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58 Cards in this Set

  • Front
  • Back
How are blood group antigens usually inherited?
biallelic, autosomal transmission
What is the most important factor in blood/solid organs transplants?
ABO histo-blood group
How are alloantibodies formed?
these are formed during transfusions between people with incompatible ABO blood group types
What type of antibodies are formed to CHO based antigens?
IgM is formed, T cell independent
What type of antibodies are formed to protein antigens?
these stimulate T cells, leads to IgG production in the end
What type of hypersensitivity reaction is a transfusion reaction?
this is type II hypersensitivity RXN
what causes intravascular immune hemolysis?
complement mediated membrane destruction (usually severe!- osmotic lysis)
What causes extravascular immune hemolysis?
the spleen- (not as severe, phagocytosis)
what test determines blood group antigens?
direct hemagglutination
What antibody type are cold acting antibodies?
IgM
What antibody type of warm acting antibodies?
IgG
What do cold acting antibodies do?
these agglutinate RBC's, via direct hemagglutination

(may fix complement)
What do warm acting antibodies do?
these usually do complement- cause intravascular hemolysis
are blood types fully expressed at birth?
no they are not, have to wait to age 3-6months
What are the ABO blood groups "built on"?
glycolipid H
what do babies initially produce anti A antibodies in response to?
lectins
what do babies initially produce anti B antibodies in response to?
ecoli
What is "forward type" blood typing?
pt CELLS are suspended in Anti-A and Anti- B, to see which ones cause agglutination
what is "back type" blood typing
pt SERUM added to known A and B type cells- look for agglutination
What is the universal donor blood type?
type O, rh Negative packed cells. (no plasma)
are there universal donors for people with atypical antibodies?
no there are not
what are the ONLY two things that cause you to develop atypical antibodies?
pregnancy, or prior blood transfusion
for blood transfusions, what are the two tests that you order?
a blood type and screen
What atypical antibodies are usually significant?
anything with a letter K or before (A,B,D-rh, C,E, Kell, Duffy-Fy, Kidd -Jka)
What is the most common Rh phenotype?
Rh positive, D positive (same thing)
What do the C/E antibodies attack? in what pts do they occur in?
these attack the Rh system- they only occur in people with prior transfusions or pregnancies
What are the two diseases of blood type mismatches?
Hemolytic transfusions reaction

hemolytic disease of newborn
How common is the Kell antigen?
is it immunogenic?
it occurs in 10% of population,
it is very immunogenic
what group of people commonly lacks the Duffy (Fy) antigens?
african americans
What is the receptor for plasmodium vivax? (malaria)
Duffy antigen
does Kidd (Jka) antigens cause mild or severe reactions?
usually serious/ life threatening
How is direct coombs test performed, and why?
this adds antihuman globulin to pt CELLS.

positive when antibodies have coated pt cells in vivo (aka the cells we took out of the pt have already been covered with antibodies- so usually is positive in anti-self hemolytic reactions)
how is the indirect coombs test performed, and why?
pt SERUM added to known reagent cells c/ known antigens.

used as antibody screen (prior to blood transfusions, this can detect very small levels of anti-something antibodies found in pt serum. used to find out what their body will reject or attack)
What 3 situations indicated giving packed red blood cells?
acute blood loss
chronic anemia with Hb < 7mg/dL
chronic anemia with Hb > 7mg/dL with CHF
What is frozen RBC given?
rare blood types.
people store their own blood in glycerol for up to 10 years
when giving platelets, are the antigens very important?
no not really
What are the two indications for platelet transfusion?
platelet count < 50,000 with bleeding

count <30,000 in general

document platelet dysfunction in a bleeding person
when is fresh frozen plasma given?
this is given for defects in coagulation factors AND
the pt is bleeding, surgery is coming
What three things does Cryoprecipitate treat when given?
bleeding due to lack of Factor VIII, fibrinogen, vWF
When are washed RBC's given?
these is used when plasma proteins must be removed

-IgA defect, repeated allergic transfusions reactions
Who gets CMV negative blood?
neonates
immunospressed people
people who will get organ transplants
What is immune serum globulin given to treat?
immunodeficincies,
and immune thrombocytopenia
What cells are implicated in graft verses host disease?
Donor T cells attack recipients tissues
What is TRALI? and what type of transfusion usually causes it?
Transfusion related acute lung injury, caused by DONOR plasma ANTIBODIES to WBC's.

typically FRESH frozen plasma is the cause
What is the pathogeneis of allergic transfusion reactions?
type I, IgE mediated.

antibodies against plasma proteins in the donor
What usually causes acute hemolytic transfusion reactions?
ABO incompatibility.
causes cell lysis, kidney shutdown, DIC
What is the Tx for hemolytic transfusion reactions?
stop transfusion
IV fluids, Mannitol
treat DIC
What are the clinical signs/ tests for delayed hemolytic transfusion reaction?
Positve DAT (direct coombs test)
jaundice, anemia.
what is hydrops fetalis?
accumulation of fluid during pregnancy, which leads to edema, ascites, effusions in a fetus
what are the three main causes of hydrops fetalis?
homozygous alpha thalassemia
aplastic anemia due to parvovirus B19
hemolytic disease of newborn
Does IgM cross the placenta?
no it does not
does IgG cross the placenta?
yes it can!
What antigen mismatch is most common in fetal hydrops?
Rh (or D gene) mismatches
After a mother has been sensitized against an Rh+ fetus (if shes Rh -), what happens to the next pregnancy that happens to be Rh+?
the maternal IgG crosses the placenta and attacks fetal RBC's
What does anemia causes by Rh hemolytic disease of the fetus lead to?
this leads to cardiac decompensation-> hydrops

and extramedullary hematopoiesis
What does hemoglobin degradation by Rh hemolytic disease of the fetus lead to?
bilirubin accumulation-> jaundice/ kernicterus (brain)
how do you treat Rh hemolytic disease? what three situations do you give it in?
give Rhogam (Rh immune globulin)- which reduces disease by 90%.

Given to Rh negative mothers @ 28 weeks gestation if they have Rh+ fetus.
Within 72 hours of delivering Rh+ infant
Is fetal/maternal ABO incompatibility common? dangerous?
it is very common, and hardly ever dangerous.