ red cells and group B plasma |
c) group O- red blood cells and group AB plasma
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How are units for exchange transfution prepared:
a) group O+ red cells and group O plasma b) group O- red cells and group A plasma c) group O- red blood cells and group AB plasma d) group O+ red cells and group B plasma |
c) group O- red blood cells and group AB plasma
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How are units for exchange transfution prepared:
a) group O+ red cells and group O plasma b) group O- red cells and group A plasma c) group O- red blood cells and group AB plasma d) group O+ red cells and group B plasma |
c) group O- red blood cells and group AB plasma
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Which of the following treatments use ultraviolent light to treat hyperbilirubinemia after the infant is delivered?
a) phototherapy b) plasma exchange c) aminocentesis d) electrophoresis |
a) phototherapy
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Which of the following treatments use ultraviolent light to treat hyperbilirubinemia after the infant is delivered?
a) phototherapy b) plasma exchange c) aminocentesis d) electrophoresis |
a) phototherapy
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Which of the following treatments use ultraviolent light to treat hyperbilirubinemia after the infant is delivered?
a) phototherapy b) plasma exchange c) aminocentesis d) electrophoresis |
a) phototherapy
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Which of the following treatments use ultraviolent light to treat hyperbilirubinemia after the infant is delivered?
a) phototherapy b) plasma exchange c) aminocentesis d) electrophoresis |
a) phototherapy
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In which type of hemolytic disease of the newborn (HDN) the first born is affected?
a) ABO b) Rh c) Lewis d) P |
a) ABO
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In which type of hemolytic disease of the newborn (HDN) the first born is affected?
a) ABO b) Rh c) Lewis d) P |
a) ABO
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In which type of hemolytic disease of the newborn (HDN) the first born is affected?
a) ABO b) Rh c) Lewis d) P |
a) ABO
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In which type of hemolytic disease of the newborn (HDN) the first born is affected?
a) ABO b) Rh c) Lewis d) P |
a) ABO
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In order for the mother to be considered for RHIg, her Rh type must be and her newborn must be _______.
a) Du Positive/Rh negative b) Rh Negative/Rh positive c) Du negative/Du negative d) Rh Postive/Rh negative |
b) Rh Negative/Rh positive
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What is the cause of hemolytic disease of the newborn (HDN)?
a) destruction of the red blood cells (RBCs) of the mother by autoantibody b) destruction of the RBC's of the fetus by antibody produced by the mother c) destruction of the RBC's of the fetus by autoantibody d) destruction of the RBC's of the mother by antibody produced by the fetus |
b) destruction of the RBC's of the fetus by antibody produced by the mother
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Which of the following assays is used to calculate the amount of fetomaterial hemorrhage in postpartum specimen?
a) antibody specimen b) Kleihauer Betke test c) rosette test d) solid phase adherence test |
b) Kleihauer Betke test
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Rhogam should be given within how many hours after delivery?
a) 24 b) 48 c) 36 d) 72 |
d) 72
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Which of the following mother/infant blood types would be considered at risk for ABO hemolytic disease of the new (HDN)?
a) Mother is group O; baby is group B b) Mother is group O; baby is group O. c) Mother is group AB; baby is group B d) Mother is group A; baby is group O |
a) mother is group O; baby is group B
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What life threatning disorder is characterized by a severe anemia, effusions, and asites from heptamegaly and splenomegaly?
a) thalassemia b) sicke cell anemia c) hereditary persistence of fetal hemoglobin d) hydrops fetalis |
d) hydrops fetalis
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Why is reverse grouping omitted in neonate ABO grouping?
a) maternal ABO antibody is identical to newborn ABO antibody b) Maternal antibodies mask the ABO antibodies of the neonate. c) newborns do not produce isoagglutination of their own. d) none of the above |
c) newborns do not produce isogluttinins of their own
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