Blood Bank - Blood Groups

Front 1

What blood group antigens are ENHANCED with enzymes (fiscin, papain)?

Back 1

ABO (including Lewis, I, P)
Rh
Kidd

"A Rhotten Kidd"

Front 2

What blood group antigens are DECREASED with enzymes?

Back 2

MNS
Duffy
Lutheran

"Duffy is destroyed"

Front 3

What blood group antigens are not effected by enzymes?

Back 3

Kell
Diego
Colton

Front 4

Name the genes responsible for adding a fucose to a Type 1 and Type 2 chain?

Back 4

Se gene (FUT2) to Type 1 chain (glycoprotein, found in secretions)

H gene (FUT1) to Type 2 chain (glycosphingolipid

Front 5

Blood group O patient makes what antibodies and why are they significant?

Back 5

Anti-A, anti-B, and anti-A,B

** Unlike antibodies from other patients, these are IgG and capable of crossing the placenta. Therefore, ABO is the MOST COMMON CAUSE OF HDN (though ABO expression is weak in the fetus so it's usually not that bad)

Front 6

Blood group A or B patient makes what type of antibodies?

Back 6

IgM, warm reacting

Front 7

What are the warm reacting antibodies?

Back 7

Rh, Kidd, SsU, Duffy, Kell

Usually IgG, require exposure

Front 8

What are the cold reacting antibodies?

Back 8

ABO, Le, MN, P, I

Usually IgM, naturally occur, usually clinically insignificant

Front 9

What % of A people are A1?

Back 9

80%

Front 10

What lectin agglutinates A1 but not A2?

Back 10

Dolichus biflorus

Front 11

What lectin agglutinates H?

Back 11

Ulex europaeus

(thus... O & A2 patients will react most)

Front 12

What blood group antigen is the point of entry for H pylori and Norwalk virus?

Back 12

Lewis b

Front 13

What type chain is the Lewis antigen system built on?

Back 13

Type 1 (in secretions & adsorbed onto the RBC)

Front 14

can a person be Lewis b+/a-?

Back 14

No
One Lewis gene
If Lewis b, you don't make anti-Lewis-a because you have Lewis a it is just outnumbered

Front 15

What neutralizes Lewis antibodies?

Back 15

Saliva from secretors

Front 16

What gene is required to make Lewis b?

Back 16

Se gene (80% of people)

Front 17

What % of people are Le(a-b-) by ethnic group, and thus make naturally occurring anti-Lewis-b, which also has H specificity?

Back 17

22% Af Am
6% Wh

**Le(a-b-) in kids increases susceptibility to UTI with EColi, candida

Front 18

Auto-anti-I associated with?

Back 18

Mycoplasma pna

Front 19

Auto-anti-i associated with?

Back 19

EBV

Front 20

Adults that lack I are usually what ethnicity? Classic association?

Back 20

Asian

Cataracts, HEMPAS (CDA2)

Front 21

Point of entry for parvovirus?

Back 21

P antigen

Front 22

What neutralizes P antibodies?

Back 22

Hydatid cyst fluid
Pigeon egg white

Front 23

What is the Donath-Landsteiner antibody?

Back 23

Auto-anti-P = IgG

Binds in the cold, hemolyzes in the warm
Causes PCH********

Classically associated with syphilis & viral infection in kids

Front 24

What is the main P group antigen?

Back 24

P1 is the ONLY real antigen

Most common phenotype is P+, P1+, Pk-

Front 25

What can happen if someone lacks all 3 P antigens

Back 25

Get anti-PP1Pk
Acute HTR & HDN & SPONTANEOUS ABORTIONS

Front 26

H + what = A blood group?
B?
O?

Back 26

A: N-acetylgalactosamine

B: galactose

O: nothing! just H antigen

Front 27

What antibodies does saliva neutralize?

Back 27

ABO
Lewis

Front 28

What antibodies does serum neutralize?

Back 28

Chido, Rogers

Front 29

What antibody does urine neutralize?

Back 29

Sda

Front 30

What is the genotype of a Bombay individual?

Back 30

hh/sese

lack both H and Se genes

Look like O on testing

Front 31

What antibodies does a Bombay individual make?

Back 31

Anti-A
Anti-B
Anti-H *** Must use Bombay donor for blood

Front 32

What is the acquired B phenotype?

Back 32

In a patient that is blood group A, exposure to enteric gram negative organisms can strip off the N-acetyl group and appear to have WEAK expression of B antigen.

These patients FORWARD type as AB, reverse as A

Front 33

What lectin is helpful in diagnosing acquired B?

Back 33

BS1 lectin. will NOT agglutinate acquired B.

Front 34

What is the Parabombay phenotype?

Back 34

hh but some Se

Can make A and B chains (if they have the genes) in secretions but not on RBCs.

Will naturally make ALLO-ANTI-H so must use Bombay donor

Front 35

What is the order of blood type among Caucasians?
African Americans?

Back 35

C: R1 > r > R2 > R0

A: R0 > r > R1 > R2

Front 36

Peripheral blood finding in Rhnull?

Back 36

stomatocytes

Front 37

Peripheral blood finding in McLeod?

Back 37

Acanthocytes

Front 38

Important facts about Kidd

Back 38

Jka > Jkb

Fixes complement! (unusual for an IgG)

Marked dosage effect
(and therefore usually NOT associated with HDN)

Wanes over time = classic anemnestic response, DHTR

Front 39

Are Rh antibodies IgG or IgD?

