Exam 13 - Heme50 - Transfusion

Front 1

What is the #1 blood group system as far as for transfusion medicine?

Back 1

ABO system

Front 2

look at slide 17

Back 2

ok

Front 3

Formation of A, B, and H RBC Antigens:

The ABO genes don’t code for the A antigen or B antigen directly.

They code for specific ... that add sugars to a basic precursor substance.
-The precursor substance on RBCs is referred to as type ... precursor substance.

Back 3

glycosyltransferases
2

Front 4

Glycosyltransferases and Immunodominant Sugars:

alpha-2-L-fucosyltransferase
-Gene and antigen ...
-L-fucose

alpha-3-N-acetylgalactosaminyltransferase
-gene and antigen ...
-N-acetyl-D-galactosamine

alpha-3-D-galactosyltransferase
-gene and antigen ...
-D-galactose

Back 4

H
A
B

Front 5

look at slide 23

Back 5

ok

Front 6

A subgroups:

Major Subgroups of A with Strong Reactions
-A1: 80% of all Group A
-A2: 19% of all Group A

Together, A1 and A2 count as 99% of all group A.

Minor Subgroups of A with Weak Reactions (<1% of all Group A)
-A3, Ax, Aend, Am, Ay, Ael

An A2 person if exposed, will make an ... antibody.

Back 6

anti-A1

Front 7

Bombay phenotypes (Oh):

Homozygous ...

Result:
-No H substance formed
-ABO genes can’t be expressed
-ABH antigens can’t be formed on the RBC

Back 7

hh

Front 8

Fisher-race: The DCE terminology:

Genetics:
-Each person inherits a set of ... genes from each parent.
*One D or d, one C or c, and one E or e.
-The combination of maternal and paternal haplotypes determines one’s genotype and dictates one’s phenoytpe.

Back 8

Rh

Front 9

Rh Antibodies:

Most Rh antibodies are ....

Causes of Rh Antibody Production:
-... and ...

The antigens of the Rh system are very good at provoking an immune response.
-... is the most immunogenic of all of the Rh antigens!!
-Fact:Exposure to <0.1 ml of Rh positive RBCs can stimulate the production of an anti-D antibody in an Rh negative patient.

Back 9

IgG
Pregnancy and Transfusion
D

Front 10

Facts About the Rh Antibodies:

IgM Rh antibodies are formed first, followed by a transition to IgG Rh antibodies.

Rh antibodies often persist for years

Considered clinically significant

Typically, Rh antibodies don’t bind complement:
-Result: Intravascular, complement-mediated hemolysis doesn’t occur.
-Extravascular hemolysis occurs when the ... removes these antibody coated RBCs.

... is most frequently seen antibody is Warm Autoimmune Hemolytic Anemia.

Back 10

spleen
Anti-e

Front 11

The Ii Blood Group System:

I is for “individuality”

At birth, infant RBCs are rich in ... and almost no detectable ....

During the first 18 months of life, the quantity of ... slowly decreases as ... increases.

Adult cells are rich in ... and have only trace amounts of ... antigen.

Back 11

i
I
i
I
I
i

Front 12

M and N antigens:

The M and N antigens are found on a glycoprotein called ..., the major RBC sialic acid-rich glycoprotein.

The antigens are defined by the first and fifth amino acids on this structure.

Both are well developed at birth.

Have not been detected on lymphs, monocytes, or granulocytes but have been detected on renal capillary endothelium and epithelium.

Back 12

glycophorin A (GPA)

Front 13

S and s antigens:

Located on a smaller glycoprotein called ...

The phenotype S-s- has not been found in whites; it exists only in blacks.

S and s are differentiated by the amino acids at the 29 position

Back 13

glycoprotein B (GPB)

Front 14

The Duffy-Malaria Association:

Since 1955, it has been known that Africans and black Americans were resistant to infection by Plasmodium vivax and that these sample populations are ...
-The ... phenotype is prevalent in blacks but virtually nonexistent in whites.

It has been suggested that Fya and Fyb are the invasion receptor for P. vivax.

Back 14

Fy(a-b-)
Fy(a-b-)

Front 15

The Lutheran (005) Blood Group System:

Blood bankers seldom deal with antibodies to the Lutheran system because their antigens are either very high or very low-incidence.
-...: 8% of the population
-...: 99.8% of the population

Back 15

Lu a
Lu b

Front 16

... Blood Group System:

Unique in the blood group systems in that inheritance is on a sex linked basis.

Back 16

XG (ISBT 012)

Front 17

PRBCs:

Important Facts:
-Both ABO identical and ABO compatible options are available for transfusion.
-Unit contains mostly RBCs with a small amount of plasma
-Each unit will raise the HgB level ...-... g/dL (HCT 3-5%).

Back 17

1.0 – 1.5

Front 18

Leukocyte-Reduced RBCs:
Important Fact:

Leukocytes in PRBCs may cause the following:
-... nonhemoltyic transfusion reactions
-Transfusion associated Graft Versus Host Disease (GVHD)
-CMV transmission
-HIV transmission
-Epstein-Barr virus transmission

These WBCs can be reduced by using a ....
-85% of the RBCs must be retained.

Back 18

Febrile
leukocyte reduction filter

Front 19

Irradiated RBCs:

Preparation:
-1500-5000 rads of radiation prior to administration
-The radiation renders the donor ... cells incompetent.

Indications For Use: (FIRM)
-(Fetus) Intrauterine transfusions, Immunocompromised patients, recipients of blood from a Relative, bone Marrow transplant patients, etc.

Back 19

T

Front 20

Platelets and Plateletpheresis:

Indications For Use:
-Severe Thromobcytopenia (<50,000 plts/uL)

Composition:
-... Platelet (Plt Single): >5.5 x 1010 plts
-Platelet ... (Plt-P): >3.0 x 1011 plts

Back 20

Pooled
Pheresis

Front 21

What is the most common type of transfusion reaction?

Back 21

febrile nonhemolytic transfusion reaction