Back 39

IgG
Warm reacting
Require previous exposure
Extravascular hemolysis

Front 40

If a blood donor tests as D negative on routine testing, what must be done?

Back 40

Test for weak D with an IAT

Front 41

Do weakD moms need Rhogam if they have a D+ baby?

Back 41

No.

This is different than partial D moms, who do need prophylaxis

Front 42

What is weak D and what are the common causes?

Back 42

Quantitative defect in D antigen

Usually a point mutation in RHD
OR a "C in trans" (RHCe on opposite chain) can inhibit D expression

Front 43

What is partial D and what are the causes?

Back 43

Qualitative defect in D antigen

RHD mutations affecting the exterior of the D antigen; people can form antibodies to the missing parts of D

On testing, will find anti-D in a D+ patient

Front 44

What is the f antigen?

Back 44

Present when ce is inherited together (r, R0)

Front 45

What would you suspect if a D- patient gets anti-D, anti-C despite no exposure?

Back 45

G antigen. This is present when either C or D is present.

Must give C-D- blood

Front 46

What chains make up the MNS system, and what bug are they receptors for?

Back 46

Glycophorin A (MN)
Glycophorin B (SsU)

P. falciparum!

Front 47

Are M & N antibodies IgM or IgG?

Is their activity increased, decreased, or no change with enzymes?

Back 47

IgM! cold reacting, naturally occurring, usually insignificant

Decreased (DUFFY, MNS)

Front 48

Are S,s,U antibodies IgM or IgG?

Back 48

IgG

warm reacting
requiring exposure
significant

Front 49

What is the lectin for N?

Back 49

vicea graminea

Front 50

What is more common:
M or N?
S or s?
U?

Back 50

M = N

s>S

U is UNIVERSAL

Front 51

Because glycophorin B "looks" like the N antigen, most people will not form N antibodies even if they are N-. Exception?

Why do we care if someone makes Anti-N - aren't these clinically insignificant?

Back 51

2% of African Americans lack glycophorin B. They can't make S,s, or U (!!!!). Thus the presence of an anti-N antibody is a marker for someone that might be able to make an anti-U, which would be very very bad, since U is universal

Front 52

Auto-anti-N seen in?

Back 52

Hemodialysis

Front 53

Duffy. IgG or M?

Back 53

IgG (warm, exposure, significant)

Front 54

Fy (a-, b-) resistant to?

Back 54

P. vivax.

68% AA

Front 55

Cold reacting antibodies

Back 55

ABO, lewis, I, P
MN

Front 56

Do we care about kell?

Back 56

YES. Can cause severe HDN, AHTR

Front 57

Which is more common: K or k?

Back 57

k. High frequency (~99.8%!)

K is low frequency (9%Wh, 2%AA)

Anti-K is common and VERY important

Front 58

What is Kx?

Back 58

Not a true antigen. Structural. When Kx decreases, Kell antigens decrease too.

Front 59

What is McLeod phenotype?

Back 59

Absence of Kx. All kells are decreased. Make anti-Kx.

Hemolytic anemia with acanthocytes
Myopathy, ataxia, neuropathy, cardiomyopathy

Associated with CGD!!!!!!! (infections with staph)

Front 60

Name 2 HTLA (high titer, low avidity) antigens?

Back 60

Chido
Rogers

Front 61

These antibodies show dosage

Back 61

Kidd (Jk)
Rh (except D)
Duffy
MNS

Front 62

What are the carbohydrate antigens? What are their features?

Back 62

ABO
Lewis
I
P

Naturally occurring
IgM
Cold reacting
Agglutinating

(i originally thought M&N were in this group but apparently not)

Front 63

What chromosome are the genes on that code for ABO?

Rh?

Back 63

9q

6

Front 64

Ceppelli effect

Back 64

Weak D due to C in trans

More common in African Americans

Front 65

If someone is anti-E, what else are they probably?

Back 65

Anti-c

Common practice to give E neg, c neg blood to someone with anti-E. (R1 blood has this)
Anti-c is a common cause of DHTR

Front 66

How to destroy a Kell antigen?

Back 66

ZZAP it! (also DDT)

They are otherwise unaffected by enzymes

Front 67

HTLA antibodies that are usually clinically significant

Back 67

Cartwright
Holley
Gregory

Front 68

Breastmilk neutralizes what antibody?

Guinea pig urine?

Back 68

I

Sda

Front 69

Rh(null) affects what blood antigens?

Back 69

Lack LW, Fy5
Weakened S,s,U

STOMATOCYTOSIS

Front 70

What genes are located within the MHC complex in chromosome 6?

Back 70

HFE (hemochromatosis)
TNF
21-hydroxylase
complement

Front 71

What is the approximate risk of a serious in utero hemorrhage in a fetus affected by NATP?

Back 71

50%

Front 72

Dosage

Back 72

MNS
Kidd
Duffy
CcEe

Front 73

Which antigen is made when altered by bacterial neuraminidase?

Back 73

T, Tn, Tk
Transience & goes away post infection

Cad is a rare inherited antigen

Front 74

Polyagglutination

type of antibody?
test?

Back 74

T, Tn, Tk, Cad
IgM
Naturally occurring IgM antibodies in adults

the test is that they are agglutinated by adult but not cord serum